{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T14:11:41Z","timestamp":1789827101636,"version":"4.0.1"},"reference-count":88,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2022,11,19]],"date-time":"2022-11-19T00:00:00Z","timestamp":1668816000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Astronauts exhibit several pathophysiological changes due to a variety of stressors related to the space environment, including microgravity, space radiation, isolation, and confinement. Space motion sickness, bone and muscle mass loss, cardiovascular deconditioning and neuro-ocular syndrome are some of the spaceflight-induced effects on human health. Optimal nutrition is of the utmost importance, and\u2014in combination with other measures, such as physical activity and pharmacological treatment\u2014has a key role in mitigating many of the above conditions, including bone and muscle mass loss. Since the beginning of human space exploration, space food has not fully covered astronauts\u2019 needs. They often suffer from menu fatigue and present unintentional weight loss, which leads to further alterations. The purpose of this review was to explore the role of nutrition in relation to the pathophysiological effects of spaceflight on the human body.<\/jats:p>","DOI":"10.3390\/nu14224896","type":"journal-article","created":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T04:13:36Z","timestamp":1669004016000},"page":"4896","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Physiological Alterations in Relation to Space Flight: The Role of Nutrition"],"prefix":"10.3390","volume":"14","author":[{"given":"Stavroula","family":"Chaloulakou","sequence":"first","affiliation":[{"name":"Department of Clinical Nutrition, \u201cEvangelismos\u201d General Hospital of Athens, 10676 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0023-8102","authenticated-orcid":false,"given":"Kalliopi Anna","family":"Poulia","sequence":"additional","affiliation":[{"name":"Laboratory of Dietetics and Quality of Life, Department of Food Science & Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, 11855 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4142-2392","authenticated-orcid":false,"given":"Dimitrios","family":"Karayiannis","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, \u201cEvangelismos\u201d General Hospital of Athens, 10676 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1016\/j.neubiorev.2021.09.055","article-title":"Neuro-consequences of the spaceflight environment","volume":"132","author":"Mhatre","year":"2022","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1080\/26896583.2021.1885283","article-title":"The individual and combined effects of spaceflight radiation and microgravity on biologic systems and functional outcomes","volume":"39","author":"Willey","year":"2021","journal-title":"J. Environ. Sci. Health Part C"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1007\/s00415-017-8427-x","article-title":"The effect of spaceflight and microgravity on the human brain","volume":"264","author":"Demertzi","year":"2017","journal-title":"J. Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"547","DOI":"10.3389\/fphys.2017.00547","article-title":"Human Pathophysiological Adaptations to the Space Environment","volume":"8","author":"Demontis","year":"2017","journal-title":"Front. Physiol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Tang, H., Rising, H.H., Majji, M., and Brown, R.D. (2021). Long-Term Space Nutrition: A Scoping Review. Nutrients, 14.","DOI":"10.3390\/nu14010194"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"771936","DOI":"10.3389\/fpsyg.2021.771936","article-title":"Can Space Tourism Boost Sustainable Behavior?","volume":"12","author":"Mammarella","year":"2021","journal-title":"Front. Psychol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"16031","DOI":"10.1038\/npjmgrav.2016.31","article-title":"Towards human exploration of space: The THESEUS review series on cardiovascular, respiratory, and renal research priorities","volume":"2","author":"Aubert","year":"2016","journal-title":"npj Microgravity"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"666683","DOI":"10.3389\/fbioe.2021.666683","article-title":"Spaceflight Induced Disorders: Potential Nutritional Countermeasures","volume":"9","author":"Costa","year":"2021","journal-title":"Front. Bioeng. Biotechnol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"16029","DOI":"10.1038\/npjmgrav.2016.29","article-title":"Towards human exploration of space: The THESEUS review series on nutrition and metabolism research priorities","volume":"2","author":"Bergouignan","year":"2016","journal-title":"npj Microgravity"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Montesinos, C.A., Khalid, R., Cristea, O., Greenberger, J.S., Epperly, M.W., Lemon, J.A., Boreham, D.R., Popov, D., Gorthi, G., and Ramkumar, N. (2021). Space Radiation Protection Countermeasures in Microgravity and Planetary Exploration. Life, 11.","DOI":"10.3390\/life11080829"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Goodwin, T.J., and Christofidou-Solomidou, M. (2018). Oxidative Stress and Space Biology: An Organ-Based Approach. Int. J. Mol. Sci., 19.","DOI":"10.3390\/ijms19040959"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1038\/s41526-022-00194-8","article-title":"The effects of microgravity on bone structure and function","volume":"8","author":"Man","year":"2022","journal-title":"npj Microgravity"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"100324","DOI":"10.1016\/j.ijgfs.2021.100324","article-title":"The current state and future trends of space nutrition from a perspective of astronauts\u2019 physiology","volume":"24","author":"Bychkov","year":"2021","journal-title":"Int. J. Gastron. Food Sci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"912","DOI":"10.3357\/AMHP.4676.2016","article-title":"Autonomous, Computer-Based Behavioral Health Countermeasure Evaluation at HI-SEAS Mars Analog","volume":"87","author":"Anderson","year":"2016","journal-title":"Aerosp. Med. Hum. Perform."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Baran, R., Marchal, S., Campos, S.G., Rehnberg, E., Tabury, K., Baselet, B., Wehland, M., Grimm, D., and Baatout, S. (2021). The Cardiovascular System in Space: Focus on In Vivo and In Vitro Studies. Biomedicines, 10.","DOI":"10.3390\/biomedicines10010059"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"697435","DOI":"10.3389\/fimmu.2021.697435","article-title":"Immunological Aspects of Isolation and Confinement","volume":"12","author":"Ponomarev","year":"2021","journal-title":"Front. Immunol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1152\/japplphysiol.00928.2015","article-title":"Effects of isolation and confinement on humans-implications for manned space explorations","volume":"120","author":"Pagel","year":"2016","journal-title":"J. Appl. Physiol."},{"key":"ref_18","first-page":"23","article-title":"Keeping the right time in space: Importance of circadian clock and sleep for physiology and performance of astronauts","volume":"1","author":"Guo","year":"2014","journal-title":"Mil Med Res"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"739747","DOI":"10.3389\/fbioe.2021.739747","article-title":"The Future of Personalized Medicine in Space: From Observations to Countermeasures","volume":"9","author":"Baatout","year":"2021","journal-title":"Front. Bioeng. Biotechnol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3746","DOI":"10.1096\/fj.201700294","article-title":"Astronaut ophthalmic syndrome","volume":"31","author":"Zwart","year":"2017","journal-title":"FASEB J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"703766","DOI":"10.3389\/fpsyg.2021.703766","article-title":"Can the Biophilia Hypothesis Be Applied to Long-Duration Human Space Flight? A Mini-Review","volume":"12","author":"Neilson","year":"2021","journal-title":"Front. Psychol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.lssr.2018.10.004","article-title":"Biological effects of space environmental factors: A possible interaction between space radiation and microgravity","volume":"20","author":"Yatagai","year":"2019","journal-title":"Life Sci. Space Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"4703286","DOI":"10.1155\/2020\/4703286","article-title":"Space Radiation Biology for \u201cLiving in Space\u201d","volume":"2020","author":"Furukawa","year":"2020","journal-title":"BioMed Res. Int."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"760313","DOI":"10.3389\/fncir.2021.760313","article-title":"Challenges to the Vestibular System in Space: How the Brain Responds and Adapts to Microgravity","volume":"15","author":"Carriot","year":"2021","journal-title":"Front. Neural Circuits"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1038\/s41526-020-0103-2","article-title":"A systematic review and meta-analysis of bone loss in space travelers","volume":"6","author":"Stavnichuk","year":"2020","journal-title":"npj Microgravity"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1136\/bjsports-2020-103602","article-title":"Pre-flight exercise and bone metabolism predict unloading-induced bone loss due to spaceflight","volume":"56","author":"Gabel","year":"2022","journal-title":"Br. J. Sports Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1016\/j.bone.2015.10.002","article-title":"Bone metabolism and renal stone risk during International Space Station missions","volume":"81","author":"Smith","year":"2015","journal-title":"Bone"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1893","DOI":"10.1007\/s11255-012-0289-7","article-title":"The kidney in space","volume":"44","author":"Liakopoulos","year":"2012","journal-title":"Int. Urol. Nephrol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"9446","DOI":"10.1038\/s41598-022-13461-1","article-title":"Incomplete recovery of bone strength and trabecular microarchitecture at the distal tibia 1 year after return from long duration spaceflight","volume":"12","author":"Gabel","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2097","DOI":"10.1007\/s40279-021-01496-9","article-title":"Effects of Spaceflight on Musculoskeletal Health: A Systematic Review and Meta-analysis, Considerations for Interplanetary Travel","volume":"51","author":"Comfort","year":"2021","journal-title":"Sports Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1359\/JBMR.040307","article-title":"Cortical and Trabecular Bone Mineral Loss from the Spine and Hip in Long-Duration Spaceflight","volume":"19","author":"Lang","year":"2004","journal-title":"J. Bone Miner. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2010","DOI":"10.1002\/jbmr.3188","article-title":"Cortical and Trabecular Bone Microstructure Did Not Recover at Weight-Bearing Skeletal Sites and Progressively Deteriorated at Non-Weight-Bearing Sites During the Year Following International Space Station Missions","volume":"32","author":"Vico","year":"2017","journal-title":"J. Bone Miner. Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"C567","DOI":"10.1152\/ajpcell.00203.2021","article-title":"Factors mediating spaceflight-induced skeletal muscle atrophy","volume":"322","author":"Lee","year":"2022","journal-title":"Am. J. Cell Physiol. Physiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2158","DOI":"10.1152\/jappl.2000.89.6.2158","article-title":"Muscle volume, MRI relaxation times (T2), and body composition after spaceflight","volume":"89","author":"Leblanc","year":"2000","journal-title":"J. Appl. Physiol."},{"key":"ref_35","first-page":"157","article-title":"Bone mineral and lean tissue loss after long duration space flight","volume":"1","author":"Leblanc","year":"2000","journal-title":"J. Musculoskelet. Neuronal Interact."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Sandal, P.H., Kim, D., Fiebig, L., Winnard, A., Caplan, N., Green, D.A., and Weber, T. (2020). Effectiveness of nutritional countermeasures in microgravity and its ground-based analogues to ameliorate musculoskeletal and cardiopulmonary deconditioning\u2014A Systematic Review. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0234412"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"100595","DOI":"10.1016\/j.ijcha.2020.100595","article-title":"The effects of microgravity and space radiation on cardiovascular health: From low-Earth orbit and beyond","volume":"30","author":"Patel","year":"2020","journal-title":"IJC Heart Vasc."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1152\/japplphysiol.01251.2013","article-title":"Peak exercise oxygen uptake during and following long-duration spaceflight","volume":"117","author":"Moore","year":"2014","journal-title":"J. Appl. Physiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.1249\/MSS.0000000000001615","article-title":"Physiological and Functional Alterations after Spaceflight and Bed Rest","volume":"50","author":"Mulavara","year":"2018","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e1915011","DOI":"10.1001\/jamanetworkopen.2019.15011","article-title":"Assessment of Jugular Venous Blood Flow Stasis and Thrombosis During Spaceflight","volume":"2","author":"Laurie","year":"2019","journal-title":"JAMA Netw. Open"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1113\/EP089409","article-title":"The effect of microgravity on the human venous system and blood coagulation: A systematic review","volume":"106","author":"Kim","year":"2021","journal-title":"Exp. Physiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1551","DOI":"10.3389\/fphys.2018.01551","article-title":"Recent Progress in Space Physiology and Aging","volume":"9","author":"Strollo","year":"2018","journal-title":"Front. Physiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.3389\/fimmu.2018.01437","article-title":"Immune System Dysregulation During Spaceflight: Potential Countermeasures for Deep Space Exploration Missions","volume":"9","author":"Crucian","year":"2018","journal-title":"Front. Immunol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"868999","DOI":"10.3389\/fbioe.2022.868999","article-title":"Space Flight-Promoted Insulin Resistance as a Possible Disruptor of Wound Healing","volume":"10","author":"Strollo","year":"2022","journal-title":"Front. Bioeng. Biotechnol."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Douglas, G.L., Wheeler, R.M., and Fritsche, R.F. (2021). Sustaining Astronauts: Resource Limitations, Technology Needs, and Parallels between Spaceflight Food Systems and those on Earth. Sustainability, 13.","DOI":"10.3390\/su13169424"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"3226","DOI":"10.1210\/jc.2007-1684","article-title":"Calorie Restriction Modulates Inactivity-Induced Changes in the Inflammatory Markers C-Reactive Protein and Pentraxin-3","volume":"93","author":"Bosutti","year":"2008","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1093\/ajcn\/86.2.366","article-title":"Calorie restriction accelerates the catabolism of lean body mass during 2 wk of bed rest","volume":"86","author":"Biolo","year":"2007","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"3439","DOI":"10.1111\/1541-4337.12633","article-title":"Factors affecting flavor perception in space: Does the spacecraft environment influence food intake by astronauts?","volume":"19","author":"Taylor","year":"2020","journal-title":"Compr. Rev. Food Sci. Food Saf."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"112829","DOI":"10.1016\/j.physbeh.2020.112829","article-title":"Meal replacement in isolated and confined mission environments: Consumption, acceptability, and implications for physical and behavioral health","volume":"219","author":"Sirmons","year":"2020","journal-title":"Physiol. Behav."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"321","DOI":"10.3389\/fphys.2019.00321","article-title":"Revisiting the Role of Exercise Countermeasure on the Regulation of Energy Balance During Space Flight","volume":"10","author":"Laurens","year":"2019","journal-title":"Front. Physiol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.3945\/jn.117.247437","article-title":"Excretion of Zinc and Copper Increases in Men during 3 Weeks of Bed Rest, with or without Artificial Gravity","volume":"147","author":"Heacox","year":"2017","journal-title":"J. Nutr."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Pittia, P., and Heer, M. (2022). Space Food for the Future: Nutritional Challenges and Technological Strategies for Healthy and High-Quality Products. In-Space Manufacturing and Resources: Earth and Planetary Exploration Applications, Wiley.","DOI":"10.1002\/9783527830909.ch13"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"2242","DOI":"10.1093\/jn\/nxaa188","article-title":"Space Food for Thought: Challenges and Considerations for Food and Nutrition on Exploration Missions","volume":"150","author":"Douglas","year":"2020","journal-title":"J. Nutr."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1038\/s41526-017-0022-z","article-title":"Initial assessment of the nutritional quality of the space food system over three years of ambient storage","volume":"3","author":"Cooper","year":"2017","journal-title":"npj Microgravity"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"H209","DOI":"10.1111\/j.1750-3841.2009.01265.x","article-title":"Assessment of Nutrient Stability in Foods from the Space Food System After Long-Duration Spaceflight on the ISS","volume":"74","author":"Zwart","year":"2009","journal-title":"J. Food Sci."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"199","DOI":"10.3389\/fpls.2020.00199","article-title":"Microbiological and Nutritional Analysis of Lettuce Crops Grown on the International Space Station","volume":"11","author":"Khodadad","year":"2020","journal-title":"Front. Plant Sci."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Baba, S., Smith, T., Hellmann, J., Bhatnagar, A., Carter, K., Vanhoover, A., and Caruso, J. (2020). Space Flight Diet-Induced Deficiency and Response to Gravity-Free Resistive Exercise. Nutrients, 12.","DOI":"10.3390\/nu12082400"},{"key":"ref_58","unstructured":"Vanhoover, A., McEnroe, B., Gray, D., O\u2019Brien, I., Kozerski, A., Selimovic, E., Carter, K., Stumbo, J., and Caruso, J. (2021). A High Protein Diet Improves Exercise Performance Outcomes to Workouts Completed on Gravity-Independent Hardware. J. Exerc. Nutr., 2."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.nutres.2020.07.001","article-title":"Nutritional interventions during bed rest and spaceflight: Prevention of muscle mass and strength loss, bone resorption, glucose intolerance, and cardiovascular problems","volume":"82","author":"Gao","year":"2020","journal-title":"Nutr. Res."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1111\/nbu.12422","article-title":"Nutritional challenges and countermeasures for space travel","volume":"45","author":"Cahill","year":"2020","journal-title":"Nutr. Bull."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1080\/26896583.2021.1891825","article-title":"Consequences of space radiation on the brain and cardiovascular system","volume":"39","author":"Davis","year":"2021","journal-title":"J. Environ. Sci. Health Part C"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Goodwin, T.J., and Christofidou-Solomidou, M. (2022). Editorial to the Special Issue: \u201cDysregulation of Human Molecular and Metabolic Mechanisms Resulting in Oxidative Stress and Damage Generation in the Space Environment\u201d. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23126466"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.1007\/s11306-013-0556-3","article-title":"Personalized medicine in human space flight: Using Omics based analyses to develop individualized countermeasures that enhance astronaut safety and performance","volume":"9","author":"Schmidt","year":"2013","journal-title":"Metabolomics"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1186\/s12967-017-1338-x","article-title":"Radioprotective agents to prevent cellular damage due to ionizing radiation","volume":"15","author":"Smith","year":"2017","journal-title":"J. Transl. Med."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"19376","DOI":"10.3390\/molecules191219376","article-title":"Potential Role of Sulfur-Containing Antioxidant Systems in Highly Oxidative Environments","volume":"19","author":"Mukwevho","year":"2014","journal-title":"Molecules"},{"key":"ref_66","first-page":"1209","article-title":"Long-term follow-up of Skylab bone demineralization","volume":"51","author":"Tilton","year":"1980","journal-title":"Aviat. Space, Environ. Med."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1016\/0094-5765(79)90059-6","article-title":"Prolonged weightlessness and calcium loss in man","volume":"6","author":"Rambaut","year":"1979","journal-title":"Acta Astronaut."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1896","DOI":"10.1002\/jbmr.1647","article-title":"Benefits for bone from resistance exercise and nutrition in long-duration spaceflight: Evidence from biochemistry and densitometry","volume":"27","author":"Smith","year":"2012","journal-title":"J. Bone Miner. Res."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Genah, S., Monici, M., and Morbidelli, L. (2021). The Effect of Space Travel on Bone Metabolism: Considerations on Today\u2019s Major Challenges and Advances in Pharmacology. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22094585"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1359\/jbmr.091041","article-title":"Capacity of Omega-3 Fatty Acids or Eicosapentaenoic Acid to Counteract Weightlessness-Induced Bone Loss by Inhibiting NF-\u03baB Activation: From Cells to Bed Rest to Astronauts","volume":"25","author":"Zwart","year":"2010","journal-title":"J. Bone Miner. Res."},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Backx, E.M., Horstman, A.M., Marzuca-Nassr, G.N., van Kranenburg, J., Smeets, J.S., Fuchs, C.J., Janssen, A.A., De Groot, L.C., Snijders, T., and Verdijk, L.B. (2018). Leucine Supplementation Does Not Attenuate Skeletal Muscle Loss during Leg Immobilization in Healthy, Young Men. Nutrients, 10.","DOI":"10.3390\/nu10050635"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1152\/japplphysiol.01162.2006","article-title":"Cardiac atrophy in women following bed rest","volume":"103","author":"Dorfman","year":"2007","journal-title":"J. Appl. Physiol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1111\/jam.14789","article-title":"Gut microbiome and human health under the space environment","volume":"130","author":"Siddiqui","year":"2021","journal-title":"J. Appl. Microbiol."},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Tesei, D., Jewczynko, A., Lynch, A.M., and Urbaniak, C. (2022). Understanding the Complexities and Changes of the Astronaut Microbiome for Successful Long-Duration Space Missions. Life, 12.","DOI":"10.3390\/life12040495"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1186\/s40168-020-00830-z","article-title":"The influence of spaceflight on the astronaut salivary microbiome and the search for a microbiome biomarker for viral reactivation","volume":"8","author":"Urbaniak","year":"2020","journal-title":"Microbiome"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"617696","DOI":"10.3389\/fmicb.2020.617696","article-title":"Temporal Characteristics of the Oropharyngeal and Nasal Microbiota Structure in Crewmembers Stayed 180 Days in the Controlled Ecological Life Support System","volume":"11","author":"Chen","year":"2021","journal-title":"Front. Microbiol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"659179","DOI":"10.3389\/fmicb.2021.659179","article-title":"Investigation of Spaceflight Induced Changes to Astronaut Microbiomes","volume":"12","author":"Morrison","year":"2021","journal-title":"Front. Microbiol."},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Avila-Herrera, A., Thissen, J., Urbaniak, C., Be, N.A., Smith, D.J., Karouia, F., Mehta, S., Venkateswaran, K., and Jaing, C. (2020). Crewmember microbiome may influence microbial composition of ISS habitable surfaces. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0231838"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"9911","DOI":"10.1038\/s41598-019-46303-8","article-title":"Study of the impact of long-duration space missions at the International Space Station on the astronaut microbiome","volume":"9","author":"Voorhies","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"553929","DOI":"10.3389\/fphys.2020.553929","article-title":"Gut Microbiome and Space Travelers\u2019 Health: State of the Art and Possible Pro\/Prebiotic Strategies for Long-Term Space Missions","volume":"11","author":"Turroni","year":"2020","journal-title":"Front. Physiol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/s00394-015-1056-1","article-title":"Daily intake of fermented milk with Lactobacillus casei strain Shirota reduces the incidence and duration of upper respiratory tract infections in healthy middle-aged office workers","volume":"56","author":"Shida","year":"2017","journal-title":"Eur. J. Nutr."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1017\/S0007114511005630","article-title":"Daily intake of Lactobacillus casei Shirota increases natural killer cell activity in smokers","volume":"108","author":"Reale","year":"2012","journal-title":"Br. J. Nutr."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"10687","DOI":"10.1038\/s41598-018-29094-2","article-title":"Probiotics into outer space: Feasibility assessments of encapsulated freeze-dried probiotics during 1 month\u2019s storage on the International Space Station","volume":"8","author":"Sakai","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1016\/j.jfoodeng.2006.02.030","article-title":"Preparation of freeze-dried yoghurt as a space food","volume":"80","author":"Venir","year":"2007","journal-title":"J. Food Eng."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1093\/af\/vfy016","article-title":"History, development, and current status of food safety systems worldwide","volume":"8","author":"Weinroth","year":"2018","journal-title":"Anim. Front."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/j.ihj.2017.01.010","article-title":"Tele-echocardiography\u2014Made for astronauts, now in hospitals","volume":"69","author":"Balasingam","year":"2017","journal-title":"Indian Heart J."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1016\/j.cell.2020.11.002","article-title":"Comprehensive Multi-omics Analysis Reveals Mitochondrial Stress as a Central Biological Hub for Spaceflight Impact","volume":"183","author":"Fazelinia","year":"2020","journal-title":"Cell"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1159\/000252852","article-title":"Space, Gravity and the Physiology of Aging: Parallel or Convergent Disciplines? A Mini-Review","volume":"56","author":"Vernikos","year":"2010","journal-title":"Gerontology"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/22\/4896\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:21:49Z","timestamp":1760145709000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/22\/4896"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,19]]},"references-count":88,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2022,11]]}},"alternative-id":["nu14224896"],"URL":"https:\/\/doi.org\/10.3390\/nu14224896","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,19]]}}}