***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: Objectives To investigate the association between long term intake of individual saturated fatty acids ( SFAs ) and the  risk of coronary heart disease  , in two large cohort studies . Design Prospect i ve , longitudinal cohort study . Setting Health professionals in the United States . Participants 73 147 women in the Nurses ’ Health Study ( 1984 - 2012 ) and 42 635 men in the Health Professionals Follow-up Study ( 1986 - 2010 ) , who were free of major chronic diseases at baseline . Main outcome measure Incidence of coronary heart disease ( n=7035 ) was self-reported , and related deaths were identified by search ing National Death Index or through report of next of kin or postal authority . Cases were confirmed by medical records review . Results Mean intake of SFAs  accounted for 9.0 - 11.3 % energy intake over time , and was mainly composed of lauric acid ( 12:0 ) , myristic acid ( 14:0 ) , palmitic acid ( 16:0 ) , and stearic acid ( 18:0 ; 8.8 - 10.7 % energy ) . Intake of 12:0 , 14:0 , 16:0 and 18:0 were highly correlated , with Spearman correlation coefficients between 0.38 and 0.93 ( all P<0.001 ) . Comparing the highest to the lowest groups of individual SFA intakes , hazard ratios of coronary heart disease were 1.07 ( 95 % confidence interval 0.99 to 1.15 ; Ptrend=0.05 ) for 12:0 , 1.13 ( 1.05 to 1.22 ; Ptrend<0.001 ) for 14:0 , 1.18 ( 1.09 to 1.27 ; Ptrend<0.001 ) for 16:0 , 1.18 ( 1.09 to 1.28 ; Ptrend<0.001 ) for 18:0 , and 1.18 ( 1.09 to 1.28 ; Ptrend<0.001 ) for all four SFAs combined ( 12:0 - 18:0 ) , after multivariate adjustment of lifestyle factors and total energy intake . Hazard ratios of coronary heart disease for isocaloric replacement of 1 % energy from 12:0 - 18:0 were 0.92 ( 95 % confidence interval 0.89 to 0.96 ; P<0.001 ) for polyunsaturated fat , 0.95 ( 0.90 to 1.01 ; P=0.08 ) for monounsaturated fat , 0.94 ( 0.91 to 0.97 ; P<0.001 ) for whole grain carbohydrates , and 0.93 ( 0.89 to 0.97 ; P=0.001 ) for plant proteins . For individual SFAs , the lowest risk of coronary heart disease was observed when the most abundant SFA , 16:0 , was replaced . Hazard ratios of coronary heart disease for replacing 1 % energy from 16:0 were 0.88 ( 95 % confidence interval 0.81 to 0.96 ; P=0.002 ) for polyunsaturated fat , 0.92 ( 0.83 to 1.02 ; P=0.10 ) for monounsaturated fat , 0.90 ( 0.83 to 0.97 ; P=0.01 ) for whole grain carbohydrates , and 0.89 ( 0.82 to 0.97 ; P=0.01 ) for plant proteins . Conclusions Higher dietary intakes of major SFAs are associated with an increased risk of coronary heart disease . Owing to similar associations and high correlations among individual SFAs , dietary recommendations for the prevention of coronary heart disease should continue to focus on replacing total saturated fat with more healthy sources of energy BACKGROUND The high consumption of low-fat and nonfat dairy products is associated with reduced risk of high blood pressure . OBJECTIVE We aim ed to investigate whether the solitary addition of nonfat dairy products to the normal routine diet was capable of lowering blood pressure in middle-aged and older adults with elevated blood pressure . DESIGN With the use of a r and omized , crossover intervention- study design , 49 adults ( 56 % women ) with elevated blood pressure ( mean ± SEM age : 53 ± 2 y ; systolic blood pressure : 135 ± 1 ; diastolic blood pressure : 80 ± 1 mm Hg ) underwent a high-dairy condition ( + 4 servings conventional nonfat dairy products/d ) and isocaloric no-dairy condition ( + 4 servings fruit products/d ) in which all dairy products were removed . Both dietary conditions lasted 4 wk with a 2-wk washout before crossing over into the alternate condition . RESULTS The high-dairy condition produced reductions in systolic blood pressure ( 135 ± 1 to 127 ± 1 mm Hg ) and pulse pressure ( 54 ± 1 to 48 ± 1 mm Hg ) ( both P < 0.05 ) . The hypotensive effects were observed within 3 wk after the initiation of the dietary intervention and in both casual seated and ambulatory ( 24-h ) measurements ( P < 0.05 ) . Pulse pressure was increased after the removal of all dairy products in the no-dairy condition ( 54 ± 1 to 56 ± 1 mm Hg ; P < 0.05 ) . There were no changes in diastolic blood pressure after either dietary condition . CONCLUSION We concluded that the solitary manipulation of conventional dairy products in the normal routine diet would modulate blood pressure in middle-aged and older adults with prehypertension and hypertension . This trial was registered at clinical trials.gov as NCT01577030 BACKGROUND AND AIMS The prevalence of type 2 diabetes ( T2DM ) is increasing . Several studies have suggested a beneficial effect of several major dairy nutrients on insulin production and sensitivity . Conversely , harmful effects have been suggested as well . This study aim ed to investigate the impact of the full-range of dairy products and its association with incidence T2DM in Dutch adults aged ≥55 years participating in the Rotterdam Study . METHODS AND RESULTS  Dairy intake was assessed with a vali date d FFQ , including total , skimmed , semi-skimmed , full-fat , fermented , and non-fermented dairy , and subclasses of these product groups . Verified prevalent and incident diabetes were documented . Cox proportional hazards regression and spline regression were used to analyse data , adjusting for age , sex , alcohol , smoking , education , physical activity , body mass index , intake of total energy , energy-adjusted meat , and energy-adjusted fish intake . Median total dairy intake was 398 g/day ( IQR 259 - 559 g/day ) . Through 9.5 ± 4.1 years of follow-up , 393 cases of incident T2DM were reported . Cox and spline regression did not point towards associations of total dairy consumption , dairy consumption based on fat content , non-fermented or fermented dairy consumption , or individual dairy product consumption with incident T2DM . The HR for total dairy intake and T2DM was 0.93 ( 95 % CI : 0.70 - 1.23 ) in the upper quartile ( P-for trend 0.76 ) . CONCLUSIONS This prospect i ve cohort study did not point towards an association between dairy consumption and T2DM The association between consumption of full-fat dairy foods and CVD may depend partly on the nature of products and may not apply to low-fat dairy foods . Increased circulating levels of inflammatory biomarkers after consumption of dairy product-rich meals suggest an association with CVD . In the present study , we tested the effects of low-fat and full-fat dairy diets on biomarkers associated with inflammation , oxidative stress or atherogenesis and on plasma lipid classes . Within full-fat dairy diets , we also compared fermented v. non-fermented products . In a r and omised cross-over study , twelve overweight/obese subjects consumed during two 3-week periods two full-fat dairy diets containing either yogurt plus cheese ( fermented ) or butter , cream and ice cream ( non-fermented ) or a low-fat milk plus yogurt diet , with the latter being consumed between and at the end of the full-fat dairy dietary periods . The concentrations of six inflammatory and two atherogenic biomarkers known to be raised in CVD were measured as well as those of plasma F2-isoprostanes and lipid classes . The concentrations of six of the eight biomarkers tended to be higher on consumption of the low-fat dairy diet than on that of the fermented dairy diet and the concentrations of two plasmalogen lipid classes reported to be associated with increased oxidisability were also higher on consumption of the low-fat dairy diet than on that of the fermented dairy diet ( P < 0.001 ) , although plasma F2-isoprostane concentrations did not differ on consumption of any of the diets . On the other h and , the concentrations of plasma sphingomyelin and IL-6 were significantly higher on consumption of the non-fermented dairy diet than on that of the low-fat dairy diet ( P < 0.02 ) . In conclusion , short-term diets containing low-fat dairy products did not lead to a more favourable biomarker profile associated with CVD risk compared with the full-fat dairy products , suggesting that full-fat fermented dairy products may be the more favourable BACKGROUND & AIMS Nonalcoholic fatty liver disease ( NAFLD ) is associated with increased risk of hepatic , cardiovascular , and metabolic diseases . High-protein diets , rich in methionine and branched chain amino acids ( BCAAs ) , apparently reduce liver fat , but can induce insulin resistance . We investigated the effects of diets high in animal protein ( AP ) vs plant protein ( PP ) , which differ in levels of methionine and BCAAs , in patients with type 2 diabetes and NAFLD . We examined levels of liver fat , lipogenic indices , markers of inflammation , serum levels of fibroblast growth factor 21 ( FGF21 ) , and activation of signaling pathways in adipose tissue . METHODS We performed a prospect i ve study of individuals with type 2 diabetes and NAFLD at a tertiary medical center in Germany from June 2013 through March 2015 . We analyzed data from 37 subjects placed on a diet high in AP ( rich in meat and dairy foods ; n = 18 ) or PP ( mainly legume protein ; n = 19 ) without calorie restriction for 6 weeks . The diets were isocaloric with the same macronutrient composition ( 30 % protein , 40 % carbohydrates , and 30 % fat ) . Participants were examined at the start of the study and after the 6-week diet period for body mass index , body composition , hip circumference , resting energy expenditure , and respiratory quotient . Body fat and intrahepatic fat were detected by magnetic resonance imaging and spectroscopy , respectively . Levels of glucose , insulin , liver enzymes , and inflammation markers , as well as individual free fatty acids and free amino acids , were measured in collected blood sample s. Hyperinsulinemic euglycemic clamps were performed to determine whole-body insulin sensitivity . Subcutaneous adipose tissue sample s were collected and analyzed for gene expression patterns and phosphorylation of signaling proteins . RESULTS Postpr and ial levels of BCAAs and methionine were significantly higher in subjects on the AP vs the PP diet . The AP and PP diets each reduced liver fat by 36%-48 % within 6 weeks ( for AP diet P = .0002 ; for PP diet P = .001 ) . These reductions were unrelated to change in body weight , but correlated with down-regulation of lipolysis and lipogenic indices . Serum level of FGF21 decreased by 50 % in each group ( for AP diet P < .0002 ; for PP diet P < .0002 ) ; decrease in FGF21 correlated with loss of hepatic fat . In gene expression analyses of adipose tissue , expression of the FGF21 receptor cofactor β-klotho was associated with reduced expression of genes encoding lipolytic and lipogenic proteins . In patients on each diet , levels of hepatic enzymes and markers of inflammation decreased , insulin sensitivity increased , and serum level of keratin 18 decreased . CONCLUSIONS In a prospect i ve study of patients with type 2 diabetes , we found diets high in protein ( either animal or plant ) significantly reduced liver fat independently of body weight , and reduced markers of insulin resistance and hepatic necroinflammation . The diets appear to mediate these changes via lipolytic and lipogenic pathways in adipose tissue . Negative effects of BCAA or methionine were not detectable . FGF21 level appears to be a marker of metabolic improvement . Clinical Trials.gov ID NCT02402985 BACKGROUND Dairy product intake may be inversely associated with risk of type 2 diabetes  , 
    Output:
    
In fact , the weight of evidence from recent large and well-controlled studies , systematic review s , and meta-analyses of both observational studies and r and omized controlled trials indicates that full-fat dairy products , particularly yogurt and cheese , do not exert the detrimental effects on insulin sensitivity , blood lipid profile , and blood pressure as previously predicted on the basis of their sodium and saturated fat contents ; they do not increase cardiometabolic disease risk and may in fact protect against cardiovascular disease and type 2 diabetes .