***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 The appropriate dietary intervention for overweight persons with type 2 diabetes mellitus ( DM2 ) is unclear . Trials comparing the effectiveness of diets are frequently limited by short follow-up times and high dropout rates . AIM The effects of a low carbohydrate Mediterranean ( LCM ) , a traditional Mediterranean ( TM ) , and the 2003 American Diabetic Association ( ADA ) diet were compared , on health parameters during a 12-month period . METHODS In this 12-month trial , 259 overweight diabetic patients ( mean age 55 years , mean body mass index 31.4 kg/m(2 ) ) were r and omly assigned to one of the three diets . The primary end-points were reduction of fasting plasma glucose , HbA1c and triglyceride ( TG ) levels . RESULTS 194 patients out of 259 ( 74.9 % ) completed follow-up . After 12 months , the mean weight loss for all patients was 8.3 kg : 7.7 kg for ADA , 7.4 kg for TM and 10.1 kg for LCM diets . The reduction in HbA1c was significantly greater in the LCM diet than in the ADA diet ( -2.0 and -1.6 % , respectively , p < 0.022 ) . HDL cholesterol increased ( 0.1 mmol/l + /- 0.02 ) only on the LCM ( p < 0.002 ) . The reduction in serum TG was greater in the LCM ( -1.3 mmol/l ) and TM ( -1.5 mmol/l ) than in the ADA ( -0.7 mmol/l ) , p = 0.001 . CONCLUSIONS An intensive 12-month dietary intervention in a community-based setting was effective in improving most modifiable cardiovascular risk factors in all the dietary groups . Only the LCM improved HDL levels and was superior to both the ADA and TM in improving glycaemic control Mediterranean-inspired diets have been shown to decrease cholesterol levels in patients with hypercholesterolaemia , who frequently exhibit endothelial dysfunction . The aims of the present study are to improve endothelial function by dietary intervention in healthy subjects with lipid levels representative of a Western population . Twenty-two healthy subjects ( mean total cholesterol , 5.6 mmol/l ) were given a Mediterranean-inspired diet rich in omega-3 fatty acids and sterol esters , but low in saturated fat , or an ordinary Swedish diet , for 4 weeks in a r and omized cross-over study . The composition of the diets were : in the Swedish diet , 2090 kcal ( where 1 kcal=4.184 kJ ; 48 % of energy from carbohydrate , 15 % from protein and 36 % from fat ) and 19 g of fibre ; in the Mediterranean-inspired diet , 1869 kcal ( 48 % of energy from carbohydrate , 16 % from protein , 34 % from fat ) and 40 g of fibre . After each dietary period , fasting blood lipids , insulin and glucose levels , as well as apo B ( apolipoprotein B ) and LDL ( low-density lipoprotein ) particle size , were analysed . Endothelial-dependent and -independent vasodilation was measured invasively by venous occlusion plethysmography , and arterial distensibility was assessed by echocardiography tracking . Fibrinolytic capacity across the forearm , as well as oxidative stress measured through urinary F(2)-isoprostane , were evaluated . Total , LDL- and apo B-cholesterol and triacylglycerol ( triglyceride ) concentrations were decreased by 17 % , 22 % , 16 % and 17 % respectively , after the Mediterranean-inspired diet compared with the Swedish diet ( P < 0.05 for all ) . However , no differences in plasma concentrations of insulin and glucose and LDL particle size , endothelial function , arterial distensibility , fibrinolytic capacity or oxidative stress were detected . Treatment for 4 weeks with a Mediterranean-inspired diet decreased blood lipids in healthy individuals with a low-risk profile for cardiovascular disease . This beneficial effect was not mirrored in vascular function or oxidative stress evaluation BACKGROUND Adherence to a Mediterranean diet may improve longevity , but relevant data are limited . METHODS We conducted a population -based , prospect i ve investigation involving 22,043 adults in Greece who completed an extensive , vali date d , food-frequency question naire at base line .  Adherence to the traditional Mediterranean diet was assessed by a 10-point Mediterranean-diet scale that incorporated the salient characteristics of this diet ( range of scores , 0 to 9 , with higher scores indicating greater adherence ) . We used proportional-hazards regression to assess the relation between adherence to the Mediterranean diet and total mortality , as well as mortality due to coronary heart disease and mortality due to cancer , with adjustment for age , sex , body-mass index , physical-activity level , and other potential confounders . RESULTS During a median of 44 months of follow-up , there were 275 deaths . A higher degree of adherence to the Mediterranean diet was associated with a reduction in total mortality ( adjusted hazard ratio for death associated with a two-point increment in the Mediterranean-diet score , 0.75 [ 95 percent confidence interval , 0.64 to 0.87 ] ) . An inverse association with greater adherence to this diet was evident for both death due to coronary heart disease ( adjusted hazard ratio , 0.67 [ 95 percent confidence interval , 0.47 to 0.94 ] ) and death due to cancer ( adjusted hazard ratio , 0.76 [ 95 percent confidence interval , 0.59 to 0.98 ] ) . Associations between individual food groups contributing to the Mediterranean-diet score and total mortality were generally not significant . CONCLUSIONS Greater adherence to the traditional Mediterranean diet is associated with a significant reduction in total mortality Background Hypercholesterolemia has been identified as a major risk factor for the development of coronary artery disease . The aim of this study was to assess the effect of a Mediterranean diet on the development of non-fatal acute coronary syndromes ( ACS ) in hypercholesterolemic people , with or without statin treatment . Methods During 2000–2001 , 848 r and omly selected patients with a first event of coronary heart disease and 1078 cardiovascular disease-free people , matched to the patients by sex , age and region , were studied . Treatment of hypercholesterolemia with statin and the adoption of a Mediterranean diet were recorded . Results Hypercholesterolemia was present in 534 ( 63 % ) out of 848 coronary patients and 399 ( 37 % ) out of 1078 control participants . One hundred and seventy-one ( 32 % ) of the hypercholesterolemic patients and 168 ( 42 % ) of the hypercholesterolemic control participants were treated with statins and also followed a Mediterranean diet . The analysis showed that the combination of a Mediterranean diet and  statin medical therapy is associated with an additional reduction of the coronary risk ( odds ratio = 0.57 , P < 0.01 ) , independently from cholesterol levels and the other cardiovascular factors . Conclusion The adoption of a Mediterranean diet by hypercholesterolemic people seems to reinforce the benefits from statin treatment on lipid levels and reduces the risk of developing ACS . However , it is hard to cl aim that our findings suggest causal evidence , and in order to explain the potential common mechanism between diet and statin treatment much remains to be learned BACKGROUND Diet has been reported to influence arterial blood pressure , and evidence indicates that the Mediterranean diet reduces cardiovascular mortality . OBJECTIVE The objective was to examine whether the Mediterranean diet , as an entity , and olive oil , in particular , reduce arterial blood pressure . DESIGN Arterial blood pressure and several sociodemographic , anthropometric , dietary , physical activity , and clinical variables were recorded at enrollment among participants in the Greek arm of the European Prospect i ve Investigation into Cancer and Nutrition ( EPIC ) study . Of these participants , 20 343 had never received a diagnosis of hypertension and were included in an analysis in which systolic and diastolic blood pressure were regressed on the indicated possible predictors , including a 10-point score that reflects adherence to the Mediterranean diet and , alternatively , the score 's individual components and olive oil . RESULTS The Mediterranean diet score was significantly inversely associated with both systolic and diastolic blood pressure . Intakes of olive oil , vegetables , and fruit were significantly inversely associated with both systolic and diastolic blood pressure , whereas cereals , meat and meat products , and ethanol intake were positively associated with arterial blood pressure . Mutual adjustment between olive oil and vegetables , which are frequently consumed together , indicated that olive oil has the dominant beneficial effect on arterial blood pressure in this population . CONCLUSIONS Adherence to the Mediterranean diet is inversely associated with arterial blood pressure , even though a beneficial component of the Mediterranean diet score-cereal intake-is positively associated with arterial blood pressure .  Olive oil intake , per se , is inversely associated with both systolic and diastolic blood pressure BACKGROUND Greater adherence to the Mediterranean diet has been associated with a lower incidence of cardiovascular disease and cancer . OBJECTIVE We studied the effect of the Mediterranean diet on total antioxidant capacity ( TAC ) in 3042 participants who had no clinical evidence of cardiovascular disease . DESIGN During 2001 - 2002 , a r and om sample of 1514 men and 1528 women aged 18 - 89 y from the Attica area of Greece was selected .  TAC was measured with an immune-diagnostic assay . Food consumption was evaluated with a vali date d food-frequency question naire , and adherence to the Mediterranean diet was assessed on the basis of a diet score that incorporated the inherent characteristics of this diet . RESULTS TAC was positively correlated with diet score . The participants in the highest tertile of the diet score had , on average , 11 % higher TAC levels than did the participants in the lowest tertile , even after adjustment for relevant confounders ( P < 0.01 ) . On the other h and , the participants in the highest tertile of the diet score had , on average , 19 % lower oxidized LDL-cholesterol concentrations than did the participants in the lowest tertile ( P < 0.01 ) . An additional analysis showed that TAC was positively correlated with the consumption of olive oil ( rho = 0.54 , P = 0.002 ) and of fruit and vegetables ( rho = 0.34 and rho = 0.31 , respectively ; P < 0.001 for both ) , whereas it was inversely associated with the consumption of red meat ( rho = -0.35 , P = 0.02 ) . CONCLUSION Greater adherence to the Mediterranean diet is associated with elevated TAC levels and low oxidized LDL-cholesterol concentrations , which may explain the beneficial role of this diet on the cardiovascular system BACKGROUND Adherence to a Mediterranean diet has been reported to increase longevity , but concerns have been expressed that such a diet may promote overweight and obesity . OBJECTIVE The objective was to investigate whether adherence to the traditional Mediterranean diet , as operationalized in a Mediterranean diet score , is associated with body mass index ( BMI ) and waist-to-hip ratio ( WHR ) . DESIGN In a general population sample of 23,597 adult men and women participating in the Greek European Prospect i ve Investigation into Cancer and Nutrition Study , a vali date d food-frequency question naire was interviewer-administered , and anthropometric , sociodemographic , physical activity , and other lifestyle characteristics were recorded . BMI and WHR were regressed on a score that reflects adherence to the traditional Mediterranean diet and potentially confounding variables . RESULTS In models in which total energy intake was included , adherence to the Mediterranean diet was unrelated to BMI in both sexes and was weakly related to WHR only in women . When energy intake was not controlled for , a 2-point increase in the score was found to correspond to increases of approximately 650 and 150 g in the weight of an average-height man and woman , respectively , whereas the WHR was found to increase by approximately 0.001 units in men and 0.004 units in women . CONCLUSIONS Adherence to a Mediterranean diet was essentially unrelated to BMI , with small differences depending on model choice and having no practical consequences . Overweight is a genuine problem in Greece and perhaps other Mediterranean countries , but it is likely to be related to limited physical activity in conjunction with excessive positive energy balance Few studies have prospect ively examined dietary patterns and adult weight change , and results to date are inconsistent . This study examines whether a Mediterranean diet ( MD ) pattern is associated with reduced 3-y incidence of obesity using data from the Spanish cohort of the European Prospect i ve Investigation into Cancer and Nutrition ( EPIC-Spain ) . The sample included 17,238 women and 10,589 men not obese and aged 29 - 
    Output:
    
Although not all studies show a protective effect of the Mediterranean diet on body weight and obesity , the evidence suggests a possible beneficial role of this dietary pattern .
Thus the Mediterranean diet protects against the development of coronary heart disease not only because of its beneficial role regarding cardiovascular risk factors , but also due to a possible effect on body weight and obesity