***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: The Minnesota Coronary Survey was a 4.5-year , open enrollment , single end-time , double-blind , r and omized clinical trial that was conducted In six Minnesota state mental hospitals and one nursing home . It Involved 4393 Institutionalized men and 4664 Institutionalized women . The trial compared the effects of a 39 % fat control diet ( 18 % saturated fat , 5 % polyunsaturated fat , 16 % monounsaturated fat , 446 mg dietary cholesterol per day ) with a 38 % fat treatment diet ( 9 % saturated fat , 15 % polyunsaturated fat , 14 % monounsaturated fat , 166 mg dietary cholesterol per day ) on serum cholesterol levels and the Incidence of myocardlal Infa rct ions , sudden deaths , and all-cause mortality . The mean duration of time on the diets was 384 days , with 1568 subjects consuming the diet for over 2 years . The mean serum cholesterol level In the pre-admission period was 207 mg/dl , falling to 175 mg/dl in the treatment group and 203 mg/dl In the control group . For the entire study population , no differences between the treatment and control groups were observed for cardiovascular events , cardiovascular deaths , or total mortality . A favorable trend for all these end-points occurred In some younger age groups OBJECTIVE To examine the influence of the PREMIER study lifestyle interventions on dietary intakes and adherence to the Dietary Approaches to Stop Hypertension ( DASH ) dietary pattern and the Dietary Reference Intakes ( DRI ) . DESIGN An 18-month multicenter , r and omized controlled trial comparing two multicomponent lifestyle intervention programs to an advice only control group . SUBJECTS/ SETTING A total of 810 participants were recruited from local communities and r and omized into the study . Individuals were eligible if they were aged 25 years or older , had body mass index between 18.5 and 45.0 , not taking antihypertensive medication , and had prehypertension or stage 1 hypertension ( systolic blood pressure 120 to 159 mm Hg and diastolic blood pressure 80 to 95 mm Hg ) . INTERVENTION The two active intervention programs were a behavioral lifestyle intervention that implements established recommendations , and an established intervention plus the DASH dietary pattern . Both interventions consisted of intensive group and individual counseling sessions . The control group received a brief advice session after r and omization and again after 6 months of data collection . Dietary intakes were collected by two r and om 24-hour recalls at baseline , 6 months , and 18 months . MAIN OUTCOME MEASURES The primary outcome of the PREMIER study was change in systolic blood pressure at 6 months . The main outcomes examined here include dietary variables collected by 24-hour recall at each time point . STATISTICAL ANALYSES Nutrient intakes were calculated and compared among the time points and the three intervention groups using mixed models with repeated measures at 6 and 18 months . Proportion of participants who met or achieved the original DASH nutrient intake levels and the DRIs were calculated and compared among the three intervention groups . P<0.01 was considered statistically significant . RESULTS Participants in both the established intervention and established intervention plus DASH dietary pattern groups substantially reduced energy , total fat , saturated fat , and sodium intake and these reductions persisted throughout the study . Established intervention plus DASH dietary pattern group participants increased intakes of fruits , vegetables , dairy , and many vitamins and minerals ; these increases were significantly greater than that of the control and established intervention groups . A majority of established intervention plus DASH dietary pattern group participants achieved at least two thirds of the DRI recommendations for most nutrients at 6 months , despite their reduction in total energy intake . Some but relatively small recidivism occurred at 18 months . CONCLUSIONS Both the established intervention and established intervention plus DASH dietary pattern group intervention were effective in helping participants follow established recommendations to control blood pressure . The advice-only control group also made some behavior changes , mainly decreasing energy and sodium intake . Only the established intervention plus DASH dietary pattern group significantly increased intakes of DASH-specific food groups , including fruits , vegetables , and dairy products , and nutrients , including protein , fiber , calcium , potassium , and magnesium . Most of the increases did not reach the levels consumed in the original DASH feeding studies . Whereas the established intervention plus DASH dietary pattern group intervention provides a useful platform to achieve the DASH dietary pattern and current DRI recommendations , intervention enhancements , including a greater emphasis on nutrient-dense foods , would likely improve this intervention Objective : Vasomotor symptoms (VMS)(hot flashes , night sweats ) are associated with natural or surgically or chemotherapy-induced menopause , the latter occurring frequently in women treated for breast cancer . To manage VMS , some women seek alternatives to menopausal hormone therapy , such as supplements or modified food choices . The objective of the present analyses was to assess associations of VMS occurrence and change in severity of VMS over 12 months with dietary intakes of fiber , fat , and selected soy-containing foods , and use of phytoestrogen or vitamin E supplements in women with recent early stage breast cancer , adjusting for covariates . Design : Using multivariate logistic regression , data were analyzed from 2,198 women with early-stage breast cancer who enrolled 2 to 48 months after diagnosis in the Women 's Healthy Eating and Living r and omized , controlled trial of a high-vegetable , high-fiber , reduced-fat diet .  Results : Being peri- or postmenopausal , using tamoxifen , having low social support or depressive symptoms , and using vitamin E or phytoestrogen supplements were significantly associated cross-sectionally with reporting moderate/severe VMS at enrollment . Increased symptom severity after 12 months was significantly associated with higher body mass index , tamoxifen use , and smoking . Decreased symptom severity at 12 months was significantly associated with high dietary fiber intake ; no decrease was observed in women who were peri- or postmenopausal , using tamoxifen , or had low fat intake or low social support . Conclusions High dietary fiber intakes , premenopausal , and high social support were related to decreased severity of VMS 1 year after study enrollment in women recently treated for breast cancer Restriction of energy intake ( ER ) , without malnutrition of essential nutrients , has repeatedly been demonstrated to increase longevity in rodents . In the antioxidant theory of aging the lack of balance between the generation of free radicals and free radical scavenging was thought to be a main causal agent , in the aging process . From this point of view the antiaging effect induced by ER might be due to the lower rate of free-radical production and related damage induced by a lower metabolic rate . The antiaging effects of ER might also occur in humans . This study explored the effects of a 10-week moderately energy-restricted diet ( 80 % of habitual ) in 24 non-obese middle-aged men ( 16 ER subjects , 8 controls ) on resting metabolic rate ( RMR ) and indicators of the primary antioxidant defense system , oxidative stress and genotoxicity . RMR decreased significantly in both groups , even when adjustments were made for the change in body composition . The increase in blood vitamin C concentration correlated with the increase in urinary 8-hydroxydeoxyguanosine ( 80HdG ) excretion . The change in urinary 80HdG excretion also correlated with the change in RMR per kg fat-free mass . No differences between groups were found for changes in indicators of genotoxicity , erythrocyte catalase , glutathione peroxidase and superoxide dismutase activity and in plasma vitamin E , A or beta-carotene concentrations . We conclude that 10 weeks of moderate ER did not affect indicators of antioxidative capacity , oxidative stress and genotoxicity of humans . Since subjects were not in energy balance at the end of the study , no conclusions can be made with respect to long-term effects BACKGROUND Dietary energy density ( ED ) reductions are associated with energy intake ( EI ) reductions . Little is known about influences on body weight ( BW ) . OBJECTIVES We examined the effects of behavioral interventions on ED values and explored how 6-mo ED changes relate to BW . DESIGN Prehypertensive and hypertensive persons were r and omly assigned to 1 of 3 groups : the established group received an 18-session intervention implementing well-established hypertension recommendations ( eg , weight loss , sodium reduction , and physical activity ) , the established+Dietary Approaches to Stop Hypertension ( DASH ) group received an 18-session intervention also implementing the DASH diet , and the advice group received 1 session on these topics . Two 24-h dietary recalls were collected ( n=658 ) . RESULTS Each group had significant declines in EI , ED , and BW . The established and established+DASH groups had the greatest EI and BW reductions . The established+DASH group had the greatest ED reduction and the greatest increase in the weight of food consumed . When groups were combined and analyzed by ED change tertiles , participants in the highest tertile ( ie , largest ED reduction ) lost more weight ( 5.9 kg ) than did those in the middle ( 4.0 kg ) or lowest ( 2.4 kg ) tertile . Participants in the highest and middle tertiles increased the weight of food they consumed ( 300 and 80 g/d , respectively ) but decreased their EI ( 500 and 250 kcal/d ) . Conversely , those in the lowest tertile decreased the weight of food consumed ( 100 g/d ) , with little change in EI . The highest and middle tertiles had favorable changes in fruit , vegetable , vitamin , and mineral intakes . CONCLUSION Both large and modest ED reductions were associated with weight loss and improved diet quality Dietary adherence to four different fat-modified diets was examined in 160 subjects by determining the fatty acid composition of serum cholesterol esters ( CEs ) and erythrocyte ( ER ) and platelet ( PT ) membranes in addition to food records . Subjects were r and omly assigned to one of the following diet groups : 1 ) high-sat--35/14:104 ( % of energy from total/saturated : monounsaturated : polyunsaturated fatty acids in the actual diet ) 2 ) AHA ( American Heart Association ) type--32/10:8:8 3 ) monoene-enriched--34/11:11:5 , or 4 ) low-fat--30/12:8:3 for 6 mo . Decreases in the proportions of palmitic acid in CEs were found in the AHA-type and monoene-enriched-diet groups . An increased proportion of linoleic acid in CEs was found in the AHA-type group . The differences in the proportions of palmitic acid in CEs and linoleic and palmitoleic acids in PTs were significant in the AHA-type and monoene-enriched-diet groups compared with the high-sat group . An increase in alpha-linolenic acid in CEs was an indicator of the use of low erucic acid rapeseed oil , which was the main source of monoenes in the monoene-enriched-diet group Two groups of patients with non-insulin-dependent diabetes mellitus ( NIDDM ) , with dietary advice r  and  omized between a low-carbohydrate ( LC ) diet and a modified-fat ( MF ) diet , were followed to determine the effect of diet on phospholipid fatty acid composition of platelets and on development of retinopathy in the 7 years following diagnosis . There was a tendency for retinopathy to occur more frequently in those r and omized to the LC diet . This difference was not statistically significant , and fatty acid composition of platelets did not differ significantly in those with and without retinopathy . Linoleic acid values from platelet phospholipid fatty acids were significantly higher in NIDDM on an MF diet compared with an LC diet . There was no difference between the two dietary subgroups with respect to platelet arachidonic acid , but this was lower in the whole diabetic population when compared with non-diabetics . The arachidonic acid values correlated with neither glycosylated haemoglobin nor mean glycaemia . Significant correlation between the fatty acid values for platelets and plasma cholesterol esters was found only for 16:0 Abstract In a clinical trial of a diet low in saturated fat and cholesterol , and high in unsaturated fat of vegetable origin , carried out on 846 middle-aged and elderly men living in an institution , the subjects were allocated r and omly to the experimental diet or to a control diet , and were followed double-blind . The combined incidence of myocardial infa rct ion , sudden death , and cerebral infa rct ion was significantly lower in the experimental group than in the control group . The incidence of fatal atherosclerotic events was also lower in the experimental group than in the control group , but total mortality-rates were similar for the two groups THE National Diet-Heart Study which was supported by the National Heart Institute , has been completed , and the final report appears as a supplement to CIRCULATION . This was a large double-blind , 2-year study on the effects of diet on blood cholesterol levels in both free-living and closed population s. The relevance of such a study originated in our minds as a result of a study we conducted for 10 months 
    Output:
    
The findings are suggestive of a small but potentially important reduction in cardiovascular risk on modification of dietary fat , but not reduction of total fat , in longer trials .