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Health & Fitness Journal

of Canada
Copyright 2014 The Authors. Journal Compilation Copyright 2014 Health & Fitness Society of BC
Volume 7 September 30, 2014 Number 3
Roy!J.!Shephard1 !

Abstract! Introduction!
short' periods' of' total' fasting,' by' longer' periods' of'
With' the' growing' numbers' of'
severe'dietary'restriction'and'by'dehydration.'Purpose:' observant' Muslims' in' North' America,'
This'article'reviews'the'extent'of'such'effects'as'seen'in' sports'scientists,'coaches,'and'trainers'are'
Methods:' A' comprehensive' review' of' the' literature' for'
increasingly' confronted' with' the' need' to'
papers' examining' physical' performance' in' relation' to' advise' athletes' who' wish' to' observe'
fasting,' dietary' restriction' and' dehydration.' Results:' Ramadan,' the' 29<day' annual' celebration'
Functional' losses' with' fasting' are' less' than' might' be'
when' neither' food' nor' fluid' is' ingested'
experimental' animals)' loss' of' motivation' may' well' between' sunrise' and' sunset' (Bouhlel' et'
account' for' some' of' the' observed' negative' effects' al.,' 2013;' Shephard,' 2012a,' b;' 2013).''
(decreases' in' maximal' oxygen' intake,' sub<maximal'
aerobic' endurance' and' muscular' strength)' in' tests'
However,' the' observance' of' Ramadan' is'
requiring' maximal' effort' from' the' subject.' Two' factors' but' one' of' many' circumstances' where' a'
contribute'to'the'limited'effects'of'food'deprivation:'the' person' attempts' to' perform' physical'
decrease' of' body' mass' reduces' the' energy' cost' of'
the' body' has' a' surprising' ability' to' make' long<term' food' and/or' fluids.' Other' possible'
adaptations' to' the' metabolism' of' stored' fat' and' tissue' scenarios' include' becoming' lost' in' the'
protein;' heavy' daily' energy' expenditures' can' be'
sustained' on' a' fat/protein' diet,' despite' ketosis.' Fluid'
wilderness' or' marooned' at' sea,' in'
stores' are' smaller' in' relation' to' the' demands' of' addition' to' deliberate' attempts' by' an'
vigorous' exercise,' and' many' aspects' of' physical' athlete' to' reduce' body' mass' (as' when'
"making' weight")' or' to' alter' body' form'
relatively'small,'athletes'who'seek'optimal'performance' (as' in' competitive' gymnasts).' Possible'
should' counter' a' deficiency' of' food' or' fluid' as' soon' as' situations'include'short'or'longer'periods'
possible.' With' careful' management' of' lifestyle,'
performance' can' generally' be' maintained' during' the'
of' total' fasting,' chronic' food' deprivation,'
intermittent' fasting' of' Ramadan,' although' this' is' a' lack' of' one' or' more' key' dietary'
probably'not'true'for'ultra<endurance'events.'Health!&! constituents,'and'dehydration.''
This' article' focuses' upon' body'
Keywords:'Dehydration,'dieting,'fasting,'ketosis,' reserves'of'food'and'fluid,'considering'the'
Ramadan'observance,'rehydration.' limits'of'human'adaptation'to'deficiencies'
From' 1Faculty' of' Kinesiology' and' Physical' Education,'
of' food' and' fluids,' comparing' and'
University'of'Toronto,'Toronto,'ON.'' contrasting' responses' with' those' seen' in'
E<mail:'' laboratory' animals.' It' examines' the'
effects' of' prolonged' starvation,' briefer'
! periods' of' fasting,' severe' food'
! deficiencies' and' fluid' deprivation' upon'


human' performance,' and' concludes' with' Finally,'poverty'or'extreme'vegetarianism'
a' brief' examination' of' the' potential' may' lead' to' a' deficiency' of' one' or' more'
problem' of' potential' adjustments' to' the' key' nutrients,' particularly' essential'
metabolic' ketosis' that' may' arise' from' amino'acids'and'trace'elements.''
fasting.' The'primary'nutritional'deficiency'may'
! be' a' lack' of' water,' rather' than' food.'
Potential!fasting!scenarios' Dehydration' can' arise' as' a' sequel' to' a'
Total' fasting' may' be' imposed' shipwreck'or'becoming'lost'in'the'desert.'
experimentally'in'the'metabolic'ward'of'a' It'is'also'seen'when'prolonged'exercise'is'
hospital' in' order' to' examine' details' of' undertaken' under' very' hot' conditions.'
physiological' responses.' ' It' may' also' However,' perhaps' most' commonly' it' is'
occur' by' misadventure,' if' a' party' of' induced' deliberately' by' an' athlete' in' an'
mountaineers,' arctic' explorers' or' attempt' to' achieve' a' lower' weight'
shipwrecked'mariners'find'themselves'in' category'than'is'appropriate'to'his'or'her'
a' situation' where' rigorous' exercise' is' body'build.'''
needed' to' escape' from' a' dangerous' !
situation,' but' supplies' of' food' and/or' Body!reserves!of!food!and!fluid'
water' have' been' exhausted.' Finally,' a' The' daily' energy' consumption' of' an'
period' of' full' or' partial' fasting' may' be' adult' ranges' from' about' 8' MJ' in' a'
required' by' the' tenets' of' a' specific' sedentary'individual,'to'16'MJ'or'more'for'
religious'belief'(for'example,'the'repeated' many' athletes' (FAO/WHO/UNU,' 2004).'
abstinence' from' both' foods' and' fluids' When' the' energy' intake' does' not' match'
expected' during' daylight' hours' this'expenditure,'the'body'draws'upon'its'
throughout'the'month'of'Ramadan).' stores'of'carbohydrate,'fat,'and'protein'to'
Severe' food' deprivation' may' occur' in' cover'the'deficiency.''
times' of' war' and' famine.' It' may' also' be' 9
imposed' experimentally,' in' order' to' Carbohydrate9
examine' the' physiological' consequences' The'carbohydrate'reserves'of'the'body'
of'famine'or'of'over<rigorous'dieting'in'an' are' quite' limited.' In' addition' to' small'
attempt' to' control' obesity.' Some' classes' amounts' of' glucose' in' the' plasma' and'
of' athlete' choose' to' impose' upon' tissues,' glycogen' is' stored' in' the' muscle'
themselves' severe' dietary' and/or' fluid' (normally' about' 400' g)' and' in' the' liver'
restrictions' in' an' attempt' to' qualify' for' a' (about' 100' g),' giving' a' total' reserve'
particular' category' in' a' weight<classified' equivalent' to' some' 8' MJ' of' energy'
sport,'or'in'the'quest'for'a'more'attractive' (Shephard,' 1982).' Carbohydrate' reserves'
physical' appearance' in' a' subjectively' can' be' increased' by' at' least' 50%' if' the'
rated' competition' such' as' gymnastics' or' person' concerned' adopts' a' high'
figure' skating.' In' the' general' population,' carbohydrate'diet'(Hawley'et'al.,'1997).'''
an' obese' and' sedentary' middle<aged' The' rate' of' depletion' of' carbohydrate'
person'may'adopt'a'very'low'energy'diet' reserves' depends' not' only' on' the' daily'
in' order' to' reduce' the' body' fat' burden.' energy' expenditure,' but' also' its' nature.'
The' daily' food' intake' may' also' be' During' moderate' intensity' rhythmic'
severely' restricted' by' a' variety' of' activity,' much' of' the' energy' requirement'
pathologies' such' as' anorexia' nervosa,' is' met' from' the' metabolism' of' fat;'
bulimia' and' gastro<intestinal' disorders.''' moreover,' a' higher' proportion' of' energy'


is' derived' from' fat' in' an' endurance' person,' but' to' at' least' 10<12' MJd<1' in'
athlete' than' in' a' sedentary' individual.' At' most' athletes.' ' The' energy' yield' of' body'
an' intensity' of' effort' demanding' more' fat'is'about'29'kJg<1,'so'if'a'person'began'
than' 70%' of' maximal' oxygen' intake' (80< with' 15' kg' of' surplus' fat,' this' could'
90%'in'an'endurance'athlete),'a'large'and' provide'a'total'reserve'of'some'435'MJ'of'
growing' fraction' of' the' total' energy' energy,' sufficient' to' sustain' the' energy'
requirement' is' met' from' the' metabolism' needs' even' of' an' active' individual' for' a'
of' carbohydrates' (Gmada' et' al.,' 2012).' month' or' longer' (Shephard,' 1982).'
The'energy'required'for'vigorous'resisted' However,' the' tolerance' of' fasting' would'
muscular' contractions,' also,' is' derived' be' much' shorter' in' a' typical' e' athlete,'
almost' exclusively' from' carbohydrate' who' would' begin' any' period' of' food'
(Shephard,'1982).''' deprivation' with' much' smaller' reserves'
A' physically' active' person' is' likely' to' of' body' fat,' and' would' face' much' higher'
deplete' their' carbohydrate' stores' within' daily'energy'demands.''''
24' hr' of' commencing' a' total' fast.' ' Any' 9
subsequent' need' for' carbohydrate' is' met' Protein'
by' the' formation' of' glucose' in' the' liver,' The' body' has' a' labile' reserve' of' some'
the' process' of' hepatic' gluconeogenesis.'' 300' g' of' protein' (Swick' and' Benevenga,'
Such' glucose' formation' depends' mainly' 1977),'much'of'which'is'found'in'the'liver.'
upon'the'breakdown'of'tissue'protein'and' Over' the' first' five' days' of' starvation,' this'
the'metabolism'of'circulating'amino'acids,' provides'the'main'basis'for'the'synthesis'
although' the' process' is' supplemented' by' of' glucose,' at' a' rate' of' about' 60' gd<1.'
the' use' of' available' glycerol' and' lactate' Thereafter,' the' main' resource' for'
(Shephard,'1982).'' continued' hepatic' gluconeogenesis' is' a'
9 progressive' breakdown' of' muscle' tissue.'
Fat!'' The' American' Heart' Association' has'
Fat' stores' provide' the' body's' main' argued' that' unless' dieters' consume' a'
long<term'reserve'of'energy.!In'sedentary' minimum' of' 100' g' of' carbohydrate' per'
North' Americans,' initial' stores' of' fat' are' day,' a' loss' of' tissue' protein' will' be'
often'quite'large.'An'obese'individual'may' inevitable' (St.' Jeor' et' al.' 2001).'
store' 20<30' kg' of' fat.' If' there' is' a' major' Unfortunately,' about' 1.6' g' of' protein' is'
reduction' in' body' fat' stores' during' a' needed'to'provide'the'equivalent'of'1g'of'
period' of' fasting' or' dieting,' there' is' a' glucose' (Manninen,' 2004),' and' the' issue'
roughly' corresponding' decrease' in' body' is' further' complicated' in' that' not' all'
mass' (Shephard,' 1991);' this' reduces' the' amino' acids' can' contribute' to' the'
energy'cost'of'most'tasks'that'require'the' synthesis'of'glucose.''
displacement' of' body' mass' (Brown,' The' total' muscle' mass' varies' widely'
1966),' although' because' of' a' loss' of' sub< between'a'strength'athlete,'an'endurance'
cutaneous' fat,' a' person' also' becomes' performer,' and' a' sedentary' adult.'
more' susceptible' to' heat' loss' in' a' very' However,' a' typical' muscle' mass' for' a'
cold'environment.'' sedentary' man' would' be' about' 35' kg'
If' the' customary' pattern' of' physical' (Shephard,' 1991;' Kim' et' al.,' 2004).' A'
activity' were' to' be' maintained' during' progressive' breakdown' of' 100' g' of' lean'
fasting,'then'energy'needs'would'amount' tissue'per'day'would'provide'a'little'over'
to' perhaps' 6' MJd<1' in' a' totally' inactive' 1'MJ'of'energy'per'day,'but'would'reduce'


lean'mass'by'almost'a'third'over'100'd'of' of' glucose.' Moreover,' the' muscles' can'
food' shortage.' The' lack' of' circulating' metabolize' at' least' seven' amino' acids'
amino' acids' would' also' limit' any' local' directly.' It' thus' may' be' more' correct' to'
response'to'strength'training'(Rasmussen' claim' that' "fat9 and9 carbohydrate9 burn9 in9
et'al.,'2000;'Tipton'et'al.,'2001;'Hawley'et' the9 flame9 of9 protein9 metabolism"'
al.,' 2007).' It' seems' likely' that' the' loss' of' (Manninen,'2004).''
lean' tissue' would' lead' to' a' progressive' Assuming' that' the' energy' intake' is' 6'
decrease'in'muscular'strength.'Because'of' MJd<1' less' than' the' energy' requirement,'
loss' of' plasma' protein,' tissue' oedema' this' deficit' could' be' covered' by'
might' also' develop,' together' with' a' metabolizing' a' combination' of' 150' g' of'
natriuresis' (excretion' of' sodium)' and' a' stored' fat' and' 100' g' of' tissue' protein.'
secondary' loss' of' potassium' from' the' Ketosis' will' develop' if' fats' are'
body'(Phinney'et'al.,'1980).'' metabolized' in' the' absence' of' a'
9 substantial' quantity' of' carbohydrate.' If'
Onset9of9metabolic9ketosis'' this' leads' to' an' acidosis,' it' can' impair'
The' classic' dictum' of' the' biochemist' athletic' performance,' but' this' is' not'
was' that' "fat9 burns9 in9 the9 flame9 of9 invariably' the' case' (Phinney,' 2004).' As'
carbohydrate9metabolism."''In'the'absence' discussed' further' below,' with' time,' the'
of' sufficient' carbohydrate' metabolism,' body' seems' to' adapt' to' exercising' on' a'
body' fats' are' partially' broken' down' to' high'fat/low'carbohydrate'diet.'' '
ketone' bodies,' and' these' cannot' be' 9
metabolized' in' the' liver' because' it' lacks' Fluid''
the' necessary' mitochondrial' enzyme,' The'body'normally'contains'45<50'L'of'
succinyl' CoA:3<ketoacid' CoA' transferase.' water' (Shephard,' 1982).' The' maximal'
Ketone' bodies' thus' accumulate' in' the' safe' loss' depends' on' circumstances,'
bloodstream,' and' by' analogy' with' including' the' amount' of' exercise' that'
diabetic'ketosis'(where'fat'metabolism'is' must' be' performed,' whether' water' has'
increased'because'of'a'lack'of'insulin,'and' been' liberated' by' the' metabolism' of'
there' is' a' massive' and' uncontrolled' intramuscular' glycogen' (a' potential'
production'of'acidic'ketone'bodies),'there' reserve' of' up' to' 2L),' and' environmental'
was' a' fear' that' the' end<result' of' an' conditions' (Shephard' and' Kavanagh,'
inadequate' carbohydrate' intake' in' an' 1975).' If' a' person' is' performing'
active' individual' would' also' be' a' fatal' endurance' exercise' in' a' temperate'
ketotic'coma.''' climate,' a' loss' of' 5<6' L' seems' to' be' quite'
During'the'past'10'years,'this'view'has' well' tolerated' (Shephard' and' Kavanagh,'
been' criticized' (Manninen,' 2004).' It' has' 1975).'
been' emphasized' that' an' active' person' Under' resting' conditions,' normal' fluid'
can'maintain'a'normal'blood'pH'during'a' losses'from'the'body'amount'to'about'2.5'
period' of' carbohydrate' restriction,' and' Ld<1'(a'urine'flow'of'1.2<1.5'L,'water'loss'
that' ketone' bodies' can' provide' a' useful' at'the'skin'surface'of'0.5'Ld<1,'respiratory'
substrate' for' cerebral' metabolism,' thus' losses' of' 0.4' Ld<1,' and' the' water' content'
sparing' any' glucose' in' the' blood' stream.' of' the' feces' of' about' 0.15<0.2' Ld<
Indeed,' both' 3<hydroxybutyrate' and' 1)(Shephard,' 1982).' However,' if' exercise'
amino<acetate' yield' somewhat' more' ATP' is' performed' in' the' heat' an' endurance'
per''molecule'than'an'equivalent'amount' athlete' may' lose' an' additional' 2' Lh<1' or'


more' by' sweating,' and' there' is' a' rapid' Total!fasting'
deterioration' of' function' if' body' fluid' Studies' of' the' impact' of' total' fasting'
reserves' cannot' be' replenished' upon' physical' performance' have' been'
(Shephard,'1982).' relatively' few,' although' several' papers'

Author! Participants! Fast!! Exercise!intensity! Change!with!fasting!
Dohm'et'al.'(1983)' Male'Holtzman'rats' 24'hr' Treadmill,'28'mmin<1'0%' 80%'increase'in'time'
grade' to'exhaustion'with'
Loy'et'al.'(1986)'' 10'young' 24'hr' Cycle'ergometry'at'86%' 73.5%'decrease'at'
competitive'male' or'79%'of'maximal' 86%,'25.7%'decrease'
cyclists' oxygen'intake' at'79%'
Dohm'et'al.'(1986)' 9'healthy'active' 23'hr' Treadmill'running'at' 7.7%'decrease'when'
young'males' 70%'of'maximal'oxygen' fasting;'increased'
intake' perception'of'exertion'
Gleeson'et'al.'(1988)' 6'healthy'young' 24'hr' Cycle'ergometry'at'100%' 13%'decrease'when'
males' of'maximal'oxygen'intake' fasting'
Maughan'&'Gleeson' 5'healthy'males' 36'hr' Cycle'ergometry'at'70%' 35%'decrease'when'
(1988)'' of'maximal'oxygen'intake' fasting'
Johnson'&'Leek'(2010)'! 22'healthy'young' 12'hr' Reach'and'balance' Deterioration'when'
women'' fasting'
Uyeno'&'Graham' Rats' 3'd' Swimming'time' Increased'after'fast'
Young'(1959)'' Dogs' 5'd' Treadmill'running' Time'to'exhaustion'
Gutirez'et'al.'(2001)'' 8'healthy'young' 3'd' PWC170,'Handgrip'force' Decrease'of'PWC170'
males' and'perception'reaction' (23<28%)'but'no'
time' change'in'other'
Knapik'et'al.'(1987)'' 8'healthy'young' 3.5'd' Cycle'ergometry'at'45%' No'change'
men' of'maximal'aerobic'
Knapik'et'al.'(1987)'' 8'healthy'young' 3.5'd' Isokinetic'and'isometric' No'change'of'
men' strength' isometric'strength'or'
Lastegola'(1965)'' 6'healthy'men' 7'd' Treadmill'maximal' 31.6%'decrease'(less'
oxygen'intake' marked'loss'at'10'd'of'
Consolazio'et'al.' 6'healthy'men' 9'd' Handgrip'force' 9.3%'decrease'


have' reported' responses' to' short<term' (1983)'observed'a'dramatic'improvement'
(12<36'hr)'and'longer'(3<10'd)'periods'of' in' the' treadmill' endurance' of' rats' after'
total'food'deprivation.'Some'investigators' they' had' undergone' a' 24<hour' fast.' An'
have'suggested'that'fasting'might'actually' 18%' decrease' in' body' mass' in' the' fasted'
improve' endurance' performance,' in' part' animals' was' associated' with' an' increase'
because' the' resting' plasma' fatty' acid' of' the' time' to' exhaustion' when' running'
concentration' is' increased' (Conlee' et' al.,' on' a' treadmill;' 284' min,' as' compared'
1976),' thus' sparing' the' remaining' with'158'min'for'the'control'animals.'The'
glycogen' reserves' (Costill' et' al.,' 1977;' augmentation' of' endurance' performance'
Hickson'et'al.,'1977);'in'part'also'because' was' judged' too' large' to' attribute' simply'
a'decrease'of'body'fat'reduces'body'mass' to'the'decrease'in'body'mass.'Dohm'et'al.'
and' thus' the' energy' cost' of' displacing' (1983)' suggested' that' glycogen' sparing'
both' the' limbs' and' the' entire' body' from'an'increased'level'of'circulating'fatty'
(Brown,' 1966).' If' there' is' any' such' acids'might'also'have'been'a'contributing'
benefit,' it' seems' more' apparent' in' factor.' The' earlier' data' of' Uyeno' and'
laboratory' animals' than' in' human' Graham' (1965)' support' these' findings;'
subjects.' they'showed'an'increased'swimming'time'
' in'fasted'rats;'gains'were'seen'within'6'hr'
Short@term9fasting9(12@369hr)9 of'food'deprivation,'and'surprisingly'were'
Over'the'first'12<36'hr'of'fasting,'much' still'present'after'3'd'without'food.'
of' the' energy' needed' by' a' person' who' is' In' contrast' with' these' animal'
resting' is' found' from' a' depletion' of' experiments,' human' data' have'
glycogen' reserves,' and' there' is' a' consistently' shown' a' negative' effect' of'
relatively'limited'usage'of'protein'and'fat' fasting' upon' endurance' performance,'
stores.'The'early'decrease'of'body'mass'is' possible' contributing' factors' including' a'
also' relatively' small,' reflecting' the' loss' of' motivation' and' a' decrease' in' the'
metabolism' of' <1' kg' of' stored' food,' and' plasma'alkaline'reserve.'Loy'et'al.'(1986)'
the' loss' of' up' to' 2' kg' of' body' water' tested'competitive'cyclists'at'79%'or'86%'
associated' with' stored' molecules' of' of' their' maximal' oxygen' intake.' Initial'
glycogen' (Shephard,' 1982).' At' this' stage,' muscle' glycogen' stores' were' unchanged'
a' decrease' of' blood' glucose' may' impair' by' 24' h' of' fasting,' but' plasma' free' fatty'
cerebral' function' and' have' a' negative' acid' levels' were' increased,' thus'
effect' upon' motivation.' Moreover,' the' potentially' sparing' carbohydrate' usage'
depletion'of'glycogen'reserves'is'likely'to' during'the'test'exercise.'Nevertheless,'the'
have' an' adverse' effect' upon' sustained' or' time' over' which' the' required' pedal'
repeated' muscular' contractions' and' the' cadence' could' be' maintained' was'
endurance' of' sustained' sub<maximal' drastically' shortened' with' fasting,' from'
aerobic'activity.' 115'to'42'min'at'86%'of'maximal'aerobic'
Empirical' observations' during' short< power,' and' from' 191' to' 142' min' at' 79%'
term' fasting' have' looked' mainly' at' of'maximal'aerobic'power.''
changes'in'the'endurance'of'sub<maximal' Dohm' et' al.' (1986)' tested' 9' well<
aerobic' exercise' (Table' 1).' There' is' less' conditioned' young' men' after' 23' hr' of'
likelihood'of'a'decrease'in'motivation'due' total' fasting.' They' noted' that' this' period'
to' a' decrease' in' blood' glucose' levels' in' of'food'deprivation'was'associated'with'a'
animals' than' in' humans.' Dohm' et' al.' small' decrease' (7.7%)' in' the' duration' of'


treadmill' running' at' 70%' of' maximal' (2010)' found' that' 12' hr' of' fasting' was'
oxygen'intake,'with'an'increased'rating'of' sufficient' to' cause' a' decline' in' functional'
perceived' exertion' after' 60' min' of' reach' and' the' ability' to' balance' on' a'
running,' and' increased' plasma' levels' of' single' limb' (whether' the' eyes' were'
free'fatty'acids'and'beta<hydroxybutyrate.' opened' or' closed).' They' linked' these'
Under' fasting' conditions,' the' respiratory' changes'to'other'typical'manifestations'of'
gas'exchange'ratio'indicated'a'substantial' hypoglycaemia' (loss' of' coordination,' a'
increase' of' fat' usage' during' the' first' half' staggering' gait,' fatigue,' disorientation,'
of'the'sub<maximal'exercise'period.'''' dizziness' and' vertigo),' although' they' did'
Gleeson' et' al.' (1988)' compared' times' not' make' any' specific' measurements' of'
to'exhaustion'in'6'young'men'pedalling'a' blood'glucose'concentrations.''
cycle'ergometer'at'100%'of'their'personal' 9
maximal' oxygen' intake;' times' were' Medium@term9fasting9(3@109d)'
significantly' shorter' after' a' 24<hour' fast' As' in' short<term' fasting,' periods' of' 3<
(212' s.)' than' when' they' were' eating' a' 10' days' without' food' have' very' different'
normal' diet' (243' s).' During' fasting,' the' effects' in' animals' and' in' humans.' Loy' et'
pre<exercise'bicarbonate'and'base'excess' al.' (1986)' found' that' the' swimming' time'
were' also' reduced,' and' blood' levels' of' to' exhaustion' was' increased' in' rats' after'
glycerol,' free' fatty' acids' and' beta< 3' d' of' food' deprivation.' This' confirmed'
hydroxybutyrate' were' increased.' The' earlier'observations'on'rats'that'had'been'
deterioration' of' performance' was' thus' forced' to' exercise' to' exhaustion' in'
thought'due'mainly'to'a'worsening'of'the' activity'cages'during'periods'of'starvation'
pre<exercise' acid/base' status' during' (Samuels,' Gilmore' and' Reinecke,' 1948).'
fasting' (Greenhaff' et' al.,' 1987a,' b),' Likewise,' Young' (1959)' found' that' in'
although' there' may' also' have' been' some' dogs,' the' time' to' exhaustion' during'
effects'from'a'decrease'of'motivation.'' treadmill' running' was' increased' even'
A' 36<hour' fast' (Maughan' and' Gleeson,' after' 5' d' without' food.' One' factor'
1988)' reduced' the' cycle' ergometer' contributing' to' the' increased'
endurance' time' at' 70%' of' maximal' performance'of'the'experimental'animals'
oxygen'intake'from'120'to'78'min,'despite' during' these' several' studies' of' sustained'
increased'plasma'levels'of'free'fatty'acids.' fasting'was'a'substantial'decrease'of'body'
None'of'the'group'became'hypoglycaemic,' mass.''
despite' the' likely' depletion' of' hepatic' In' contrast' to' the' response' seen' in'
glycogen' stores,' and' none' reached' high' animals,' fasting' humans' typically' show' a'
blood' lactate' levels.' In' this' study,' one' reduced' absolute' maximal' oxygen' intake'
controversial'factor'that'was'suggested'as' or' peak' aerobic' power' (measured' in'
contributing'to'the'impaired'performance' Lmin<1),' a' shortening' of' the' endurance'
during' fasting' was' a' fall' of' branch< time' during' sustained' submaximal'
chained' plasma' amino' acids,' with' aerobic' effort,' and' in' some' instances'
resulting' alterations' in' brain' tryptophan' decreased' isokinetic' muscle' strength.'
levels'and'central'fatigue.' Factors' differentiating' these' responses'
There' has' been' only' limited' from' those' of' animals' may' include' a'
examination'of'the'impact'of'fasting'upon' greater'loss'of'motivation'in'humans,'and'
the' various' components' of' cerebral' a' lesser' compensation' of' the' fluid' and'
function.' However,' Johnson' and' Leck'


mineral' losses' associated' with' a' explanation' of' the' unchanged' maximal'
metabolic'ketosis'(Young,'1959).'' aerobic'power.'
Gutirez' et' al.' (2001)' fasted' 8' young' Lategola' (1965)' observed' a' 31.6%'
men' for' 3' d.' This' led' to' a' decrease' of' decrease' of' the' absolute' maximal' oxygen'
physical' working' capacity' at' a' heart' rate' intake' (Lmin<1)' over' a' 7<d' fast,' although'
of'170'bpm'(the'loss'of'working'capacity' this' effect' was' slightly' attenuated' by' the'
was' similar' whether' the' subjects' rested' 10th' day' of' fasting.' However,' as' in' the'
or' exercised' during' their' fast);' however,' study' of' Henschel,' Taylor' and' Keys'
they' observed' no' changes' in' handgrip' (1954),' the' relative' aerobic' power'
force' or' perception<reaction' time.' The' (mLkg<1min<1)' and' treadmill' endurance'
body' mass' decreased' by' 3.5' kg' over' the' times' showed' no' significant' change'
3<d' study,' but' muscle' mass' decreased' by' during' the' fast.' In' the' same' study,' there'
only'0.5%,'and'body'fat'by'0.4%,'so'much' was' a' small' decrease' of' handgrip'
of' the' 3.5' kg' loss' must' have' reflected' a' strength,' statistically' significant' at' 9.3%'
decrease'in'the'fluid'content'of'the'body.'' ' by'the'9th'day'of'fasting'(Consolazio'et'al.,'
Knapik'et'al.'(1987)'studied'the'effects' 1967).''
of'a'3.5<d'total'fast'in'8'young'men.'There' As' in' shorter' periods' of' starvation,'
were'no'changes'in'the'endurance'of'cycle' effects' upon' cerebral' function' have'
ergometry' at' a' relatively' low' intensity' of' received' only' limited' attention,' although'
effort' (45%' of' maximal' oxygen' intake).'' Taylor'et'al.'(1945)'noted'a'deterioration'
The' anaerobic' power' and' isometric' of' motor' speed' and' coordination' in'
strength' of' the' torso' and' handgrip' also' subjects' who' were' required' to' exercise'
remained' unchanged,' but' a' small' for'3'h'15'mind<1'during'a'fast'that'lasted'
decrement' of' isokinetic' elbow' flexion' for'2.5'd.''
strength' was' seen' at' two' speeds' of' There' are' numerous' hormonal' effects'
rotation'(11%'at'0.52'rads<1,'and'8.6%'at' of' total' fasting' that' may' influence' the'
3.14'rads<1).' availability' of' metabolites,' the' rate' of'
In' a' study' where' 12' participants' tissue' breakdown' and' the' individual's'
engaged' in' substantial' physical' work' tolerance' of' ketosis.' In' particular,' the'
during' 5' d' of' fasting' (walking' at' 5.6'''' normal' secretory' bursts' of' growth'
kmh<1,' 10%' grade' for' 3' h' 15' mind<1),' hormone' are' augmented' in' both' number'
Henschel,'Taylor'and'Keys'(1954)'noted'a' and' amplitude' after' 2' d' of' fasting'
7.7%' decrease' of' absolute' maximal' (Hartman' et' al.,' 1992).' Following' a' 4<d'
aerobic' power' (Lmin<1)' over' 5' d' of' fast' non<obese' individuals' also' show' a'
fasting.' Scores' for' the' Harvard' fitness' decrease' in' secretions' of' insulin' and'
index'also'showed'a'substantial'decrease' insulin<like' growth' factor' 1' (Bang' et' al.,'
by'Day'4'of'the'fast,'although'the'relative' 1994),' thus' encouraging' the' release' of'
maximal' aerobic' power' (mLkg<1min<1)' amino' acids' from' muscle' for'
remained' unchanged' throughout' the' gluconeogenesis' (Pozefsky' et' al.,' 1976)'
study.' The' authors' concluded' that' an' and' decreasing' the' anabolic' response' to'
acidosis' was' responsible' for' much' of' the' any'sort'of'muscle'training.'
deterioration' in' performance' during' '
fasting;' however,' the' 5.5' kg' decrease' of' '
body' mass' would' seem' a' more' plausible' '


Table! 2:! Main! changes! of! physical! related' to' a' loss' of' sub<cutaneous' fat).'
performance! seen! in! Minnesota! starvation! Clinical' examination' showed' ankle'
experiment! (24%! loss! of! body! mass! over! 24!
oedema' and' an' accumulation' of' fluid' in'
Decline' in' oxygen' cost' of' walking' at' 5.6' the' knee' joints,' suggestive' of' a' decrease'
kmh<1,' proportional' to' decrease' in' body' in'plasma'proteins.!
mass.' The'course'of'weight'loss'was'carefully'
Harvard'Fitness'Test'Scores:'control'64;'12' documented' (Table' 2).' On' average,' the'
wk'33;'24'wk'18' men' lost' 16.8' kg' ' (24%' of' their' body'
Duration' of' run:' control' 242' sec;' 12' wk'
mass)' over' the' 24' wk.' Specific' gravity'
Decrease'of'heart'volume' measurements' suggested' that' 6.5' kg' of'
22%'decrease'of'red'cell'count' the' total' loss' was' fat;' some' of' the'
Decrease' of' maximal' oxygen' intake' and' remainder' was' likely' water,' but' 9<10' kg,'
grip' strength' when' 12<16%' loss' of' body' or' about' a' third' of' the' subjects'' initial'
mass.' lean' tissue' mass' was' also' metabolized.'
! Decreases' in' limb' circumference' were'
Severe!food!deprivation! consistent'with'such'losses.'However,'the'
The9Minnesota9starvation9study''! plasma' volume' showed' only' a' small'
Ancel' Keys' and' his' colleagues' (1950)' decrease.' There' was' also' a' 56%' increase'
made' a' very' thorough' evaluation' of' the' in' extracellular' fluid' volume,' and' since'
physiological' effects' of' prolonged' semi< the' abdominal' circumference' showed'
starvation'(24'wk)'in'experiments'upon'a' relatively' little' change,' an' intra<
panel'of'36'moderately'active'and'healthy' abdominal' accumulation' of' ascitic' fluid'
conscientious' objectors' during' and' may' be' presumed,' again' probably' a'
immediately'following'World'War'II.'! reflection' of' low' plasma' protein'
The' initial' body' fat' stores' of' their' concentrations.'!
subjects' averaged' 9.6' kg.' ' At' least' one' The' changes' of' performance'
member' of' the' group' failed' to' comply' developing' during' the' severe' restriction'
with' the' dietary' restrictions' that' were' of' food' intake' were' much' as' would' be'
imposed,' and' information' on' this' predicted'from'the'studies'of'total'fasting'
individual' was' excluded' from' the' final' (Table' 2).' As' the' fast' continued,' the'
data' analyses.' During' the' 24<week' trial,' oxygen' cost' of' sub<maximal' treadmill'
the'subjects'were'given'a'very'limited'diet' walking'at'a'speed'of'5.6'kmhr<1'declined'
of' the' type' that' might' be' anticipated' in' almost' direct' proportion' to' the'
under' famine' conditions' (mainly' decrease' of' body' mass.' One' measure' of'
potatoes,' rutabagas,' turnips,' bread,' and' the' decline' in' aerobic' performance' was'
macaroni).'The'total'intake'of'food'energy' the'score'obtained'on'a'treadmill'version'
was'reduced'from'a'normal'figure'of'14.5' of' the' Harvard' Fitness' Test.' For' this' test,'
to' 6.5' MJd<1.' In' addition' to' any' required' subjects' were' required' to' run' at' 11.3'
laboratory' exercise' tests,' the' subjects' kmhr<1,' 8.6%' grade,' and' an' arbitrary'
continued'to'undertake'about'15'h'of'light' score'of'50'T/SP'was'calculated,'where'T'
housekeeping' per' week,' as' their' physical' was' the' duration' of' the' run' (in' seconds),'
condition' allowed.' Subjective' complaints' and' SP' was' the' sum' of' 3' recovery' heart'
included' feelings' of' hunger,' and' in' a' rates' (counted' between' 1<1.5,' 2<2.5,' and'
number' of' individuals' there' was' also' an' 4<4.5' min' post<exercise).' The' tolerated'
enhanced' sensitivity' to' cold' (probably' length' of' run' decreased' from' an' initial'


242'sec'to'106'sec'at'12'wk,'and'50'sec'at' during'food'deprivation,'and'many'of'the'
24' wk' of' food' restriction,' while' the' tests' showed' no' consistent' difference'
respective' Harvard' fitness' test' scores' between' controls' and' those' undergoing'
were' 64,' 33' and' 18' (Buskirk,' 1957).' The' semi<starvation.'!
maximal' aerobic' power' (measured' in' Data' on' maximal' oxygen' intake' were'
Lmin<1)' also' showed' a' substantial' obtained' on' a' few' subjects.' The'
deterioration' by' the' time' that' the' body' reductions' in' maximal' oxygen' intake' in'
mass'had'decreased'by'12<16%'(Taylor'et' absolute' units' (Lmin<1)' were' for' acute'
al.,' 1957).' Furthermore,' the' heart' size' as' starvation' (4.5' d)' 7.5%,' for' severe' food'
seen' in' PA' radiographs' decreased' over' restriction' (2.41' MJd<1' for' 12' d)' 4.1%,'
the'experiment,'and'there'was'also'a'22%' and' for' prolonged' but' more' moderate'
decrease'in'the'red'cell'count.'! food' restriction' (4.2' MJd<1' for' 180' d)'
In' terms' of' muscular' performance,' 37.3%' (Buskirk,' 1957).' However,' as' in'
there' were' large' decrements' of' handgrip' the' other' studies' noted' above,' the'
force' and' a' marked' deterioration' in' maximal' aerobic' power' per' unit' of' body'
coordination' as' fasting' continued' mass' remained' unchanged' throughout.''
(Broek,' 1955;' Broek' et' al.,' 1946).' Some'acidosis'and'dehydration'developed'
Scores' on' a' back<lift' dynamometer' had' with' prolonged' food' restriction,' but' the'
decreased' by' 16%' at' 12' wk' and' 31%' at' heart' rate' when' walking' at' 5.6' kmhr<1'
24' wk;' decreases' of' handgrip' at' 12' and' was' actually' less' than' in' the' control'
24' wk' were' 22%' and' 40%,' respectively.'' period'(Buskirk,'1957).'!
Clinical' observations' also' suggested' Finally,'studies'in'patients'with'chronic'
deterioration' in' the' patellar' reflex' (Keys' malnutrition' due' to' gastro<intestinal'
et' al.,' 1950),' and' pattern' tracing' ability' disorders' or' deliberate' dieting' have'
was' impaired,' although' tapping' speeds' shown' an' increased' response' of' the'
showed' little' change.' Finally,' as' the' adductor' pollicis' to' electrical' stimulation'
experiment' progressed,' there' were' of' the' ulnar' nerve,' with' a' slowing' of'
marked' personality' changes,' particularly' muscular' relaxation,' and' a' decrease' of'
an' increase' of' apathy' and' introversion;' muscular'endurance'(Lopes'et'al.,'1982).'!
such' changes' could' certainly' have' a' !
negative' effect' upon' scores' in' tests' Inadequate!fluid!intake!
requiring'maximal'subject'cooperation.! Fluid' requirements' depend' largely'
9 upon'the'individual's'rate'of'sweating,'as'
Other9studies9of9severe9food9deprivation! determined'by'the'volume'of'activity'that'
Further' studies' of' severe' food' is' being' performed,' and' environmental'
deprivation' have' been' conducted' on' conditions' of' temperature,' humidity' and'
military' volunteers.' In' 1953,' subjects' wind' speed.' The' impact' of' a' given' sweat'
were'restricted'to'a'diet'of'2.41'MJd<1' for' loss' upon' athletic' performance' depends'
12' d,' and' in' 1955' to' 4.2' MJd<1' for' 24' d' also'on'the'extent'to'which'intramuscular'
(Taylor' et' al.,' 1957).' In' contrast' to' the' glycogen'is'depleted;'the'release'of'bound'
earlier' experiments' on' the' conscientious' water' from' glycogen' can' in' some'
objectors,' the' observers' in' the' military' circumstances' contribute' as' much' as' 2%'
trial' considered' that' apprehension' and' to' the' overall' pool' of' body' fluids'
loss'of'motivation'contributed'to'the'poor' (Shephard,'1982).'!
and' variable' performance' of' the' soldiers'


dehydration! Dehydration!
Author! Variable! Reported!change!
(%!body! Method!
Bigard'et'al.'(2001)'' 2.95%' Knee'extension'strength' No'change'of'strength,'trend'to'faster' Sauna'
and'endurance' fatigue'
Bijlani'&'Sharma' 2<3%' Forearm'extension' Reduced'endurance'at'3%' Heat'
Bosco'et'al.'(1968)'' 2.5%' Maximal'isometric' Strength/mass'ratio'decreased,'11%' Water'deprivation'
strength' decrease'in'strength'
Caterisano'et'al.' 3.0%' Cybex'muscular' Decrease'in'inactive'and' Sauna'
(1988)'' endurance' anaerobically'trained,'but'not'in'
Evetovich'et'al.' 2.9%' Maximal'&'sub<maximal' No'significant'change' Water'deprivation'
(2002)''' isometric,'isokinetic'
Fogelholm'et'al.' 5<6%' Sprint'and'1'min' Unchanged'performance' Combination'of'
(1993)'' anaerobic'test' techniques'
Greenleaf'et'al.' 3.3%' Maximal'isometric' No'significant'change'elbow'flexion' Exercise/heat''
(1967)'' strength'(female)' or'knee'extension'
Greiwe'et'al.'(1998)'' 3.8%' Isometric'strength'of' No'significant'change' Sauna'
Gutirrez'et'al.' 1.8%'(men)' Rowing'&'handgrip' No'effect'in'men;'decrease'of'squat' Sauna'
(2003)'' 1.4%' strength,'squat'&' jump'in'women'after'rehydration'
(women)' counter<movement'
Hayes'&'Morse' 1.0,'2.6%' Isometric,'isotonic'leg' Isometric'force'reduced'at'1%,' Exercise/heat'
(2010)'' torque,'vertical'jump' isokinetic'torque'reduced'at'2.6%,'no'
Hickner'et'al.'(1991)'' 4.0%' Isometric'arm'cranking' 4.5%'decreased'power' Combination'of'
Hoffman'et'al.'(1995)'' 1.9%' Squat'&'counter< No'significant'changes' Exercise/water'
movement'jumps,'30' deprivation'
Houston'et'al.'(1981)'' 4.5%' Isokinetic'knee' 10.5<11.5%'decrease'at'speeds'of'30< Combination'of'
extension' 300'degreess<1' techniques'
Judelson'et'al.'(2008)'' 5.0%' Squat'performance' No'change' Heat/water'
Kraemer'et'al.'(2001)'' 6.0%' Isometric'&'isokinetic' 11.4%'decrease'of'handgrip'force,' Combination'of'
strength' decrease'of'isokinetic'force'in' techniques'
Montain'et'al.'(1998)'' 4.2%' Knee'extension' Strength'unchanged,'time'to' Exercise/heat'
Priard'et'al.'(2012)'' 3.2%' Knee'extensors' No'change'of'isometric'strength'or' Exercise/heat'
Saltin'(55)' 3.8%' Isometric'strength' No'significant'change' Exercise/heat'
Saltin'(1964)' 3.8%' Isometric'strength' No'significant'change' Sauna'
' elbow'flexors,'knee'
Schoffstall'et'al.' 1.5%' IRM'bench'press' 5.6%'decrease' Sauna'
Serfass'et'al.'(1984)'' 5.0%' Isometric'and'isokinetic' No'change'in'performance' Combination'of'
tests'on'biceps' techniques'
Viitsalo'et'al.'(1987)' 3.4%;'3.8%' Vertical'jump'' Improved'performance' Sauna,'diuretic'
Watson'et'al.'(2005)'' 2.0%' 100,'200,'400'm'sprints,' No'changes' Furosemide<
vertical'jump' induced'
Webster'et'al.'(1990)'' 4.9%' Peak'torque,'average' Decreased'performance'in'upper' Exercise'in'sweat'
work'per'repetition' limb,'no'change'lower'limb' suit'


The' minimum' fluid' need' has' been' Caldwell' and' associates' (1984)' tested'
estimated' at' about' 250' mL' per' kJ' of' a' group' of' boxers,' wrestlers' and' judoku.'
energy' expended.' Most' experimental' After'a'diuretic<induced'3.1%'loss'of'body'
studies' of' fluid' deprivation' have' been' of' mass,' they' observed' a' 2.9%' decrease' of'
relatively' short' duration;' possibly,' the' maximal'oxygen'intake'and'the'work<rate'
body' may' make' some' adaptations' to' during' maximal' exercise' was' also'
longer' periods' of' water' deprivation.' decreased;'a'weight'loss'achieved'in'24'hr'
Empirical' data' show' a' consistent' or'less'by'use'of'a'sauna'or'diuretics'was'
deterioration' of' aerobic' performance' as' more' detrimental' to' performance' than' a'
fluid'is'restricted,'and'muscle'force'is'also' loss' that' developed' over' 48' hr.' Webster'
reduced'with'more'extensive'fluid'loss.! et' al.' (1990)' also' found' a' 6.7%' decrease'
9 of'peak'oxygen'intake'with'a'4.9%'weight'
Aerobic9performance! loss.''!
The' endurance' of' sustained,' sub< Saltin' (1964a)' found' no' change' of'
maximal' aerobic' effort' commonly' maximal' aerobic' power' when' 5%'
deteriorates' if' any' type' of' fluid' dehydration' was' induced' by' a' period' of'
deprivation'or'loss'causes'the'body'mass' sauna' exposure,' but' subjects' did' show' a'
to'decrease'by'>2%;'both'running'speeds' substantial'decrease'of'endurance'during'
and' times' to' exhaustion' are' decreased' submaximal' effort.' During' submaximal'
(Buskirk' et' al.,' 1958;' Craig' and' effort,' heart' rates' were' also' higher' with'
Cummings,' 1966;' Kozlowski,' 1966;' dehydration'(Saltin,'1964b).''!
Webster' et' al.,' 1990;' Walsh' et' al.,' 1994;' Two' studies' found' no' adverse' effects'
Fritzsche' et' al.,' 2000;' Cheuvront' et' al.,' upon' physical' performance' from' 3.3%'
2003,'2007;'Casa'et'al,'2005).'! dehydration.'Penkman'et'al.'(2008)'found'
A' 1.6<2.1%' diuretic<induced' no' change' in' the' outcome' of' a' 2000' m'
dehydration'was'sufficient'to'increase'the' rowing' event,' and' Greenleaf,' Prang' and'
times' for' performance' of' 5,000' and' Averkin'(1967)'observed'no'change'in'the'
10,000' m' runs' by' 8' and' 6%' respectively' scores'on'a'Harvard'Fitness'test'following'
(Armstrong' et' al.,' 1985);' an' increased' dehydration.''
cardiovascular' strain,' an' impaired' 9
thermoregulation' and' metabolic' Muscular9performance9
disturbances' may' all' have' contributed' to' There' is' general' agreement' that'
a' decrease' of' performance' over' such' substantial'dehydration'can'have'adverse'
distances.' ' Nadel' and' colleagues' (1980)' effects' upon' muscular' performance'
noted' that' with' 2.2%' diuretic<induced' (Fogelholm,' 1994;' Judelson' et' al.' (2007),'
dehydration,' the' cardiac' stroke' volume' although' there' remains' a' need' to' clarify'
during'exhausting'exercise'was'decreased' the'critical'amount'of'dehydration'needed'
by' an' average' of' 17' mLbeat<1' (about' for' a' significant' functional' limitation'
15%).! (Table' 3).' ' One' review' concluded' that'
Yoshida'et'al.'(2002)'tested'4'differing' hypohydration' could' decrease' strength'
levels'of'dehydration,'induced'by'exercise' by' 2%,' muscular' power' by' 3%,' and' high'
in' the' heat;' in' their' study,' scores' on' a' intensity' endurance' by' as' much' as' 10%'
Harvard'fitness'test'were'decreased'with' (Judelson' et' al.,' 2007).' The' consensus' of'
2.5%'dehydration.! one'recent'review'(Kraft'et'al.,'2012)'was'


torque' were' unchanged' up' to' 4%' there'changes'in'scores'for'sit<ups,'push<
dehydration,' but' that' the' torque' during' ups,'and'100'yard'and'400'yard'runs.'9
slower' contractions' was' impaired' with' Furosemide<induced' dehydration' (a'
>2%' dehydration.' However,' individual' 2.2%'decrease'of'body'mass)'did'not'alter'
responses' differ,' depending' on' the' the' performance' of' sprinters' in' 50,' 200'
method' of' dehydration,' other' possible' and' 400' m' races,' nor' did' it' change' their'
associated' stressors' such' as' prolonged' vertical' jump' heights' (Watson' et' al.,'
exercise,' heat' exposure' or' food' 2005),' although' in' all' of' these' and' other'
restriction,'and'alleviating'factors'such'as' jumping' events' a' smaller' body' mass' was'
high'initial'fluid'reserves'(Table'3).'' being'propelled'after'dehydration.'Others,'
Individual' studies' confirm' the' also,'have'found'no'change'of'jump'height'
impression'that'losses'of'performance'are' with' a' rapid' 1.8<2%' dehydration'
larger' for' power' and' endurance' than' for' (Hoffman' et' al.,' 1995;' Gutirrez' et' al.,'
isometric'strength.'Serfass'and'associates' 2003),' and' jump' performance' has' even'
(1984)' found' no' deterioration' of' been' improved' with' a' 3<6%' decrease' in'
handgrip' force' or' ability' to' make' 180' body'mass'(Viitasalo'et'al.,'1987).'9
repeated' contractions' in' wrestlers' after' A' few' studies' have' found' changes' in'
dehydration' equal' to' 5%' of' body' mass.' isometric' performance.' Thus,' Hickner' et'
Judelson' et' al.' (2008)' also' found' no' al.' (1991)' observed' a' decreased' power'
deterioration' of' back<mounted' squat' output'on'an'isometric'arm<cranking'test'
performance,' even' with' 5%' dehydration.' with'4.5%'dehydration.'Hayes'and'Morse'
However,' there' were' substantial' (2010)' produced' dehydration' by' jogging'
hormonal' changes,' including' increased' in' the' heat;' no' deterioration' was' seen' in'
levels'of'cortisol'and'noradrenaline,'and'a' vertical' jump' height' or' isokinetic' leg'
reduced' testosterone' response' to' extension' at' a' rotation' speed' of' 120'
exercise.'' degreess<1' s,' but' isokinetic' extension'
Evetovich' et' al.' (2002)' found' no' torque' at' 30' degreess<1' was' impaired' by'
deterioration' in' maximal' or' submaximal' >2.6%' dehydration,' and' isometric' leg'
isometric'or'isokinetic'performance'of'the' extension' was' impaired' with' >1%'
biceps'with'2.9%'dehydration.'Even'4.2%' dehydration.'Bosco'et'al.,'(1968)'also'saw'
dehydration' had' little' effect' on' knee' a' decline' of' maximal' isometric' strength'
strength;'in'contrast,'muscular'endurance' with' dehydration,' probably' related' to'
was' reduced' by' 15%,' although' a' part' of' electrolytic' disturbances' within' the'
this'loss'could'reflect'a'loss'of'motivation' muscle' cytoplasm.' ' Further,' the' time' to'
and'central'drive'(Montain'et'al.,'1998).' muscular'exhaustion'and'the'tolerance'of'
Webster' and' co<workers' (1990)' repeated' muscular' efforts' was' also'
observed'a'decrease'in'upper'limb'but'not' impaired'with'>2%'dehydration'(Kraft'et'
lower'limb'torque'with'4.9%'dehydration.' al.,'2012).'9
In' one' of' the' few' studies' of' female' 9
subjects,'Greenleaf'and'colleagues'(1967)' Anaerobic9power9and9capacity9
tested' young' women' following' a' 3.2%' Some' authors' have' found' no' effect' of'
dehydration'induced'by'a'combination'of' fluid' deprivation' upon' anaerobic' power'
exercise'and'heat;'there'were'no'changes' and' capacity.' Others' have' seen' some'
in' maximal' isometric' force' of' knee' impact,' but' nevertheless,' the' fluid' deficit'
extension' or' elbow' flexion,' nor' were' needed' to' influence' anaerobic' function'


has' been' larger' than' that' needed' for' a' Cerebral9function9
decrease' of' aerobic' power,' probably' in' Cognitive' performance' (particularly'
the'range'3<4%'(Kraft'et'al.,'2012).''9 motivation' to' maximal' effort)' begins' to'
In' one' trial,' a' 2.7%' decrease' of' body' deteriorate' with' a' cumulative' fluid' loss'
mass' had' no' effect' on' anaerobic' power,' decreasing' body' mass' by' >2%' (Murray,'
anaerobic'capacity'or'the'fatigue'index'as' 2007).' Degoutte' et' al.' (2006)' examined'
measured'by'the'Wingate'test'(Cheuvront' the' cerebral' effects' of' combined' weight'
et' al.,' 2006).' Other' authors' found' that' loss.' Judoku' were' asked' to' restrict' the'
scores'on'a'30's'Wingate'test'of'anaerobic' intake'of'food'and'fluid'in'order'to'reduce'
power' and' capacity' were' unchanged' by' their' body' mass' by' 5%' in' the' week'
thermal' dehydration' of' as' much' as' 5%' preceding' competition.' Compared' to'
(Jacobs,' 1980;' Hoffman' et' al.,' 1995).' competitors' who' maintained' their' body'
However,' Webster' et' al.,' (1990)' noted' a' mass,'food'intake'was'reduced'by'some'4'
21%' decrease' of' anaerobic' power' and' a' MJd<1,' and' the' Profile' of' Mood' States'
10%'decrease'of'anaerobic'capacity'when' questionnaire'showed'a'loss'of'vigor,'with'
wrestlers'reduced'their'body'mass'by'5%' increases'of'fatigue'and'tension'and'a'5%'
over' 36' hr;' in' their' study,' the' anaerobic' decrease' in' hand<grip' force.' Greater'
test' continued' for' 40' rather' than' 30' s.' dehydration' impairs' cerebral' blood' flow,'
Likewise,' Jones' et' al.' (2008)' found' that' with' impairment' of' coordination' and'
3.1%' dehydration' reduced' the' peak' eventual'loss'of'consciousness'(Shephard,'
anaerobic' power' by' 14.5%' in' the' upper' 1982).'9
body' and' 19.2%' in' the' lower' body.' 9
Yoshida' et' al.' (2002)' tested' 4' differing' Other9adverse9effects9
levels'of'dehydration,'induced'by'exercise' Other' adverse' effects' of' exercising'
in' the' heat' with' partial' fluid' deprivation;' while' dehydrated' include' an' increase' of'
they'concluded'that'anaerobic'power'was' oxidant' stress' that' could' potentially'
decreased' with' 3.9%,' but' not' with' 2.5%' increase'muscular'soreness,'seen'with'3%'
dehydration.' Times' for' both' 5' and' 10' m' depletion'of'water'(Paik'et'al.,'2009),'and'
dashes' were' also' increased' with' 3%' a' deterioration' in' some' aspects' of'
dehydration'(Magal'et'al.,'2003).'9 immune' function,' particularly' a' slowing'
9 of' lymphocyte' proliferation' rates'
Thermoregulation9 (Penkman'et'al.,'2008)'that'could'increase'
Quite' small' decreases' in' body' fluids' susceptibility'to'infection.'''''9
have' adverse' effects' upon' the' body's' 9
capacity'for'thermoregulation'(Claremont' Time9needed9for9rehydration9
et' al.,' 1975;' Kovacs,' 2008),' probably' If' a' competitor' has' been' "making'
because' of' a' 27%' reduction' in' cardiac' weight,"' performance' is' commonly'
stroke' volume' and' a' 20%' reduction' in' restored' over' about' 5' hr' of' rapid'
skin'blood'flow;'there'was'no'evidence'of' rehydration,' but' there' may' be' a'
any' attenuation' of' sweating' when' persistent' 2%' deficit' of' body' mass,' and'
subjects' cycled' for' 2' hr' in' the' heat' this' can' lead' to' a' continuing' impairment'
without' fluid' replacement' (Montain' and' of'physical'working'capacity'(Herbert'and'
Coyle,'1992).9 Ribisl,' 1972).' A' full' recovery' from'
9 dehydration'can'take'as'long'as'24<36'hr,'
9 thus' potentially' leading' to' poor'


performance' on' the' part' of' athletes' who' party' from' the' U.S.' Army' spent' nearly' a'
attempt' a' rapid' rehydration' immediately' year' searching' the' arctic' tundra.' They'
after' completing' their' "weigh<in"' for' a' travelled' by' foot' and' by' dog' sled,'
weight<classified'sport.9 covering' a' distance' of' 4360' km' in' just'
! over' 11' months,' and' wintering' on' King'
The!issue!of!Ketosis9 William' Island.' They' had' no' sources' of'
The9classical9view9of9ketosis9 food' other' than' the' Inuit' diet' of' fish' and'
Many' nutritional' scientists' have' game' after' the' first' month' of' their'
argued' that' an' adequate' metabolism' of' journey.' Schwatka' commented'
carbohydrate' is' important' to' avoiding' (Stackpole,' 1965):' "When9 first9 thrown9
ketosis' and' thus' optimizing' physical' wholly9 upon9 a9 diet9 of9 reindeer9 meat,9 it9
performance.' Patients' following' low' seems9 inadequate9 to9 properly9 nourish9 the9
carbohydrate' diets' commonly' complain' system,9and9there9is9an9apparent9weakness9
of'weakness'and'early'fatigue.'The'classic' and9 inability9 to9 perform9 severe9 exertive9
studies'of'Christensen'and'Hansen'(1939)' fatiguing9 journeys.9 But9 this9 soon9 passes9
demonstrated' that' relative' to' a' high' away9in9the9course9of9two9or9three9weeks."''
carbohydrate' diet,' a' low' carbohydrate' At' the' end' of' the' year,' Schwatka' and' an'
intake' cut' the' time' to' exhaustion' on' a' Inuit' companion' remained' in' sufficiently'
cycle'ergometer'from'206'to'81'min.' good' condition' to' cover' the' final' 105' km'
9 of'their'trek'in'less'than'2'd.''
The9example9of9the9Inuit'9 9
The' lifestyle' of' the' traditional' Inuit' Laboratory9trials9of9a9ketotic9diet9
provides' an' interesting' exception' to' this' In' 1929,' the' Schwatka' observations'
classical' viewpoint,' since' they' have' were' replicated' in' the' laboratory,' with' a'
typically' engaged' in' a' very' high' level' of' subject'eating'a'diet'of'meat'and'fat'for'an'
daily' physical' activity' (Shephard' and' entire' year.' He' remained' in' apparently'
Rode,'1996)'despite'having'access'to'little' good' health' throughout' this' period'
or' no' dietary' carbohydrate' during' their' (McLellan' and' Dubois,' 1930;' McLellan,'
hunting' expeditions' (Phinney,' 2004).' Rupp,' and' Toscani,' 1930).' A' recent' and'
Possibly,'their'adaptation'to'a'protein/fat' more' sophisticated' study' of' a' ketogenic'
diet' has' been' helped' by' an' increased' diet' was' conducted' in' a' metabolic' ward.'
intake' of' salt' from' the' drinking' of' The' participants' received' 1.2' g' protein'
brackish' water' and' the' ingestion' of' per' kg' of' body' mass' each' day,' and'
caribou'blood'(which'itself'has'a'high'salt' essentially' lived' off' their' reserves' of' fat'
content)(Phinney,'2004).'9 for' a' 6<week' period' (Phinney,' 2004).'
9 During'repeated'treadmill'testing,'a'back<
Adaptation9of9Europeans9to9a9ketotic9diet999 pack'was'adjusted'to'maintain'a'constant'
Europeans,' also,' can' develop' a' total' weight' of' body' mass' plus' pack.' No'
tolerance' to' a' fat' and' protein' diet' over' decline' of' maximal' oxygen' intake' was'
the' course' of' several' weeks.' The' U.S.' seen'over'the'6<week'study.'9
Schwatka' expedition,' organized' between' A'further'4<week'experiment'(Phinney'
1878'and'1880'CE'to'seek'evidence'of'the' et' al.,' 1983a,' b)' provided' well<trained'
ill<fated'Franklin'expedition'provides'one' cyclists' with' less' than' 20' g' of'
good' example' of' this' phenomenon.'' carbohydrate'per'day.'Their'carbohydrate'
Lieutenant' Frederick' Schwatka' and' a' oxidation' fell' by' 30%,' but' the' subjects'


maintained' a' normal' blood' glucose' negative' impact' upon' the' habitual'
concentration' throughout' the' study.' physical'activity'of'an'ordinary'individual'
Moreover,' they' showed' no' change' in' who' was' attempting' to' decrease' his' or'
either' their' maximal' oxygen' intakes' or' her' body' mass.' Bogardus' et' al.' (1981)'
their'endurance'times'when'cycling'at'62< examined' the' effects' of' a' very' low'
64%' of' maximal' oxygen' intake.' Tests' in' carbohydrate'diet'(<1%)'when'exercising'
elite' gymnasts' have' also' shown' no' at'75%'of'maximal'oxygen'intake;'in'this'
deterioration' of' performance' in' any' of' a' study,' there' was' a' 50%' decrease' of'
series' of' gymnastic' performance' tests' endurance'time'on'a'cycle'ergometer,'but'
(hanging' straight' leg' raise,' ground' push' this' could' reflect' either' a' physiological'
up,'parallel'bar'dips,'pull'up,'squat'jump,' change' such' as' the' reduction' in' glycogen'
countermovement' jump,' 30' sec' stores' or' a' decrease' in' motivation' of' the'
continuous' jumps)' after' 30' d' of' subjects'when'their'diet'was'restricted.9
consuming' a' high' protein' ketogenic' diet' 9
(Paoli'et'al.,'2012).'9 Two9important9caveats9
Other' reports' have' shown' varied' There' seem' two' important' caveats'
effects'of'a'high'ketone'diet,'ranging'from' with'respect'to'the'apparent'tolerance'of'
enhanced'through'unchanged'to'impaired' a' prolonged' ketotic' diet.' Firstly,' the'
physical' performance.' Brinkworth' et' al.' individual's' protein' intake' must' be'
(2009)' assigned' 60' middle<aged' obese' increased' sufficiently' (possibly' by' as'
individuals' to' a' 30%' energy' deficit,' an' much' as' 30<50' gd<1)' to' permit' adequate'
isoenergetic,' or' a' hyper<energetic' diet.' gluconeogenesis' without' a' progressive'
The' energy' deficit' diet' had' no' effect' on' breakdown' of' muscle' protein,' and'
maximal' or' sub<maximal' aerobic' activity' secondly,'because'intramuscular'glycogen'
or' muscle' strength' over' 30' d' of' dieting.' reserves' are' depleted,' one' must' accept'
Walberg' et' al.' (1988)' exposed' obese' that' the' ability' to' perform' sustained'
women' to' an' iso<nitrogenous' but' low' muscular' efforts' is' likely' to' be'
calorie'and'very'low'carbohydrate'diet'for' compromised.'9
4' wk;' study' participants' showed' a' As'the'body'adapts'to'a'ketotic'diet,'the'
decrease'in'body'mass'of'about'2'kgwk<1,' ketones'may'possibly'replace'some'of'the'
and' a' final' 12%' decrease' of' the' absolute' glucose' that' normally' provides' the' main'
maximal' aerobic' power,' measured' in' source' of' metabolites' for' the' brain'
Lmin<1,'but'no'change'of'relative'aerobic' (Bistrian,' 1978).' However,' if' the' total'
power,'measured'in'mLkg<1min<1.'Russell' intake' of' protein' is' deficient,' the'
et'al.'(1983)'assessed'muscle'function'by' development' of' ketosis' is' likely' to'
electrical' stimulation' of' the' adductor' increase' the' rate' of' protein' loss' relative'
pollicis'muscle.'After'2'wk'of'partial'and'2' to' dieting' with' a' non<ketotic' diet'
wk' of' complete' fasting,' there' was' an' (Vasquez' and' Adibi,' 1992).' ' If' protein'
increase' of' muscle' force,' a' slowing' of' intake' does' not' match' the' demands' of'
relaxation,'and'greater'fatigue.'White'and' augmented'gluconeogenesis,'there'will'be'
associates'(2007)'found'that'after'2'wk'of' a' progressive' loss' of' lean' tissue,' and' this'
a'low'carbohydrate,'low'calorie,'ketogenic' will' have' adverse' effects' upon' both'
diet,' the' perceived' fatigue' at' any' given' aerobic' and' muscular' activity,' as' seen' in'
intensity' of' exercise' was' increased,' and' the' starvation' experiments' of' Ancel' Keys'
they' argued' that' this' could' have' a' and' his' colleagues' (1950).' This' point' is'


well' illustrated' in' a' recent' experiment;' over' 24' wk' of' grossly' inadequate' food'
moderately' obese' women' with' a' daily' intake,' maximal' oxygen' intake,' the'
food' intake' of' 2.1' MJ,' a' carbohydrate' Harvard'Fitness'test'score,'the'duration'of'
intake' <10' gd<1' and' a' protein' intake' of' treadmill'running'and'handgrip'force'are'
1.5' g' per' kg' of' body' mass' showed' no' all' reduced,' with' a' decrease' in' red' cell'
significant' decrease' of' maximal' oxygen' count'and'radiographic'estimates'of'heart'
intake' when' their' body' mass' had' volume.' The' only' positive' effect' of' a'
decreased' by' 17' kg;' however,' a' parallel' limited' food' intake' is' a' decrease' in' the'
group' who' were' given' what' would' have' oxygen' cost' of' walking,' seemingly' due' to'
been' regarded' as' an' adequate' protein' a'decrease'in'body'mass.9
intake'if'they'were'not'dieting'(1.1'gkg<1)' Athletic'performance'is'also'vulnerable'
showed'a'15%'decline'of'maximal'aerobic' to' relatively' small' disturbances' of' fluid'
power' (Davis' and' Phinney,' 1990).' The' balance.' A' dehydration' of' 2%' is' often'
group' with' the' lower' protein' intake' also' sufficient' to' impair' aerobic' function,'
showed'a'13%'decrease'of'peak'isokinetic' thermoregulation' and' cerebral' function,'
force,'although'there'were'no'inter<group' although' larger' fluid' losses' (4<5%)' are'
differences' in' the' time' to' muscular' usually' needed' to' reduce' anaerobic'
fatigue'(Davis'and'Phinney,'1990).9 power,' anaerobic' capacity' and' muscular'
! performance.' Athletes' seeking' to' "make'
Practical!implications9 weight"' following' deliberate' dehydration'
Although' it' is' difficult' to' separate' may' require' 24' hr' to' achieve' full'
reduced'motivation'from'the'phyiological' rehydration' and' thus' a' recovery' of'
effects'of'fasting'and'dehydration,'if'there' performance.9
is'a'substantial'reduction'in'the'intake'of' Ketosis' is' associated' with' a' lack' of'
food'or'fluid,'there'are'generally'negative' dietary' carbohydrate,' but' this' seems' less'
implications' for' athletic' performance.' detrimental'to'physical'performance'than'
Where' possible,' athletes' should' thus' was' once' believed.' The' traditional' Inuit'
maintain' energy' and' fluid' balance,' and' population' can' sustain' high' daily' energy'
correct' any' deficit' as' rapidly' as' is' expenditures' very' well' on' a' diet' that' is'
practical.' Although' the' decrease' of' body' mainly' protein' and' fat,' and' Europeans'
mass'associated'with'fasting'can'increase' also' seem' capable' of' adapting' to' a' very'
the' tolerance' of' running' to' exhaustion' in' small' dietary' intake' of' carbohydrate.' ' As'
laboratory'animals,'in'humans,'even'brief' adaptation' develops,' the' brain' can'
periods' of' total' fasting' (24<36' hr)' metabolize' ketotic' products' thus' sparing'
generally' decrease' times' to' exhaustion' body'glucose'reserves.9
and' impair' sustained' muscular' Although'athletic'performance'is'likely'
contractions,'often'with'a'deterioration'in' to'be'less'than'optimal,'studies'of'athletes'
motor' coordination' and' balance.' Longer' observing' the' intermittent' fasting'
periods' of' fasting' (2.5<10' d)' reduce' the' required' by' Ramadan' have' not' to' date'
human' PWC170' and' the' maximal' oxygen' demonstrated' any' dangers' to' health,' and'
intake'(as'measured'in'Lmin<1,'but'not'in' changes' in' physical' performance' have'
mLkg<1min<1).' Some' studies' also' show' been' small' (Shephard,' 2012' a,' b).'
decreases' in' isokinetic' and' isometric' Potential'issues'include'a'reduced'period'
strength.' Further,' the' Minnesota' for' sleeping,' disturbances' of' circadian'
starvation' experiments' demonstrate' that' rhythm,'a'decrease'of'plasma'glucose'and'


fluid' reserves' in' the' afternoon' and' Further!Reading!
evening,' and' a' decrease' in' the' levels' of' Keys,' A.,' Broek,' J.,' Henschel,' A.,'
plasma'amino'acids'needed'for'an'optimal' Mickelson,'O.,'and'Taylor,'H.L.'(1950).'The9
training'response.'However,'most'of'these' biology9of9human9starvation.'Minneapolis,'
issues' can' be' circumvented' within' the' MN:'University'of'Minnesota'Press.''
requirements' of' Islam,' given' a' very' !
careful'regulation'of'food'and'fluid'intake' References!
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