***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 evaluate the effectiveness of a culturally appropriate lifestyle intervention combined with orlistat in producing weight loss with obese Mexican-American women . SUBJECTS : Mexican-American women ( N=108 ) , aged 21–65 y , with a body mass index ( BMI ) ≥27 kg/m2 were r and omized to 1 y of treatment with  orlistat and a culturally tailored lifestyle modification intervention ( OLM ; n=56 ) or a wait-list control group ( WLC ; n=52 ) . DESIGN : A r and omized , controlled , open-label 12-month study . Orlistat was dosed at 120 mg , three times per day . The OLM intervention included behavior modification , a low-fat ( ≤30 % of total daily calories ) diet , and moderate physical activity ( ≥150 min/week).MEASUREMENT : Primary outcomes included changes in body weight ( kg ) , BMI , waist circumference , blood pressure , glucose , and lipids . RESULTS : A total of 72 ( 37 OLM , 35 WLC ) and 66 participants ( 32 OLM , 34 WLC ) completed the 6- and 12-month follow-ups , respectively . Repeated- measures ANOVA demonstrated a significant time × treatment interaction ( Wilks ' λ=12.61 ; P<0.001 ) , indicating that OLM-treated patients achieved significant weight loss relative to the WLC group during the study ( mean percentage weight loss±s.e.m . ; −8.1%±1.2 vs −1.6%±0.7 at 6 months and −8.8%±1.5 vs −0.2%±1.0 at 12 months , respectively ) . OLM-treated patients also experienced significant reductions in waist circumference , low-density-lipoprotein , and total cholesterol . CONCLUSIONS : This study demonstrates the effectiveness of an intervention combining orlistat and lifestyle modification with Mexican-American women , a population with substantial risk for obesity PURPOSE The purpose of this study was to evaluate the effects of a culturally sensitive diabetes education program for Hispanics with type 2 diabetes . METHODS This study is a prospect i ve cohort study to test the impact of a comprehensive diabetes education program on blood glucose control on Hispanics with type 2 diabetes . The educational program focused on maintaining glycemic control and general aspects of managing diabetes and complications . The study participants were recruited by flyers placed in Hispanic markets and in ambulatory care clinics . A total of 34 Hispanic male and female subjects with type 2 diabetes participated in the study . The concentrations of glucose , insulin , hemoglobin A1c ( HbA1c ) , total cholesterol , triglycerides , low-density lipoprotein and high-density lipoprotein ( HDL ) cholesterol were analyzed at baseline and at 3 months . RESULTS A significant mean change was observed for HbA1c , fasting plasma glucose , cholesterol/HDL ratio , and HDL after 3 months of education compared with baseline . There were significant reductions in weight , total fat , percent fat , trunk fat , and waist-to-hip ratio compared with baseline . After 3 months , subjects showed a significant positive correlation between changes in body mass index and insulin and weight , total fat , trunk fat , and fat free mass and insulin . CONCLUSIONS A culturally sensitive program conducted in Spanish had a significant impact on important clinical parameters in Hispanic subjects with diabetes in a relatively short time period . The study demonstrates the importance of design ing education intervention studies that are sensitive to cultural diversity , particularly in at-risk diabetic subjects This study tested the effects of an exercise and diet modification training program for weight loss  among Latinas . Forty four obese women were assigned to an experimental training group ( n = 22 ) or a control ( n = 22 ) , at r and om . One session per week for eight weeks included instruction for diet modification and walking for exercise , and all women were led in 20 min of walking during each session . Instruction was provided by a bi-cultural Spanish-speaking physician . Statistically significant ( P < 0.05 ) decreases , relative to controls , were obtained for Body Mass Index , waist to hip ratio , and serum cholesterol . Significant increases were obtained for fitness , exercise rate and frequency , and diet/exercise knowledge . Results suggest that the training was effective for decreasing obesity and increasing fitness among Low SES , Mexican-American women . Implication s for weight control and disease prevention among under-served population s are discussed The increasing prevalence of diabetes and obesity , growing health disparities , and shortage of bilingual and culturally trained health care professionals underscore the role of trained community health workers ( CHWs ) to provide economically sustainable and culturally relevant services . This prospect i ve r and omized design evaluated the relative effectiveness of a CHW intervention among Hispanic persons with newly diagnosed type 2 diabetes , as compared with usual clinic practice in three inner-city health centers . In sum , 189 Hispanic patients newly diagnosed with type 2 diabetes were r and omly assigned to one of three 6-month diabetes management approaches — CHW , case management , and st and ard provider care— and assessed for diabetes-related health measures and clinical indicators at baseline and postintervention . Participants in the CHW group achieved greater improvements than did the controls in program measures : health status , emergency department utilization , dietary habits , physical activity , and medication adherence . They also had 2.9 times greater odds of decreasing body mass index OBJECTIVE To examine associations of diet with acculturation among Hispanic immigrants from Mexico to Washington state and to compare dietary patterns of Hispanic with non-Hispanic white residents . DESIGN Data are part of the baseline assessment for a community-r and omized cancer prevention trial . The Fat-Related Diet Habits question naire and the National 5-A-Day for Better Health program dietary assessment instruments were used to collect data on fat and fruit and vegetable intake , respectively . Data were also collected on demographic characteristics and acculturation status . SUBJECTS/ SETTING A total of 1,689 adult Hispanic and non-Hispanic white residents of 20 communities in the Yakima Valley , WA , completed in-person interviews . STATISTICAL ANALYSES PERFORMED Mixed model regression analyses tested associations of acculturation with diet . These models compared the fat and the fruit and vegetable intake of Hispanics vs non-Hispanic white residents . Additional analyses compared the diets of highly acculturated Hispanics with low-acculturated Hispanics . All models included age , sex , income , and education and were also adjusted for the r and om effect of community . RESULTS Dietary patterns varied by ethnicity and acculturation status . On average , compared with non-Hispanic white residents , Hispanics consumed one more serving of fruits and vegetables per day ( P<.001 ) . Dietary habits changed as Hispanics acculturated to the United States . Highly acculturated Hispanics ate fewer servings of fruits and vegetables per day compared with those not highly acculturated ( P<.05 ) . Highly acculturated Hispanics had slightly higher , but not statistically significant , scores on the Fat-Related Diet Habits question naire , which corresponds to a higher fat intake , compared with low-acculturated Hispanics . The early dietary changes made on acculturation included adding fat at the table to breads and potatoes . APPLICATIONS/ CONCLUSIONS Nutrition professionals should encourage their Hispanic clients to maintain their traditional dietary practice s , such as a high intake of fruits and vegetables and eating bread and potatoes without added fat OBJECTIVES Our community-academic partnership employed community-based participatory research to develop and pilot a simple , peer-led intervention to promote weight loss  , which can prevent diabetes and eliminate racial/ethnic disparities in incident diabetes among overweight adults with prediabetes . METHODS We recruited overweight adults at community sites , performed oral glucose tolerance testing to identify persons with blood glucose levels in the prediabetes range , and r and omized eligible people to a  peer-led lifestyle intervention group or delayed intervention  in 1 year . Outcomes , including weight , blood pressure , and health behaviors , were measured at baseline and 3 , 6 , and 12 months . RESULTS More than half of those tested ( 56 % , or 99 of 178 ) had prediabetes and enrolled in the study . Participants were predominantly Spanish-speaking , low-income , undereducated women . The intervention group lost significantly more weight than the control group and maintained weight loss at 12 months ( 7.2 versus 2.4 pounds ; P < .01 ) . One fourth ( 24 of 99 ) of participants progressed to diabetes . CONCLUSIONS In underserved minority communities , prediabetes prevalence may be higher than previously reported . Low-cost , community-based interventions can succeed in encouraging weight loss to prevent diabetes Background Diabetes outcomes are worse for underserved patients from certain ethnic/racial minority population s.  Telephonic disease management is a cost-effective strategy to deliver self-management services and possibly improve diabetes outcomes for such patients . Objective We conducted a trial to test the effectiveness of a supplemental telephonic disease management program compared to usual care alone for patients with diabetes cared for in a community health center . Design R and omized controlled trial . Participants All patients had type 2 diabetes , and the majority was Hispanic or African American . Most were urban-dwelling with low socioeconomic status , and nearly all had Medicaid or were uninsured . Measurements Clinical measures included glycemic control , blood pressure , lipid levels , and body mass index . Vali date d surveys were used to measure dietary habits and physical activity . Results A total of 146 patients were r and omized to the intervention and 149 to the control group .  Depressive symptoms were highly prevalent in both groups . Using an intention to treat analysis , there were no significant differences in the primary outcome ( HbA1c ) between the intervention and control groups at 12 months . There were also no significant differences for secondary clinical or behavioral outcome measures including BMI , systolic or diastolic blood pressure , LDL cholesterol , smoking , or intake of fruits and vegetables , or physical activity . Conclusions A clinic-based telephonic disease management support for underserved patients with diabetes did not improve clinical or behavioral outcomes at 1 year as compared to patients receiving usual care alone The beneficial effects of moderate-intensity exercise on cardiorespiratory fitness and body composition are well documented , with the greatest health benefits reported in sedentary individuals who engage in moderate levels of exercise . The published literature contains no quantification of the threshold of lower limits of beneficial exercise or estimates of benefits derived from lower exercise levels . The specific aim of this study was to compare the effects of two walking frequencies , holding intensity and duration constant , on blood lipids , body composition , and exercise maintenance regimens of Mexican American women . A quasi-experimental design , with two treatment groups and one comparison group , was used to explore the dose-response effects of low-intensity exercise on cardiovascular outcomes . Significant interactions were found between walking and total serum cholesterol and skin-fold sums . This study demonstrated the clinical efficacy of a low-intensity exercise regimen on cardiovascular risk factors and exercise adherence A pilot study was conducted to determine if a nutritional intervention aim ed at portion control leads to significant weight loss in a community of low-income Mexican American women . Nineteen low-income Mexican American women were r and omized to a st and ard care group or an intervention group in portion control . The trial was 20 weeks in length , and the intervention included four 2-hour classes . Both interventions were administered by a certified nurse-midwife ( CNM ) and a promotora de salud ( i.e. , lay health advisor ) . Women in the intervention group lost more weight than women in the st and ard care group , though this difference was not statistically significant . The mean weight loss in the intervention group was 6.57 pounds ( 2.9 kg ) compared to a mean weight loss of 2.8 pounds ( 1.3 kg ) in the st and ard care group ( P = .47 ) . Mean weight loss , regardless of group , was significantly greater when participants reported self-weighing ( P = .02 ) . This pilot study in portion control for low-income Mexican American women merits further study Current knowledge is scarce on Latino dietary practice s. This study compared the dietary  practice s , alcohol consumption , and smoking behavior of Latinos and non-Latino whites in two r and omly selected sample s. Telephone surveys of adults 35 - 74 years of age from the Kaiser Permanente Medical Care Program ( Latinos = 844 ; non-Latino whites = 510 ) and from census tract-based areas ( Latinos = 806 ; non-Latino whites = 436 ) were conducted in the San Francisco Bay Area . Latino ethnicity was a significant predictor of dietary and alcohol consumption practice s in multivariate logistic regression models after adjustment for sex , education , age , employment , health insurance , martial status , county of residence , and self-perceived health status . Compared with non-Latino whites , Latinos were significantly less likely to report eating vegetables and more likely to eat rice , beans , and fried foods and to drink whole milk . Less acculturated Latinos were more likely to eat fruits , rice , beans , meat , and fried foods and to drink whole milk than more acculturated Latinos . Latino men were significantly more likely to be binge drinkers , and Latina women were significantly more likely to abstain from drinking alcohol during the month prior to the interview . As Latina women acculturate to the U.S. mainstream , they report more cigarette smoking and alcohol consumption . Although Latinos reported higher levels of selected high-fi 
    Output:
    
CONCLUSIONS Most interventions targeted physical activity and /or diet behavioral modification in Latinas and were led by bicultural/bilingual professionals .