{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T10:53:00Z","timestamp":1781520780361,"version":"3.54.1"},"reference-count":45,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"unspecified","delay-in-days":11,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"PROADI-SUS","award":["NUP 25000.160094\/2023-09"],"award-info":[{"award-number":["NUP 25000.160094\/2023-09"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,5,18]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>An affordable heart-healthy dietary approach is essential for the management of familial hypercholesterolaemia (FH); however, the optimal dietary pattern and the role of adjunctive nutrient supplementation remain uncertain. This study aims to evaluate the effects of the Brazilian Cardioprotective Diet (DICA Br), adapted from the Portfolio Diet, with or without phytosterol and\/or krill oil supplementation in individuals with probable or definite FH according to the Dutch Lipid Clinic Network (Dutch MEDPED) criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>The DICA-FH study is a national, multicentre, randomised, factorial, parallel-group, superiority, placebo-controlled clinical trial with a 1:1:1:1 allocation ratio. Participants aged \u226516 years receiving age-appropriate lipid-lowering therapy will be randomised into four groups: (1) adapted cardioprotective diet (DICA-FH) plus phytosterol placebo and krill oil placebo; (2) DICA-FH plus phytosterol 2\u2009g\/day and krill oil placebo; (3) DICA-FH plus phytosterol placebo and krill oil 2\u2009g\/day or (4) DICA-FH plus phytosterol 2\u2009g\/day and krill oil 2\u2009g\/day. All participants will undergo whole-genome sequencing and receive appropriate genetic counselling. Primary outcomes will be means of low-density lipoprotein cholesterol and lipoprotein(a) levels after 120 days. Secondary outcomes will include additional lipid biomarkers, adherence to protocol and adverse events. The planned sample size is 300 participants. Follow-up is expected to conclude in July 2026.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This study was registered under CAAE 65549622.2.1001.0060 and received ethical approval from the Hcor Research Ethics Committee (approval number 5.805.072) and the Brazilian National Research Ethics Commission (CONEP; approval number 6.864.951). Written informed consent will be obtained from all participants prior to enrolment. The study findings will be disseminated through peer-reviewed publications, scientific conferences and channels aimed at the general public.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT06331195\">NCT06331195<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-119951","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T09:55:47Z","timestamp":1781517347000},"page":"e119951","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of a culturally adapted heart-healthy diet with phytosterols and\/or krill oil on lipid-related outcomes in familial hypercholesterolaemia: protocol for a multicentre randomised controlled trial in Brazil"],"prefix":"10.1136","volume":"16","clinical-trial-number":[{"clinical-trial-number":"nct06331195","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct06331195","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Erlon Oliveira","family":"de Abreu-Silva","sequence":"first","affiliation":[{"name":"Hcor Research Institute, S\u00e3o Paulo, Brazil"},{"name":"Division of Health Care Sciences, Dresden International University, Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel H","family":"Vieira Machado","sequence":"additional","affiliation":[{"name":"Hcor Research Institute, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda Jafet","family":"El Khouri","sequence":"additional","affiliation":[{"name":"Hcor Research Institute, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiana Borges","family":"dos Santos","sequence":"additional","affiliation":[{"name":"Hcor Research Institute, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monike A Matos","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Hcor Research Institute, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fl\u00e1via C Soares","family":"Kojima","sequence":"additional","affiliation":[{"name":"Hcor Research Institute, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger A Novaes","family":"Peron","sequence":"additional","affiliation":[{"name":"Hcor Research Institute, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas Simoes","family":"Machado","sequence":"additional","affiliation":[{"name":"Hcor Research Institute, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gisele C de Souza","family":"Malvezzi","sequence":"additional","affiliation":[{"name":"Hcor Research Institute, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leticia Barbante","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Hcor Research Institute, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thabata Silva","family":"Veiga","sequence":"additional","affiliation":[{"name":"Hcor Research Institute, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karina do Lago","family":"Negrelli","sequence":"additional","affiliation":[{"name":"Hcor Research Institute, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro G M","family":"de Barros e Silva","sequence":"additional","affiliation":[{"name":"Hcor Research Institute, S\u00e3o Paulo, Brazil"},{"name":"Paulista School of Medicine, Universidade Federal de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renato H Nakagawa","family":"Santos","sequence":"additional","affiliation":[{"name":"Academic Research Organization, Einstein Hospital Israelita, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c2ngela C","family":"Bersch-Ferreira","sequence":"additional","affiliation":[{"name":"Department of Education and Research, Beneficencia Portuguesa de Sao Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana Bastos","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Carlos Chagas Filho Biophysics Institute, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil"},{"name":"Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tha\u00eds Martins","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Graduate Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Cristina","family":"Izar","sequence":"additional","affiliation":[{"name":"Paulista School of Medicine, Universidade Federal de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geni Rodrigues","family":"Sampaio","sequence":"additional","affiliation":[{"name":"Department of Nutrition, School of Public Health, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nagila R Teixeira","family":"Damasceno","sequence":"additional","affiliation":[{"name":"Department of Nutrition, School of Public Health, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo Macedo","family":"Rogero","sequence":"additional","affiliation":[{"name":"Department of Nutrition, School of Public Health, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A Ferraz da Silva","family":"Torres","sequence":"additional","affiliation":[{"name":"Department of Nutrition, School of Public Health, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patr\u00edcia Vieira","family":"de Luca","sequence":"additional","affiliation":[{"name":"Patient Author, Brazilian Association of Familial Hypercholesterolemia, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda A Heleno","family":"Batista","sequence":"additional","affiliation":[{"name":"Molecular Biology Laboratory, Instituto Dante Pazzanese de Cardiologia, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2798-6263","authenticated-orcid":false,"given":"Alexandre Biasi","family":"Cavalcanti","sequence":"additional","affiliation":[{"name":"Hcor Research Institute, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1994-4610","authenticated-orcid":false,"given":"Aline","family":"Marcadenti","sequence":"additional","affiliation":[{"name":"Hcor Research Institute, S\u00e3o Paulo, Brazil"},{"name":"Graduate Program in Health Sciences (Cardiology), Instituto de Cardiologia\/Funda\u00e7\u00e3o Universit\u00e1ria de Cardiologia do Rio Grande do Su, Porto Alegre, Brazil"},{"name":"Graduate Program in Public Health, School of Public Health, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,12]]},"reference":[{"key":"2026061205051656000_16.6.e119951.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(20)33180-6"},{"key":"2026061205051656000_16.6.e119951.2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.032321"},{"key":"2026061205051656000_16.6.e119951.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0021-9150(02)00330-1"},{"key":"2026061205051656000_16.6.e119951.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2019.08.007"},{"key":"2026061205051656000_16.6.e119951.5","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1111\/joim.12981","article-title":"Familial hypercholesterolemia and elevated lipoprotein(a): double heritable risk and new therapeutic opportunities","volume":"287","author":"Vuorio","year":"2020","journal-title":"J Intern Med"},{"key":"2026061205051656000_16.6.e119951.6","first-page":"135","article-title":"Special Commentary: Is diet management helpful in familial hypercholesterolemia?","volume":"22","author":"Gidding","year":"2019","journal-title":"Curr Opin Clin Nutr Metab Care"},{"key":"2026061205051656000_16.6.e119951.7","doi-asserted-by":"crossref","unstructured":"Toft-Nielsen F , Emanuelsson F , Nordestgaard BG , et al . Clinical familial hypercholesterolemia, heart healthy dietary adherence, and cardiovascular risk. Atherosclerosis 2025;408. doi:10.1016\/j.atherosclerosis.2025.120463","DOI":"10.1016\/j.atherosclerosis.2025.120463"},{"key":"2026061205051656000_16.6.e119951.8","doi-asserted-by":"publisher","DOI":"10.1007\/s12529-014-9402-x"},{"key":"2026061205051656000_16.6.e119951.9","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.clnesp.2025.07.010","article-title":"Dietary habits are suboptimal in patients referred to lipid clinics on suspicion of familial hypercholesterolaemia","volume":"69","author":"Pedersen","year":"2025","journal-title":"Clin Nutr ESPEN"},{"key":"2026061205051656000_16.6.e119951.10","article-title":"Dietary interventions (plant sterols, stanols, omega-3 fatty acids, soy protein and dietary fibers) for familial hypercholesterolaemia","volume":"2014","author":"Malhotra","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"2026061205051656000_16.6.e119951.11","doi-asserted-by":"crossref","DOI":"10.3390\/nu12082436","article-title":"Diet and Cardiovascular Disease Risk Among Individuals with Familial Hypercholesterolemia: Systematic Review and Meta-Analysis","volume":"12","author":"Barkas","year":"2020","journal-title":"Nutrients"},{"key":"2026061205051656000_16.6.e119951.12","doi-asserted-by":"crossref","DOI":"10.3390\/nu13010235","article-title":"Impact of Diet on Plasma Lipids in Individuals with Heterozygous Familial Hypercholesterolemia: A Systematic Review of Randomized Controlled Nutritional Studies","volume":"13","author":"Roy","year":"2021","journal-title":"Nutrients"},{"key":"2026061205051656000_16.6.e119951.13","first-page":"782","article-title":"Update of the Brazilian guideline for familial hypercholesterolemia\u20142021","volume":"117","author":"Izar","year":"2021","journal-title":"Arq Bras Cardiol"},{"key":"2026061205051656000_16.6.e119951.14","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz455"},{"key":"2026061205051656000_16.6.e119951.15","doi-asserted-by":"crossref","first-page":"2014","DOI":"10.1016\/j.numecd.2021.04.006","article-title":"Adherence to a Mediterranean diet, dyslipidemia and inflammation in familial hypercholesterolemia","volume":"31","author":"Antoniazzi","year":"2021","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"2026061205051656000_16.6.e119951.16","doi-asserted-by":"crossref","DOI":"10.1186\/s12937-024-00922-8","article-title":"Diet in secondary prevention: the effect of dietary patterns on cardiovascular risk factors in patients with cardiovascular disease: a systematic review and network meta-analysis","volume":"23","author":"Bonekamp","year":"2024","journal-title":"Nutr J"},{"key":"2026061205051656000_16.6.e119951.17","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.1053\/meta.2002.35578","article-title":"A dietary portfolio approach to cholesterol reduction: combined effects of plant sterols, vegetable proteins, and viscous fibers in hypercholesterolemia","volume":"51","author":"Jenkins","year":"2002","journal-title":"Metab Clin Exp"},{"key":"2026061205051656000_16.6.e119951.18","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.pcad.2018.05.004","article-title":"Portfolio Dietary Pattern and Cardiovascular Disease: A Systematic Review and Meta-analysis of Controlled Trials","volume":"61","author":"Chiavaroli","year":"2018","journal-title":"Prog Cardiovasc Dis"},{"key":"2026061205051656000_16.6.e119951.19","doi-asserted-by":"publisher","DOI":"10.1001\/jama.290.4.502"},{"key":"2026061205051656000_16.6.e119951.20","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.1161\/CIRCULATIONAHA.123.065551","article-title":"Portfolio Diet Score and Risk of Cardiovascular Disease: Findings From 3 Prospective Cohort Studies","volume":"148","author":"Glenn","year":"2023","journal-title":"Circulation"},{"key":"2026061205051656000_16.6.e119951.21","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-025-22479-9","article-title":"Portfolio diet and LDL-C in a young, multiethnic cohort: cross-sectional analyses with cumulative exposure modeling","volume":"25","author":"Chen","year":"2025","journal-title":"BMC Public Health"},{"key":"2026061205051656000_16.6.e119951.22","unstructured":"National Institute for Health and Care Excellence (NICE) . Familial hypercholesterolaemia: identification and management. Available: www.nice.org.uk\/guidance\/cg71 [Accessed 7 Oct 2021]."},{"key":"2026061205051656000_16.6.e119951.23","first-page":"624","article-title":"Dietary plant sterols supplementation does not alter lipoprotein kinetics in men with the metabolic syndrome","volume":"16","author":"Ooi","year":"2007","journal-title":"Asia Pac J Clin Nutr"},{"key":"2026061205051656000_16.6.e119951.24","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/j.atherosclerosis.2013.03.001","article-title":"Phytosterol capsules and serum cholesterol in hypercholesterolemia: a randomized controlled trial","volume":"228","author":"Ottestad","year":"2013","journal-title":"Atherosclerosis"},{"key":"2026061205051656000_16.6.e119951.25","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.123.029512","article-title":"Association Between Omega-3 Fatty Acid Intake and Dyslipidemia: A Continuous Dose-Response Meta-Analysis of Randomized Controlled Trials","volume":"12","author":"Wang","year":"2023","journal-title":"J Am Heart Assoc"},{"key":"2026061205051656000_16.6.e119951.26","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/j.clnu.2020.05.034","article-title":"Omega-3 polyunsaturated fatty acid supplementation improves lipid metabolism and endothelial function by providing a beneficial eicosanoid-pattern in patients with acute myocardial infarction: A randomized, controlled trial","volume":"40","author":"Yuan","year":"2021","journal-title":"Clin Nutr"},{"key":"2026061205051656000_16.6.e119951.27","unstructured":"Brasil. Minist\u00e9rio da Sa\u00fade . Alimenta\u00e7\u00e3o cardioprotetora: manual de orienta\u00e7\u00f5es para os profissionais de sa\u00fade da Aten\u00e7\u00e3o B\u00e1sica. Bras\u00edlia Minist\u00e9rio da Sa\u00fade; 2018.138. Available: http:\/\/189.28.128.100\/dab\/docs\/portaldab\/publicacoes\/alimentacao_cardioprotetora_orien_pro_saude_ab.pdf"},{"key":"2026061205051656000_16.6.e119951.28","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.ahj.2015.08.010","article-title":"The Brazilian Cardioprotective Nutritional Program to reduce events and risk factors in secondary prevention for cardiovascular disease: study protocol (The BALANCE Program Trial)","volume":"171","author":"Weber","year":"2016","journal-title":"Am Heart J"},{"key":"2026061205051656000_16.6.e119951.29","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.nutos.2024.01.005","article-title":"An adapted cardioprotective diet with or without phytosterol and\/or krill oil supplement in familial hypercholesterolemia: A pilot study protocol","volume":"54","author":"de Abreu-Silva","year":"2024","journal-title":"Clin Nutr Open Sci"},{"key":"2026061205051656000_16.6.e119951.30","doi-asserted-by":"crossref","DOI":"10.3390\/nu17122008","article-title":"An Adapted Cardioprotective Diet with or Without Phytosterol and\/or Krill Oil Supplementation in Familial Hypercholesterolemia: Results of a Pilot Randomized Clinical Trial","volume":"17","author":"de Abreu-Silva","year":"2025","journal-title":"Nutrients"},{"key":"2026061205051656000_16.6.e119951.31","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2021.41898","article-title":"Effectiveness of a Novel \u03c9-3 Krill Oil Agent in Patients With Severe Hypertriglyceridemia: A Randomized Clinical Trial","volume":"5","author":"Mozaffarian","year":"2022","journal-title":"JAMA Netw Open"},{"key":"2026061205051656000_16.6.e119951.32","first-page":"215","article-title":"Validation of the \u201cCAGE\u201d alcoholism screening test in a Brazilian psychiatric inpatient hospital setting","volume":"16","author":"Masur","year":"1983","journal-title":"Braz J Med Biol Res"},{"key":"2026061205051656000_16.6.e119951.33","doi-asserted-by":"crossref","DOI":"10.1186\/s12937-024-01020-5","article-title":"Effects of mixed nuts as part of a Brazilian Cardioprotective diet on LDL-cholesterol in adult patients after myocardial infarction: a multicenter randomized controlled clinical trial","volume":"23","author":"Bersch-Ferreira","year":"2024","journal-title":"Nutr J"},{"key":"2026061205051656000_16.6.e119951.34","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.092128"},{"key":"2026061205051656000_16.6.e119951.35","doi-asserted-by":"publisher","DOI":"10.1038\/s41436-021-01172-3"},{"key":"2026061205051656000_16.6.e119951.36","unstructured":"Sistema Vivanda de Alimenta\u00e7\u00e3o. Available: https:\/\/vivandapesquisa.com.br\/ [Accessed 26 Nov 2025]."},{"key":"2026061205051656000_16.6.e119951.37","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.11.079"},{"key":"2026061205051656000_16.6.e119951.38","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1186\/s12874-017-0426-1","article-title":"Sample size calculations based on a difference in medians for positively skewed outcomes in health care studies","volume":"17","author":"O\u2019Keeffe","year":"2017","journal-title":"BMC Med Res Methodol"},{"key":"2026061205051656000_16.6.e119951.39","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-134-8-200104170-00012"},{"key":"2026061205051656000_16.6.e119951.40","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.19.2545"},{"key":"2026061205051656000_16.6.e119951.41","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v045.i05"},{"key":"2026061205051656000_16.6.e119951.42","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2024-081123","article-title":"CONSORT 2025 statement: updated guideline for reporting randomised trials","volume":"389","author":"Hopewell","year":"2025","journal-title":"BMJ"},{"key":"2026061205051656000_16.6.e119951.43","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/MOL.0000000000000908","article-title":"Cardiovascular disease prevention in heterozygous familial hypercholesterolemia: how important is a healthy diet in the era of long-lasting cholesterol-lowering drug therapies?","volume":"35","author":"Roy","year":"2024","journal-title":"Curr Opin Lipidol"},{"key":"2026061205051656000_16.6.e119951.44","doi-asserted-by":"crossref","first-page":"2024","DOI":"10.3390\/nu12072024","article-title":"Diet and Lp(a): Does Dietary Change Modify Residual Cardiovascular Risk Conferred by Lp(a)?","volume":"12","author":"Enkhmaa","year":"2020","journal-title":"Nutrients"},{"key":"2026061205051656000_16.6.e119951.45","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1016\/j.clnu.2014.06.010","article-title":"A modified portfolio diet complements medical management to reduce cardiovascular risk factors in diabetic patients with coronary artery disease","volume":"34","author":"Keith","year":"2015","journal-title":"Clin Nutr"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2026-119951","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T09:55:53Z","timestamp":1781517353000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2026-119951"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":45,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6,12]]},"published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1136\/bmjopen-2026-119951"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2026-119951","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]}}}