{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T19:11:31Z","timestamp":1761419491345,"version":"build-2065373602"},"reference-count":61,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,9,20]],"date-time":"2021-09-20T00:00:00Z","timestamp":1632096000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007771","name":"\u015al\u0105ski Uniwersytet Medyczny","doi-asserted-by":"publisher","award":["KNW-1-115\/N\/7\/K and KNW-1-040\/K\/8\/K"],"award-info":[{"award-number":["KNW-1-115\/N\/7\/K and KNW-1-040\/K\/8\/K"]}],"id":[{"id":"10.13039\/100007771","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Objectives: To assess pancreatic exocrine function in patients with anorexia nervosa using a breath test with 13C-labeled mixed triglycerides (MTG-BT) and to determine the relationship between the test results and selected biochemical and hormonal parameters. Material and methods: Anthropometric measurements, biochemical and hormonal parameters (serum leptin, soluble leptin receptor (sLR), acylated and desacylated ghrelin, free leptin index (FLI)), and MTG-BT were performed in a group of 31 girls with the restrictive type of AN, as well as 38 healthy girls (C). Results: The average cumulative dose of 13C-triglycerides recovered with exhaled air (%CD) was similar in both study groups, while the average time from 13C-triglycerides administration to peak 13CO2 excretion in expired air (time to peak (TTP)) was significantly longer in patients with AN compared to C. In both groups, %CD correlated negatively with FLI. TTP correlated negatively with sLR and FLI in the AN and with serum insulin and HOMA-IR values in the C. Conclusions: In girls with AN, the pancreatic efficiency of lipase secretion was found to be normal, while the kinetics of this enzyme secretion were disturbed. These changes may result from disorders in the functioning of the adipose\u2013insular and islet\u2013acinar axes.<\/jats:p>","DOI":"10.3390\/nu13093280","type":"journal-article","created":{"date-parts":[[2021,9,21]],"date-time":"2021-09-21T22:34:01Z","timestamp":1632263641000},"page":"3280","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Exocrine Pancreatic Function in Girls with Anorexia Nervosa"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8492-8054","authenticated-orcid":false,"given":"\u017baneta","family":"Malczyk","sequence":"first","affiliation":[{"name":"Chair and Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, ul. 3 Maja 13\/15, 41-800 Zabrze, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wojciech","family":"Roczniak","sequence":"additional","affiliation":[{"name":"Institute of Medicine, Jan Grodek State University in Sanok, ul. Mickiewicza 21, 38-500 Sanok, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bogdan","family":"Mazur","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, ul. Jordana 19, 41-808 Zabrze, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6764-8261","authenticated-orcid":false,"given":"Jaros\u0142aw","family":"Kwiecie\u0144","sequence":"additional","affiliation":[{"name":"Chair and Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, ul. 3 Maja 13\/15, 41-800 Zabrze, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katarzyna","family":"Ziora","sequence":"additional","affiliation":[{"name":"Chair and Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, ul. 3 Maja 13\/15, 41-800 Zabrze, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karolina","family":"G\u00f3rska-Flak","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Institute of Medicine, University of Opole, Al. Wincentego Witosa 26, 45-401 Opole, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanna","family":"O\u015bwi\u0119cimska","sequence":"additional","affiliation":[{"name":"Institute of Medicine, Jan Grodek State University in Sanok, ul. Mickiewicza 21, 38-500 Sanok, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"721","DOI":"10.12740\/PP\/35482","article-title":"Zaburzenia motoryki przewodu pokarmowego u chorych na jad\u0142owstr\u0119t psychiczny\u2013przegl\u0105d pi\u015bmiennictwa [Gastrointestinal motility disorders in patients with anorexia nervosa\u2013A review of the literature","volume":"49","author":"Banasiuk","year":"2015","journal-title":"Psychiatr. Pol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1056\/NEJMcp1803175","article-title":"Anorexia Nervosa","volume":"382","author":"Mitchell","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders(DSM-V), American Psychiatric Association.","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.biopsych.2018.03.014","article-title":"Prevalence and correlates of DSM-5-defined eating disorders in a nationally representative sample of U.S. adults","volume":"84","author":"Udo","year":"2018","journal-title":"Biol. Psychiatry"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"15074","DOI":"10.1038\/nrdp.2015.74","article-title":"Anorexia nervosa","volume":"1","author":"Treasure","year":"2015","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1016\/1054-139X(95)00069-5","article-title":"Eating disorders in adolescents: A background paper","volume":"16","author":"Fisher","year":"1995","journal-title":"J. Adolesc. Health"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1016\/S2215-0366(15)00356-9","article-title":"Anorexia nervosa: Aetiology, assessment, and treatment","volume":"2","author":"Zipfel","year":"2015","journal-title":"Lancet Psychiatry"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1002\/eat.22584","article-title":"Childhood body mass index in adolescent-onset anorexia nervosa","volume":"49","author":"Berkowitz","year":"2016","journal-title":"Int. J. Eat. Disord"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/7854_2010_91","article-title":"The heritability of eating disorders: Methods and current findings","volume":"6","author":"Thornton","year":"2011","journal-title":"Curr. Top. Behav. Neurosci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1007\/s13105-016-0540-2","article-title":"Neurobiochemical and psychological factors influencing the eating behaviors and attitudes in anorexia nervosa","volume":"73","author":"Grzelak","year":"2017","journal-title":"J. Physiol. Biochem."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"219","DOI":"10.12740\/PP\/65274","article-title":"Powik\u0142ania gastroenterologiczne i zasady realimentacji pacjent\u00f3w z jad\u0142owstr\u0119tem psychicznym [Gastrointestinal complications and refeeding guidelines in patients with anorexia nervosa","volume":"51","author":"Malczyk","year":"2017","journal-title":"Psychiatr. Pol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1016\/S0899-9007(00)00575-X","article-title":"Impaired pancreatic secretion in severely malnourished patients is a consequence of primary pancreatic dysfunction","volume":"17","author":"Winter","year":"2001","journal-title":"Nutrition"},{"key":"ref_13","first-page":"45","article-title":"Exocrine pancreatic dysfunction in malnourished Australian aboriginal children","volume":"154","author":"Cleghorn","year":"1991","journal-title":"Med. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"50","DOI":"10.7326\/0003-4819-106-1-50","article-title":"Hyperamylasemia in patients with eating disorders","volume":"106","author":"Humphries","year":"1987","journal-title":"Ann Intern. Med."},{"key":"ref_15","first-page":"681","article-title":"Hepatic and pancreatic dysfunction in anorexia nervosa: A report of two cases","volume":"12","author":"Nordgren","year":"1977","journal-title":"Biol. Psychiatry"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1136\/pgmj.61.711.39","article-title":"Acute pancreatitis and gastric dilatation in a patient with anorexia nervosa","volume":"61","author":"Backett","year":"1985","journal-title":"Postgrad. Med. J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1002\/erv.2223","article-title":"Intestinal absorption and pancreatic function are preserved in anorexia nervosa patients in both a severely malnourished state and after recovery","volume":"21","author":"Lage","year":"2013","journal-title":"Eur. Eat. Disord. Rev."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1097\/00006842-198811000-00007","article-title":"Pancreatic abnormalities in patients with eating disorders","volume":"50","author":"Kobayashi","year":"1988","journal-title":"Psychosom. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1007\/BF01295117","article-title":"Biochemical and ultrasonic abnormalities of the pancreas in anorexia nervosa","volume":"28","author":"Cox","year":"1983","journal-title":"Dig. Dis. Sci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1913","DOI":"10.1055\/s-2008-1066848","article-title":"Hyperamylasemia in anorexia nervosa and bulimia nervosa. Indication of a pancreatic disease?","volume":"114","author":"Hempen","year":"1989","journal-title":"Dtsche Med. Wochenschr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/S2213-8587(13)70180-3","article-title":"Endocrine consequences of anorexia nervosa","volume":"2","author":"Misra","year":"2014","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1097\/MOG.0b013e3283639326","article-title":"Modulation of pancreatic exocrine and endocrine secretion","volume":"29","author":"Chandra","year":"2013","journal-title":"Curr. Opin. Gastroenterol."},{"key":"ref_23","first-page":"523","article-title":"Brain-gut axis in the modulation of pancreatic enzyme secretion","volume":"61","author":"Jaworek","year":"2010","journal-title":"J. Physiol. Pharmacol."},{"key":"ref_24","first-page":"262","article-title":"Ocena st\u0119\u017cenia leptyny oraz rozpuszczalnej frakcji receptora dla niej u dzieci i m\u0142odzie\u017cy z chorob\u0105 Le\u015bniowskiego-Crohna [Assessment of the concentration of leptin and its soluble fraction of its receptor in children and adolescents with Crohn\u2019s disease]","volume":"4","author":"Murawska","year":"2009","journal-title":"Prz. Gastroenterol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1006\/bbrc.2001.4885","article-title":"Different isoforms of the soluble leptin receptor determine the leptin binding activity of human circulating blood","volume":"283","author":"Lammert","year":"2001","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1055\/s-0030-1253422","article-title":"Leptin, soluble leptin receptors, free leptin index, and their relationship with insulin resistance and BMI: High normal BMI is the threshold for serum leptin increase in humans","volume":"42","author":"Owecki","year":"2010","journal-title":"Horm. Metab. Res."},{"key":"ref_27","first-page":"33","article-title":"St\u0119\u017cenie leptyny w surowicy krwi u dziewcz\u0105t z jad\u0142owstr\u0119tem psychicznym [Serum leptin concentration in girls with anorexia nervosa]","volume":"1","author":"Ziora","year":"2003","journal-title":"Endokrynol. Pediatric"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"3486","DOI":"10.1210\/jc.2003-032251","article-title":"Hormonal and body composition predictors of soluble leptin receptor, leptin, and free leptin index in adolescent girls with anorexia nervosa and controls and relation to insulin sensitivity","volume":"89","author":"Misra","year":"2004","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"422","DOI":"10.5603\/EP.a2017.0035","article-title":"Adipokine profile in patients with anorexia nervosa","volume":"68","author":"Baranowska","year":"2017","journal-title":"Endokrynol. Pol."},{"key":"ref_30","first-page":"145","article-title":"Role of feed-regulating peptides on pancreatic exocrine secretion","volume":"59","author":"Kapica","year":"2008","journal-title":"J. Physiol. Pharmacol."},{"key":"ref_31","first-page":"691","article-title":"Leptin directly regulates exocrine pancreas lipase and two related proteins in the rat","volume":"96","author":"Elinson","year":"2006","journal-title":"Br. J. Nutr"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"242","DOI":"10.7326\/0003-4819-61-2-242","article-title":"The exocrine pancreas in diabetes mellitus","volume":"61","author":"Vacca","year":"1964","journal-title":"Ann. Intern. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"587","DOI":"10.33549\/physiolres.931089","article-title":"Increased insulin sensitivity in patients with anorexia nervosa: The role of adipocytokines","volume":"56","author":"Dostalova","year":"2007","journal-title":"Physiol. Res."},{"key":"ref_34","first-page":"87","article-title":"Rola wybranych czynnik\u00f3w oreksygenicznych: Oreksyny A (OXA), oreksyny B (OXB), greliny (GRE) i anoreksygenicznych: Leptyny (LEP) w kontroli homeostazy organizmu w warunkach fizjologii [The role of selected orexigenic factors: Orexin A (OXA), orexin B (OXB), ghrelin (GRE) and anorexigenic factors: Leptin (LEP) in the control of homeostasis under physiological conditions]","volume":"5","year":"2005","journal-title":"Psychiatr. Psychol. Klin."},{"key":"ref_35","first-page":"165","article-title":"Changes of plasma obestatin, ghrelin and NPY in anorexia and bulimia nervosa patients before and after a high-carbohydrate breakfast","volume":"60","author":"Hill","year":"2011","journal-title":"Physiol. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"3057","DOI":"10.1210\/jc.2009-2196","article-title":"Ghrelin and obestatin circadian levels differentiate bingeing-purging from restrictive anorexia nervosa","volume":"95","author":"Germain","year":"2010","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_37","first-page":"383","article-title":"Fasting and postprandial levels of ghrelin, leptin and insulin in lean, obese and anorexic subject","volume":"8","author":"Korek","year":"2013","journal-title":"Prz. Gastroenterol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1530\/EJE-1450669","article-title":"Weight gain decreases elevated plasma ghrelin concentrations of patients with anorexia nervosa","volume":"145","author":"Otto","year":"2001","journal-title":"Eur. J. Endocrinol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.jpeds.2003.10.036","article-title":"Ghrelin levels in obesity and anorexia nervosa: Effect of weight reduction or recuperation","volume":"144","author":"Argente","year":"2004","journal-title":"J. Pediatric"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2161","DOI":"10.1210\/jc.2004-1251","article-title":"Ghrelin, peptide YY, glucose-dependent insulinotropic polypeptide, and hunger responses to a mixed meal in anorexic, obese, and control female adolescents","volume":"90","author":"Stock","year":"2005","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_41","first-page":"211","article-title":"Regulacja hormonalna \u0142aknienia [Hormonal regulation of appetite]","volume":"19","author":"Korek","year":"2013","journal-title":"Med. Og\u00f3lna Nauk. Zdrowiu"},{"key":"ref_42","first-page":"1","article-title":"Rola greliny w organizmie [The role of ghrelin in the body]","volume":"65","author":"Kemona","year":"2011","journal-title":"Post\u0119py Hig. Med. Doswadczalnej"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1038\/nrendo.2016.175","article-title":"The endocrine manifestations of anorexia nervosa: Mechanisms and management","volume":"13","author":"Schorr","year":"2017","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_44","first-page":"1","article-title":"Wska\u017aniki rozwoju somatycznego u dzieci i m\u0142odzie\u017cy warszawskiej [Somatic development indices in children and adolescents from Warsaw]","volume":"5","author":"Palczewska","year":"2001","journal-title":"Med. Wieku Rozw."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1007\/BF00280883","article-title":"Homeostasis model assessment: Insulin resistance and beta-cell function from fasting plasma glucose and insulin concentration in man","volume":"28","author":"Matthews","year":"1985","journal-title":"Diabetologia"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1097\/00006676-199901000-00011","article-title":"Bonnet monkey model for pancreatic changes in induced malnutrition","volume":"18","author":"Sandhyamani","year":"1999","journal-title":"Pancreas"},{"key":"ref_47","first-page":"305","article-title":"The pancreas in kwashiorkor: An electron microscopic study","volume":"20","author":"Blackburn","year":"1969","journal-title":"Lab. Investig."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1097\/MPA.0b013e3181dbf330","article-title":"13C breath tests for the assessment of exocrine pancreatic function","volume":"39","author":"Braden","year":"2010","journal-title":"Pancreas"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1136\/gut.38.1.23","article-title":"Relation between gastric emptying rate and rate of intraluminal lipolysis","volume":"38","author":"Maes","year":"1996","journal-title":"Gut"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1007\/BF01320484","article-title":"Definition of gastric emptying abnormality in patients with anorexia nervosa","volume":"30","author":"McCallum","year":"1985","journal-title":"Dig. Dis. Sci."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1016\/0016-5085(87)90557-9","article-title":"Gastric electromechanical and neurohormonal function in anorexia nervosa","volume":"93","author":"Abell","year":"1987","journal-title":"Gastroenterology"},{"key":"ref_52","first-page":"591","article-title":"Role of leptin in the control of postprandial pancreatic secretion","volume":"54","author":"Jaworek","year":"2003","journal-title":"J. Physiol. Pharmacol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/S0167-0115(03)00064-8","article-title":"Exogenous lepton inhibits the secretion of pancreatic juice via a duodenal CCK1-vagal-dependent mechanism in anaesthetized rats","volume":"114","author":"Matyjek","year":"2003","journal-title":"Regul. Pept."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1016\/j.cell.2009.06.051","article-title":"A serotonin-dependent mechanism explains the leptin regulation of bone mass, appetite, and energy expenditure","volume":"138","author":"Yadav","year":"2009","journal-title":"Cell"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1097\/MED.0b013e328341e12b","article-title":"Eating disorders and gastrointestinal peptides","volume":"18","author":"Tong","year":"2011","journal-title":"Curr. Opin. Endocrinol. Diabetes Obes."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1921","DOI":"10.1113\/jphysiol.2012.247577","article-title":"Gastric vagal afferent modulation by leptin is influenced by food intake status","volume":"591","author":"Kentish","year":"2013","journal-title":"J. Physiol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1152\/ajpgi.00077.2010","article-title":"The islet-acinar axis of the pancreas: More than just insulin","volume":"299","author":"Barreto","year":"2010","journal-title":"Am. J. Physiol. Gastrointest. Liver Physiol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1210\/endo-115-3-1102","article-title":"Insulin receptors on pancreatic acinar cells in guinea pigs","volume":"115","author":"Sjodin","year":"1984","journal-title":"Endocrinology"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1900\/RDS.2016.13.132","article-title":"Pancreas volume and fat deposition in diabetes and normal physiology: Consideration of the interplay between endocrine and exocrine pancreas","volume":"13","author":"Saisho","year":"2016","journal-title":"Rev. Diabet. Stud."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1111\/j.1469-7793.2001.0231k.x","article-title":"Inhibition of pancreatic protein secretion by ghrelin in therat","volume":"537","author":"Zhang","year":"2001","journal-title":"J. Physiol."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Schalla, M.A., and Stengel, A. (2018). The role of ghrelin in anorexia nervosa. Int. J. Mol. Sci., 19.","DOI":"10.3390\/ijms19072117"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/9\/3280\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:02:25Z","timestamp":1760166145000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/9\/3280"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,20]]},"references-count":61,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,9]]}},"alternative-id":["nu13093280"],"URL":"https:\/\/doi.org\/10.3390\/nu13093280","relation":{},"ISSN":["2072-6643"],"issn-type":[{"type":"electronic","value":"2072-6643"}],"subject":[],"published":{"date-parts":[[2021,9,20]]}}}