{"publication_id":"60d2c379-d1f7-471e-9252-90414e695085","content_hash":"sha256:bb02d367f817adfd1776a3c4ffa8de862cf866f5336b03060e1482d5507eb286","nodes":[{"id":"60d2c379-d1f7-471e-9252-90414e695085","type":"publication","title":"Hypothesis-Generating Brief: Ramadan Fasting Effects"},{"id":"claim_1","type":"claim","text":"We conducted an AI-assisted structured evidence synthesis across 48 curated references, mapping each study to direct versus indirect evidence and to one of six outcome classes (cardiometabolic, immune, contextual-other, safety, muscle function, deficiency-prevalence), with an explicit audit trail retaining study-level direction-of-effect."},{"id":"claim_2","type":"claim","text":"Outside cardiometabolism, immune-class findings are themselves mixed: DEMIRCI 2023 reports an improvement in endothelial function in hypertensive patients after Ramadan (positive direction), whereas the Trabelsi 2022 narrative review (null direction) frames any immunological impact as inconsistent, a null vs positive tension that can be interpreted as partial rather than contradictory."},{"id":"claim_3","type":"claim","text":"The review is organized around the distinction between direct interventional hard-endpoint evidence, adjacent/review/context evidence, and mechanistic evidence so that biological plausibility is not confused with clinical certainty."},{"id":"claim_4","type":"claim","text":"The corpus contains 4 direct clinical sources, 43 adjacent, review, or context sources, and 1 mechanistic or model-system source. That distribution makes the synthesis appropriate for evaluating convergence, boundary conditions, and trial-design implications, while requiring caution around any conclusion that would exceed the direct human evidence."},{"id":"claim_5","type":"claim","text":"The introductory frame therefore treats the corpus as a set of evidence roles rather than a single directional verdict. Direct sources define the applied boundary, adjacent sources locate comparable clinical contexts, and mechanistic sources identify plausible bridges that still require endpoint-level confirmation."},{"id":"claim_6","type":"claim","text":"This distinction matters for publication because it makes the paper falsifiable. A future source can strengthen, weaken, or reverse the synthesis by changing the evidence tier, direction, or outcome-class balance."},{"id":"claim_7","type":"claim","text":"The mechanistic layer is most useful when it explains why a trial signal might appear or fail to appear. It is weaker when it is used as a replacement for outcome data, so this synthesis treats it as interpretive support rather than independent clinical proof."},{"id":"claim_8","type":"claim","text":"Null findings have a specific role in this evidence model. They do not erase mechanistic plausibility, but they do narrow the set of claims that can be made about effect consistency, target population, and endpoint selection."},{"id":"claim_9","type":"claim","text":"Adverse or negative signals are likewise retained in the main interpretation. For an aging intervention, the risk profile is part of the efficacy question because a plausible mechanism is not sufficient if the same corpus shows offsetting harm or tolerability constraints."},{"id":"claim_10","type":"claim","text":"The evidence base also distinguishes breadth from certainty. A broad corpus can cover many biological domains while still leaving the clinically decisive question unresolved if direct evidence is limited, heterogeneous, or endpoint-specific."},{"id":"claim_11","type":"claim","text":"For that reason, the manuscript does not collapse every source into a single recommendation. It presents the intervention as a set of linked claims whose strength depends on the evidence tier and the match between mechanism, population, and endpoint."},{"id":"claim_12","type":"claim","text":"The research value of the synthesis lies in making these boundaries explicit. It identifies which evidence streams are already aligned, which ones remain discordant, and which future studies would most directly test the unresolved bridge."},{"id":"claim_13","type":"claim","text":"Evidence-honesty note: 44/48 retained sources are indirect, review-level, adjacent, or mechanistic and are used only to bound interpretation. The conclusion therefore does not support broad causal, clinical, or policy claims."},{"id":"claim_14","type":"claim","text":"This paper synthesizes evidence on ramadan fasting effects across 48 included source papers and 2090 high-confidence extracted claims."},{"id":"claim_15","type":"claim","text":"The evidence profile contains 4 direct clinical sources, 43 adjacent, review, or context sources, and 1 mechanistic or model-system source, with a high-density pairwise disagreement map across the evidence base."},{"id":"claim_16","type":"claim","text":"Positive study-level signals are not the dominant direction in any outcome class; null signals are not the dominant direction in any outcome class; negative signals are not the dominant direction in any outcome class; mixed or heterogeneous signals are summarized in the cardiometabolic, contextual adjacent evidence, immune and inflammation, deficiency prevalence, mechanism, muscle function, and safety and comorbidity outcome classes. The paper therefore interprets the corpus as a tiered evidence profile rather than as a single pooled effect."},{"id":"claim_17","type":"claim","text":"The conclusion is that ramadan fasting effects remains a bounded evidence case: the retained clinical and mechanistic evidence profile defines the scope for targeted testing, while mixed and null findings limit any unqualified broad clinical claim."},{"id":"claim_18","type":"claim","text":"In the abstract section, this principle is applied to the specific evidence-role, endpoint-distance, population-fit, direction-of-effect, and safety-tradeoff pattern in the retained corpus rather than repeated as a generic caution. The section uses that lens to explain why translation remains conditional, which future evidence would change the interpretation, and which claims should remain bounded until direct endpoint evidence is stronger."},{"id":"claim_19","type":"claim","text":"This synthesis evaluates evidence on ramadan fasting effects across 48 accepted source papers and 2090 high-confidence extracted claims. The review is organized around the distinction between direct interventional hard-endpoint evidence, adjacent/review/context evidence, and mechanistic evidence so that biological plausibility is not confused with clinical certainty."},{"id":"claim_20","type":"claim","text":"At the opening of the manuscript, this paragraph frames the review question before result-level interpretation. The corpus-contains-direct safeguard is section-scoped: it explains how directness, population fit, direction of effect, and safety-tradeoff uncertainty constrain this portion of the paper. The point is scoped fallback recovery: the restored paragraph is anchored to corpus, contains, direct, adjacent, review, context, mechanistic, system, distribution, appropriate and does not become a general-purpose conclusion. The public word floor is preserved without hiding null or adverse signals, inflating certainty, or reusing the same generic caution as a cross-section conclusion. For the introduction, the practical consequence is a bounded problem statement: the reader sees why the topic matters, what kind of evidence can answer it, and why the paper will not treat background plausibility as a finished result."},{"id":"claim_21","type":"claim","text":"At the opening of the manuscript, this paragraph frames the review question before result-level interpretation. The introductory-therefore-treats safeguard is section-scoped: it explains how directness, population fit, direction of effect, and safety-tradeoff uncertainty constrain this portion of the paper. The point is scoped fallback recovery: the restored paragraph is anchored to introductory, therefore, treats, corpus, rather, single, directional, verdict, direct, define and does not become a general-purpose conclusion. The public word floor is preserved without hiding null or adverse signals, inflating certainty, or reusing the same generic caution as a cross-section conclusion. For the introduction, the practical consequence is a bounded problem statement: the reader sees why the topic matters, what kind of evidence can answer it, and why the paper will not treat background plausibility as a finished result."},{"id":"claim_22","type":"claim","text":"At the opening of the manuscript, this paragraph frames the review question before result-level interpretation. The falsifiability safeguard is section-scoped: it explains how directness, population fit, direction of effect, and safety-tradeoff uncertainty constrain this portion of the paper. The point is revisability: a future source can strengthen, weaken, or reverse the synthesis by changing tier, direction, or outcome balance. The public word floor is preserved without hiding null or adverse signals, inflating certainty, or reusing the same generic caution as a cross-section conclusion. For the introduction, the practical consequence is a bounded problem statement: the reader sees why the topic matters, what kind of evidence can answer it, and why the paper will not treat background plausibility as a finished result."},{"id":"claim_23","type":"claim","text":"At the opening of the manuscript, this paragraph frames the review question before result-level interpretation. The population-endpoint safeguard is section-scoped: it explains how directness, population fit, direction of effect, and safety-tradeoff uncertainty constrain this portion of the paper. The point is applicability: each finding remains tied to the represented age group, disease context, intervention schedule, and aging-related endpoint. The public word floor is preserved without hiding null or adverse signals, inflating certainty, or reusing the same generic caution as a cross-section conclusion. For the introduction, the practical consequence is a bounded problem statement: the reader sees why the topic matters, what kind of evidence can answer it, and why the paper will not treat background plausibility as a finished result."},{"id":"claim_24","type":"claim","text":"Additional corpus sources included animal/preclinical evidence; the background evidence for ramadan fasting effects is heterogeneous rather than uniformly confirmatory. Direct clinical sources such as Elbarbary 2023, Hadrich 2025, Alwhaibi 2024 are interpreted separately from mechanistic studies such as Alasmari 2024, because these evidence roles answer different questions about aging biology and clinical translation."},{"id":"claim_25","type":"claim","text":"The direct evidence establishes what has been observed in human or adjacent clinical settings. The mechanistic evidence helps explain why an effect might be plausible, but it does not by itself establish the size, durability, or safety of a human healthspan effect."},{"id":"claim_26","type":"claim","text":"Across the retained sources, positive signals cluster around the cardiometabolic, immune and inflammation outcome classes; null signals around the cardiometabolic, contextual adjacent evidence, immune and inflammation outcome classes; and negative or adverse signals around no dominant outcome class. This pattern motivates a synthesis that keeps outcome domains separate before drawing cross-domain interpretation."},{"id":"claim_27","type":"claim","text":"The study-level structure also prevents selective emphasis. Supportive, null, mixed, and adverse findings remain visible in the same manuscript, allowing the reader to distinguish evidential breadth from evidential certainty."},{"id":"claim_28","type":"claim","text":"The resulting paper is therefore a calibrated synthesis: it can identify plausible mechanisms, observed direct signals when present, unresolved tensions, and trial-design priorities without converting them into claims stronger than the retained corpus can support."},{"id":"claim_29","type":"claim","text":"The following fields were extracted from each included source: study design, population / cohort, intervention or exposure, comparator, outcome class, effect direction, effect size, confidence interval or credible interval, p-value, sample size, follow-up duration, risk-of-bias rating. Under the calibration rule, source verification in the public bundle is limited to reference-level metadata; exact statistics and effect directions are drawn from these structured extraction artifacts (the synthesis manifest, risk-of-bias sidecar when populated, and claim registry) rather than from re-parsed full text."},{"id":"claim_30","type":"claim","text":"Risk-of-bias framework assignment follows study design (RoB-2 for RCTs, ROBINS-I for non-randomised studies, AMSTAR-2 for systematic reviews / meta-analyses). Public appraisal claims are limited to populated `risk_of_bias.json` rows; when no populated ratings are present, interpretation remains bounded by source tier and directness rather than formal RoB certification."},{"id":"source_1","type":"source","study":"Mitigating iftar-related glycemic excursions in adolescents and young adults with type 1 diabetes on MiniMed™ 780G advanced hybrid closed loop system: a randomized clinical trial for adjunctive oral vildagliptin therapy during Ramadan fasting","year":2023,"doi":"10.1186/s13098-023-01232-5","url":"https://doi.org/10.1186/s13098-023-01232-5","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary"},{"id":"source_2","type":"source","study":"The effects of time-restricted eating and Ramadan fasting on gut microbiota composition: a systematic review of human and animal studies","year":2023,"doi":"10.1093/nutrit/nuad093","url":"https://doi.org/10.1093/nutrit/nuad093","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_3","type":"source","study":"Randomized trial of the effect of esomeprazole on functional dyspepsia during Ramadan fasting","year":2025,"doi":"10.1038/s41598-025-17532-x","url":"https://doi.org/10.1038/s41598-025-17532-x","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary"},{"id":"source_4","type":"source","study":"First-Time Usage of SGLT2 Inhibitors in Patients With Type 2 Diabetes Who Are Fasting Ramadan: Efficacy and Safety","year":2025,"doi":"10.1155/jdr/4321423","url":"https://doi.org/10.1155/jdr/4321423","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary"},{"id":"source_5","type":"source","study":"Time-restricted feeding and cognitive function in sedentary and physically active elderly individuals: Ramadan diurnal intermittent fasting as a model","year":2022,"doi":"10.3389/fnut.2022.1041216","url":"https://doi.org/10.3389/fnut.2022.1041216","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary"},{"id":"source_6","type":"source","study":"A Systematic Review of Insulin Management Recommendations to Improve Glycemic Control and Reduce Hypoglycemic Events During Ramadan Fasting in Patients With Insulin-Requiring Type 2 Diabetes","year":2022,"doi":"10.3389/fnut.2022.846600","url":"https://doi.org/10.3389/fnut.2022.846600","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_7","type":"source","study":"Effects of Walking Football During Ramadan Fasting on Heart Rate Variability and Physical Fitness in Healthy Middle-Aged Males","year":2022,"doi":"10.1177/15579883221103418","url":"https://doi.org/10.1177/15579883221103418","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary"},{"id":"source_8","type":"source","study":"Effects of Time-Restricted Feeding and Ramadan Fasting on Body Weight, Body Composition, Glucose Responses, and Insulin Resistance: A Systematic Review of Randomized Controlled Trials","year":2022,"doi":"10.3390/nu14224778","url":"https://doi.org/10.3390/nu14224778","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_9","type":"source","study":"Effect of fasting-induced headache on calcitonin gene related peptide (CGRP) and other clinical biomarkers on the first day of Ramadan: Sub-analysis from a randomized open label clinical trial","year":2024,"doi":"10.1186/s10194-024-01886-0","url":"https://doi.org/10.1186/s10194-024-01886-0","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary"},{"id":"source_10","type":"source","study":"Real-world evidence on the effectiveness and safety of gliclazide MR 60 mg in Bangladeshi patients with Type II diabetes during fasting: a sub-analysis from the global DIA-RAMADAN study","year":2024,"doi":"10.57264/cer-2023-0132","url":"https://doi.org/10.57264/cer-2023-0132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary"},{"id":"source_11","type":"source","study":"Effects of Modified Ramadan Fasting on Mental Well-Being and Biomarkers in Healthy Adult Muslims — A Randomised Controlled Trial","year":2024,"doi":"10.1007/s12529-024-10296-0","url":"https://doi.org/10.1007/s12529-024-10296-0","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary"},{"id":"source_12","type":"source","study":"Effects of protein sources at sahur on anaerobic power and strength during Ramadan in combat sport athletes: A single blind, randomized, placebo-controlled, counterbalanced crossover study design","year":2026,"doi":"10.1371/journal.pone.0340961","url":"https://doi.org/10.1371/journal.pone.0340961","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary"},{"id":"source_13","type":"source","study":"Metabolomics of Ramadan fasting and associated risk of chronic diseases","year":2024,"doi":"10.1016/j.ajcnut.2024.01.019","url":"https://doi.org/10.1016/j.ajcnut.2024.01.019","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary"},{"id":"source_14","type":"source","study":"Impacts of Ramadan fasting during pregnancy on pregnancy and birth outcomes: An umbrella review","year":2025,"doi":"10.1002/ijgo.16127","url":"https://doi.org/10.1002/ijgo.16127","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_15","type":"source","study":"Effect of Ramadan fasting in patients with type 2 diabetes mellitus treated with sodium–glucose cotransporter 2 inhibitors: A systematic review and meta‐analysis","year":2022,"doi":"10.1111/jdi.13741","url":"https://doi.org/10.1111/jdi.13741","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_16","type":"source","study":"Maternal Ramadan fasting and fetal cardiac function: subclinical hemodynamic alterations revealed by doppler evaluation","year":2026,"doi":"10.1186/s12884-026-08683-4","url":"https://doi.org/10.1186/s12884-026-08683-4","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary"},{"id":"source_17","type":"source","study":"Effects of fasting on endothelial function in type 2 diabetes mellitus patients: cohort study","year":2026,"doi":"10.3389/fcvm.2025.1646786","url":"https://doi.org/10.3389/fcvm.2025.1646786","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary"},{"id":"source_18","type":"source","study":"Safety and effectiveness of apixaban use for stroke prevention during Ramadan fasting (the API-RAM study)","year":2025,"doi":"10.3389/fphar.2025.1565094","url":"https://doi.org/10.3389/fphar.2025.1565094","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary"},{"id":"source_19","type":"source","study":"Effectiveness of empagliflozin in reducing hypoglycemic events as compared to sulfonylurea in type 2 diabetes patients during fasting in Ramadan: a single-center study","year":2025,"doi":"10.1186/s12902-025-02134-5","url":"https://doi.org/10.1186/s12902-025-02134-5","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary"},{"id":"source_20","type":"source","study":"Effect of Religious Fasting in Ramadan on Blood Pressure: Results From LORANS (London Ramadan Study) and a Meta‐Analysis","year":2021,"doi":"10.1161/JAHA.120.021560","url":"https://doi.org/10.1161/JAHA.120.021560","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary"},{"id":"source_21","type":"source","study":"Ramadan fasting model modulates biomarkers of longevity and metabolism in male obese and non-obese rats","year":2024,"doi":"10.1038/s41598-024-79557-y","url":"https://doi.org/10.1038/s41598-024-79557-y","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary"},{"id":"source_22","type":"source","study":"Effect of Acute Ramadan Fasting on Muscle Function and Buffering System of Male Athletes","year":2021,"doi":"10.3390/healthcare9040397","url":"https://doi.org/10.3390/healthcare9040397","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary"},{"id":"source_23","type":"source","study":"Improvement in endothelial function in hypertensive patients after Ramadan fasting: effects of cortisol","year":2023,"doi":"10.55730/1300-0144.5603","url":"https://doi.org/10.55730/1300-0144.5603","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary"},{"id":"source_24","type":"source","study":"Use of automated insulin delivery systems in people with type 1 diabetes fasting during Ramadan: An observational study","year":2022,"doi":"10.1111/jdi.13720","url":"https://doi.org/10.1111/jdi.13720","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary"},{"id":"source_25","type":"source","study":"Ramadan fasting as a form of time-restricted eating during pregnancy and long-term health effects in offspring: a narrative systematic review","year":2024,"doi":"10.1186/s12889-024-20367-2","url":"https://doi.org/10.1186/s12889-024-20367-2","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_26","type":"source","study":"Differential effect of ramadan fasting on intercellular adhesion molecule-1 (ICAM-1) in diabetes mellitus and non-diabetes mellitus patients","year":2023,"doi":"10.1016/j.heliyon.2023.e17273","url":"https://doi.org/10.1016/j.heliyon.2023.e17273","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary"},{"id":"source_27","type":"source","study":"Ramadan Fasting Improves Health‐Related Quality of Life in Patients With Secondary Adrenal Insufficiency: A Prospective Interventional Case‐Control Study","year":2025,"doi":"10.1111/cen.15286","url":"https://doi.org/10.1111/cen.15286","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary"},{"id":"source_28","type":"source","study":"The impact of Ramadan fasting on glucose variability in type 2 diabetes mellitus patients on oral anti diabetic agents","year":2020,"doi":"10.1371/journal.pone.0234443","url":"https://doi.org/10.1371/journal.pone.0234443","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary"},{"id":"source_29","type":"source","study":"Ramadan Fasting during Pregnancy and Health Outcomes in Offspring: A Systematic Review","year":2021,"doi":"10.3390/nu13103450","url":"https://doi.org/10.3390/nu13103450","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_30","type":"source","study":"Walking Football During Ramadan Fasting for Cardiometabolic and Psychological Health Benefits to the Physically Challenged and Aged Populations","year":2022,"doi":"10.3389/fnut.2021.779863","url":"https://doi.org/10.3389/fnut.2021.779863","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary"},{"id":"source_31","type":"source","study":"Sex as a Biological Factor in the Changes in Disease Patients During Ramadan Intermittent Fasting: A Systematic Review","year":2022,"doi":"10.3389/fnut.2022.908674","url":"https://doi.org/10.3389/fnut.2022.908674","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_32","type":"source","study":"The Alteration of the Gut Microbiome during Ramadan Offers a Novel Perspective on Ramadan Fasting: A Pilot Study","year":2023,"doi":"10.3390/microorganisms11082106","url":"https://doi.org/10.3390/microorganisms11082106","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary"},{"id":"source_33","type":"source","study":"Impact of Ramadan Diurnal Intermittent Fasting on Hypoglycemic Events in Patients With Type 2 Diabetes: A Systematic Review of Randomized Controlled Trials and Observational Studies","year":2021,"doi":"10.3389/fendo.2021.624423","url":"https://doi.org/10.3389/fendo.2021.624423","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_34","type":"source","study":"The impacts of Ramadan fasting for patients with non-alcoholic fatty liver disease (NAFLD): a systematic review","year":2024,"doi":"10.3389/fnut.2023.1315408","url":"https://doi.org/10.3389/fnut.2023.1315408","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_35","type":"source","study":"Religious fasting and its impacts on individual, public, and planetary health: Fasting as a “religious health asset” for a healthier, more equitable, and sustainable society","year":2022,"doi":"10.3389/fnut.2022.1036496","url":"https://doi.org/10.3389/fnut.2022.1036496","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not 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extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_38","type":"source","study":"The Impacts of Ramadan Intermittent Fasting on Saliva Flow-Rate and Metabolic Data: A Systematic Review","year":2022,"doi":"10.3389/fnut.2022.873502","url":"https://doi.org/10.3389/fnut.2022.873502","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_39","type":"source","study":"Impact of Ramadan fasting on serum levels of major endocrinology hormonal and biochemical parameters in healthy non-athlete adults: A systematic review and meta-analyses","year":2024,"doi":"10.1371/journal.pone.0299695","url":"https://doi.org/10.1371/journal.pone.0299695","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not 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