{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T13:01:09Z","timestamp":1775134869615,"version":"3.50.1"},"reference-count":57,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Dietary treatment may play a complimentary part alongside established medical treatment pathways for children with Crohn\u2019s disease. The aim of this review was to explore the impact of a range of dietary treatments, including the capability of preserving the mucosal barrier, during the maintenance phase of Crohn\u2019s disease. Methods: Randomised controlled trials and cohort studies were retrieved from five databases (Cochrane library, MEDLINE, EMBASE, ScienceDirect, and Web of Science) and through hand searching (last search: June 2025). In the inclusion criteria, this review only included studies that directly assessed children with Crohn\u2019s disease who achieved clinical remission after the induced phase but simultaneously appeared to have signs of inflammation. Results: Six studies were identified, three of which reported outcomes directly associated with the mucosal barrier, while the other studies reported intestinal inflammation and nutritional status. A range of dietary approaches were investigated, with mixed outcomes. A carbohydrate-based diet had a mixed-effect influence on the mucosal barrier, whereas an exclusion diet significantly reduced intestinal inflammation (p = 0.01). One study reported that bovine colostrum (BC) milk (a novel approach) demonstrated mucosal integrity improvement, while the timing of partial enteral nutrition (PEN) also improved nutritional status. Importantly, compliance with all these strict regimes is complex and difficult to implement, even with the support of a dietitian. Conclusions: Consideration of the most appropriate dietary approach within CD management including remission has reported mixed effects to date. Further research is needed, especially to establish the benefits and any negative consequences of dietary intervention more clearly, and especially regarding mucosal integrity.<\/jats:p>","DOI":"10.3390\/nu18071146","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T11:51:03Z","timestamp":1775130663000},"page":"1146","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Gut Health Responses to Nutritional Interventions in Paediatric Crohn\u2019s Disease, Including the Potential Outcomes of Mucosal Barrier Preservation: A Systematic Review"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0490-833X","authenticated-orcid":false,"given":"Ervine Chastine","family":"Marind","sequence":"first","affiliation":[{"name":"School of Bioscience, University of Nottingham, Nottingham NG7 2RD, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3951-8531","authenticated-orcid":false,"given":"Fiona","family":"McCullough","sequence":"additional","affiliation":[{"name":"School of Bioscience, University of Nottingham, Nottingham NG7 2RD, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"549","DOI":"10.7861\/clinmed.2023-0493","article-title":"Crohn\u2019s disease: An update","volume":"23","author":"Cockburn","year":"2023","journal-title":"Clin. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.21037\/dmr-21-1","article-title":"A close view on histopathological changes in inflammatory bowel disease, a narrative review","volume":"4","author":"Kellermann","year":"2021","journal-title":"Dig. Med. Res."},{"key":"ref_3","unstructured":"NICE (2025, August 18). Crohn\u2019s Disease: Management: National Institute for Health and Care Excellence. Available online: https:\/\/www.nice.org.uk\/guidance\/ng129."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1111\/apt.18264","article-title":"Differences in disease characteristics and treatment exposures between paediatric and adult-onset inflammatory bowel disease using a registry-based cohort","volume":"60","author":"Granot","year":"2024","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1097\/MPG.0000000000003422","article-title":"Perianal Crohn Disease Is More Common in Children and Is Associated with Complicated Disease Course Despite Higher Utilization of Biologics: A Population-based Study from the epidemiology group of the Israeli IBD Research Nucleus (epiIIRN)","volume":"74","author":"Atia","year":"2022","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1007\/s00384-025-04917-7","article-title":"Role and mechanism of gut microbiota-host interactions in the pathogenesis of Crohn\u2019s disease","volume":"40","author":"Xu","year":"2025","journal-title":"Int. J. Color. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2247019","DOI":"10.1080\/19490976.2023.2247019","article-title":"The microbiome landscape in pediatric Crohn\u2019s disease and therapeutic implications","volume":"15","author":"Fetter","year":"2023","journal-title":"Gut Microbes"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Pastorelli, L., De Salvo, C., Mercado, J.R., Vecchi, M., and Pizarro, T.T. (2013). Central Role of the Gut Epithelial Barrier in the Pathogenesis of Chronic Intestinal Inflammation: Lessons Learned from Animal Models and Human Genetics. Front. Immunol., 4.","DOI":"10.3389\/fimmu.2013.00280"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1093\/jcag\/gwad052","article-title":"Understanding Predictors of Crohn\u2019s Disease: Determinants of Altered Barrier Function in Pre-Disease Phase of Crohn\u2019s Disease","volume":"7","author":"Neustaeter","year":"2024","journal-title":"J. Can. Assoc. Gastroenterol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1093\/advances\/nmz061","article-title":"Negative Effects of a High-Fat Diet on Intestinal Permeability: A Review","volume":"11","author":"Rohr","year":"2020","journal-title":"Adv. Nutr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.jff.2016.11.016","article-title":"Bovine colostrum demonstrates anti-inflammatory and antibacterial activity in in vitro models of intestinal inflammation and infection","volume":"28","author":"Chae","year":"2017","journal-title":"J. Funct. Foods"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1016\/j.crohns.2014.04.005","article-title":"Consensus guidelines of ECCO\/ESPGHAN on the medical management of pediatric Crohn\u2019s disease","volume":"8","author":"Ruemmele","year":"2014","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"371","DOI":"10.15386\/mpr-2900","article-title":"Exclusive enteral nutrition in Crohn\u2019s disease pediatric patients: From clinical remission to transmural healing","volume":"98","author":"Tita","year":"2025","journal-title":"Med. Pharm. Rep."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Geesala, R., Gongloor, P., Recharla, N., and Shi, X.Z. (2024). Mechanisms of Action of Exclusive Enteral Nutrition and Other Nutritional Therapies in Crohn\u2019s Disease. Nutrients, 16.","DOI":"10.3390\/nu16213581"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1053\/j.gastro.2019.04.021","article-title":"Crohn\u2019s Disease Exclusion Diet Plus Partial Enteral Nutrition Induces Sustained Remission in a Randomized Controlled Trial","volume":"157","author":"Levine","year":"2019","journal-title":"Gastroenterology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2019","DOI":"10.1016\/j.chom.2024.10.001","article-title":"Exclusive enteral nutrition initiates individual protective microbiome changes to induce remission in pediatric Crohn\u2019s disease","volume":"32","author":"Siebert","year":"2024","journal-title":"Cell Host Microbe"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.crohns.2012.07.001","article-title":"Use of exclusive enteral nutrition in paediatric Crohn\u2019s disease in The Netherlands","volume":"7","author":"Kindermann","year":"2013","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Zhao, X., Xu, X.X., Liu, Y., Xi, E.Z., An, J.J., Tabys, D., and Liu, N. (2019). The In Vitro Protective Role of Bovine Lactoferrin on Intestinal Epithelial Barrier. Molecules, 24.","DOI":"10.3390\/molecules24010148"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Karak\u00fclah, Y.S., Yal\u00e7\u0131nta\u015f, Y.M., Bechelany, M., and Karav, S. (2025). Clinical Applications of Bovine Colostrum in GastrointestinaI Disorders: Mechanisms, Evidence, and Therapeutic Potential. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms262110673"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Coskun, M. (2014). Intestinal Epithelium in Inflammatory Bowel Disease. Front. Med., 1.","DOI":"10.3389\/fmed.2014.00024"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Marco, M.L., Cunningham, M., Bischoff, S.C., Clarke, G., Delzenne, N., Lewis, J.D., Meisel, M., Merenstein, D., O\u2019Toole, P.W., and Staudacher, H.M. (2026). The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of gut health. Nat. Rev. Gastroenterol. Hepatol.","DOI":"10.1038\/s41575-026-01176-x"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/S2468-1253(24)00390-X","article-title":"The intestinal barrier: A pivotal role in health, inflammation, and cancer","volume":"10","author":"Neurath","year":"2025","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Bischoff, S.C., Barbara, G., Buurman, W., Ockhuizen, T., Schulzke, J.D., Serino, M., Tilg, H., Watson, A., and Wells, J.M. (2014). Intestinal permeability\u2013a new target for disease prevention and therapy. BMC Gastroenterol., 14.","DOI":"10.1186\/s12876-014-0189-7"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e00617","DOI":"10.14309\/ctg.0000000000000617","article-title":"Fecal Calprotectin for the Diagnosis and Management of Inflammatory Bowel Diseases","volume":"14","author":"Kapel","year":"2023","journal-title":"Clin. Transl. Gastroenterol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1097\/MPG.0000000000001227","article-title":"Which PCDAI Version Best Reflects Intestinal Inflammation in Pediatric Crohn Disease?","volume":"64","author":"Turner","year":"2017","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.3748\/wjg.v25.i10.1266","article-title":"Consecutive fecal calprotectin measurements for predicting relapse in pediatric Crohn\u2019s disease patients","volume":"25","author":"Foster","year":"2019","journal-title":"World J. Gastroenterol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"460","DOI":"10.3748\/wjg.v7.i4.460","article-title":"Non-invasive investigation of inflammatory bowel disease","volume":"7","author":"Tibble","year":"2001","journal-title":"World J. Gastroenterol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1053\/j.gastro.2022.10.014","article-title":"Intestinal Barrier Healing Is Superior to Endoscopic and Histologic Remission for Predicting Major Adverse Outcomes in Inflammatory Bowel Disease: The Prospective ERIca Trial","volume":"164","author":"Rath","year":"2023","journal-title":"Gastroenterology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1756283x17747780","DOI":"10.1177\/1756283X17747780","article-title":"The Lewis score or the capsule endoscopy Crohn\u2019s disease activity index: Which one is better for the assessment of small bowel inflammation in established Crohn\u2019s disease?","volume":"11","author":"Yablecovitch","year":"2018","journal-title":"Ther. Adv. Gastroenterol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1007\/s12664-023-01416-x","article-title":"Role of adjuvant Crohn\u2019s disease exclusion diet plus enteral nutrition in asymptomatic pediatric Crohn\u2019s disease having biochemical activity: A randomized, pilot study","volume":"43","author":"Arcucci","year":"2024","journal-title":"Indian J. Gastroenterol."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Allen, S.J., Belnour, S., Renji, E., Carter, B., Bray, L., Allen, A., Jones, E., Urban, B., Moule, S., and Wang, D. (2022). Dietary Therapy to Improve Nutrition and Gut Health in Paediatric Crohn\u2019s Disease; A Feasibility Study. Nutrients, 14.","DOI":"10.3390\/nu14214598"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: A revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"87","DOI":"10.5009\/gnl13345","article-title":"Effect of Short-Term Partial Enteral Nutrition on the Treatment of Younger Patients with Severe Crohn\u2019s Disease","volume":"9","author":"Kang","year":"2015","journal-title":"Gut Liver"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"i4919","DOI":"10.1136\/bmj.i4919","article-title":"ROBINS-I: A tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"Sterne","year":"2016","journal-title":"BMJ"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1097\/MPG.0000000000000449","article-title":"Clinical and mucosal improvement with specific carbohydrate diet in pediatric Crohn disease","volume":"59","author":"Cohen","year":"2014","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1097\/MPG.0000000000001619","article-title":"Lack of Mucosal Healing from Modified Specific Carbohydrate Diet in Pediatric Patients with Crohn Disease","volume":"65","author":"Wahbeh","year":"2017","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Matuszczyk, M., Meglicka, M., Wiernicka, A., Jarzebicka, D., Osiecki, M., Kotkowicz-Szczur, M., and Kierkus, J. (2022). Effect of the Crohn\u2019s Disease Exclusion Diet (CDED) on the Fecal Calprotectin Level in Children with Active Crohn\u2019s Disease. J. Clin. Med., 11.","DOI":"10.3390\/jcm11144146"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Ulfman, L.H., Leusen, J.H.W., Savelkoul, H.F.J., Warner, J.O., and van Neerven, R.J.J. (2018). Effects of Bovine Immunoglobulins on Immune Function, Allergy, and Infection. Front. Nutr., 5.","DOI":"10.3389\/fnut.2018.00052"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Raoul, P., Cintoni, M., Palombaro, M., Basso, L., Rinninella, E., Gasbarrini, A., and Mele, M.C. (2022). Food Additives, a Key Environmental Factor in the Development of IBD through Gut Dysbiosis. Microorganisms, 10.","DOI":"10.3390\/microorganisms10010167"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1093\/ecco-jcc\/jjaa161","article-title":"The Medical Management of Paediatric Crohn\u2019s Disease: An ECCO-ESPGHAN Guideline Update","volume":"15","author":"Aloi","year":"2021","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1080\/03007995.2021.1920901","article-title":"Crohn\u2019s disease exclusion diet in children with Crohn\u2019s disease: A case series","volume":"37","author":"Scarallo","year":"2021","journal-title":"Curr. Med. Res. Opin."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1093\/ecco-jcc\/jjac105","article-title":"Successful Dietary Therapy in Paediatric Crohn\u2019s Disease is Associated with Shifts in Bacterial Dysbiosis and Inflammatory Metabotype Towards Healthy Controls","volume":"17","author":"Verburgt","year":"2023","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2976","DOI":"10.4049\/jimmunol.1700105","article-title":"Microbial-Derived Butyrate Promotes Epithelial Barrier Function through IL-10 Receptor\u2013Dependent Repression of Claudin-2","volume":"199","author":"Zheng","year":"2017","journal-title":"J. Immunol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2029","DOI":"10.1007\/s10620-006-9449-x","article-title":"Polymeric formula has direct anti-inflammatory effects on enterocytes in an in vitro model of intestinal inflammation","volume":"52","author":"Leach","year":"2007","journal-title":"Dig. Dis. Sci."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"jjaf122","DOI":"10.1093\/ecco-jcc\/jjaf122","article-title":"ECCO Consensus on Dietary Management of Inflammatory Bowel Disease","volume":"19","author":"Svolos","year":"2025","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/S2468-1253(25)00262-6","article-title":"Cyclic exclusive enteral nutrition versus partial enteral nutrition to maintain long-term drug-free remission in paediatric Crohn\u2019s disease (CD-HOPE): An open-label, endpoint-blinded, randomised controlled trial","volume":"11","author":"Pigneur","year":"2026","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1838","DOI":"10.1093\/ibd\/izac010","article-title":"Food-Related Quality of Life in Children and Adolescents with Crohn\u2019s Disease","volume":"28","author":"Brown","year":"2022","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Suskind, D.L., Lee, D., Kim, Y.M., Wahbeh, G., Singh, N., Braly, K., Nuding, M., Nicora, C.D., Purvine, S.O., and Lipton, M.S. (2020). The Specific Carbohydrate Diet and Diet Modification as Induction Therapy for Pediatric Crohn\u2019s Disease: A Randomized Diet Controlled Trial. Nutrients, 12.","DOI":"10.3390\/nu12123749"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Yan, J., Wang, L., Gu, Y., Hou, H., Liu, T., Ding, Y., and Cao, H. (2022). Dietary Patterns and Gut Microbiota Changes in Inflammatory Bowel Disease: Current Insights and Future Challenges. Nutrients, 14.","DOI":"10.3390\/nu14194003"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"213","DOI":"10.4291\/wjgp.v5.i3.213","article-title":"Escherichia coli in chronic inflammatory bowel diseases: An update on adherent invasive Escherichia coli pathogenicity","volume":"5","year":"2014","journal-title":"World J. Gastrointest. Pathophysiol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1053\/j.gastro.2021.05.047","article-title":"A Randomized Trial Comparing the Specific Carbohydrate Diet to a Mediterranean Diet in Adults with Crohn\u2019s Disease","volume":"161","author":"Lewis","year":"2021","journal-title":"Gastroenterology"},{"key":"ref_53","first-page":"316","article-title":"Durable Clinical and Biochemical but Not Endoscopic Remission in Pediatric Crohn\u2019s Disease on Specific Carbohydrate Diet Monotherapy","volume":"50","author":"Britto","year":"2020","journal-title":"Ann. Clin. Lab. Sci."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1093\/ecco-jcc\/jjy207","article-title":"Mucosal Healing and Bacterial Composition in Response to Enteral Nutrition vs. Steroid-based Induction Therapy\u2014A Randomised Prospective Clinical Trial in Children with Crohn\u2019s Disease","volume":"13","author":"Pigneur","year":"2018","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1097\/MPG.0b013e3182144c74","article-title":"Serum Concentrations of VEGF and TGF-\u03b21 During Exclusive Enteral Nutrition in IBD","volume":"53","author":"Wedrychowicz","year":"2011","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"151499","DOI":"10.1016\/j.ijmm.2021.151499","article-title":"Regulation of the gut barrier by carbohydrates from diet\u2013Underlying mechanisms and possible clinical implications","volume":"311","author":"Bischoff","year":"2021","journal-title":"Int. J. Med. Microbiol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"28990","DOI":"10.1038\/srep28990","article-title":"High Fat Diets Induce Colonic Epithelial Cell Stress and Inflammation that is Reversed by IL-22","volume":"6","author":"Gulhane","year":"2016","journal-title":"Sci. Rep."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/7\/1146\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T12:01:11Z","timestamp":1775131271000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/7\/1146"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,2]]},"references-count":57,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["nu18071146"],"URL":"https:\/\/doi.org\/10.3390\/nu18071146","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,2]]}}}