***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 
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    ***EXAMPLES*** 
    Input: The study was carried out in 10 females with type 2 diabetes aged 32 - 60 yrs . All of them were receiving weight-maintaining diets composed of 12 per cent protein , 30 per cent fat and 58 per cent carbohydrate . The only difference among all study -diets was the types of complex carbohydrate used . High-glycemic diet ( HG ) or low glycemic diet ( LG ) consisted mainly of glutinous rice or mungbean noodles and the intermediate-glycemic diet ( DM ) was solely white rice . After the metabolic evaluation of the baseline diet ( BL ) , each subject was placed on DM and followed r and omly by HG and LG or vice versa for 4 weeks each . The diurnal plasma glucose levels tended to be lowest after LG . The integrated plasma glucose levels among all diets were not different . The integrated insulin levels after DM and LG did not differ but they were lower than HG and BL . Long-term ingestion of all test-diets spilt less urinary glucose than BL , the lowest was LG . HbA1 levels and nitrogen balance after all diets were better than BL , the best was LG . It was concluded that in addition to strict dietary control , ingestion of mungbean noodles ( a low glycemic diet ) without increasing fiber intake , can improve diabetic control and protein conservation in type 2 diabetes BACKGROUND Results of 6-wk studies suggest that high-carbohydrate diets are deleterious for people with type 2 diabetes . OBJECTIVE Our objective was to see whether long-term replacement of dietary monounsaturated fatty acids ( MUFAs ) with carbohydrate from breakfast cereals with either a high or a low glycemic index ( GI ) affected blood glucose and lipids in subjects with type 2 diabetes . DESIGN Subjects with type 2 diabetes ( n = 91 ) were r and omly assigned to receive approximately 10 % of energy from a low-GI breakfast cereal , a high-GI cereal , or oil or margarine containing MUFA for 6 mo . Eating breakfast cereal was prohibited for subjects in the MUFA group . RESULTS Seventy-two subjects completed the trial . The subjects who received cereals consumed approximately 10 % more energy from carbohydrate than did the subjects in the MUFA group . Changes in glycated hemoglobin , body weight , and fasting cholesterol and triacylglycerol did not differ significantly among groups . HDL cholesterol increased by approximately 10 % in the MUFA group compared with subjects who consumed either high- or low-GI cereals ( P = 0.002 ) . The ratio of total to HDL cholesterol was higher in the subjects who consumed the high-GI cereal than in the MUFA group at 3 mo but not at 6 mo ( diet x time interaction , P = 0.041 ) . During 8-h metabolic profiles , mean plasma insulin was higher and mean free fatty acids were lower in the 2 cereal groups than in the MUFA group ( P < 0.05 ) . CONCLUSIONS A 10 % increase in carbohydrate intake associated with breakfast cereal consumption had no deleterious effects on glycemic control or blood lipids over 6 mo in subjects with type 2 diabetes . The increase in plasma insulin and the reduction in free fatty acids associated with higher carbohydrate intake may reduce the rate of progression of diabetes BACKGROUND Little is known about the effects of the amount and type of carbohydrates on risk of coronary heart disease ( CHD ) .  OBJECTIVE The objective of this study was to prospect ively evaluate the relations of the amount and type of carbohydrates with risk of CHD . DESIGN A cohort of 75521 women aged 38 - 63 y with no previous diagnosis of diabetes mellitus , myocardial infa rct ion , angina , stroke , or other cardiovascular diseases in 1984 was followed for 10 y. Each participant 's dietary glycemic load was calculated as a function of glycemic index , carbohydrate content , and frequency of intake of individual foods reported on a vali date d food-frequency question naire at baseline . All dietary variables were up date d in 1986 and 1990 . RESULTS During 10 y of follow-up ( 729472 person-years ) , 761 cases of CHD ( 208 fatal and 553 nonfatal ) were documented . Dietary glycemic load was directly associated with risk of CHD after adjustment for age , smoking status , total energy intake , and other coronary disease risk factors . The relative risks from the lowest to highest quintiles of glycemic load were 1.00 , 1.01 , 1 . 25 , 1.51 , and 1.98 ( 95 % CI : 1.41 , 2.77 for the highest quintile ; P for trend < 0.0001 ) . Carbohydrate classified by glycemic index , as opposed to its traditional classification as either simple or complex , was a better predictor of CHD risk . The association between dietary glycemic load and CHD risk was most evident among women with body weights above average ¿ ie , body mass index ( in kg/m(2 ) ) > /= 23 . CONCLUSION These epidemiologic data suggest that a high dietary glycemic load from refined carbohydrates increases the risk of CHD , independent of known coronary disease risk factors The influence of dietary carbohydrate types on insulin action and muscle substrates was investigated . Seven healthy young men ingested two isoenergetic diets with 46 - 47 % of energy as carbohydrates , 41 % as fat , and 13 - 14 % as protein , in which the carbohydrates either had a high glycemic index ( HGI ) or a low glycemic index ( LGI ) for 30 d , two times in a r and omized crossover design . A euglycemic hyperinsulinemic clamp procedure was performed at the end of each dietary period . Whole-body glucose uptake was similar with both diets at a low plasma insulin concentration ( 370 pmol/L ) but decreased ( P < 0.05 ) at a high insulin concentration ( 2.4 nmol/L ) with the LGI diet compared with the HGI diet . Higher plasma fatty acid concentrations during part of the day were found with the LGI diet compared with the HGI diet ( P < 0.05 ) . Initially , blood glucose and plasma insulin concentrations were lower ( P < 0.05 ) during part of the day with the LGI than with the HGI diet , but after 30 d of the diet this difference diminished . Muscle glycogen and triacylglycerol concentrations were increased ( P < 0.05 ) by 14 % and 22 % , respectively , with the HGI diet compared with the LGI diet , and muscle triacylglycerol concentrations did not correlate with insulin action . It is concluded that when ingesting a diet with an energy composition common in Western countries , switching the carbohydrates from high to low GI sources decreases insulin action on whole-body glucose disposal at a high but not at a physiologic plasma insulin concentration . Furthermore , adaptation in terms of carbohydrate digestion and /or absorption to a diet rich in LGI carbohydrates may take place over 4 wk BACKGROUND The concept of a body weight set point , determined predominantly by genetic mechanisms , has been proposed to explain the poor long-term results of conventional energy-restricted diets in the treatment of obesity . OBJECTIVE The objective of this study was to examine whether dietary composition affects hormonal and metabolic adaptations to energy restriction . DESIGN A r and omized , crossover design was used to compare the effects of a high-glycemic-index ( high-GI ) and a low-glycemic-index ( low-GI ) energy-restricted diet . The macronutrient composition of the high-GI diet was ( as percent of energy ) 67 % carbohydrate , 15 % protein , and 18 % fat and that of the low-GI diet was 43 % carbohydrate , 27 % protein , and 30 % fat ; the diets had similar total energy , energy density , and fiber contents . The subjects , 10 moderately overweight young men , were studied for 9 d on 2 separate occasions . On days -1 to 0 , they consumed self-selected foods ad libitum . On days 1 - 6 , they received an energy-restricted high- or low-GI diet . On days 7 - 8 , the high- or low-GI diets were consumed ad libitum . RESULTS Serum leptin decreased to a lesser extent from day 0 to day 6 with the high-GI diet than with the low-GI diet . Resting energy expenditure declined by 10.5 % during the high-GI diet but by only 4.6 % during the low-GI diet ( 7.38 + /- 0.39 and 7.78 + /- 0.36 MJ/d , respectively , on days 5 - 6 ; P = 0.04 ) . Nitrogen balance tended to be more negative , and energy intake from snacks on days 7 - 8 was greater , with the high-GI than the low-GI diet . CONCLUSION Diets with identical energy contents can have different effects on leptin concentrations , energy expenditure , voluntary food intake , and nitrogen balance , suggesting that the physiologic adaptations to energy restriction can be modified by dietary composition BACKGROUND The role of glycemic index ( GI ) in appetite and body-weight regulation is still not clear . OBJECTIVE The objective of the study was to investigate the long-term effects of a low-fat , high-carbohydrate diet with either low glycemic index ( LGI ) or high glycemic index ( HGI ) on ad libitum energy intake , body weight , and composition , as well as on risk factors for type 2 diabetes and ischemic heart disease in overweight healthy subjects . DESIGN The study was a 10-wk parallel , r and omized , intervention trial with 2 matched groups . The LGI or HGI test foods , given as replacements for the subjects ' usual carbohydrate-rich foods , were equal in total energy , energy density , dietary fiber , and macronutrient composition . Subjects were 45 ( LGI diet : n = 23 ; HGI diet : n = 22 ) healthy overweight [ body mass index ( in kg/m(2 ) ) : 27.6 + /- 0.2 ] women aged 20 - 40 y. RESULTS Energy intake , mean ( + /- SEM ) body weight ( LGI diet : -1.9 + /- 0.5 kg ; HGI diet : -1.3 + /- 0.3 kg ) , and fat mass ( LGI diet : -1.0 + /- 0.4 kg ; HGI diet : -0.4 + /- 0.3 kg ) decreased over time , but the differences between groups were not significant . No significant differences were observed between groups in fasting serum insulin , homeostasis model assessment for relative insulin resistance , homeostasis model assessment for beta cell function , triacylglycerol , nonesterified fatty acids , or HDL cholesterol . However , a 10 % decrease in LDL cholesterol ( P < 0.05 ) and a tendency to a larger decrease in total cholesterol ( P = 0.06 ) were observed with consumption of the LGI diet as compared with the HGI diet . CONCLUSIONS This study does not support the contention that low-fat LGI diets are more beneficial than HGI diets with regard to appetite or body-weight regulation as evaluated over 10 wk . However , it confirms previous findings of a beneficial effect of LGI diets on risk factors for ischemic heart disease Eight patients with noninsulin-dependent diabetes underwent two 2-wk study periods in r and om order during which they were provided with carbohydrate foods with either a high or low glycemic index ( GI ) . Over both high-GI and low-GI periods there were significant reductions in body weight , serum fructosamine , and cholesterol . Reductions in fasting blood glucose , HbA1c , and urinary c-peptide-to-creatinine ratio were significant only over the low-GI period despite a smaller mean weight loss . Reductions in triglyceride were significant only over the high-GI diet . Inclusion of low-GI foods into diets of patients with diabetes may be an additional measure that favorably influences carbohydrate metabolism without increasing insulin dem and The determine the effect of different foods on the blood glucose , 62 commonly eaten foods and sugars were fed individually to groups of 5 to 10 healthy fasting volunteers .  Blood glucose levels were measured over 2 h , and expressed as a percentage of the area under the glucose response curve when the same amount of carbohydrate was taken as glucose . The largest rises were seen with vegetables ( 70 + /- 5 % ) , followed by breakfast cereals ( 65 + /- 5 % ) , cereals and biscuits ( 60 + /- 3 % ) , 
    Output:
    
Falling trends in energy , available carbohydrate , and protein intakes then occurred with progressive reductions in GI .
Fat intake was essentially unchanged .
Among GI studies , observed reductions in glycemic load are most often not solely due to substitution of high for low glycemic carbohydrate foods .