Do dry roasting, lightly salting nuts affect their cardioprotective properties and acceptability?

Purpose Previous studies have reported improvements in cardiovascular disease (CVD) risk factors with the consumption of raw nuts. However, around one-third of nuts consumed are roasted and salted. Thus, it is important to determine whether roasting and salting nuts affect the health benefits observ...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:European journal of nutrition 2017-04, Vol.56 (3), p.1025-1036
Hauptverfasser: Tey, Siew Ling, Robinson, Terryn, Gray, Andrew R., Chisholm, Alexandra W., Brown, Rachel Clare
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 1036
container_issue 3
container_start_page 1025
container_title European journal of nutrition
container_volume 56
creator Tey, Siew Ling
Robinson, Terryn
Gray, Andrew R.
Chisholm, Alexandra W.
Brown, Rachel Clare
description Purpose Previous studies have reported improvements in cardiovascular disease (CVD) risk factors with the consumption of raw nuts. However, around one-third of nuts consumed are roasted and salted. Thus, it is important to determine whether roasting and salting nuts affect the health benefits observed with raw nuts. This study aimed to compare the effects of consuming two different forms of hazelnuts on cardiovascular risk factors and acceptance. Methods Using a randomised crossover design, 72 participants were asked to consume 30 g/day of either raw or dry roasted, lightly salted hazelnuts for 28 days each. CVD risk factors were measured at the beginning and end of each treatment period. “Desire to consume” and “overall liking” for both forms of hazelnuts were assessed daily using a 150-mm visual analogue scale. Results Body composition, blood pressure, plasma total and low-density lipoprotein-cholesterol, apolipoprotein A1 and B100, glucose and α-tocopherol concentrations did not differ between forms of hazelnuts (all P  ≥ 0.054). High-density lipoprotein (HDL)-cholesterol ( P  = 0.037) and triacylglycerol ( P  
doi_str_mv 10.1007/s00394-015-1150-4
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1881751474</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1826645095</sourcerecordid><originalsourceid>FETCH-LOGICAL-c405t-3046a0ee6f53dfd993b6ecf4fadc4912e191d586a75805d436897534d2d578dc3</originalsourceid><addsrcrecordid>eNqNkU2LFDEQhoMo7rr6A7xIwIsHW6vy2X2SZf2EBS96DpmkejZLT_eYpIX592aYdRFB8JSi8uRNFQ9jzxHeIIB9WwDkoDpA3SFq6NQDdo5Kms4I1A_va7Bn7EkptwAgpMHH7EwYq4wQeM78-4XHfOB58aWmefuaT2l7U6cDL346Nvi81sL9OFKovN5Qyjz4HNOyz0ttvfSTeCv3lGuiBs6R-xBoX_0mTake3j1lj0Y_FXp2d16w7x8_fLv63F1__fTl6vK6Cwp07SQo44HIjFrGMQ6D3BgKoxp9DGpAQThg1L3xVvegY9usH6yWKoqobR-DvGCvTrltmh8rlep2qQSaJj_TshaHfY9Wo7LqP1BhjNIw6Ia-_Au9XdY8t0UaZQ3KQUPfKDxRIS-lZBrdPqedzweH4I6q3EmVa6rcUZU7DvHiLnnd7Cjev_jtpgHiBJR2NW8p__H1P1N_AaZRni8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1876139508</pqid></control><display><type>article</type><title>Do dry roasting, lightly salting nuts affect their cardioprotective properties and acceptability?</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Tey, Siew Ling ; Robinson, Terryn ; Gray, Andrew R. ; Chisholm, Alexandra W. ; Brown, Rachel Clare</creator><creatorcontrib>Tey, Siew Ling ; Robinson, Terryn ; Gray, Andrew R. ; Chisholm, Alexandra W. ; Brown, Rachel Clare</creatorcontrib><description>Purpose Previous studies have reported improvements in cardiovascular disease (CVD) risk factors with the consumption of raw nuts. However, around one-third of nuts consumed are roasted and salted. Thus, it is important to determine whether roasting and salting nuts affect the health benefits observed with raw nuts. This study aimed to compare the effects of consuming two different forms of hazelnuts on cardiovascular risk factors and acceptance. Methods Using a randomised crossover design, 72 participants were asked to consume 30 g/day of either raw or dry roasted, lightly salted hazelnuts for 28 days each. CVD risk factors were measured at the beginning and end of each treatment period. “Desire to consume” and “overall liking” for both forms of hazelnuts were assessed daily using a 150-mm visual analogue scale. Results Body composition, blood pressure, plasma total and low-density lipoprotein-cholesterol, apolipoprotein A1 and B100, glucose and α-tocopherol concentrations did not differ between forms of hazelnuts (all P  ≥ 0.054). High-density lipoprotein (HDL)-cholesterol ( P  = 0.037) and triacylglycerol ( P  &lt; 0.001) concentrations were significantly lower following the consumption of dry roasted, lightly salted hazelnuts when compared to the raw hazelnuts. Compared with baseline, consuming both forms of hazelnuts significantly improved HDL-cholesterol and apolipoprotein A1 concentrations, total-C/HDL-C ratio, and systolic blood pressure without significantly changing body composition. Acceptance ratings did not differ between forms of hazelnuts and remained high throughout the study. Conclusion Dry roasting and lightly salting nuts do not appear to negate the cardioprotective effects observed with raw nut consumption, and both forms of nuts are resistant to monotony. Public health messages could be extended to include dry roasted and lightly salted nuts as part of a heart healthy diet.</description><identifier>ISSN: 1436-6207</identifier><identifier>EISSN: 1436-6215</identifier><identifier>DOI: 10.1007/s00394-015-1150-4</identifier><identifier>PMID: 26746221</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject><![CDATA[Adult ; alpha-Tocopherol - blood ; Apolipoprotein A-I - blood ; Blood Glucose - metabolism ; Blood Pressure ; Body Composition ; Body Mass Index ; Cardiovascular Diseases - prevention & control ; Chemistry ; Chemistry and Materials Science ; Cholesterol, HDL - blood ; Cholesterol, LDL - blood ; Corylus ; Cross-Over Studies ; Diet ; Dietary Fats - administration & dosage ; Dietary Proteins - administration & dosage ; Fatty Acids - administration & dosage ; Fatty Acids, Monounsaturated - administration & dosage ; Fatty Acids, Unsaturated ; Female ; Food Handling - methods ; Humans ; Male ; Middle Aged ; Nutrition ; Nuts ; Original Contribution ; Patient Compliance ; Risk Factors ; Sodium Chloride, Dietary - administration & dosage ; Triglycerides - blood]]></subject><ispartof>European journal of nutrition, 2017-04, Vol.56 (3), p.1025-1036</ispartof><rights>Springer-Verlag Berlin Heidelberg 2016</rights><rights>European Journal of Nutrition is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-3046a0ee6f53dfd993b6ecf4fadc4912e191d586a75805d436897534d2d578dc3</citedby><cites>FETCH-LOGICAL-c405t-3046a0ee6f53dfd993b6ecf4fadc4912e191d586a75805d436897534d2d578dc3</cites><orcidid>0000-0001-6951-7073</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00394-015-1150-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00394-015-1150-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26746221$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tey, Siew Ling</creatorcontrib><creatorcontrib>Robinson, Terryn</creatorcontrib><creatorcontrib>Gray, Andrew R.</creatorcontrib><creatorcontrib>Chisholm, Alexandra W.</creatorcontrib><creatorcontrib>Brown, Rachel Clare</creatorcontrib><title>Do dry roasting, lightly salting nuts affect their cardioprotective properties and acceptability?</title><title>European journal of nutrition</title><addtitle>Eur J Nutr</addtitle><addtitle>Eur J Nutr</addtitle><description>Purpose Previous studies have reported improvements in cardiovascular disease (CVD) risk factors with the consumption of raw nuts. However, around one-third of nuts consumed are roasted and salted. Thus, it is important to determine whether roasting and salting nuts affect the health benefits observed with raw nuts. This study aimed to compare the effects of consuming two different forms of hazelnuts on cardiovascular risk factors and acceptance. Methods Using a randomised crossover design, 72 participants were asked to consume 30 g/day of either raw or dry roasted, lightly salted hazelnuts for 28 days each. CVD risk factors were measured at the beginning and end of each treatment period. “Desire to consume” and “overall liking” for both forms of hazelnuts were assessed daily using a 150-mm visual analogue scale. Results Body composition, blood pressure, plasma total and low-density lipoprotein-cholesterol, apolipoprotein A1 and B100, glucose and α-tocopherol concentrations did not differ between forms of hazelnuts (all P  ≥ 0.054). High-density lipoprotein (HDL)-cholesterol ( P  = 0.037) and triacylglycerol ( P  &lt; 0.001) concentrations were significantly lower following the consumption of dry roasted, lightly salted hazelnuts when compared to the raw hazelnuts. Compared with baseline, consuming both forms of hazelnuts significantly improved HDL-cholesterol and apolipoprotein A1 concentrations, total-C/HDL-C ratio, and systolic blood pressure without significantly changing body composition. Acceptance ratings did not differ between forms of hazelnuts and remained high throughout the study. Conclusion Dry roasting and lightly salting nuts do not appear to negate the cardioprotective effects observed with raw nut consumption, and both forms of nuts are resistant to monotony. Public health messages could be extended to include dry roasted and lightly salted nuts as part of a heart healthy diet.</description><subject>Adult</subject><subject>alpha-Tocopherol - blood</subject><subject>Apolipoprotein A-I - blood</subject><subject>Blood Glucose - metabolism</subject><subject>Blood Pressure</subject><subject>Body Composition</subject><subject>Body Mass Index</subject><subject>Cardiovascular Diseases - prevention &amp; control</subject><subject>Chemistry</subject><subject>Chemistry and Materials Science</subject><subject>Cholesterol, HDL - blood</subject><subject>Cholesterol, LDL - blood</subject><subject>Corylus</subject><subject>Cross-Over Studies</subject><subject>Diet</subject><subject>Dietary Fats - administration &amp; dosage</subject><subject>Dietary Proteins - administration &amp; dosage</subject><subject>Fatty Acids - administration &amp; dosage</subject><subject>Fatty Acids, Monounsaturated - administration &amp; dosage</subject><subject>Fatty Acids, Unsaturated</subject><subject>Female</subject><subject>Food Handling - methods</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nutrition</subject><subject>Nuts</subject><subject>Original Contribution</subject><subject>Patient Compliance</subject><subject>Risk Factors</subject><subject>Sodium Chloride, Dietary - administration &amp; dosage</subject><subject>Triglycerides - blood</subject><issn>1436-6207</issn><issn>1436-6215</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkU2LFDEQhoMo7rr6A7xIwIsHW6vy2X2SZf2EBS96DpmkejZLT_eYpIX592aYdRFB8JSi8uRNFQ9jzxHeIIB9WwDkoDpA3SFq6NQDdo5Kms4I1A_va7Bn7EkptwAgpMHH7EwYq4wQeM78-4XHfOB58aWmefuaT2l7U6cDL346Nvi81sL9OFKovN5Qyjz4HNOyz0ttvfSTeCv3lGuiBs6R-xBoX_0mTake3j1lj0Y_FXp2d16w7x8_fLv63F1__fTl6vK6Cwp07SQo44HIjFrGMQ6D3BgKoxp9DGpAQThg1L3xVvegY9usH6yWKoqobR-DvGCvTrltmh8rlep2qQSaJj_TshaHfY9Wo7LqP1BhjNIw6Ia-_Au9XdY8t0UaZQ3KQUPfKDxRIS-lZBrdPqedzweH4I6q3EmVa6rcUZU7DvHiLnnd7Cjev_jtpgHiBJR2NW8p__H1P1N_AaZRni8</recordid><startdate>20170401</startdate><enddate>20170401</enddate><creator>Tey, Siew Ling</creator><creator>Robinson, Terryn</creator><creator>Gray, Andrew R.</creator><creator>Chisholm, Alexandra W.</creator><creator>Brown, Rachel Clare</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RQ</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6951-7073</orcidid></search><sort><creationdate>20170401</creationdate><title>Do dry roasting, lightly salting nuts affect their cardioprotective properties and acceptability?</title><author>Tey, Siew Ling ; Robinson, Terryn ; Gray, Andrew R. ; Chisholm, Alexandra W. ; Brown, Rachel Clare</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-3046a0ee6f53dfd993b6ecf4fadc4912e191d586a75805d436897534d2d578dc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>alpha-Tocopherol - blood</topic><topic>Apolipoprotein A-I - blood</topic><topic>Blood Glucose - metabolism</topic><topic>Blood Pressure</topic><topic>Body Composition</topic><topic>Body Mass Index</topic><topic>Cardiovascular Diseases - prevention &amp; control</topic><topic>Chemistry</topic><topic>Chemistry and Materials Science</topic><topic>Cholesterol, HDL - blood</topic><topic>Cholesterol, LDL - blood</topic><topic>Corylus</topic><topic>Cross-Over Studies</topic><topic>Diet</topic><topic>Dietary Fats - administration &amp; dosage</topic><topic>Dietary Proteins - administration &amp; dosage</topic><topic>Fatty Acids - administration &amp; dosage</topic><topic>Fatty Acids, Monounsaturated - administration &amp; dosage</topic><topic>Fatty Acids, Unsaturated</topic><topic>Female</topic><topic>Food Handling - methods</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nutrition</topic><topic>Nuts</topic><topic>Original Contribution</topic><topic>Patient Compliance</topic><topic>Risk Factors</topic><topic>Sodium Chloride, Dietary - administration &amp; dosage</topic><topic>Triglycerides - blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tey, Siew Ling</creatorcontrib><creatorcontrib>Robinson, Terryn</creatorcontrib><creatorcontrib>Gray, Andrew R.</creatorcontrib><creatorcontrib>Chisholm, Alexandra W.</creatorcontrib><creatorcontrib>Brown, Rachel Clare</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium &amp; Calcified Tissue Abstracts</collection><collection>Career &amp; Technical Education Database</collection><collection>Nursing &amp; Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of nutrition</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tey, Siew Ling</au><au>Robinson, Terryn</au><au>Gray, Andrew R.</au><au>Chisholm, Alexandra W.</au><au>Brown, Rachel Clare</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Do dry roasting, lightly salting nuts affect their cardioprotective properties and acceptability?</atitle><jtitle>European journal of nutrition</jtitle><stitle>Eur J Nutr</stitle><addtitle>Eur J Nutr</addtitle><date>2017-04-01</date><risdate>2017</risdate><volume>56</volume><issue>3</issue><spage>1025</spage><epage>1036</epage><pages>1025-1036</pages><issn>1436-6207</issn><eissn>1436-6215</eissn><abstract>Purpose Previous studies have reported improvements in cardiovascular disease (CVD) risk factors with the consumption of raw nuts. However, around one-third of nuts consumed are roasted and salted. Thus, it is important to determine whether roasting and salting nuts affect the health benefits observed with raw nuts. This study aimed to compare the effects of consuming two different forms of hazelnuts on cardiovascular risk factors and acceptance. Methods Using a randomised crossover design, 72 participants were asked to consume 30 g/day of either raw or dry roasted, lightly salted hazelnuts for 28 days each. CVD risk factors were measured at the beginning and end of each treatment period. “Desire to consume” and “overall liking” for both forms of hazelnuts were assessed daily using a 150-mm visual analogue scale. Results Body composition, blood pressure, plasma total and low-density lipoprotein-cholesterol, apolipoprotein A1 and B100, glucose and α-tocopherol concentrations did not differ between forms of hazelnuts (all P  ≥ 0.054). High-density lipoprotein (HDL)-cholesterol ( P  = 0.037) and triacylglycerol ( P  &lt; 0.001) concentrations were significantly lower following the consumption of dry roasted, lightly salted hazelnuts when compared to the raw hazelnuts. Compared with baseline, consuming both forms of hazelnuts significantly improved HDL-cholesterol and apolipoprotein A1 concentrations, total-C/HDL-C ratio, and systolic blood pressure without significantly changing body composition. Acceptance ratings did not differ between forms of hazelnuts and remained high throughout the study. Conclusion Dry roasting and lightly salting nuts do not appear to negate the cardioprotective effects observed with raw nut consumption, and both forms of nuts are resistant to monotony. Public health messages could be extended to include dry roasted and lightly salted nuts as part of a heart healthy diet.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>26746221</pmid><doi>10.1007/s00394-015-1150-4</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0001-6951-7073</orcidid></addata></record>
fulltext fulltext
identifier ISSN: 1436-6207
ispartof European journal of nutrition, 2017-04, Vol.56 (3), p.1025-1036
issn 1436-6207
1436-6215
language eng
recordid cdi_proquest_miscellaneous_1881751474
source MEDLINE; SpringerLink Journals - AutoHoldings
subjects Adult
alpha-Tocopherol - blood
Apolipoprotein A-I - blood
Blood Glucose - metabolism
Blood Pressure
Body Composition
Body Mass Index
Cardiovascular Diseases - prevention & control
Chemistry
Chemistry and Materials Science
Cholesterol, HDL - blood
Cholesterol, LDL - blood
Corylus
Cross-Over Studies
Diet
Dietary Fats - administration & dosage
Dietary Proteins - administration & dosage
Fatty Acids - administration & dosage
Fatty Acids, Monounsaturated - administration & dosage
Fatty Acids, Unsaturated
Female
Food Handling - methods
Humans
Male
Middle Aged
Nutrition
Nuts
Original Contribution
Patient Compliance
Risk Factors
Sodium Chloride, Dietary - administration & dosage
Triglycerides - blood
title Do dry roasting, lightly salting nuts affect their cardioprotective properties and acceptability?
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-03T22%3A21%3A58IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Do%20dry%20roasting,%20lightly%20salting%20nuts%20affect%20their%20cardioprotective%20properties%20and%20acceptability?&rft.jtitle=European%20journal%20of%20nutrition&rft.au=Tey,%20Siew%20Ling&rft.date=2017-04-01&rft.volume=56&rft.issue=3&rft.spage=1025&rft.epage=1036&rft.pages=1025-1036&rft.issn=1436-6207&rft.eissn=1436-6215&rft_id=info:doi/10.1007/s00394-015-1150-4&rft_dat=%3Cproquest_cross%3E1826645095%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1876139508&rft_id=info:pmid/26746221&rfr_iscdi=true