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The influence of Ramadan on physical performancemeasures in young Muslim footballersDonald T. Kirkendall a , John B. Leiper b , Zakia Bartagi c , Jiri Dvorak a & Yacine Zerguini da FIFA Medical Assessment and Research Centre, Schulthess Clinic , Zurich, Switzerlandb School of Sport and Exercise Sciences, Loughborough University , Loughborough, UKc National Centre for Medicine and Scientific Research in Sport , Tunis, Tunisiad Centre d'Evaluation et d'Expertise en Médecine du Sport , Algiers, AlgeriaPublished online: 26 Mar 2009.

To cite this article: Donald T. Kirkendall , John B. Leiper , Zakia Bartagi , Jiri Dvorak & Yacine Zerguini (2008) The influenceof Ramadan on physical performance measures in young Muslim footballers, Journal of Sports Sciences, 26:S3, S15-S27, DOI:10.1080/02640410802422199

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The influence of Ramadan on physical performance measures in youngMuslim footballers

DONALD T. KIRKENDALL1, JOHN B. LEIPER2, ZAKIA BARTAGI3, JIRI DVORAK1, &

YACINE ZERGUINI4

1FIFA Medical Assessment and Research Centre, Schulthess Clinic, Zurich, Switzerland, 2School of Sport and Exercise

Sciences, Loughborough University, Loughborough, UK, 3National Centre for Medicine and Scientific Research in Sport,

Tunis, Tunisia and 4Centre d’Evaluation et d’Expertise en Medecine du Sport, Algiers, Algeria

(Accepted 20 August 2008)

AbstractRamadan alters the normal patterns of food intake and sleep. The aim of this study was to describe the impact of Ramadanon physical performance in youth Muslim athletes. The members of four Tunisian teams (age 18 years, N¼ 85) resided atthe Tunisian Football Federation training ground. Each player chose either to fast or not fast during the 4-week period ofRamadan. Two teams were randomly chosen for morning testing; the remaining teams were tested in the afternoon. Testingtook place 3 weeks before and in the second and fourth weeks of Ramadan. A subgroup of 45 players was tested again 3weeks after Ramadan. Each player was assessed for speed, power, agility, endurance, and for passing and dribbling skills. Novariables were negatively affected by fasting. Almost all variables had improved significantly by the third test session (trainingeffect). A limited number of variables were also significant for time of day or in an interaction with week of testing. Changesin performance were most likely due to the effects of training and familiarity with the test methods. Based on these data,Ramadan had little effect on objective tests of physical performance in this sample of youth players observing Ramadan.

Keywords: Ramadan, football, performance

Introduction

The physiological and clinical effects of Ramadan

have been the focus of study for many years. For

example, Ramadan has little effect on lipid, carbohy-

drate or protein metabolism or hormonal concentra-

tions, while increases in variables such as uric acid or

urea have been attributed to mild dehydration (Roky,

Houti, Moussamih, Qotbi, & Aadil, 2004). There are

documented alterations with normal chronobiologi-

cal rhythms with phase shifts in body temperature,

cortisol, and melatonin (Reilly & Waterhouse, 2007).

Psychomotor performance, alertness, and nocturnal

sleep patterns can all suffer with the change in food

intake and sleep patterns (Roky et al., 2004) and may

be related to the increase in motor vehicle accidents

reported to occur during Ramadan (Shanks, Ansari,

& al-Kalai, 1994). During voluntary exercise, sub-

maximal factors (e.g. heart rate) are hardly affected

while maximal work declines (Cisse, Martineaud,

N’Doye, & Gueye, 1993).

The sporting calendar is not modified for religious

observances, thus it makes sense to determine if this

religious fast has any untoward effects on perfor-

mance. This is especially important for Islamic

football players because of the extensive recreational

up to professional participation throughout the world

and the dense schedule of competitive football

matches. Thus, the main aim of this study was to

assess physical performance in youth football players

over the course of Ramadan in 2006. In addition, we

were interested to see if there were any effects of time

of day that might offer suggestions regarding

scheduling activity during this fasting period.

Methods

Participants

The study was carried out in Tunis, Tunisia in 2006

when Ramadan started on the 23 September and

finished on 22 October. In Tunisia, most of the

population are Muslims, although it is up to the

individual whether they observe the Ramadan fast.

Four Tunisian junior football squads affiliated with

professional clubs were invited to take part in this

Correspondence: D. T. Kirkendall, FIFA Medical Assessment and Research Centre, Schulthess Clinic, Lengghalde 2, 8008 Zurich, Switzerland.

E-mail: donald_kirkendall@yahoo.com

Journal of Sports Sciences, December 2008; 26(S3): S15–S27

ISSN 0264-0414 print/ISSN 1466-447X online � 2008 Taylor & Francis

DOI: 10.1080/02640410802422199

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study designed to evaluate the effect of the Ramadan

fast on physical performance, biochemical and

physiological factors, subjective perception of dis-

comfort and effort, and lifestyle changes while

undertaking their usual training regimen during a

residential training camp (Leiper et al., 2008b).

Three of the clubs were affiliated with teams in

League 1 and the fourth team was affiliated with a

team in League 3 of the Tunisian National Senior

League. Following written and verbal explanation of

the study protocol, a total of 85 players agreed to

participate in the study that had been approved by

the National Research Ethics Committee.

Body mass was measured using an electronic

balance (Seca Instruments, Hamburg, Germany),

height was determined using a stadiometer, and

skinfold thicknesses were measured using a Harpen-

den calliper (Baty International, West Sussex, UK).

Percent body fat was estimated according to Durnin

and Wormsley (1974). The mean physical character-

istics of the players were: age 18 years (s¼ 1); stature

1.78 m (s¼ 0.06); body mass 70.6 kg (s¼ 8.2); body

mass index 22.4 kg � m72 (s¼ 2.2); estimated per-

cent body fat 12.4% (s¼ 3.2). Eighty-five players

agreed to participate in the study for the 3 weeks

immediately before Ramadan and during the

month of Ramadan; a subgroup of 45 players

from two of the recruited teams agreed to con-

tinue participating for the 3 weeks directly after

Ramadan.

Fifty-three (62%) of the players voluntarily chose

to follow the fasting guidelines for the month of

Ramadan, while 32 (38%) voluntarily chose not to

observe the fast at that time. Two teams were chosen

at random to undergo the physical tests in the

morning (n¼ 46, beginning approximately 2 h and

15 min after their morning meal) and the remaining

two teams were tested in the afternoon (n¼ 39,

beginning approximately 1 h and 45 min after a

midday meal taken by the non-fasting group)

(Leiper, Junge, Maughan, Zerguini, & Dvorak,

2008a). Thus, 32 fasting players were tested in the

morning and 21 were tested in the afternoon, and 14

non-fasting players were tested in the morning and

18 in the afternoon. Details on the patterns of eating

can be found elsewhere in this issue (Maughan et al.,

2008b). In the subgroup of 45 players who continued

participating in the study for 3 weeks after Ramadan,

21 had observed the Ramadan and 24 had not.

All tests were performed at the National Centre for

Medicine and Scientific Research in Sport. The

environmental temperature, relative humidity, and

barometric pressure within the sports hall were

recorded before, hourly during, and at the end of

each test period in the morning and afternoon of

each test day using an analog indoor weather station

(Table I). Tests were conducted 3 weeks before the

start of Ramadan, during the second and fourth

weeks of Ramadan, and the subgroup were again

tested 3 weeks after Ramadan.

Performance tests

Before performing a test, a staff member of the

Centre explained the protocol to each player who

then had the opportunity to ask questions. No prior

specific familiarization sessions were carried out

before the players were tested. All players practised

each of the football-specific tests immediately before

being assessed. All the players had previous experi-

ence with the fitness tests as part of their club’s

testing programmes or training schedules. The order

of performing the battery of tests was the same

during each test session. Water was supplied during

each test session. During Ramadan, some of the

fasting players used the water only to rinse their

mouths, while the non-fasting individuals drank

normally. Anthropometric data (mass, height, and

skinfold measurements) were recorded 3 weeks

before Ramadan and during the second and fourth

weeks of Ramadan on the same days as the

performance tests. The following performance tests

were undertaken in the order shown on each test

occasion (Leiper et al., 2008b).

Station 1: 76 30-m repeated sprint test. This task

(Figure 1) consisted of seven maximal 30-m sprints

(with an intermediary split time at 10 m) followed by

a standard 25-s active recovery between sprints

(Krustrup et al., 2005; Spencer, Fitzsimons, Daw-

son, & Goodman, 2006). This repeated-sprint test

was originally designed for field hockey. During the

recovery period, the players jogged back to the

starting position and awaited the next start com-

mand. The sprints were carried out on an indoor

synthetic running track and the players wore their

preferred running shoes. Time was recorded using

photoelectric cells with an accuracy of 0.01 s

Table I. Environmental conditions in the sports hall averaged for

the morning (am) and afternoon (pm) sessions by test week (mean

values with standard deviations in parentheses).

Pre-Ramadan

Week 2 of

Ramadan

Week 4 of

Ramadan

Air temperature (8C)

am 28.7 (1.2) 27.8 (1.5) 23.3 (0.9)

pm 30.7 (0.9) 30.5 (1.8) 25.2 (0.4)

Relative humidity (%)

am 59 (5) 72 (2) 74 (4)

pm 56 (2) 66 (4) 71 (2)

Barometric pressure (mmHg)

am 973 (2) 990 (18) 1012 (1)

am 972 (2) 1006 (1) 1010 (1)

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(Brower Timing Systems, Draper, UT). The photo-

electric cell gates were set at about 1 m above the

ground. Each player began every sprint from a

consistent starting stance 0.5 m behind the start

line. The player commenced the sprint on a verbal

command from the technician timing the recovery

duration. Time was automatically activated as the

player passed the starting gate at the 0-m mark. A

split time was obtained at 10 m and the total sprint

time at the final gate set 30 m from the start. Once

the player crossed the finish line, the recovery

technician began timing the 25-s recovery period

using a stopwatch. During the recovery period, the

player slowly jogged back to the starting line while

the timing technician recorded the 0–10 m split time

and the total 30-m time. To make the most efficient

use of time, two players were tested together, with

their start times staggered, allowing each player to

run individually and still have the full 25 s recovery

between sprints. All players were verbally encour-

aged to give a maximal effort on each of the seven

sprints. Running times for the 10-m and 30-m

distances were recorded and entered into a spread-

sheet (Spencer et al., 2006). A fatigue index for each

trial was calculated as the percent change of the

fastest time (usually the first or second run) from the

slowest time (usually the sixth or seventh run).

Station 2: Loughborough Soccer Dribbling Test. The

Loughborough Soccer Dribbling Test (LSDT;

Figure 2) requires a player to dribble an indoor

football as fast as possible, out and back, slaloming

between a line of six cones spaced at 3-m intervals

from the start point and finish gates defined by

cones placed 2.5 m apart (McGregor, Hulse, &

Strudwick, 2002). Six trials are completed with

1 min rest between trials. Each run was manually

timed using a stopwatch. The sum of the six trials

(excluding the rest periods) was used as the final

score for this test. This has a reported test–retest

reliability of 0.99 (McGregor et al., 2002).

Station 3: Vertical jump test. Vertical jumps were

measured using a Quattro Jump portable force plate

(Model 9290AD, Kistler Instrument AG, Switzer-

land), interfaced to a notebook computer, at a

sampling rate of 500 Hz. Players were instructed to

begin from a standing position with their hands on

their hips, then perform a countermovement im-

mediately followed by a maximum jump keeping

their hands on their hips (Canavan & Vescovi, 2004;

Pua, Koh, & Teo, 2006). The players were in-

structed to land on the platform as close to their take-

off location as possible. Jump technique was demon-

strated to each participant, and then each player

performed two sub-maximal trials. Three maximal

countermovement jumps were separated by an ample

rest period and the best result was used for analysis.

Flight time was recorded in milliseconds and

converted to jump height using a standard formula

(Bosco, Luhtanen, & Komi, 1983). The test–retest

reliability was 0.95–0.97 (Canavan & Vescovi, 2004).

Station 4: Agility. The 4-line agility test (Rosch et al.,

2000) was performed within an area marked by four

parallel lines (Figure 3). The player lay prone with

his arms extended to touch the start line (line A). On

a verbal command from the timing technician, the

player jumped to his feet and ran 10 m to line B,

which he touched with his foot. He then turned and

ran 20 m to touch line C with his foot, before turning

again and running 10 m back to line A. On touching

this line, he turned once again and sprinted 30 m to

line D, the finish line. Time was recorded manually

with a stopwatch to the nearest one-hundredth of a

second.Figure 1. The 30-m sprint and recovery test.

Figure 2. Loughborough Soccer Dribbling Test (McGregor et al., 2002).

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Station 5: Loughborough Soccer Passing Test. The

Loughborough Soccer Passing test (LSPT; Ali et al.,

2007) was performed in an area marked by tape that

had an inner (1.26 3.0 m) and outer rectangle

(2.56 4.0 m) and four standard gymnasium

benches placed on their side as shown in Figure 4.

Cones defined the corners of each rectangle as well

as the centre of the inner rectangle. Each of the

benches had a different coloured (green, blue, red,

and white) card (506 50 cm) taped to the centre of

the bench. The passing zone is the area between the

two marked rectangles. Two of the benches were set

6 m from the central cone (long passes) and two

were set 4.5 m from the central cone (short passes).

The LSPT consists of 16 passes (8 long and 8

short) being made from the marked passing zone to

one of the four coloured targets that are called out in

a randomized order. The player stands by the central

cone with an indoor football at his feet. The test

starts when the technician calls out the first colour

from the designated list. The passes must be

executed from within the passing zone, hit the

coloured target that was called, and the ball must

then cross into the inner rectangle before the next

pass is made. The target colours were called out in

French as soon as the previous pass struck the bench.

A second individual manually recorded the length of

time to make the 16 passes and recorded the penalty

time points accrued during the test. The test was

completed when the ball hit the target of the

sixteenth pass. Time penalties of 2 s were added if

the target was missed, if the pass was made outside

the passing zone, or if any cone was stuck; a 5-s

penalty was added if the bench was missed. Each

player completed two trials using a different list of

randomized colour order for each trial. The total

time, in seconds, to complete both trials plus time

penalties was recorded for analysis. The test has a

reported test–retest reliability of 0.83 (Ali et al.,

2007; McGregor et al., 2002).

Station 6: 20-m multistage shuttle run test. After all tests

for Stations 1–5 were completed, the test equipment

was cleared away and the sports hall was prepared for

the 20-m multistage shuttle run test (MST; Leger &

Lambert, 1982). The sports hall had lines marked on

the floor that were 20 m apart with approximately

1.5 m turning area behind each of the two lines.

Cones were placed on the lines to mark out an

approximately 1–1.5 m running lane for each player.

Eight to thirteen players took the MST on each

occasion and all had at least a 30-min rest period

after finishing the test at Station 5 and before starting

the shuttle run. The audiotape with the recorded

audio signals for the test was calibrated before each

run and was played through a sound system in the

sports hall.

Following an explanation of the test protocol, the

players lined up with their toes behind the start line.

On the start signal, the players ran 20 m out and

back paced by the audio signal. Each successful 20-m

run was a completion of a shuttle, and to complete

the distance one foot had to cross the line before, or

in time with, the next audio signal. The audio signals

occur at a progressively increasing pace with every

minute of the test requiring the player to increase his

running speed to keep up with the running pace. The

test for an individual player was terminated when

that player could not maintain the pace of the audio

signals for two consecutive shuttles or if he volunta-

rily withdrew. Spotters were placed at each of the two

lines to identify and warn individuals who failed to

place their foot on or over the line in time at the end

of a shuttle. The levels and shuttles reached by each

individual were recorded and the total distance

covered by each player was calculated from standard

Figure 3. Schematic diagram of the agility test (Rosch et al., 2000).

Figure 4. Loughborough Soccer Passing Test (Ali et al., 2007).

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tables. One staff member gave verbal encouragement

to the players during the test. For each team of

players, two MSTs were run to accommodate all the

players. This procedure has a reported test–retest

reliability of 0.975 (Leger & Lambert, 1982).

Data analysis

Continuous data were summarized with means and

standard deviations. Players were grouped according

to whether they were in a fasting or non-fasting group

during Ramadan and time of day tested (morning

(am) or afternoon (pm)). The data were analysed

using a mixed-model repeated-measures analysis of

variance (Geisser-Greenhouse correction) with one

repeated factor (weeks) and two grouping factors

(fasting vs. non-fasting, time of day). Tukey’s follow-

up procedure was used to determine significant F-

values where appropriate. All data were analysed

using SPSS (SPSS Inc., Chicago, IL), version 11.0.

Statistical significance was set at P5 0.05.

Results

The performance data are analysed by week (pre-

Ramadan, Week 2, Week 4), group (fasting vs. non-

fasting), and time of day (am vs. pm). Tables II and

III summarize the data.

Station 1: 76 30-m repeated sprint test

Figure 5 provides a typical plot of 30-m sprint times

for the seven repetitions. For the combined data on

all 85 players, there was a main effect of weeks

(P5 0.001) for 10-m sprint time, which slowed

significantly from 1.79 s (s¼ 0.07) on the pre-

Ramadan test occasion to 1.82 s (s¼ 0.08) 2 weeks

into the fast, but returned to 1.79 s (s¼ 0.08) 4

weeks into Ramadan. Although there was no main

effect for fasting or time of day (Table II), there was

an interaction between week and time of day

(P5 0.001). The players tested in the morning

slowed significantly from 1.78 s (s¼ 0.06) on the

pre-Ramadan test occasion to 1.85 s (s¼ 0.06) 2

weeks into the fast, but returned to 1.80 s (s¼ 0.04)

4 weeks into Ramadan (Table II). The players tested

in the afternoon were much more consistent, with

times of 1.80 s (s¼ 0.07), 1.79 s (s¼ 0.07), and

1.79 s (s¼ 0.08) respectively. No other interactions

were observed.

The combined data for the 30-m sprint again

showed that there was a significant main effect for

week (P¼ 0.001), with the overall mean for the three

test occasions being significantly different from each

other (pre-Ramadan: 4.35 s, s¼ 0.16; Week 2:

4.41 s, s¼ 0.18; Week 4: 4.38 s, s¼ 0.16). There

was also a significant main effect for fasting

(Table II), with those participating in the fast

running faster (4.34 s, s¼ 0.17) than those not

observing the fast (4.43 s, s¼ 0.15). There was no

main effect for time of day. There was a significant

interaction of week and time of day. The players

tested in the morning slowed from 4.33 s (s¼ 0.15)

pre-Ramadan to 4.45 s (s¼ 0.18) at Week 2 and

4.40 s (s¼ 0.14) at Week 4, whereas those tested in

the afternoon ran consistent times on the three test

Table II. Sprint times and fatigue index (FI) by measurement occasion, fasting, and time of day (mean values with standard deviations in

parentheses).

Pre Ramadan Week 2 of Ramadan Week 4 of Ramadan Subgroup pre-Ramadan 3 weeks after Ramadan

Fastest 0–10 m (s)

Fasting am 1.77 (0.06) 1.85 (0.08) 1.79 (0.09) 1.78 (0.08) 1.82 (0.06)

Fasting pm 1.77 (0.06) 1.76 (0.06) 1.76 (0.06) 1.78 (0.05) 1.76 (0.11)

Non-fasting am 1.79 (0.06) 1.85 (0.06) 1.80 (0.04) 1.80 (0.07) 1.86 (0.04)

Non-fasting pm 1.82 (0.07) 1.82 (0.08) 1.81 (0.08) 1.84 (0.08) 1.83 (0.08)

Fastest 0–30 m (s)

Fasting am 4.29 (0.14) 4.44 (0.19) 4.39 (0.16) 4.31 (0.18) 4.45 (0.21)

Fasting pm 4.27 (0.15) 4.29 (0.16) 4.27 (0.16) 4.30 (0.12) 4.28 (0.25)

Non-fasting am 4.41 (0.12) 4.48 (0.14) 4.41 (0.10) 4.44 (0.12) 4.52 (0.12)

Non-fasting pm 4.44 (0.18) 4.44 (0.15) 4.43 (0.17) 4.51 (0.16) 4.48 (0.18)

FI% 0–10 m

Fasting am 78.8 (7.2) 711.8 (9.5) 712.0 (5.2) 78.2 (4.1) 710.4 (11.3)

Fasting pm 79.2 (0.7) 711.1 (11.1) 79.8 (3.4) 79.5 (5.5) 78.2 (4.3)

Non-fasting am 78.6 (4.0) 712.5 (4.8) 710.9 (5.9) 79.3 (4.1) 78.1 (3.4)

Non-fasting pm 79.5 (5.1) 78.3 (4.2) 79.2 (8.8) 78.2 (3.7) 78.7 (3.2)

FI% 0–30 m

Fasting am 77.73 (3.3) 710.6 (5.0) 78.8 (4.1) 77.2 (5.1) 75.6 (3.4)

Fasting pm 78.54 (0.9) 78.0 (2.8) 79.0 (4.6) 79.9 (3.3) 77.1 (8.0)

Non-fasting am 76.49 (3.0) 79.1 (3.5) 79.2 (3.7) 77.2 (3.0) 77.1 (3.5)

Non-fasting pm 78.03 (3.7) 77.2 (2.8) 710.7 (10.7) 78.5 (4.1) 710.1 (3.7)

Note: FI%¼ ((fastest7 slowest)/fastest)6 100.

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occasions (pre-Ramadan: 4.35 s, s¼ 0.18; Week 2:

4.35 s, s¼ 0.17; Week 4: 4.34 s, s¼ 0.18).

Another aspect of football performance is short-

term fatigue (Bangsbo, Mohr, & Krustrup, 2006),

whereby players slow in response to repeated sprints

(Table II). This fatigue will influence their ability to

sprint repeatedly when the need arises. The data for

the players showed there were no significant main

effects or interactions for fatigue for the 10-m sprint

distance.

There was a significant main effect for week for the

30-m distance, with a more pronounced slowing over

the seven sprints from the pre-Ramadan test

(77.7%, s¼ 3.5) to the tests performed in Week 2

Figure 5. Mean (+s) pre-Ramadan 30-m sprint times (s).

Table III. Performance results by measurement occasion, fasting, and time of day (mean values with standard deviations in parentheses).

Pre Ramadan Week 2 of Ramadan Week 4 of Ramadan Subgroup pre-Ramadan 3 weeks after Ramadan

MST (m)x

Fasting am 1676 (348) 1527 (394) 1755 (445) 1543 (416) 1886 (254)

Fasting pm 1582 (433) 1637 (487) 1746 (390) 1520 (531) 1951 (495)

Non-fasting am 1593 (392) 1523 (493) 1810 (576) 1431 (271) 1720 (440)

Non-fasting pm 1604 (381) 1633 (443) 1757 (475) 1640 (407) 1860 (494)

Vertical jump (cm)

Fasting am 55.0 (5.97) 54.8 (5.57) 54.4 (5.70) 52.6 (5.7) 53.7 (5.9)

Fasting pm 55.8 (7.21) 58.0 (6.20) 59.3 (6.99) 52.3 (5.9) 58.3 (5.6)

Non-fasting am 54.1 (5.08) 54.3 (4.71) 53.7 (4.21) 53.4 (5.4) 54.0 (5.1)

Non-fasting pm 50.9 (8.64) 52.9 (8.09) 54.6 (8.18) 47.9 (4.6) 52.1 (4.1)

Agility (s)

Fasting am 15.6 (0.54) 15.7 (0.57) 15.4 (0.54) 15.6 (0.59) 15.2 (0.62)

Fasting pm 15.4 (0.54) 15.4 (0.75) 15.2 (0.55) 15.5 (0.62) 15.2 (0.59)

Non-fasting am 15.7 (0.64) 15.4 (0.86) 15.5 (0.64) 15.7 (0.60) 15.1 (0.48)

Non-fasting pm 15.4 (0.66) 15.4 (0.67) 15.2 (0.61) 15.6 (0.66) 15.0 (0.89)

LSDT (s)

Fasting am 91.8 (9.2) 88.5 (6.8) 87.3 (5.6) 91.7 (4.9) 86.0 (4.0)

Fasting pm 90.6 (7.6) 84.1 (9.8) 85.5 (6.7) 94.7 (5.9) 86.2 (5.0)

Non-fasting am 95.4 (5.9) 89.3 (7.5) 89.1 (5.2) 94.7 (6.7) 89.4 (4.7)

Non-fasting pm 92.5 (6.9) 89.9 (6.2) 83.6 (5.3) 96.6 (5.8) 86.2 (4.6)

LSPT (s)

Fasting am 60.6 (5.4) 58.4 (5.3) 60.2 (5.4) 57.5 (5.7) 60.1 (2.7)

Fasting pm 60.3 (6.0) 57.9 (7.1) 58.9 (4.7) 60.7 (6.3) 59.4 (6.4)

Non-fasting am 61.8 (4.6) 61.2 (5.7) 64.2 (5.0) 62.1 (5.0) 66.5 (4.9)

Non-fasting pm 61.3 (4.8) 57.5 (4.7) 60.1 (5.6) 62.5 (4.3) 60.9 (2.9)

Notes: MST¼multistage shuttle test; LSDT¼Loughborough Soccer Dribbling Test; LSPT¼Loughborough Soccer Passing Test.

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(79.0%, s¼ 4.3) and Week 4 (79.3%, s¼ 6.1) of

Ramadan. There was also a significant main effect

for time of day (P¼ 0.007), with those tested in the

morning performing significantly worse (78.79%,

s¼ 3.9) than those tested in the afternoon (78.58%,

s¼ 5.06), although this small difference is probably

of little consequence. No effect of fasting was

observed (fasting: 78.84%, s¼ 4.23; non-fasting:

78.47%, s¼ 4.96; P¼ 0.66). There was a significant

interaction of week and time of day (P¼ 0.02). The

players tested in the morning showed a decrement in

repeated sprint times from pre-Ramadan (77.3%,

s¼ 3.3) to the second week of Ramadan (710.1,

s¼ 4.6) but was less pronounced (78.9%, s¼ 3.9)

during the fourth week of Ramadan (Table II).

For the players tested in the afternoon, there was

little difference between the pre-Ramadan test

values (78.3%, s¼ 3.8) and those measured at

Week 2 (77.6%, s¼ 3.6), but they had declined

significantly by the fourth week of Ramadan

(79.8%, s¼ 8.0).

Post-Ramadan. The 10-m time for the subgroup

that had followed the fast (1.78 s, s¼ 0.08;

Table II) was faster than for the group that did not

observe the fast (1.83 s, s¼ 0.07; P¼ 0.011). There

was no main effect for time of day or week. There

was a significant interaction of time of day and week,

with those tested in the morning being slower 3

weeks after Ramadan (1.79 s, s¼ 0.07 vs. 1.84 s,

s¼ 0.07) while those tested in the afternoon ran

faster (1.82 s, s¼ 0.06 vs. 1.79 s, s¼ 0.10). The

same pattern was evident for the 30-m sprint times

(Table II).

Station 2: Loughborough Soccer Dribbling Test

For all 85 players, there was a significant main

effect of week for the dribbling task. Dribbling test

scores, which were recorded in seconds, were slowest

on the pre-Ramadan test occasion (overall

mean¼ 92.3 s, s¼ 7.9). The times improved signifi-

cantly by Week 2 of Ramadan (overall

mean¼ 87.3 s, s¼ 7.7) and remained significantly

faster by Week 4 of Ramadan (overall mean 86.2 s,

s¼ 6.0). There was no main effect for fasting (Table

III). The players who were tested in the morning

(overall morning mean¼ 90.2 s, s¼ 6.7) performed

the test significantly slower than those tested in the

afternoon (overall afternoon mean¼ 88.7 s, s¼ 7.1;

p¼ 0.011). There were no significant interaction

effects.

Post-Ramadan. For the subgroup of 45 players who

were tested post-Ramadan, there was a significant

(P5 0.001) improvement in dribbling test times

from 94.3 s (s¼ 5.9) to 87.0 s (s¼ 4.6). There were

no other significant main effects or interactions

(Table III).

Station 3: Vertical jump test

There was a significant main effect for week

(P5 0.001) for the overall group of 85 players.

There were small but significant increases in vertical

jump height from pre-Ramadan (54.2 cm, s¼ 6.9) to

the second (55.1 cm, s¼ 6.3) and fourth week

(55.5 cm, s¼ 6.6) of Ramadan. There was also a

significant main effect for fasting (P¼ 0.044; Table

III), with the fasting group jumping higher than the

non-fasting group (55.9 cm, s¼ 6.3 vs. 53.4 cm,

s¼ 6.9). There was no main effect for time of day.

There was a significant interaction between week and

time of day (P5 0.001). There were no differences

between the three jump heights for players tested in

the morning, but there was a consistent increase in

jump performance in players tested in the afternoon

(Figure 6).

Post-Ramadan. There was a significant improvement

in vertical jump performance from 51.7 cm (s¼ 5.6)

before the onset of Ramadan to 54.6 cm (s¼ 5.04) 3

weeks after Ramadan, but there were no main effects

for fasting or time of day (Table III). There was an

interaction of week and time of day (P5 0.001), with

players tested in the morning showing no change

while players tested in the afternoon showed

improvement. There were no other significant

interactions.

Station 4: Agility

There was a significant main effect for week

(P¼ 0.001) for the 85 players. The overall time for

the pre-Ramadan test (15.54 s, s¼ 0.59) was not

different from that 2 weeks into Ramadan (15.5 s,

s¼ .69), both of which were significantly slower than

that 4 weeks into Ramadan (15.33 s, s¼ 0.58). There

was no main effect of fasting, time of day or any

interaction (Table III).

Post-Ramadan. There was a significant improvement

(P5 0.001) in agility time from the pre-Ramadan

measurement occasion (15.8 s, s¼ 0.61) to that post-

Ramadan (15.1 s, s¼ 0.66) for the subgroup of 45

players. There were no other significant main effects

or interactions (Table III).

Station 5: Loughborough Soccer Passing Test

For the passing test, which was scored in

seconds, there was a main effect for week for the

85 players. The Pre-Ramadan passing score (overall

mean¼ 60.9 s, s¼ 5.3) improved significantly in the

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second week of Ramadan (overall mean 58.6 s,

s¼ 5.8), but had returned towards the pre-Ramadan

value by the fourth week of Ramadan (60.6 s,

s¼ 5.4). There were no main effects for fasting

(P¼ 0.09), time of day (P¼ 0.08) or any interactions

(week6 time of day: P¼ 0.06).

Post-Ramadan. There was a significant (P¼ 0.004)

main effect of fasting for the subgroup of 45 players

tested 3 weeks after Ramadan (Table III). The

subgroup of players who had fasted during Ramadan

scored better (59.6 s, s¼ 5.1) than those who had not

fasted (63.0 s, s¼ 5.6), but there were no other main

effects. There was a significant interaction of week

and time of day (P¼ 0.005) with the players being

tested in the morning showing a significant decrease

in performance from the pre-Ramadan test to the

post-Ramadan test (59.8 s, s¼ 7.3 vs. 63.3 s,

s¼ 6.5), while those tested in the afternoon showed

an improvement (62.0 s, s¼ 7.9 vs. 59.9 s, s¼ 6.5).

There were no other significant interactions.

Station 6: 20-m multistage shuttle run test

There was a significant main effect for week for the

85 players (P5 0.0001). Before the beginning of the

fast, the overall running distance averaged 1625 m

(s¼ 354). At 2 weeks into the fast, the mean overall

distance covered was lower (1576 m, s¼ 439), but

not significantly so. At 4 weeks into the fast, the

distance covered had increased to 1761 m (s¼ 452),

significantly further than at the previous two test

occasions. There was no main effect for fasting

(fasting: 1653 m; non-fasting: 1656 m; Table III) or

for time of day (am: 1649 m; pm: 1659 m). There

were no significant interactions.

Post-Ramadan. For the subgroup of 45 players, there

was a significant improvement (P5 0.001) in the

shuttle run distance from the pre-Ramadan (1540 m,

s¼ 62) to the post-Ramadan test (1861 m, s¼ 63).

There were no other significant main effects or

interactions (Table III).

Discussion

While there is much information on selected health,

sociological, and physical responses to the month-

long period of Ramadan fasting (Azizi, 2002; Leiper,

Molla, & Molla, 2003), there is little in the literature

about exercise in general and athletic performance in

particular. Our purpose in this study was to

determine any effects of the holy period of fasting

on performance in young Islamic football players. In

most cases where there was an effect of week, players

seemed to have the most difficulty during the early

part of the fast before reverted back to, and in some

cases exceeded, their pre-fasting results. There were

a few instances of an effect of fasting, most notably

for the vertical jump by the fasting players, particu-

larly those tested in the afternoon. Differences due to

fasting for the 30-m sprint times were more reflective

of initial selection instead of fasting, as relative

changes according to group and time paralleled each

other.

Sporting events are programmed throughout the

annual calendar, with the result that training and

competition can present unique challenges for the

Islamic athlete. Based on the current schedule, the

2010 Olympics in London will occur over Ramadan.

During Ramadan, there are two sets of circum-

stances in which Islamic athletes may find them-

selves. They may be in a Muslim country where most

Figure 6. Mean (+s) vertical jump height (cm) by week and time of day.

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teams and colleagues are following the guidelines of

this holy month, or they may be playing in a non-

Muslim country where some of their team-mates,

opponents, friends, and others may not be under-

taking these religious practices. Athletic competition

in either case may be influenced by the practice of

Ramadan.

Ramadan is less a formal fast and more a phase

shift in food intake with a change in sleep cycles to

accommodate the change in the timing of food intake

(Bogdan, Bouchareb, & Touitou, 2001). The overall

energy intake and composition of that intake of the

participants in this project are reported elsewhere in

this issue (Maughan, Bartagi, Dvorak, & Zerguini,

2008a) and suggest that there was little effect of the

intermittent fast on any of the parameters measured.

In other reports, the overall energy intake either

decreased (Angel & Schwartz, 1975; Husain, Dun-

can, Cheah, & Ch’ng, 1987) or changed little

(Adlouni, Ghalim, Benslimane, Lecerf, & Saile,

1997; Frost & Pirani, 1987) with some variation in

macronutrient intake (Beltaifa et al., 2002). How

the changes in dietary timing and intake affected

the blood, sweat, and psychological parameters of the

players in the present study are reported elsewhere

(Leiper et al., 2008a ; Maughan et al., 2008b). While

the small changes in nutritional intake are unlikely to

have any major impact on performance, it is possible

that the phase shift in food, and especially in fluid

intake, and change in sleep patterns could affect

physical performance. In addition, any influence that

the time between eating the last meal before

exercising and the ability to carry out strenuous

physical exercise has might have some bearing on

when to schedule training or competition during

Ramadan.

While speed and endurance are usually the

primary focus of studies on diet and exercise

performance, a football player might be concerned

with how the fast might affect selected factors specific

to the game. Tests of football-specific performance

can be found in many coaching textbooks that assess

the players’ skill with a ball. We chose validated tests

of dribbling and passing performance as measures of

football-specific skills (Ali et al., 2007; McGregor

et al., 2002; Rosch et al., 2000).

Dribbling performance improved steadily through-

out the month regardless of whether the individuals

were fasting or not, with players being tested in the

afternoon scoring better than those tested in the

morning. Most of this improvement occurred be-

tween the pre- Ramadan test and that 2 weeks into

Ramadan. In general, there was little further

improvement except for the non-fasting players

tested in the afternoon. Passing performance was

unaffected by fasting or the time of day when tested.

Performance was improved 2 weeks into Ramadan,

but this effectively reverted to pre-Ramadan values

by the fourth week of Ramadan. While the elements

of both of these football-specific tests were well

known to the players, they were allowed only a

limited opportunity to become accustomed to under-

taking the tests in the environment in which they

were assessed. It is likely that the slight improve-

ments seen in some aspects of the football-specific

tests were due to a learning effect as they became

increasingly familiar with the tests. Any learning

effect did not seem to be lasting, or the players lost

their motivation to perform these demanding tasks.

However, these tests do require some cognitive input

for accurate performance, especially the passing test,

so the phase shift in food and fluid intake and sleep

patterns could affect fasting players’ ability to focus

on the task and thus halt the improvements demon-

strated during the second week of Ramadan. Laraqui

et al. (2001) suggested that changing sleep patterns

(poorer quality and reduced sleep duration) during

Ramadan was more of a factor in the development of

work difficulties than were hunger and thirst during

Ramadan. In the present study, although there was

little change in sleep quality or duration, the fasting

participants reported that their alertness was de-

creased throughout the day and was somewhat

different to their usual circadian rhythm of alertness

(Leiper et al., 2008a). Other studies have found a

decrease in alertness and psychomotor performance

(Roky, Iraki, Hajkhlifa, Lakhdar Ghazal, & Hakkou,

2000), which could explain the increase in motor

vehicle accidents during Ramadan (Shanks et al.,

1994), and the poorer athletic performance in

football players (Meckel, Ismaeel, & Eliakim, 2008;

Zerguini, Kirkendall, Junge, & Dvorak, 2007). Thus,

based on the data in the present study and in the

literature, there is an argument that the daytime fast

and change in sleep quality can, in the longer term,

have an impact on skill performance and could help

to explain why players subjectively reported a decline

in training quality during Ramadan (Zerguini et al.,

2007). In the present study, however, our fasting

participants recorded very little perceived change in

the difficulty of training, mood or alertness through-

out Ramadan (Leiper et al., 2008a). To date, no

study has implicated the phase shift in sleep pattern

or altered pattern of dietary intake during the

Ramadan intermittent fast as producing a decline

in match performance.

The tests of physical performance carried out in

the present study focused on factors believed to be

important for football performance: endurance,

speed, temporary fatigue, leg power, and agility.

Each requires a maximal effort on each trial. While

there were a number of differences based on week of

testing, few tests showed a main effect for fasting and

there were no interactions that included fasting.

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Most of the significant findings were due to week of

testing (pre-Ramadan, Week 2 of Ramadan, Week 4

of Ramadan) and the absence of any negative effect

of fasting suggests that some of these responses may

have been due to training in a residential environ-

ment.

Endurance was assessed using one of the many

20-m shuttle run tests. The one used in this project

was the widely used Leger shuttle, which is a

continuous run with steadily increasing running

speeds. When a player fails to keep pace on two

successive runs, they are asked to step out and the

total distance run (in metres) is recorded. Our results

for endurance showed a significant decline in

running distance in the second week of Ramadan,

but by the fourth week the distances exceeded the

baseline values and there was no time of day effect.

This is in contrast to the pilot work to this study

(Zerguini et al., 2007) and another investigation

testing adolescent football players (Meckel et al.,

2008) in which endurance declined throughout the

fast probably due to the different living conditions

(residency vs. freely living). Meckel and colleagues

(2008) noted that the players in their study reduced

their voluntary strenuous physical activity during

Ramadan and that the intensity of their football

training was also reduced. In the present study, all

players trained on most days and the number,

intensity, and duration of training sessions were not

modified because of Ramadan (Leiper et al., 2008a).

Vertical jump performance improved steadily with

time, by about 1.5 cm from before to the fourth week

of Ramadan. Much of this improvement was due to

increases in jump height by those tested in the

afternoon, rather than by those tested in the

morning. In the absence of fasting as a factor, these

results appear to be due to this period of concen-

trated residential training, but we are unsure why

players tested in the afternoon should perform better

than those tested in the morning for reasons other

than improved performance in the afternoon has

previously been reported for leg strength and

anaerobic power (Reilly, Atkinson, & Waterhouse,

2000). Agility showed little change from the pre-

Ramadan test to the second week of Ramadan test

occasion, but there was some improvement by the

fourth week, probably due to this concentrated

period of football-specific training. The average

improvement, however, amounted to an average of

only 0.2 s.

When there was an effect of time of day, most

performances (e.g. sprinting, vertical jump, drib-

bling) were best when tested in the afternoon. Most

research into circadian rhythms has reported better

performances in the afternoon, roughly paralleling

the diurnal variation in body temperature (Reilly

et al., 2000), but the actual effect of Ramadan on

normal circadian rhythms of performance are less

well defined (Reilly & Waterhouse, 2007). While the

present investigation was not specifically designed to

address the effect of Ramadan on circadian rhythms,

these data suggest that within the limitations of this

project, a selected group of performance measures

followed the typical pattern of better afternoon

results.

While football requires endurance, the outcome of

a match can depend on sprinting by attackers and

defenders (Bangsbo et al., 2006). The 0–10 m sprint

time is a measure of acceleration from a standing start,

whereas the 0–30 m time is an evaluation of overall

sprint speed for a distance typically seen in a football

match. Individual sprints can assess sprint speed, but

repeated sprints can add a fatigue component to the

process. The results for sprint speed showed, again, an

interaction of week and time of day. The players tested

in the morning ran the 10-m sprints slower during the

second week of Ramadan, but returned to pre-

Ramadan speeds during testing in the fourth week of

Ramadan. Players tested in the afternoon showed no

change in performance.

Relative fatigue for the 10-m distance was un-

affected over the course of the study with no

significant main effects or interactions. The players

did show evidence of short-term fatigue for the 30-m

distance. Significantly greater fatigue was seen at

Weeks 2 and 4 into Ramadan by players tested in the

morning, while players tested in the afternoon only

showed more fatigue at Week 4. This minor (51%),

but statistically significant, difference in fatigue

between those tested in the morning and afternoon

is probably of little importance. Given no statistical

change in fatigue at the 10-m distance, it appeared

that the players were unable to maintain their speed

over the final 20 m of the latter repetitions. In the

absence of any other main effects, it is possible that

this reflects the emphasis of training on endurance,

because performance on the multistage shuttle test

showed improvement at the 4-week test occasion as

well as 3 weeks following Ramadan.

There is little published information on the

76 30-m sprint test, but variations are widely used

by clubs to monitor training status in team-sport

athletes. When applied to teams during the off-

season, levels of fatigue in excess of a 10% slowing in

sprint time are common. When teams have been

tested during their competitive season, changes in

the levels of fatigue can be between 0 and 75%

(unpublished observations) of the original values,

showing an improvement in their ability to recover

between high-intensity sprints. This improvement is

probably a more important response to training than

a single sprint that might show small responses to

training. Thus, a player whose level of fatigue is

710% or worse can undergo specific training to

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improve his ability to recover from sprint running. In

the present study, in some test sessions at least one

player (not always the same player) performed poorly

in the later runs, skewing the data. This is evident on

close examination of the standard deviations that

ranged from a low of 0.85 s to a high of 11.1 s.

While there was a consistent pattern of sprint

results, and these sprint tests showed an effect of

fasting, the average difference between the fasting

and non-fasting groups ranged between 0.05 s and

0.011 s, which, while critical in sprinting competi-

tion, is probably of questionable practical signifi-

cance in football. How fasting and time of day might

affect the longer sprints of the Olympics is a matter of

conjecture at this point, but worthy of investigation.

There is limited data to which the findings of the

present study can be compared other than those of the

pilot for this project and the study of Meckel et al.

(2008). The study by Zerguini and co-workers (2007)

was conducted on Algerian professional football

players, while the study by Meckel et al. (2007) was

carried out on adolescents playing in an Israeli youth

league. Both of these studies demonstrated significant

reductions in speed, agility, dribbling speed, and

endurance over the course of the fasting period of

Ramadan. These findings are at odds with those of the

present study, which may reflect differences in the

characteristics of the player populations and living

conditions used. While the players in the Algerian

study were senior professional players and those of the

Israeli study were adolescents, both groups of players

were freely living. The present study recruited

adolescent youth team players to a residential training

camp. In other competitive athletes, performance in

100-m and 800-m races was adversely affected by

Ramadan (Kheddar, Archour, Abou-Messad, Bou-

zayan, & Nacef, 1983) as were military duties

(Boussif, Bigard, Chalabi, Buezennec, 1996; Cisse

et al., 1993). In general, reductions in performance

were attributed to dehydration, the daily restriction of

food intake, and changes to the sleep–wake cycle

(Ballal & Bakir, 1993; Ramadan, 2002).

The specific changes seen in performance in the

present study were somewhat consistent, showing

that any decline in performance was transient,

occurring within the first 2 weeks of Ramadan,

and usually had recovered by the last week of

Ramadan. Our study showed no evidence of

decreased performance due to the main effect of

fasting. This would suggest that the effects of the

initial change in sleep and food intake habits, which

may have been most noticeable during the first 2

weeks of the fast, were followed by adjustments to

the behavioural changes that led to test results close

to, or better than, those recorded pre-Ramadan. In

some of the performance tests, afternoon testing

showed the better results.

With no cases of a main effect for fasting, changes

over time were probably due to football-specific

training or familiarity with the test procedures.

Trainers had autonomy over their training pro-

gramme (except to limit training on the day

preceding the physical tests). While a detailed

summary of the day-to-day training schedule is

beyond the scope of this project, it is quite possible

that with a team in residence instead of living freely,

the trainer might impose a more rigorous training

programme during Ramadan. If the case, a transient

decline in selected aspects of performance early in

an intense period of training might be expected as

the players adjust to the new training load (Stone,

O’Bryant, & Garhammer, 1981) during a change in

lifestyle imposed by this residency programme.

Subsequent improvements in performance would

reflect training adaptations. This might be the case

for endurance, leg power, agility, and sprint speeds,

but not for fatigue from sprinting, which could

indicate a training focus on other aspects other than

recovery from sprinting. However, the overall

subjective rating of perceived exertion during each

day’s training was ‘‘somewhat hard’’ throughout the

study period for both the fasting and non-fasting

group, and there was no evidence of the players

finding the training becoming more difficult either

with time or during fasting (Leiper et al., 2008a).

This would suggest that the players did not consider

the training load to be significantly increased during

the study. It should be pointed out that coaches and

athletes routinely rate training load and intensity

differently (Foster, Heimann, Esten, Brice, &

Porcari, 2001).

Studies such as the present one are subject to

numerous limitations. All tests of performance

require a maximal effort from motivated players.

We have to assume that all participants performed at

their maximal capacity on all tests. No attempt was

made to dictate training load, as this rested with the

technical trainer for each team (Leiper et al., 2008b).

We also have to assume that each player following

the fast did indeed fully follow the tenets of

Ramadan. From a research design standpoint,

allowing participants to choose their treatment is

also a limitation. Extrapolation of the results from

such tests to actual match performance is a

challenge, as matches are affected by many factors,

including the opponents, styles of play, standing in

the league, score, environment, and so on. In

addition, these tests were performed when the

players were rested. Had these tests been conducted

when the players were fatigued, the results might

have been different. Future studies might consider

assessing players after some standard work protocol

like the Loughborough Intermittent Shuttle Test

(Nicholas, Nuttall, & Williams, 2000).

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In conclusion, the residential setting was con-

structed to follow the ideal concept of Ramadan,

which might provide a healthier lifestyle than when

freely living. Table IV summarizes the basic findings.

In general, the period of fasting had little negative

impact on performance. On selected tests, those

players following the fast outperformed those not

fasting. A limited number of test results showed poor

performance during the second week of fasting, which

then returned to, or exceeded, pre-fasting values by the

fourth week of Ramadan. This might suggest that there

is a period of adjustment to the change in training,

lifestyle, food intake, and sleep patterns over the first

few weeks of residency. With time, the players’

performance at this camp setting returned to their

pre-Ramadan values, or improved, as they adjusted to

the residential setting and their training. Based on

these results, in a controlled residential camp setting,

any changes in performance were probably more the

result of their training, as there were no adverse main

effects of fasting on performance.

Acknowledgements

We are grateful to all of the players who participated

so willingly in the study. The costs were met by

grants from F-MARC (FIFA Medical Assessment

and Research Centre) and from the Tunisian Foot-

ball Federation.

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Table IV. Summary of the performance results by fasting, time of day, week, and week6 time of day interaction.

Factor Fasting Time of day Week 2 vs. Pre Week 4 vs. Pre Week6 time of day

Sprint, 0–10 m None None Slower Recovered am: Decreased at Week 2; recovered

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pm: No change

Sprint, 0–30 m F 4 NFa None Slower Recovered am: Decreased at Week 2; recovered

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LSDT None pm4am Improved Stayed improved

Vertical jump F4NFa None Improved Improved am: No change

pm: Improved with time

Agility None None None Improved

LSPT None None Improved Returned

20-m MST None None Decreased improved

Notes: aF4NF¼ the performance by fasting players was better than that of non-fasting players.

Abbreviations: LSDT¼Loughborough Soccer Dribbling Test; LSPT¼Loughborough Soccer Passing Test; MST¼multistage shuttle test;

am¼players tested in the morning; pm¼players tested in the afternoon.

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