***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: In this study , the authors evaluated the effectiveness of the Energize Your Life ! social-marketing campaign pilot study to improve knowledge , attitudes , and fruit intake among community college students . The authors used a cross-sectional , quasi-experimental , pre- and posttest design . They r and omly selected community college students ( N = 1,367 ) and exposed the intervention campus to fruit fairs to distribute fresh fruit , 100 % fruit juice , and fruit smoothie sample s and information about fruit to students . The authors also addressed policy change to increase the accessibility of fruit on campus . There was a significant increase in fruit intake between pre- and posttest at the intervention campus . Although students had positive attitudes toward intake , most did not achieve the minimum recommended daily 2 servings of fruit . Approximately 25 % of the students had insufficient funds , which affected their food intake . Longer-term social marketing interventions may be an effective means of improving the dietary quality of community college students Canteens are known to be promising setting s for activities to promote intake of fruits and vegetables , but it remains unclear to what extent distributing free fruits and vegetables can influence dietary patterns of customers . The present study evaluated the effect of providing fruits and vegetables for free in a university canteen on the daily diet of university canteen customers . Canteen customers ( n 209 ) were r and omly allocated to a fruit and vegetable group ( FVG ) and a control group ( CG ) . FVG participants were given two portions of fruits and one portion of vegetables for free at lunchtime . Food and beverage intake was measured using a dietary record for 3 d and dietary quality was appraised using a comprehensive scoring system . The FVG participants ate 80 g more fruits ( P < 0.01 ) and 108 g more vegetables ( P < 0.001 ) on a daily basis compared with the CG participants . No differences were found for energy density , total energy , Na and energy from fat between the groups per day . A higher intake of fruits and vegetables was observed at lunch and of vegetables during the dinner and evening snacks . The FVG participants were more likely to comply with dietary recommendations for fruits and vegetables and had a better dietary profile on the study days and for the lunch consumed on those days . The results of the present study demonstrate how modifications of a canteen lunch can be instrumental to enhance the nutritional quality of lunch as well as the overall quality of the diet of the customers In a cross-over study , participants ( n=59 ) were r and omly assigned to receive either 100 kcal packs or st and ard size packages of snacks for 1 week . After a minimum of a 1-week washout period , participants received the other form of the snack for 1 week . Snack consumption was recorded by participants in a diary . Participants consumed an average of 186.9 fewer grams of snacks per week when receiving 100 kcal snack packs compared to st and ard size packages of snacks . Post hoc comparisons revealed the effect of package size depended on both r and omization order and study week . Total grams of snacks consumed in week 1 differed significantly between the two r and omized groups . In week 2 , however , grams of snacks did not differ significantly between the two groups . This interaction was primarily due to a significantly lower consumption of snacks from st and ard size packages in the week following the portion-controlled packages . The results suggest that portion-controlled packaging reduce total intake from the provided snacks . Further , initial exposure to portion-controlled packages might have increased awareness of portion size such that less was consumed when larger packages were available OBJECTIVE To evaluate the effectiveness of incorporating two self-regulation strategies ( goal setting and self-monitoring ) into a nutrition education class to enhance dietary fiber self-efficacy and foster a positive change in dietary fiber consumption . DESIGN College students in an introductory nutrition class ( n = 113 ) were r and omly assigned to one of four treatment conditions : goal setting , self-monitoring , goal setting and self-monitoring , and no goal setting and no self-monitoring .  Twenty-six college students from an introductory health class served as the control group . STATISTICAL ANALYSES The main and interaction effects of goal setting and self-monitoring on postintervention variables were analyzed using analysis of covariance with baseline intake levels as the covariate . Analysis of variance was used to examine differences in the mean changes between the groups . Path analysis was conducted to analyze the causal linkage among the pretest and intervening variables to predict postintervention knowledge , self-efficacy , and fiber consumption . RESULTS Goal setting had a significant main effect on dietary fiber self-efficacy and on dietary fiber consumption Subjects who set goals scored 15 % higher on the dietary fiber self-efficacy scale and consumed 91 % more fiber than subjects who did not set goals . Self-monitoring had no significant main effect on either dietary fiber self-efficacy or dietary fiber consumption . There was no significant interaction between goal setting and self-monitoring . Changes in dietary fiber scores differed between the groups . Increases in dietary fiber for the goal setting and self-monitoring group were significantly higher than the goal - setting , self-monitoring , no goal setting and no self-monitoring , and control groups . In addition , the goal setting only group had significantly greater increases in fiber intake than the self-monitoring , no goal setting and no self-monitoring , and control groups . Changes in self-efficacy scores were significantly different between the groups . The goal setting and goal setting and self-monitoring groups had significantly higher self-efficacy scores than the control group . Path analysis revealed that both goal setting and self-monitoring affected dietary fiber consumption through knowledge and dietary fiber self-efficacy , goal setting had a strong direct effect on fiber consumption , and postintervention knowledge affected fiber consumption only through self-efficacy . APPLICATIONS/ CONCLUSIONS Our findings suggest that dietary change requires active self-regulation of food intake . Combining goal setting and self-monitoring significantly enhances dietary behavior change . This strategy can easily be incorporated into nutrition education or counseling programs to enhance dietary behavior change As portion size ( PS ) increases , so does food intake . The effect of decreasing PS on food intake in a nonlaboratory setting is unknown . This 5-week study sought to determine whether decreasing PS result ed in decreased intake of the same food , and if so , at what point further PS reductions might lack benefit . It also assessed effects of PS reduction on food production and waste in a university all-you-can-eat dining facility ( DF ) . Subjects were primarily freshmen who regularly ate lunch at the DF , and self-selected French fries ( FF ) presented in individual paper bags , portioned originally at 88 g , and decreased approximately 15 g/week for 3 weeks . Diners were covertly observed choosing one or more bags . Total FF production and plate waste ( PW ) were determined daily . Decreasing PS result ed in significant decreases in consumption per diner ( P < 0.05 ) and PW ( P < 0.05 ) , and nonsignificant decreases in total FF consumption and production . PS was positively correlated with consumption per diner ( r = 0.897 , P = 0.001 ) and PW ( r = 0.852 , P = 0.001 ) , but inversely correlated with number of diners choosing > or=2 bags ( r = -0.809 , P = 0.003 ) . Total FF production was positively correlated with PW ( r = 0.728 , P = 0.011 ) . This study shows that reducing PS of a particular item in an all-you-can-eat environment results in reduced intake of that food for most individuals , and that reducing PS reduces PW and food production Objectives : To investigate the importance of cost and awareness of health- or disease-promoting properties of foods and meals for choices by customers of a cafeteria . Design : A non-r and omized intervention study . Setting : A medium size cafeteria in the Harvard School of Public Health . Participants : Customers of the cafeteria mainly consisting of public health students , faculty , and school staff and workers from the medical campus . Intervention : The purchase of healthy foods and dishes was subsidized and their prices reduced by 20 % . This promotion was accompanied by the distribution of educational material . Main Outcome Measures : Change in consumption of healthy and less healthy foods . Analysis : The geometric mean was used to calculate the change in consumption . Results : During the intervention , we observed a 6 % increase in the consumption of healthy foods ( 95 % confidence interval [ CI ] ; 5 % to 8 % ) , and a 2 % decline in the consumption of less-healthy foods ( 95 % CI ; −1 % to −4 % ) . After the prices returned to their original levels , the consumption of healthy foods increased further to 17 % ( 95 % CI ; 13 % to 20 % ) and a 2 % decline in the consumption of less-healthy foods ( 95 % CI ; % 1 to −5 % ) persisted . Conclusions : Subsidizing healthful meals and educating consumers about the importance of a healthy diet can result in a modest increase in the selection of healthy foods and meals that can be maintained beyond the periods of subsidy and promotion This study examines the feasibility and effectiveness of an environmental intervention for improving diet by comparing the impact of health messages , lowered prices , and their combination on the purchase of healthy food items in a restaurant . Price decreases alone , rather than a combination of price decreases and health messages , were associated with a higher level of increased purchases of some healthy food items as compared with control items over a 4-month period . Price decreases may be a more powerful means than health messages of increasing consumption of healthy foods . Health messages may have paradoxical effects if foods labeled as healthy are assumed to taste bad This study examined the effects of an environmental intervention promoting more non-energy-containing beverage consumption compared to sugar-sweetened soft drink consumption through vending machines in an urban college setting . Eight soft drink vending machines were r and omly selected and assigned to one of three conditions over a 9-week period : energy-content labels on non-energy-containing beverage selection panels ( intervention I ) , labels plus motivational posters ( intervention II ) , or control . The totals of all beverages sold and machine revenue were recorded at baseline ( 2 weeks ) , intervention ( 5 weeks ) , and postintervention ( 2 weeks ) periods . Use of energy-content labels and motivational posters , compared with control group , result ed in a significantly lower growth rate of sugar-sweetened beverage sales ( P<0.05 ) . Total revenue for all beverages increased during the intervention period . It is estimated that the non-energy-containing beverages combined accounted for 70.52 % of the increased revenue . Results of this study suggest that energy-content labels and motivational posters on beverage vending machines may be an effective way to influence beverage sales OBJECTIVE Calorie-labeling has been suggested as an anti-obesity measure but there is no evidence for its effect , to date . Early adulthood is a critical life-cycle period for unwanted weight gain and obesity development . This study examined whether providing calorie information would help young adults to avoid weight gain . METHODS Using a pragmatic interrupted time-series study design , weight changes over 36 weeks were reported among two year-groups , each of 120 young adults , similar in age , gender , and ethnicity , living in fully-catered accommodation . Year 1 : subjects were observed without calorie-labeling , apart from a 5-week pilot . Year 2 : calorie-labeling was present prominently and consistently at main meals for 30 of the 36 weeks . RESULTS Mean weight changes over 36 weeks , per protocol , were + 3.5 kg ( 95 % CI = 2.8 - 4.1 kg ) ( n = 64 ) in Year 1 and -0.15 kg ( 95 % CI = -0.7 - 0.3 kg ) ( n = 87 ) in Year 2 . Weight changes were significantly different between years , for males and females ( both P < 0.001 ) . Intention-to-treat analysis showed similar results . Relative Risk for weight gain in Year 2 , compared to Year 1 , was 0.5 ( P < 0·0001 ) . CONCLUSIONS Calorie-labeling was associated with a 3.5 kg less weight gain , representing a low-cost " nudging " approach to combat the rapid weight gain seen in young adults OBJECTIVE A few studies link out-of-home eating to higher energy consumption , overweight and obesity in both adults and children . The present study was undertaken to investigate the nutritional value of meals available in a university cafeteria , in order to develop a target nutritional tool to help consumers make a more conscious nutritional choice . DESIGN A cross-sectional study . SETTING In a university cafeteria in Pavia , northern Italy , the recipes and ingredients of each meal served during the whole year were obtained from the cooks . Energy , protein , fat , carbohydrate and fibre contents were computed for each meal st and ardized portion . Thirteen pyramid figures , subdivided into three coloured levels , were used to depict the energy and nutrient content of each meal . SUBJECTS Four hundred r and omly selected customers were interviewed on the cafeteria nutritional proposal . RESULTS Foods available in the cafeteria consisted of 216 items and were distributed in the pyramids according to their energy content : the lowest ones at the bottom ( green level ) and the highest ones at the top ( red level ) , passing through an orange level in the middle . Energy values ranged from 460 kJ ( 110 kcal ) for a portion of dressed vegetables to 5021 kJ ( 1200 kcal ) for a pizza . The depicted pyramids were displayed in the cafeteria , so that customers could choose their meal according to its nutritional value . The meals ' nutritional content 
    Output:
    
Potentially useful interventions in tertiary education setting s were nutrition messages/nutrient labeling , providing healthy options , and portion size control of unhealthy foods .
Price decreases for and the increased availability of healthy options combined with nutrition information result ed in improvements in dietary habits .