***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 Mediterranean diet has been suggested to play a beneficial role for health and longevity . However , to our knowledge , no prospect i ve US study has investigated the Mediterranean dietary pattern in relation to mortality . METHODS Study participants included 214,284 men and 166,012 women in the National Institutes of Health (NIH)-AARP ( formerly known as the American Association of Retired Persons ) Diet and Health Study . During follow-up for all-cause mortality ( 1995 - 2005 ) , 27,799 deaths were documented . In the first 5 years of follow-up , 5,985 cancer deaths and 3,451 cardiovascular disease ( CVD ) deaths were reported . We used a 9-point score to assess conformity with the Mediterranean dietary pattern ( components included vegetables , legumes , fruits , nuts , whole grains , fish , monounsaturated fat-saturated fat ratio , alcohol , and meat ) . We calculated hazard ratios ( HRs ) and 95 % confidence intervals ( CIs ) using age- and multivariate-adjusted Cox models . RESULTS The Mediterranean diet was associated with reduced all-cause and cause-specific mortality . In men , the multivariate HRs comparing high to low conformity for all-cause , CVD , and cancer mortality were 0.79 ( 95 % CI , 0.76 - 0.83 ) , 0.78 ( 95 % CI , 0.69 - 0.87 ) , and 0.83 ( 95 % CI , 0.76 - 0.91 ) , respectively . In women , an inverse association was seen with high conformity with this pattern : decreased risks that ranged from 12 % for cancer mortality to 20 % for all-cause mortality ( P = .04 and P < .001 , respectively , for the trend ) . When we restricted our analyses to never smokers , associations were virtually unchanged . CONCLUSION These results provide strong evidence for a beneficial effect of higher conformity with the Mediterranean dietary pattern on risk of death from all causes , including deaths due to CVD and cancer , in a US population 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 Objective To assess the relation between adherence to a Mediterranean diet and the incidence of diabetes  among initially healthy participants . Design Prospect i ve cohort study with estimates of relative risk adjusted for sex , age , years of university education , total energy intake , body mass index , physical activity , sedentary habits , smoking , family history of diabetes , and personal history of hypertension . Setting Spanish university department . Participants 13 380 Spanish university graduates without diabetes at baseline followed up for a median of 4.4 years . Main outcome measures Dietary habits assessed at baseline with a vali date d 136 item food frequency question naire and scored on a nine point index . New cases of diabetes confirmed through medical reports and an additional detailed question naire posted to those who self reported a new diagnosis of diabetes by a doctor during follow-up . Confirmed cases of type 2 diabetes . Results Participants who adhered closely to a Mediterranean diet had a lower risk of diabetes . The incidence rate ratios adjusted for sex and age were 0.41 ( 95 % confidence interval 0.19 to 0.87 ) for those with moderate adherence ( score 3 - 6 ) and 0.17 ( 0.04 to 0.75 ) for those with the highest adherence ( score 7 - 9 ) compared with those with low adherence ( score < 3 ) . In the fully adjusted analyses the results were similar . A two point increase in the score was associated with a 35 % relative reduction in the risk of diabetes ( incidence rate ratio 0.65 , 0.44 to 0.95 ) , with a significant inverse linear trend ( P=0.04 ) in the multivariate analysis . Conclusion Adherence to a Mediterranean diet is associated with a reduced risk of diabetes The aim of the present study was to investigate the effect of long-term diet and very long chain n-3 fatty acids ( VLC n-3 ) intervention on plasma coagulation factor VII ( FVII ) , choline-containing phospholipids ( PC ) and triglycerides ( TG ) , especially related to the R353Q polymorphism of the FVII gene . The present investigation included 219 subjects from the Diet and Omega-3 Intervention Trial on atherosclerosis ( DOIT ) , a 2x2 factorial design ed study in elderly men with long-st and ing hypercholesterolemia . The subjects were r and omly allocated to receive placebo capsules ( corn oil ) ( control ) , placebo capsules and dietary advice ( " Mediterranean type " diet ) , VLC n-3 capsules , or VLC n-3 capsules and dietary advice combined . The R353Q genotype and the levels of FVIIc , FVIIag , FVIIa , PC , and TG at baseline and after 6 months were determined . Diet intervention was followed by a significant reduction of 5.1 % in the levels of FVIIag and 2.4 mU/ml in FVIIa ( 95 % CI -7.4 , -2.9 , and -3.8 , -1.1 , respectively ) ( both p<0.001 ) compared to the no diet group , independent of genotype . No effects of diet intervention on FVIIc , PC or TG were observed . After VLC n-3 supplementation the TG levels were significantly reduced compared to placebo ( p=0.01 ) , whereas all FVII levels and PC remained unchanged . Dietary advice towards a " Mediterranean type " diet , but not VLC n-3 supplementation , was shown to reduce the levels of FVIIag and FVIIa after 6 months , independent of genotype . The results indicate the dietary advice to be more favourable in reducing this risk factor for CVD as compared to specific VLC n-3 supplementation BACKGROUND The Polyp Prevention Trial ( PPT ) was a multicenter r and omized clinical trial design ed to determine the effects of a high-fiber ( 4.30 g/MJ ) , high-fruit- and -vegetable ( 0.84 servings/MJ ) , low-fat ( 20 % of energy from fat ) diet on the recurrence of adenomatous polyps in the large bowel . OBJECTIVE Our goal was to determine whether the PPT intervention plan could effect change in 3 dietary goals and to examine the intervention 's effect on the intake of other food groups and nutrients . DESIGN Participants with large-bowel adenomatous polyps diagnosed in the past 6 mo were r and omly assigned to either the intervention ( n = 1037 ) or the control ( n = 1042 ) group and remained in the trial for 4 y. Three dietary assessment instruments were used to measure dietary change : food-frequency question naires ( in 100 % of the sample ) , 4-d food records ( in a 20 % r and om cohort ) , and 24-h dietary recalls ( in a 10 % r and om sample ) . RESULTS Intervention participants made and sustained significant changes in all PPT goals as measured by the dietary assessment instruments ; the control participants ' intakes remained essentially the same throughout the trial . The absolute differences between the intervention and control groups over the 4-y period were 9.7 % of energy from fat ( 95 % CI : 9.0 % , 10.3 % ) , 1.65 g dietary fiber/MJ ( 95 % CI : 1.53 , 1.74 ) , and 0.27 servings of fruit and vegetables/MJ ( 95 % CI : 0.25 , 0.29 ) . Intervention participants also reported significant changes in the intake of other nutrients and food groups . The intervention group also had significantly higher serum carotenoid concentrations and lower body weights than did the control group . CONCLUSION Motivated , free-living individuals , given appropriate support , can make and sustain major dietary changes over a 4-y period 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 CONTEXT Higher adherence to a Mediterranean-type diet is linked to lower risk for mortality and chronic diseases , but its association with cognitive decline is unclear . O 
    Output:
    
AUTHORS ' CONCLUSIONS The limited evidence to date suggests some favourable effects on cardiovascular risk factors .
More comprehensive interventions describing themselves as the Mediterranean diet may produce more beneficial effects on lipid levels than those interventions with fewer dietary components .