Abstract
Ramadan requires individuals to abstain from food and fluid intake between sunrise and sunset; physiological considerations predict that poorer mood, physical performance and mental performance will result. In addition, any difficulties will be worsened because preparations for fasting and recovery from it often mean that nocturnal sleep is decreased in length, and this independently affects mood and performance. Previous field studies have indicated that some of these predictions are borne out in practice; in the first study of the present thesis, a field study performed in Libya, these predictions were tested further by adding more physiological measurements and tests of performance. Findings indicated that Ramadan was associated with negative effects upon a wide range of variables, including rising urine daytime osmolality (indicative of progressive dehydration), subjective estimates of amounts of activities actually performed and those wished to be done (indicating less activity in the daytime), and metabolic and subjective responses to a short bout of exercise (increased effort required and metabolism tending towards fat rather than glucose catabolism). Because of the difficulties of performing a battery of tasks in a field study, two laboratory-based experiments were then performed, the second differing from the first in studying a greater range of variables and more time-points during the daytime. These two studies also differed from the situation in Ramadan in that non-Muslim students were volunteers and fasting was performed for only one day. Many of the changes previously found in Ramadan were duplicated in this work, so justifying the use of laboratory experiments lasting one day and using non-Muslim subjects as a model for some of the problems present in Ramadan. However, it was also found that preparations before the fast were often less marked than was the case with Muslims in Ramadan, a difference that can be attributed to subjects' lack of experience of fasting as well as the amount of time spent fasting. A difficulty of interpretation in all these studies was that changes could be due to fasting and/or the length of sleep, which tends to decrease. These two factors were separated in the final experiment, an intervention study performed in the laboratory. This study compared effects of different durations of fasting (4, 8 or 16 h) upon a wide variety of measures (including subjective and objective assessments of performance, dehydration and responses to a short bout of exercise) - but with an unchanged amount of nocturnal sleep and daytime naps not allowed. Many of the negative effects observed in previous studies were present in this experiment also. These findings indicate that fasting was responsible for much of the change previously observed, though some effect of sleep loss, particularly if occurring on successive days (as would occur in Ramadan) cannot be excluded. One finding common to all studies was that tests of performance that had shown variations due to the combination of circadian influences, time awake and sleep loss in other experiments (including grip strength, the Stroop test and accuracy at throwing darts) seemed little affected. Possible reasons for these negative findings are discussed, together with further experiments to separate out effects of sleep loss and fasting, and the role of subjects' experience in studies of fasting. In addition, more detailed studies to investigate changes in sleep and the type and level of physical activities when fasting are proposed