***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: Asthma is an increasingly common disorder responsible for considerable morbidity and mortality . Although obesity is a risk factor for asthma and weight loss can improve symptoms , many patients do not adhere to low calorie diets and the impact of dietary restriction on the disease process is unknown . A study was design ed to determine if overweight asthma patients would adhere to an alternate day calorie restriction ( ADCR ) dietary regimen , and to establish the effects of the diet on their symptoms , pulmonary function and markers of oxidative stress , and inflammation . Ten subjects with BMI > 30 were maintained for 8 weeks on a dietary regimen in which they ate ad libitum every other day , while consuming less than 20 % of their normal calorie intake on the intervening days . At baseline , and at design ated time points during the 8-week study , asthma control , symptoms , and Quality of Life question naires ( ACQ , ASUI , mini-AQLQ ) were assessed and blood was collected for analyses of markers of general health , oxidative stress , and inflammation . Peak expiratory flow ( PEF ) was measured daily on awakening . Pre- and postbronchodilator spirometry was obtained at baseline and 8 weeks . Nine of the subjects adhered to the diet and lost an average of 8 % of their initial weight during the study . Their asthma-related symptoms , control , and QOL improved significantly , and PEF increased significantly , within 2 weeks of diet initiation ; these changes persisted for the duration of the study . Spirometry was unaffected by ADCR .  Levels of serum beta-hydroxybutyrate were increased and levels of leptin were decreased on CR days , indicating a shift in energy metabolism toward utilization of fatty acids and confirming compliance with the diet . The improved clinical findings were associated with decreased levels of serum cholesterol and triglycerides , striking reductions in markers of oxidative stress ( 8-isoprostane , nitrotyrosine , protein carbonyls , and 4-hydroxynonenal adducts ) , and increased levels of the antioxidant uric acid . Indicators of inflammation , including serum tumor necrosis factor-alpha and brain-derived neurotrophic factor , were also significantly decreased by ADCR .  Compliance with the ADCR diet was high , symptoms and pulmonary function improved , and oxidative stress and inflammation declined in response to the dietary intervention . These findings demonstrate rapid and sustained beneficial effects of ADCR on the underlying disease process in subjects with asthma , suggesting a novel approach for therapeutic intervention in this disorder Background Obesity is associated with an atherogenic lipid profile characterized by a predominance of small LDL and HDL particles . Weight loss , by dietary restriction or exercise , increases LDL particle size . Whether these interventions can augment HDL size in conjunction with LDL size remains unknown . Objective This study compared the effects of alternate day fasting ( ADF ) , calorie restriction ( CR ) , and endurance exercise on LDL and HDL particle size in overweight and obese subjects . Methods In a 12-week parallel-arm trial , adult subjects ( n = 60 ) were r and omized to 1 of 4 groups : 1 ) ADF ( 75 % energy restriction for 24-h alternated with ad libitum feeding for 24-h ) , 2 ) CR ( 25 % energy restriction every day ) , 3 ) exercise ( moderate intensity training 3 x/week ) , or 4 ) control .  Results Body weight was reduced ( P < 0.001 ) by ADF , CR , and exercise ( 5.2 ± 1.1 % , 5.0 ± 1.4 % , 5.1 ± 0.9 % , respectively ) . Plasma LDL cholesterol decreased ( P < 0.05 ) with ADF ( 10 ± 4 % ) and CR ( 8 ± 4 % ) , whereas HDL cholesterol increased ( P < 0.05 ) with exercise ( 16 ± 5 % ) . Integrated LDL particle size was augmented ( P = 0.01 ) by ADF and CR . The proportion of small LDL particles decreased ( P = 0.04 ) with ADF only , and the proportion of large HDL particles increased ( P = 0.03 ) with exercise only . Conclusion These results indicate that dietary restriction increases LDL particle size , while endurance training augments HDL particle size , with minimal weight loss . None of these interventions concomitantly increased both LDL and HDL particle size , however The ability of alternate-day fasting ( ADF ) to modulate adipocyte parameters in a way that is protective against coronary heart disease ( CHD ) has yet to be tested . Accordingly , we examined the effects of ADF on adipokine profile , body composition , and CHD risk indicators in obese adults . Sixteen obese subjects ( 12 women/4 men ) participated in a 10-week trial with three consecutive dietary intervention phases : ( i ) 2-week baseline control phase , ( ii ) 4-week ADF controlled feeding phase , and ( iii ) 4-week ADF self-selected feeding phase . After 8 weeks of treatment , body weight and waist circumference were reduced ( P < 0.05 ) by 5.7 ± 0.9 kg , and 4.0 ± 0.9 cm , respectively . Fat mass decreased ( P < 0.05 ) by 5.4 ± 0.8 kg , whereas fat-free mass did not change . Plasma adiponectin was augmented ( P < 0.05 ) by 30 % from baseline . Leptin and resistin concentrations were reduced ( P < 0.05 ) by 21 and 23 % , respectively , post treatment . Low-density lipoprotein cholesterol ( LDL-C ) and triacylglycerol concentrations were 25 % and 32 % lower ( P < 0.05 ) , respectively , after 8 weeks of ADF . High-density lipoprotein cholesterol ( HDL-C ) , C-reactive protein , and homocysteine concentrations did not change . Decreases in LDL-C were related to increased adiponectin ( r = -0.61 , P = 0.01 ) and reduced waist circumference ( r = 0.39 , P = 0.04 ) . Lower triacylglycerol concentrations were associated with augmented adiponectin ( r = -0.39 , P = 0.04 ) and reduced leptin concentrations ( r = 0.45 , P = 0.03 ) post-treatment . These findings suggest that adipose tissue parameters may play an important role in mediating the cardioprotective effects of ADF in obese humans OBJECTIVE To determine whether an intermittent very-low-calorie diet ( VLCD )  improves weight loss and glycemic control more than moderate caloric restriction alone . RESEARCH DESIGN AND METHODS Individuals with type 2 diabetes ( n = 54 ) who were ≥ 20 % over ideal body weight participated in a 20-week behavioral weight control program . Subjects were r and omized to either a st and ard behavioral therapy ( SBT ) group or to one of two VLCD groups . SBT subjects received a 1,500−1,800 kcal/day diet throughout . Both VLCD groups followed a VLCD for 5 consecutive days during week 2 , followed by either intermittent VLCD therapy for 1 day/week for 15 weeks ( 1-day ) or for 5 consecutive days every 5 weeks ( 5-day ) , with a 1,500−1,800 kcal/day diet at other times . RESULTS Both VLCD groups lost more weight than the SBT group over the 20 weeks ( P = 0.04 ) . Although the groups did not differ in fasting plasma glucose ( FPG ) changes at 20 weeks , more subjects in the 5-day group attained a normal HbA1c when compared with the SBT group ( P = 0.04 ) . This benefit was independent of the effects of weight loss . The best predictor of overall change in FPG and HbA1c was the FPG response during the first 3 weeks of the program . CONCLUSIONS Periodic VLCDs  improved weight loss  in diabetic subjects . A regimen with intermittent 5-day VLCD therapy seemed particularly promising , because more subjects in this group attained a normal HbA1c . Moreover , the glucose response to a 3-week period of diet therapy predicted glycemic response at 20 weeks , and it was a better predictor of the 20-week response than initial or overall weight loss OBJECTIVE : To investigate the effectiveness of intensive innovative methods for implementing dietary prescriptions on weight management and glycaemic control in overweight men with Type II diabetes . DESIGN : A r and omised clinical trial with a 12-week intervention period — three isocaloric dietary intervention groups ( intermittent energy restriction , pre-portioned meals and self-selected meals ) each with weekly dietitian contact — and a follow-up visit after 18 months . SUBJECTS : A total of 51 men with Type II diabetes ( mean age 54 y , mean body mass index ( BMI ) 31.7 kg/m2 ) .  MEASUREMENTS : Weight , body composition , waist circumference , glycaemic control ( HbA1c ) and blood lipids . RESULTS : For all subjects , intensive diet therapy over the 12-week intervention period result ed in a mean reduction in energy intake of 2360±2780 kJ/day ( 564±665 kcal/day ) and significant reductions in weight ( 6.4±4.6 kg ) , waist circumference ( 8.1±4.6 cm ) , percent body fat ( 1.9±1.5 % ) , HbA1c ( 1.0±1.4 % ) and triglyceride levels ( 0.3±0.6 mmol/l ) compared to baseline levels . Intervention group did not affect clinical outcomes , with the exception of percent body fat . A total of 27 ( 52.9 % ) subjects attended the 18-month follow-up visit . At this visit , none of the improvements in clinical parameters was maintained , with all parameters returning to preintervention levels . CONCLUSIONS : A dietary prescription of 6000–7000 kJ/day ( 1400–1700 kcal/day ) was effective in achieving a 6 % weight loss and improving glycaemic control . The method of implementation made no difference to the outcomes between groups at 12 weeks or 18 months . Thus , we propose that it was the intensive weekly contact with a health professional in combination with moderate energy restriction that facilitated the successful short-term results seen Effective strategies are needed to help individuals  lose weight and maintain weight loss . The primary aim of this study was to investigate the effect of intermittent energy restriction ( IER ) compared to continuous energy restriction ( CER )  on weight loss after 8 weeks and weight loss maintenance after 12 months . Secondary aims were to determine changes in waist and hip measurements and diet quality . In a r and omized parallel study , overweight and obese ( body mass index [ BMI ] ≥ 27 kg m−2 ) women were stratified by age and BMI before r and omization . Participants undertook an 8‐week intensive period with weight , waist and hip circumference measured every 2 weeks , followed by 44 weeks of independent dieting . A food frequency question naire was completed at baseline and 12 months , from which diet quality was determined . Weight loss was not significantly different between the two groups at 8 weeks ( −3.2 ± 2.1 kg CER , n = 20 , −2.0 ± 1.9 kg IER , n = 25 ; P = 0.06 ) or at 12 months ( −4.2 ± 5.6 kg CER , n = 17 −2.1 ± 3.8 kg IER , n = 19 ; P = 0.19 ) . Weight loss between 8 and 52 weeks was –0.7 ± 49 kg CER vs. −1 ± 1.1 kg IER ; P = 0.6 . Waist and hip circumference decreased significantly with time ( P < 0.01 ) , with no difference between groups . There was an increase in the Healthy Eating Index at 12 months in the CER compared with the IER group ( CER 8.4 ± 9.1 vs. IER −0.3 ± 8.4 , P = 0.006 ) . This study indicates that intermittent dieting was as effective as continuous dieting over 8 weeks and for weight loss maintenance at 12 months . This may be useful for individuals who find CER too difficult to maintain BACKGROUND The Cochrane Collaboration is strongly encouraging the use of a newly developed tool , the Cochrane Collaboration Risk of Bias Tool ( CCRBT ) , for all review groups . However , the psychometric properties of this tool to date have yet to be described . Thus , the objective of this study was to add information about psychometric properties of the CCRBT including inter-rater reliability and concurrent validity , in comparison with the Effective Public Health Practice Project Quality Assessment Tool ( EPHPP ) . METHODS Both tools were used to assess the method ological quality of 20 r and omized controlled trials included in our systematic review of the effectiveness of knowledge translation interventions  to improve the management of cancer pain . Each study assessment was completed independently by two review ers using each tool . We analysed the inter-rater reliability of each tool 's individual domains , as well as final grade assigned to each study . RESULTS The EPHPP had fair inter-rater agreement for individual domains and excellent agreement for the final grade . In contrast , the CCRBT had slight inter-rater agreement for individual domains and fair inter-rater agreement for final grade . 
    Output:
    
The majority of studies that reported body composition outcomes have shown equal efficacy for fat mass , fat-free mass and waist circumference .
Conclusions : Weight loss was achieved in overweight and obese adults following IER and this loss was comparable to a DER diet .