***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: An increasing body of research suggests that many patients have difficulty adopting the eating guidelines after weight-loss surgery , thereby reducing the long-term success of the procedure . Given such difficulties , it is possible that the typical preoperative education regarding post-surgical eating behavior guidelines is ineffective in motivating some individuals to comply . Presently , no accurate predictors of intentions to comply with post-bariatric surgery guidelines have been identified . In the present pilot study , a psychosocial intervention based on protection motivation theory ( PMT ) was presented to patients undergoing bariatric surgery .  PMT is a well-established preventive health model that has been utilized in a variety of health domains . Participants for this study were recruited before undergoing bariatric surgery , and were r and omly assigned to one of two groups : PMT group vs. control . In addition to routine messages from the bariatric surgeon , participants in the PMT group received an intervention based in PMT that focused on the importance of adhering to post-surgical eating behavior guidelines and how best to adhere to these guidelines . Participants in the control group received st and ard of care information from the bariatric surgeon . Results indicated that the PMT intervention did not have a significant impact . However , follow-up analyses revealed that two aspects of PMT , perceived self-efficacy and perceived threat of not following the guidelines , predicted patients ' intentions to comply with post-surgical guidelines . Findings are discussed in terms of the method ological compromises that result ed from the applied research setting as well as promising avenues for future investigation OBJECTIVES To determine current and ideal frequencies with which  nutrition support dietitians  perform each item on a list of 15 tasks and evaluate dietitian preparation for the practice of nutrition support . DESIGN Data were collected using two question naires , one completed by the  chief clinical dietitian  and the other completed by the  nutrition support dietitian at each hospital surveyed . Both versions of the question naires contained a list of 15 tasks that had been vali date d as being related to advanced nutrition support by a panel of 20 nutrition support experts using a modified Delphi method . Follow-up telephone calls were made to increase the number of responses . SAMPLE Question naires were mailed to the chief clinical dietitian at 300 r and omly selected , general medical/surgical hospitals with 300 or more beds in the United States and Puerto Rico . A total of 134 chief clinical dietitians ( 45 % ) and 129 nutrition support dietitians ( 43 % ) responded to the surveys ; 124 ( 41 % ) and 120 ( 40 % ) question naires , respectively , were usable for statistical analyses . STATISTICAL ANALYSES The Wilcoxon matched-pairs signed-ranks test was used to determine differences between nutrition support dietitian actual and ideal frequencies and between chief clinical dietitian actual and ideal frequencies for each of the 15 tasks . The Mann-Whitney U-Wilcoxon rank sum W test was used to determine differences between nutrition support dietitian and chief clinical dietitian actual frequencies and between nutrition support dietitian and chief clinical dietitian ideal frequencies for each of the 15 tasks . Descriptive statistics were used to analyze the questions regarding educational preparation for nutrition support practice and demographic data . RESULTS The ideal frequency for each of the 15 tasks was significantly greater ( P < .0001 ) than the actual frequency reported by nutrition support dietitians and chief clinical dietitians . Whereas chief clinical dietitians and nutrition support dietitians agreed on the ideal frequency for most tasks , the nutrition support dietitian ideal frequency indicated for the tasks " determines macronutrient composition of parenteral nutrition " and " performs physical examinations related to nutritional status , fluid status , and gastrointestinal function " was significantly greater ( P < .001 , P < .05 ) , respectively ) than the ideal frequency indicated by chief clinical dietitians . Of the nutrition support dietitians , 79 % agreed and 16 % somewhat agreed that experiences beyond those required for becoming a registered dietitian are needed to provide nutrition support dietitians with specialized clinical skills . APPLICATIONS/ CONCLUSIONS Nutrition support dietitians desire increased responsibility for delivering nutrition support to their patients and this desire is largely supported by chief clinical dietitians . Nutrition support dietitians appear to have a strong interest in post registration qualifying experiences that would provide a foundation for exp and ing their roles . According to the results of this study , programs design ed to provide practical , clinical experience in nutrition support are needed OBJECTIVE To examine the influence of the PREMIER study lifestyle interventions on dietary intakes and adherence to the Dietary Approaches to Stop Hypertension ( DASH ) dietary pattern and the Dietary Reference Intakes ( DRI ) . DESIGN An 18-month multicenter , r and omized controlled trial comparing two multicomponent lifestyle intervention programs to an advice only control group . SUBJECTS/ SETTING A total of 810 participants were recruited from local communities and r and omized into the study . Individuals were eligible if they were aged 25 years or older , had body mass index between 18.5 and 45.0 , not taking antihypertensive medication , and had prehypertension or stage 1 hypertension ( systolic blood pressure 120 to 159 mm Hg and diastolic blood pressure 80 to 95 mm Hg ) . INTERVENTION The two active intervention programs were a behavioral lifestyle intervention that implements established recommendations , and an established intervention plus the DASH dietary pattern . Both interventions consisted of intensive group and individual counseling sessions . The control group received a brief advice session after r and omization and again after 6 months of data collection . Dietary intakes were collected by two r and om 24-hour recalls at baseline , 6 months , and 18 months . MAIN OUTCOME MEASURES The primary outcome of the PREMIER study was change in systolic blood pressure at 6 months . The main outcomes examined here include dietary variables collected by 24-hour recall at each time point . STATISTICAL ANALYSES Nutrient intakes were calculated and compared among the time points and the three intervention groups using mixed models with repeated measures at 6 and 18 months . Proportion of participants who met or achieved the original DASH nutrient intake levels and the DRIs were calculated and compared among the three intervention groups . P<0.01 was considered statistically significant . RESULTS Participants in both the established intervention and established intervention plus DASH dietary pattern groups substantially reduced energy , total fat , saturated fat , and sodium intake and these reductions persisted throughout the study . Established intervention plus DASH dietary pattern group participants increased intakes of fruits , vegetables , dairy , and many vitamins and minerals ; these increases were significantly greater than that of the control and established intervention groups . A majority of established intervention plus DASH dietary pattern group participants achieved at least two thirds of the DRI recommendations for most nutrients at 6 months , despite their reduction in total energy intake . Some but relatively small recidivism occurred at 18 months . CONCLUSIONS Both the established intervention and established intervention plus DASH dietary pattern group intervention were effective in helping participants follow established recommendations to control blood pressure . The advice-only control group also made some behavior changes , mainly decreasing energy and sodium intake . Only the established intervention plus DASH dietary pattern group significantly increased intakes of DASH-specific food groups , including fruits , vegetables , and dairy products , and nutrients , including protein , fiber , calcium , potassium , and magnesium . Most of the increases did not reach the levels consumed in the original DASH feeding studies . Whereas the established intervention plus DASH dietary pattern group intervention provides a useful platform to achieve the DASH dietary pattern and current DRI recommendations , intervention enhancements , including a greater emphasis on nutrient-dense foods , would likely improve this intervention OBJECTIVE Changing dietary and physical activity habits has the potential to postpone or prevent the development of type 2 diabetes . However , it needs to be assessed whether moderate interventions , in agreement with current guidelines for the general population , are effective . We evaluated the impact of a 2-year combined diet and physical activity intervention program on glucose tolerance in Dutch subjects at increased risk for developing diabetes . RESEARCH METHODS AND PROCEDURES Subjects with glucose intolerance were r and omly assigned to either the lifestyle intervention group ( INT ) or control group ( CON ) . The INT received regular dietary advice and was stimulated to increase their physical activity . The CON received a brief leaflet about healthy diet and increased physical activity . Primary outcome measure was the change in glucose tolerance . RESULTS In total , 88 subjects completed 2 years of intervention ( 40 subjects in the INT , 48 subjects in the CON , mean BMI 29.4 kg/m2 ) . Subjects in the INT reduced their body weight , waist circumference , and ( saturated ) fat intake and improved their aerobic capacity . Two-hour plasma glucose concentration declined from 8.7 to 8.0 mM in the INT and rose from 8.6 to 9.4 mM in the CON ( p < 0.01 ) . Subjects adherent to both the diet and exercise intervention showed the largest reduction in 2-hour glucose levels . DISCUSSION Our results showed that a lifestyle intervention program according to general recommendations improves glucose tolerance , even in a less obese and more physical active population . Furthermore , our results underscore the importance of combining diet and physical activity to improve glucose tolerance and insulin resistance Abstract Compared to other racial/ethnic groups , African American ( AA ) women are more likely to be obese but less likely to participate in weight loss interventions or to successfully lose weight . Sustained motivation for weight loss may be especially difficult for AA women due to socioeconomic and cultural factors . The purpose of this study was to examine whether the addition of motivational interviewing ( MI ) to a culturally-targeted behavioral weight loss program for AA women improved adherence to the program , diet and physical activity behaviors , and weight loss outcomes .  Forty-four obese ( mean BMI = 39.4 , SD = 7.1 ) AA women were r and omized to receive a 16-week behavioral weight loss program plus four MI sessions , or the same behavioral weight loss program plus four health education ( HE ; attention control ) sessions . Results showed that participants in both MI and HE conditions lost a significant amount of weight , reduced their energy intake and percent calories from fat , and increased their fruit and vegetable consumption ( ps < .05 ) . However , adherence to the behavioral weight loss program and changes in diet , physical activity , and weight did not differ across MI and HE conditions . Future research is warranted to determine the sub population s with which MI is most effective Efforts to increase blood pressure ( BP ) control rates in blacks , a traditionally underserved high-risk population must address both provider practice and patient adherence issues . The home-based BP Intervention for blacks study is a 3-arm r and omized controlled trial design ed to test 2 strategies to improve hypertension management and outcomes in a de central ized service setting serving a vulnerable and complex home care population . The primary study outcomes are systolic BP , diastolic BP , and BP control ; secondary outcomes are nurse adherence to hypertension management recommendations and patient adherence to medication , healthy diet  , and other self-management strategies .  Nurses ( n=312 ) in a nonprofit Medicare-certified home health agency are r and omized along with their eligible hypertensive patients ( n=845 ) . The 2 interventions being tested are ( 1 ) a " basic " intervention delivering key evidence -based reminders to home care nurses and patients while the patient is receiving traditional postacute home health care ; and ( 2 ) an " augmented " intervention that includes that same as the basic intervention , plus transition to an ongoing Hypertension Home Support Program that extends support for 12 months . Outcomes are measured at 3 and 12 months after baseline interview . The interventions will be assessed relative to usual care and to each other . Systems change to improve BP management and outcomes in home health will not easily occur without new intervention models and rigorous evaluation of their impact . Results from this trial will provide important information on potential strategies to improve BP control in a low-income chronically ill patient population OBJECTIVE : To compare two group treatment programmes for obese out patients . Both programmes included behaviour modification , nutrition counselling , very-low-calorie diet ( VLCD ) and a continuous measuring of metabolic and anthropometrical status , but they differed regarding the treatment intensiveness . The main aim was to study whether intensive treatment gives a larger weight reduction compared with less intensive treatment and what level of input from health care personnel is needed to reach adequate treatment results . DESIGN : A 2-y r and omised clinical trial . SUBJECTS : A total of 43 obese subjects aged 24–60 y , BMI 35 kg/m2 (29–48).INTERVENTION : Two programmes were used . Both were based on group therapy and were supervised by a dietitian and a psychologist . Group 1 received a continuous intensive treatment with planned group meetings every fortnight during the first year and six group meetings the second year . Group 2 had planned group meetings every third month  . Anthropometrical and metabolic data were measured every third month in both groups . The VLCD periods were the same . RESULTS : There was no evidence that a more intensive treatment promotes a larger weight reduction . Weight reduction after 1 y : group 1 , −7.6 ( ±0.97 ) kg , BMI −2.6 ( ±0.3 ) kg/m2 ; group 2 , −6.4 ( ±1.16 ) kg , BMI −2.2 
    Output:
    
Interventions shown to improve at least one diet adherence outcome are : telephone follow-up , video , contract , feedback , nutritional tools and more complex interventions including multiple interventions .
However , these interventions also shown no difference in some diet adherence outcomes compared to a control/usual care group making inconclusive results about the most effective intervention to enhance dietary advice .
Studies investigating interventions such as a group session , individual session , reminders , restriction and behaviour change techniques reported no diet adherence outcome showing a statistically significant difference favouring the intervention group .