***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 criticism of R and omized Controlled Trials ( RCTs ) in primary care is that they lack external validity , participants being unrepresentative of the wider population . Our aim was to determine whether published primary care-based RCTs report information about how the study sample is assembled , and whether this is associated with RCT characteristics . Methods We review ed  RCTs published in four primary care journals in the years 2001–2004 . Main outcomes were : ( 1 ) eligibility fraction ( proportion eligible of those screened ) , ( 2 ) enrolment fraction ( proportion r and omised of those eligible ) , ( 3 ) recruitment fraction ( proportion of potential participants actually r and omised ) , and ( 4 ) number of patients needed to be screened ( NNS ) in order to r and omize one participant . Results A total of 148 RCTs were review ed . One hundred and three trials ( 70 % ) reported the number of individuals assessed by investigators for eligibility , 119 ( 80 % ) reported the number eligible for participation , and all reported the actual number recruited . The median eligibility fraction was 83 % ( IQR 40 % to 100 % ) , and the median enrolment fraction was 74 % ( IQR 49 % to 92 % ) . The median NNS was 2.43 , with some trials reportedly recruiting every patient or practice screened for eligibility , and one trial screening 484 for each patient recruited . We found no association between NNS and journal , trial size , multi- or single-centre , funding source or type of intervention . There may be associations between provision of sufficient recruitment data for the calculation of NNS and funding source and type of intervention . Conclusion RCTs reporting recruitment data in primary care suggest that once screened for eligibility and found to match inclusion criteria patients are likely to be r and omized . This finding needs to be treated with caution as it may represent inadequate identification or reporting of the eligible population . A substantial minority of RCTs did not provide sufficient information about the patient recruitment process The transition to college has been identified as a critical period for increases in overweight status . Overweight college students are at-risk of becoming obese adults , and , thus prevention efforts targeting college age individuals are key to reducing adult obesity rates . The current study evaluated an Internet intervention with first year college students ( N=170 ) r and omly assigned to one of four treatment conditions : 1 ) no treatment , 2 ) 6-week online intervention 3 ) 6-week weight and caloric feedback only ( via email ) , and 4 ) 6-week combined feedback and online intervention . The combined intervention group had lower BMI s at post-testing than the other three groups . This study demonstrated the effectiveness and feasibility of an online intervention to prevent weight gain among college students This study examines the combined effects of caloric restriction on body composition , blood lipid , and satiety in slightly overweight women by varying food density and aerobic exercise .  Twenty-three women were r and omly assigned to one of two groups for a four-week weight management program : the high-energy density diet plus exercise ( HDE : n = 12 , 22 ± 2 yrs , 65 ± 7 kg , 164 ± 5 cm , 35 ± 4 % fat ) and low-energy density diet plus exercise ( LDE : n = 11 , 22 ± 1 yrs , 67 ± 7 kg , 161 ± 2 cm , 35 ± 4 % fat ) groups . Subjects maintained a low-calorie diet ( 1,500 kcal/day ) during the program . Isocaloric ( 483 ± 26 for HDE , 487 ± 27 kcal for LDE ) but different weight ( 365 ± 68 for HDE , 814 ± 202 g for LDE ) of lunch was provided . After lunch , they biked at 60 % of maximum capacity for 40 minutes , five times per week . The hunger level was scaled ( 1 : extremely hungry ; 9 : extremely full ) at 17:30 each day . Before and after the program , the subjects ' physical characteristics were measured , and fasting blood sample s were drawn . The daily energy intake was 1,551 ± 259 for HDE and 1,404 ± 150 kcal for LDE ( P > 0.05 ) . After four weeks , the subjects ' weights and % fat decreased for both LDE ( -1.9 kg and -1.5 % , P < 0.05 ) and HDE ( -1.6 kg and -1.4 % , respectively , P < 0.05 ) . The hunger level was significantly higher for HDE ( 2.46 ± 0.28 ) than for LDE ( 3.10 ± 0.26 ) ( P < 0.05 ) . The results suggest that a low-energy density diet is more likely to be tolerated than a high-energy density diet for a weight management program combining a low-calorie diet and exercise , mainly because of a reduced hunger sensation Aim : The aim of the study was to develop and implement an obesity and weight gain prevention program targeted to a high-risk group . Method : Women , 18–28 years old , with at least one severely obese parent , were r and omized to the intervention or control group of the ‘ Health Hunters ’ program .  During 1 year of follow-up , the intervention group received an individualized behavioral program focusing on food choice , physical activity and other lifestyle factors . Anthropometric measures , DXA-based body composition and fitness levels were measured at baseline and after 1 year . Self-reported changes in obesity-related behaviors were also assessed . Results : Baseline examinations were conducted in 40 women , of whom 30 completed follow-up examinations 1 year later . Pregnancy was the most common reason for failure to complete the study . Compared to the control group ( which gained weight ) , the intervention group displayed significant improvements in body weight , body mass index , waist circumference , waist-to-hip ratio and self-reported physical activity . Changes in body composition , although not significant , suggested that the intervention tended to be associated with improved body composition . Further analysis of changes in diet and fitness in relation to concurrent weight changes indicated that the strongest ‘ protective ’ associations were for energy percent protein , fiber density and fitness . Conclusion : Pilot data from the Health Hunters obesity prevention program indicates that it is effective in high-risk young women with familial predisposition for obesity OBJECTIVE This paper describes the design and findings of a pilot Mothers In Motion ( P-MIM ) program . DESIGN A r and omized controlled trial that collected data via telephone interviews and finger stick at 3 time points : baseline and 2 and 8 months post-intervention . SETTING Three Special Supplemental Nutrition Program for Women , Infants , and Children ( WIC ) sites in southern Michigan . PARTICIPANTS One hundred and twenty nine overweight and obese African-American and white mothers , 18 - 34 years old . INTERVENTION The 10-week , theory-based , culturally sensitive intervention messages were delivered via a series of 5 chapters on a DVD and complemented by 5 peer support group teleconferences . MAIN OUTCOME MEASURES Dietary fat , fruit , and vegetable intake ; physical activity ; stress ; feelings ; body weight ; and blood glucose . ANALYSIS General linear mixed model was applied to assess treatment effects across 2 and 8 months post-intervention . RESULTS No significant effect sizes were found in primary and secondary outcome variables at 2 and 8 months post-intervention . However , changes in body weight and blood glucose showed apparent trends consistent with the study 's hypotheses . CONCLUSIONS AND IMPLICATION S The P-MIM showed promise for preventing weight gain in low-income overweight and obese women . However , a larger experimental trial is warranted to determine the effectiveness of this intervention Background The literature on changes in health-related quality of life ( HRQOL ) in weight loss studies is inconsistent , and few studies use more than one type of measure . The purpose of the current study was to compare one-year changes in HRQOL as a function of weight change using three different measures : a weight-related measure ( Impact of Weight on Quality of Life-Lite [ IWQOL-Lite ) ] ) and two generic measures ( SF-36 ; EQ-5D ) . Methods Data were obtained from 926 participants ( mean Body Mass Index ( BMI ) ( kg/m2 ) = 35.4 ; 84 % female ; mean age = 49.5 years ) in a placebo-controlled r and omized trial for weight loss . At baseline and one-year , participants completed all three HRQOL measures . HRQOL was compared across weight change categories ( ≥ 5 % and 0–4.9 % gain , 0–4.9 % , 5.0–9.9 % and ≥ 10 % loss ) , using effect sizes . Results The weight-related measure of HRQOL exhibited greater improvements with one-year weight loss than either of the generic instruments , with effect sizes ranging from 0.24 to 0.62 for 5–9.9 % weight reductions and 0.44 to 0.95 for ≥ 10 % reductions . IWQOL-Lite Self-Esteem also showed a small improvement with weight gain . Changes in the two generic measures of HRQOL were inconsistent with each other , and in the case of the SF-36 , variable across domains . For participants gaining ≥ 5 % of weight , the greatest reductions in HRQOL occurred with respect to SF-36 Mental Health , MCS , and Vitality , with effect sizes of -0.82 , -0.70 , and -0.63 respectively . Conclusion This study found differences between weight-related and generic measures of health-related quality of life in a one-year weight loss trial , reflecting the potential value of using more than one measure in a trial . Although weight loss was generally associated with improved IWQOL-Lite , physical SF-36 subscale and EQ-5D scores , a small amount of weight gain was associated with a slight improvement on weight-specific HRQOL and almost no change on the EQ-5D , suggesting the need for further research to more fully study these relationships . We believe our findings have relevance for weight loss patients and obesity clinicians/ research ers in informing them of likely HRQOL outcomes associated with varying amounts of weight loss or gain PURPOSE To describe the theoretical rationale , intervention design , and clinical trial of a two-year weight control intervention for young adults deployed via social and mobile media . METHODS A total of 404 overweight or obese college students from three Southern California universities ( M(age ) = 22 ( ± 4 ) years ; M ( BMI ) = 29 ( ± 2.8 ) ; 70 % female ) were r and omized to participate in the intervention or to receive an informational web-based weight loss program . The intervention is based on behavioral theory and integrates intervention elements across multiple touch points , including Facebook , text messaging , smartphone applications , blogs , and e-mail . Participants are encouraged to seek social support among their friends , self-monitor their weight weekly , post their health behaviors on Facebook , and e-mail their weight loss questions /concerns to a health coach . The intervention is adaptive because new theory-driven and iteratively tailored intervention elements are developed and released over the course of the two-year intervention in response to patterns of use and user feedback . Measures of body mass index , waist circumference , diet , physical activity , sedentary behavior , weight management practice s , smoking , alcohol , sleep , body image , self-esteem , and depression occur at 6 , 12 , 18 , and 24 months . Currently , all participants have been recruited , and all are in the final year of the trial . CONCLUSION Theory-driven , evidence -based strategies for physical activity , sedentary behavior , and dietary intake can be embedded in an intervention using social and mobile technologies to promote healthy weight-related behaviors in young adults Exercise is recommended by public health agencies for weight management ; however , the role of exercise is generally considered secondary to energy restriction . Few studies exist that have verified completion of exercise , measured the energy expenditure of exercise , and prescribed exercise with equivalent energy expenditure across individuals and genders . Objective The objective of this study was to evaluate aerobic exercise , without energy restriction , on weight loss in sedentary overweight and obese men and women . Design and Methods This investigation was a r and omized , controlled , efficacy trial in 141 overweight and obese participants ( body mass index , 31.0 ± 4.6 kg/m2 ; age 22.6 ± 3.9 years ) . Participants were r and omized ( 2:2:1 ratio ) to exercise at either 400 kcal/session or 600 kcal/session or to a non-exercise control . Exercise was supervised , 5 days/week , for 10 months . All participants were instructed to maintain usual ad libitum diets . Due to the efficacy design , completion of ≥ 90 % of exercise sessions was an a priori definition of per protocol , and these participants were included in the analysis . Results Weight loss from baseline to 10 months for the 400 and 600 kcal/session groups was 3.9 ± 4.9 kg ( 4.3 % ) and 5.2 ± 5.6 kg ( 5.7 % ) , respectively compared to weight gain for controls of 0.5 ± 3.5 kg ( 0.5 % ) ( p<0.05 ) . Differences for weight loss from baseline to 10 months between the exercise groups and differences between men and women within groups were not statistically significant . Conclusions Supervised exercise , with equivalent energy expenditure , results in clinical ly significant weight loss with no significant difference between men and women OBJECTIVE To conduct a prospect i ve , longitudinal study examining weight fluctuation and its predictors before and during the first year of college . DESIGN Men ( n = 266 ) and women ( n = 341 ) enrolled at Dartmouth College 
    Output:
    
Over half of the studies were effective in the short term for significantly reducing body weight and /or BMI ; however , few showed long-term maintenance .