{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T03:38:11Z","timestamp":1789097891501,"version":"build-2803163510"},"reference-count":128,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002241","name":"Japan Science and Technology Agency (JST) through the Center of Innovation Program","doi-asserted-by":"publisher","award":["JPMJPF2201"],"award-info":[{"award-number":["JPMJPF2201"]}],"id":[{"id":"10.13039\/501100002241","id-type":"DOI","asserted-by":"publisher"}]},{"name":"KAKENHI Grants-in-Aid for Scientific Research","award":["25K20188"],"award-info":[{"award-number":["25K20188"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Glaucoma is a major ocular neurodegenerative disease and a leading cause of irreversible blindness worldwide, with prevalence projected to exceed 110 million by 2040. Although lowering intraocular pressure (IOP) remains the only proven treatment, glaucoma arises from a complex interplay of genetic, local, and systemic factors\u2014including oxidative stress, vascular dysregulation, mitochondrial dysfunction, and neuroinflammation. Emerging evidence suggests that modifiable lifestyle factors may influence these pathogenic pathways. In this review, higher dietary nitrate from leafy greens is consistently associated with lower primary open-angle glaucoma risk, aligning with nitric-oxide-mediated endothelial support and more stable ocular perfusion pressure. Flavonoids (anthocyanins and flavanols), carotenoids (lutein\/zeaxanthin), and B vitamins have strong biological rationale for glaucoma prevention but have limited support from long-term, large population-based studies. The effect of polyunsaturated fats on glaucoma remains inconsistent and warrants source-(plant vs. animal) and substitution-based analyses. Consistent protective effects of aerobic exercise and high-quality sleep may be associated with favorable metabolic profiles and ocular perfusion, potentially mitigating retinal ganglion cell loss. Conversely, smoking and alcohol use are frequently coupled with poorer diet quality (e.g., lower vegetable intake) and heightened oxidative stress, which may exacerbate glaucomatous neurodegeneration. However, much of the current literature is constrained by cross-sectional designs, reliance on self-reported food frequency questionnaires, and insufficient use of structural endpoints such as retinal nerve fiber layer imaging. This review focuses on the potential of lifestyle modification and future directions in prevention and treatment strategies for glaucoma, highlighting the need for large-scale, multi-ethnic, genotype-stratified longitudinal studies and randomized controlled trials to establish causality and define optimal intervention strategies.<\/jats:p>","DOI":"10.3390\/nu17213369","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T13:59:36Z","timestamp":1761659976000},"page":"3369","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Diet, Exercise, and Lifestyle in Glaucoma: Current Evidence and Future Perspectives"],"prefix":"10.3390","volume":"17","author":[{"given":"Akiko","family":"Hanyuda","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Keio University School of Medicine, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan"},{"name":"Department of Ophthalmology, Tohoku University Graduate School of Medicine, Seiryo-machi, Aoba-ku, Sendai 980-8574, Miyagi, Japan"},{"name":"Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo 104-0045, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoru","family":"Tsuda","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Tohoku University Graduate School of Medicine, Seiryo-machi, Aoba-ku, Sendai 980-8574, Miyagi, Japan"},{"name":"Division of Ophthalmic Precision Medicine Development, United Centers for Advanced Research and Translational Medicine (ART), Tohoku University Graduate School of Medicine, Seiryo-machi, Aoba-ku, Sendai 980-8575, Miyagi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriko","family":"Himori","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Tohoku University Graduate School of Medicine, Seiryo-machi, Aoba-ku, Sendai 980-8574, Miyagi, Japan"},{"name":"Department of Aging Vision Healthcare, Tohoku University Graduate School of Biomedical Engineering, Aramaki Aza Aoba, Aoba-ku, Sendai 980-8579, Miyagi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0176-5545","authenticated-orcid":false,"given":"Kota","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Tohoku University Graduate School of Medicine, Seiryo-machi, Aoba-ku, Sendai 980-8574, Miyagi, Japan"},{"name":"Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Seiryo-machi, Aoba-ku, Sendai 980-8574, Miyagi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2684-0684","authenticated-orcid":false,"given":"Naoki","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Tohoku University Graduate School of Medicine, Seiryo-machi, Aoba-ku, Sendai 980-8574, Miyagi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Nakazawa","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Tohoku University Graduate School of Medicine, Seiryo-machi, Aoba-ku, Sendai 980-8574, Miyagi, Japan"},{"name":"Division of Ophthalmic Precision Medicine Development, United Centers for Advanced Research and Translational Medicine (ART), Tohoku University Graduate School of Medicine, Seiryo-machi, Aoba-ku, Sendai 980-8575, Miyagi, Japan"},{"name":"Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Seiryo-machi, Aoba-ku, Sendai 980-8574, Miyagi, Japan"},{"name":"Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, Seiryo-machi, Aoba-ku, Sendai 980-8574, Miyagi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2081","DOI":"10.1016\/j.ophtha.2014.05.013","article-title":"Global prevalence of glaucoma and projections of glaucoma burden through 2040: A systematic review and meta-analysis","volume":"121","author":"Tham","year":"2014","journal-title":"Ophthalmology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2183","DOI":"10.1016\/S0140-6736(17)31469-1","article-title":"Glaucoma","volume":"390","author":"Jonas","year":"2017","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1007\/s10384-022-00970-9","article-title":"The Japan Glaucoma Society guidelines for glaucoma 5th edition","volume":"67","author":"Kiuchi","year":"2023","journal-title":"Jpn. J. Ophthalmol."},{"key":"ref_4","first-page":"S12","article-title":"Apoptosis and anti-apoptosis signalling in glaucomatous retinopathy","volume":"11","author":"Tatton","year":"2001","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.phrs.2012.03.002","article-title":"Protecting the retinal neurons from glaucoma: Lowering ocular pressure is not enough","volume":"66","author":"Pascale","year":"2012","journal-title":"Pharmacol. Res."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Omodaka, K., Kikawa, T., Kabakura, S., Himori, N., Tsuda, S., Ninomiya, T., Takahashi, N., Pak, K., Takeda, N., and Akiba, M. (2022). Clinical characteristics of glaucoma patients with various risk factors. BMC Ophthalmol., 22.","DOI":"10.1186\/s12886-022-02587-5"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1097\/ICU.0b013e3280895aea","article-title":"Glaucoma as a neurodegenerative disease","volume":"18","author":"Gupta","year":"2007","journal-title":"Curr. Opin. Ophthalmol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s40123-018-0120-3","article-title":"The Role of Diet in Glaucoma: A Review of the Current Evidence","volume":"7","year":"2018","journal-title":"Ophthalmol. Ther."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.mrrev.2005.11.001","article-title":"The role of oxidative stress in glaucoma","volume":"612","author":"Izzotti","year":"2006","journal-title":"Mutat. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/S0079-6123(08)01127-8","article-title":"Oxidative stress and glaucoma: Injury in the anterior segment of the eye","volume":"173","author":"Izzotti","year":"2008","journal-title":"Prog. Brain Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e1839","DOI":"10.1038\/cddis.2015.180","article-title":"DRP1 inhibition rescues retinal ganglion cells and their axons by preserving mitochondrial integrity in a mouse model of glaucoma","volume":"6","author":"Kim","year":"2015","journal-title":"Cell Death Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1186\/s12967-019-1971-7","article-title":"Smoking and microbiome in oral, airway, gut and some systemic diseases","volume":"17","author":"Huang","year":"2019","journal-title":"J. Transl. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1016\/j.identj.2024.04.007","article-title":"Interaction Between Tobacco Smoke Exposure and Zinc Intake and Its Effect on Periodontitis: Evidence From NHANES","volume":"74","author":"Liu","year":"2024","journal-title":"Int. Dent. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1080\/14622200701243177","article-title":"The effects of foods, beverages, and other factors on cigarette palatability","volume":"9","author":"McClernon","year":"2007","journal-title":"Nicotine Tob. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.2105\/AJPH.80.11.1323","article-title":"Food and nutrient intake differences between smokers and non-smokers in the US","volume":"80","author":"Subar","year":"1990","journal-title":"Am. J. Public Health"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1080\/07388551.2016.1207153","article-title":"Docosahexaenoic acid: One molecule diverse functions","volume":"37","author":"Hashimoto","year":"2017","journal-title":"Crit. Rev. Biotechnol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1254\/jphs.10R33FM","article-title":"Neuroprotective and ameliorative actions of polyunsaturated fatty acids against neuronal diseases: Beneficial effect of docosahexaenoic acid on cognitive decline in Alzheimer\u2019s disease","volume":"116","author":"Hashimoto","year":"2011","journal-title":"J. Pharmacol. Sci."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"5122","DOI":"10.1523\/JNEUROSCI.3652-17.2018","article-title":"Structural and Functional Rescue of Chronic Metabolically Stressed Optic Nerves through Respiration","volume":"38","author":"Pappenhagen","year":"2018","journal-title":"J. Neurosci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/0039-6257(94)90157-0","article-title":"The vascular endothelium as a regulator of the ocular circulation: A new concept in ophthalmology?","volume":"39","author":"Haefliger","year":"1994","journal-title":"Surv. Ophthalmol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1722","DOI":"10.1016\/j.neurobiolaging.2014.01.019","article-title":"Forced exercise protects the aged optic nerve against intraocular pressure injury","volume":"35","author":"Chrysostomou","year":"2014","journal-title":"Neurobiol. Aging"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1097\/JSM.0000000000000073","article-title":"Reductions in intraocular pressure after acute aerobic exercise: A meta-analysis","volume":"24","author":"Roddy","year":"2014","journal-title":"Clin. J. Sport Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/j.sleep.2013.02.002","article-title":"Investigation of the relationship between sleep duration, all-cause mortality, and preexisting disease","volume":"14","author":"Magee","year":"2013","journal-title":"Sleep Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1559","DOI":"10.1016\/j.ophtha.2013.01.006","article-title":"Obstructive sleep apnea and increased risk of glaucoma: A population-based matched-cohort study","volume":"120","author":"Lin","year":"2013","journal-title":"Ophthalmology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1016\/j.ophtha.2018.10.012","article-title":"Greater Physical Activity Is Associated with Slower Visual Field Loss in Glaucoma","volume":"126","author":"Lee","year":"2019","journal-title":"Ophthalmology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1097\/IJG.0000000000002576","article-title":"Impact of Physical Activity Levels on Visual Field Progression in Individuals with Glaucoma","volume":"34","author":"Seo","year":"2025","journal-title":"J. Glaucoma"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1016\/j.ophtha.2006.02.063","article-title":"Intraocular pressure changes and ocular biometry during Sirsasana (headstand posture) in yoga practitioners","volume":"113","author":"Baskaran","year":"2006","journal-title":"Ophthalmology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.4103\/ijo.IJO_2054_22","article-title":"Effect of yoga on intra-ocular pressure in patients with glaucoma: A systematic review and meta-analysis","volume":"71","author":"Chetry","year":"2023","journal-title":"Indian J. Ophthalmol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1136\/bjophthalmol-2014-305498","article-title":"Swimming goggle wear is not associated with an increased prevalence of glaucoma","volume":"99","author":"Franchina","year":"2015","journal-title":"Br. J. Ophthalmol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1097\/IJG.0000000000000482","article-title":"Effects of Swimming Goggles Wearing on Intraocular Pressure, Ocular Perfusion Pressure, and Ocular Pulse Amplitude","volume":"25","author":"Paula","year":"2016","journal-title":"J. Glaucoma"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1566","DOI":"10.1249\/MSS.0b013e31819e420f","article-title":"Relationship of incident glaucoma versus physical activity and fitness in male runners","volume":"41","author":"Williams","year":"2009","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"3470","DOI":"10.1038\/s41433-023-02535-7","article-title":"Association between lifestyle habits and glaucoma incidence: A retrospective cohort study","volume":"37","author":"Fujita","year":"2023","journal-title":"Eye"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1016\/j.ophtha.2023.06.009","article-title":"The Association of Physical Activity with Glaucoma and Related Traits in the UK Biobank","volume":"130","author":"Madjedi","year":"2023","journal-title":"Ophthalmology"},{"key":"ref_33","first-page":"3062807","article-title":"Acute Effects of Triathlon Race on Oxidative Stress Biomarkers","volume":"2020","author":"Gussoni","year":"2020","journal-title":"Oxid. Med. Cell. Longev."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.1111\/opo.13531","article-title":"Intraocular pressure and ocular perfusion pressure responses during low-intensity endurance exercise in primary-open angle glaucoma patients versus age- and sex-matched controls: Influence of walking pace and external load","volume":"45","author":"Vera","year":"2025","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Vera, J., Morenas-Aguilar, M.D., and Garc\u00eda-Ramos, A. (2025). Evidence-Based Exercise Recommendations for the Reduction and Stabilization of Intraocular Pressure: A Practical Guide for Eye Care and Sport Specialists. Appl. Sci., 15.","DOI":"10.3390\/app15031396"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"K\u00f6nigstein, K., Dipla, K., and Zafeiridis, A. (2023). Training the Vessels: Molecular and Clinical Effects of Exercise on Vascular Health\u2014A Narrative Review. Cells, 12.","DOI":"10.3390\/cells12212544"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Lin, Y., Fan, R., Hao, Z., Li, J., Yang, X., Zhang, Y., and Xia, Y. (2022). The Association Between Physical Activity and Insulin Level Under Different Levels of Lipid Indices and Serum Uric Acid. Front. Physiol., 13.","DOI":"10.3389\/fphys.2022.809669"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.jpsychires.2014.10.003","article-title":"A meta-analytic review of the effects of exercise on brain-derived neurotrophic factor","volume":"60","author":"Szuhany","year":"2015","journal-title":"J. Psychiatr. Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1762","DOI":"10.1001\/archopht.121.12.1762","article-title":"Prospective study of cigarette smoking and the risk of primary open-angle glaucoma","volume":"121","author":"Kang","year":"2003","journal-title":"Arch. Ophthalmol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1080\/09286586.2024.2391028","article-title":"Cigarette Smoking and its Association with Primary Open Angle Glaucoma: A Systematic Review and Meta-Analysis","volume":"32","author":"Yee","year":"2025","journal-title":"Ophthalmic Epidemiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1111\/ceo.13008","article-title":"Social, health and ocular factors associated with primary open-angle glaucoma amongst Chinese Singaporeans","volume":"46","author":"Chiam","year":"2018","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/j.puhe.2003.09.009","article-title":"Epidemiological association between cigarette smoking and primary open-angle glaucoma: A meta-analysis","volume":"118","author":"Bonovas","year":"2004","journal-title":"Public Health"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/j.annepidem.2011.03.006","article-title":"M. A prospective study of diabetes, lifestyle factors, and glaucoma among African-American women","volume":"21","author":"Wise","year":"2011","journal-title":"Ann. Epidemiology"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"825","DOI":"10.4103\/0301-4738.171963","article-title":"Epidemiology and clinical characteristics of patients with glaucoma: An analysis of hospital data between 2003 and 2012","volume":"63","author":"Zhao","year":"2015","journal-title":"Indian J. Ophthalmol."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Miyoshi, K., Kimura, Y., and Miyawaki, T. (2024). Dietary Habits, Nutrition Intake, and Alcohol Consumption Based on Types of Smoking and Smoking Status: A Cross-Sectional Study. Nutrients, 16.","DOI":"10.3390\/nu16223881"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e001421","DOI":"10.1136\/bmjophth-2023-001421","article-title":"Impact of smoking on choroidal microvasculature dropout in glaucoma: A cross-sectional study","volume":"8","author":"Nishida","year":"2023","journal-title":"BMJ Open Ophthalmol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1016\/j.ophtha.2022.06.017","article-title":"Impact of Smoking on Visual Field Progression in a Long-term Clinical Follow-up","volume":"129","author":"Mahmoudinezhad","year":"2022","journal-title":"Ophthalmology"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1658","DOI":"10.1136\/bjo-2022-321237","article-title":"Smoking and progressive retinal nerve fibre layer thinning in glaucoma","volume":"107","author":"Nishida","year":"2023","journal-title":"Br. J. Ophthalmol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"3065","DOI":"10.1038\/s41433-023-02471-6","article-title":"Obstructive sleep apnoea and glaucoma: A systematic review and meta-analysis","volume":"37","author":"Cheong","year":"2023","journal-title":"Eye"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Carnero, E., Bragard, J., Urrestarazu, E., Rivas, E., Polo, V., Larrosa, J.M., Ant\u00f3n, V., Pel\u00e1ez, A., and Moreno-Monta\u00f1\u00e9s, J. (2020). Continuous intraocular pressure monitoring in patients with obstructive sleep apnea syndrome using a contact lens sensor. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0229856"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e479","DOI":"10.1111\/aos.13693","article-title":"The relationship between increased oxidative stress and visual field defect progression in glaucoma patients with sleep apnoea syndrome","volume":"96","author":"Yamada","year":"2018","journal-title":"Acta Ophthalmol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1007\/s00417-019-04483-z","article-title":"CPAP therapy reduces oxidative stress in patients with glaucoma and OSAS and improves the visual field","volume":"258","author":"Himori","year":"2020","journal-title":"Graefe\u2019s Arch. Clin. Exp. Ophthalmol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1167\/iovs.66.11.15","article-title":"Associations Among Sleep Duration, Sleep Quality, and Age-Related Ocular Diseases: Insights from Longitudinal and Mediation Analyses","volume":"66","author":"Huang","year":"2025","journal-title":"Investig. Opthalmol. Vis. Sci."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.ajo.2025.08.019","article-title":"Sleep Disturbance as a Risk Factor for Retinal Neurodegeneration and Subsequent Glaucoma","volume":"280","author":"Akada","year":"2025","journal-title":"Am. J. Ophthalmol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1038\/s41433-020-0820-5","article-title":"Low-carbohydrate-diet scores and the risk of primary open-angle glaucoma: Data from three US cohorts","volume":"34","author":"Hanyuda","year":"2020","journal-title":"Eye"},{"key":"ref_56","first-page":"11206721211012862","article-title":"Carbohydrate intake and risk of glaucoma in the sun cohort","volume":"32","author":"Santiago","year":"2021","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Kinouchi, R., Ishiko, S., Hanada, K., Hayashi, H., Mikami, D., Tani, T., Zenimaru, T., Kawai, M., Nakabayashi, S., and Kinouchi, M. (2018). A low meat diet increases the risk of open-angle glaucoma in women-The results of population-based, cross-sectional study in Japan. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0204955"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1177\/0260106020924562","article-title":"Dietary habits are useful as risk factors for primary open-angle glaucoma while controlling for heredity and metabolic disease","volume":"26","author":"Mylona","year":"2020","journal-title":"Nutr. Health"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"e760","DOI":"10.1111\/aos.14971","article-title":"Prospective study of dietary intake of branched-chain amino acids and the risk of primary open-angle glaucoma","volume":"100","author":"Hanyuda","year":"2022","journal-title":"Acta Ophthalmol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1007\/s00394-022-03003-w","article-title":"MIND diet lowers risk of open-angle glaucoma: The Rotterdam Study","volume":"62","author":"Vergroesen","year":"2023","journal-title":"Eur. J. Nutr."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1093\/ajcn\/79.5.755","article-title":"Dietary fat consumption and primary open-angle glaucoma","volume":"79","author":"Kang","year":"2004","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1016\/j.clnu.2013.11.005","article-title":"Omega 3:6 ratio intake and incidence of glaucoma: The SUN cohort","volume":"33","author":"Toledo","year":"2014","journal-title":"Clin. Nutr."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"e18314","DOI":"10.1097\/MD.0000000000018314","article-title":"Associations of nutrient intakes with glaucoma among Japanese Americans","volume":"98","author":"Yoserizal","year":"2019","journal-title":"Medicine"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1167\/iovs.66.12.3","article-title":"Association of Plasma Omega-3 Fatty Acids With POAG","volume":"66","author":"Kai","year":"2025","journal-title":"Investig. Opthalmol. Vis. Sci."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/j.ajo.2012.03.048","article-title":"The association of consumption of fruits\/vegetables with decreased risk of glaucoma among older African-American women in the study of osteoporotic fractures","volume":"154","author":"Giaconi","year":"2012","journal-title":"Am. J. Ophthalmol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1001\/jamaophthalmol.2014.100","article-title":"A prospective study of folate, vitamin B6, and vitamin B12 intake in relation to exfoliation glaucoma or suspected exfoliation glaucoma","volume":"132","author":"Kang","year":"2014","journal-title":"JAMA Ophthalmol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1007\/s10654-012-9672-z","article-title":"Nutrient intake and risk of open-angle glaucoma: The Rotterdam Study","volume":"27","author":"Ramdas","year":"2012","journal-title":"Eur. J. Epidemiol."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Jung, K.I., Kim, Y.C., and Park, C.K. (2018). Dietary Niacin and Open-Angle Glaucoma: The Korean National Health and Nutrition Examination Survey. Nutrients, 10.","DOI":"10.3390\/nu10040387"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1093\/aje\/kwg167","article-title":"Antioxidant intake and primary open-angle glaucoma: A prospective study","volume":"158","author":"Kang","year":"2003","journal-title":"Am. J. Epidemiol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1136\/jim-2020-001645","article-title":"Association of vitamin D with incident glaucoma: Findings from the Women\u2019s Health Initiative","volume":"69","author":"Carbone","year":"2021","journal-title":"J. Investig. Med."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1016\/j.ajo.2008.01.022","article-title":"Glaucoma risk and the consumption of fruits and vegetables among older women in the study of osteoporotic fractures","volume":"145","author":"Coleman","year":"2008","journal-title":"Am. J. Ophthalmol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1001\/jamaophthalmol.2015.5601","article-title":"Association of Dietary Nitrate Intake with Primary Open-Angle Glaucoma: A Prospective Analysis from the Nurses\u2019 Health Study and Health Professionals Follow-up Study","volume":"134","author":"Kang","year":"2016","journal-title":"JAMA Ophthalmol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1159\/000335961","article-title":"Two-year randomized, placebo-controlled study of black currant anthocyanins on visual field in glaucoma","volume":"228","author":"Ohguro","year":"2012","journal-title":"Ophthalmologica"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1089\/jmf.2012.2241","article-title":"Ginkgo biloba extract and bilberry anthocyanins improve visual function in patients with normal tension glaucoma","volume":"15","author":"Shim","year":"2012","journal-title":"J. Med. Food"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1089\/jop.2012.0071","article-title":"Effects of black currant anthocyanins on intraocular pressure in healthy volunteers and patients with glaucoma","volume":"29","author":"Ohguro","year":"2013","journal-title":"J. Ocul. Pharmacol. Ther."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"e341","DOI":"10.1111\/aos.12373","article-title":"The short-term effect of flavonoid-rich dark chocolate on retinal vessel diameter in glaucoma patients and age-matched controls","volume":"92","author":"Terai","year":"2014","journal-title":"Acta Ophthalmol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"2293","DOI":"10.2147\/OPTH.S314288","article-title":"The Effect of Dietary Antioxidant Supplementation in Patients with Glaucoma","volume":"15","author":"Himori","year":"2021","journal-title":"Clin. Ophthalmol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1016\/S0161-6420(02)01745-1","article-title":"Effect of Ginkgo biloba extract on preexisting visual field damage in normal tension glaucoma","volume":"110","author":"Quaranta","year":"2003","journal-title":"Ophthalmology"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"e692","DOI":"10.1111\/aos.13705","article-title":"Prospective study of flavonoid intake and risk of primary open-angle glaucoma","volume":"96","author":"Kang","year":"2018","journal-title":"Acta Ophthalmol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/j.ophtha.2022.11.014","article-title":"Effect of Low-Fat Dietary Modification on Incident Open-Angle Glaucoma","volume":"130","author":"Mehta","year":"2023","journal-title":"Ophthalmology"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1038\/nrd2466","article-title":"The nitrate-nitrite-nitric oxide pathway in physiology and therapeutics","volume":"7","author":"Lundberg","year":"2008","journal-title":"Nat. Rev. Drug Discov."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"S51","DOI":"10.1016\/S0039-6257(99)00026-0","article-title":"Potential role of nitric oxide and endothelin in the pathogenesis of glaucoma","volume":"43","author":"Haefliger","year":"1999","journal-title":"Surv. Ophthalmol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"H985","DOI":"10.1152\/ajpheart.00292.2006","article-title":"Endothelial dysfunction: A multifaceted disorder (The Wiggers Award Lecture)","volume":"291","author":"Vanhoutte","year":"2006","journal-title":"Am. J. Physiol.-Heart Circ. Physiol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1016\/j.ophtha.2013.09.012","article-title":"Association of CAV1\/CAV2 genomic variants with primary open-angle glaucoma overall and by gender and pattern of visual field loss","volume":"121","author":"Loomis","year":"2014","journal-title":"Ophthalmology"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1038\/eye.2014.42","article-title":"Vascular tone pathway polymorphisms in relation to primary open-angle glaucoma","volume":"28","author":"Kang","year":"2014","journal-title":"Eye"},{"key":"ref_86","first-page":"3243","article-title":"Topical nipradilol: Effects on optic nerve head circulation in humans and periocular distribution in monkeys","volume":"43","author":"Mizuno","year":"2002","journal-title":"Investig. Opthalmol. Vis. Sci."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.clindermatol.2008.01.011","article-title":"Lutein and zeaxanthin in eye and skin health","volume":"27","author":"Roberts","year":"2009","journal-title":"Clin. Dermatol."},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Johra, F.T., Bepari, A.K., Bristy, A.T., and Reza, H.M. (2020). A Mechanistic Review of \u03b2-Carotene, Lutein, and Zeaxanthin in Eye Health and Disease. Antioxidants, 9.","DOI":"10.3390\/antiox9111046"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"4471","DOI":"10.1167\/iovs.18-24170","article-title":"Macular Pigment and Visual Function in Patients with Glaucoma: The San Diego Macular Pigment Study","volume":"59","author":"Daga","year":"2018","journal-title":"Investig. Opthalmol. Vis. Sci."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"e001331","DOI":"10.1136\/bmjophth-2023-001331","article-title":"Association of macular pigment optical density with retinal layer thicknesses in eyes with and without manifest primary open-angle glaucoma","volume":"8","author":"Lawler","year":"2023","journal-title":"BMJ Open Ophthalmol."},{"key":"ref_91","first-page":"9410952","article-title":"Potential Protective and Therapeutic Roles of the Nrf2 Pathway in Ocular Diseases: An Update","volume":"2020","author":"Wang","year":"2020","journal-title":"Oxidative Med. Cell. Longev."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"4796","DOI":"10.1167\/iovs.05-0397","article-title":"Flavonoids protect retinal ganglion cells from oxidative stress-induced death","volume":"46","author":"Maher","year":"2005","journal-title":"Investig. Opthalmol. Vis. Sci."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"1841","DOI":"10.1007\/s00417-015-3168-y","article-title":"The effect of flavonoids on visual function in patients with glaucoma or ocular hypertension: A systematic review and meta-analysis","volume":"253","author":"Patel","year":"2015","journal-title":"Graefe\u2019s Arch. Clin. Exp. Ophthalmol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1167\/iovs.11-9038","article-title":"The association between glaucoma prevalence and supplementation with the oxidants calcium and iron","volume":"53","author":"Wang","year":"2012","journal-title":"Investig. Opthalmol. Vis. Sci."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.3109\/02713683.2013.803124","article-title":"Glaucoma prevalence and the intake of iron and calcium in a population-based study","volume":"38","author":"Wang","year":"2013","journal-title":"Curr. Eye Res."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"6483","DOI":"10.1167\/iovs.10-5410","article-title":"Intralysosomal iron induces lysosomal membrane permeabilization and cathepsin D-mediated cell death in trabecular meshwork cells exposed to oxidative stress","volume":"51","author":"Lin","year":"2010","journal-title":"Investig. Opthalmol. Vis. Sci."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"201","DOI":"10.4103\/0301-4738.181753","article-title":"Peripapillary retinal nerve fiber layer thickness in patients with iron deficiency anemia","volume":"64","author":"Cikmazkara","year":"2016","journal-title":"Indian J. Ophthalmol."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1167\/iovs.07-1361","article-title":"Mitochondrial complex I defect induces ROS release and degeneration in trabecular meshwork cells of POAG patients: Protection by antioxidants","volume":"49","author":"He","year":"2008","journal-title":"Investig. Opthalmol. Vis. Sci."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1136\/bjo.2008.141218","article-title":"Should we be considering selenium in glaucoma?","volume":"93","author":"King","year":"2009","journal-title":"Br. J. Ophthalmol."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1136\/bjo.2007.125997","article-title":"Relationship between glaucoma and selenium levels in plasma and aqueous humour","volume":"93","author":"Bruhn","year":"2009","journal-title":"Br. J. Ophthalmol."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/j.exer.2005.08.024","article-title":"Alterations in human trabecular meshwork cell homeostasis by selenium","volume":"82","author":"Conley","year":"2006","journal-title":"Exp. Eye Res."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1007\/s12011-013-9644-5","article-title":"Evaluation of essential and toxic trace elements in pseudoexfoliation syndrome and pseudoexfoliation glaucoma","volume":"153","author":"Ceylan","year":"2013","journal-title":"Biol. Trace Elem. Res."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1001\/jamaophthalmol.2015.2438","article-title":"Association between body levels of trace metals and glaucoma prevalence","volume":"133","author":"Lin","year":"2015","journal-title":"JAMA Ophthalmol."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1056\/NEJMra1816604","article-title":"Coffee, Caffeine, and Health","volume":"383","author":"Hu","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1007\/s00417-010-1455-1","article-title":"The effect of caffeine on intraocular pressure: A systematic review and meta-analysis","volume":"249","author":"Li","year":"2011","journal-title":"Graefe\u2019s Arch. Clin. Exp. Ophthalmol."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"1924","DOI":"10.1167\/iovs.07-1425","article-title":"Caffeine consumption and the risk of primary open-angle glaucoma: A prospective cohort study","volume":"49","author":"Kang","year":"2008","journal-title":"Investig. Opthalmol. Vis. Sci."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1016\/j.ophtha.2020.12.009","article-title":"Intraocular Pressure, Glaucoma, and Dietary Caffeine Consumption: A Gene-Diet Interaction Study from the UK Biobank","volume":"128","author":"Kim","year":"2021","journal-title":"Ophthalmology"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.ogla.2020.09.019","article-title":"Relationship between Intraocular Pressure and Coffee Consumption in a Japanese Population without Glaucoma: The Nagahama Study","volume":"4","author":"Nakano","year":"2021","journal-title":"Ophthalmol. Glaucoma"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"6427","DOI":"10.1167\/iovs.12-10085","article-title":"The Relationship between caffeine and coffee consumption and exfoliation glaucoma or glaucoma suspect: A prospective study in two cohorts","volume":"53","author":"Pasquale","year":"2012","journal-title":"Investig. Opthalmol. Vis. Sci."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1017\/S0029665111003302","article-title":"Nutritional influences on epigenetics and age-related disease","volume":"71","author":"Park","year":"2012","journal-title":"Proc. Nutr. Soc."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1007\/s00417-011-1877-4","article-title":"Plasma homocysteine, serum folic acid, serum vitamin B12, serum vitamin B6, MTHFR and risk of pseudoexfoliation glaucoma: A meta-analysis","volume":"250","author":"Xu","year":"2012","journal-title":"Graefe\u2019s Arch. Clin. Exp. Ophthalmol."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/j.ophtha.2022.01.023","article-title":"Alcohol, Intraocular Pressure, and Open-Angle Glaucoma: A Systematic Review and Meta-analysis","volume":"129","author":"Stuart","year":"2022","journal-title":"Ophthalmology"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1080\/09286580601187963","article-title":"Prospective study of alcohol consumption and the risk of primary open-angle glaucoma","volume":"14","author":"Kang","year":"2007","journal-title":"Ophthalmic Epidemiol."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.ogla.2022.11.008","article-title":"The Association of Alcohol Consumption with Glaucoma and Related Traits: Findings from the UK Biobank","volume":"6","author":"Stuart","year":"2023","journal-title":"Ophthalmol. Glaucoma"},{"key":"ref_115","doi-asserted-by":"crossref","unstructured":"Lamparter, J., Schmidtmann, I., Schuster, A.K., Siouli, A., Wasielica-Poslednik, J., Mirshahi, A., H\u00f6hn, R., Unterrainer, J., Wild, P.S., and Binder, H. (2018). Association of ocular, cardiovascular, morphometric and lifestyle parameters with retinal nerve fibre layer thickness. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0197682"},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1097\/OPX.0000000000001650","article-title":"Factors Associated with the Macular Ganglion Cell-Inner Plexiform Layer Thickness in a Cohort of Middle-aged U","volume":"98","author":"Paulsen","year":"2021","journal-title":"S. Adults. Optom. Vis. Sci."},{"key":"ref_117","unstructured":"UK Department of Health (2025, October 24). UK Chief Medical Officers\u2019 Low Risk Drinking Guidelines, Available online: https:\/\/assets.publishing.service.gov.uk\/media\/5a80b7ed40f0b623026951db\/UK_CMOs__report.pdf."},{"key":"ref_118","unstructured":"US Department of Agriculture, and US Department of Health and Human Services (2025, October 24). Dietary Guidelines for Americans, 2020\u20132025, Available online: https:\/\/www.dietaryguidelines.gov\/sites\/default\/files\/2020-12\/Dietary_Guidelines_for_Americans_2020-2025.pdf."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1097\/01.ijg.0000185436.15675.b3","article-title":"The prevalence of pseudoexfoliation syndrome in a Japanese population: The Hisayama study","volume":"14","author":"Miyazaki","year":"2005","journal-title":"J. Glaucoma"},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"298","DOI":"10.3109\/09286586.2015.1131992","article-title":"Prevalence of Pseudoexfoliation Syndrome and Associated Factors in South Koreans: The Korean National Health and Nutrition Examination Survey","volume":"23","author":"Kim","year":"2016","journal-title":"Ophthalmic Epidemiol."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1136\/bjo.2009.157636","article-title":"Exfoliation syndrome in the Reykjavik Eye Study: Risk factors for baseline prevalence and 5-year incidence","volume":"94","author":"Arnarsson","year":"2010","journal-title":"Br. J. Ophthalmol."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.ophtha.2022.08.023","article-title":"Long-Term Alcohol Consumption and Risk of Exfoliation Glaucoma\/Glaucoma Suspect among US Health Professionals","volume":"130","author":"Hanyuda","year":"2022","journal-title":"Ophthalmology"},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"1486","DOI":"10.1093\/hmg\/ddy053","article-title":"Genome-wide association study identifies seven novel susceptibility loci for primary open-angle glaucoma","volume":"27","author":"Shiga","year":"2018","journal-title":"Hum. Mol. Genet."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.1038\/s41467-020-20851-4","article-title":"Genome-wide meta-analysis identifies 127 open-angle glaucoma loci with consistent effect across ancestries","volume":"12","author":"Gharahkhani","year":"2021","journal-title":"Nat. Commun."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1016\/j.ophtha.2024.05.026","article-title":"Genetic Risk Stratification of Primary Open-Angle Glaucoma in Japanese Individuals","volume":"131","author":"Akiyama","year":"2024","journal-title":"Ophthalmology"},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"e799","DOI":"10.1111\/aos.13353","article-title":"Optic nerve head microcirculation in autosomal dominant optic atrophy and normal-tension glaucoma","volume":"95","author":"Himori","year":"2017","journal-title":"Acta Ophthalmol."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1097\/APO.0000000000000183","article-title":"Ocular Blood Flow and Influencing Factors for Glaucoma","volume":"5","author":"Nakazawa","year":"2016","journal-title":"Asia-Pacific J. Ophthalmol."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1167\/iovs.65.13.44","article-title":"Metabolomic Profiling of Open-Angle Glaucoma Etiologic Endotypes: Tohoku Multi-Omics Glaucoma Study","volume":"65","author":"Hanyuda","year":"2024","journal-title":"Investig. Ophthalmol. Vis. Sci."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/21\/3369\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T02:31:13Z","timestamp":1761705073000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/21\/3369"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,27]]},"references-count":128,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["nu17213369"],"URL":"https:\/\/doi.org\/10.3390\/nu17213369","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,27]]}}}