***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 : A relatively high percentage of energy intake as protein has been shown to increase satiety and decrease energy efficiency during overfeeding . AIM : To investigate whether addition of protein may improve weight maintenance by preventing or limiting weight regain after weight loss of 5–10 % in moderately obese subjects . DESIGN OF THE STUDY : In a r and omized parallel design , 148 male and female subjects ( age 44.2±10.1 y ; body mass index ( BMI ) 29.5±2.5 kg/m2 ; body fat 37.2±5.0 % ) followed a very low-energy diet ( 2.1 MJ/day ) during 4 weeks . For subsequent 3 months weight-maintenance assessment , they were stratified according to age , BMI , body weight , restrained eating , and resting energy expenditure ( REE ) , and r and omized over two groups . Both groups visited the University with the same frequency , receiving the same counseling on dem and by the dietitian . One group ( n=73 ) received 48.2 g/day additional protein to their diet . Measurements at baseline , after weight loss , and after 3 months weight maintenance were body weight , body composition , metabolic measurements , appetite profile , eating attitude , and relevant blood parameters . RESULTS : Changes in body mass , waist circumference , REE , respiratory quotient ( RQ ) , total energy expenditure ( TEE ) , dietary restraint , fasting blood-glucose , insulin , triacylglycerol , leptin , β-hydroxybutyrate , glycerol , and free fatty acids were significant during weight loss and did not differ between groups . During weight maintenance , the ‘ additional-protein group ’ showed in comparison to the nonadditional-protein group 18 vs 15 en% protein intake , a 50 % lower body weight regain only consisting of fat-free mass , a 50 % decreased energy efficiency , increased satiety while energy intake did not differ , and a lower increase in triacylglycerol and in leptin ; REE , RQ , TEE , and increases in other blood parameters measured did not differ . CONCLUSION : A 20 % higher protein intake , that is , 18 % of energy vs 15 % of energy during weight maintenance after weight loss , result ed in a 50 % lower body weight regain , only consisting of fat-free mass , and related to increased satiety and decreased energy efficiency This study examined the effects of calorie alternation and exercise on weight loss .  Moderately obese women ( 130 - 160 % of ideal body weight ) were r and omly assigned to an alternating- or constant-calorie diet with or without aerobic exercise . Both diets provided an average of 1200 kcal/d over a 12-wk period ; daily intake of subjects in the alternating-diet condition varied in a prescribed pattern from 600 to 1800 kcal/d . Exercising subjects walked 5 d/wk . All subjects participated in an intensive outpatient behavior-modification program . At the end of the study , exercised subjects had greater reductions in body weight and body fat percentage than did nonexercised subjects . The type of caloric restriction did not affect weight or fat loss . Changes in resting metabolic rate did not differ among groups . Alternating calories was neither beneficial nor detrimental as a weight-loss strategy whereas exercise was clearly beneficial in weight-loss therapy We assessed the effect of ingestion of green tea ( GT ) extract along with a low-energy diet ( LED ) on resting energy expenditure ( REE ) , substrate oxidation and body weight as GT has been shown to increase energy expenditure and fat oxidation in the short term in both animals and people . Forty-six overweight women ( BMI 27.6 ( sd 1.8 ) kg/m2 ) were fed in energy balance from day 1 to day 3 , followed by a LED with GT ( 1125 mg tea catechins + 225 mg caffeine/d ) or placebo ( PLAC ) from day 4 to day 87 . Caffeine intake was st and ardised to 300 mg/d . Energy expenditure was measured on days 4 and 32 . Reductions in weight ( 4.19 ( sd 2.0 ) kg PLAC , 4.21 ( sd 2.7 ) kg GT ) , BMI , waist : hip ratio , fat mass and fat-free mass were not statistically different between treatments . REE as a function of fat-free mass and fat mass was significantly reduced over 32 d in the PLAC group ( P<0.05 ) but not in the GT group . Dietary restraint increased over time ( P<0.001 ) in both groups , whereas disinhibition and general hunger decreased ( P<0.05 ) . The GT group became more hungry over time and less thirsty , and showed increased prospect i ve food consumption compared with PLAC ( P<0.05 ) . Taken together , the ingestion of GT along with a LED had no additional benefit for any measures of body weight or body composition . Although the decrease in REE as a function of fat-free mass and fat mass was not significant with GT treatment , whereas it was with PLAC treatment , no significant effect of treatment over time was seen , suggesting that a robust limitation of REE reduction during a LED was not achieved by GT This study was undertaken to investigate the effects of green tea on weight reduction in obese Thais . A r and omized , controlled trial involving 60 obese subjects ( body mass index , BMI > 25 kg/m2 ) was conducted . All subjects consumed a Thai diet containing 3 meals ( 8373.6 kJ/day ) for 12 weeks , prepared by the Nutritional Unit at Srinagarind Hospital . The diet contained 65 % carbohydrates , 15 % protein , and 20 % fat . Body weight , BMI , body composition , resting energy expenditure , and substrate oxidation were measured at baseline , and during weeks 4 , 8 , and 12 of the study . Serum levels of leptin and urine VMA were measured at baseline and during the 12th week . Differences over time and between the treatments ( green tea or placebo ) over time were determined using two-factor ANOVA with repeated measures . In comparing the two groups , differences in weight loss were 2.70 , 5.10 , and 3.3 kg during the 4th , 8th , and 12th weeks of the study , respectively . At the 8th and 12th weeks of the study , body weight loss was significantly different ( P < 0.05 ) . At the 8th week , the difference in resting energy expenditure was 183.38 kJ/day ( P < 0.001 ) , the difference in the respiratory quotient was 0.02 ( P < 0.05 ) , and no significant differences existed in satiety score , food intake , or physical activity . Urine VMA was significantly different in the 12th week of the study ( P < 0.05 ) . We conclude that green tea can reduce body weight in obese Thai subjects by increasing energy expenditure and fat oxidation The aim of this study was to determine if the rates of lipolysis and the conversion of glycerol into glucose are higher during weight reduction with a ketogenic than a nonketogenic very-low-calorie diet ( VLCD ) . Sixteen obese women were r and omly assigned to consume either a ketogenic or nonketogenic 615-kcal/d diet for 28 days while confined to a metabolic ward . Glycerol and glucose rates of appearance ( Ras ) and the conversion of glycerol into glucose were measured before and after 14 and 28 days of treatment with a simultaneous , primed , constant infusion of U-[14C]-glycerol and 6-[3H]-glucose .  Resting energy expenditure ( REE ) and rates of substrate oxidation were measured by indirect calorimetry . Data were analyzed by repeated- measures ANOVA . There were no diet or time effects on the plasma glycerol concentration or glycerol Ra . There was a modest but significant time effect on the glucose Ra and on the conversion of glycerol into glucose when expressed as a percentage of the glycerol or glucose Ra . However , even after 28 days of treatment , the conversion of glycerol into glucose accounted for only 16 % and 58 % of glucose and glycerol Ras , respectively . At day 28 , plasma glucose and alanine concentrations were lower and the rate of protein oxidation was higher in the ketogenic than in the nonketogenic VLCD group . ( ABSTRACT TRUNCATED AT 250 WORDS OBJECTIVE To determine what effect diet-induced approximately 12 kg weight loss in combination with exercise training has on body composition and resting energy expenditure ( REE ) in premenopausal African-American ( AA ) and European-American ( EA ) women . METHODS AND PROCEDURES This study was a longitudinal , r and omized weight loss clinical intervention , with either aerobic ( AT ) , resistance ( RT ) , or no exercise training ( NT ) .  Forty-eight AA and forty-six EA premenopausal overweight ( BMI between 27 and 30 ) women underwent weight loss to a BMI < 25 .  Body composition ( densitometry ) , REE ( indirect calorimetry ) , maximal oxygen uptake ( VO2max ) , and muscular strength ( isometric elbow flexion ) were evaluated when subjects were in energy balance . RESULTS AA women lost less fat-free mass ( FFM , P < or=0.05 ) ( 47.0+/-4.6 to 46.9+/-5.0 kg ) than EA women ( 46.4+/-4.9 to 45.2+/-4.6 kg ) . Regardless of race , RT maintained FFM ( P < or=0.05 ) following weight loss ( 46.9+/-5.2 to 47.2+/-5.0 kg ) whereas AT ( 45.4+/-4.2 to 44.4+/-4.1 kg ) and NT ( 47.9+/-4.7 to 46.4+/-5.1 kg ) decreased FFM ( P < or=0.05 ) . Both AT and NT decreased in REE with weight loss but RT did not . Significant time by group interactions ( all P < or=0.05 ) for strength indicated that RT maintained strength and AT did not . DISCUSSION AA women lost less FFM than EA women during equivalent weight losses . However , following weight loss in both AA and EA , RT conserved FFM , REE , and strength fitness when compared to women who AT or did not train CONTEXT Weight loss elicits physiological adaptations relating to energy intake and expenditure that antagonize ongoing weight loss . OBJECTIVE To test whether dietary composition affects the physiological adaptations to weight loss , as assessed by resting energy expenditure . DESIGN , STUDY , AND PARTICIPANTS : A r and omized parallel- design study of 39 overweight or obese young adults aged 18 to 40 years who received an energy-restricted diet , either low-glycemic load or low-fat .  Participants were studied in the General Clinical Research Centers of the Brigham and Women 's Hospital and the Children 's Hospital , Boston , Mass , before and after 10 % weight loss . The study was conducted from January 4 , 2001 , to May 6 , 2003 . MAIN OUTCOME MEASURES Resting energy expenditure measured in the fasting state by indirect calorimetry , body composition by dual-energy x-ray absorptiometry , cardiovascular disease risk factors , and self-reported hunger . RESULTS Resting energy expenditure decreased less with the low-glycemic load diet than with the low-fat diet , expressed in absolute terms ( mean [ SE ] , 96 [ 24 ] vs 176 [ 27 ] kcal/d ; P = .04 ) or as a proportion ( 5.9 % [ 1.5 % ] vs 10.6 % [ 1.7 % ] ; P = .05 ) . Participants receiving the low-glycemic load diet reported less hunger than those receiving the low-fat diet ( P = .04 ) . Insulin resistance ( P = .01 ) , serum triglycerides ( P = .01 ) , C-reactive protein ( P = .03 ) , and blood pressure ( P = .07 for both systolic and diastolic ) improved more with the low-glycemic load diet . Changes in body composition ( fat and lean mass ) in both groups were very similar ( P = .85 and P = .45 , respectively ) . CONCLUSIONS Changes in dietary composition within prevailing norms can affect physiological adaptations that defend body weight . Reduction in glycemic load may aid in the prevention or treatment of obesity , cardiovascular disease , and diabetes mellitus The present study was performed to further investigate the adaptive component of thermogenesis that appears during prolonged energy restriction . Fifteen obese men and twenty obese women underwent a 15-week weight-loss programme .  During this programme , body weight and composition as well as resting energy expenditure ( REE ) were measured at baseline , after 2 and 8 weeks of energy restriction ( -2929 kJ/d ) and drug therapy ( or placebo ) , and finally 2 - 4 weeks after the end of the 15-week drug therapy and energy restriction intervention , when subjects were weight stable . Regression equations were established in a control population of the same age . These equations were then used to predict REE in obese men and women at baseline , after 2 and 8 weeks , as well as after the completion of the programme . In both men and women body weight and fat mass were significantly reduced in all cases ) while fat-free mass remained unchanged throughout the programme . At baseline , REE predicted from the regression equation was not 
    Output:
    
Men and women have a similar decrease in resting EE relative to weight loss except in the case of pharmacological interventions .
Short interventions also produced greater resting EE losses relative to weight loss