***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: Coronary heart disease ( CHD ) risk factors and the risk of CHD increase with increased adiposity . Fat loss induced by negative energy balance improves all metabolic CHD risk factors . To determine whether fat loss induced by long-term calorie restriction ( CR ) or increased energy expenditure induced by exercise ( EX ) has different effects on CHD risk factors in nonobese subjects , we conducted a 1-yr controlled trial involving 48 nonobese subjects who were r and omly assigned to one of three groups : CR , 20 % CR diet ( n = 18 ) ; EX , 20 % increase in energy expenditure through daily exercise with no increase in energy intake ( n = 18 ) ; or HL , healthy lifestyle guidelines ( n = 10 ) . Subjects were 29 women and 17 men aged 57 + /- 3 yr , with BMI 27.3 + /- 2.0 kg/m(2 ) . Assessment s included total body fat by DEXA , lipoproteins , blood pressure , HOMA-IR , C-reactive protein ( CRP ) , and estimated 10-yr CHD risk score . Body fat decreased by 6.3 + /- 3.8 kg in CR , 5.6 + /- 4.4 kg in EX , and 0.4 + /- 1.7 kg in HL , which corresponded to reductions of 24.9 , 22.3 , and 1.2 % of baseline body fat mass , respectively . These CR- and EX-induced energy deficits were accompanied by reductions in most of the major CHD risk factors , including plasma LDL-cholesterol , total cholesterol/HDL ratio , HOMA-IR index , and CRP concentrations that were similar in the two intervention groups . Data from the present study provide evidence that CR- and EX-induced negative energy balance result in substantial and similar improvements in the major risk factors for CHD in normal-weight and overweight middle-aged adults Diet and exercise studies of premenopausal women have shown reductions in obesity and other cardiovascular disease ( CVD ) risk factors . Forty-one healthy , moderately obese ( 120 - 140 % of ideal body weight , LBW ) , postmenopausal women ( 65.6 + /- 3.3 y ) participating in 24-wk diet or diet + exercise programs  were studied to determine whether similar CVD risk reduction would occur . Daily energy need ( DEN ) was estimated from basal energy expenditure and self-reported activity . The diet + exercise group ( n = 16 ) reduced their daily energy intake ( DEI ) by 2092 kJ from their DEN and expended 837 kJ/d in walking and resistance exercise . The two diet-only groups ( n = 13 and n = 12 ) reduced their DEI by 2092 and 2929 kJ from their DEN , respectively . Body weight , waist-to-hip and subscapula-to-triceps ratios , blood lipids ( total , low-density-lipoprotein , and high-density-lipoprotein cholesterol , and triacylglycerols ) , glucose , and insulin concentrations were measured at baseline and after 12 and 24 wk of diet and diet + exercise . Data were analyzed by using analysis of variance with repeated measures ( P < or = 0.05 ) and Tukey 's post hoc test . Loss of body weight was significant for all groups between baseline and 12 and 24 wk ( baseline : 79.3 + /- 7.6 kg ; 12 wk ; 75.1 + /- 7.7 kg ; 24 wk ; 72.8 + /- 8.0 kg ) but did not differ among groups . No significant time or treatment effects were observed between baseline and 24 wk for changes in mean blood lipid , glucose , and fasting insulin concentrations or measures of body fat distribution . Although 24 wk of diet or diet+exercise significantly reduced body weight in this group , this loss in body weight was not accompanied by a reduction of other commonly accepted CVD risks To assess the individual and combined effects of weight loss and weight training on body weight and body composition , 40 obese women were r and omly assigned to one of four groups for an 8 wk weight-loss study . These groups were control ( C ) ; diet without exercise ( DO ) ; diet plus weight training ( DPE ) ; and weight training without diet ( EO ) . Body weight decreased for DO ( -4.47 kg ) and DPE ( -3.89 kg ) compared with C ( -0.38 kg ) and EO ( 0.45 kg ) . Lean body weight ( LBW ) increased for EO ( 1.07 kg ) compared with DO ( -0.91 kg ) and C ( -0.31 kg ) and for DPE ( 0.43 kg ) compared with DO . Upper-arm muscle areas ( determined by radiograph ) increased for DPE ( 11.2 cm2 ) and EO ( 10.4 cm2 ) compared with C ( 2.7 cm2 ) and DO ( 2.1 cm2 ) . It was concluded that weight training results in comparable gains in muscle area and strength for DPE and EO . Adding weight training exercise to a caloric restriction program results in maintenance of LBW compared with DO BACKGROUND Weight reduction reduces bone mineral density ( BMD ) and increases the risk of osteoporosis . OBJECTIVE We investigated whether bone is mobilized in postmenopausal women during energy restriction and whether hormones regulate bone turnover and mass . DESIGN Twenty-seven obese postmenopausal women with a mean ( + /-SD ) age of 55.9 + /- 7.9 y and body mass index ( in kg/m(2 ) ) of 33.0 + /- 3.8 completed the 6-mo study . Fourteen women followed a moderate energy-restricted diet ( WL group ) and 13 control subjects maintained their body weight ( WM group ) . Body weight , bone turnover markers , serum parathyroid hormone ( PTH ) , and dietary intake were measured throughout the study . Total-body BMD , sex hormone binding globulin , leptin , and estrone were measured at baseline and at week 25 . RESULTS In the WL group , body weight decreased by 10.2 + /- 5.5 % ( P < 0.001 ) , body fat mass decreased by 18.7 + /- 11.3 % ( P < 0.001 ) , and total-body BMD decreased by 1.2 + /- 1.2 % ; these changes were significantly different from those in the WM group ( P < 0.05 ) . Serial measurements showed chronically elevated rates of bone resorption and formation during energy restriction that were greater than in the WM group ( P < 0.05 ) . Serum sex hormone binding globulin increased and leptin decreased with weight loss ( P < 0.05 ) . Serum PTH tended to increase in the WL group but not in the WM group ( P < 0.06 ) . The reduction in fat mass with weight loss was directly associated with a decrease in serum estrone ( P < 0.01 , R(2 ) = 0.50 ) . CONCLUSIONS Moderate energy restriction increases bone turnover in obese postmenopausal women and may be regulated in part by alterations in serum PTH and estrone This study examines the effects of weight loss by caloric restriction ( WL ) and aerobic exercise plus weight loss ( AEx+WL ) on total and regional bone mineral density ( BMD ) in older women . Healthy , postmenopausal women [ age 63 + /- 1 ( SE ) yr ] not on hormone-replacement therapy underwent 6 mo of WL ( n = 15 ) consisting of dietary counseling one time per week with a caloric deficit ( 250 - 350 kcal/day ) or AEx+WL ( n = 15 ) consisting of treadmill exercise three times per week in addition to the weight loss . Maximal aerobic capacity increased only in the AEx+WL group ( P < 0 . 001 ) . Body weight , percent fat , and fat mass decreased similarly in both groups ( P < 0.005 ) , with no changes in fat-free mass . Total body BMD ( by dual-energy X-ray absorptiometry ) decreased in both groups ( P < 0.05 ) . Femoral neck , Ward 's triangle , and greater trochanter BMD decreased in the WL group ( P < /= 0.05 ) but were not significantly different after AEx+WL .  L2-L4 BMD did not significantly change in either group . Thus WL and AEx+WL both result in losses of total body BMD ; however , AEx+WL appears to prevent the loss in regional BMD seen with WL alone in healthy , older women . This suggests that the addition of exercise to weight-loss programs may reduce the risk for bone loss BACKGROUND Caloric restriction ( CR ) increases maximal life span in short-lived organisms , and its effects are being explored in nonhuman primates . The objectives of this study were to determine the feasibility of prolonged CR in nonobese adults and to compare the effects of CR- and exercise-induced weight loss on body composition and abdominal adiposity . METHODS A r and omized , controlled trial was conducted with 48 healthy , nonobese women and men , aged 57 + /- 1 ( mean + /- st and ard error [ SE ] ) years , with body mass index 27.3 + /- 0.3 kg/m2 . Participants were r and omly assigned to a 20 % calorically-restricted diet ( CR , n = 19 ) , exercise design ed to produce a similar energy deficit ( EX , n = 19 ) , or a healthy lifestyle control group ( HL , n = 10 ) for 1 year . Assessment s included weight , body composition by dual-energy x-ray absorptiometry , abdominal adipose tissue by magnetic resonance imaging , and energy intake by doubly labeled water . RESULTS The average level of CR achieved by the CR group was 11.5 + /- 2.1 % , and the EX group completed 59 + /- 6.7 % of their prescribed exercise . Weight changes were greater ( p < or=.0005 ) in the CR ( -8.0 + /- 0.9 kg ) and EX ( -6.4 + /- 0.9 ) groups as compared to the HL group ( -1.3 + /- 0.9 kg ) , corresponding to reductions of 10.7 % , 8.4 % , and 1.7 % of baseline weights , respectively . Whole-body fat mass and visceral and subcutaneous abdominal adipose tissue decreased significantly ( p < .005 ) and comparably in the CR and EX groups , but did not change in the HL group . CONCLUSIONS CR for 1 year was feasible , but the level of CR achieved was less than prescribed . CR and exercise were equally effective in reducing weight and adiposity The purpose of this study was to compare the effects of exercise and /or caloric restriction for 12 wk on body composition , maximal aerobic power ( VO2max ) , and serum lipids and lipoproteins in overweight individuals . Forty-eight males and 48 females ( means age = 36.6 yr ) , 120 - 140 % of ideal body weight , were r and omly assigned to groups ( N = 12 each ) of diet-exercise ( DE ) , diet ( D ) , exercise ( E ) , and sedentary control ( C ) . The dietary regimen consisted of 1,200 kcal X d-1 , while exercise consisted of 5 d X wk-1 of 30 min of walk/running . For the males , body weight ( BW ) and fat weight loss in the DE group ( -11.8 and 23 % , respectively ) were significantly greater than in the D group ( -9.1 and -18 % ) , with both groups significantly greater than for E and C. In the females , BW and fat weight loss for DE ( -10.4 and -24 % ) were significantly greater than for D ( -7.8 and -20 % ) , with both groups significantly greater than E and C. Both DE and D males and females had a decrease in fat-free weight of -4.5 and -2.4 % , respectively . In both sexes , the increase in VO2max-BW ( ml X kg -1 X min-1 ) in DE ( 25 % ) was significantly greater than for E ( 15 % ) , D ( 11 % ) , and C ( 0 % ) , with differences between E and D nonsignificant . However , increases in absolute VO2max ( 1 X min-1 ) and VO2max-fat-free weight ( ml X kg-1 X min-1 ) were similar ( P greater than 0.05 ) for DE and E ( 14 % ) but significantly greater compared to D and C ( 2 % ) . ( ABSTRACT TRUNCATED AT 250 WORDS OBJECTIVE : To determine the effect of replacing some dietary carbohydrate with protein , during energy restriction , on weight loss , total energy expenditure ( TEE ) , resting energy expenditure ( REE ) , respiratory quotient ( RQ ) , and the thermic effect of feeding ( TEF ) in subjects with hyperinsulinemia . DESIGN : Parallel , clinical intervention study of 12 weeks energy restriction ( 6.5 MJ/day ) and 4 weeks energy balance ( 8.2 MJ/day ) in two groups of subjects r and omly assigned to either a high-protein ( HP ) diet ( 27 % of energy ( % E ) as protein , 45%E as carbohydrate ) or a lower-protein ( LP ) diet ( 16%E as protein , 57%E as carbohydrate).SUBJECTS : A total of 36 obese nondiabetic volunteers 
    Output:
    
These findings suggest that exercise is an effective tool to help men and postmenopausal women aged > or = 50 years , with a BMI greater than 25 kg/m(2 ) preserve FFM after moderate ER-induced weight loss , which is important for combating sarcopenic obesity