Relevant data will be performed by Revman 5.3 software provided by the Cochrane Collaboration and Stata 14.0 statistical software. Relative risk (RR) will be used for dichotomy results with 95% confidence intervals, and Mean difference (MD) or normalized mean difference (SMD) will be used for continuous variables with 95% confidence intervals.

The choice of random effect model or fixed effect model depends on the heterogeneity of the original research. In this study, the Cochrane Q test and I2 will be used to analyze the heterogeneity between studies, If there is no heterogeneity (I2<50%, P > .1), fixed effect model will be used in meta analysis. Otherwise, we will choose subgroup analysis, sensitivity analysis or meta regression to explore the causes of heterogeneity. If the cause cannot be found and the degree of heterogeneity is acceptable, the random effect will be selected.

Subgroup analysis was performed to identify the source of heterogeneity among trials. In this study, type of intervention (fasting or caloric restriction), percent of caloric restriction (less than 50% or more than 50% daily requirement caloric intake) and the health of the subject (healthy subjects or patients with disease) were considered as predefined source of heterogeneity.

Sensitivity analysis is to explore the impact of individual studies on aggregate results, which will be judged by the method of excluding studies one by one, to check the robustness of the comprehensive results.

Funnel plot, Begg tests, Egger test will be used to investigate whether there is publication bias in this study. If the funnel plot is asymmetric, we will continue to process the asymmetric funnel plot through the shear compensation method, to ensure the symmetry of the funnel plot and eliminate publication bias.

Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system will be used to evaluate the quality of evidence for the outcomes. Comprehensive results caused by five factors (risk of bias, inconsistency, indirectness, imprecision, publication bias) affect the quality of evidence, which is divided into four levels: high level, medium level, low level, very low level.[10,11]

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