Dietary Interventions and Vitamin D3 Replacement in Pituitary Tumors: a Systematic Review
Abstract
Objective: Pituitary neuroendocrine tumors (PitNETs) cause hormonal imbalances that impair metabolic health and quality of life (QoL). Dietary interventions may mitigate these comorbidities. This review evaluated the effectiveness of dietary strategies in improving disease-related metabolic, and bone outcomes in patients with PitNETs.
Design: Systematic review of interventional and observational studies on dietary interventions in acromegaly, Cushing's disease, prolactinomas, and hypopituitarism.
Methods: A systematic search was performed on January 20th, 2026. Eligible studies assessed dietary interventions targeting metabolic or bone-related outcomes. Risk of bias was evaluated using ROBINS-I and the Newcastle-Ottawa Scale. Extracted outcomes included dietary intake, body composition, metabolic parameters, biochemical control, and bone health.
Results: Of 2,256 screened records, eight studies (355 participants) met the inclusion criteria, including five interventional and three observational studies. In acromegaly, an isocaloric very low-carbohydrate ketogenic diet (VLCKD) reduced IGF-I levels. In Cushing's disease, VLCKD and energy-restricted diets (ERD) improved BMI and metabolic parameters. In prolactinoma, ERD combined with increased physical activity improved weight and biochemical control. In hypopituitarism, ERD with increased physical activity and sibutramine improved body composition and metabolic outcomes. Vitamin D replacement reduced vertebral fracture risk in…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 355 participants or records.
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