***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: 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 The aim of this study was to determine whether moderate restriction of dietary salt intake leads to an additional fall in blood pressure in treated hypertensive men who are asked to simultaneously reduce their usual alcohol intake . Sixty-three subjects entered an initial 2-week familiarization period during which they continued their usual alcohol intake and commenced a " low sodium " diet ( less than 60 mmol/day ) supplemented with 100 mmol sodium chloride per day as enteric-coated tablets . Subjects were then r and omly assigned to either drink a low alcohol beer alone for a 4-week period ( reducing their self-reported alcohol consumption from 537 to 57 ml/week ) or to continue their usual alcohol intake ( 543 versus 557 ml/week ) . Within the low and normal alcohol intake groups , subjects were assigned to either a low or normal sodium intake . The low sodium groups continued the sodium-restricted diet but were switched to placebo sodium chloride tablets for the 4 weeks . This result ed in a fall in the 24-hour urinary sodium excretion from 144 to 69 mmol/day . The normal sodium groups continued the low sodium diet but kept taking 100 mmol/day of the sodium chloride tablets , and their urinary sodium excretion remained unchanged ( 125 versus 142 mmol/day ) . Regular antihypertensive therapy was continued throughout . Fifty-nine subjects completed the trial . In those who reduced their alcohol intake there was a fall in both systolic blood pressure ( -5.4 mm Hg supine , p less than 0.01 ) and diastolic blood pressure ( -3.2 mm Hg supine , p less than 0.01 ) . ( ABSTRACT TRUNCATED AT 250 WORDS A direct pressor effect of alcohol is proposed as the basis for the association between regular alcohol consumption and an increase in blood pressure found in population studies . To examine this further , a r and omized controlled crossover trial of the effects of varying alcohol intake on blood pressure in 46 healthy male drinkers was conducted . From an average of 336 ml of ethanol per week , alcohol consumption was reduced by 80 % for 6 weeks by drinking a low alcohol content beer alone . This reduction was associated with a significant reduction in systolic and diastolic blood pressure ( p less than 0.001 and p less than 0.05 respectively ) . The mean difference in supine systolic blood pressure during the last 2 weeks of normal or low alcohol intake was 3.8 mm Hg , which correlated significantly with change in alcohol consumption ( r = 0.53 , p less than 0.001 ) . Reduction of alcohol intake also caused a significant decrease in weight ( p less than 0.001 ) . After adjustment for weight change , an independent effect of alcohol on systolic but not diastolic blood pressure was still evident , with a 3.1 mm Hg fall predicted for a decrease in consumption from 350 ml of ethanol equivalent per week to 70 ml per week ( p less than 0.01 ) . Systolic blood pressure rose again when normal drinking habits were resumed . These results provide clear evidence for a direct and reversible pressor effect of regular moderate alcohol consumption in normotensive men and suggest that alcohol may play a major role in the genesis of early stages of blood pressure elevation UNLABELLED Introduction Recent pharmacotherapy findings from new alcohol reduction programmes could change the paradigm of alcohol-dependence treatment . MATERIAL AND METHOD This study review s the neurobiological background and pharmacotherapy of alcohol-dependence disorder , focusing on opioid receptor antagonists , abstinence-oriented treatment and moderation-oriented treatment . RESULTS 1 . Alcohol-dependence treatment programs show only low to moderate efficacy . 2 . Patients usually show low motivation to sustain abstinence but high motivation to reduce alcohol use . 3 . A treatment program based on continued reduction of drinking and associated with intermittent treatment with naltrexone can be useful for low-severity alcohol-dependent patients . DISCUSSION Although high severity alcohol-dependent patients should stop drinking alcohol , low severity patients may have the option of reducing their alcohol consumption if they take an opioid antagonist medication every day that they decide to drink alcohol . In the short term , the continuing drinking-reduction programmes may reduce the number of drinks per drinking day and in the long term , they may progressively decrease the obsession for drinking , alcohol seeking behavior , and related medical , behavioral and social disorders . To change the paradigm in the treatment of alcohol-dependence disorder there is a need for further r and omized controlled trials in order to assess their efficacy and tolerability Objective : The aim of the present study was to conduct a cross-validation trial of the efficacy of a computerized school-based intervention for alcohol misuse in adolescents . Method : A cluster r and omized control trial was carried out . Intervention and control groups were assessed at baseline , immediately after and 6 months after the intervention . A total of 764 Year 8 students from 10 independent secondary schools in Sydney , Australia participated in the study . Half of the schools were r and omly allocated to the computerized prevention programme ( n=397 ) , and half to their usual classes ( n=367 ) . The six-lesson computerized intervention was evidence and curriculum based while having a focus on harm-minimization . Knowledge , expectancies , alcohol consumption ( frequency , quantity and binging ) , patterns of use , and harms associated with one 's own use of alcohol were assessed . Results : There were significant improvements in knowledge regarding alcohol use at immediate and 6 month follow up . Average weekly alcohol consumption was reduced immediately after the intervention . No differences between groups were found on alcohol expectancies , frequency of drinking to excess and harms related to alcohol use over time . Conclusions : The present results support the Climate Management and Treatment Education ( CLIMATE ) Schools : alcohol module as an effective intervention in increasing alcohol knowledge and reducing alcohol use in the short term AIMS To compare 5 year outcomes ( general hospital and mental health morbidity and mortality ) among general hospital psychiatric in- patients r and omized to receive either an alcohol reduction motivational interview ( MI ) or information pack ( IP )  , and compare these to matched controls . DESIGN We recruited 120 patients aged 18 - 64 years who scored > /=8 on the Alcohol Use Disorders Identification Test ( AUDIT ) . We selected matched controls from in- patients not recruited but who reached the same AUDIT threshold . At 5 years , follow-up data were collected via a state-wide hospital record system . FINDINGS There were no significant differences between the MI and IP groups in terms of ' survival ' to their first alcohol-related , other general hospital or mental health admission over 5 years . Matched controls had significantly more mental health in-patient episodes ( F[1,226 ] 4.4 , P < 0.05 ) and greater length of hospital stay ( F[1,226 ] 4.8 , P < 0.05 ) than the combined MI-IP group . Furthermore , the MI-IP group had longer ' survival ' times to both first general hospital ( mean 583 versus 392 days ) and mental health in-patient ( mean 788 versus 580 days ) events . Collapsed across groups , dependent and harmful consumers had shorter ' survival ' times than hazardous consumers ( AUDIT classifications ) . CONCLUSIONS Alcohol interventions have medium-term health benefits for those with mental health and alcohol use problems . Importantly , there were no differences in outcome between the intervention groups . The low cost of providing an IP makes it attractive as an alcohol intervention . The AUDIT provided an effective means of identifying those who are at risk of subsequent alcohol-related admissions and may benefit from intervention Seventy two women drinking 21 units ( 210 g ) or more of alcohol per week were recruited from an opportunistic screening programme in eight English general practice s. The women were r and omized into control and treatment groups . Women in the treatment group received ten minutes advice from their general practitioner to reduce alcohol consumption .  At one year follow-up , when analyzed by intention to treat , women in the treatment group had reduced their alcohol consumption from an average of 35 - 24 units per week . Similar reductions were found in the control group ( from 37 - 27 units per week ) . The lack of evidence for a treatment effect may be explained by contamination of the control group by informal interventions AIMS The School Health and Alcohol Harm Reduction Project ( SHAHRP study ) aim ed to reduce alcohol-related harm in secondary school students . DESIGN The study used a quasi-experimental research design in which r and omly selected and allocated intervention and comparison groups were assessed at eight , 20 and 32 months after baseline . SETTING Metropolitan , government secondary schools in Perth , Western Australia . PARTICIPANTS The sample involved over 2300 students . The retention rate was 75.9 % over 32 months . INTERVENTION The evidence -based intervention , a curriculum programme with an explicit harm minimization goal , was conducted in two phases over a 2-year period . MEASURES Knowledge , attitude , total alcohol consumption , risky consumption , context of use , harm associated with own use and harm associated with other people 's use of alcohol . FINDINGS There were significant knowledge , attitude and behavioural effects early in the study , some of which were maintained for the duration of the study . The intervention group had significantly greater knowledge during the programme phases , and significantly safer alcohol-related attitudes to final follow-up , but both scores were converging by 32 months . Intervention students were significantly more likely to be non-drinkers or supervised drinkers than were comparison students . During the first and second programme phases , intervention students consumed 31.4 % and 31.7 % less alcohol . Differences were converging 17 months after programme delivery . Intervention students were 25.7 % , 33.8 % and 4.2 % less likely to drink to risky levels from first follow-up onwards . The intervention reduced the harm that young people reported associated with their own use of alcohol , with intervention students experiencing 32.7 % , 16.7 % and 22.9 % less harm from first follow-up onwards . There was no impact on the harm that students reported from other people 's use of alcohol . CONCLUSIONS The results of this study support the use of harm reduction goals and classroom approaches in school drug education Fifty-four untreated , mildly hypertensive men whose daily alcohol consumption was > or = 28 ml ethanol and who drank at least 4 times per week took part in a r and omized , controlled crossover trial . The purpose of the trial was to test the effects of alcohol reduction on blood pressure . After a 2-week familiarization period , the participants were assigned to either a reduced alcohol drinking group or a usual drinking group for 3 weeks ( experimental period 1 ) . The situation was then reversed for the next 3 weeks ( experimental period 2 ) . The participants were requested to limit their daily alcohol consumption to zero or reduce it as much as possible for the reduced alcohol consumption period . The self-reported alcohol consumption was 56.1 + /- 3.6 ( SEM ) ml/day during the usual alcohol drinking period and 26.1 + /- 3.0 ml/day during the period of reduced alcohol consumption . Systolic and diastolic blood pressures in the intervention group were found by analysis of variance to be significantly lower ( 2.6 - 4.8 and 2.2 - 3.0 mm Hg , respectively ) than those in the control group during experimental period 2 for systolic blood pressure and experimental period 1 for diastolic blood pressure . Significant ( 3.6 mm Hg ) and nonsignificant ( 1.9 mm Hg ) decreases in systolic and diastolic blood pressure , respectively , were observed . The method of Hills and Armitage was used , reducing ethanol in daily alcohol consumption by 28 ml . The lowering effect of reduced 
    Output:
    
Major benefits were observed for reducing alcohol-associated injuries , recovery of ventricular heart function in alcoholic cardiomyopathy , blood pressure lowering , normalization of biochemical parameter , body weight reduction , histological improvement in pre-cirrhotic alcohol-related liver disease and slowed progression of an already existing alcohol-attributable liver fibrosis .
Furthermore , reduced withdrawal symptoms , prevalence of psychiatric episodes and duration of in-patient hospital days , improvement of anxiety and depression symptoms , self-confidence , physical and mental quality of life , fewer alcohol-related adverse consequences as well as lower psychosocial stress levels and better social functioning can result from reduced alcohol intake .
The review ed literature demonstrated remarkable socioeconomic cost benefits in areas such as the medical health-care system or workforce productivity .
Individuals with heightened vulnerability further benefit significantly from alcohol reduction ( e.g. hypertension , hepatitis C , psychiatric co-morbidities , pregnancy , but also among adolescents and young adults ) .