As Ramadan nears, so do tough decisions for World Cup-bound Muslim players

For more than 1 billion Muslims around the world, Thursday marks the beginning of Ramadan. It’s the beginning of a month of obligatory fasting; of abstention from food and drink between sunrise and sunset; of purification and self-discipline.

For over 100 soccer players from six predominantly Muslim nations and several others, however, it will also be a month of preparation for the biggest days of their professional lives. One day before the holy month ends, the 2018 World Cup will begin.

Ramadan, therefore, presents a dilemma.

“It’s not easy, for sure, to train and play while I’m fasting,” says Omar Gaber, an Egyptian defender named to his country’s provisional roster for the upcoming tournament in Russia. “But I have to do it. Some players make up [the fast] later. But for me, it’s only 30 days in the whole year. And for us, in our religion, it’s a very good thing to be near to God.”

Other Muslim players will choose differently. Many will take advantage of exemptions, reserved for those who are ill, traveling, or carrying out physically strenuous tasks. Germany’s Mesut Ozil, for example, did not fast when Ramadan fell during the 2014 World Cup knockout stages because, as he said at the time, he was “working.”

And there is good reason to delay the fast until a later date. Bodies need fuel. “By the end of Ramadan, there is an increased risk of nutritional and energy deficiency in active athletes,” a document outlining upcoming FIFA-commissioned research on the topic states. “The post-Ramadan effects have been given little attention and exactly how long the effects, if any, will last remains unclear.”

But for professionals wholeheartedly committed to both their faith and their football, the decision can be agonizing. It has been the source of friction between managers and players. A majority of Muslim players featured in a study at the 2012 Olympics said their coaches did not want them to fast. In 2014, France manager Didier Deschamps called it a “touchy subject.” This time around, a French team spokesman told Yahoo Sports that the question, as it pertains to Muslim stars such as Paul Pogba and N’Golo Kante, was a “private matter.”

Fortunately, though, it’s a matter that has been the subject of extensive medical research. And it’s a topic on which experts and team doctors are far more knowledgeable now than they were in the past.

The effects of fasting on performance

Fifteen years ago, according to Dr. Yacine Zerguini, a member of FIFA’s medical committee, “the available literature contained no scientific studies analyzing the interaction of football and Ramadan.”

Since, there have been many. There have been international conferences. And they’ve yielded a few tentative conclusions: that eating only two meals a day – one early in the morning, one late at night – can lead to nutritional deficiencies; that dehydration can be a problem; that sleep loss can lead to daytime fatigue; and that changes to training schedules to accommodate Ramadan can come with their own side-effects.

But none of the studies have been both conclusive and comprehensive. Some have been conflicting. Some have shown no detrimental effects. Others have shown that overuse injuries increase if typical training regimens are maintained. Others have shown that changes to training regimens lead to decreases in physical fitness.

Some players, on the other hand, have said there are benefits. “You clean your body … and you feel even stronger after Ramadan,” Ivorian defender Kolo Toure said in 2013.

Zak Abdel, formerly Egypt’s goalkeeping coach, has a similar anecdote: “When we had [legendary Egyptian midfielder Mohamed] Aboutrika, he was so strong mentally that he played his best when he was fasting.”

That’s why Zerguini, an Algerian who has spearheaded several of the studies, stresses that every player must approach Ramadan based on his or her own needs.

“The main conclusion is that there is no single coping strategy,” he told Yahoo Sports in an email through a spokesman. “And in fact a ‘one size fits all’ approach is unlikely to be the solution. Instead, regimens need to be carefully tailored for the individual player.”

How players and teams adjust during Ramadan

Teams, though, do devise programs to curb any potential negative impacts. Egypt’s soccer federation, according to manager Hector Cuper, “has hired specialists to help me and the players” over the next 30 days.

“We will organize and monitor their eating and sleeping and hope that this will not affect them badly,” Cuper said at a news conference in March. “It may be a problem for the coaches because the players will stop eating from sunrise until sunset, so it will not be easy during training. But that is to do with the religion and I can’t prevent them from observing Ramadan.”

Many predominantly Muslim teams restructure their schedules to better accommodate fasting players. That was one of 11 key recommendations in a 2012 paper authored by Zerguini, former FIFA chief medical officer Jiri Dvorak and two other renowned experts. There were also dietary suggestions, and advice on workload management.

But one of the 11 arrived back at the most important point: “Individualized monitoring” is crucial. Every athlete’s body responds differently.

And besides, team-wide adjustments might not be feasible if Muslims are a minority within a squad. Which is perhaps one of the reasons that Ozil and German teammate Sami Khedira, France’s Pogba and Kante, Switzerland’s Granit Xhaka and Xherdan Shaqiri, and other Muslim stars have decided against fasting during other major tournaments.

To fast or not to fast?

The 2018 World Cup is not the first high-profile international competition that has coincided with the holy month. Ramadan – which is based on a roughly 354-day lunar calendar – also fell during the 2012 Olympics, the knockout stages of the 2014 World Cup, and Euro 2016.

Two years ago, no French players fasted. Neither did German players. Neither did Belgium’s Marouane Fellaini and Mousa Dembele. Four years ago, Swiss players also abstained. Many take advantage of exemptions, just as Dr. Michel D’Hooghe, the chairman of FIFA’s medical committee, advised in 2014.

For players from predominantly Muslim nations, however, the choice may be more difficult. As several FIFA-affiliated documents and presentations note, a decision to not fast “may receive criticism and disapproval from family, friends and members of the community who give more priority to religion or sport.” Some players will abstain from food and drink, but break the fast on matchdays.

Many teams, including Egypt, will leave the decision up to individual players. Even an absence of external pressure, though, won’t make it an easy one.

“It’s a personal decision,” says Vancouver Whitecaps midfielder Aly Ghazal, an Egyptian international. “It’s between you and God, nobody else controls if you do it or not. But it is flexible depending on how you are physically … It’s different from person to person. Some guys can do it and play like normal, even if they don’t eat. And some guys, they can’t handle it. If you do it, you do it. It’s between the person and Allah.”

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Yahoo Sports’ Doug McIntyre contributed reporting.

Henry Bushnell covers global soccer for Yahoo Sports. Have a tip? Question? Comment? Email him at henrydbushnell@gmail.com, or follow him on Twitter @HenryBushnell, and on Facebook.

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