***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 Observational studies in adults suggest that a diet with a high glycemic index ( GI ) or glycemic load ( GL ) , a high intake of sugary foods , or a low fiber intake may increase the risk of overweight . OBJECTIVES We aim ed to examine prospect ively whether dietary GI , GL , added sugar intake , or fiber intake between age 2 and 7 y are associated with the development of body composition . If so , we aim ed to ascertain whether these associations are modified by meal frequency . DESIGN Linear mixed-effect regression analyses were performed in 380 participants of the DOrtmund Nutrition and Anthropometric Longitudinally Design ed ( DONALD ) Study for whom 4 - 6 weighed 3-d dietary records and anthropometric data were obtained between ages 2 and 7 y. RESULTS Changes in dietary GI , GL , or added sugar intake between ages 2 and 7 y were not associated with concurrent changes in percentage body fat ( % BF , as estimated from skinfold thicknesses ) or body mass index SD scores . An increase in fiber intake was related to a concurrent decrease in % BF between ages 2 and 7 y only in children who consumed < 6 meals/d as toddlers ( beta + /- SE from fully adjusted model : -0.26 + /- 0.09%BF per 1-SD increase in fiber intake , P = 0.005 ) , whereas children with a higher meal frequency had no concurrent change ( 0.07 + /- 0.07%BF per 1-SD increase in fiber intake , P = 0.3 ) . CONCLUSIONS Dietary GI , GL , or added sugar intake between ages 2 and 7 y does not appear to influence the development of body composition . Potential benefits associated with increasing fiber intake throughout childhood may be limited to toddlers with a lower meal frequency BACKGROUND Ad libitum , low-carbohydrate diets decrease caloric intake and cause weight loss . It is unclear whether these effects are due to the reduced carbohydrate content of such diets or to their associated increase in protein intake . OBJECTIVE We tested the hypothesis that increasing the protein content while maintaining the carbohydrate content of the diet lowers body weight by decreasing appetite and spontaneous caloric intake . DESIGN Appetite , caloric intake , body weight , and fat mass were measured in 19 subjects placed sequentially on the following diets : a weight-maintaining diet ( 15 % protein , 35 % fat , and 50 % carbohydrate ) for 2 wk , an isocaloric diet ( 30 % protein , 20 % fat , and 50 % carbohydrate ) for 2 wk , and an ad libitum diet ( 30 % protein , 20 % fat , and 50 % carbohydrate ) for 12 wk .  Blood was sample d frequently at the end of each diet phase to measure the area under the plasma concentration versus time curve ( AUC ) for insulin , leptin , and ghrelin . RESULTS Satiety was markedly increased with the isocaloric high-protein diet despite an unchanged leptin AUC . Mean ( + /-SE ) spontaneous energy intake decreased by 441 + /- 63 kcal/d , body weight decreased by 4.9 + /- 0.5 kg , and fat mass decreased by 3.7 + /- 0.4 kg with the ad libitum , high-protein diet , despite a significantly decreased leptin AUC and increased ghrelin AUC . CONCLUSIONS An increase in dietary protein from 15 % to 30 % of energy at a constant carbohydrate intake produces a sustained decrease in ad libitum caloric intake that may be mediated by increased central nervous system leptin sensitivity and results in significant weight loss . This anorexic effect of protein may contribute to the weight loss produced by low-carbohydrate diets OBJECTIVE To determine the effects of the Dietary Approaches to Stop Hypertension ( DASH ) eating pattern on cardiometabolic risks in type 2 diabetic patients . RESEARCH DESIGN AND METHODS A r and omized crossover clinical trial was undertaken in 31 type 2 diabetic patients . For 8 weeks , participants were r and omly assigned to a control diet or the DASH eating pattern . RESULTS After following the DASH eating pattern , body weight ( P = 0.007 ) and waist circumference ( P = 0.002 ) reduced significantly . Fasting blood glucose levels and A1C decreased after adoption of the DASH diet ( −29.4 ± 6.3 mg/dl ; P = 0.04 and −1.7 ± 0.1 % ; P = 0.04 , respectively ) . After the DASH diet , the mean change for HDL cholesterol levels was higher ( 4.3 ± 0.9 mg/dl ; P = 0.001 ) and LDL cholesterol was reduced ( −17.2 ± 3.5 mg/dl ; P = 0.02 ) . Additionally , DASH had beneficial effects on systolic ( −13.6 ± 3.5 vs. −3.1 ± 2.7 mmHg ; P = 0.02 ) and diastolic blood pressure ( −9.5 ± 2.6 vs. −0.7 ± 3.3 mmHg ; P = 0.04 ) . CONCLUSIONS Among diabetic patients , the DASH diet had beneficial effects on cardiometabolic risks CONTEXT Dietary factors may trigger or exacerbate the autoimmune disease process . OBJECTIVE Our objective was to examine  dietary glycemic index ( GI ) and glycemic load ( GL ) for association with islet autoimmunity ( IA ) development , and progression from IA to type 1 diabetes . DESIGN The Diabetes Autoimmunity Study in the Young follows children at increased genetic type 1 diabetes risk . Diet is collected prospect ively via a parent-reported food frequency question naire . SETTING This was an observational study of children in the Denver area . PATIENTS A total of 1776 Diabetes Autoimmunity Study in the Young children younger than 11.5 yr was included in the study . INTERVENTIONS There were no interventions . MAIN OUTCOME MEASURES IA , defined as the presence of autoantibodies to insulin , glutamic acid decarboxylase , or protein tyrosine phosphatase at two consecutive visits , or the presence of autoantibodies at one visit and diabetic on the next consecutive visit was determined . Type 1 diabetes was diagnosed by a physician . A total of 89 subjects developed IA , and 17 subsequently developed type 1 diabetes during follow-up . Our hypothesis was formulated after data collection . RESULTS GI and GL were not associated with IA development . More rapid progression to type 1 diabetes in children with IA was associated with higher dietary GI ( hazard ratio : 2.20 ; 95 % confidence interval : 1.17 - 4.15 ) and marginally associated with GL ( hazard ratio : 1.59 ; 95 % confidence interval : 0.96 - 2.64 ) at the first IA-positive visit . CONCLUSIONS Higher dietary GI and GL are not associated with IA development , but higher GI is associated with more rapid progression to type 1 diabetes in children with IA , perhaps due to increased dem and on the beta-cell to release insulin . Further study is needed to confirm this finding and identify the underlying biological mechanism Background Glycemic load ( GL ) is the product of glycemic index of a food and amount of available carbohydrate in that food divided by 100 . GL represents quality and quantity of dietary carbohydrate . Little is known about the role of GL in hunger , satiety , and food intake in preschool children . The aim of this study was to investigate the effect of two breakfast meals differing in GL on hunger , satiety , and subsequent food intake at lunch in preschool children aged 4 - 6 y. Methods Twenty three subjects consumed low-GL ( LGL ) and high-GL ( HGL ) breakfast meals  according to a r and omized crossover design followed by an ad libitum lunch 4 h after consumption of breakfast . Children were asked to consume meals until they are full . Each treatment was repeated twice in non-consecutive days and data were averaged . Results Children in LGL group consumed significantly lower amounts of GL , total carbohydrate , energy , energy density , and dietary fiber and higher amounts of protein and fat at the breakfast compared to those in HGL group . Prior to lunch , children were hungrier in the HGL intervention group compared to the LGL intervention group ( P < 0.03 ) . However , no significant difference was observed between LGL and HGL intervention groups in the amount of food and energy consumed during lunch . Conclusions Decreased hunger in children prior to lunch in LGL group is likely due to higher protein and fat content of LGL breakfast . Diets that are low in GL can be recommended as part of healthy diet for preschool children The authors prospect ively examined whether change in dietary glycemic index ( GI ) , glycemic load ( GL ) , fiber intake , or whole-grain intake during puberty is associated with concurrent change in percentage of body fat ( % BF ) or body mass index ( BMI ; weight (kg)/height)(2 ) . Linear mixed-effects regression analyses were performed in 215 participants from the Dortmund Nutritional and Anthropometric Longitudinally Design ed ( DONALD ) Study ( Dortmund , Germany ) who possessed weighed 3-day dietary records and anthropometric data at puberty onset ( defined by age at takeoff ) and over the subsequent 4 years ( 1988 - 2007 ) . Neither changes in dietary GI , GL , fiber intake , nor whole-grain intake were associated with concurrent changes in % BF throughout puberty ( change in % BF : -0.03 ( st and ard error ( SE ) , 0.11 ) per st and ard deviation ( SD ) increase in GI ( P = 0.8 ) ; -0.01 ( SE , 0.11 ) per SD increase in GL ( P = 0.9 ) ; 0.02 ( SE , 0.14 ) per SD increase in fiber intake ( P = 0.9 ) ; and 0.09 ( SE , 0.13 ) per SD increase in whole-grain intake ( P = 0.5 ) ) . Similarly , no concurrent associations were observed between these dietary factors and BMI SD scores . Associations of dietary GI with % BF and BMI SD score differed between overweight and normal-weight adolescents ( for concurrent association , P for interaction was 0.03 for % BF and 0.08 for BMI SD score ) . Dietary GI , GL , and fiber and whole-grain intakes in healthy , free-living adolescents do not appear to be relevant to the development of % BF or BMI during puberty UNLABELLED Some short-term pediatric studies have suggested beneficial effects of low glycemic load ( LGL ) meals on feelings of hunger and on energy intake . However , the effects of LGL diets have not been systematic ally studied in obese Hispanic children , who st and to benefit from successful interventions . OBJECTIVE To examine the effects of LGL and high-GL ( HGL ) meals on appetitive responses and ad libitum energy intake of obese Hispanic youth . METHODS A total of 88 obese Hispanic youth aged 7 - 15 years were enrolled in a community-based obesity intervention program and r and omly assigned to consume meals design ed as either LGL ( n = 45 ) or HGL ( n = 43 ) . After 12 weeks , participants were admitted for a 24-hour metabolic study . Following the morning test meal , subjects serially reported hunger , fullness , and satiety using a visual analog scale . Blood insulin and glucose were measured . After 5 hours , participants were fed another test meal and given a snack platter from which to eat ad libitum . All test food was weighed and the energy , macronutrients , and glycemic load ( GL ) of consumed foods were calculated . RESULTS The HGL group had significantly higher insulin ( p = 0.0005 ) and glucose ( p = 0.0001 ) responses to the breakfast meal compared with the LGL group . There were no significant between-group differences in energy consumed from the snack platter ( 1303 vs. 1368 kcal , p = 0.5 ) , or in the subjective feelings of hunger ( p = 0.3 ) , fullness ( p = 0.5 ) or satiety ( p = 0.3 ) between the two groups . CONCLUSIONS Our study provides no evidence that , for obese Hispanic youth , changing the GL of the diet affects short-term hunger , fullness , satiety , or energy intake . Clinical Trials.gov Identifier : NCT01068197 OBJECTIVE Recent reports have suggested that a low glycemic index ( GI ) diet may have a role in the management of obesity through its ability to increase the satiety value of food and modulate appetite . To date , no long-term clinical trials have examined the effect of dietary GI on body weight regulation . The majority of evidence comes from single-day studies , most of which have been conducted in adults . The purpose of this study was to investigate the effect of 3 test breakfasts-low-GI , low-GI with 10 % added sucrose , and high-GI-on  ad libitum lunch intake , appetite , and satiety and to compare these with baseline values when habitual breakfast was consumed . METHODS A 3-way crossover study 
    Output:
    
Results : The majority of cross-sectional studies have found children′s obesity  directly linked with glycemic index and glycemic load ; however , cohort studies found controversial results .
Also , the intervention studies indicate the negative effect of glycemic index and glycemic load on obesity in children .