Khaberni - During Ramadan, eating, sleeping, and activity patterns change significantly, directly reflecting on the body's physiological balance. While some fasters choose to stop exercising for fear of exhaustion or dehydration, others insist on maintaining their usual training routines.
Between these, a fundamental question arises: What does science say about physical activity during fasting? Do recommendations vary between healthy individuals and those with illnesses, especially those on chronic medications?
Exercise in Ramadan: Conditional, not prohibited
Physiologically, the body undergoes progressive metabolic stages during fasting. Hours after abstaining from food, blood glucose levels drop, then the body relies on glycogen stored in the liver and muscles, before gradually switching to using fats as the primary energy source.
These changes are natural but are accompanied by a gradual fluid loss, which may limit the capacity for physical exertion, especially in hot conditions.
Scientific reviews published in databases like PubMed suggest that fasting does not necessarily lead to a comprehensive deterioration in physical performance, especially in moderate-intensity exercises, although it might affect certain components of maximum performance like high speed or extreme endurance later in the day.
Some studies have shown that maintaining moderate physical activity during Ramadan is associated with improvements in body composition indicators, weight management, and some metabolic markers.
In contrast, behavioral studies have observed a general decrease in daily activity rates among fasters compared to non-fasters, suggesting that the real challenge lies not in the danger of the sport itself but in the tendency towards lethargy during the month.
Potential benefits: Improving metabolism and mental health
Clinical studies conducted during Ramadan in various countries have shown that engaging in moderate, regular physical activity may contribute to:
Improving insulin sensitivity and glucose control in some groups.
Reducing body fat percentage and improving some blood lipid markers.
Supporting mental health and reducing stress thanks to the release of endorphins.
Experiments on overweight individuals have shown that incorporating organized physical activity during Ramadan can enhance fat loss without significantly impacting muscle mass, provided the exercise is moderate and accompanied by adequate nutrition after breaking the fast.
However, these positive outcomes are linked to crucial factors such as exercise intensity, timing, and the individual's health condition; furthermore, this becomes a sensitive area for patients on medications as fasting affects not only energy and fluids but may also alter the dynamics of medications in terms of absorption, distribution, and duration of effect.
Diabetic patients taking glucose-lowering medications are particularly prone to complications during exercise in fasting hours, as physical activity increases glucose uptake from muscles, and without food intake, a sharp drop in blood sugar may occur. Clinical Ramadan studies have documented an increase in hypoglycemia episodes among some patients whose medication doses were not appropriately adjusted.
Patients with high blood pressure or heart diseases who take diuretics or blood pressure-lowering medications might be susceptible to low blood pressure or dehydration if fasting accompanies intense physical activity. Fluid loss through sweating, along with the medication's effect, may lead to dizziness or fainting, especially later in the day.
Even patients on medications that do not directly affect sugar or fluids, such as certain thyroid or psychiatric drugs, may experience altered responsiveness due to changes in sleep patterns and dosing schedules, reflecting on their physical endurance.
Untreated patients: The risk of underestimation
Another often overlooked group in the discussion are patients suffering from mild chronic conditions or in early stages, who are not on medication.
In the case of a diabetes patient controlled by diet alone, or someone with mild untreated hypertension, physical activity may seem completely safe; however, long fasting with fluid shortage and disrupted sleep could reveal subtle imbalances in blood sugar and pressure. Therefore, one should not assume absolute safety merely because of the absence of medication.
Timing and intensity of exercise: What do the guidelines recommend?
Medical literature agrees that the best times for physical activity during Ramadan are:
About an hour before breaking the fast, sticking to light to moderate intensity exercises.
Or two to three hours after breaking the fast, once fluids and energy have been restored.
However, high-intensity or long-duration exercises during fasting hours are associated with a higher risk of dehydration, and disturbances in blood pressure or sugar, especially in patients.
The medical decision is individual... not collective
The conclusion confirmed by clinical studies and sports medicine experience is that fasting does not prohibit physical activity, but it does necessitate reorganizing it. The benefit is possible, but the risks are real, especially for patients. Therefore, the decision remains distinctively individual.
The treating physician is the authorized party to assess the risk level, adjust medication doses if necessary, and determine the type and intensity of exercise and its timing. The equation in Ramadan is not between sports or fasting, but between enthusiasm and knowledge.
In the end, maintaining health is part of the purpose of worship, and moderation is the golden rule where science and experience meet.
