In order to understand the physiological adaptations during Ramadan fasting (RF), we studied the body composition, electrolyte balance, hematological response and physical performance in 15 healthy male Kuwaitis (mean age 37 years). Body composition, biochemical analysis, hematological count and exercise performance were evaluated on four occasions: 1 week before RF, 2 weeks during RF, during the last 4 days of RF, and 1 week to 10 days after RF. Cardiopulmonary exercise was performed on a Monark bicycle ergometer at 100 W for 6–8 min. Body composition was obtained using the skin-fold technique, and biochemical and hematological analyses were done using established standard techniques. Subjects lost 1.2% of their total body weight and 5 % of their body fat weight within 2 weeks of RF (p < 0.05). Total serum proteins, albumin and osmolarity significantly increased (p < 0.05) at the end of RF. White blood cells, platelets and serum iron were significantly decreased at the end of RF (p < 0.05). There was no significant change in red blood cell count and hematocrit during RF. Submaximal heart rate was significantly decreased (p < 0.05) by 5.4% whereas submaximal oxygen uptake increased by 12.7% at the end of RF. There was no significant difference in submaximal minute ventilation during the study period. It is concluded that RF is associated with metabolic, hematologic and cardiopulmonary adaptations which are of paramount importance in this period of restricted fluid, mineral and food intake.

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