{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T22:12:20Z","timestamp":1782771140042,"version":"3.54.5"},"reference-count":95,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2019,12,2]],"date-time":"2019-12-02T00:00:00Z","timestamp":1575244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The current state of knowledge related to diet in Hashimoto thyroiditis (HT) is far from satisfactory, as many HT subjects experience several disorders and report reduced quality of life. There are three aims of the study: (1) to develop a qualitative dietary protocol (QDP; \u2018Diet4Hashi\u2019) as a simple, graphic\u2013text tool dedicated to TH subjects, (2) to evaluate the use of the QDP in dietetic counseling compared to conventional dietetic counseling (CDC) in HT women, and (3) to assess the impact of both the QDP and the CDC on the diet quality, quality of life, adiposity, and metabolic parameters of HT women. The QDP is based on subject self-monitoring supported with a graphic\u2013text tool to help them in food selection and adequate food frequency consumption, while the CDC on oral explanation and printed sample menus were provided by a dietician. The QDP contains two lists: (A) foods recommended for consumption and (B) foods with limited consumption, along with indicated consumption frequency per day\/week\/month. Both approaches include the same dietary recommendations for HT extracted from the literature but differ in subject\u2013dietician cooperation. To summarize the evidence regarding dietary recommendations in HT, the PubMed, Embase, and Cochrane Library databases (to March 2019) and the bibliographies of key articles were searched. The study is designed as a dietary intervention lasting six months in two parallel groups: experimental and control. In the experimental group, the QDP will be applied, while in the control group, the CDC will be applied. In total, the study will include a baseline of 100 women with diagnosed HT. The subjects will be randomly allocated into the experimental\/control groups (50\/50). Data related to diet quality and other lifestyle factors, nutrition knowledge, quality of life, thyroid function, body composition, blood pressure, serum fasting glucose, and lipid profile at baseline and after a six-month follow-up will be collected. This study was conducted to develop a dietary protocol (Diet4Hashi) that is easy to follow for HT subjects, and it will contribute to providing valuable data that are useful to dieticians and physicians. It is anticipated that this graphic\u2013text qualitative dietary protocol, by improving food selection and diet quality, may reduce adiposity and improve metabolic parameters and the quality of life of HT women.<\/jats:p>","DOI":"10.3390\/ijerph16234841","type":"journal-article","created":{"date-parts":[[2019,12,3]],"date-time":"2019-12-03T04:58:39Z","timestamp":1575349119000},"page":"4841","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Evaluation of Qualitative Dietary Protocol (Diet4Hashi) Application in Dietary Counseling in Hashimoto Thyroiditis: Study Protocol of a Randomized Controlled Trial"],"prefix":"10.3390","volume":"16","author":[{"given":"Natalia","family":"Wojtas","sequence":"first","affiliation":[{"name":"Department of Human Nutrition, University of Warmia and Mazury in Olsztyn, Sloneczna 45F, 10-718 Olsztyn, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8571-9935","authenticated-orcid":false,"given":"Lidia","family":"Wadolowska","sequence":"additional","affiliation":[{"name":"Department of Human Nutrition, University of Warmia and Mazury in Olsztyn, Sloneczna 45F, 10-718 Olsztyn, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"El\u017cbieta","family":"Bandurska-Stankiewicz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, School of Medicine, University of Warmia and Mazury, 10-718 Olsztyn, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,12,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/PAP.0b013e3182534868","article-title":"Hashimoto thyroiditis: A century later","volume":"19","author":"Ahmed","year":"2012","journal-title":"Adv. Anat. Pathol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Latina, A., Gullo, D., Trimarchi, F., and Benvenga, S. (2013). Hashimoto\u2019s thyroiditis: Similar and dissimilar characteristics in neighboring areas: Possible implications for the epidemiology of thyroid cancer. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0055450"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"576","DOI":"10.2174\/138920211798120763","article-title":"Hashimoto\u2019s Thyroiditis: From Genes to the Disease","volume":"12","author":"Zaletel","year":"2011","journal-title":"Curr. Genom."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"988","DOI":"10.4158\/EP12280.GL","article-title":"American Association of Clinical Endocrinologists and American Thyroid Association Taskforce on Hypothyroidism in Adults. Clinical practice guidelines for hypothyroidism in adults: Cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association","volume":"18","author":"Garber","year":"2012","journal-title":"Endocr. Pract."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1210\/jc.2013-2409","article-title":"The incidence and prevalence of thyroid dysfunction in Europe: A meta-analysis","volume":"99","author":"Galofre","year":"2014","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_6","first-page":"41","article-title":"Hypothyroidism being caused by chronic autoimmune inflammation of the thyroid gland","volume":"7","author":"Szwajkosz","year":"2017","journal-title":"J. Educ. Health Sport"},{"key":"ref_7","unstructured":"GUS (2019, April 10). Health Status of the Population in Poland in 2019, Available online: http:\/\/stat.gov.pl\/cps\/rde\/xbcr\/gus\/ZO_stan_zdrowia_2009.pdf."},{"key":"ref_8","unstructured":"GUS (2019, April 10). Health of Women in Poland in 2004\u20132009, Available online: http:\/\/stat.gov.pl\/cps\/rde\/xbcr\/gus\/ZO_Zdrowie_kobiet_w_Polsce_w_latach_2004-2009.pdf."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1210\/jcem.87.2.8182","article-title":"Serum TSH, T4 and thyroid antibodies in the United States population (1988\u20131994): National Health and Nutrition Examination Survey (NHANES III)","volume":"87","author":"Hollowell","year":"2002","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_10","first-page":"421","article-title":"Effects of thyroid autoimmunity on abdominal obesity and hyperlipidaemia","volume":"62","author":"Tamer","year":"2011","journal-title":"Endokrynol. Pol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1159\/000123428","article-title":"Hypothalamic thyroid hormone in energy balance regulation","volume":"1","author":"Herwig","year":"2008","journal-title":"Obes. Facts"},{"key":"ref_12","first-page":"470","article-title":"Rola osteoprotegeryny i witaminy D w patologii tarczycy","volume":"60","author":"Tuchendler","year":"2009","journal-title":"Endokrynol. Pol."},{"key":"ref_13","first-page":"14","article-title":"Hashimoto\u2019s thyroiditis and carbohydrate metabolism disorders in patients hospitalised in the Department of Endocrinology and Diabetology of Ludwik Rydygier Collegium Medicum in Bydgoszcz between 2001 and 2010","volume":"63","author":"Gierach","year":"2012","journal-title":"Endokrynol. Pol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1089\/thy.2010.0191","article-title":"Hashimoto\u2019s thyroiditis affects symptom load and quality of life unrelated to hypothyroidism: A prospective case-control study in women undergoing thyroidectomy for benign goiter","volume":"2","author":"Ott","year":"2011","journal-title":"Thyroid"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1210\/er.2006-0043","article-title":"The clinical significance of subclinical thyroid dysfunction","volume":"29","author":"Biondi","year":"2008","journal-title":"Endocr. Rev."},{"key":"ref_16","unstructured":"Ruchala, M. (2015). Choroba Hashimoto i Niedoczynno\u015b\u0107 Tarczycy, Leczenie, Medycyna Praktyczna."},{"key":"ref_17","first-page":"417","article-title":"The Effect of Gluten-Free Diet on Thyroid Autoimmunity in Drug-Na\u00efve Women with Hashimoto\u2019s Thyroiditis: A Pilot Study","volume":"127","author":"Krysiak","year":"2018","journal-title":"Exp. Clin. Endocrinol. Diabetes"},{"key":"ref_18","first-page":"51","article-title":"A concise review of Hashimoto thyroiditis (HT) and the importance of iodine, selenium, vitamin D and gluten on the autoimmunity and dietary management of HT patients. Points that need more investigation","volume":"20","author":"Liontiris","year":"2017","journal-title":"Hell J. Nucl. Med."},{"key":"ref_19","unstructured":"American Thyroid Association (2019, June 10). Low Iodine Diet. Available online: https:\/\/www.thyroid.org\/low-iodine-diet\/."},{"key":"ref_20","unstructured":"American Dietetic Association (2019, June 15). Iodine, a Critically Important Nutrient and 7 Cancer Prevention Tips for Your Diet. Available online: https:\/\/www.eatright.org\/search-results?keyword=thyroid."},{"key":"ref_21","first-page":"47","article-title":"Zasadno\u015b\u0107 stosowania diety bezglutenowej w chorobie Hashimoto: Stanowisko Grupy Ekspert\u00f3w Sekcji Dietetyki Medycznej Polskiego Towarzystwa \u017bywienia Pozajelitowego, Dojelitowego i Metabolizmu (POLSPEN) (The rationale for using a gluten-free diet in Hashimoto\u2019s disease: The position of the Expert Group of the Medical Dietetics Section of the Polish Society of Parenteral Nutrition, Enteral Nutrition and Metabolism (POLSPEN))","volume":"2","author":"Bednarczuk","year":"2018","journal-title":"Post\u0119py \u017bywienia Klinicznego"},{"key":"ref_22","first-page":"4556","article-title":"Efficacy of the Autoimmune Protocol Diet as Part of a Multi-disciplinary, Supported Lifestyle Intervention for Hashimoto\u2019s Thyroiditis","volume":"11","author":"Abbott","year":"2019","journal-title":"Cureus"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Matana, A., Torlak, V., Brdar, D., Popovic, M., Lozic, B., Barbalic, M., Perica, V.B., Punda, A., Pola\u0161ek, O., and Hayward, C. (2017). Dietary factors associated with plasma thyroid peroxidase and thyroglobulin antibodies. Nutrients, 9.","DOI":"10.3390\/nu9111186"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1941","DOI":"10.1016\/j.jand.2017.06.364","article-title":"Effectiveness of Dietetic Consultations in Primary Health Care: A Systematic Review of Randomized Controlled Trials","volume":"12","author":"Mitchell","year":"2017","journal-title":"J. Acad. Nutr Diet."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1186\/1745-6215-13-111","article-title":"Long-term dietary intervention trials: Critical issues and challenges","volume":"13","author":"Crichton","year":"2012","journal-title":"Trials"},{"key":"ref_26","unstructured":"American Thyroid Association (2019, March 15). Guidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement. Available online: https:\/\/www.thyroid.org\/professionals\/ata-professional-guidelines\/."},{"key":"ref_27","unstructured":"IZZ (2019, March 23). Piramida Zdrowego Zywienia i Aktywnosci Fizycznej [Pyramid of Healthy Eating and Physical Activity]. Available online: http:\/\/www.izz.waw.pl\/zasady-prawidowego-ywienia."},{"key":"ref_28","unstructured":"Jarosz, M. (2017). Normy Zywienia dla Populacji Polskiej\u2014Nowelizacja, Wyd. IZZ. Nutrition Standards for the Polish Population\u2014Amendment."},{"key":"ref_29","unstructured":"Kunachowicz, H., Przygoda, B., Nadolna, I., and Iwanow, K. (2019). Sk\u0142adu i Warto\u015bci Od\u017cywczej \u017bywno\u015bci [Tables of food composition and nutritional values], PZWL. [2nd ed.]."},{"key":"ref_30","unstructured":"Jezewska-Zychowicz, M., Gawecki, J., Wadolowska, L., Czarnocinska, J., Galinski, G., Kollajtis-Dolowy, A., Roszkowski, W., Wawrzyniak, A., Przybylowicz, K., and Krusinska, B. (2017). Dietary Habits and Nutrition Beliefs Questionnaire and the Manual for Developing of Nutritional Data, The Committee of Human Nutrition, Polish Academy of Sciences. Available online: http:\/\/www.knozc.pan.pl\/images\/stories\/MLonnie\/EN_Kwestionariusz_KomPAN_i_PROCEDURA_versja_2_znak_tow_2019_2.pdf."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1845","DOI":"10.3390\/nu10121845","article-title":"Reproducibility of a Questionnaire for Dietary Habits, Lifestyle and Nutrition Knowledge Assessment (KomPAN) in Polish Adolescents and Adults","volume":"10","author":"Kowalkowska","year":"2018","journal-title":"Nutrients"},{"key":"ref_32","first-page":"367","article-title":"ThyPROpl\u2014The Polish version of the thyroid-specific quality of life questionnaire ThyPRo","volume":"66","author":"Watt","year":"2015","journal-title":"Endokrynol. Pol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1530\/EJE-09-0521","article-title":"Validity and reliability of the novel thyroid-specific quality of life questionnaire, ThyPRO","volume":"162","author":"Watt","year":"2010","journal-title":"Eur. J. Endocrinol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"3708","DOI":"10.1210\/jc.2014-1322","article-title":"The thyroid-related quality of life measure ThyPRO has good responsiveness and ability to detect relevant treatment effects","volume":"99","author":"Watt","year":"2014","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_35","unstructured":"ISAK (2001). International Standards for Anthropometric Assessment, International Society for the Advancement of Kinanthropometry. Available online: http:\/\/www.ceap.br\/material\/MAT17032011184632.pdf."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1111\/j.1467-789X.2011.00952.x","article-title":"Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: Systematic review and meta-analysis","volume":"13","author":"Ashwell","year":"2012","journal-title":"Obes Rev."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1016\/S0140-6736(05)67402-8","article-title":"The metabolic syndrome\u2014A new worldwide definition","volume":"266","author":"Alberti","year":"2005","journal-title":"Lancet"},{"key":"ref_38","unstructured":"World Health Organization (1998). Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation on Obesity, World Health Organization. WHO\/NUT\/NCD\/98.1.1998."},{"key":"ref_39","unstructured":"National Institutes of Health, National Heart, Lung, and Blood Institute (2018, July 10). Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK2003\/."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1093\/ajcn\/81.1.74","article-title":"Comparison of multifrequency bioelectrical impedance analysis with dual-energy X-ray absorptiometry for assessment of percentage body fat in a large, healthy population","volume":"81","author":"Sun","year":"2005","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1046\/j.1532-5415.2002.50216.x","article-title":"Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability","volume":"50","author":"Janssen","year":"2002","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.1097\/HJH.0000000000000221","article-title":"European Society of Hypertension practice guidelines for ambulatory blood pressure monitoring","volume":"32","author":"Parati","year":"2014","journal-title":"J. Hypertens."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1953","DOI":"10.1097\/HJH.0000000000001940","article-title":"2018 ESC\/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension","volume":"36","author":"Williams","year":"2018","journal-title":"J. Hypertens."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1161\/CIRCULATIONAHA.109.192644","article-title":"Harmonizing the metabolic syndrome. A joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity","volume":"120","author":"Alberti","year":"2009","journal-title":"Circulation"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"3168","DOI":"10.1016\/j.jacc.2018.11.002","article-title":"2018 AHA\/ACC\/AACVPR\/AAPA\/ABC\/ACPM\/ADA\/AGS\/APhA\/ASPC\/NLA\/PCNA Guideline on the Management of Blood Cholesterol: Executive Summary: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"73","author":"Grundy","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1016\/j.clnu.2011.03.009","article-title":"Effect of orange juice and beverages with phytosterols on cytokines and PAI-1 activity","volume":"30","author":"Devaraj","year":"2011","journal-title":"Clin. Nutr."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2684","DOI":"10.3390\/nu5072684","article-title":"Dairy products, dietary calcium and bone health: Possibility of prevention of osteoporosis in women: The Polish experience","volume":"5","author":"Wadolowska","year":"2013","journal-title":"Nutrients"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1007\/s12020-013-0065-1","article-title":"Decrease in TSH levels after lactose restriction in Hashimoto\u2019s thyroiditis patients with lactose intolerance","volume":"46","author":"Asik","year":"2014","journal-title":"Endocrine"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"5743","DOI":"10.1021\/jf203611t","article-title":"Beneficial effects of blueberries in experimental autoimmune encephalomyelitis","volume":"60","author":"Xin","year":"2012","journal-title":"J. Agric. Food Chem."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.jbspin.2012.08.010","article-title":"Gallic acid, a natural polyphenolic acid, induces apoptosis and inhibits proinflammatory gene expressions in rheumatoid arthritis fibroblast-like synoviocytes","volume":"80","author":"Yoon","year":"2013","journal-title":"Joint Bone Spine"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"4642","DOI":"10.3390\/nu5114642","article-title":"Vegan diets and hypothyroidism","volume":"5","author":"Tonstad","year":"2013","journal-title":"Nutrients"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1080\/01635581.2014.951734","article-title":"Dietary factors and thyroid cancer risk: A meta-analysis of observational studies","volume":"66","author":"Liu","year":"2014","journal-title":"Nutr. Cancer"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"184","DOI":"10.3121\/cmr.2007.738","article-title":"Celiac disease and autoimmune thyroid disease","volume":"5","author":"Jones","year":"2007","journal-title":"Clin. Med. Res."},{"key":"ref_54","first-page":"364","article-title":"Prevalence and clinical features of celiac disease in patients with autoimune thyroiditis: Cross-sectional study","volume":"132","author":"Ventura","year":"2014","journal-title":"Med. J."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"201538","DOI":"10.1155\/2012\/201538","article-title":"Frequency of celiac disease in patients with hypothyroidism","volume":"2012","author":"Mehrdad","year":"2012","journal-title":"J. Thyroid Res."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1089\/thy.2016.0108","article-title":"Prevalence of Celiac Disease in Patients with Autoimmune Thyroid Disease: A Meta-Analysis","volume":"26","author":"Roy","year":"2016","journal-title":"Thyroid"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1136\/gut.49.4.502","article-title":"Duration of gluten exposure in adult coeliac disease does not correlate with the risk for autoimmune disorders","volume":"49","author":"Sategna","year":"2001","journal-title":"Gut"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1016\/j.cgh.2007.12.022","article-title":"Incidence of autoimmune diseases in celiac disease: Protective effect of the gluten-free diet","volume":"6","author":"Cosnes","year":"2008","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1007\/s11130-015-0467-8","article-title":"Selenium in Gluten-free Products","volume":"70","author":"Rybicka","year":"2015","journal-title":"Plant Foods Hum. Nutr."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Klusek, J., Nasierowska-Guttmejer, A., Kowalik, A., Wawrzycka, I., Chrapek, M., Lewitowicz, P., Radowicz-Chil, A., Klusek, J., and Gluszek, S. (2019). The Influence of Red Meat on Colorectal Cancer Occurrence Is Dependent on the Genetic Polymorphisms of S-Glutathione Transferase Genes. Nutrients, 11.","DOI":"10.3390\/nu11071682"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Laskowski, W., Gorska-Warsewicz, H., and Kulykovets, O. (2018). Meat, Meat Products and Seafood as Sources of Energy and Nutrients in the Average Polish Diet. Nutrients, 10.","DOI":"10.3390\/nu10101412"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"40","DOI":"10.4103\/0974-7753.114714","article-title":"Zinc deficiency associated with hypothyroidism: An overlooked cause of severe alopecia","volume":"5","author":"Betsy","year":"2013","journal-title":"Int. J. Trichology"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"263","DOI":"10.14310\/horm.2002.1276","article-title":"Relationship between serum zinc levels, thyroid hormones and thyroid volume following successful iodine supplementation","volume":"9","author":"Ertek","year":"2010","journal-title":"Hormones (Athens)"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1080\/07315724.2014.926161","article-title":"Effects of Zinc and Selenium Supplementation on Thyroid Function in Overweight and Obese Hypothyroid Female Patients: A Randomized Double-Blind Controlled Trial","volume":"34","author":"Mahmoodianfard","year":"2015","journal-title":"J. Am. Coll. Nutr."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1159\/000103324","article-title":"Effect of zinc supplementation on thyroid hormone function. A case study of two college females","volume":"51","author":"Maxwell","year":"2007","journal-title":"Ann. Nutr. Metab."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1007\/s12011-010-8691-4","article-title":"Effect of zinc supplementation on the status of thyroid hormones and Na, K, And Ca levels in blood following ethanol feeding","volume":"140","author":"Pathak","year":"2011","journal-title":"Biol. Trace Elem. Res."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1210\/er.2001-0034","article-title":"Selenium, the thyroid, and the endocrine system","volume":"26","author":"Kohrle","year":"2005","journal-title":"Endocr. Rev."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1017\/S0007114508939830","article-title":"Food-chain selenium and human health: Emphasis on intake","volume":"100","author":"Rayman","year":"2008","journal-title":"Br. J. Nutr."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.1016\/S0140-6736(11)61452-9","article-title":"Selenium and human health","volume":"379","author":"Rayman","year":"2012","journal-title":"Lancet"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1494","DOI":"10.3390\/nu7031494","article-title":"A Review of Dietary Selenium Intake and Selenium Status in Europe and the Middle East","volume":"7","author":"Stoffaneller","year":"2015","journal-title":"Nutrients"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.jtemb.2014.04.009","article-title":"Effects of nationwide addition of selenium to fertilizers on foods, and animal and human health in Finland: From deficiency to optimal selenium status of the population","volume":"31","author":"Alfthan","year":"2014","journal-title":"J. Trace Elem. Med. Biol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.jtemb.2014.07.016","article-title":"Serum and urinary selenium levels in obese children: A cross-sectional study","volume":"29","author":"Blazewicz","year":"2015","journal-title":"J. Trace Elem. Med. Biol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.1089\/thy.2016.0256","article-title":"Selenium supplementation significantly reduces thyroid autoantibody levels in patients with chronic autoimmune thyroiditis: A systematic review and meta-analysis","volume":"26","author":"Wichman","year":"2016","journal-title":"Thyroid"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1484S","DOI":"10.3945\/ajcn.2010.28674J","article-title":"Selenium bioavailability: Current knowledge and future research requirements","volume":"91","author":"Collings","year":"2010","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1089\/acm.2017.0159","article-title":"Commentary: Health Concerns of Brazil Nut Consumption","volume":"24","author":"Mazokopakis","year":"2018","journal-title":"J. Altern. Complement. Med."},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Farhangi, M.A., Dehghan, P., Tajmiri, S., and Abbasi, M.M. (2016). The effects of Nigella sativa on thyroid function, serum Vascular Endothelial Growth Factor (VEGF)\u20131, Nesfatin-1 and anthropometric features in patients with Hashimoto\u2019s thyroiditis: A randomized controlled trial. BMC Complement. Altern. Med., 16.","DOI":"10.1186\/s12906-016-1432-2"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/j.nutres.2011.07.004","article-title":"PROP taster status not related to reported cruciferous vegetable intake among ethnically diverse children","volume":"31","author":"Baranowski","year":"2011","journal-title":"Nutr. Res."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1639","DOI":"10.1007\/s11011-017-0052-y","article-title":"Aspartame and soft drink-mediated neurotoxicity in rats: Implication of oxidative stress, apoptotic signaling pathways, electrolytes and hormonal levels","volume":"32","author":"Lebda","year":"2017","journal-title":"Metab. Brain Dis."},{"key":"ref_79","first-page":"3268","article-title":"Autoimmune Thyroiditis with Hypothyroidism Induced by Sugar Substitutes","volume":"10","author":"Sachmechi","year":"2018","journal-title":"Cureus"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"231","DOI":"10.15171\/hpp.2015.028","article-title":"Fast Food Pattern and Cardiometabolic Disorders: A Review of Current Studies","volume":"5","author":"Bahadoran","year":"2015","journal-title":"Health Promot. Perspect."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/S0140-6736(04)17663-0","article-title":"Fast-food habits, weight gain, and insulin resistance (the CARDIA study): 15-year prospective analysis","volume":"365","author":"Pereira","year":"2005","journal-title":"Lancet"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1177\/0890117116660772","article-title":"Frequency of eating out at both fast-food and sit-down restaurants was associated with high body mass index in non-large metropolitan communities in Midwest","volume":"32","author":"Bhutani","year":"2018","journal-title":"Am. J. Health. Promot."},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Pabich, M., and Materska, M. (2019). Biological Effect of Soy Isoflavones in the Prevention of Civilization Diseases. Nutrients, 11.","DOI":"10.3390\/nu11071660"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1177\/1535370213489488","article-title":"Soy extracts suppressed iodine uptake and stimulated the production of autoimmunogen in rat thyrocytes","volume":"238","author":"Tran","year":"2013","journal-title":"Exp. Biol. Med."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1089\/thy.2006.16.249","article-title":"Effects of soy protein and soybean isoflavones on thyroid function in healthy adults and hypothyroid patients: A review of the relevant literature","volume":"16","author":"Messina","year":"2006","journal-title":"Thyroid"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"R241","DOI":"10.1530\/EJE-14-0047","article-title":"Mechanisms in endocrinology autoimmune thyroid disease: Old and new players","volume":"170","author":"Effraimidis","year":"2014","journal-title":"Eur. J. Endocrinol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"213","DOI":"10.3803\/EnM.2016.31.2.213","article-title":"Clinical relevance of environmental factors in the pathogenesis of autoimmune thyroid disease","volume":"31","author":"Wiersinga","year":"2016","journal-title":"Endocrinol. Metab."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1530\/EJE-12-0356","article-title":"Moderate alcohol consumption may protect against overt autoimmune hypothyroidism: A population-based case-control study","volume":"167","author":"Carle","year":"2012","journal-title":"Eur. J. Endocrinol."},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Stachowska, E., Ryterska, K., Maciejewska, D., Banaszczak, M., Milkiewicz, P., Milkiewicz, M., Gutowska, I., Ossowski, P., Kaczorowska, M., and Gutowska, I. (2016). Nutritional Strategies for the Individualized Treatment of Non-Alcoholic Fatty Liver Disease (NAFLD) Based on the Nutrient-Induced Insulin Output Ratio (NIOR). Int. J. Mol. Sci., 17.","DOI":"10.3390\/ijms17071192"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1007\/s00726-018-2622-7","article-title":"Plasma profile and urine excretion of amino acids in children with celiac disease on gluten-free diet after oligofructose-enriched inulin intervention: Results of a randomised placebo-controlled pilot study","volume":"50","author":"Drabinska","year":"2018","journal-title":"Amino Acids"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"590","DOI":"10.5114\/aoms.2018.75895","article-title":"Metabolic and genetic profiling of young adults with and without a family history of premature coronary heart disease (MAGNETIC). Study design and methodology","volume":"15","author":"Osadnik","year":"2019","journal-title":"Arch. Med. Sci."},{"key":"ref_92","doi-asserted-by":"crossref","unstructured":"Krusinska, B., Hawrysz, I., Wadolowska, L., Slowinska, M.A., Biernacki, M., Czerwinska, A., and Golota, J.J. (2018). Associations of Mediterranean diet and a posteriori derived dietary patterns with breast and lung cancer risk: A case-control study. Nutrients, 10.","DOI":"10.3390\/nu10040470"},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Krusinska, B., Wadolowska, L., Slowinska, M.A., Biernacki, M., Drozdowski, M., and Chadzynski, T. (2018). Associations of dietary patterns and metabolic-hormone profiles with breast cancer risk: A case-control study. Nutrients, 10.","DOI":"10.3390\/nu10122013"},{"key":"ref_94","unstructured":"Food and Agriculture Organization (2018). Dietary Assessment: A resource Guide to Method Selection and Application in Low Resource Settings, Food and Agriculture Organization. Available online: http:\/\/www.fao.org\/3\/i9940en\/I9940EN."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1017\/S136898001400086X","article-title":"Are context-specific measures of parental-reported physical activity and sedentary behaviour associated with accelerometer data in 2-9-year-old European children?","volume":"18","author":"Verbestel","year":"2015","journal-title":"Public Health Nutr."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/16\/23\/4841\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:39:18Z","timestamp":1760189958000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/16\/23\/4841"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,2]]},"references-count":95,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2019,12]]}},"alternative-id":["ijerph16234841"],"URL":"https:\/\/doi.org\/10.3390\/ijerph16234841","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12,2]]}}}