{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T09:54:03Z","timestamp":1787910843059,"version":"build-2784847793"},"reference-count":51,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T00:00:00Z","timestamp":1726099200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Paolo Sorbini Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Managing metabolism for optimal training, performance, and recovery in medium-to-high-level endurance runners involves enhancing energy systems through strategic nutrient intake. Optimal carbohydrate intake before, during, and after endurance running can enhance glycogen stores and maintain optimal blood glucose levels, influencing various physiological responses and adaptations, including transitory post-endurance inflammation. This randomized trial investigates the impact of a high-dose 2:1 maltodextrin\u2013fructose supplementation to medium-to-high-level endurance runners immediately before, during, and after a 15 km run at 90% VO2max intensity on post-exercise inflammatory stress. Methods: We evaluated inflammatory biomarkers and lipidomic profiles before the endurance tests and up to 24 h after. We focused on the effects of high-dose 2:1 maltodextrin\u2013fructose supplementation on white blood cell count, neutrophil number, IL-6, cortisol, and CRP levels, as well as polyunsaturated fatty acids, \u03c9-3 index, and AA\/EPA ratio. Results: This supplementation significantly reduced inflammatory markers and metabolic stress. Additionally, it may enhance the post-activity increase in blood \u03c9-3 fatty acid levels and reduce the increase in \u03c9-6 levels, resulting in a lower trend of AA\/EPA ratio at 24 h in the treated arm. Conclusions: Adequate carbohydrate supplementation may acutely mitigate inflammation during a one-hour endurance activity of moderate-to-high intensity. These effects could be beneficial for athletes engaging in frequent, high-intensity activities.<\/jats:p>","DOI":"10.3390\/nu16183078","type":"journal-article","created":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T11:04:33Z","timestamp":1726139073000},"page":"3078","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Effects of Maltodextrin\u2013Fructose Supplementation on Inflammatory Biomarkers and Lipidomic Profile Following Endurance Running: A Randomized Placebo-Controlled Cross-Over Trial"],"prefix":"10.3390","volume":"16","author":[{"given":"Stefano","family":"Righetti","sequence":"first","affiliation":[{"name":"Department of Cardiology, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6285-607X","authenticated-orcid":false,"given":"Alessandro","family":"Medoro","sequence":"additional","affiliation":[{"name":"Department of Medicine and Health Sciences \u201cV. Tiberio\u201d, University of Molise, 86100 Campobasso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1825-3527","authenticated-orcid":false,"given":"Francesca","family":"Graziano","sequence":"additional","affiliation":[{"name":"Biostatistics and Clinical Epidemiology, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy"},{"name":"Bicocca Bioinformatics Biostatistics and Bioimaging Center B4, School of Medicine and Surgery, University of Milan-Bicocca, 20126 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Mondazzi","sequence":"additional","affiliation":[{"name":"Sport Service Mapei, Sport Nutrition, 21057 Olgiate Olona, Italy"},{"name":"School of Clinical Nutrition, University of Milan, 20126 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Martegani","sequence":"additional","affiliation":[{"name":"Department of Biotechnology and Life Science, University of Insubria, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Chiappero","sequence":"additional","affiliation":[{"name":"Equipe Enervit Srl, Scientific Research Unit of Enervit Spa, 20126 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Casiraghi","sequence":"additional","affiliation":[{"name":"Equipe Enervit Srl, Scientific Research Unit of Enervit Spa, 20126 Milan, Italy"},{"name":"Department of Public Health, Experimental and Forensic Sciences, University of Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Petroni","sequence":"additional","affiliation":[{"name":"Equipe Enervit Srl, Scientific Research Unit of Enervit Spa, 20126 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3441-889X","authenticated-orcid":false,"given":"Graziamaria","family":"Corbi","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Sciences, University of Naples \u201cFederico II\u201d, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Pina","sequence":"additional","affiliation":[{"name":"Equipe Enervit Srl, Scientific Research Unit of Enervit Spa, 20126 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1592-5586","authenticated-orcid":false,"given":"Giovanni","family":"Scapagnini","sequence":"additional","affiliation":[{"name":"Department of Medicine and Health Sciences \u201cV. Tiberio\u201d, University of Molise, 86100 Campobasso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2578-7199","authenticated-orcid":false,"given":"Sergio","family":"Davinelli","sequence":"additional","affiliation":[{"name":"Department of Medicine and Health Sciences \u201cV. Tiberio\u201d, University of Molise, 86100 Campobasso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camillo","family":"Ricordi","sequence":"additional","affiliation":[{"name":"Cell Transplant Center, Diabetes Research Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Amawi, A., AlKasasbeh, W., Jaradat, M., Almasri, A., Alobaidi, S., Hammad, A.A., Bishtawi, T., Fataftah, B., Turk, N., and Al Saoud, H. (2023). Athletes\u2019 nutritional demands: A narrative review of nutritional requirements. Front. Nutr., 10.","DOI":"10.3389\/fnut.2023.1331854"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Mart\u00edn-Rodr\u00edguez, A., Belinch\u00f3n-deMiguel, P., Rubio-Zarapuz, A., Tornero-Aguilera, J.F., Mart\u00ednez-Guardado, I., Villanueva-Tobaldo, C.V., and Clemente-Su\u00e1rez, V.J. (2024). Advances in Understanding the Interplay between Dietary Practices, Body Composition, and Sports Performance in Athletes. Nutrients, 16.","DOI":"10.3390\/nu16040571"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/s40279-014-0148-z","article-title":"A step towards personalized sports nutrition: Carbohydrate intake during exercise","volume":"44","author":"Jeukendrup","year":"2014","journal-title":"Sports Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1007\/BF00236069","article-title":"Carbohydrate supercompensation and muscle glycogen utilization during exhaustive running in highly trained athletes","volume":"61","author":"Madsen","year":"1990","journal-title":"Eur. J. Appl. Physiol. Occup. Physiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1055\/s-2008-1034594","article-title":"Effect of exercise-diet manipulation on muscle glycogen and its subsequent utilization during performance","volume":"2","author":"Sherman","year":"1981","journal-title":"Int. J. Sports Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"E543","DOI":"10.1152\/ajpendo.00232.2016","article-title":"Liver glycogen metabolism during and after prolonged endurance-type exercise","volume":"311","author":"Gonzalez","year":"2016","journal-title":"Am. J. Physiol. Endocrinol. Metab."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"117","DOI":"10.2165\/00007256-200333020-00004","article-title":"Determinants of post-exercise glycogen synthesis during short-term recovery","volume":"33","author":"Jentjens","year":"2003","journal-title":"Sports Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1038\/nri3041","article-title":"The anti-inflammatory effects of exercise: Mechanisms and implications for the prevention and treatment of disease","volume":"11","author":"Gleeson","year":"2011","journal-title":"Nat. Rev. Immunol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1016\/bs.pmbts.2015.07.003","article-title":"Exercise and the Regulation of Inflammatory Responses","volume":"135","author":"Allen","year":"2015","journal-title":"Prog. Mol. Biol. Transl. Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1152\/japplphysiol.00622.2016","article-title":"Recovery of the immune system after exercise","volume":"122","author":"Peake","year":"2017","journal-title":"J. Appl. Physiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"3719","DOI":"10.1096\/fj.201700080R","article-title":"Nutritional interventions and the IL-6 response to exercise","volume":"31","author":"Hennigar","year":"2017","journal-title":"FASEB J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1615\/CritRevEukaryotGeneExpr.2016015920","article-title":"Macrophage Polarization: Implications on Metabolic Diseases and the Role of Exercise","volume":"26","author":"Silveira","year":"2016","journal-title":"Crit. Rev. Eukaryot. Gene Expr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1662","DOI":"10.1152\/jappl.1997.82.5.1662","article-title":"Carbohydrate and the cytokine response to 2.5 h of running","volume":"82","author":"Fagoaga","year":"1997","journal-title":"J. Appl. Physiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1917","DOI":"10.1152\/japplphysiol.01130.2002","article-title":"Carbohydrate ingestion influences skeletal muscle cytokine mRNA and plasma cytokine levels after a 3-h run","volume":"94","author":"Nieman","year":"2003","journal-title":"J. Appl. Physiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1123\/ijsnem.15.5.465","article-title":"Influence of acute vitamin C and\/or carbohydrate ingestion on hormonal, cytokine, and immune responses to prolonged exercise","volume":"15","author":"Davison","year":"2005","journal-title":"Int. J. Sport Nutr. Exerc. Metab."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Nieman, D.C., and Mitmesser, S.H. (2017). Potential Impact of Nutrition on Immune System Recovery from Heavy Exertion: A Metabolomics Perspective. Nutrients, 9.","DOI":"10.3390\/nu9050513"},{"key":"ref_17","first-page":"8","article-title":"Consensus Statement Immunonutrition and Exercise","volume":"23","author":"Bermon","year":"2017","journal-title":"Exerc. Immunol. Rev."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1152\/physrev.90100.2007","article-title":"Muscle as an endocrine organ: Focus on muscle-derived interleukin-6","volume":"88","author":"Pedersen","year":"2008","journal-title":"Physiol. Rev."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1038\/s42255-022-00538-4","article-title":"Interleukin 6 as an energy allocator in muscle tissue","volume":"4","author":"Kistner","year":"2022","journal-title":"Nat. Metab."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/sms.14241","article-title":"IL-6 signaling in acute exercise and chronic training: Potential consequences for health and athletic performance","volume":"33","author":"Nash","year":"2023","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1111\/j.1469-7793.2001.00633.x","article-title":"Interleukin-6 production in contracting human skeletal muscle is influenced by pre-exercise muscle glycogen content","volume":"537","author":"Steensberg","year":"2001","journal-title":"J. Physiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1152\/japplphysiol.00164.2004","article-title":"The anti-inflammatory effect of exercise","volume":"98","author":"Petersen","year":"2005","journal-title":"J. Appl. Physiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1080\/17461391.2014.920926","article-title":"Carbohydrate availability and exercise training adaptation: Too much of a good thing?","volume":"15","author":"Bartlett","year":"2015","journal-title":"Eur. J. Sport Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1111\/1440-1681.12246","article-title":"Ramping up the signal: Promoting endurance training adaptation in skeletal muscle by nutritional manipulation","volume":"41","author":"Hawley","year":"2014","journal-title":"Clin. Exp. Pharmacol. Physiol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Naderi, A., Gobbi, N., Ali, A., Berjisian, E., Hamidvand, A., Forbes, S.C., Koozehchian, M.S., Karayigit, R., and Saunders, B. (2023). Carbohydrates and Endurance Exercise: A Narrative Review of a Food First Approach. Nutrients, 15.","DOI":"10.3390\/nu15061367"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1080\/15502783.2022.2131460","article-title":"Effects of carbohydrate and protein supplement strategies on endurance capacity and muscle damage of endurance runners: A double blind, controlled crossover trial","volume":"19","author":"Liang","year":"2022","journal-title":"J. Int. Soc. Sports Nutr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1136\/bjsports-2016-095999","article-title":"Effect of exercise training on C reactive protein: A systematic review and meta-analysis of randomised and non-randomised controlled trials","volume":"51","author":"Fedewa","year":"2017","journal-title":"Br. J. Sports Med."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Cerqueira, \u00c9., Marinho, D.A., Neiva, H.P., and Louren\u00e7o, O. (2020). Inflammatory Effects of High and Moderate Intensity Exercise\u2014A Systematic Review. Front. Physiol., 10.","DOI":"10.3389\/fphys.2019.01550"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Medoro, A., Buonsenso, A., Centorbi, M., Calcagno, G., Scapagnini, G., Fiorilli, G., and Davinelli, S. (2024). Omega-3 Index as a Sport Biomarker: Implications for Cardiovascular Health, Injury Prevention, and Athletic Performance. J. Funct. Morphol. Kinesiol., 9.","DOI":"10.3390\/jfmk9020091"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1080\/10408398.2020.1724871","article-title":"Metabolic indices of polyunsaturated fatty acids: Current evidence, research controversies, and clinical utility","volume":"61","author":"Davinelli","year":"2021","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_31","first-page":"64","article-title":"Influence of carbohydrate on the immune response to intensive, prolonged exercise","volume":"4","author":"Nieman","year":"1998","journal-title":"Exerc. Immunol. Rev."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/j.cyto.2010.10.001","article-title":"The effect of carbohydrate ingestion on plasma interleukin-6, hepcidin and iron concentrations following prolonged exercise","volume":"53","author":"Walshe","year":"2011","journal-title":"Cytokine"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1889","DOI":"10.1007\/s00421-011-2156-0","article-title":"The effects of carbohydrate ingestion during endurance running on post-exercise inflammation and hepcidin levels","volume":"112","author":"Sim","year":"2012","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2786","DOI":"10.1519\/JSC.0000000000000470","article-title":"Effects of carbohydrate ingestion on acute leukocyte, cortisol, and interleukin-6 response in high-intensity long-distance running","volume":"28","author":"Ihalainen","year":"2014","journal-title":"J. Strength Cond. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1079\/BJN19780152","article-title":"Generalized equations for predicting body density of men","volume":"40","author":"Jackson","year":"1978","journal-title":"Br. J. Nutr."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1249\/00005768-198023000-00009","article-title":"Generalized equations for predicting body density of women","volume":"12","author":"Jackson","year":"1980","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Cadario, F., Pozzi, E., Rizzollo, S., Stracuzzi, M., Beux, S., Giorgis, A., Carrera, D., Fullin, F., Riso, S., and Rizzo, A.M. (2019). Vitamin D and \u03c9-3 Supplementations in Mediterranean Diet During the 1st Year of Overt Type 1 Diabetes: A Cohort Study. Nutrients, 11.","DOI":"10.20944\/preprints201907.0048.v1"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1080\/15438620600854793","article-title":"Influence of carbohydrate on immune function following 2 h cycling","volume":"14","author":"Nieman","year":"2006","journal-title":"Res. Sports Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1007\/s40279-017-0751-x","article-title":"Assessment of Metabolic Flexibility by Means of Measuring Blood Lactate, Fat, and Carbohydrate Oxidation Responses to Exercise in Professional Endurance Athletes and Less-Fit Individuals","volume":"48","author":"Brooks","year":"2018","journal-title":"Sports Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1016\/j.nut.2004.04.017","article-title":"Carbohydrate intake during exercise and performance","volume":"20","author":"Jeukendrup","year":"2004","journal-title":"Nutrition"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1152\/japplphysiol.01023.2003","article-title":"Oxidation of exogenous glucose, sucrose, and maltose during prolonged cycling exercise","volume":"96","author":"Jentjens","year":"2004","journal-title":"J. Appl. Physiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1152\/japplphysiol.00974.2003","article-title":"Oxidation of combined ingestion of glucose and fructose during exercise","volume":"96","author":"Jentjens","year":"2004","journal-title":"J. Appl. Physiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1016\/j.metabol.2004.12.004","article-title":"Oxidation of combined ingestion of glucose and sucrose during exercise","volume":"54","author":"Jentjens","year":"2005","journal-title":"Metabolism"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1079\/BJN20041368","article-title":"High rates of exogenous carbohydrate oxidation from a mixture of glucose and fructose ingested during prolonged cycling exercise","volume":"93","author":"Jentjens","year":"2005","journal-title":"Br. J. Nutr."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1249\/01.mss.0000241645.28467.d3","article-title":"Dose-response effects of ingested carbohydrate on exercise metabolism in women","volume":"39","author":"Wallis","year":"2007","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1123\/ijsn.2.1.48","article-title":"Gastrointestinal complaints in relation to dietary intake in triathletes","volume":"2","author":"Rehrer","year":"1992","journal-title":"Int. J. Sport Nutr."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1055\/s-2000-8858","article-title":"The effect of a sports drink on gastroesophageal reflux during a run-bike-run test","volume":"21","author":"Peters","year":"2000","journal-title":"Int. J. Sports Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1016\/S0026-0495(03)00330-5","article-title":"Regulation of glucose kinetics during intense exercise in humans: Effects of \u03b1- and \u03b2-adrenergic blockade","volume":"52","author":"Howlett","year":"2003","journal-title":"Metabolism"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1080\/17461391.2021.1998643","article-title":"Omega-3 index and AA\/EPA ratio as biomarkers of running-related injuries: An observational study in recreational runners","volume":"23","author":"Davinelli","year":"2023","journal-title":"Eur. J. Sport Sci."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1016\/j.freeradbiomed.2022.11.017","article-title":"Targeting NRF2\u2013KEAP1 axis by Omega-3 fatty acids and their derivatives: Emerging opportunities against aging and diseases","volume":"193","author":"Davinelli","year":"2022","journal-title":"Free Radic. Biol. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"833","DOI":"10.2165\/00007256-200333110-00004","article-title":"Effects of the menstrual cycle on exercise performance","volume":"33","year":"2003","journal-title":"Sports Med."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/18\/3078\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:55:05Z","timestamp":1760111705000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/18\/3078"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,12]]},"references-count":51,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2024,9]]}},"alternative-id":["nu16183078"],"URL":"https:\/\/doi.org\/10.3390\/nu16183078","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,12]]}}}