***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: Introduction Epidemiologic evidence suggests that tomato-based products could reduce the risk of cardiovascular diseases . One of the main cardiovascular risk factors is low levels of high-density lipoprotein cholesterol ( HDL-C ) . This study aim ed to prospect ively evaluate the effect of tomato consumption on HDL-C levels . Subject and methods We conducted a r and omized , single-blinded , controlled clinical trial . We screened 432 subjects with a complete lipid profile . Those individuals with low HDL-C ( men < 40 mg/dL and women < 50 mg/dL ) but normal triglyceride levels ( < 150 mg/dL ) were included . Selected participants completed a 2-week run-in period on an isocaloric diet and then were r and omized to receive 300 g of cucumber ( control group ) or two uncooked Roma tomatoes a day for 4 weeks . Results A total of 50 individuals ( women = 41 ; 82 % ) with a mean age of 42 ± 15.5 years and a mean body mass index of 27.6 ± 5.0 kg/m2 completed the study . A significant increase in HDL-C levels was observed in the tomato group ( from 36.5 ± 7.5 mg/dL to 41.6 ± 6.9 mg/dL , P < 0.0001 versus the control group ) . After stratification by gender , the difference in HDL-C levels was only significant in women . The mean HDL-C increase was 5.0 ± 2.8 mg/dL ( range 1–12 mg/dL ) . Twenty patients ( 40 % ) finished the study with levels > 40 mg/dL. A linear regression model that adjusted for those parameters that impact HDL-C levels ( age , gender , waist-to-hip ratio , body mass index , fasting triglyceride concentration , simple sugars , alcohol , physical activity , and omega-3 consumption ) showed an independent association between tomato consumption and the increase in HDL-C ( r2 = 0.69 ; P < 0.0001 ) . Conclusion Raw tomato consumption produced a favorable effect on HDL-C levels in overweight women In addition to the inverse association of dietary lycopene with various cancers , studies suggest a role for lycopene in cardiovascular disease ( CVD ) prevention . We determined whether the intake of lycopene or tomato-based foods is associated with the risk of CVD in a prospect i ve cohort of 39,876 middle-aged and older women initially free of CVD and cancer . Participants completed a food-frequency question naire and provided self-reports of coronary risk factors . Dietary lycopene levels were divided into quintiles , and primary lycopene food sources ( total tomato-based products , including tomatoes , tomato juice , tomato sauce and pizza ) were categorized . During 7.2 y of follow-up , 719 CVD cases ( including myocardial infa rct ion , stroke , revascularization and CVD death ) occurred . Compared with women in the 1st quintile of lycopene , those in increasing quintiles had multivariate relative risks ( RR ) of CVD of 1.11 , 1.14 , 1.15 and 0.90 ( P for trend = 0.34 ) . For the consumption of tomato-based products , women consuming 1.5 to < 4 , 4 to < 7 , 7 to < 10 and > or=10 servings/wk had RR ( 95 % CI ) of CVD of 1.02 ( 0.82 - 1.26 ) , 1.04 ( 0.82 - 1.31 ) , 0.68 ( 0.49 - 0.96 ) and 0.71 ( 0.42 - 1.17 ) ( P for trend = 0.029 ) compared with women consuming < 1.5 servings/wk . Among lycopene food sources , those in the highest levels of tomato sauce ( > or=2 servings/wk ) and pizza intake ( > or=2 servings/wk ) , with multivariate RR of 0.76 ( 0.55 - 1.05 ) and 0.66 ( 0.37 - 1.18 ) , respectively , had potential reductions in CVD risk . Dietary lycopene was not strongly associated with the risk of CVD . However , the possible inverse associations noted for higher levels of tomato-based products , particularly tomato sauce and pizza , with CVD suggest that dietary lycopene or other phytochemicals consumed as oil-based tomato products confer cardiovascular benefits Aims The mechanisms by which a ‘ Mediterranean diet ’ reduces cardiovascular disease ( CVD ) burden remain poorly understood . Lycopene is a potent antioxidant found in such diets with evidence suggesting beneficial effects . We wished to investigate the effects of lycopene on the vasculature in CVD patients and separately , in healthy volunteers ( HV ) . Methods and Results We r and omised 36 statin treated CVD patients and 36 healthy volunteers in a 2∶1 treatment allocation ratio to either 7 mg lycopene or placebo daily for 2 months in a double-blind trial . Forearm responses to intra-arterial infusions of acetylcholine  ( endothelium-dependent vasodilatation ; EDV ) ,  sodium nitroprusside  ( endothelium-independent vasodilatation ; EIDV ) , and NG-monomethyl-L-arginine  ( basal nitric oxide ( NO ) synthase activity ) were measured using venous plethysmography . A range of vascular and biochemical secondary endpoints were also explored . EDV in CVD patients post-lycopene improved by 53 % ( 95 % CI : + 9 % to + 93 % , P = 0.03 vs. placebo ) without changes to EIDV , or basal NO responses . HVs did not show changes in EDV after lycopene treatment . Blood pressure , arterial stiffness , lipids and hsCRP levels were unchanged for lycopene vs. placebo treatment groups in the CVD arm as well as the HV arm . At baseline , CVD patients had impaired EDV compared with HV ( 30 % lower ; 95 % CI : −45 % to −10 % , P = 0.008 ) , despite lower LDL cholesterol ( 1.2 mmol/L lower , 95 % CI : −1.6 to −0.9 mmol/L , P<0.001 ) . Post-therapy EDV responses for lycopene-treated CVD patients were similar to HVs at baseline ( 2 % lower , 95 % CI : −30 % to + 30 % , P = 0.85 ) , also suggesting lycopene improved endothelial function . Conclusions Lycopene supplementation improves endothelial function in CVD patients on optimal secondary prevention , but not in HVs . Trial Registration Clinical Trials.gov Epidemiological studies suggest that consumption of tomato products reduces the risk of CVD via antioxidant , hypocholesterolaemic and anti-inflammatory mechanisms . Although experimental data also describe beneficial effects on endothelial function , clinical data in human subjects are lacking . To test the hypothesis that tomato ingestion ameliorates endothelial function , we r and omised healthy non-smoking postmenopausal women to consume a buttered roll with and without tomato purée ( 70 g ) in a cross-over design . Endothelial-dependent flow-mediated dilation ( FMD ) and endothelial-independent nitro-mediated dilation of the brachial artery were assessed with high-resolution ultrasound ( 13 MHz linear array transducer ) . Acute ( 24 h ) and long-term ( 7 d ) effects were examined after daily consumption of the described meal . Nineteen volunteers completed the protocol and provided technically suitable ultrasound measurement data . Plasma lycopene levels increased from 0·30 ( sem 0·04 ) ( baseline ) to 0·42 ( sem 0·04 ) and to 0·74 ( sem 0·06 ) μm after 24 h and 7 d , respectively , with tomato purée consumption . These data indicated an effective absorption of the tomato product . However , both acute and long-term tomato purée consumption had no effects on endothelium-dependent or -independent dilation of the brachial artery . In addition , we found no correlation between lycopene plasma levels and FMD . In conclusion , consumption of tomato products associated with a significant increase in plasma lycopene levels had no effects on endothelial function in healthy postmenopausal women It is well established that exercise induces excessive production of reactive species leading to oxidative stress , which has been implicated in oxidative damage of macromolecules , immune dysfunction , muscle damage and fatigue . The present study examined the effect of supplementation of ultra-marathon runners for a two-months-period with a special whey protein bar containing carbohydrates and protein in a specific ratio ( 1:1 ) ( N=16 ) , prepared using as starting material the by-products of cheese manufacturing , and supplementation with commercially available tomato juice  ( N=15 ) .  Thiobarbituric-acid reactive substances and protein carbonyls were significantly decreased in both supplementation groups , while a pronounced increased in reduced glutathione was observed in the protein bar group . Total anti-oxidant activity remained unchanged in both groups . Flow-mediated dilatation , used as an estimate of endothelial function , was increased in both groups , with a significant rise observed only in the tomato juice administration group . In conclusion , supplementation of ultra marathon runners for a two-months-period with a special protein bar and tomato juice significantly improved the oxidative status of the subjects , while tomato juice also improved vascular endothelial function in these athletes Consumption of tomato products is linked to beneficial outcomes through antioxidant and anti-inflammatory mechanisms . The aim of this study was to determine whether a 14-day period of tomato paste supplementation would improve endothelial function . Nineteen volunteers ( mean age , 39 ± 13 years ; 8 men/11 women ) were studied in a r and omized ( exposure sequence ) , single-blind ( operator ) , crossover design . The study consisted of a supplementation arm ( 70 g tomato paste containing 33.3 mg of lycopene ) and a control arm , during which no tomato paste was added to their regular diet . Volunteers maintained their regular diet during study arms . Two-week washout periods preceded each arm . Flow-mediated dilatation ( FMD ) measured by brachial artery ultrasonography was used as an estimate of endothelial function at day 1 ( acute response ) and day 15 ( midterm response ) . Plasma lipid peroxides were measured with a photometric enzyme-linked immunosorbent assay as an index of total oxidative status . Tomato supplementation led to an overall FMD increase compared with the control period ( P = .047 for repeated- measures 3 × 2 analysis of variance ) . At day 1 , FMD was not significantly increased ( P = .329 ) . By day 15 , tomato supplementation result ed in an increase in FMD by 3.3 % ± 1.4 % , whereas at the control arm , FMD declined by -0.5 % ± 0.6 % ( P = .03 ) ; magnitudes of change are absolute FMD values . Total oxidative status decreased at the end of the supplementation period compared with baseline values ( P = .038 ) . Daily tomato paste consumption exerts a beneficial midterm but not short-term effect on endothelial function . Further studies are warranted to explore the effects of tomato paste on endothelial dilation in different age groups and comorbidities AIM Menopause is a pro-atherogenic state with a sharp rise in the incidence of coronary artery disease . This pilot study was design ed as an equivalence r and omized clinical trial to explore the potential of LycoRed ( containing 2000 microg lycopene ) as an alternative to hormone replacement therapy ( HRT ) for the prevention of coronary artery disease in postmenopausal women . METHODS Forty-one healthy postmenopausal women were r and omly allocated to receive either continuous combined HRT ( n = 21 ) or LycoRed ( n = 20 ) for six months . Serum lipid profile , marker of lipid peroxidation ( malondialdehyde ) , and the level of endogenous antioxidant ( glutathione ) were measured at the baseline , and 3 and 6 months after the intervention in both groups . RESULTS At 6 months , HRT result ed in a significant decrease in total cholesterol ( TC ) level by 23.5 % , low-density lipoproteins ( LDL ) by 19.6 % , and an increase in high-density lipoproteins ( HDL ) by 38.9 % . The LycoRed group showed similar changes in TC ( -24.2 % ) , LDL ( -14.9 % ) and HDL ( + 26.1 % ) . Triglyceride levels showed a smaller though significant increase at 6 months , but not at 3 months , in both groups . There was no significant change in the very LDL ( VLDL ) level in either group . Malondialdehyde levels decreased significantly by 16.3 % and 13.3 % , whereas glutathione levels increased significantly by 5.9 % and 12.5 % in HRT and LycoRed groups , respectively . CONCLUSION Both HRT and LycoRed had a favorable effect on serum lipids and oxidative stress markers which were comparable . LycoRed can be used as an alternative to 
    Output:
    
No other outcome was significantly affected by these interventions .
The available evidence on the effects of tomato products and lycopene supplementation on CV risk factors supports the view that increasing the intake of these has positive effects on blood lipids , blood pressure and endothelial function .
These results support the development of promising individualised nutritional strategies involving tomatoes to tackle CVD