{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T20:25:55Z","timestamp":1791923155915,"version":"4.3.4"},"reference-count":41,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T00:00:00Z","timestamp":1756252800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Carlos III National Health Institute","award":["IFI20\/00034"],"award-info":[{"award-number":["IFI20\/00034"]}]},{"name":"Carlos III National Health Institute","award":["B1-2022_32"],"award-info":[{"award-number":["B1-2022_32"]}]},{"name":"University of M\u00e1laga","award":["IFI20\/00034"],"award-info":[{"award-number":["IFI20\/00034"]}]},{"name":"University of M\u00e1laga","award":["B1-2022_32"],"award-info":[{"award-number":["B1-2022_32"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Breast cancer-related lymphedema (BCRL) is more prevalent and severe in women with overweight or obesity. This study evaluated the effect of a comprehensive lifestyle intervention\u2014comprising supervised exercise, a hypocaloric Mediterranean diet, and optional meal replacement\u2014on lymphedema outcomes in this population. Methods: In this pilot randomized controlled trial, 112 women with BCRL and BMI 25\u201340 kg\/m2 were assigned to an intervention group\u2014receiving supervised resistance and aerobic training, dietary counseling, and optional high-protein meal replacement\u2014or to a control group with standard advice. The primary outcome was change in affected limb volume at 3 and 6 months. Secondary outcomes included morphofunctional parameters, muscle strength, dietary intake, and serum levels of cytokines (IL-1\u03b2, IL-6, IL-10, and TNF-\u03b1). Analyses also explored outcomes according to whether participants achieved \u2265 5% weight loss. Results: Ninety-four participants completed the trial (intervention n = 43, control n = 51). At 6 months, women who achieved \u22655% weight loss had greater reductions in affected limb volume (\u2212664.9 \u00b1 362.1 mL vs. \u2212395.6 \u00b1 596.9 mL). The intervention group showed significantly greater improvements in BMI (\u22121.14 \u00b1 1.22 kg\/m2), waist circumference (\u22123.59 \u00b1 4.6 cm), triceps skinfold (\u22124.61 \u00b1 3.02 mm), fat mass (\u22122.38 \u00b1 2.75 kg), extracellular water (\u22120.58 \u00b1 0.85 L), and quadriceps strength (+7.1 \u00b1 9.7 kg). No significant changes were observed in circulating cytokines. Conclusions: In this pilot randomized controlled trial, a structured dietary and exercise intervention improved morphofunctional outcomes in overweight women with BCRL. Weight loss of \u22655% emerged as a potentially relevant therapeutic target that may inform the design of future studies aimed at optimizing lymphedema management.<\/jats:p>","DOI":"10.3390\/nu17172768","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T08:19:32Z","timestamp":1756282772000},"page":"2768","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Targeting Lymphedema in Overweight Breast Cancer Survivors: A Pilot Randomized Controlled Trial of Diet and Exercise Intervention"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9197-7962","authenticated-orcid":false,"given":"Yolanda","family":"Ruiz-Molina","sequence":"first","affiliation":[{"name":"Servicio de Medicina F\u00edsica y Rehabilitaci\u00f3n, Hospital Virgen de la Victoria, 29010 Malaga, Spain"},{"name":"Departamento de Medicina y Dermatolog\u00eda, Universidad de M\u00e1laga, 29010 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8727-3231","authenticated-orcid":false,"given":"Marina","family":"Padial","sequence":"additional","affiliation":[{"name":"Departamento de Medicina y Dermatolog\u00eda, Universidad de M\u00e1laga, 29010 Malaga, Spain"},{"name":"Servicio de Endocrinolog\u00eda y Nutrici\u00f3n, Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga y Plataforma en Nanomedicina\u2013IBIMA Plataforma Bionand, Hospital Regional Universitario de M\u00e1laga, 29010 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda del Mar","family":"Mart\u00edn-Bravo","sequence":"additional","affiliation":[{"name":"Servicio de Medicina F\u00edsica y Rehabilitaci\u00f3n, Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga y Plataforma en Nanomedicina\u2013IBIMA Plataforma Bionand, Hospital Regional Universitario de M\u00e1laga, 29010 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5131-4478","authenticated-orcid":false,"given":"Mar\u00eda","family":"Garc\u00eda-Olivares","sequence":"additional","affiliation":[{"name":"Departamento de Medicina y Dermatolog\u00eda, Universidad de M\u00e1laga, 29010 Malaga, Spain"},{"name":"Servicio de Endocrinolog\u00eda y Nutrici\u00f3n, Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga y Plataforma en Nanomedicina\u2013IBIMA Plataforma Bionand, Hospital Regional Universitario de M\u00e1laga, 29010 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0503-9708","authenticated-orcid":false,"given":"Nuria","family":"Porras","sequence":"additional","affiliation":[{"name":"Servicio de Endocrinolog\u00eda y Nutrici\u00f3n, Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga y Plataforma en Nanomedicina\u2013IBIMA Plataforma Bionand, Hospital Regional Universitario de M\u00e1laga, 29010 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Chicharro","sequence":"additional","affiliation":[{"name":"Departamento de Medicina y Dermatolog\u00eda, Universidad de M\u00e1laga, 29010 Malaga, Spain"},{"name":"Servicio de Medicina F\u00edsica y Rehabilitaci\u00f3n, Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga y Plataforma en Nanomedicina\u2013IBIMA Plataforma Bionand, Hospital Regional Universitario de M\u00e1laga, 29010 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Mora-Robles","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga y Plataforma en Nanomedicina\u2013IBIMA Plataforma Bionand, Hospital Regional Universitario de M\u00e1laga, 29010 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7059-1577","authenticated-orcid":false,"given":"Andr\u00e9s","family":"Gonz\u00e1lez-Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Plataforma de Bioinform\u00e1tica, Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga y Plataforma en Nanomedicina\u2013IBIMA Plataforma Bionand, 29590 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corina Ver\u00f3nica","family":"Sasso","sequence":"additional","affiliation":[{"name":"Departamento de Medicina y Dermatolog\u00eda, Universidad de M\u00e1laga, 29010 Malaga, Spain"},{"name":"Servicio de Endocrinolog\u00eda y Nutrici\u00f3n, Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga y Plataforma en Nanomedicina\u2013IBIMA Plataforma Bionand, Hospital Regional Universitario de M\u00e1laga, 29010 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7646-2899","authenticated-orcid":false,"given":"Gabriel","family":"Olveira","sequence":"additional","affiliation":[{"name":"Departamento de Medicina y Dermatolog\u00eda, Universidad de M\u00e1laga, 29010 Malaga, Spain"},{"name":"Servicio de Endocrinolog\u00eda y Nutrici\u00f3n, Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga y Plataforma en Nanomedicina\u2013IBIMA Plataforma Bionand, Hospital Regional Universitario de M\u00e1laga, 29010 Malaga, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red (CIBER) de Diabetes y Enfermedades Metab\u00f3licas Asociadas, Instituto de Salud Carlos III, 29071 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2972","DOI":"10.1245\/s10434-017-5960-x","article-title":"Breast Cancer-Related Lymphedema Risk Is Related to Multidisciplinary Treatment and Not Surgery Alone: Results from a Large Cohort Study","volume":"24","author":"Nguyen","year":"2017","journal-title":"Ann. Surg. Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1001\/archsurg.2010.231","article-title":"Risk Factors for Lymphedema in a Prospective Breast Cancer Survivorship Study: The Pathways Study","volume":"145","author":"Kwan","year":"2010","journal-title":"Arch. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Ly, C., Kataru, R., and Mehrara, B. (2017). Inflammatory Manifestations of Lymphedema. Int. J. Mol. Sci., 18.","DOI":"10.3390\/ijms18010171"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Bowman, C., and Rockson, S.G. (2024). The Role of Inflammation in Lymphedema: A Narrative Review of Pathogenesis and Opportunities for Therapeutic Intervention. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25073907"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1038\/s41523-021-00276-y","article-title":"The Impact of Lymphedema on Health-Related Quality of Life up to 10 Years after Breast Cancer Treatment","volume":"7","author":"Toyserkani","year":"2021","journal-title":"npj Breast Cancer"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"4119","DOI":"10.1002\/cncr.34489","article-title":"Burden of Lymphedema in Long-term Breast Cancer Survivors by Race and Age","volume":"128","author":"Ren","year":"2022","journal-title":"Cancer"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"80","DOI":"10.47102\/annals-acadmedsg.2023264","article-title":"Defining Breast Cancer-Related Lymphedema (BCRL) Prevalence and Risk Factors: A Pragmatic Approach to Lymphedema Surveillance","volume":"53","author":"Hing","year":"2024","journal-title":"Ann. Acad. Med. Singap."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1097\/PRS.0000000000007021","article-title":"Body Mass Index and Lymphedema Morbidity: Comparison of Obese versus Normal-Weight Patients","volume":"146","author":"Greene","year":"2020","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1590\/1809-2950\/14743623012016","article-title":"Influence of Body Mass Index on the Frequency of Lymphedema and Other Complications after Surgery for Breast Cancer","volume":"23","author":"Oliveira","year":"2016","journal-title":"Fisioter. Pesqui."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.breast.2020.05.007","article-title":"Effects of Weight Reduction on the Breast Cancer-Related Lymphedema: A Systematic Review and Meta-Analysis","volume":"52","author":"Tsai","year":"2020","journal-title":"Breast"},{"key":"ref_11","first-page":"278","article-title":"Body Mass Index Increases the Risk of Breast Cancer-Related Lymphedema at 6\u201318 Months after Surgery: A Retrospective Study","volume":"31","author":"Wang","year":"2023","journal-title":"Support. Care Cancer"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1590\/1809-2950\/15214123032016","article-title":"Preval\u00eancia de Linfedema Ap\u00f3s Tratamento de C\u00e2ncer de Mama Em Pacientes Com Sobrepeso","volume":"23","author":"Paiva","year":"2016","journal-title":"Fisioter. Pesqui."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3233","DOI":"10.21873\/anticanres.15109","article-title":"Integrated Treatment of Breast Cancer-Related Lymphedema: A Descriptive Review of the State of the Art","volume":"41","author":"Marchica","year":"2021","journal-title":"Anticancer. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/s12282-022-01428-z","article-title":"What Do We Know about Treating Breast-Cancer-Related Lymphedema? Review of the Current Knowledge about Therapeutic Options","volume":"30","author":"Anuszkiewicz","year":"2023","journal-title":"Breast Cancer"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1868","DOI":"10.1002\/cncr.22994","article-title":"A Randomized Controlled Trial of Weight Reduction as a Treatment for Breast Cancer-related Lymphedema","volume":"110","author":"Shaw","year":"2007","journal-title":"Cancer"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"100763","DOI":"10.1016\/j.rh.2022.10.002","article-title":"Role of Weight Lost in Breast Cancer-Related Lymph","volume":"57","author":"Valdivieso","year":"2023","journal-title":"Rehabilitacion"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3939","DOI":"10.1002\/cncr.33819","article-title":"Weight Loss Does Not Decrease Risk of Breast Cancer\u2013Related Arm Lymphedema","volume":"127","author":"Roberts","year":"2021","journal-title":"Cancer"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2985","DOI":"10.1016\/j.jacc.2013.11.004","article-title":"AHA\/ACC\/TOS Guideline for the Management of Overweight and Obesity in Adults","volume":"63","author":"Jensen","year":"2013","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1177\/1559827617742108","article-title":"Lifestyle Modification Group for Lymphedema and Obesity Results in Significant Health Outcomes","volume":"14","author":"Keith","year":"2020","journal-title":"Am. J. Lifestyle Med."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"del-Rosal-Jurado, A., Romero-Galisteo, R., Trinidad-Fern\u00e1ndez, M., Gonz\u00e1lez-S\u00e1nchez, M., Cuesta-Vargas, A., and Ruiz-Mu\u00f1oz, M. (2020). Therapeutic Physical Exercise Post-Treatment in Breast Cancer: A Systematic Review of Clinical Practice Guidelines. J. Clin. Med., 9.","DOI":"10.3390\/jcm9041239"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2153","DOI":"10.2147\/OTT.S97864","article-title":"Effects of Exercise Intervention in Breast Cancer Survivors: A Meta-Analysis of 33 Randomized Controlled Trails","volume":"2016","author":"Zhu","year":"2016","journal-title":"OncoTargets Ther."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1001\/jamaoncol.2019.2109","article-title":"Effect of Home-Based Exercise and Weight Loss Programs on Breast Cancer\u2013Related Lymphedema Outcomes Among Overweight Breast Cancer Survivors: The WISER Survivor Randomized Clinical Trial","volume":"5","author":"Schmitz","year":"2019","journal-title":"JAMA Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Casas, R., Sacanella, E., Urp\u00ed-Sard\u00e0, M., Chiva-Blanch, G., Ros, E., Mart\u00ednez-Gonz\u00e1lez, M.-A., Covas, M.-I., Lamuela-Raventos, R.M., Salas-Salvad\u00f3, J., and Fiol, M. (2014). The Effects of the Mediterranean Diet on Biomarkers of Vascular Wall Inflammation and Plaque Vulnerability in Subjects with High Risk for Cardiovascular Disease. A Randomized Trial. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0100084"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Pant, A., Chew, D., Mamas, M., and Zaman, S. (2024). Cardiovascular Disease and the Mediterranean Diet: Insights into Sex-Specific Responses. Nutrients, 16.","DOI":"10.3390\/nu16040570"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Vitale, M., Masulli, M., Calabrese, I., Rivellese, A., Bonora, E., Signorini, S., Perriello, G., Squatrito, S., Buzzetti, R., and Sartore, G. (2018). Impact of a Mediterranean Dietary Pattern and Its Components on Cardiovascular Risk Factors, Glucose Control, and Body Weight in People with Type 2 Diabetes: A Real-Life Study. Nutrients, 10.","DOI":"10.3390\/nu10081067"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1894","DOI":"10.1093\/jn\/134.8.1894","article-title":"Meal Replacements Are as Effective as Structured Weight-Loss Diets for Treating Obesity in Adults with Features of Metabolic Syndrome","volume":"134","author":"Noakes","year":"2004","journal-title":"J. Nutr."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Noronha, J.C., Kendall, C.W., and Sievenpiper, J.L. (2022). Meal Replacements for Weight-Related Complications in Type 2 Diabetes: What Is the State of the Evidence?. Front. Endocrinol., 13.","DOI":"10.3389\/fendo.2022.875535"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1080\/02841860701403020","article-title":"Factors Associated with Increased Breast Cancer-Related Lymphedema Volume","volume":"46","author":"Vignes","year":"2007","journal-title":"Acta Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1863","DOI":"10.1038\/s41366-018-0220-0","article-title":"Effects of Daily Consumption of the Probiotic Bifidobacterium Animalis Subsp. Lactis CECT 8145 on Anthropometric Adiposity Biomarkers in Abdominally Obese Subjects: A Randomized Controlled Trial","volume":"43","author":"Pedret","year":"2019","journal-title":"Int. J. Obes."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.rh.2011.03.008","article-title":"Validaci\u00f3n de herramienta inform\u00e1tica para el c\u00e1lculo de linfedema en pacientes con afectaci\u00f3n unilateral de extremidad superior","volume":"45","year":"2011","journal-title":"Rehabilitaci\u00f3n"},{"key":"ref_31","first-page":"98","article-title":"Normative Reference Values for Hand Grip Dynamometry in Spain. Association with Lean Mass","volume":"35","author":"Porras","year":"2018","journal-title":"Nutr. Hosp."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Contreras-Bol\u00edvar, V., Olveira, C., Porras, N., Abu\u00edn-Fern\u00e1ndez, J., Garc\u00eda-Olivares, M., S\u00e1nchez-Torralvo, F., Gir\u00f3n, M., Ruiz-Garc\u00eda, I., and Olveira, G. (2021). Oral Nutritional Supplements in Adults with Cystic Fibrosis: Effects on Intake, Levels of Fat-Soluble Vitamins, and Bone Remodeling Biomarkers. Nutrients, 13.","DOI":"10.3390\/nu13020669"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1016\/j.recesp.2018.08.007","article-title":"Dieta mediterr\u00e1nea hipocal\u00f3rica y factores de riesgo cardiovascular: An\u00e1lisis transversal de PREDIMED-Plus","volume":"72","author":"Corella","year":"2019","journal-title":"Rev. Espa\u00f1ola Cardiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1550","DOI":"10.1038\/sj.ejcn.1602004","article-title":"Development of a Short Dietary Intake Questionnaire for the Quantitative Estimation of Adherence to a Cardioprotective Mediterranean Diet","volume":"58","author":"Wright","year":"2004","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1949","DOI":"10.1002\/cncr.22638","article-title":"Randomized Controlled Trial Comparing a Low-fat Diet with a Weight-reduction Diet in Breast Cancer-related Lymphedema","volume":"109","author":"Shaw","year":"2007","journal-title":"Cancer"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Lee, S.-O., and Kim, I.-K. (2024). Molecular Pathophysiology of Secondary Lymphedema. Front. Cell Dev. Biol., 12.","DOI":"10.3389\/fcell.2024.1363811"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"154e","DOI":"10.1097\/PRS.0000000000000268","article-title":"Lymphedema and Obesity: Is There a Link?","volume":"134","author":"Mehrara","year":"2014","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1080\/01635581.2021.1957129","article-title":"Benefits of Dietary Management in Breast Cancer Patients: A Systematic Review and Meta-Analysis","volume":"74","author":"Wang","year":"2022","journal-title":"Nutr. Cancer"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/s10549-014-3162-9","article-title":"Safety and Efficacy of Progressive Resistance Training in Breast Cancer: A Systematic Review and Meta-Analysis","volume":"148","author":"Cheema","year":"2014","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_40","first-page":"3593","article-title":"Resistance Exercise and Breast Cancer\u2013Related Lymphedema\u2014A Systematic Review Update and Meta-Analysis","volume":"28","author":"Hasenoehrl","year":"2020","journal-title":"Support. Care Cancer"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1007\/s13187-019-01564-9","article-title":"Low-Intensity Resistance Training and Compression Garment in the Management of Breast Cancer\u2013Related Lymphedema: Single-Blinded Randomized Controlled Trial","volume":"35","author":"Omar","year":"2020","journal-title":"J. Cancer Educ."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/17\/2768\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:33:30Z","timestamp":1760034810000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/17\/2768"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,27]]},"references-count":41,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["nu17172768"],"URL":"https:\/\/doi.org\/10.3390\/nu17172768","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,27]]}}}