***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: Background : Adequate calcium consumption during early adulthood can help prevent osteoporosis in women . Purpose : The effects of gain-framed , targeted messaging on calcium intake were examined over 12 months . Methods : Young women ( 18–19 years ) not consuming sufficient calcium were r and omly assigned to receive st and ard care material s ( control ) or gain-framed , targeted material s ( experimental ) .  Health belief model ( HBM ) constructs , calcium intake and markers of bone formation , resorption and bone mineral density were assessed at various time points throughout the year . Results : Calcium intake increased significantly more in the experimental versus the control condition ( p < 0.01 ) . Self-efficacy was the only HBM construct to improve significantly more in the experimental condition versus control ( p = 0.05 ) . The HBM did not mediate changes in calcium intake . Measures of bone health did not differ between conditions by the end of this nonpharmacological intervention ( p 's > 0.05 ) . Conclusions : It is possible to increase  young women 's calcium consumption through gain-framed , targeted messages OBJECTIVE To assess the prevalence of and explanations for the avoidance of dairy foods , including symptoms attributed to their consumption , diagnoses and psychological predictors of avoidance . Also considered were comparisons with symptom-related avoidance of wheat in the same sample . DESIGN Cross-sectional population survey . SETTING The study was conducted in Australia using a national postal omnibus survey . SUBJECTS Adults aged 18 years and over ( n 1184 ; 52·9 % female ) selected at r and om from the Australian Electoral Roll . RESULTS Despite few cl aims of formally diagnosed allergy or intolerance , 11·8 % of the sample reported avoiding dairy products because of adverse physiological effects , which commonly included gastrointestinal symptoms . Unlike wheat ( 3·5 % ) or wheat- and -dairy ( 3·6 % ) avoidance , dairy avoidance ( 8·2 % ) was predicted by age ( negatively ) and worry about illness ( positively ) . CONCLUSIONS The findings are further evidence of a widespread tendency for consumers to exercise control over their health by eliminating dietary factors considered suspect without medical evidence or oversight . Unanswered questions include the decision processes underlying dairy avoidance , whether symptoms are attributed correctly , the agents and physiological mechanism(s ) involved , the relative contributions of symptom severity and vigilance to the association with illness worry , and the nutritional adequacy of dairy avoiders ' diets . Irrespective of the accuracy of self-diagnoses , if the elimination of suspect foods is an end in itself the paradoxical possibility for nutritional imbalances may have significant public health implication BACKGROUND Rapid developments in technology have encouraged the use of smartphones in health promotion research and practice . Although many applications ( apps ) relating to diet and nutrition are available from major smartphone platforms , relatively few have been tested in research studies in order to determine their effectiveness in promoting health . METHODS In this article , we summarize data on the use of smartphone applications  for promoting healthy diet and nutrition based upon bibliographic search es in PubMed and CINAHL with relevant search terms pertaining to diet , nutrition , and weight loss through August 2015 . RESULTS A total of 193 articles were identified in the bibliographic search es . By screening abstract s or full-text articles , a total of three relevant qualitative studies and 9 r and omized controlled trials were identified . In qualitative studies , participants preferred applications that were quick and easy to administer , and those that increase awareness of food intake and weight management . In r and omized trials , the use of smartphone apps was associated with better dietary compliance for lower calorie , low fat , and high fiber foods , and higher physical activity levels ( p=0.01 - 0.02 ) which result ed in more weight loss ( p=0.042-<0.0001 ) . DISCUSSION Future studies should utilize r and omized controlled trial research design s , larger sample sizes , and longer study periods to better establish the diet and nutrition intervention capabilities of smartphones . There is a need for culturally appropriate , tailored health messages to increase knowledge and awareness of health behaviors such as healthy eating . Smartphone apps are likely to be a useful and low-cost intervention for improving diet and nutrition and addressing obesity in the general population . Participants prefer applications that are quick and easy to administer and those that increase awareness of food intake and weight management Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more An educational intervention trial to increase calcium ( Ca ) intake was conducted on female college students taking a dietician course and the efficacy of the trial was assessed by a prospect i ve cohort study . The one hundred and eight 18- or 19-year-old students were divided into two cohorts , i.e. , a control group and an intervention group . The educational intervention was given to the intervention group only and both group received 3 surveys , before the intervention ( baseline , BL ) , 1 week after the intervention ( WAI ) , and 1 year after the intervention ( YAI ) . The amount of Ca intake at BL did not differ significantly between the cohorts . The Ca intake of the control group did not change significantly in the 3 surveys . The intervention group significantly increased Ca intake at WAI and maintained a higher level of Ca intake at the time of YAI . These results suggest some efficacy of the educational intervention to increase Ca intake in the female college students Background The unprecedented rise in obesity among young adults , who have limited interaction with health services , has not been successfully abated . Objective The objective of this study was to assess the maintenance outcomes of a 12-week mHealth intervention on prevention of weight gain in young adults and lifestyle behaviors at 9 months from baseline . Methods A two-arm , parallel , r and omized controlled trial ( RCT ) with subjects allocated to intervention or control 1:1 was conducted in a community setting in Greater Sydney , Australia . From November 2012 to July 2014 , 18- to 35-year-old overweight individuals with a body mass index ( BMI ) of 25 - 31.99 kg/m2 and those with a BMI ≥ 23 kg/m2 and a self-reported weight gain of ≥ 2 kg in the past 12 months were recruited . A 12-week mHealth program “ TXT2BFiT ” was administered to the intervention arm . This included 5 coaching calls , 96 text messages , 12 emails , apps , and downloadable re sources from the study website . Lifestyle behaviors addressed were intake of fruits , vegetables , sugar-sweetened beverages ( SSBs ) , take-out meals , and physical activity . The control group received 1 phone call to introduce them to study procedures and 4 text messages over 12 weeks . After 12 weeks , the intervention arm received 2 further coaching calls , 6 text messages , and 6 emails with continued access to the study website during 6-month follow-up . Control arm received no further contact . The primary outcome was weight change ( kg ) with weight measured at baseline and at 12 weeks and self-report at baseline , 12 weeks , and 9 months . Secondary outcomes were change in physical activity ( metabolic equivalent of task , MET-mins ) and categories of intake for fruits , vegetables , SSBs , and take-out meals . These were assessed via Web-based surveys . Results Two hundred and fifty young adults enrolled in the RCT . Intervention participants weighed less at 12 weeks compared with controls ( model β=−3.7 , 95 % CI −6.1 to −1.3 ) and after 9 months ( model β=− 4.3 , 95 % CI − 6.9 to − 1.8 ) . No differences in physical activity were found but all diet behaviors showed that the intervention group , compared with controls at 9 months , had greater odds of meeting recommendations for fruits ( OR 3.83 , 95 % CI 2.10 - 6.99 ) ; for vegetables ( OR 2.42 , 95 % CI 1.32 - 4.44 ) ; for SSB ( OR 3.11 , 95 % CI 1.47 - 6.59 ) ; and for take-out meals ( OR 1.88 , 95 % CI 1.07 - 3.30 ) . Conclusions Delivery of an mHealth intervention for prevention of weight gain result ed in modest weight loss at 12 weeks with further loss at 9 months in 18- to 35-year-olds . Although there was no evidence of change in physical activity , improvements in dietary behaviors occurred , and were maintained at 9 months . Owing to its scalable potential for widespread adoption , replication trials should be conducted in diverse population s of overweight young adults . Trial Registration Australian and New Zeal and Clinical Trials Registry ( ANZCTR ) : ACTRN12612000924853 ; ( Archived by WebCite at http://www.webcitation.org/6i6iRag55 Background There is a large quality of care gap for patients with osteoporosis . As a fragility fracture is a strong indicator of underlying osteoporosis , it offers an ideal opportunity to initiate investigation and treatment . However , studies of post-fracture population s document screening and treatment rates below 20 % in most setting s. This is despite the fact that bone mineral density ( BMD ) scans are effective at identifying patients at high risk of fracture , and effective drug treatments are widely available . Effective interventions are required to remedy this incongruity in current practice . Methods This study review ed r and omised controlled trials ( RCT ) involving fully qualified healthcare professionals caring for patients with a fragility fracture in all healthcare setting s. Any intervention design ed to modify the behaviour of healthcare professionals or implement a service delivery change was considered . The main outcomes were  BMD scanning and osteoporosis treatment with anti-resorptive therapy .  The electronic data bases Medline and Embase were search ed from 1994 to June 2010 to identify relevant articles in English .  Post-intervention risk differences ( RDs ) were calculated for the main outcomes and any additional study primary outcomes ; the trials were meta-analysed . Results A total of 2814 potentially relevant articles were sifted ; 18 were assessed in full text . Nine RCTs evaluating ten interventions met the inclusion criteria for the review . All were from North America . Four studies focused on patients with a hip fracture , three on fractures of the wrist/distal forearm , and two included several fracture sites consistent with a fragility fracture . All studies reported positive effects of the intervention for the main study outcomes of BMD scanning and osteoporosis treatment . For BMD scanning the overall risk ratio ( 95 % CI ) was 2.8 ( 2.16 to 3.64 ) ; the RD was 36 % ( 21 % to 50 % ) . For treatment with anti-resorptive therapy the overall risk ratio ( 95 % CI ) was 2.48 ( 1.92 to 3.2 ) ; the RD was 20 % ( 10 % to 30 % ) . Conclusions All interventions produced positive effects on BMD scanning and osteoporosis treatment rates post-fracture . Despite sizeable increases , investigation and treatment rates remain sub-optimal . Long-term compliance with osteoporosis medications needs to be addressed , as the majority of studies reported treatment rates at six-month follow up only . Studies would be more informative if treatment criteria were defined a priori to facilitate underst and ing of whether patients were being treated appropriately and integrated economic analyses would be helpful for informing policy implementation decisions CONTEXT Components of the insulin resistance syndrome ( IRS ) , including obesity , glucose intolerance , hypertension , and dyslipidemia , are major risk factors for type 2 diabetes and heart disease . Although diet has been postulated to influence IRS , the independent effects of dairy consumption on development of this syndrome have not been investigated . OBJECTIVE To examine associations between dairy intake and incidence of IRS , adjusting for confounding lifestyle and dietary factors . DESIGN The Coronary Artery Risk Development in Young Adults ( CARDIA ) study , a population -based prospect i ve study . SETTING AND PARTICIPANTS General community sample from 4 US metropolitan areas of 3157 black and white adults aged 18 to 30 years who were followed up from 1985 - 1986 to 1995 - 1996 . MAIN OUTCOME MEASURE Ten-year cumulative incidence of IRS and its association with  dairy consumption  , measured by diet history interview . RESULTS  Dairy consumption was inversely associated with the incidence of all IRS components among individuals who were overweight ( body mass index > or = 25 kg/m(2 ) ) at baseline but not among leaner individuals ( body mass index < 25 kg/m(2 ) ) . The adjusted odds of developing IRS ( 2 or more components ) were 72 % lower ( odds ratio , 0.28 ; 95 % confidence interval , 0.14 - 0.58 ) among overweight individuals in the highest ( > or = 35 times per week , 24/102 individuals ) compared with the lowest ( < 10 times per week , 85/190 individuals ) category of dairy consumption . Each daily occasion of dairy consumption was associated with a 21 % lower odds of IRS ( odds ratio , 0.79 ; 95 % confidence interval , 0.70 - 0.88 ) . These associations 
    Output:
    
Our review suggests  young adults respond favorably to interventions but the effect size is small