{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:04:30Z","timestamp":1792785870385,"version":"4.5.0"},"reference-count":57,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Erasmus MC fellowship","award":["EP22.0382"],"award-info":[{"award-number":["EP22.0382"]}],"id":[{"id":"https:\/\/ror.org\/018906e22","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Pituitary neuroendocrine tumors (PitNETs) cause hormonal imbalances that impair metabolic health and quality of life (QoL). Dietary interventions may mitigate these comorbidities. This review evaluated the effectiveness of dietary strategies in improving disease-related metabolic and bone outcomes in patients with PitNETs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Systematic review of interventional and observational studies on dietary interventions in acromegaly, Cushing's disease (CD), prolactinomas, and hypopituitarism (HP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search was performed on January 20, 2026. Eligible studies assessed dietary interventions targeting metabolic or bone-related outcomes. Risk of bias was evaluated using ROBINS-I and the Newcastle\u2013Ottawa Scale. Extracted outcomes included dietary intake, body composition, metabolic parameters, biochemical control, and bone health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 2256 screened records, 8 studies (355 participants) met the inclusion criteria, including 5 interventional and 3 observational studies. In acromegaly, an isocaloric very-low-carbohydrate ketogenic diet (VLCKD) reduced insulin-like growth factor 1 (IGF-I) levels. In CD, VLCKD and energy-restricted diets (ERD) improved BMI and metabolic parameters. In prolactinoma, ERD combined with increased physical activity improved weight and biochemical control. In HP, ERD with increased physical activity and sibutramine improved body composition and metabolic outcomes. Vitamin D replacement reduced vertebral fracture risk in acromegaly and improved insulin sensitivity and lipid levels in CD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Evidence on dietary strategies for PitNET management is limited. Low-carbohydrate diet and ERD may improve adverse metabolic comorbidities, while vitamin D3 replacement shows potential benefits for insulin sensitivity in CD and fracture risk in acromegaly. Larger randomized trials are needed to confirm effects on disease control, comorbidities, and QoL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejendo\/lvag182","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T18:25:45Z","timestamp":1789755945000},"page":"S23-S35","source":"Crossref","is-referenced-by-count":0,"title":["Dietary interventions and vitamin D3 replacement in pituitary tumors: a systematic review"],"prefix":"10.1093","volume":"195","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4883-5804","authenticated-orcid":false,"given":"Eline","family":"te Nijenhuis-Noort","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Dietetics, Erasmus Medical Center , Rotterdam, GD 3015 ,","place":["The Netherlands"]},{"name":"Department of Medicine, Division of Endocrinology, Center for Endocrine Tumors Leiden, Leiden University Medical Center , Albinusdreef 2, Leiden, ZA 2333 ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3168-8982","authenticated-orcid":false,"given":"Romy","family":"van de Groef","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center , Rotterdam, GD 3015 ,","place":["The Netherlands"]},{"name":"Pituitary Center Rotterdam, Erasmus Medical Center , Rotterdam, GD 3015 ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3040-4685","authenticated-orcid":false,"given":"Julie","family":"Refardt","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center , Rotterdam, GD 3015 ,","place":["The Netherlands"]},{"name":"Pituitary Center Rotterdam, Erasmus Medical Center , Rotterdam, GD 3015 ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4956-4037","authenticated-orcid":false,"given":"Iris C M","family":"Pelsma","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Endocrinology, Center for Endocrine Tumors Leiden, Leiden University Medical Center , Albinusdreef 2, Leiden, ZA 2333 ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5817-3594","authenticated-orcid":false,"given":"Nienke R","family":"Biermasz","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Endocrinology, Center for Endocrine Tumors Leiden, Leiden University Medical Center , Albinusdreef 2, Leiden, ZA 2333 ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten A","family":"Berk","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, 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