Effects of Fasting During Ramadan Month on Cognitive Function in Muslim Athletes

Purpose: Our study aimed to profile the effect of fasting during the Ramadan month on cognitive function in a group of healthy Muslim athletes. Methods: Eighteen male athletes underwent computerized neuropsychological testing during (fasting) and after (non-fasting) Ramadan. Diet was standardized, and tests were performed at 0900h and 1600h to characterize potential time-of-day (TOD) interactions. Psychomotor function (processing speed), vigilance (visual attention), visual learning and memory, working memory (executive function), verbal learning and memory were examined. Capillary glucose, body temperature, urine specific gravity, and sleep volume were also recorded. Results: Fasting effects were observed for psychomotor function (Cohen’s d=1.3, P=0.01) and vigilance (d=0.6, P=0.004), with improved performance at 0900h during fasting; verbal learning and memory was poorer at 1600h (d=-0.8, P=0.03). A TOD effect was present for psychomotor function (d=-0.4, P<0.001), visual learning (d=-0.5, P=0.04), verbal learning and memory (d=-1.3, P=0.001), with poorer performances at 1600h. There was no significant fasting effect on visual learning and working memory. Conclusions: Our results show that the effect of fasting on cognition is heterogeneous and domain-specific. Performance in functions requiring sustained rapid responses was better in the morning, declining in the late afternoon, whereas performance in non-speed dependent accuracy measures was more resilient.