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Espinosa A, Rubio-Blancas A, Camacho-Zamora A, Salcedo-Grajales I, Bravo-García AP, Rodríguez-Vega S, Barrera-Flores R, Molina-Segui F, May-Hau A, Ferreyro-Bravo F, Martínez Vázquez SE, Nava-González EJ, Laviada Molina HA. [Intermittent fasting: effects in diverse clinical settings]. NUTR HOSP 2024; 41:230-243. [PMID: 38047415 DOI: 10.20960/nh.04790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Abstract
Introduction Introduction: intermittent fasting plans propose to limit food intake during specific periods as nutritional therapeutic strategies to treat different metabolic conditions in various clinical entities. However, the heterogeneity between each context of intermittent fasting could generate different results in metabolic parameters. Objective: to evaluate the clinical application of intermittent fasting and to discern whether it offers advantages over other traditional strategies. Methods: structured questions were formulated (PICO), and the methodology followed the guidelines established by the PRISMA 2020 statement. The search was conducted in different databases (PubMed, Cochrane Library and Google Scholar). Results: we found 3,962 articles, of which 56 were finally included; 3,906 articles that did not directly or indirectly answer the structured questions were excluded. Conclusions: compared to conventional diets, the various AI schemes do not generate advantages or disadvantages in terms of weight loss and lipid profile, although in the alternate-day variant there are greater insulin reductions than those observed in the continuous energy restriction. The heterogeneity of the interventions, the populations studied, the comparators, the results, and the type of design make it impossible to extrapolate the effects found in all clinical scenarios and generalize the recommendations.
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Affiliation(s)
- Alan Espinosa
- Departamento de Nutrición. Escuela de Salud Pública. Universidad de Harvard
| | | | | | | | | | | | | | | | - Abraham May-Hau
- Escuela de Ciencias de la Salud. Universidad Marista de Mérida
| | | | - Sophia E Martínez Vázquez
- Departamento de Gastroenterología. Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán"
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In utero Ramadan exposure and child nutrition. J Dev Orig Health Dis 2023; 14:96-109. [PMID: 35796235 DOI: 10.1017/s204017442200037x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
In this study, we empirically analyse whether in utero exposure to the Ramadan fasting period is negatively associated with child nutrition. The data for the analyses come from a retrospective assessment of 759,799 children from 103 Demographic and Health Surveys (DHS) across 56 countries during 2003-2020. Considering the month-long Ramadan exposure as a natural experiment, we implement an intent-to-treat framework, comparing stunting and underweight among children aged 0-5 years who were exposed to Ramadan fasting at any time in utero with those who were not exposed. Our findings do not show significant evidence to conclude that in utero exposure to the Ramadan fasting period is negatively associated with child nutrition. On the contrary, except for stunting in Muslim children who had in utero exposure to Ramadan fasting during the first months of pregnancy, we find no significant association between in utero exposure to Ramadan fasting and child stunting and underweight. Our main results are robust to multiple robustness checks.
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Nuryakin C, Muchtar PA, Massie NWG, Hambali S. Having exams during Ramadan: The case of Indonesia. ECONOMICS AND HUMAN BIOLOGY 2022; 47:101183. [PMID: 36150255 DOI: 10.1016/j.ehb.2022.101183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 09/03/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
This paper studies the impact of fasting on students' learning outcomes in the Indonesian context, the world's largest Muslim country. Precisely, we measure the effects of Ramadan fasting by using a simple 2 × 2 difference-in-differences setting, exploiting the fact that, in 2018 and 2019, the Ramadan period coincided with the final exam periods in Universitas Indonesia. Our study uses Universitas Indonesia's comprehensive student database (SIAK-NG), which provides detailed test scores, student-level, and course-level characteristics, and details on test schedules. It allows us to investigate Ramadan fasting's direct effects, differential effects (whether morning and afternoon test effects vary or not), and cumulative effects (whether or not effects vary over time). We find no evidence of Ramadan's negative effects on students' test scores after controlling for semester-course-class fixed effects, student, class, and course characteristics. Consistently, we also find no evidence of morning-afternoon differential effects. We argue that the absence of (or weak) Ramadan's effects is likely because Muslim students had adapted to the fasting environment earlier in the Ramadan period, allowing them to improve their scores as the exam period progresses. The regression results also suggest that the fasting effects are more positive among students with less good academic performance.
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Affiliation(s)
- Chaikal Nuryakin
- Departemen Ilmu Ekonomi, Faculty of Economics and Business, Universitas Indonesia; Lembaga Penyelidikan Ekonomi dan Masyarakat, LPEM FEB UI.
| | - Pyan A Muchtar
- Economic Research Institute for ASEAN and East Asia (ERIA) Central Senayan II. Gelora Bung Karno, 10270, Central Jakarta.
| | | | - Sean Hambali
- Lembaga Penyelidikan Ekonomi dan Masyarakat, LPEM FEB UI.
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Mahanani MR, Abderbwih E, Wendt AS, Deckert A, Antia K, Horstick O, Dambach P, Kohler S, Winkler V. Long-Term Outcomes of in Utero Ramadan Exposure: A Systematic Literature Review. Nutrients 2021; 13:nu13124511. [PMID: 34960063 PMCID: PMC8704584 DOI: 10.3390/nu13124511] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/15/2021] [Accepted: 12/15/2021] [Indexed: 11/21/2022] Open
Abstract
Health outcomes of in utero Ramadan exposure have been reported in a systematic literature review; however, the available literature on long-term effects were not fully covered. Our study aims to specifically review the long-term outcomes of in utero Ramadan exposure. We searched for original research articles analyzing any long-term outcome of in utero Ramadan exposure, excluding maternal and perinatal outcomes. Sixteen studies from 8304 non-duplicate search results were included. Most studies suggest negative consequences from in utero Ramadan exposure on health, as well as on economic outcomes later in adulthood. Higher under-five mortality rate, higher mortality under three months, and under one year, shorter stature, lower body mass index, increased incidence of vision, hearing and learning disabilities, lower mathematics, writing and reading scores, as well as a lower probability to own a home were associated with Ramadan exposure during conception or the first trimester of pregnancy. Furthermore, age and sex seem to play a pivotal role on the association. Existing studies suggest that in utero Ramadan exposure may adversely impact long-term health and economic well-being. However, evidence is limited. Meanwhile, increasing awareness of the potential risks of Ramadan fasting during pregnancy should be raised among pregnant women and clinicians and other antenatal care workers should promote better maternal healthcare.
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Affiliation(s)
- Melani R. Mahanani
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (M.R.M.); (E.A.); (A.D.); (K.A.); (O.H.); (P.D.); (S.K.)
| | - Eman Abderbwih
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (M.R.M.); (E.A.); (A.D.); (K.A.); (O.H.); (P.D.); (S.K.)
| | - Amanda S. Wendt
- Potsdam Institute for Climate Impact Research, Member of the Leibniz Association, P.O. Box 601203, 14412 Potsdam, Germany;
| | - Andreas Deckert
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (M.R.M.); (E.A.); (A.D.); (K.A.); (O.H.); (P.D.); (S.K.)
| | - Khatia Antia
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (M.R.M.); (E.A.); (A.D.); (K.A.); (O.H.); (P.D.); (S.K.)
| | - Olaf Horstick
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (M.R.M.); (E.A.); (A.D.); (K.A.); (O.H.); (P.D.); (S.K.)
| | - Peter Dambach
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (M.R.M.); (E.A.); (A.D.); (K.A.); (O.H.); (P.D.); (S.K.)
| | - Stefan Kohler
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (M.R.M.); (E.A.); (A.D.); (K.A.); (O.H.); (P.D.); (S.K.)
| | - Volker Winkler
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (M.R.M.); (E.A.); (A.D.); (K.A.); (O.H.); (P.D.); (S.K.)
- Correspondence: ; Tel.: +49-6221-56-5031
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Ramadan Fasting during Pregnancy and Health Outcomes in Offspring: A Systematic Review. Nutrients 2021; 13:nu13103450. [PMID: 34684451 PMCID: PMC8540108 DOI: 10.3390/nu13103450] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/16/2021] [Accepted: 09/26/2021] [Indexed: 11/18/2022] Open
Abstract
Ramadan is one of the five pillars of Islam, during which fasting is obligatory for all healthy individuals. Although pregnant women are exempt from this Islamic law, the majority nevertheless choose to fast. This review aims to identify the effects of Ramadan fasting on the offspring of Muslim mothers, particularly on fetal growth, birth indices, cognitive effects and long-term effects. A systematic literature search was conducted until March 2020 in Web of Science, Pubmed, Cochrane Library, Embase and Google Scholar. Studies were evaluated based on a pre-defined quality score ranging from 0 (low quality) to 10 (high quality), and 43 articles were included. The study quality ranged from 2 to 9 with a mean quality score of 5.4. Only 3 studies had a high quality score (>7), of which one found a lower birth weight among fasting women. Few medium quality studies found a significant negative effect on fetal growth or birth indices. The quality of articles that investigated cognitive and long-term effects was poor. The association between Ramadan fasting and health outcomes of offspring is not supported by strong evidence. To further elucidate the effects of Ramadan fasting, larger prospective and retrospective studies with novel designs are needed.
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Chaudhry TT, Mir A. The Impact of Prenatal Exposure to Ramadan on Child Anthropomorphic Outcomes in Pakistan. Matern Child Health J 2021; 25:1136-1146. [PMID: 33909206 DOI: 10.1007/s10995-021-03154-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES This study analyzes the intent-to-treat effect of prenatal exposure to Ramadan (the Islamic month of fasting) on outcomes including stunting and underweight for children under age 5 years in Pakistan born between 2003 and 2018. METHODS The study uses observational data from four rounds of the UN-supported Multiple Indicator Cluster Survey (MICS) data collected on 204,186 children under-5 from Punjab, Pakistan in 2007-2008, 2010-2011, 2013-2014, and 2017-2018. Excluding data on outliers and observations with incomplete data, multivariate logistic regression analysis was conducted on the appended cross-sectional data of 179,943 children under-5 to assess the risk of stunting or underweight according to the month of gestation coinciding with Ramadan. RESULTS We observe a significant increase in the risk of stunting and underweight associated with exposure to Ramadan following an inverted-U pattern. The peak impact of Ramadan exposure on a child being underweight occurs in the third month of pregnancy, where the probability of being underweight is 20 percent higher as compared to children whose gestation did not coincide with Ramadan. The peak impact of Ramadan exposure on stunting occurs in the fourth month of pregnancy, where the probability of stunting is 22 percent higher as compared to children whose gestation did not coincide with Ramadan. These results vary little by gender. In contrast, exposure to Ramadan in the ninth month of gestation is associated with a reduction in the risk of stunting for boys and underweight for both boys and girls. CONCLUSIONS FOR PRACTICE Our analysis indicates that prenatal exposure to Ramadan during the first two trimesters have negative implications for children's growth. The study highlights the critical role of maternal habits during early pregnancy, especially nutritional intake, for the long-term physical development of children.
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Affiliation(s)
- Theresa Thompson Chaudhry
- Department of Economics, Lahore School of Economics, Intersection Main Blvd DHV Ph VI and Burki Rd., Burki, Lahore, 53200, Pakistan.
| | - Azka Mir
- Department of Economics, Lahore School of Economics, Intersection Main Blvd DHV Ph VI and Burki Rd., Burki, Lahore, 53200, Pakistan
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Seiermann AU, Al-Mufti H, Waid JL, Wendt AS, Sobhan S, Gabrysch S. Women's fasting habits and dietary diversity during Ramadan in rural Bangladesh. MATERNAL AND CHILD NUTRITION 2021; 17:e13135. [PMID: 33522117 PMCID: PMC8189200 DOI: 10.1111/mcn.13135] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 11/30/2020] [Accepted: 12/09/2020] [Indexed: 01/01/2023]
Abstract
Little is known about fasting practices and dietary changes during Ramadan in low‐ and lower‐middle‐income countries. Although pregnant women are exempt from fasting, they may still fast. This is of interest as dietary habits during pregnancy may affect the development of the unborn child. In a community‐based sample of young women in rural Sylhet division, Bangladesh, we described fasting practices and beliefs (n = 852). We also examined reported food group consumption and minimally adequate dietary diversity for women (MDD‐W) by Ramadan occurrence (n = 1,895) and by fasting adherence (n = 558) using logistic regression with Hindu women as a seasonal control. During Ramadan in 2018, 78% of pregnant Muslim women fasted every day. Over 80% of Muslim women believe that they should fast during pregnancy and over 50% expect positive health effects on the mother and the unborn child. We found strong evidence that Muslim women have more diverse diets during Ramadan, with higher odds of MDD‐W (OR [95% CI]: 5.0 [3.6, 6.9]) and increased consumption of pulses, dairy, fruit, and large fish. Dietary diversity increased to a lesser extent on non‐fasting days during Ramadan. Ramadan appears to improve dietary quality in both fasting and non‐fasting Muslim women in a rural population in Bangladesh. These results help to interpret findings from studies on Ramadan during pregnancy on later‐life outcomes and thus contribute to a better understanding of intrauterine influences of maternal nutrition on healthy child development.
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Affiliation(s)
- Andrea U Seiermann
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.,Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Hudaalrahman Al-Mufti
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.,Nineveh Directorate of Health, Ministry of Health, Nineveh, Iraq
| | - Jillian L Waid
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.,Bangladesh Country Office, Helen Keller International, Dhaka, Bangladesh.,Research Department 2, Potsdam Institute for Climate Impact Research, Potsdam, Germany
| | - Amanda S Wendt
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.,Research Department 2, Potsdam Institute for Climate Impact Research, Potsdam, Germany
| | - Shafinaz Sobhan
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.,Research Department 2, Potsdam Institute for Climate Impact Research, Potsdam, Germany.,Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Sabine Gabrysch
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.,Research Department 2, Potsdam Institute for Climate Impact Research, Potsdam, Germany.,Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Sociocultural and economic determinants of stunting and thinness among adolescent boys and girls in Nepal. J Biosoc Sci 2020; 53:531-556. [PMID: 32638672 DOI: 10.1017/s0021932020000358] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Despite the increasing interest in the determinants of adolescent undernutrition in low- and middle-income countries, a comprehensive multi-level overview at the country level is missing. Using the nationally representative 2014 Nepal Adolescent Nutrition Survey, this study aimed to provide a comprehensive overview of the sociocultural and economic determinants of stunting and thinness of adolescent boys and girls in Nepal. Multivariate logistic regression models were used to estimate the associations between multiple individual, household and community determinants and stunting and thinness among 3773 adolescents aged 10-19 years (1888 boys and 1885 girls). The prevalence rates of stunting and thinness indicated suboptimal nutritional status and an inadequate growth environment in Nepali adolescents. The results highlighted an association of paternal occupation and education, household income, number of earning household members, geographical place of residence, caste/ethnicity and nutritional knowledge with stunting, with higher odds for males and older adolescents. Paternal occupation, education, household income, geographical region, caste/ethnicity and nutrition knowledge were associated with thinness, with higher odds for males and younger adolescents. The findings underscore the importance of involving adolescents, their parents and their communities in interventions. Such interventions should not only be aimed at improving adolescent nutrition but also at optimizing adolescents' growth environment for better health and development. Future research should focus on context-specific causal pathways and mechanisms through which sociocultural and economic determinants influence nutritional outcomes within broader societal, cultural and political settings. A longitudinal approach, including a range of dietary and nutrition indicators would allow understanding how and when the relative importance of these factors change during adolescence.
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Viinikainen J, Bryson A, Böckerman P, Elovainio M, Hutri-Kähönen N, Juonala M, Lehtimäki T, Pahkala K, Rovio S, Pulkki-Råback L, Raitakari O, Pehkonen J. Do childhood infections affect labour market outcomes in adulthood and, if so, how? ECONOMICS AND HUMAN BIOLOGY 2020; 37:100857. [PMID: 32078928 DOI: 10.1016/j.ehb.2020.100857] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 01/24/2020] [Accepted: 01/29/2020] [Indexed: 06/10/2023]
Abstract
A burgeoning body of literature suggests that poor childhood health leads to adverse health outcomes, lower educational attainment and weaker labour market outcomes in adulthood. We focus on an important but under-researched topic, which is the role played by infection-related hospitalization (IRH) in childhood and its links to labour market outcomes later in life. The participants aged 24-30 years in 2001 N = 1706 were drawn from the Young Finns Study, which includes comprehensive registry data on IRHs in childhood at ages 0-18 years. These data are linked to longitudinal registry information on labour market outcomes (2001-2012) and parental background (1980). The estimations were performed using ordinary least squares (OLS). The results showed that having an additional IRH is associated with lower log earnings (b = -0.110, 95 % confidence interval (CI): -0.193; -0.026), fewer years of being employed (b = -0.018, 95 % CI: -0.031; -0.005), a higher probability of receiving any social income transfers (b = 0.012, 95 % CI: -0.002; 0.026) and larger social income transfers, conditional on receiving any (b = 0.085, 95 % CI: 0.025; 0.145). IRHs are negatively linked to human capital accumulation, which explains a considerable part of the observed associations between IRHs and labour market outcomes. We did not find support for the hypothesis that adult health mediates the link.
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Affiliation(s)
- Jutta Viinikainen
- Jyväskylä University School of Business and Economics, P.O.Box 35, FI-40014, Jyväskylä, Finland.
| | - Alex Bryson
- University College London, NIESR, London, United Kingdom and IZA, Bonn, Germany.
| | - Petri Böckerman
- Jyväskylä University School of Business and Economics, University of Jyväskylä, Jyväskylä, Finland; Labour Institute for Economic Research, Helsinki, Finland and IZA, Bonn, Germany.
| | - Marko Elovainio
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland and National Institute for Health and Welfare, Helsinki, Finland.
| | - Nina Hutri-Kähönen
- Department of Paediatrics, Tampere University Hospital, Tampere, Finland and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland, Division of Medicine, Turku University Hospital, Turku, Finland, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories and Faculty of Medicine and Health Technology, Finnish Cardiovascular Research Center, Tampere University, Tampere, Finland.
| | - Katja Pahkala
- Research Centre for Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland, Sports & Exercise Medicine Unit, Department of Physical Activity and Health, Paavo Nurmi Centre, Turku, Finland.
| | - Suvi Rovio
- Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
| | - Laura Pulkki-Råback
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki,Finland.
| | - Olli Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku and Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland.
| | - Jaakko Pehkonen
- Jyväskylä University School of Business and Economics, University of Jyväskylä, Jyväskylä, Finland.
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Beshyah S, Badi A, El-Ghul A, Gabroun A, Dougman K, Eledrisi M. The Year in “Ramadan Fasting and Health” (2018): A Narrative Review. IBNOSINA JOURNAL OF MEDICINE AND BIOMEDICAL SCIENCES 2019. [DOI: 10.4103/ijmbs.ijmbs_77_19] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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11
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Lakhdar A. The Year in Ramadan Fasting and Health: Changing Perspectives and a Slow Pace! IBNOSINA JOURNAL OF MEDICINE AND BIOMEDICAL SCIENCES 2019. [DOI: 10.4103/ijmbs.ijmbs_81_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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