***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 appropriate dietary intervention for overweight persons with type 2 diabetes mellitus ( DM2 ) is unclear . Trials comparing the effectiveness of diets are frequently limited by short follow-up times and high dropout rates . AIM The effects of a low carbohydrate Mediterranean ( LCM ) , a traditional Mediterranean ( TM ) , and the 2003 American Diabetic Association ( ADA ) diet were compared , on health parameters during a 12-month period . METHODS In this 12-month trial , 259 overweight diabetic patients ( mean age 55 years , mean body mass index 31.4 kg/m(2 ) ) were r and omly assigned to one of the three diets . The primary end-points were reduction of fasting plasma glucose , HbA1c and triglyceride ( TG ) levels . RESULTS 194 patients out of 259 ( 74.9 % ) completed follow-up . After 12 months , the mean weight loss for all patients was 8.3 kg : 7.7 kg for ADA , 7.4 kg for TM and 10.1 kg for LCM diets . The reduction in HbA1c was significantly greater in the LCM diet than in the ADA diet ( -2.0 and -1.6 % , respectively , p < 0.022 ) . HDL cholesterol increased ( 0.1 mmol/l + /- 0.02 ) only on the LCM ( p < 0.002 ) . The reduction in serum TG was greater in the LCM ( -1.3 mmol/l ) and TM ( -1.5 mmol/l ) than in the ADA ( -0.7 mmol/l ) , p = 0.001 . CONCLUSIONS An intensive 12-month dietary intervention in a community-based setting was effective in improving most modifiable cardiovascular risk factors in all the dietary groups . Only the LCM improved HDL levels and was superior to both the ADA and TM in improving glycaemic control Mediterranean-inspired diets have been shown to decrease cholesterol levels in patients with hypercholesterolaemia , who frequently exhibit endothelial dysfunction . The aims of the present study are to improve endothelial function by dietary intervention in healthy subjects with lipid levels representative of a Western population . Twenty-two healthy subjects ( mean total cholesterol , 5.6 mmol/l ) were given a Mediterranean-inspired diet rich in omega-3 fatty acids and sterol esters , but low in saturated fat , or an ordinary Swedish diet , for 4 weeks in a r and omized cross-over study . The composition of the diets were : in the Swedish diet , 2090 kcal ( where 1 kcal=4.184 kJ ; 48 % of energy from carbohydrate , 15 % from protein and 36 % from fat ) and 19 g of fibre ; in the Mediterranean-inspired diet , 1869 kcal ( 48 % of energy from carbohydrate , 16 % from protein , 34 % from fat ) and 40 g of fibre . After each dietary period , fasting blood lipids , insulin and glucose levels , as well as apo B ( apolipoprotein B ) and LDL ( low-density lipoprotein ) particle size , were analysed . Endothelial-dependent and -independent vasodilation was measured invasively by venous occlusion plethysmography , and arterial distensibility was assessed by echocardiography tracking . Fibrinolytic capacity across the forearm , as well as oxidative stress measured through urinary F(2)-isoprostane , were evaluated . Total , LDL- and apo B-cholesterol and triacylglycerol ( triglyceride ) concentrations were decreased by 17 % , 22 % , 16 % and 17 % respectively , after the Mediterranean-inspired diet compared with the Swedish diet ( P < 0.05 for all ) . However , no differences in plasma concentrations of insulin and glucose and LDL particle size , endothelial function , arterial distensibility , fibrinolytic capacity or oxidative stress were detected . Treatment for 4 weeks with a Mediterranean-inspired diet decreased blood lipids in healthy individuals with a low-risk profile for cardiovascular disease . This beneficial effect was not mirrored in vascular function or oxidative stress evaluation 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 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 BACKGROUND Although the typical diet of the Mediterranean region has received much recognition over the past several years for its association with substantial health benefits , it remains unknown whether its favorable effects are mediated through changes in adiponectin concentrations . OBJECTIVE The objective was to determine whether adherence to a Mediterranean-type diet is associated with higher plasma adiponectin concentrations . DESIGN This study was a prospect i ve and cross-sectional evaluation of plasma adiponectin concentrations and dietary data from 987 diabetic women from the Nurses ' Health Study who had no history of cardiovascular disease at the time blood was drawn in 1990 . RESULTS Women who scored highest on a 9-point scale that measures adherence to a Mediterranean-type dietary pattern tended to be older , were less likely to be current smokers , had lower body mass indexes and waist circumferences , and had higher total energy intakes , physical activities , and plasma adiponectin concentrations than did women with the lowest scores . Median plasma adiponectin concentrations were 23 % higher in women who most closely followed a Mediterranean-type diet than in low adherers after adjustment for age and energy intake ( P < 0.01 ) . Body composition , lifestyle , and medical history explained some , but not all , of the observed association between diet and adiponectin concentrations because high adherers tended to have greater adiponectin concentrations than did moderate or low adherers , even after adjustment for these variables . CONCLUSIONS Our data suggest that , of the several components of the Mediterranean dietary pattern score , alcohol , nuts , and whole grains show the strongest association with adiponectin concentrations . Close adherence to a Mediterranean-type diet is associated with higher adiponectin concentrations BACKGROUND An important therapeutic goal for patients with type 2 diabetes is weight loss , which improves metabolic abnormalities . Ad libitum low-fat diets cause weight loss in nondiabetic population s. Compared with diets higher in monounsaturated fat , however , eucaloric low-fat diets may increase plasma triacylglycerol concentrations and worsen glycemic control in persons with type 2 diabetes . OBJECTIVE We investigated whether , in type 2 diabetes patients , an ad libitum low-fat diet would cause greater weight loss than would a high-monounsaturated fat diet and would do this without increasing plasma triacylglycerol concentrations or worsening glycemic control . DESIGN Eleven patients with type 2 diabetes were r and omly assigned to receive an ad libitum low-fat , high-carbohydrate diet or a high-monounsaturated fat diet , each for 6 wk . The diets offered contained 125 % of the estimated energy requirement to allow self- selection of food quantity . The response variables were body weight ; fasting plasma lipid , lipoprotein , glucose , glycated hemoglobin A(1c ) , and fructosamine concentrations ; insulin sensitivity ; and glucose disposal . RESULTS Body weight decreased significantly ( 1.53 kg ; P < 0.001 ) only with the low-fat diet .  Plasma total , LDL- , and HDL-cholesterol concentrations tended to decrease during both diets . There were no interaction effects between diet and the lipid profile response over time . Plasma triacylglycerol concentrations , glycemic control , and insulin sensitivity did not differ significantly between the 2 diets . CONCLUSION Contrary to expectations , the ad libitum , low-fat , high-fiber diet promoted weight loss in patients with type 2 diabetes without causing unfavorable alterations in plasma lipids or glycemic control A r and omised crossover study of eight overweight or obese 
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These results are of considerable public health importance , because this dietary pattern can be easily adopted by all population groups and various cultures and cost-effectively serve for primary and secondary prevention of the MS and its individual components