***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 determine whether barley , as the soluble fiber source , would beneficially change  cardiovascular risk factors .  Soluble fiber from oats has been recognized as beneficial in decreasing blood cholesterol levels . Although barley contains high amounts of soluble fiber , it is not consumed as extensively as oats . Methods : Eighteen moderately hypercholesterolemic men ( 28–62 y ) consumed a controlled equilibration diet ( Step 1 , 30 % fat , 55 % carbohydrate , 15 % protein , < 300 mg cholesterol ) for 2 weeks followed by the diet with about 20 % of energy replaced with brown rice/whole wheat , ½ barley & ½ brown rice/whole wheat or barley ( < 0.4 g , 3 g and 6 g added soluble fiber/2800 kcal , respectively ) for 5 weeks in a Latin square design . Fasting blood was drawn twice weekly . Total cholesterol , HDL cholesterol , and triacylglycerols were measured enzymatically and lipid fractions were measured by nuclear magnetic resonance spectroscopy . Results : Compared with pre study concentrations , total cholesterol ( 14 % , 17 % , and 20 % , respectively ) and LDL cholesterol ( 17 % , 17 % , and 24 % , respectively ) were significantly lower ( p < 0.0001 ) after the low , medium , and high-soluble fiber diets . Triacylglycerol was 6 % , 10 % , and 16 % lower ( p = 0.09 ) whereas HDL cholesterol ( 9 % , 7 % , and 18 % ) was higher ( p < 0.001 ) after the experimental diets . Total cholesterol and LDL cholesterol after the high-soluble fiber diet were significantly lower than concentrations after the low- or medium-soluble fiber  diets . Mean LDL particle number significantly decreased ( p < 0.007 ) and the large LDL cholesterol fraction showed a trend toward lower concentrations ( p = 0.06 ) . Conclusion : Increasing soluble fiber through consumption of barley in a healthy diet can reduce cardiovascular risk factors BACKGROUND This study was undertaken to determine the effects of month-long whole grain oat and wheat cereal supplementation on endothelial function following a fatty meal as measured by brachial artery reactivity studies . METHODS Fifty healthy adult subjects underwent brachial artery reactivity studies before and after a high-fat meal along with alpha-tocopherol ( vitamin E ) , oats , or a comparable bowl of wheat cereal and were again tested after the high-fat meal following month-long supplementation with oat or wheat cereal in a r and om crossover with interim washout . RESULTS In the acute phase , the fatty meal attenuated the hyperemic brachial artery flow response when administered concurrently with wheat cereal ( -13.4 % ; P = 0.02 ) , whereas hyperemic flow was maintained by concurrent administration of either oatmeal or alpha-tocopherol . Following month-long supplementation , postpr and ial peak flow ( wheat + 3.88 + /- 5.62 % ; oat -10.78 + /- 7.15 % ) , and peak diameter ( wheat -1.40 + /- 0.96 % ; oat -0.86 + /- 0.88 % ) did not differ from prepr and ial values . Oat and wheat treatments did not differ when directly compared . CONCLUSIONS Month-long , daily supplementation with either whole-grain oat or wheat cereal may prevent postpr and ial impairment of vascular reactivity in response to a high-fat meal Twenty normal weight female volunteers divided into high and low restraint groups consumed breakfast meals of high and low-fibre content ( 12.0 g and 3.0 g fibre respectively ) on two separate occasions . Visual analogue scales were used to record hunger , fullness , desire to eat , and a measure of prospect i ve consumption for 21/2 hours after each meal . At this point , a tray of pre-weighed lunch foods was offered and subjects were requested to eat as much or as little as they desired . The two breakfast meals ( of equal weight ) were based on toast , breakfast cereal , milk , butter and orange marmalade . No significant difference in energy intake at lunch was found after the high and low fibre breakfasts , or between the restraint groups . There was no significant difference between ratings after the high and low-fibre meals except for fullness , which was greater after the high-fibre breakfast . The effect of fibre overall , was relatively weak compared to the differences between the two restraint groups , with the high restraint group consistently expressing significantly less hunger before , during and after the breakfasts compared to the low restraint group Our objective was to evaluate whether isocaloric replacement of refined rice with whole grains and other plant products as a form of powder reduces coronary artery disease ( CAD ) risk factors , such as insulin dem and and lipid peroxidation in CAD patients . Seventy-six male patients with CAD were r and omly assigned to either a group ingesting a whole-grain meal daily or a control group for 16 weeks . In the whole-grain group , serum concentrations of glucose and insulin decreased by 24 % and 14 % , respectively , without altering body weight and energy intake , whereas daily intakes of fiber and vitamin E increased by 25 % and 41 % , respectively . Consumption of whole grains and legume powder in CAD patients without diabetes decreased fasting levels of glucose and insulin . The areas under the curve for insulin and glucose during the oral glucose tolerance test were also decreased . CAD patients with diabetes in the whole-grain group also showed reductions in fasting glucose and in the area under the curve for glucose . In the whole-grain group , plasma malondialdehyde and homocysteine and urinary 8-epi-prostagl and in F2&agr ; concentrations decreased by ≈28 % . Also , lipid-corrected concentrations of & agr;-carotene , retinol , tocopherols , and lycopene increased by 11 % to 40 % , and the percentage composition of n-6 fatty acids of serum phospholipid increased by 14 % in the whole-grain group . The replacement of refined rice with whole grain and legume powder as a source of carbohydrate in a meal showed significant beneficial effects on glucose , insulin , and homocysteine concentrations and lipid peroxidation in CAD patients . These effects are likely to substantially reduce the risk factors for CAD and diabetes OBJECTIVE As lipoprotein(a ) is an independent risk factor for the development of coronary heart disease we determined the effect on serum lipid and lipoprotein(a ) levels of dietary fibre and of treatment with insulin in patients with diabetes mellitus type II . METHODS Twelve type II diabetic patients ( mean age 62 ( SD 10 ) yrs , body mass index 25.8 ( SD 3.5 ) kg/m2 ) , all treated with oral antidiabetic agents  , were studied in a r and omised cross-over trial , in which they used breads meals prepared with guar gum ( a mean of 11.2 g guar per day ) for 3 months in comparison with normal high-fibre bread .  Fifteen other patients ( age 70 ( 8) , BMI 27.4 ( 5.6 ) kg/m2 ) poorly controlled on oral hypoglycaemic agents  , were treated with insulin . RESULTS The guar treatment of the 12 patients result ed in lower total cholesterol ( 5.24 vs 5.7 mmol/l , p less than 0.1 ) and LDL cholesterol ( 3.77 vs 4.33 mmol/l , p less than 0.001 ) in comparison with normal high-fibre bread . Lipoprotein(a ) levels were not different ( 76 vs 82 mg/l ) . Insulin therapy in the 15 other patients decreased HbA1c levels after 6 months from 11.0 to 7.7 % ( p less than 0.001 ) , total cholesterol from 6.8 to 6.1 mmol/l ( p less than 0.05 ) , and LDL cholesterol from 4.4 to 4.1 mmol/l ( p less than 0.05 ) . Lp(a ) decreased only slightly in 11/15 patients , from 491 to 441 mg/l ( p = 0.07 ) . CONCLUSION Neither the use of the dietary fibre guar nor improved metabolic control with insulin therapy lowered elevated lipoprotein(a ) levels in type II diabetic patients Subjects with obesity and elevated fasting blood glucose are at high risk of developing type 2 diabetes which may be reduced by a dietary intervention leading to an improvement of insulin resistance . We investigated the potential of a whole-grain based dietary product ( WG ) with reduced starch content derived from double-fermented wheat during a hypo-energetic diet to positively influence body weight , fasting blood glucose , insulin resistance and lipids in comparison to a nutrient-dense meal replacement product ( MR ) in a r and omized two-way cross-over study with two 4-week treatment periods separated by a 2-week wash-out . Subjects replaced at least two daily meals with WG and MR , respectively , targeting for a consumption of 200 g of either product per day . Total daily energy intake was limited to 7120 kJ. Thirty-one subjects ( BMI 33.9 ( SD 2.7 ) kg/m2 , fasting blood glucose 6.3 ( SD 0.8 ) mmol/l ) completed the study . In both treatment groups body weight ( -2.5 ( SD 2.0 ) v. - 3.2 ( SD 1.6 ) kg for WG v. MR ) , fasting blood glucose ( -0.4 ( SD 0.3 ) v. -0.5 ( SD 0.5 ) mmol/l ) , total cholesterol ( -0.5 ( SD 0.5 ) v. -0.6 ( SD 0.5 ) mmol/l ) , TAG ( -0.3 ( SD 0.9 ) v. -0.3 ( SD 1.2 ) mmol/l ) and homeostasis model assessment ( HOMA ) insulin resistance score ( -0.7 ( SD 0.8 ) v. -1.1 ( SD 1.7 ) microU/ml x mmol/l ) improved ( P < 0.05 ) with no significant differences between the treatments . After statistical adjustment for the amount of body weight lost , however , the comparison between both groups revealed that fasting serum insulin ( P = 0.031 ) and HOMA insulin resistance score ( P = 0.049 ) improved better with WG than with MR . We conclude that WG favourably influences metabolic risk factors for type 2 diabetes independent from the amount of body weight lost during a hypo-energetic diet Objective : To test the hypothesis that a high carbohydrate breakfast with breakfast cereal leads to a meaningful reduction in dietary energy intake from fat , especially from saturated fat , and thus lower serum cholesterol levels . Design : An open r and omized controlled cross-over trial . The subjects were r and omized into intervention breakfast cereal or usual breakfast ( control ) groups . Setting : Free-living subjects aged 29–71 y in Eastern Finl and Subjects : 224 enrolled , 209 completed the study . The subjects were recruited from a survey of a r and om population sample and from other sources , and their serum cholesterol was not lower than 5.0 mmol/l . Recruited persons did not have any chronic disease or very low saturated fat intake . Intervention : The cereal group consumed 80 g ( men ) or 60 g ( women ) cereal at breakfast and the control group continued their usual dietary habits for six weeks . After a wash out of six weeks , a cross-over with another six week trial period took place . Measurements ( including serum sample s and a 3 d food record ) took place before and after the two trial periods . Results : The intervention period led to 2.5 en% ( energy percent units ) reduction in saturated fatty acids intake . The reduction in total fat intake was 5.5 en% . This was compensated for by increased intake of carbohydrates . The reduction in saturated fatty acids intake led to modest ( but in group 1 significant ) 0.15 mmol/l ( 2.5 % ) reduction in total serum cholesterol level . Conclusions : The trial showed that regular cereal breakfast can lead to reduced intake of total and saturated fatty acids of the daily diet and consequently to reduction in serum cholesterol level . Sponsorship : Supported by the Kellogg Company of Great Britain This study was design ed as a test of the serum lipid response and dietary adaptation to recommended daily inclusion of instant oats in an otherwise regular diet . Hypercholesterolemic adults were r and omly assigned to a control or intervention group . Participants in the intervention group were given packages of instant oats and requested to eat two servings per day ( approximately two ounces dry weight ) , substituting the oats for other carbohydrate foods in order to maintain baseline calorie intake and keep weight stable . Serum lipids were measured in blood collected by venipuncture at baseline , four weeks , and eight weeks . Baseline mean total cholesterol ( 
    Output:
    
There is insufficient evidence from RCTs of an effect of whole grain diets on cardiovascular outcomes or on major CVD risk factors such as blood lipids and blood pressure .