{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T08:09:37Z","timestamp":1780560577267,"version":"3.54.1"},"reference-count":63,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"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>Objectives: This study compared the risk profiles, nutrient intake, and kidney function of calcium oxalate stone formers with and without enteric hyperoxaluria. Methods: Thirty-seven patients with calcium oxalate stone disease and enteric hyperoxaluria (cases) and 37 sex- and age-matched idiopathic calcium oxalate stone formers (controls) were enrolled. Patients did not receive any nutritional counseling prior to the start of the study, and they discontinued medications affecting urinary parameters four weeks before their study participation. Anthropometric, clinical, and metabolic parameters were recorded. Dietary and 24-h urinary variables were measured under the habitual diet and under a balanced, standardized diet. The [13C2] oxalate absorption and calcium loading tests were carried out. Results: The median [13C2] oxalate absorption was significantly higher in cases (14.8%) than in controls (8.9%). Under the balanced diet, hypocitraturia, hypomagnesuria, low urine volume and pH value were significantly more common in the case group, whereas hypercalciuria occurred more frequently in the control group, affecting 45.9% of controls and 5.4% of cases. Furthermore, the control group exhibited a greater reduction in urinary calcium excretion under the balanced diet. Urinary oxalate excretion and the ion-activity product index of calcium oxalate were significantly higher under both diets, with a greater decline observed in the case group under the balanced diet. The estimated glomerular filtration rate (eGFR) was lower in cases. A multivariable linear regression analysis revealed a significant association between urine pH and eGFR. Conclusions: Calcium oxalate stone formers with and without enteric hyperoxaluria benefit from a balanced diet and sufficient fluid intake. The reduction in urinary oxalate excretion and the biochemical risk of recurrent calcium oxalate stone formation were even more pronounced in patients with enteric hyperoxaluria. Particular attention should be paid to low urine pH, as it is hypothesized to be a potential indicator of impaired kidney function.<\/jats:p>","DOI":"10.3390\/nu18111788","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T15:07:52Z","timestamp":1780326472000},"page":"1788","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Risk Profiles, Nutrient Intake, and Kidney Function of Calcium Oxalate Stone Formers with and without Enteric Hyperoxaluria. A Matched Case-Control Study"],"prefix":"10.3390","volume":"18","author":[{"given":"Charlotte","family":"Ernsten","sequence":"first","affiliation":[{"name":"University Stone Center, Clinic and Polyclinic for Urology and Pediatric Urology, University Hospital Bonn, University of Bonn, 53127 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6345-9634","authenticated-orcid":false,"given":"Nikolai","family":"Spuck","sequence":"additional","affiliation":[{"name":"Institute for Medical Biometry, Informatics, and Epidemiology (IMBIE), University Hospital Bonn, University of Bonn, 53113 Bonn, Germany"},{"name":"Core Facility Biostatistics, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albrecht","family":"Hesse","sequence":"additional","affiliation":[{"name":"University Stone Center, Clinic and Polyclinic for Urology and Pediatric Urology, University Hospital Bonn, University of Bonn, 53127 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roswitha","family":"Siener","sequence":"additional","affiliation":[{"name":"University Stone Center, Clinic and Polyclinic for Urology and Pediatric Urology, University Hospital Bonn, University of Bonn, 53127 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1007\/s00345-017-2008-6","article-title":"Epidemiology of stone disease across the world","volume":"35","author":"Sorokin","year":"2017","journal-title":"World J. Urol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.euf.2017.04.001","article-title":"Burden of urolithiasis: Trends in prevalence, treatments, and costs","volume":"3","author":"Raheem","year":"2017","journal-title":"Eur. Urol. Focus"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2141","DOI":"10.2215\/CJN.05660614","article-title":"Stone composition as a function of age and sex","volume":"9","author":"Lieske","year":"2014","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.1007\/s00345-022-04060-w","article-title":"Urinary stone composition in Germany: Results from 45,783 stone analyses","volume":"40","author":"Siener","year":"2022","journal-title":"World J. Urol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1016\/S0889-8529(02)00030-0","article-title":"Hyperoxaluric calcium nephrolithiasis","volume":"31","author":"Asplin","year":"2002","journal-title":"Endocrinol. Metab. Clin. N. Am."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"102322","DOI":"10.1016\/j.clinre.2024.102322","article-title":"Pathophysiology and management of enteric hyperoxaluria","volume":"48","author":"Desenclos","year":"2024","journal-title":"Clin. Res. Hepatol. Gastroenterol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Siener, R., Ernsten, C., Welchowski, T., and Hesse, A. (2024). Metabolic profile of calcium oxalate stone patients with enteric hyperoxaluria and impact of dietary intervention. Nutrients, 16.","DOI":"10.3390\/nu16162688"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.34067\/KID.0004982020","article-title":"Risk factors for kidney stone formation following bariatric surgery","volume":"1","author":"Prochaska","year":"2020","journal-title":"Kidney360"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1056\/NEJM197307262890402","article-title":"Mechanism for hyperoxaluria in patients with ileal dysfunction","volume":"289","author":"Chadwick","year":"1973","journal-title":"N. Engl. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1007\/s00240-015-0846-5","article-title":"The management of patients with enteric hyperoxaluria","volume":"44","author":"Asplin","year":"2016","journal-title":"Urolithiasis"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1016\/S0016-5085(74)80003-X","article-title":"Hyperoxaluria in patients with ileal resection: An abnormality in dietary oxalate absorption","volume":"66","author":"Earnest","year":"1974","journal-title":"Gastroenterology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1056\/NEJM197702102960602","article-title":"Importance of the colon in enteric hyperoxaluria","volume":"296","author":"Dobbins","year":"1977","journal-title":"N. Engl. J. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1016\/S0016-5085(76)80318-6","article-title":"Effect of bile salts and fatty acids on the colonic absorption of oxalate","volume":"70","author":"Dobbins","year":"1976","journal-title":"Gastroenterology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e5287","DOI":"10.1136\/bmj.e5287","article-title":"Kidney stones and kidney function loss: A cohort study","volume":"345","author":"Alexander","year":"2012","journal-title":"BMJ"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"sfae030","DOI":"10.1093\/ckj\/sfae030","article-title":"Risk of incident chronic kidney disease among patients with urolithiasis: A nationwide longitudinal cohort study","volume":"17","author":"Kim","year":"2024","journal-title":"Clin. Kidney J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1007\/s40620-016-0329-y","article-title":"Metabolic diagnosis and medical prevention of calcium nephrolithiasis and its systemic manifestations: A consensus statement","volume":"29","author":"Gambaro","year":"2016","journal-title":"J. Nephrol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.juro.2016.12.135","article-title":"The risk of chronic kidney disease associated with urolithiasis and its urological treatments: A review","volume":"198","author":"Gambaro","year":"2017","journal-title":"J. Urol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1016\/j.juro.2006.03.095","article-title":"Renal function in patients with nephrolithiasis","volume":"176","author":"Worcester","year":"2006","journal-title":"J. Urol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2693","DOI":"10.1093\/ibd\/izaf039","article-title":"Risk factors for chronic kidney disease in patients with Crohn\u2019s disease","volume":"31","author":"Rodriguez","year":"2025","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"29","DOI":"10.5049\/EBP.2021.19.2.29","article-title":"Metabolic acidosis in chronic kidney disease: Pathogenesis, clinical consequences, and treatment","volume":"19","author":"Kim","year":"2021","journal-title":"Electrolytes Blood Press"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Korus, J., Szymczak, M., Go\u0142\u0119biowski, M., Rydzek, J., Majcherczyk, K., Wilk, J., Bu\u0142dy\u015b, K., Zmonarski, S., and Go\u0142\u0119biowski, T. (2025). Metabolic acidosis in patients with chronic kidney disease: Diagnosis, pathogenesis, and treatment\u2014A narrative review. Diagnostics, 15.","DOI":"10.3390\/diagnostics15162052"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1111\/ajt.12029","article-title":"Enteric oxalate nephropathy in the renal allograft: An underrecognized complication of bariatric surgery","volume":"13","author":"Troxell","year":"2013","journal-title":"Am. J. Transplant."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1016\/j.mayocp.2023.08.014","article-title":"Clinicopathologic characteristics, etiologies, and outcome of secondary oxalate nephropathy","volume":"99","author":"Nasr","year":"2024","journal-title":"Mayo Clin. Proc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"487","DOI":"10.2215\/CJN.08000520","article-title":"Pathophysiology and treatment of enteric hyperoxaluria","volume":"16","author":"Witting","year":"2021","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1053\/j.ajkd.2013.11.022","article-title":"Urinary lithogenic risk profile in recurrent stone formers with hyperoxaluria: A randomized controlled trial comparing DASH (Dietary Approaches to Stop Hypertension)-style and low-oxalate diets","volume":"63","author":"Noori","year":"2014","journal-title":"Am. J. Kidney Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/S0308-8146(02)00212-1","article-title":"Comparison of extraction methods for the determination of soluble and total oxalate in foods by HPLC-enzyme-reactor","volume":"78","author":"Hesse","year":"2002","journal-title":"Food Chem."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Siener, R. (2021). Nutrition and kidney stone disease. Nutrients, 13.","DOI":"10.3390\/nu13061917"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Siener, R., L\u00f6hr, P., and Hesse, A. (2023). Urinary risk profile, impact of diet, and risk of calcium oxalate urolithiasis in idiopathic uric acid stone disease. Nutrients, 15.","DOI":"10.3390\/nu15030572"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Hesse, A., Tiselius, H.-G., Siener, R., and Hoppe, B. (2009). Urinary Stones: Diagnosis, Treatment, and Prevention of Recurrence, Karger. [3rd ed.].","DOI":"10.1159\/isbn.978-3-8055-9150-8"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Siener, R., Pitzer, M.S., Speller, J., and Hesse, A. (2023). Risk profile of patients with brushite stone disease and the impact of diet. Nutrients, 15.","DOI":"10.3390\/nu15184092"},{"key":"ref_31","unstructured":"Deutsche Gesellschaft f\u00fcr Urologie e.V., and Arbeitskreis Harnsteine der Akademie der Deutschen Urologen (2019). S2k-Leitlinie zur Diagnostik, Therapie und Metaphylaxe der Urolithiasis (AWMF-Registernummer 043-025), Aktualisierung 2018, Arbeitskreis Harnsteine der Akademie der Deutschen Urologen. Available online: https:\/\/register.awmf.org\/de\/leitlinien\/detail\/043-025."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1016\/S0022-5347(17)47703-2","article-title":"EQUIL2: A basic computer program for the calculation of urinary saturation","volume":"134","author":"Werness","year":"1985","journal-title":"J. Urol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1016\/S0889-8529(02)00027-0","article-title":"Medical evaluation of nephrolithiasis","volume":"31","author":"Tiselius","year":"2002","journal-title":"Endocrinol. Metab. Clin. N. Am."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"604","DOI":"10.7326\/0003-4819-150-9-200905050-00006","article-title":"A new equation to estimate glomerular filtration rate","volume":"150","author":"Levey","year":"2009","journal-title":"Ann. Intern. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1016\/S0022-5347(05)63993-6","article-title":"Reference range for gastrointestinal oxalate absorption measured with a standardized [13C2]oxalate absorption test","volume":"169","author":"Voss","year":"2003","journal-title":"J. Urol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1711","DOI":"10.1016\/S0022-5347(05)01001-3","article-title":"Intestinal oxalate absorption is higher in idiopathic calcium oxalate stone formers than in healthy controls: Measurements with the [13C2]oxalate absorption test","volume":"175","author":"Voss","year":"2006","journal-title":"J. Urol."},{"key":"ref_37","first-page":"1","article-title":"mice: Multivariate imputation by chained equations in R","volume":"45","year":"2011","journal-title":"J. Stat. Softw."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2032","DOI":"10.1111\/j.1523-1755.2004.00975.x","article-title":"Rapid communication: Relative effect of urinary calcium and oxalate on saturation of calcium oxalate","volume":"66","author":"Pak","year":"2004","journal-title":"Kidney Int."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Siener, R., Ernsten, C., Speller, J., Scheurlen, C., Sauerbruch, T., and Hesse, A. (2024). Intestinal oxalate absorption, enteric hyperoxaluria, and risk of urinary stone formation in patients with Crohn\u2019s disease. Nutrients, 16.","DOI":"10.3390\/nu16020264"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2208","DOI":"10.1093\/ndt\/gfaa281","article-title":"Subsequent urinary stone events are predicted by the magnitude of urinary oxalate excretion in enteric hyperoxaluria","volume":"36","author":"Kausz","year":"2021","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1080\/10256010410001671609","article-title":"The effect of oral administration of calcium and magnesium on intestinal oxalate absorption in humans","volume":"40","author":"Voss","year":"2004","journal-title":"Isot. Environ. Health Stud."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1136\/gut.15.5.360","article-title":"Fat-reduced diet in the treatment of hyperoxaluria in patients with ileopathy","volume":"15","author":"Andersson","year":"1974","journal-title":"Gut"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1056\/NEJMoa010369","article-title":"Comparison of two diets for the prevention of recurrent stones in idiopathic hypercalciuria","volume":"346","author":"Borghi","year":"2002","journal-title":"N. Eng. J. Med."},{"key":"ref_44","unstructured":"Skolarikos, A., Jung, H., Neisius, A., Pet\u0159\u00edk, A., Kamphuis, G.M., Davis, N.F., Somani, B., Tailly, T., Lardas, M., and Gambaro, G. (2025). EAU Guidelines on Urolithiasis, EAU Guidelines Office. Available online: http:\/\/uroweb.org\/guidelines\/compilations-of-all-guidelines."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1016\/S0272-6386(12)80667-6","article-title":"Magnesium deficiency: Pathophysiologic and clinical overview","volume":"24","author":"Cameron","year":"1994","journal-title":"Am. J. Kidney Dis."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1016\/S0022-5347(01)66321-3","article-title":"Urinary volume, water and recurrences in idiopathic calcium nephrolithiasis: A 5-year randomized prospective study","volume":"155","author":"Borghi","year":"1996","journal-title":"J. Urol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1093\/ndt\/gfad221","article-title":"Twenty-four-hour urine oxalate and risk of chronic kidney disease","volume":"39","author":"Puurunen","year":"2024","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1001\/jamainternmed.2018.7980","article-title":"Association of urinary oxalate excretion with the risk of chronic kidney disease progression","volume":"179","author":"Waikar","year":"2019","journal-title":"JAMA Intern. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2232","DOI":"10.2215\/CJN.07400715","article-title":"Acid-base homeostasis","volume":"10","author":"Hamm","year":"2015","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_50","first-page":"F223","article-title":"Citrate excretion: A window on renal metabolism","volume":"244","author":"Simpson","year":"1983","journal-title":"Am. J. Physiol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1038\/ki.1990.265","article-title":"Renal handling of citrate","volume":"38","author":"Hamm","year":"1990","journal-title":"Kidney Int."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1159\/000464049","article-title":"Alkali citrate for preventing recurrence of calcium oxalate stones","volume":"17","author":"Hauser","year":"1990","journal-title":"Eur. Urol."},{"key":"ref_53","first-page":"61","article-title":"Urinary patterns of patients with renal stones associated with chronic inflammatory bowel disease","volume":"74","author":"Trinchieri","year":"2002","journal-title":"Arch. Ital. Urol. Androl."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1159\/000330487","article-title":"Low urine pH is a predictor of chronic kidney disease","volume":"35","author":"Nakanishi","year":"2012","journal-title":"Kidney Blood Press. Res."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/j.semnephrol.2019.04.009","article-title":"Acid base balance and progression of kidney disease","volume":"39","author":"Chen","year":"2019","journal-title":"Semin. Nephrol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1053\/j.ackd.2022.05.004","article-title":"Regulation of acid-base balance in patients with chronic kidney disease","volume":"29","author":"Nagami","year":"2022","journal-title":"Adv. Chronic Kidney Dis."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1007\/s00424-024-02912-5","article-title":"Metabolic acidosis in chronic kidney disease: Mere consequence or also culprit?","volume":"476","author":"Kuhn","year":"2024","journal-title":"Pflug. Arch."},{"key":"ref_58","unstructured":"(2024). Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int., 105, 117\u2013314."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"2402","DOI":"10.1111\/j.1523-1755.2004.66029.x","article-title":"The effect of fruits and vegetables on urinary stone risk factors","volume":"66","author":"Meschi","year":"2004","journal-title":"Kidney Int."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1053\/j.jrn.2025.03.002","article-title":"Plant-based diet and chronic kidney disease: A systematic review and meta-analysis","volume":"35","author":"Dang","year":"2025","journal-title":"J. Ren. Nutr."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"535","DOI":"10.7326\/0003-4819-158-7-201304020-00005","article-title":"Medical management to prevent recurrent nephrolithiasis in adults: A systematic review for an American College of Physicians clinical guideline","volume":"158","author":"Fink","year":"2013","journal-title":"Ann. Intern. Med."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"659","DOI":"10.7326\/M13-2908","article-title":"Dietary and pharmacologic management to prevent recurrent nephrolithiasis in adults: A clinical practice guideline from the American College of Physicians","volume":"161","author":"Qaseem","year":"2014","journal-title":"Ann. Intern. Med."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1007\/s40620-015-0210-4","article-title":"Treatment effect, adherence, and safety of high fluid intake for the prevention of incident and recurrent kidney stones: A systematic review and meta-analysis","volume":"29","author":"Cheungpasitporn","year":"2016","journal-title":"J. Nephrol."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/11\/1788\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T07:45:28Z","timestamp":1780559128000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/11\/1788"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,1]]},"references-count":63,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["nu18111788"],"URL":"https:\/\/doi.org\/10.3390\/nu18111788","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,1]]}}}