{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:08:33Z","timestamp":1792789713440,"version":"4.5.0"},"reference-count":50,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T00:00:00Z","timestamp":1735603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"EU FP7-KBBE-2009-3 ATHENA Project","award":["245121."],"award-info":[{"award-number":["245121."]}]},{"name":"Italian Ministry of Health (Ricerca Corrente 2022-24).","award":["245121."],"award-info":[{"award-number":["245121."]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: The impact of the dietary macronutrient composition and its subcomponents (saccharides, fatty acids, and protein sources) on radiation-induced acute skin toxicity (AST) in breast cancer (BC) patients is unknown. Hence, we examined the association between dietary macronutrients and their subcomponents and the risk of \u2265grade 2 (G2) AST post-radiotherapy among women with BC. Methods: An observational study was conducted among 161 BC patients treated with radiotherapy and enrolled in the ATHENA project in Italy. Habitual dietary intake was assessed at study entry (T0) using a 188-item food frequency questionnaire (FFQ). AST was measured at T1 (after 3 or 5 weeks of radiotherapy) and defined according to the Radiation Therapy Oncology Group criteria. A prospective analysis used multivariable-adjusted logistic regression models to examine the association between the dietary macronutrient composition and its subcomponents at T0 and the odds of \u2265G2 AST post-radiotherapy. Results: \u2265G2 AST post-radiotherapy was observed in 43 (27%) patients. Among dietary macronutrient models, a higher intake of dietary carbohydrates was positively associated with a 30% higher odds of \u2265G2 AST post-radiotherapy (OR = 1.30; 95% CI 1.01 to 1.67; for 30 g\/d). Conversely, a higher dietary protein intake was inversely associated with a 76% lower odds of \u2265G2 AST post-radiotherapy (OR = 0.24; 95% CI 0.06 to 0.91; for 30 g\/d). There was no association with dietary fat. In macronutrient subcomponent models, only animal protein was inversely associated with a 51% lower odds of \u2265G2 AST post-radiotherapy (0.49; 95% CI 0.25 to 0.95; for 15 g\/d). Conclusions: Dietary carbohydrates were associated with a higher risk of radiation-induced AST among women with BC, whereas dietary protein, especially animal protein, was associated with a lower risk. Cautiously balancing carbohydrate and protein intakes could be a part of the clinical management strategy for \u2265G2 AST reduction post-radiotherapy among BC women.<\/jats:p>","DOI":"10.3390\/nu17010136","type":"journal-article","created":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T07:00:37Z","timestamp":1735628437000},"page":"136","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Dietary Macronutrient Composition and Risk of Radiation-Induced Acute Skin Toxicity in Women with Breast Cancer: Results from the ATHENA Project"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9465-8978","authenticated-orcid":false,"given":"Sukshma","family":"Sharma","sequence":"first","affiliation":[{"name":"Research Unit of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Bracone","sequence":"additional","affiliation":[{"name":"Research Unit of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9767-7998","authenticated-orcid":false,"given":"Augusto","family":"Di Castelnuovo","sequence":"additional","affiliation":[{"name":"Research Unit of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7109-1128","authenticated-orcid":false,"given":"Emilia","family":"Ruggiero","sequence":"additional","affiliation":[{"name":"Research Unit of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5104-0318","authenticated-orcid":false,"given":"Amalia","family":"De Curtis","sequence":"additional","affiliation":[{"name":"Research Unit of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1276-5070","authenticated-orcid":false,"given":"Francesco","family":"Deodato","sequence":"additional","affiliation":[{"name":"Istituto di Radiologia, Universit\u00e0 Cattolica S. Cuore, 00168 Rome, Italy"},{"name":"Radiotherapy Unit, Responsible Research Hospital, 86100 Campobasso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0529-201X","authenticated-orcid":false,"given":"Gabriella","family":"Macchia","sequence":"additional","affiliation":[{"name":"Radiotherapy Unit, Responsible Research Hospital, 86100 Campobasso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariangela","family":"Boccardi","sequence":"additional","affiliation":[{"name":"Radiotherapy Unit, Responsible Research Hospital, 86100 Campobasso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Savino","family":"Cilla","sequence":"additional","affiliation":[{"name":"Medical Physic Unit, Responsible Research Hospital, 86100 Campobasso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9793-3410","authenticated-orcid":false,"given":"Alessio Giuseppe","family":"Morganti","sequence":"additional","affiliation":[{"name":"Department of Experimental, Diagnostic and Speciality Medicine\u2014DIMES, Alma Mater Studiorum Bologna University, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4759-3179","authenticated-orcid":false,"given":"Chiara","family":"Cerletti","sequence":"additional","affiliation":[{"name":"Research Unit of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7823-1402","authenticated-orcid":false,"given":"Giovanni","family":"de Gaetano","sequence":"additional","affiliation":[{"name":"Research Unit of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3318-0442","authenticated-orcid":false,"given":"Katia","family":"Petroni","sequence":"additional","affiliation":[{"name":"Department of Biosciences, Universit\u00e0 degli Studi di Milano, 20133 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9505-3118","authenticated-orcid":false,"given":"Chiara","family":"Tonelli","sequence":"additional","affiliation":[{"name":"Department of Biosciences, Universit\u00e0 degli Studi di Milano, 20133 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Benedetta","family":"Donati","sequence":"additional","affiliation":[{"name":"Research Unit of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0514-5885","authenticated-orcid":false,"given":"Licia","family":"Iacoviello","sequence":"additional","affiliation":[{"name":"Research Unit of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy"},{"name":"Department of Medicine and Surgery, LUM University, 70010 Casamassima, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8082-6552","authenticated-orcid":false,"given":"Marialaura","family":"Bonaccio","sequence":"additional","affiliation":[{"name":"Research Unit of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the EU-ATHENA Trial Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1002\/cncr.21324","article-title":"The Role of Radiotherapy in Cancer Treatment: Estimating Optimal Utilization from a Review of Evidence-Based Clinical Guidelines","volume":"104","author":"Delaney","year":"2005","journal-title":"Cancer"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"193","DOI":"10.7150\/ijms.3635","article-title":"Cancer and Radiation Therapy: Current Advances and Future Directions","volume":"9","author":"Baskar","year":"2012","journal-title":"Int. J. Med. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Burguin, A., Diorio, C., and Durocher, F. (2021). Breast Cancer Treatments: Updates and New Challenges. J. Pers. Med., 11.","DOI":"10.3390\/jpm11080808"},{"key":"ref_5","first-page":"23379","article-title":"Radiation-Induced Skin Injury: Pathogenesis, Treatment, and Management","volume":"12","author":"Yang","year":"2020","journal-title":"Aging"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Xie, Y., Wang, Q., Hu, T., Chen, R., Wang, J., Chang, H., and Cheng, J. (2021). Risk Factors Related to Acute Radiation Dermatitis in Breast Cancer Patients After Radiotherapy: A Systematic Review and Meta-Analysis. Front. Oncol., 11.","DOI":"10.3389\/fonc.2021.738851"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3109\/09637486.2014.950207","article-title":"Diet and Breast Cancer: A Systematic Review","volume":"66","author":"Mourouti","year":"2015","journal-title":"Int. J. Food Sci. Nutr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3209","DOI":"10.21873\/anticanres.12586","article-title":"Dietary Patterns and Breast Cancer Risk: A Systematic Review","volume":"38","author":"Dandamudi","year":"2018","journal-title":"Anticancer Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"107868","DOI":"10.1016\/j.maturitas.2023.107868","article-title":"High Adherence to Western Dietary Pattern Increases Breast Cancer Risk (an EPIC-Spain Study)","volume":"179","author":"Lope","year":"2024","journal-title":"Maturitas"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1007\/s10552-019-01193-z","article-title":"Healthy Dietary Patterns and Risk and Survival of Breast Cancer: A Meta-Analysis of Cohort Studies","volume":"30","author":"Hou","year":"2019","journal-title":"Cancer Causes Control"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13058-019-1096-1","article-title":"Associations between Dietary Patterns and the Risk of Breast Cancer: A Systematic Review and Meta-Analysis of Observational Studies","volume":"21","author":"Xiao","year":"2019","journal-title":"Breast Cancer Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1016\/S0140-6736(96)91008-9","article-title":"Intake of Macronutrients and Risk of Breast Cancer","volume":"347","author":"Franceschi","year":"1996","journal-title":"Lancet"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1080\/01635581.2011.523499","article-title":"Macronutrient Composition Influence on Breast Cancer Risk in Hispanic and Non-Hispanic White Women: The 4-Corners Breast Cancer Study","volume":"63","author":"Murtaugh","year":"2011","journal-title":"Nutr. Cancer"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1771","DOI":"10.1007\/s00394-024-03379-x","article-title":"Macronutrient Composition of Plant-Based Diets and Breast Cancer Risk: The E3N Prospective Cohort Study","volume":"63","author":"Koemel","year":"2024","journal-title":"Eur. J. Nutr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1089\/acm.2011.0334","article-title":"Complementary and Alternative Medicine Use in Radiotherapy: What Are Patients Using?","volume":"18","author":"Gillett","year":"2012","journal-title":"J. Altern. Complement. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.tipsro.2020.08.001","article-title":"A Systematic Review of Home-Based Dietary Interventions during Radiation Therapy for Cancer","volume":"16","author":"Allenby","year":"2020","journal-title":"Tech. Innov. Patient Support. Radiat. Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.jdermsci.2020.01.009","article-title":"Ionizing Radiation Induces Cutaneous Lipid Remolding and Skin Adipocytes Confer Protection against Radiation-Induced Skin Injury","volume":"97","author":"Xiao","year":"2020","journal-title":"J. Dermatol. Sci."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2068","DOI":"10.1016\/j.clnu.2020.09.030","article-title":"Skin Toxicity Following Radiotherapy in Patients with Breast Carcinoma: Is Anthocyanin Supplementation Beneficial?","volume":"40","author":"Bracone","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1136\/bmj.c332","article-title":"CONSORT 2010 Statement: Updated Guidelines for Reporting Parallel Group Randomised Trials","volume":"340","author":"Schulz","year":"2010","journal-title":"BMJ"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1177\/030089160308900603","article-title":"Diet in the Italian EPIC Cohorts: Presentation of Data and Methodological Issues","volume":"89","author":"Pala","year":"2003","journal-title":"Tumori"},{"key":"ref_21","unstructured":"Salvini, S., Istituto Europeo di Oncologia, Parpinel, M., Gnagnarella, P., Maisonneuve, P., and Turrini, A. (2024, November 26). Banca Dati Di Composizione Degli Alimenti per Studi Epidemiologici in Italia. Available online: https:\/\/agris.fao.org\/search\/en\/providers\/122621\/records\/647396a93ed73003714cde3a."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1016\/0360-3016(95)00060-C","article-title":"Toxicity Criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC)","volume":"31","author":"Cox","year":"1995","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"466","DOI":"10.3109\/0284186X.2015.1110253","article-title":"Dose-Surface Analysis for Prediction of Severe Acute Radio-Induced Skin Toxicity in Breast Cancer Patients","volume":"55","author":"Pastore","year":"2016","journal-title":"Acta Oncol."},{"key":"ref_24","first-page":"1887","article-title":"Robust Causal Inference Using Directed Acyclic Graphs: The R Package \u201cDagitty\u201d","volume":"45","author":"Textor","year":"2016","journal-title":"Int. J. Epidemiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1093\/ije\/dyaa213","article-title":"Use of Directed Acyclic Graphs (DAGs) to Identify Confounders in Applied Health Research: Review and Recommendations","volume":"50","author":"Tennant","year":"2021","journal-title":"Int. J. Epidemiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1016\/j.ijrobp.2008.10.089","article-title":"Radioprotective Effect of Moderate Wine Consumption in Patients with Breast Carcinoma","volume":"74","author":"Morganti","year":"2009","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"437","DOI":"10.3322\/caac.21689","article-title":"Radiation Therapy-Associated Toxicity: Etiology, Management, and Prevention","volume":"71","author":"Wang","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"849","DOI":"10.3945\/ajcn.116.150565","article-title":"Randomized Controlled Trial of Dietary Fiber for the Prevention of Radiation-Induced Gastrointestinal Toxicity during Pelvic Radiotherapy","volume":"106","author":"Wedlake","year":"2017","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/j.semradonc.2017.04.008","article-title":"Management of Radiation Toxicity in Head and Neck Cancers","volume":"27","author":"Siddiqui","year":"2017","journal-title":"Semin. Radiat. Oncol."},{"key":"ref_30","first-page":"1","article-title":"Identification of Key Proteins in the Signaling Crossroads between Wound Healing and Cancer Hallmark Phenotypes","volume":"11","author":"Abarca","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_31","first-page":"4231516","article-title":"The Effect of a Compound Protein on Wound Healing and Nutritional Status","volume":"2022","author":"Wang","year":"2022","journal-title":"Evid. Based Complement. Altern. Med."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Jakovija, A., and Chtanova, T. (2023). Skin Immunity in Wound Healing and Cancer. Front. Immunol., 14.","DOI":"10.3389\/fimmu.2023.1060258"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.tifs.2016.03.006","article-title":"The \u201cSisters\u201d \u03b1-Helices of Collagen, Elastin and Keratin Recovered from Animal by-Products: Functionality, Bioactivity and Trends of Application","volume":"51","author":"Ferraro","year":"2016","journal-title":"Trends Food Sci. Technol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Ryan, J.T., Ross, R.P., Bolton, D., Fitzgerald, G.F., and Stanton, C. (2011). Bioactive Peptides from Muscle Sources: Meat and Fish. Nutrients, 3.","DOI":"10.3390\/nu3090765"},{"key":"ref_35","first-page":"46","article-title":"Diet and Dermatology: The Role of Dietary Intervention in Skin Disease","volume":"7","author":"Katta","year":"2014","journal-title":"J. Clin. Aesthet. Dermatol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"pkaa101","DOI":"10.1093\/jncics\/pkaa101","article-title":"Protein Intake by Source and Breast Cancer Incidence and Mortality: The Women\u2019s Health Initiative","volume":"4","author":"Pan","year":"2020","journal-title":"JNCI Cancer Spectr."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Burns, J.S., and Manda, G. (2017). Metabolic Pathways of the Warburg Effect in Health and Disease: Perspectives of Choice, Chain or Chance. Int. J. Mol. Sci., 18.","DOI":"10.3390\/ijms18122755"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/978-3-030-65768-0_1","article-title":"Glucose Metabolism in Cancer: The Warburg Effect and Beyond","volume":"1311","author":"Bose","year":"2021","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1007\/s44178-023-00058-5","article-title":"Feasibility and Metabolic Effects of a 5:2 Fasting Intervention in Women with Breast Cancer during Radiotherapy","volume":"2","author":"Klement","year":"2023","journal-title":"Holist. Integr. Oncol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"613","DOI":"10.3945\/an.116.014423","article-title":"Dietary Guidelines for Breast Cancer Patients: A Critical Review","volume":"8","year":"2017","journal-title":"Adv. Nutr."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Urz\u00ec, A.G., Tropea, E., Gattuso, G., Spoto, G., Marsala, G., Calina, D., Libra, M., and Falzone, L. (2023). Ketogenic Diet and Breast Cancer: Recent Findings and Therapeutic Approaches. Nutrients, 15.","DOI":"10.3390\/nu15204357"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"K\u00e4mmerer, U., Klement, R.J., Joos, F.T., S\u00fctterlin, M., and Reuss-Borst, M. (2021). Low Carb and Ketogenic Diets Increase Quality of Life, Physical Performance, Body Composition, and Metabolic Health of Women with Breast Cancer. Nutrients, 13.","DOI":"10.3390\/nu13031029"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Bhatnagar, R., Dixit, N.M., Yang, E.H., and Sallam, T. (2022). Cancer Therapy\u2019s Impact on Lipid Metabolism: Mechanisms and Future Avenues. Front. Cardiovasc. Med., 9.","DOI":"10.3389\/fcvm.2022.925816"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.3390\/nursrep13040126","article-title":"Lipid Disturbances in Breast Cancer Patients during Chemotherapy","volume":"13","author":"Alimperti","year":"2023","journal-title":"Nurs. Rep."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"245","DOI":"10.3322\/caac.21591","article-title":"American Cancer Society Guideline for Diet and Physical Activity for Cancer Prevention","volume":"70","author":"Rock","year":"2020","journal-title":"CA Cancer J. Clin."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12885-019-5896-6","article-title":"Short- and Long-Term Impact of Adapted Physical Activity and Diet Counseling during Adjuvant Breast Cancer Therapy: The \u201cAPAD1\u201d Randomized Controlled Trial","volume":"19","author":"Carayol","year":"2019","journal-title":"BMC Cancer"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.breast.2021.08.008","article-title":"Evidence-Based Tailored Nutrition Educational Intervention Improves Adherence to Dietary Guidelines, Anthropometric Measures and Serum Metabolic Biomarkers in Early-Stage Breast Cancer Patients: A Prospective Interventional Study","volume":"60","author":"Trestini","year":"2021","journal-title":"Breast"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"2227","DOI":"10.1093\/aje\/kwy126","article-title":"Combining a Food Frequency Questionnaire With 24-Hour Recalls to Increase the Precision of Estimation of Usual Dietary Intakes-Evidence From the Validation Studies Pooling Project","volume":"187","author":"Freedman","year":"2018","journal-title":"Am. J. Epidemiol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/S0002-8223(01)00018-9","article-title":"Biased Over- Or Under-Reporting Is Characteristic of Individuals Whether Over Time or by Different Assessment Methods","volume":"101","author":"Black","year":"2001","journal-title":"J. Am. Diet. Assoc."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"926","DOI":"10.12688\/f1000research.10703.1","article-title":"Dietary Assessment Methods in Epidemiological Research: Current State of the Art and Future Prospects","volume":"6","author":"Naska","year":"2017","journal-title":"F1000Research"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/1\/136\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:57:40Z","timestamp":1760115460000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/1\/136"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,31]]},"references-count":50,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1]]}},"alternative-id":["nu17010136"],"URL":"https:\/\/doi.org\/10.3390\/nu17010136","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,31]]}}}