***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: OBJECTIVE : To identify contrasts between the risk factors associated with abdominal weight gain and those associated with peripheral weight gain . DESIGN : Prospect i ve mail survey . SUBJECTS : 44 080 white , non-Hispanic , healthy women who were question ed in 1982 ( baseline age 40–54 y ) and 1992 about weight , diet , alcohol use , smoking , 10 physical activities and other variables . MEASUREMENTS : Self reports in 1992 identified 4261 women who gained weight in the abdomen and 7440 women who gained in the periphery ( sites other than the abdomen ) . Using identical logistic models adjusted for age , baseline body mass index ( BMI ) and numerous covariates , the abdominal-gain group and the peripheral-gain group were separately compared with 10 888 women who did not gain weight . RESULTS : The likelihood of abdominal gain exceeded that of peripheral gain ( by comparison of estimated odds ratios , abdominal vs peripheral ) for high meat eaters ( 1.50 vs 1.15 ) , frequent users of liquor ( 1.09 vs 0.54 ) , moderate cigarette smokers ( 0.86 vs 0.59 ) , heavy cigarette smokers ( 0.96 vs 0.36 ) , cigarette quitters ( 2.13 vs 1.63 ) , women with high parity ( 1.52 vs 1.15 ) and those who reported major weight gain since age 18 y ( 1.22 vs 0.65 ) . Abdominal gain was less likely than peripheral gain for high vegetable eaters ( 0.71 vs 0.91 ) , women who exercised ≥4 h/wk [ ( especially aerobics/calisthenics ( 0.28 vs 0.91 ) or walking ( 0.84 vs 1.06 ) ] , women who completed menopause ( 0.74 vs 0.98 ) and consistent users of estrogen replacement therapy ( 0.93 vs 1.22 ) . CONCLUSION : A behavior or characteristic may be associated differently with the risks of abdominal and peripheral weight gain . This insight could strengthen recommendations for preventing major chronic diseases We have examined the independent and combined effects on blood pressure and blood lipids of alcohol restriction and weight loss in overweight male drinkers with a view to assessing overall effects on cardiovascular risk of two widely promoted nonpharmacological approaches for hypertension . Eighty-six men with a mean age of 44.3 years , a mean regular alcohol intake of 440 ml/wk ( five or six st and ard drinks per day ) , a mean blood pressure of 137.4 mm Hg systolic and 84.8 mm Hg diastolic , and a mean body mass of 92.5 kg entered a controlled two-way factorial study . The subjects were r and omly assigned to four groups for an 18-week intervention in which members of two groups drank only low-alcohol beer , thereby reducing their alcohol intake  by 374 ml/wk , while those of the other two groups continued their normal alcohol intake . Within the low and normal alcohol intake groups subjects either continued their usual diet or reduced their caloric intake by 4,200 - 6,300 kJ/day ( 1,000 - 1,500 kcal/day ) ( with protein , fat , and carbohydrate provided as 15 % , 30 % , and 55 % of total calories , respectively ) . Calorie reduction and alcohol restriction caused weight losses of 7.5 ( p less than 0.001 ) and 2.1 ( p less than 0.01 ) kg , respectively . Calorie reduction and alcohol restriction were associated with decreases in systolic blood pressure of 5.4 ( p less than 0.001 ) and 4.8 ( p less than 0.01 ) mm Hg , respectively , and in diastolic blood pressure of 4.2 ( p less than 0.001 ) and 3.3 ( p less than 0.01 ) mm Hg , respectively . ( ABSTRACT TRUNCATED AT 250 WORDS Background Body mass , as well as distribution of body fat , are predictors of both diabetes and cardiovascular disease . In Northern Sweden , despite a marked increase in average body mass , prevalence of diabetes was stagnant and myocardial infa rct ions decreased . A more favourable distribution of body fat is a possible contributing factor . This study investigates the relative importance of individual food items for time trends in waist circumference ( WC ) and hip circumference ( HC ) on a population level . Methods Independent cross-sectional surveys conducted in 1986 , 1990 , 1994 and 1999 in the two northernmost counties of Sweden with a common population of 250000 . R and omly selected age stratified sample s , altogether 2982 men and 3087 women aged 25–64 years . Question naires were completed and anthropometric measurements  taken . For each food item , associations between frequency of consumption and waist and hip circumferences were estimated . Partial regression coefficients for every level of reported intake were multiplied with differences in proportion of the population reporting the corresponding levels of intake in 1986 and 1999 . The sum of these product terms for every food item was the respective estimated impact on mean circumference . Results Time trends in reported food consumption associated with the more favourable gynoid distribution of adipose tissue were increased use of  vegetable oil , pasta and 1.5 % fat milk . Trends associated with abdominal obesity were increased consumption of beer in men and higher intake of hamburgers and  French fried potatoes  in women . Conclusion Food trends as markers of time trends in body fat distribution have been identified . The method is a complement to conventional approaches to establish associations between food intake and disease risk on a population level CONTEXT Obesity is a well-established risk factor for coronary heart disease ( CHD ) , but whether regional fat distribution contributes independently to risk remains unclear . OBJECTIVE To compare waist-hip ratio ( WHR ) and waist circumference in determining risk of  CHD in women . DESIGN AND SETTING Prospect i ve cohort study among US female registered nurses participating in the Nurses ' Health Study conducted between 1986 , when the nurses completed a question naire , and follow-up in June 1994 . PARTICIPANTS A total of 44702 women aged 40 to 65 years who provided waist and hip circumferences and were free of prior CHD , stroke , or cancer in 1986 . MAIN OUTCOME MEASURES Incidence of CHD ( nonfatal myocardial infa rct ion or CHD death ) . RESULTS During 8 years of follow-up 320 CHD events ( 251 myocardial infa rct ions and 69 CHD deaths ) were documented . Higher WHR and greater waist circumference were independently associated with a significantly increased age-adjusted risk of CHD . After adjusting for body mass index ( BMI ) ( defined as weight in kilograms divided by the square of height in meters ) and other cardiac risk factors , women with a WHR of 0.88 or higher had a relative risk ( RR ) of 3.25 ( 95 % confidence interval [ CI ] , 1.78 - 5.95 ) for CHD compared with women with a WHR of less than 0.72 . A waist circumference of 96.5 cm ( 38 in ) or more was associated with an RR of 3.06 ( 95 % CI , 1.54 - 6.10 ) . The WHR and waist circumference were independently strongly associated with increased risk of CHD also among women with a BMI of 25 kg/m2 or less . After adjustment for reported hypertension , diabetes , and high cholesterol level , a WHR of 0.76 or higher or waist circumference of 76.2 cm ( 30 in ) or more was associated with more than a 2-fold higher risk of CHD . CONCLUSIONS The WHR and waist circumference are independently associated with risk of CHD in women BACKGROUND Epidemiologic studies have shown alcohol consumption to be inversely as well as positively related to body weight and body fat . Metabolic studies have shown an increase in energy intake as well as compensation after alcohol consumption . OBJECTIVE Our objective was to assess the effects on energy intake of an apéritif compared with those of a water appetizer and 3 fruit juice appetizers . DESIGN Fifty-two men and women aged 20 - 45 y with a body mass index ( in kg/m2 ) between 20 and 32 were r and omly given 1 MJ ( 340 mL ) alcohol ( wine or beer ) , fat ( cream fruit juice ) , protein ( protein fruit juice ) , carbohydrate ( grape juice ) , or water , or no preload 30 min before an ad libitum lunch consumed from the universal eating monitor . RESULTS Energy intake ( 3.5+/-0.3 MJ compared with 2.7+/-0.2 MJ , P < 0.001 ) and eating rate were higher ( 44+/-3 g/min compared with 38+/-3 g/min , P < 0.01 ) , meal duration was longer ( 14 min compared with 12.0 min , P < 0.01 ) , satiation started to increase later ( 3.5 min compared with 1.5 min , P < 0.01 ) , and eating was prolonged after maximum satiation ( 2.5 min compared with 0.6 min , P < 0.01 ) after an apéritif than after a fat , protein , or carbohydrate appetizer , . Twenty-four-hour energy intake was higher on a day that an apéritif was consumed than after water or no preload . CONCLUSION Twenty-four-hour energy intake was elevated with a 1-MJ apéritif but not with a 1-MJ liquid carbohydrate , fat , or protein appetizer Alcohol drinking in light-to-moderate amounts has been associated with reduced coronary heart disease ( CHD ) risk . However , there is evidence that the way people consume alcohol ( drinking pattern ) may affect risk . Central adiposity , a known CHD risk factor may be one mechanism in the pathway between alcohol consumption and CHD risk . Our study examined whether various drinking patterns differentially affect fat distribution , particularly abdominal fat in women and men . In a r and omly selected population -based cohort ( n = 2343 ) , 35 - 79 y old , we assessed drinking pattern as reported for the past 30 d , including beverage type and amount , frequency of consumption , percentage of time drinking while eating and number of drinks consumed/drinking day .  Central adiposity was determined using an abdominal caliper to measure supine height of the abdomen . Current drinkers tended to have smaller abdominal heights than nondrinkers ( women , P < 0.0001 ; men , P = 0.0559 ) . For drinking pattern , frequency was inversely associated , but drinking intensity ( drinks/drinking day ) was positively associated with central adiposity in women ( P trend for frequency , 0.0007 ; intensity , 0.0010 ) and men ( P trend for frequency , 0.0005 ; intensity , 0.0004 ) , even when age , education , physical activity , smoking status and amount of alcohol ( g ) were included in the models . When frequency and intensity were considered together , daily drinkers of < 1 drink/drinking day had the smallest mean abdominal height measures with the largest measures in less than weekly drinkers who consumed 4 or more drinks/drinking day . These results support the hypothesis that drinking pattern affects the distribution of body fat , an important CHD risk factor BACKGROUND The diet may influence the development of abdominal obesity , but the few studies that have prospect ively examined the relations between diet and changes in waist circumference ( WC ) have given inconsistent results . OBJECTIVE Associations between total energy intake , energy intake from macronutrients , and energy intake from macronutrient subgroups based on different food sources and 5-y differences in WC ( DWC ) were investigated . DESIGN A Danish cohort of 22 570 women and 20 126 men aged 50 - 64 y with baseline data on WC , diet , BMI , and potential confounders reported their WC 5 y later . Associations of baseline diet with DWC were assessed by multiple linear regression analysis . RESULTS Neither total energy intake nor energy intake from each of the macronutrients was associated with DWC , except for an inverse association with protein , especially animal protein . In women , positive associations with DWC were seen for carbohydrate from refined grains and potatoes and from foods with simple sugars , whereas carbohydrate from fruit and vegetables was inversely associated and significantly different from any other carbohydrate subgroup . The results for men resembled those for women , although none were significant . Vegetable fat was positively associated with DWC for both men and women in a combined analysis . A U-shaped association between alcohol from wine and DWC was present for both sexes , and alcohol from spirits was positively associated with DWC in women . CONCLUSIONS Although no significant associations with total energy or energy from fat , carbohydrate , or alcohol were observed , protein intake was inversely related to DWC , and some macronutrient subgroups were significantly associated with DWC BACKGROUND Cross-sectional studies have reported a lower prevalence of  abdominal obese persons among frequent drinkers than among nonfrequent drinkers . OBJECTIVE We tested the hypothesis that drinking frequency is associated with subsequent changes in waist circum 
    Output:
    
In conclusion , the available data provide inadequate scientific evidence to assess whether beer intake at moderate levels ( < 500 mL/day ) is associated with general or abdominal obesity .
Higher intake , however , may be positively associated with abdominal obesity