{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:19:16Z","timestamp":1791389956762,"version":"4.3.3"},"reference-count":41,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Abbott Nutrition, USA"},{"id":[{"id":"https:\/\/ror.org\/00p99t114","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Anabolic resistance is thought to underlie muscle loss in sarcopenia. Here, we investigated the adjuvant role of beta-hydroxy-beta-methylbutyrate (HMB), a leucine metabolite, on the acute muscle anabolic response to oral protein supplementation in older adults. Methods: A total of 24 community-dwelling older adults (68.5 \u00b1 0.6 years; 13 men, 11 women) were randomized in a cross-over double-blind design to 40 g whey protein (Control) or 40 g whey protein with 3 g calcium\u2013HMB (HMB). Subjects received a primed constant infusion of 13C6 phenylalanine to assess muscle protein synthesis (MPS, by tracer incorporation in myofibrils) and muscle protein breakdown (MPB, via arterio-venous dilution) at baseline and post supplementation. Fasted and 3 h fed-state plasma HMB, aminoacidemia, rates of MPS, MPB, limb and muscle blood flow were measured. Results: In all subjects, both interventions displayed significant increases in MPS in response to feeding [fasted to 3 h-fed change (mean \u00b1 SEM, standard error of the mean). Males: control, +0.032 \u00b1 0.006%.h\u22121; HMB, +0.023 \u00b1 0.004%.h\u22121; females: control, +0.023 \u00b1 0.006%.h\u22121; HMB, +0.038 \u00b1 0.006%.h\u22121, p &lt; 0.05]. In older women, the addition of HMB further enhanced the MPS response (fasted to 3 h-fed change, p = 0.0495) and area under the curve (p = 0.0364) versus protein alone. During the late-fed period, MPB significantly decreased in HMB versus control (p = 0.0298), and this was also observed when subjects were separated by sex (p = 0.0012). Conclusions: High-dose protein bolus feeding increased MPS in older adults. Surprisingly, 40 g whey did not maximize the anabolic response in older women, and HMB further increased the MPS feeding response to protein. HMB further suppressed the MPB feeding response over a longer period of time. Further work is needed to understand the apparent sexual dimorphic MPS response to high protein.<\/jats:p>","DOI":"10.3390\/nu18091449","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T06:50:01Z","timestamp":1777618201000},"page":"1449","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Effect of \u03b2-Hydroxy-\u03b2-Methyl Butyrate (HMB) upon Acute Fed-State Muscle Protein Turnover in Older Men and Women: A Randomized Double-Blind Controlled Crossover Clinical Trial"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8971-6635","authenticated-orcid":false,"given":"Kenneth","family":"Smith","sequence":"first","affiliation":[{"name":"MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and Nottingham NIHR BRC, School of Medicine, University of Nottingham, Derby DE22 3DT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6641-8774","authenticated-orcid":false,"given":"Haitham","family":"Abdullah","sequence":"additional","affiliation":[{"name":"MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and Nottingham NIHR BRC, School of Medicine, University of Nottingham, Derby DE22 3DT, UK"},{"name":"Department of Diabetes and Endocrinology, Royal Derby Hospital, Derby DE22 3NE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0822-5055","authenticated-orcid":false,"given":"Supreeth","family":"Rudrappa","sequence":"additional","affiliation":[{"name":"MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and Nottingham NIHR BRC, School of Medicine, University of Nottingham, Derby DE22 3DT, UK"},{"name":"Department of Diabetes and Endocrinology, Royal Derby Hospital, Derby DE22 3NE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3471-5894","authenticated-orcid":false,"given":"Amanda","family":"Gates","sequence":"additional","affiliation":[{"name":"MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and Nottingham NIHR BRC, School of Medicine, University of Nottingham, Derby DE22 3DT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Lewis","sequence":"additional","affiliation":[{"name":"MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and Nottingham NIHR BRC, School of Medicine, University of Nottingham, Derby DE22 3DT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7548-8288","authenticated-orcid":false,"given":"Iskandar","family":"Idris","sequence":"additional","affiliation":[{"name":"MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and Nottingham NIHR BRC, School of Medicine, University of Nottingham, Derby DE22 3DT, UK"},{"name":"Department of Diabetes and Endocrinology, Royal Derby Hospital, Derby DE22 3NE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8236-681X","authenticated-orcid":false,"given":"Joseph J.","family":"Bass","sequence":"additional","affiliation":[{"name":"MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and Nottingham NIHR BRC, School of Medicine, University of Nottingham, Derby DE22 3DT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9009-3049","authenticated-orcid":false,"given":"Hannah","family":"Crossland","sequence":"additional","affiliation":[{"name":"MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and Nottingham NIHR BRC, School of Medicine, University of Nottingham, Derby DE22 3DT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8808-8243","authenticated-orcid":false,"given":"Daniel J.","family":"Wilkinson","sequence":"additional","affiliation":[{"name":"MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and Nottingham NIHR BRC, School of Medicine, University of Nottingham, Derby DE22 3DT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4225-9478","authenticated-orcid":false,"given":"Min","family":"Tian","sequence":"additional","affiliation":[{"name":"28 Cabot Ct., Wayne, PA 19087, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah S.","family":"Hustead","sequence":"additional","affiliation":[{"name":"7575 Lilyhill Ct., Worthington, OH 43085, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9419-7040","authenticated-orcid":false,"given":"Geraldine E.","family":"Baggs","sequence":"additional","affiliation":[{"name":"Abbott Nutrition, Research & Development, Columbus, OH 43219, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5491-7266","authenticated-orcid":false,"given":"Suzette L.","family":"Pereira","sequence":"additional","affiliation":[{"name":"Abbott Nutrition, Research & Development, Columbus, OH 43219, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1430-1870","authenticated-orcid":false,"given":"Bethan E.","family":"Phillips","sequence":"additional","affiliation":[{"name":"MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and Nottingham NIHR BRC, School of Medicine, University of Nottingham, Derby DE22 3DT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7286-046X","authenticated-orcid":false,"given":"Philip J.","family":"Atherton","sequence":"additional","affiliation":[{"name":"MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and Nottingham NIHR BRC, School of Medicine, University of Nottingham, Derby DE22 3DT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"ref_1","first-page":"16","article-title":"Sarcopenia: Revised European consensus on definition and diagnosis","volume":"48","author":"Bahat","year":"2018","journal-title":"Age Ageing"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1001\/jama.2018.12621","article-title":"From Lifespan to Healthspan","volume":"320","author":"Olshansky","year":"2018","journal-title":"JAMA"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1113\/jphysiol.2011.225003","article-title":"Muscle protein synthesis in response to nutrition and exercise","volume":"590","author":"Atherton","year":"2012","journal-title":"J. Physiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1080\/07853890.2018.1511918","article-title":"Implications of low muscle mass across the continuum of care: A narrative review","volume":"50","author":"Prado","year":"2018","journal-title":"Ann. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2636","DOI":"10.1016\/S0140-6736(19)31138-9","article-title":"Sarcopenia","volume":"393","author":"Sayer","year":"2019","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2113","DOI":"10.1016\/j.clnu.2018.11.021","article-title":"Muscle loss: The new malnutrition challenge in clinical practice","volume":"38","author":"Landi","year":"2019","journal-title":"Clin. Nutr."},{"key":"ref_7","first-page":"463","article-title":"Advances in nutritional science and physiological function: An editorial review","volume":"27","author":"Prado","year":"2024","journal-title":"Curr. Opin. Clin. Nutr. Metab. Care"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"E450","DOI":"10.1152\/ajpendo.00112.2015","article-title":"The impact of delivery profile of essential amino acids upon skeletal muscle protein synthesis in older men: Clinical efficacy of pulse vs. bolus supply","volume":"309","author":"Mitchell","year":"2015","journal-title":"Am. J. Physiol.-Endocrinol. Metab."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"828S","DOI":"10.3945\/an.115.011650","article-title":"Human Skeletal Muscle Protein Metabolism Responses to Amino Acid Nutrition","volume":"7","author":"Mitchell","year":"2016","journal-title":"Adv. Nutr."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.3945\/ajcn.2010.29819","article-title":"Muscle full effect after oral protein: Time-dependent concordance and discordance between human muscle protein synthesis and mTORC1 signaling1234","volume":"92","author":"Atherton","year":"2010","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_11","unstructured":"Dardevet, D. (2016). Chapter 9\u2014Feeding Modulation of Amino Acid Utilization: Role of Insulin and Amino Acids in Skeletal Muscle. The Molecular Nutrition of Amino Acids and Proteins, Academic Press."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Deane, C.S., Cox, J., and Atherton, P.J. (2024). Critical variables regulating age-related anabolic responses to protein nutrition in skeletal muscle. Front. Nutr., 11.","DOI":"10.3389\/fnut.2024.1419229"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1093\/gerona\/glu103","article-title":"Protein Ingestion to Stimulate Myofibrillar Protein Synthesis Requires Greater Relative Protein Intakes in Healthy Older Versus Younger Men","volume":"70","author":"Moore","year":"2014","journal-title":"J. Gerontol. Ser. A"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2041","DOI":"10.1093\/jn\/nxaa024","article-title":"Protein Type, Protein Dose, and Age Modulate Dietary Protein Digestion and Phenylalanine Absorption Kinetics and Plasma Phenylalanine Availability in Humans","volume":"150","author":"Gorissen","year":"2020","journal-title":"J. Nutr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1093\/ajcn\/65.2.489","article-title":"Splanchnic and whole-body leucine kinetics in young and elderly men","volume":"65","author":"Boirie","year":"1997","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e00119","DOI":"10.1002\/phy2.119","article-title":"Development of a new Sonovue\u2122 contrast-enhanced ultrasound approach reveals temporal and age-related features of muscle microvascular responses to feeding","volume":"1","author":"Mitchell","year":"2013","journal-title":"Physiol. Rep."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1096\/fj.04-2640fje","article-title":"Anabolic signaling deficits underlie amino acid resistance of wasting, aging muscle","volume":"19","author":"Cuthbertson","year":"2005","journal-title":"FASEB J."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Smith, G.I., Atherton, P., Villareal, D.T., Frimel, T.N., Rankin, D., Rennie, M.J., and Mittendorfer, B. (2008). Differences in Muscle Protein Synthesis and Anabolic Signaling in the Postabsorptive State and in Response to Food in 65\u201380 Year Old Men and Women. PLoS ONE, 3.","DOI":"10.1371\/journal.pone.0001875"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/2042-6410-3-11","article-title":"Sexually dimorphic effect of aging on skeletal muscle protein synthesis","volume":"3","author":"Smith","year":"2012","journal-title":"Biol. Sex Differ."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1152\/japplphysiol.00886.2023","article-title":"Postabsorptive and postprandial myofibrillar protein synthesis rates at rest and after resistance exercise in women with postmenopause","volume":"136","author":"McKenna","year":"2024","journal-title":"J. Appl. Physiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1901","DOI":"10.1093\/jn\/nxab055","article-title":"Protein Source and Quality for Skeletal Muscle Anabolism in Young and Older Adults: A Systematic Review and Meta-Analysis","volume":"151","author":"Morgan","year":"2021","journal-title":"J. Nutr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1016\/j.clnu.2016.04.025","article-title":"Enriching a protein drink with leucine augments muscle protein synthesis after resistance exercise in young and older men","volume":"36","author":"Atherton","year":"2017","journal-title":"Clin. Nutr."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Lin, Z., Zhao, A., and He, J. (2022). Effect of \u03b2-hydroxy-\u03b2-methylbutyrate (HMB) on the Muscle Strength in the Elderly Population: A Meta-Analysis. Front. Nutr., 9.","DOI":"10.3389\/fnut.2022.914866"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1007\/s41999-020-00409-9","article-title":"Effects of oral administration of \u03b2-hydroxy \u03b2-methylbutyrate on lean body mass in older adults: A systematic review and meta-analysis","volume":"12","author":"Lin","year":"2021","journal-title":"Eur. Geriatr. Med."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Su, H., Zhou, H., Gong, Y., Xiang, S., Shao, W., Zhao, X., Ling, H., Chen, G., Tong, P., and Li, J. (2024). The effects of \u03b2-hydroxy-\u03b2-methylbutyrate or HMB-rich nutritional supplements on sarcopenia patients: A systematic review and meta-analysis. Front. Med., 11.","DOI":"10.3389\/fmed.2024.1348212"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1093\/ajcn\/nqy373","article-title":"\u03b2-Hydroxy-\u03b2-methylbutyrate and its impact on skeletal muscle mass and physical function in clinical practice: A systematic review and meta-analysis","volume":"109","author":"Bear","year":"2019","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2911","DOI":"10.1113\/jphysiol.2013.253203","article-title":"Effects of leucine and its metabolite \u03b2-hydroxy-\u03b2-methylbutyrate on human skeletal muscle protein metabolism","volume":"591","author":"Wilkinson","year":"2013","journal-title":"J. Physiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2068","DOI":"10.1016\/j.clnu.2017.09.024","article-title":"Impact of the calcium form of \u03b2-hydroxy-\u03b2-methylbutyrate upon human skeletal muscle protein metabolism","volume":"37","author":"Wilkinson","year":"2018","journal-title":"Clin. Nutr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1158\/0008-5472.277.65.1","article-title":"Attenuation of proteasome-induced proteolysis in skeletal muscle by \u03b2-hydroxy-\u03b2-methylbutyrate in cancer-induced muscle loss","volume":"65","author":"Smith","year":"2005","journal-title":"Cancer Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"8731","DOI":"10.1158\/0008-5472.CAN-04-1760","article-title":"Mechanism of the attenuation of proteolysis-inducing factor stimulated protein degradation in muscle by \u03b2-hydroxy-\u03b2-methylbutyrate","volume":"64","author":"Smith","year":"2004","journal-title":"Cancer Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1016\/S0955-2863(01)00182-6","article-title":"\u03b2-hydroxy-\u03b2-methylbutyrate (HMB) kinetics and the influence of glucose ingestion in humans","volume":"12","author":"Vukovich","year":"2001","journal-title":"J. Nutr. Biochem."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1582","DOI":"10.1016\/j.jada.2009.06.369","article-title":"A Moderate Serving of High-Quality Protein Maximally Stimulates Skeletal Muscle Protein Synthesis in Young and Elderly Subjects","volume":"109","author":"Symons","year":"2009","journal-title":"J. Am. Diet. Assoc."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"994","DOI":"10.1210\/jc.2018-01734","article-title":"The Muscle Protein Synthetic Response to Whey Protein Ingestion Is Greater in Middle-Aged Women Compared With Men","volume":"104","author":"Horstman","year":"2018","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1123\/ijsnem.2024-0041","article-title":"The Anabolic Response to Protein Ingestion During Recovery From Exercise Has No Upper Limit in Magnitude and Duration In Vivo in Humans: A Commentary","volume":"34","author":"Witard","year":"2024","journal-title":"Int. J. Sport Nutr. Exerc. Metab."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Tessari, P. (2023). Stepwise Discovery of Insulin Effects on Amino Acid and Protein Metabolism. Nutrients, 16.","DOI":"10.3390\/nu16010119"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"4389","DOI":"10.1039\/D3FO04174C","article-title":"Beta-Hydroxy-beta-methylbutyrate (HMB) leads to phospholipase D2 (PLD2) activation and alters circadian rhythms in myotubes","volume":"15","author":"Chapnik","year":"2024","journal-title":"Food Funct."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1093\/ajcn\/85.2.446","article-title":"Response of albumin synthesis to oral nutrients in young and elderly subjects","volume":"85","author":"Caso","year":"2007","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1016\/j.clnu.2016.05.004","article-title":"Anabolic effects of leucine-rich whey protein, carbohydrate, and soy protein with and without \u03b2-hydroxy-\u03b2-methylbutyrate (HMB) during fasting-induced catabolism: A human randomized crossover trial","volume":"36","author":"Rittig","year":"2017","journal-title":"Clin. Nutr."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"5152","DOI":"10.1039\/C9FO00769E","article-title":"Beta-hydroxy beta-methyl butyrate decreases muscle protein degradation via increased Akt\/FoxO3a signaling and mitochondrial biogenesis in weanling piglets after lipopolysaccharide challenge","volume":"10","author":"Duan","year":"2019","journal-title":"Food Funct."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Gir\u00f3n, M.D., V\u00edlchez, J.D., Shreeram, S., Salto, R., Manzano, M., Cabrera, E., Campos, N., Edens, N.K., Rueda, R., and L\u00f3pez-Pedrosa, J.M. (2015). \u03b2-Hydroxy-\u03b2-Methylbutyrate (HMB) Normalizes Dexamethasone-Induced Autophagy-Lysosomal Pathway in Skeletal Muscle. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0117520"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"E1409","DOI":"10.1152\/ajpendo.90530.2008","article-title":"Attenuation of depression of muscle protein synthesis induced by lipopolysaccharide, tumor necrosis factor, and angiotensin II by \u03b2-hydroxy-\u03b2-methylbutyrate","volume":"295","author":"Eley","year":"2008","journal-title":"Am. J. Physiol.-Endocrinol. Metab."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/9\/1449\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T06:54:57Z","timestamp":1777618497000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/9\/1449"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,30]]},"references-count":41,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["nu18091449"],"URL":"https:\/\/doi.org\/10.3390\/nu18091449","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,30]]}}}