***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 BACKGROUND Studies of weight-control diets that are high in protein or low in glycemic index have reached varied conclusions , probably owing to the fact that the studies had insufficient power . METHODS We enrolled overweight adults from eight European countries who had lost at least 8 % of their initial body weight with a 3.3-MJ ( 800-kcal ) low-calorie diet .  Participants were r and omly assigned , in a two-by-two factorial design , to one of five ad libitum diets to prevent weight regain over a 26-week period : a low-protein and low-glycemic-index diet , a low-protein and high-glycemic-index diet , a high-protein and low-glycemic-index diet , a high-protein and high-glycemic-index diet , or a control diet . RESULTS A total of 1209 adults were screened ( mean age , 41 years ; body-mass index [ the weight in kilograms divided by the square of the height in meters ] , 34 ) , of whom 938 entered the low-calorie-diet phase of the study . A total of 773 participants who completed that phase were r and omly assigned to one of the five maintenance diets ; 548 completed the intervention ( 71 % ) . Fewer participants in the high-protein and the low-glycemic-index groups than in the low-protein-high-glycemic-index group dropped out of the study ( 26.4 % and 25.6 % , respectively , vs. 37.4 % ; P=0.02 and P=0.01 for the respective comparisons ) . The mean initial weight loss with the low-calorie diet was 11.0 kg . In the analysis of participants who completed the study , only the low-protein-high-glycemic-index diet was associated with subsequent significant weight regain ( 1.67 kg ; 95 % confidence interval [ CI ] , 0.48 to 2.87 ) . In an intention-to-treat analysis , the weight regain was 0.93 kg less ( 95 % CI , 0.31 to 1.55 ) in the groups assigned to a high-protein diet than in those assigned to a low-protein diet ( P=0.003 ) and 0.95 kg less ( 95 % CI , 0.33 to 1.57 ) in the groups assigned to a low-glycemic-index diet than in those assigned to a high-glycemic-index diet ( P=0.003 ) . The analysis involving participants who completed the intervention produced similar results . The groups did not differ significantly with respect to diet-related adverse events . CONCLUSIONS In this large European study , a modest increase in protein content and a modest reduction in the glycemic index led to an improvement in study completion and maintenance of weight loss . ( Funded by the European Commission ; Clinical Trials.gov number , NCT00390637 . ) Abstract Purpose To test the effect of three diets in their ability to sustain weight loss and improve type 2 diabetes ( T2D ) and cardiovascular disease ( CVD ) risk markers after 18-month intervention . Methods Following a ≥8 % weight loss , 131 healthy , overweight/obese ( BMI ± SD 31.5 ± 2.6 kg/m2 ) men ( n = 55 ) and women ( n = 76 ) aged 28.2 ± 4.8 years were r and omized to either 1 . Moderate fat ( 40 E% ) with 20 E% MUFA and low in glycemic index ( GI ) ( MUFA , n = 54 ) , 2 . Low fat ( 25 E% ) and medium in GI ( LF , n = 51 ) or 3 . Control ( 35 E% fat ) and high in GI ( CTR , n = 26 ) all with similar protein content , and all provided ad libitum . First 6-month intervention with 100 % food provision ( previously reported ) following 12 months of moderately intensive intervention with 20 % food provision now reported . Results Attrition rate was higher in MUFA ( 63 % ) than in LF ( 37 % , P = 0.019 ) and CTR ( 42 % , P = 0.09 ) group . Weight regain in completers was not different between groups ( mean ± SEM ) , MUFA 7.1 ± 2.1 % versus LF 5.6 ± 1.3 % versus CTR 7.2 ± 1.5 % , nor was body fat regain , MUFA 4.8 ± 1.0 % versus LF 4.7 ± 0.8 % versus CTR 5.7 ± 0.6 % . The MUFA group reduced LDL/HDL ratio by −0.47 ± 0.09 compared with −0.23 ± 0.11 in LF ( P < 0.05 ) and 0.06 ± 0.14 ( P < 0.005 ) in CTR groups . Conclusions Weight regain or body composition did not differ between diets over 18 months . No effects on risk markers for T2D or CVD were found , with the exception of an improvement in the LDL/HDL ratio by the MUFA diet compared to the CTR diet . The LF diet was generally more satisfactory and the MUFA diet seemed more difficult to follow Weight regain after successful weight loss is a big problem in obesity management . This study aim ed to investigate whether weight regain after a weight loss period is correlated with the macronutrient composition and /or the inflammatory index of the diet during that period . Sixty one overweight and obese adults participated in this experimental study . Subjects lost approximately 10 % of their initial weight by means of very low-calorie diet for five weeks , or a low calorie diet for 12 weeks . After that , subjects in both groups followed a strict weight maintenance diet based on individual needs for four weeks , which was followed by a nine-month weight maintenance period without dietary counseling .  Anthropometrics and dietary intake data were recorded before weight loss ( baseline ) and during the weight maintenance period . On average , participants regained approximately half of their lost weight . We found no evidence that macronutrient composition during the weight maintenance period was associated with weight regain . The dietary inflammatory index ( r = 0.304 , p = 0.032 ) was positively correlated with weight regain and remained significant after correction for physical activity ( r = 0.287 , p = 0.045 ) . Our data suggest that the inflammatory properties of diet play a role in weight regain after weight loss in overweight and obese adults BACKGROUND Conjugated linoleic acid ( CLA ) is marketed as a safe , simple , and effective dietary supplement to promote the loss of body fat and weight . However , most previous studies have been of short duration and inconclusive , and some recent studies have question ed the safety of long-term supplementation with CLA . OBJECTIVE Our aim was to assess the effect of 1-y supplementation with CLA ( 3.4 g/d ) on body weight and body fat regain in moderately obese people . DESIGN One hundred twenty-two obese healthy subjects with a body mass index ( in kg/m2 ) > 28 underwent an 8-wk dietary run-in with energy restriction ( 3300 - 4200 kJ/d ) . One hundred one subjects who lost > 8 % of their initial body weight were subsequently r and omly assigned to a 1-y double-blind CLA ( 3.4 g/d ; n = 51 ) or placebo ( olive oil ; n = 50 ) supplementation regime in combination with a modest hypocaloric diet of -1250 kJ/d . The effects of treatment on body composition and safety were assessed with the use of dual-energy X-ray absorptiometry and with blood sample s and the incidence of adverse events , respectively . RESULTS After 1 y , no significant difference in body weight or body fat regain was observed between the treatments . The CLA group ( n = 40 ) regained a mean ( + /-SD ) 4.0 + /- 5.6 kg body weight and 2.1 + /- 5.0 kg fat mass compared with a regain of 4.0 + /- 5.0 kg body weight and 2.7 + /- 4.9 kg fat mass in the placebo group ( n = 43 ) . No significant differences in reported adverse effects or indexes of insulin resistance were observed , but a significant increase in the number of leukocytes was observed with CLA supplementation . CONCLUSION A 3.4-g daily CLA supplementation for 1 y does not prevent weight or fat mass regain in a healthy obese population The purpose of this study was to determine whether gamma-linolenate ( GLA ) supplementation would suppress weight regain following major weight loss . Fifty formerly obese humans were r and omized into a double-blind study and given either 890 mg/d of GLA ( 5 g/d borage oil ) or 5 g/d olive oil ( controls ) for 1 y. Body weight and composition and adipose fatty acids of fasting subjects were assessed at 0 , 3 , 12 , and 33 mo . After 12 subjects in each group had completed 1 y of supplementation , weight regain differed between the GLA ( 2.17 + /- 1.78 kg ) and control ( 8.78 + /- 2.78 kg ) groups ( P < 0.03 ) . The initial study was terminated , and all remaining subjects were assessed over a 6-wk period . Unblinding revealed weight regains of 1.8 + /- 1.6 kg in the GLA group and 7.6 + /- 2.1 kg in controls for the 13 and 17 subjects , respectively , who completed a minimum of 50 wk in the study . Weight regain did not differ in the remaining 10 GLA and 5 control subjects who completed < 50 wk in the study . In a follow-up study , a subgroup from both the original GLA ( GLA-GLA , n = 9 ) and the original control ( Control-GLA , n = 14 ) population s either continued or crossed over to GLA supplementation for an additional 21 mo . Interim weight regains between 15 and 33 mo were 6.48 + /- 1.79 kg and 6.04 + /- 2.52 kg for the GLA-GLA and Control-GLA groups , respectively . Adipose triglyceride GLA levels increased 152 % ( P < 0.0001 ) in the GLA group at 12 mo , but did not increase further after 33 mo of GLA administration . In conclusion , GLA reduced weight regain  in humans following major weight loss , suggesting a role for essential fatty acids in fuel partitioning in humans prone to obesity BACKGROUND The optimal dietary content and type of fat and carbohydrate for weight management has been debated for decades . OBJECTIVE The objective was to compare the effects of 3 ad libitum diets on the maintenance of an initial weight loss of > or=8 % and risk factors for CVD and diabetes during a 6-mo controlled dietary intervention . DESIGN Nondiabetic overweight or obese [ mean + /- SD body mass index ( in kg/m(2 ) ) : 31.5 + /- 2.6 ] men ( n = 55 ) and women ( n = 76 ) aged 28 
    Output:
    
No significant effect of the other strategies is detected .