***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 The effect of energy restriction and macronutrient composition on gene expression in adipose tissue is not well defined . OBJECTIVE The aim of the study was to investigate the effect of different low-energy diets on gene expression in human adipose tissue . DESIGN Forty obese women were r and omly assigned to a moderate-fat , moderate-carbohydrate diet or a low-fat , high-carbohydrate hypoenergetic ( -600 kcal/d ) diet for 10 wk . Subcutaneous adipose tissue sample s were obtained before and after the diet period . High- quality RNA sample s were obtained from 23 women at both time points , and these sample s were hybridized to microarrays containing the 8500 most extensively described human genes . The results were confirmed by separate messenger RNA measurements . RESULTS Both diets result ed in weight losses of approximately 7.5 % of baseline body weight . A total of 52 genes were significantly up-regulated and 44 were down-regulated as a result of the intervention , and no diet-specific effect was observed . No major effect on lipid-specific transcription factors or genes regulating signal transduction , lipolysis , or synthesis of acylglycerols was observed . Most changes were modest ( < 25 % of baseline ) , but all genes regulating the formation of polyunsaturated fatty acids from acetyl-CoA and malonyl-CoA were markedly down-regulated ( 35 - 60 % decrease ) . CONCLUSIONS Macronutrients have a secondary role in changes in adipocyte gene expression after energy-restricted diets . The most striking alteration after energy restriction is a coordinated reduction in the expression of genes regulating the production of polyunsaturated fatty acids The influence of weight reduction and female sex hormones on the regulation of lipolysis was investigated in isolated abdominal sc adipocytes from 20 obese hyper and rogenic women with polycystic ovary syndrome ( PCOS ) . Nine PCOS women were reinvestigated after 8 - 12 weeks of weight reduction therapy ( WR ) with a very low calorie diet , inducing a mean loss of 8 + /- 3 kg , and 8 PCOS women were reinvestigated after 12 weeks of treatment with combined oral contraceptives ( OC ) , containing ethinyl estradiol and norethisterone ; the remaining 3 subjects were drop-outs . Both WR and OC normalized hyper and rogenicity . WR caused a 50 % reduction of basal lipolysis rate and a 5- to 7-fold increased noradrenaline and terbutaline sensitivity ( P < 0.02 ) ; the latter could be ascribed to a 2-fold increased beta2-adrenoceptor density ( P < 0.02 ) as determined with radiolig and binding . There was no change with regard to dobutamine ( beta1-adrenoceptor sensitivity ) or clonidine , ( alpha2-adrenoceptor sensitivity ) or to beta1-adrenoceptor density . OC treatment did not influence the basal lipolysis rate or beta2- or alpha2-adrenoceptor sensitivity , but lowered the beta1-adrenoceptor sensitivity 7-fold ( P < 0.03 ) without a reduction in beta1-adrenoceptor density . The OC treatment effect was not observed when forskolin and dibutyryl cAMP , acting on adenylate cyclase or protein kinase A , respectively , were used , suggesting a partial uncoupling of beta1-adrenoceptors . WR therapy , but not OC therapy , caused , in addition to changes in lipolysis function , improved in vivo insulin sensitivity and lower plasma noradrenaline levels . These findings suggest that factors other than hyper and rogenicity modulate lipolysis regulation in obese subjects with PCOS . Disturbances in sympathetic pathways could be of pathogenic importance BACKGROUND Limited evidence suggests that a higher ratio of protein to carbohydrate during weight loss has metabolic advantages . OBJECTIVE The objective was to evaluate the effects of a diet with a high ratio of protein to carbohydrate during weight loss on body composition , cardiovascular disease risk , nutritional status , and markers of bone turnover and renal function in overweight women . DESIGN The subjects were r and omly assigned to 1 of 2 isocaloric 5600-kJ dietary interventions for 12 wk according to a parallel design : a high-protein ( HP ) or a high-carbohydrate ( HC ) diet . RESULTS One hundred women with a mean ( + /-SD ) body mass index ( in kg/m(2 ) ) of 32 + /- 6 and age of 49 + /- 9 y completed the study .  Weight loss was 7.3 + /- 0.3 kg with both diets . Subjects with high serum triacylglycerol ( > 1.5 mmol/L ) lost more fat mass with the HP than with the HC diet ( x + /- SEM : 6.4 + /- 0.7 and 3.4 + /- 0.7 kg , respectively ; P = 0.035 ) and had a greater decrease in triacylglycerol concentrations with the HP ( -0.59 + /- 0.19 mmol/L ) than with the HC ( -0.03 + /- 0.04 mmol/L ) diet ( P = 0.023 for diet x triacylglycerol interaction ) . Triacylglycerol concentrations decreased more with the HP ( 0.30 + /- 0.10 mmol/L ) than with the HC ( 0.10 + /- 0.06 mmol/L ) diet ( P = 0.007 ) . Fasting LDL-cholesterol , HDL-cholesterol , glucose , insulin , free fatty acid , and C-reactive protein concentrations decreased with weight loss . Serum vitamin B-12 increased 9 % with the HP diet and decreased 13 % with the HC diet ( P < 0.0001 between diets ) . Folate and vitamin B-6 increased with both diets ; homocysteine did not change significantly . Bone turnover markers increased 8 - 12 % and calcium excretion decreased by 0.8 mmol/d ( P < 0.01 ) . Creatinine clearance decreased from 82 + /- 3.3 to 75 + /- 3.0 mL/min ( P = 0.002 ) . CONCLUSION An energy-restricted , high-protein , low-fat diet provides nutritional and metabolic benefits that are equal to and sometimes greater than those observed with a high-carbohydrate diet Several studies have demonstrated that high density lipoprotein cholesterol ( HDL-C ) is increased after either dietary weight loss or aerobic exercise training , but it is unclear whether the effects of these two interventions are separate and independent , or just related to the amount of weight or fat lost . The effect of dietary weight loss or aerobic training on apolipoprotein A1 ( Apo-A-I ) has not been extensively studied . In the present study we evaluated the effects of either dietary weight loss or aerobic exercise training on lipoproteins and Apo A-I , and assessed whether they are related to changes in body composition .  Twenty-six obese , otherwise healthy , untrained , nonsmoking , male subjects were weight stabilized for ten days , during which maximal aerobic capacity , body composition , and fat cell size were measured . At the end of this ten-day period lipoproteins and Apo A-I were measured . Subjects were then r and omized into either a dietary weight loss ( n = 12 ) or aerobic exercise group ( n = 14 ) . At the end of three months the groups were restabilized and restudied . Although both groups lost weight , the weight loss was greater in the diet group ( -13.1 v -2.8 kg , P less than 0.001 ) . Important differences in body composition were also detected after the two interventions with 25 % of the total weight loss in the diet group coming from fat free mass . Significant decrements in triglyceride ( -54 + /- 67 mg/dL , P less than 0.05 ) , total cholesterol ( -29 + /- 27 mg/dL , P less than 0.01 ) . ( ABSTRACT TRUNCATED AT 250 WORDS BACKGROUND Exercise intensity may affect the selective loss of abdominal adipose tissue . OBJECTIVE This study showed whether aerobic exercise intensity affects the loss of abdominal fat and improvement in cardiovascular disease risk factors under conditions of equal energy deficit in women with abdominal obesity . DESIGN This was a r and omized trial in 112 overweight and obese [ body mass index ( in kg/m(2 ) ) : 25 - 40 ; waist circumference > 88 cm ] , postmenopausal women assigned to one of three 20-wk interventions of equal energy deficit  : calorie restriction ( CR only ) , CR plus moderate-intensity aerobic exercise ( CR + moderate-intensity ) , or CR plus vigorous-intensity exercise ( CR + vigorous-intensity ) . The diet was a controlled program of underfeeding during which meals were provided at individual calorie levels ( approximately 400 kcal/d ) . Exercise ( 3 d/wk ) involved treadmill walking at an intensity of 45 - 50 % ( moderate-intensity ) or 70 - 75 % ( vigorous-intensity ) of heart rate reserve . The primary outcome was abdominal visceral fat volume . RESULTS Average weight loss for the 95 women who completed the study was 12.1 kg ( + /-4.5 kg ) and was not significantly different across groups . Maximal oxygen uptake ( O(2)max ) increased more in the CR + vigorous-intensity group than in either of the other groups ( P < 0.05 ) . The CR-only group lost relatively more lean mass than did either exercise group ( P < 0.05 ) . All groups showed similar decreases in abdominal visceral fat ( approximately 25 % ; P < 0.001 for all ) . However , changes in visceral fat were inversely related to increases in O(2)max ( P < 0.01 ) . Changes in lipids , fasting glucose or insulin , and 2-h glucose and insulin areas during the oral-glucose-tolerance test were similar across treatment groups . CONCLUSION With a similar amount of total weight loss , lean mass is preserved , but there is not a preferential loss of abdominal fat when either moderate- or vigorous-intensity aerobic exercise is performed during caloric restriction . This trial was registered at ( Clinical Trials.gov ) as : NCT00664729 INTRODUCTION Adiponectin is an adipose tissue-derived anti-inflammatory protein that is down-regulated in obesity . The effects of caloric restriction and exercise-induced weight loss on adiponectin are not clear . PURPOSE To determine whether addition of aerobic exercise training to caloric restriction has additive effects over caloric restriction alone on circulating adiponectin concentrations and adiponectin release from abdominal and gluteal adipose tissue . METHODS Overweight or obese ( body mass index , 25 - 40 kg·m(-2 ) ; waist > 88 cm ) postmenopausal women were r and omized to 20-wk caloric restriction with and without aerobic exercise ( CR + EX , n = 48 ; and CR , n = 22 ) . Blood sample s were collected for measuring plasma adiponectin concentration , and abdominal and gluteal subcutaneous adipose tissue biopsies were performed in a subgroup to determine in vitro adiponectin release , before and after the interventions . RESULTS The interventions elicited similar amounts of weight loss ( CR + EX , -11.3 ± 4.6 kg ; CR,-11.2 ± 3.4 kg ) and fat loss ( CR + EX , -8.0 ± 3.5 kg ; CR , -7.4 ± 2.7 kg ) . The two groups had differential changes in plasma adiponectin concentrations ( for interaction , P = 0.014 ) ; CR + EX increased ( 6.9 ± 3.9 to 8.5 ± 4.9 μg·mL(-1 ) ; P = 0.0001 ) , whereas CR did not alter ( 6.4 ± 4.4 to 6.5 ± 4.5 μg·mL(-1 ) ; P = 0.42 ) plasma adiponectin . Likewise , adiponectin release from abdominal and gluteal subcutaneous adipose tissue increased with CR + EX ( P = 0.0076 and P = 0.089 , respectively ) but did not change with CR ( P = 0.13 and P = 0.95 , respectively ) . CONCLUSION Despite similar reductions in body weight and fat mass , the addition of aerobic exercise to caloric restriction increased plasma adiponectin concentrations , which may be partly explained by increased adiponectin release from abdominal and gluteal subcutaneous adipose tissue OBJECTIVE The purpose of this article was to determine the relationships among total body fat , visceral adipose tissue ( VAT ) , fat cell size ( FCS ) , ectopic fat deposition in liver ( intrahepatic lipid [ IHL ] ) and muscle ( intramyocellular lipid [ IMCL ] ) , and insulin sensitivity index ( S(i ) ) in healthy overweight , glucose-tolerant subjects and the effects of calorie restriction by diet alone or in conjunction with exercise on these 
    Output:
    
These relationships were no longer significant when focusing only on lifestyle interventions .
Moreover , age , sex and intervention type did not independently affect adipocyte size reduction in either model .
Weight loss in obese individuals is consistently associated with a decrease in adipocyte size that is more pronounced in upper-body adipocytes .
It remains to be clarified how biological differences and intervention characteristics influence this relationship , and whether it corresponds with reductions in other aspects of adipose tissue dysfunction and disease risk