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      Effects of Ramadan Observance on Dietary Intake and Body Composition of Adolescent Athletes: Systematic Review and Meta-Analysis

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          Abstract

          To evaluate the effects of Ramadan observance on dietary intake, body mass and body composition of adolescent athletes (design: systematic review and meta-analysis; data sources: PubMed and Web of Science; eligibility criteria for selecting studies: single-group, pre-post, with or without control-group studies, conducted in athletes aged <19 years, training at least 3 times/week, and published in any language before 12 February 2020). Studies assessing body mass and/or body composition and/or dietary intake were deemed eligible. The methodological quality was assessed using ‘QualSyst’. Of the twelve selected articles evaluating body mass and/or body composition, one was of strong quality and eleven were rated as moderate. Ten articles evaluated dietary intake; four were rated as strong and the remaining moderate in quality. Continuation of training during Ramadan did not change body mass from before to the first week (trivial effect size (ES) = −0.011, p = 0.899) or from before to the fourth week of Ramadan (trivial ES = 0.069, p = 0.277). Additionally, Ramadan observance did not change body fat content from before to the first week (trivial ES = −0.005, p = 0.947) and from before to the fourth week of Ramadan (trivial ES = -0.057, p = 0.947). Lean body mass remained unchanged from before to the fourth week of Ramadan (trivial ES = −0.025, p = 0.876). Dietary data showed the intake of energy (small ES = -0.272, p = 0.182), fat (trivial ES = 0.044, p = 0.842), protein (trivial ES = 0.069, p = 0.720), carbohydrate (trivial ES = 0.075, p = 0.606) and water (trivial ES = −0.115, p = 0.624) remained essentially unchanged during as compared to before Ramadan. Continued training of adolescent athletes at least three times/week during Ramadan observance has no effect on body mass, body composition or dietary intake.

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          Current status of body composition assessment in sport: review and position statement on behalf of the ad hoc research working group on body composition health and performance, under the auspices of the I.O.C. Medical Commission.

          Quantifying human body composition has played an important role in monitoring all athlete performance and training regimens, but especially so in gravitational, weight class and aesthetic sports wherein the tissue composition of the body profoundly affects performance or adjudication. Over the past century, a myriad of techniques and equations have been proposed, but all have some inherent problems, whether in measurement methodology or in the assumptions they make. To date, there is no universally applicable criterion or 'gold standard' methodology for body composition assessment. Having considered issues of accuracy, repeatability and utility, the multi-component model might be employed as a performance or selection criterion, provided the selected model accounts for variability in the density of fat-free mass in its computation. However, when profiling change in interventions, single methods whose raw data are surrogates for body composition (with the notable exception of the body mass index) remain useful.
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            Position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and athletic performance.

            It is the position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine that physical activity, athletic performance, and recovery from exercise are enhanced by optimal nutrition. These organizations recommend appropriate selection of foods and fluids, timing of intake, and supplement choices for optimal health and exercise performance. This updated position paper couples a rigorous, systematic, evidence-based analysis of nutrition and performance-specific literature with current scientific data related to energy needs, assessment of body composition, strategies for weight change, nutrient and fluid needs, special nutrient needs during training and competition, the use of supplements and ergogenic aids, nutrition recommendations for vegetarian athletes, and the roles and responsibilities of sports dietitians. Energy and macronutrient needs, especially carbohydrate and protein, must be met during times of high physical activity to maintain body weight, replenish glycogen stores, and provide adequate protein to build and repair tissue. Fat intake should be sufficient to provide the essential fatty acids and fat-soluble vitamins, as well as contribute energy for weight maintenance. Although exercise performance can be affected by body weight and composition, these physical measures should not be a criterion for sports performance and daily weigh-ins are discouraged. Adequate food and fluid should be consumed before, during, and after exercise to help maintain blood glucose concentration during exercise, maximize exercise performance, and improve recovery time. Athletes should be well hydrated before exercise and drink enough fluid during and after exercise to balance fluid losses. Sports beverages containing carbohydrates and electrolytes may be consumed before, during, and after exercise to help maintain blood glucose concentration, provide fuel for muscles, and decrease risk of dehydration and hyponatremia. Vitamin and mineral supplements are not needed if adequate energy to maintain body weight is consumed from a variety of foods. However, athletes who restrict energy intake, use severe weight-loss practices, eliminate one or more food groups from their diet, or consume unbalanced diets with low micronutrient density, may require supplements. Because regulations specific to nutritional ergogenic aids are poorly enforced, they should be used with caution, and only after careful product evaluation for safety, efficacy, potency, and legality. A qualified sports dietitian and in particular in the United States, a Board Certified Specialist in Sports Dietetics, should provide individualized nutrition direction and advice subsequent to a comprehensive nutrition assessment.
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              Effect of Ramadan Fasting on Weight and Body Composition in Healthy Non-Athlete Adults: A Systematic Review and Meta-Analysis

              Background: Ramadan involves one month of fasting from sunrise to sunset. In this meta-analysis, we aimed to determine the effect of Ramadan fasting on weight and body composition. Methods: In May 2018, we searched six databases for publications that measured weight and body composition before and after Ramadan, and that did not attempt to influence physical activity or diet. Results: Data were collected from 70 publications (90 comparison groups, 2947 participants). There was a significant positive correlation between starting body mass index and weight lost during the fasting period. Consistently, there was a significant reduction in fat percentage between pre-Ramadan and post-Ramadan in people with overweight or obesity (−1.46 (95% confidence interval: −2.57 to −0.35) %, p = 0.010), but not in those of normal weight (−0.41 (−1.45 to 0.63) %, p = 0.436). Loss of fat-free mass was also significant between pre-Ramadan and post-Ramadan, but was about 30% less than loss of absolute fat mass. At 2–5 weeks after the end of Ramadan, there was a return towards, or to, pre-Ramadan measurements in weight and body composition. Conclusions: Even with no advice on lifestyle changes, there are consistent—albeit transient—reductions in weight and fat mass with the Ramadan fast, especially in people with overweight or obesity.
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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                28 May 2020
                June 2020
                : 12
                : 6
                : 1574
                Affiliations
                [1 ]Institut Supérieur du Sport et de l’éducation physique de Sfax, Université de Sfax, Sfax 3000, Tunisie; trabelsikhaled@ 123456gmail.com (K.T.); omarboukhris24@ 123456yahoo.com (O.B.); h_chtourou@ 123456yahoo.fr (H.C.)
                [2 ]Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia
                [3 ]Institute of Sport Science, Otto von Guericke University Magdeburg, 39104 Magdeburg, Germany; ammar.achraf@ 123456ymail.com
                [4 ]Activité Physique: Sport et Santé, UR18JS01, Observatoire National du Sport, Tunis 1003, Tunisie
                [5 ]Exercise Science Research Center, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR 72701, USA; jordan@ 123456neurotrack.com
                [6 ]Neurotrack Technologies, 399 Bradford St, Redwood City, CA 94063, USA; nick@ 123456neurotrack.com
                [7 ]Clinical Excellence Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
                [8 ]School of Sport and Exercise, College of Health, Massey University, Palmerston North 4442, New Zealand; sstannard@ 123456gmail.com
                [9 ]Institute of Sport and Sport Science, Department of Movement and Training Science, Heidelberg University, 69120 Heidelberg, Germany; florian.engel@ 123456issw.uni-heidelberg.de
                [10 ]Institute of Sport Science, University of Würzburg, 97082 Würzburg, Germany; billy.sperlich@ 123456uni-wuerzburg.de
                [11 ]Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child, Health (DINOGMI), University of Genoa, 16132 Genoa, Italy; sgarbarino.neuro@ 123456gmail.com
                [12 ]Department of Health Sciences (DISSAL), Postgraduate School of Public Health, University of Genoa, 16132 Genoa, Italy
                [13 ]Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, 4700 Keele Street, Toronto, ON M3J 1P3, Canada
                [14 ]Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 1A1, Canada; royjshep@ 123456shaw.ca
                Author notes
                [* ]Correspondence: robertobragazzi@ 123456gmail.com ; Tel.: +39-010-353-8508
                [†]

                Equally contributed as first authors.

                [‡]

                Equally contributed as last authors.

                Author information
                https://orcid.org/0000-0003-2623-9557
                https://orcid.org/0000-0003-0347-8053
                https://orcid.org/0000-0002-2861-0164
                https://orcid.org/0000-0002-8508-552X
                https://orcid.org/0000-0001-8409-868X
                https://orcid.org/0000-0002-5482-9151
                Article
                nutrients-12-01574
                10.3390/nu12061574
                7353054
                32481549
                2c316655-88b6-4b8b-aa03-601bb564fa86
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 04 April 2020
                : 26 May 2020
                Categories
                Review

                Nutrition & Dietetics
                athletes,adolescent,energy intake,fat mass,lean mass,ramadan,systematic review and meta-analysis

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