Critical analysis of the published literature about the effects of Ramadan intermittent fasting on healthy children's physical capacities

R amadan is the month in which Muslims refrain from food and fluid intake from dawn to sunset. It is quite questionable whether pre-pubescent children should be allowed to fast while religion advises such a practice only after puberty, but it is a relatively current practice that children make their first attempt to fast the entire month while they are still pre-pubescent. Most published studies examining the effects of Ramadan intermittent fasting (RIF) on sport performance were performed on adult subjects, and data regarding its effects on children are few. We searched MEDLINE, EMBASE, and ISI Web of Science on April 10, 2015, using the combination of the following medical subject headings: (‘fasting’ AND ‘exercise test’) AND (‘child’ OR ‘adolescent’)]. Only four studies (1 4) examined the effect of RIF on children’s physical performance. They were published between 2008 (2) and 2014 (1) in North Africa (n 2) (1, 4) and the Middle East (n 2) (2, 3). The four studies’ methodologies and main results are detailed, respectively, in Tables 1 and 2. The effects of RIF on the physical capacities of children seem controversial, but there is a tendency toward a decrease in endurance performance, while a slight decrement or no significant effect on short-term explosive performance has been shown (1 4). The sample sizes of children in these four studies varied between 12 (4) and 19 (2). Two remarks concerning this issue should be raised: