***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: Technology may improve self-monitoring adherence and dietary changes in weight loss treatment . Our study aim ed to investigate whether using a personal digital assistant ( PDA ) with dietary and exercise software , with and without a feedback message , compared to using a paper diary/record ( PR ) , results in greater weight loss and improved self-monitoring adherence . Healthy adults ( N = 210 ) with a mean BMI of 34.01 kg/m(2 ) were r and omized to one of three self-monitoring approaches : PR ( n = 72 ) , PDA with self-monitoring software ( n = 68 ) , or PDA with self-monitoring software and daily feedback messages ( PDA+FB , n = 70 ) . All participants received st and ard behavioral treatment .  Self-monitoring adherence and change in body weight , waist circumference , and diet were assessed at 6 months ; retention was 91 % . All participants had a significant weight loss ( P < 0.01 ) but weight loss did not differ among groups . A higher proportion of PDA+FB participants ( 63 % ) achieved ≥ 5 % weight loss in comparison to the PR group ( 46 % ) ( P < 0.05 ) and PDA group ( 49 % ) ( P = 0.09 ) . Median percent self-monitoring adherence over the 6 months was higher in the PDA groups ( PDA 80 % ; PDA+FB 90 % ) than in the PR group ( 55 % ) ( P < 0.01 ) . Waist circumference decreased more in the PDA groups than the PR group ( P = 0.02 ) . Similarly , the PDA groups reduced energy and saturated fat intake more than the PR group ( P < 0.05 ) . Self-monitoring adherence was greater in the PDA groups with the greatest weight change observed in the PDA+FB group PURPOSE The present study evaluated whether an intervention using a short message service ( SMS ) by cellular phone and Internet would improve blood pressure , weight control , and serum lipids of obese patients with hypertension during 8 weeks . METHODS This is a quasi-experimental design with pre- and follow-up tests . Participants were recruited from the family medicine outpatient department of tertiary care hospital located in an urban city of South Korea . Twenty-eight patients were assigned to an intervention group and 21 to a control group . The goal of intervention was to bring blood pressure , body weight , and serum lipids levels close to normal ranges . Patients in the intervention group were requested to record their blood pressure and body weight in a weekly web based diary through the Internet or by cellular phones . The research ers sent optimal recommendations as an intervention to each patient , by both cellular phone and Internet weekly . The intervention was applied for 8 weeks . RESULTS Systolic ( SBP ) and diastolic blood pressures ( DBP ) significantly decreased by 9.1 and 7.2 mmHg respectively at 8 weeks from the baseline in the intervention group ( p<0.05 ) . However , after 8 weeks from the baseline both SBP and DBP in the control group had not changed significantly . Yet , There were significant mean decreases in body weight and waist circumference by 1.6 kg ( p<0.05 ) and 2.8 cm ( p<0.05 ) in the intervention group , respectively . In the control group increases in body weight and waist circumference ( p<0.05 ) mean changes were also significant . High density lipoprotein cholesterol ( HDL-C ) significantly increased , with a mean change of 3.7 mg/dl at 8 weeks from baseline in the intervention group ( p<0.05 ) . The mean change of HDL-C in the control group was , however , not significant . CONCLUSION During 8 weeks using this web-based intervention by way of cellular phone and Internet SMS improved blood pressure , body weight , waist circumference , and HDL-C in patients with obese hypertension Background For most individuals , long-term maintenance of weight loss requires long-term , supportive intervention . Internet-based weight loss maintenance programs offer considerable potential for meeting this need . Careful design processes are required to maximize adherence and minimize attrition . Objective This paper describes the development , implementation and use of a Web-based intervention program design ed to help those who have recently lost weight sustain their weight loss over 1 year . Methods The weight loss maintenance website was developed over a 1-year period by an interdisciplinary team of public health research ers , behavior change intervention experts , applications developers , and interface design ers . Key interactive features of the final site include social support , self-monitoring , written guidelines for diet and physical activity , links to appropriate websites , supportive tools for behavior change , check-in accountability , tailored reinforcement messages , and problem solving and relapse prevention training . The weight loss maintenance program included a reminder system ( automated email and telephone messages ) that prompted participants to return to the website if they missed their check-in date . If there was no log-in response to the email and telephone automated prompts , a staff member called the participant . We tracked the proportion of participants with at least one log-in per month , and analyzed log-ins as a result of automated prompts . Results The mean age of the 348 participants enrolled in an ongoing r and omized trial and assigned to use the website was 56 years ; 63 % were female , and 38 % were African American . While weight loss data will not be available until mid-2008 , website use remained high during the first year with over 80 % of the participants still using the website during month 12 . During the first 52 weeks , participants averaged 35 weeks with at least one log-in . Email and telephone prompts appear to be very effective at helping participants sustain ongoing website use . Conclusions Developing interactive websites is expensive , complex , and time consuming . We found that extensive paper prototyping well in advance of programming and a versatile product manager who could work with project staff at all levels of detail were essential to keeping the development process efficient . Trial Registration clinical trials.gov OBJECTIVE To develop and evaluate a pictorial , web-based version of the NCI diet history question naire ( Web-PDHQ ) . DESIGN The Web-PDHQ and paper version of the DHQ ( Paper-DHQ ) were administered 4 weeks apart with 218 participants r and omised to order . Dietary data from the Web-PDHQ and Paper-DHQ were vali date d using a r and omly selected 4 d food record recording period ( including a weekend day ) and two r and omly selected 24 h dietary recalls during the 4 weeks intervening between these two diet history administrations . SETTING Research office in Reston , VA , USA . PARTICIPANTS Computer-literate men and women recruited through newspaper advertisements . RESULTS Mean correlation of energy and the twenty-five examined nutrients between the Web-PDHQ and Paper-DHQ was 0.71 and 0.51 , unadjusted and energy-adjusted by the residual method , respectively . Moderate mean correlations ( unadjusted 0.41 and 0.38 ; energy-adjusted 0.41 and 0.34 ) were obtained between both the Web-PDHQ and Paper-DHQ with the 4 d food record on energy and nutrients , but the correlations between the Web-PDHQ and Paper-DHQ with the 24 h recalls were modest ( unadjusted 0.31 and 0.29 ; energy-adjusted 0.37 and 0.26 ) . A subset of participants ( n 48 ) completing the Web-PDHQ at the initial visit performed a retest on the same question naire 1 week later to determine repeatability , and the unadjusted mean correlation was 0.82 . CONCLUSIONS These data indicate that the Web-PDHQ has comparable repeatability and validity to the Paper-DHQ but did not improve the relationship of the DHQ to other food intake measures ( e.g. food records , 24 h recall ) PURPOSE The present study evaluated whether an intervention using the SMS by personal cellular phone and internet would improve the levels of plasma glucose of obese type 2 diabetes at 3 , 6 , 9 , and 12 months . METHODS This is a quasi-experimental design with pre- and follow-up tests . Participants were recruited from the endocrinology outpatient department of tertiary care hospital located in an urban city of South Korea . Eighteen patients were r and omly assigned to an intervention group and 16 to a control group . The goal of the intervention was to decrease body weight and keep blood glucose concentrations close to the normal range . Patients were requested to record their blood glucose level  in a weekly diary on the website by personal cellular phones or computer internet . The research er sent optimal recommendations to each patient , by both the cellular phone and the Internet weekly . The intervention was applied for 1 year . RESULTS Glycosylated hemoglobin ( HbA(1)c ) decreased 1.22 percentage points at 3 months , 1.09 percentage points at 6 months , 1.47 percentage points at 9 months , and 1.49 percentage points at 12 months compared with baseline in the intervention group ( all time points , p<0.05 ) . The percentage change in the control group was , however , not significant . Patients in the intervention group had a decrease of 2-h post-pr and ial test ( 2HPPT ) of 120.1mg/dl at 3 months , 58.9 mg/dl at 6 months , 62.0mg/dl at 9 months , and 102.9 mg/dl at 12 months compared with baseline ( all time points , p<0.05 ) . The mean change in the control group was , however , not significant . CONCLUSION This web-based intervention using SMS of personal cellular phone and Internet improved HbA(1)c and 2HPPT at 3 , 6 , 9 , and 12 months in patients with obese type 2 diabetes OBJECTIVE To determine the characteristics and behaviors associated with adherence to dietary protein interventions among participants with chronic renal disease in the Modification of Diet in Renal Disease ( MDRD ) Study . DESIGN Participants were categorized as consistent adherers or nonadherers on the basis of urinary urea nitrogen excretion and dietary protein intake data from self-reports . Psychosocial and behavioral factors were compared between groups . SUBJECTS Subgroups of consistently adherent and non-adherent participants in the MDRD Study . SETTING 15 clinical centers in the United States . INTERVENTION In the nutrition intervention program , participants were assigned r and omly to a usual- , low- , or very-low-protein diet group . Each eating pattern also specified a phosphorus goal . STATISTICAL ANALYSIS Analysis of variance . RESULT Psychosocial factors significantly related to adherence included participant knowledge , attitude , support , satisfaction , and self-perception of success . Behavioral strategies including participant self-monitoring of protein intake and the provision of feedback by the dietitian were also significantly related to adherence . APPLICATION Nutrition interventions for patients with renal disease should focus on psychosocial factors and behavioral approaches . Such approaches can be successfully incorporated into treatment programs and will assist the dietitian in promoting adherence to usual- , low- , and very-low-protein eating patterns Objective : To evaluate the capability of DietMatePro , a PDA-based dietary assessment program , to monitor dietary intake and to improve adherence to a dietary regimen . Design : R and omized controlled trial . Subjects . Overweight and obese ( Body Mass Index ( BMI ) 25–40 ) participants without dietary restrictions . Intervention : Participants ( n = 174 ) were r and omized to record usual dietary intake using either DietMatePro or a paper food diary for one week to compare concordance with 24-hr recall . At the week 1 visit , participants were individually counseled to follow the diet recommendations of the Ornish Prevention Diet for three weeks and continue monitoring food intake using the assigned method to estimate adherence to the intervention by monitoring condition . Outcome Measures : Spearman correlations between week 1 24-hr recall and the assigned recording method were compared to assess validity . Mean pre-post changes in intake measured by 24-hr recall were compared according to monitoring condition to measure adherence to the Ornish diet . Results : Correlations of energy and nutrient values reported on the food label ranged from 0.41 to 0.71 for the DietMatePro condition versus 0.63 to 0.83 for the paper-based diary . Diet adherence was higher among DietMatePro ( 43 % ) compared to the paper diary ( 28 % ) group ( p = 0.039 ) . Conclusions /Applications : DietMatePro does not appear to produce more valid data than paper-based approaches . DietMatePro may improve adherence to dietary regimens compared to paper-based methods 
    Output:
    
The tested web applications offered similar functionalities for recording food intake .
The systems studied provided some degree of personalization : users can access some systems via PCs or mobile phones and they can choose among various types of data input content for recording food intake .
Many functions , such as search in a food data base , reports , graphical presentation , listing of favorite foods , and overview of the user 's own meals , are optimized to simplify the recording process and save time .
Data sharing and reports are common features of the review ed systems .
However , none use the user 's recorded food history to make suggestions on new nutritional intake , during the food recording process .