***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 
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    ***EXAMPLES*** 
    Input: Background Tailored nutrition interventions have been shown to be more effective than non-tailored material s in changing dietary behaviours , particularly fat intake and fruit and vegetable intake . But further research examining efficacy of tailored nutrition education in comparison to other nutrition education methods and across a wider range of dietary behaviours is needed . The Stages to Healthy Eating Patterns Study ( STEPs ) was an intervention study , in middle-aged adults with cardiovascular risk factors , to examine the effectiveness of printed , tailored , iterative dietary feedback delivered by mail in improving short-term dietary behaviour in the areas of saturated fat , fruit , vegetable and grain and cereal intake . Methods STEPs was a 3-month r and omised controlled trial with a pre and post-test design . There were three experimental conditions : 1 ) tailored , iterative , printed dietary feedback ( TF ) with three instalments mail-delivered over a 3-month period that were re-tailored to most recent assessment of dietary intake , intention to change and assessment of self-adequacy of dietary intake . Tailoring for dietary intake was performed on data from a vali date d 63-item combination FFQ design ed for the purpose 2 ) small group nutrition education sessions ( GE ) : consisting of two 90-minute dietitian-led small group nutrition education sessions and 3 ) and a wait-listed control ( C ) group who completed the dietary measures and socio-demographic question naires at baseline and 3-months later . Dietary outcome measures in the areas of saturated fat intake ( g ) , and the intake of fruit ( serves ) , vegetables ( serves ) , grain and cereals as total and wholegrain ( serves ) were collected using 7-day estimated dietary records . Descriptive statistics , paired t-tests and general linear models adjusted for baseline dietary intake , age and gender were used to examine the effectiveness of different nutrition interventions . Results The TF group reported a significantly greater increase in fruit intake ( 0.3 serves/d P = 0.031 ) in comparison to GE and the C group . All three intervention groups showed a reduction in total saturated fat intake . GE also had a within-group increase in mean vegetable intake after 3 months , but this increase was not different from changes in the other groups . Conclusions In this study , printed , tailored , iterative dietary feedback was more effective than small group nutrition education in improving the short-term fruit intake behaviour , and as effective in improving saturated fat intake of middle-aged adults with cardiovascular risk factors . This showed that a low-level dietary intervention could achieve modest dietary behaviour changes that are of public health significance Objective To examine the hypothesis that mid-life adiposity is associated with a reduced probability of maintaining an optimal health status among those who survive to older ages . Design Prospect i ve cohort study . Setting The Nurses ’ Health Study , United States . Participants 17 065 women who survived until at least the age of 70 , provided information on occurrence of chronic disease , cognitive function , physical function , and mental health at older ages , and were free from major chronic diseases at mid-life ( mean age was 50 at baseline in 1976 ) . Main outcome measures Healthy survival to age 70 and over was defined as having no history of 11 major chronic diseases and having no substantial cognitive , physical , or mental limitations . Results Of the women who survived until at least age 70 , 1686 ( 9.9 % ) met our criteria for healthy survival . Increased body mass index ( BMI ) at baseline was significantly associated with linearly reduced odds of healthy survival compared with usual survival , after adjustment for various lifestyle and dietary variables ( P<0.001 for trend ) . Compared with lean women ( BMI 18.5 - 22.9 ) , obese women ( BMI ≥30 ) had 79 % lower odds of healthy survival ( odds ratio 0.21 , 95 % confidence interval 0.15 to 0.29 ) . In addition , the more weight gained from age 18 until mid-life , the less likely was healthy survival after the age of 70 . The lowest odds of healthy survival were among women who were overweight ( BMI ≥25 ) at age 18 and gained ≥10 kg weight ( 0.18 , 0.09 to 0.36 ) , relative to women who were lean ( BMI 18.5 - 22.9 ) and maintained a stable weight . Conclusions These data provide evidence that adiposity in mid-life is strongly related to a reduced probability of healthy survival among women who live to older ages , and emphasise the importance of maintaining a healthy weight from early adulthood Background A few observational studies have found an inverse association between adherence to a  Mediterranean diet and the risk of depression .  R and omized trials with an intervention based on this dietary pattern could provide the most definitive answer to the findings reported by observational studies . The aim of this study was to compare in a r and omized trial the effects of two Mediterranean diets versus a low-fat diet on depression risk after at least 3 years of intervention . Methods This was a multicenter , r and omized , primary prevention field trial of cardiovascular disease ( Prevención con Dieta Mediterránea ( PREDIMED Study ) ) based on community-dwelling men aged 55 to 80 years and women aged 60 to 80 years at high risk of cardiovascular disease ( 51 % of them had type 2 diabetes ; DM2 ) attending primary care centers affiliated with 11 Spanish teaching hospitals . Primary analyses were performed on an intention-to-treat basis . Cox regression models were used to assess the relationship between the nutritional intervention groups and the incidence of depression . Results We identified 224 new cases of depression during follow-up . There was an inverse association with depression for participants assigned to a Mediterranean diet supplemented with nuts ( multivariate hazard ratio ( HR ) 0.78 ; 95 % confidence interval ( CI ) 0.55 to 1.10 ) compared with participants assigned to the control group , although this was not significant . However , when the analysis was restricted to participants with DM2 , the magnitude of the effect of the intervention with the Mediterranean diet supplemented with nuts did reach statistical significance ( multivariate HR = 0.59 ; 95 % CI 0.36 to 0.98 ) . Conclusions The result suggest that a Mediterranean diet supplemented with nuts could exert a beneficial effect on the risk of depression in patients with DM2.Trial registration This trial has been registered in the Current Controlled Trials with the number IS RCT N Background The increased prevalence of overweight and obesity warrants preventive actions , particularly among people in transitional stages associated with lifestyle changes , such as occupational retirement . The purpose is to investigate the effect of a one year low-intensity computer-tailored energy balance programme among recent retirees on waist circumference , body weight and body composition , blood pressure , physical activity and dietary intake . Methods A r and omised controlled trial was conducted among recent retirees ( N = 413 ; mean age 59.5 years ) . Outcome measures were assessed using anthropometry , bio-impedance , blood pressure measurement and question naires . Results Waist circumference , body weight and blood pressure decreased significantly in men of the intervention and control group , but no significant between-group-differences were observed at 12 or at 24-months follow-up . A significant effect of the programme was only observed on waist circumference ( -1.56 cm ( 95%CI : -2.91 to -0.21 ) ) at 12 month follow up among men with low education ( n = 85 ) . Physical activity and dietary behaviours improved in both the intervention and control group during the intervention period . Although , these behaviours changed more favourably in the intervention group , these between-group-differences were not statistically significant . Conclusions The multifaceted computer-tailored programme for recent retirees did not appear to be effective . Apparently the transition to occupational retirement and /or participation in the study had a greater impact than the intervention programme . Trial registration Clinical Trials NCT00122213 OBJECTIVE To test the effects of two Mediterranean diet ( MedDiet ) interventions versus a low-fat diet on incidence of diabetes . RESEARCH DESIGN AND METHODS This was a three-arm r and omized trial in 418 nondiabetic subjects aged 55–80 years recruited in one center ( PREDIMED-Reus , northeastern Spain ) of the Prevención con Dieta Mediterránea [ PREDIMED ] study , a large nutrition intervention trial for primary cardiovascular prevention in individuals at high cardiovascular risk . Participants were r and omly assigned to education on a low-fat diet ( control group ) or to one of two MedDiets , supplemented with either free virgin olive oil ( 1 liter/week ) or nuts ( 30 g/day ) . Diets were ad libitum , and no advice on physical activity was given . The main outcome was diabetes incidence diagnosed by the 2009 American Diabetes Association criteria . RESULTS After a median follow-up of 4.0 years , diabetes incidence was 10.1 % ( 95 % CI 5.1–15.1 ) , 11.0 % ( 5.9–16.1 ) , and 17.9 % ( 11.4–24.4 ) in the MedDiet with olive oil group , the MedDiet with nuts group , and the control group , respectively . Multivariable adjusted hazard ratios of diabetes were 0.49 ( 0.25–0.97 ) and 0.48 ( 0.24–0.96 ) in the MedDiet supplemented with olive oil and nuts groups , respectively , compared with the control group . When the two MedDiet groups were pooled and compared with the control group , diabetes incidence was reduced by 52 % ( 27–86 ) . In all study arms , increased adherence to the MedDiet was inversely associated with diabetes incidence . Diabetes risk reduction occurred in the absence of significant changes in body weight or physical activity . CONCLUSIONS MedDiets without calorie restriction seem to be effective in the prevention of diabetes in subjects at high cardiovascular risk Background : Although several studies have investigated the association of the Mediterranean diet with overall mortality or risk of specific cancers , data on overall cancer risk are sparse . Methods : We examined the association between adherence to  Mediterranean dietary pattern  and overall cancer risk using data from the European Prospect i ve Investigation Into Cancer and nutrition , a multi-centre prospect i ve cohort study including 142 605 men and 335 873 .  Adherence to Mediterranean diet was examined using a score ( range : 0–9 ) considering the combined intake of fruits and nuts , vegetables , legumes , cereals , lipids , fish , dairy products , meat products , and alcohol . Association with cancer incidence was assessed through Cox regression modelling , controlling for potential confounders . Results : In all , 9669 incident cancers in men and 21 062 in women were identified . A lower overall cancer risk was found among individuals with greater adherence to Mediterranean diet ( hazard ratio=0.96 , 95 % CI 0.95–0.98 ) for a two-point increment of the Mediterranean diet score . The apparent inverse association was stronger for smoking-related cancers than for cancers not known to be related to tobacco ( P (heterogeneity)=0.008 ) . In all , 4.7 % of cancers among men and 2.4 % in women would be avoided in this population if study subjects had a greater adherence to Mediterranean dietary pattern . Conclusion : Greater adherence to a Mediterranean dietary pattern could reduce overall cancer risk CONTEXT Obesity in the United States has increased dramatically during the past several decades . There is debate about optimum calorie balance for prevention of weight gain , and proponents of some low-carbohydrate diet regimens have suggested that the increasing obesity may be attributed , in part , to low-fat , high-carbohydrate diets . OBJECTIVES To report data on body weight in a long-term , low-fat diet trial for which the primary end points were breast and colorectal cancer and to examine the relationships between weight changes and changes in dietary components . DESIGN , SETTING , AND PARTICIPANTS R and omized intervention trial of 48,835 postmenopausal women in the United States who were of diverse background s and ethnicities and participated in the Women 's Health Initiative Dietary Modification Trial ; 40 % ( 19,541 ) were r and omized to the intervention and 60 % ( 29,294 ) to a control group . Study enrollment was between 1993 and 1998 , and this analysis includes a mean follow-up of 7.5 years ( through August 31 , 2004 ) . INTERVENTIONS The intervention included group and individual sessions to promote a decrease in fat intake and increases in vegetable , fruit , and grain consumption and did not include weight loss or caloric restriction goals . The control group received diet-related education material s. MAIN OUTCOME MEASURE Change in body weight from baseline to follow-up . RESULTS Women in the intervention group lost weight in the first year ( mean of 2.2 kg , P<.001 ) and maintained lower weight than control women during an average 7.5 years of follow-up ( difference , 1.9 kg , P<.001 at 1 year and 0.4 kg , P = .01 at 7.5 years ) 
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Conclusions Increases in F&V intakes were positively associated with the number of participant intervention contacts .
Dietary interventions delivered during the retirement transition are therefore effective , sustainable in the longer term and likely to be of public health significance