***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: PURPOSE Research suggests that posttraumatic stress disorder ( PTSD ) may be associated with later medical morbidity . To assess this , we examined all-cause and cause-specific mortality among a national r and om sample of U.S. Army veterans with and without PTSD after military service . METHODS We used Cox proportional hazards regressions to examine the causes of death among 15,288 male U.S. Army veterans 16 years after completion of a telephone survey , approximately 30 years after their military service . These men were included in a national r and om sample of veterans from the Vietnam War Era . Our analyses adjusted for race , Army volunteer status , Army entry age , Army discharge status , Army illicit drug abuse , intelligence , age , and , additionally -- for cancer mortality -- pack-years of cigarette smoking . RESULTS Our findings indicated that adjusted postwar mortality for all-cause , cardiovascular , cancer , and external causes of death ( including motor vehicle accidents , accidental poisonings , suicides , homicides , injuries of undetermined intent ) was associated with PTSD among Vietnam Theater veterans ( N = 7,924 ) , with hazards ratios ( HRs ) of 2.2 ( p < 0.001 ) , 1.7 ( p = 0.034 ) , 1.9 ( p = 0.018 ) , and 2.3 ( p = 0.001 ) , respectively . For Vietnam Era veterans with no Vietnam service ( N = 7,364 ) , PTSD was associated with all-cause mortality ( HR = 2.0 , p = 0.001 ) . PTSD-positive era veterans also appeared to have an increase in external-cause mortality as well ( HR = 2.2 , p = 0.073 ) . CONCLUSIONS Our study suggests that Vietnam veterans with PTSD may be at increased risk of death from multiple causes . The reasons for this increased mortality are unclear but may be related to biological , psychological , or behavioral factors associated with PTSD and warrant further investigation IMPORTANCE Posttraumatic stress disorder ( PTSD ) indicates a chronic stress reaction in response to trauma . This prevalent condition has been identified as a possible risk factor for obesity . Whether PTSD symptoms alter the trajectory of weight gain or constitute a comorbid condition has not been established . OBJECTIVE To determine whether women who develop PTSD symptoms are subsequently more likely to gain weight and become obese relative to trauma-exposed women who do not develop PTSD symptoms or women with no trauma exposure or PTSD symptoms and whether the effects are independent of depression . DESIGN , SETTING , AND PARTICIPANTS The Nurses ' Health Study II , a prospect i ve observational study initiated in 1989 with follow-up to 2005 , using a PTSD screener to measure PTSD symptoms and time of onset . We included the sub sample of the Nurses ' Health Study II ( 54 224 participants ; ages 24 - 44 years in 1989 ) in whom trauma and PTSD symptoms were measured . EXPOSURES Trauma and PTSD symptoms . MAIN OUTCOMES AND MEASURES Development of overweight and obesity using body mass index ( BMI ) ( calculated as weight in kilograms divided by height in meters squared ) cut points 25.0 and 30.0 , respectively ; change in BMI during follow-up among women reporting PTSD symptom onset before 1989 ; and BMI trajectory before and after PTSD symptom onset among women who developed PTSD symptoms in 1989 or during follow-up . RESULTS Among women with at least 4 PTSD symptoms before 1989 ( cohort initiation ) , BMI increased more steeply ( b = 0.09 [ SE = 0.01 ] ; P < .001 ) during the follow-up . Among women who developed PTSD symptoms in 1989 or later , BMI trajectory did not differ by PTSD status before PTSD onset . After PTSD symptom onset , women with at least 4 symptoms had a faster rise in BMI ( b = 0.08 [ SE = 0.02 ] ; P < .001 ) . The onset of at least 4 PTSD symptoms in 1989 or later was also associated with an increased risk of becoming overweight or obese ( odds ratio , 1.36 [ 95 % CI , 1.19 - 1.56 ] ) among women with a normal BMI in 1989 . Effects were maintained after adjusting for depression . CONCLUSIONS AND RELEVANCE Experience of PTSD symptoms is associated with an increased risk of becoming overweight or obese , and PTSD symptom onset alters BMI trajectories over time . The presence of PTSD symptoms should raise clinician concerns about physical health problems that may develop and prompt closer attention to weight status OBJECTIVE To examine the relationship between body mass index ( BMI ) in bereaved youth and nonbereaved controls 5 years after a parent 's death . The study was conducted from August 9 , 2002 , through December 31 , 2013 . DESIGN A prospect i ve , longitudinal , controlled study of the effects of sudden parental death on youth . SETTING Bereaved families were recruited through coroner records and by advertisement .  Nonbereaved families were recruited using r and om-digit dialing and by advertisement . PARTICIPANTS 123 parentally bereaved offspring were compared with 122 nonbereaved control offspring , all of whom were aged 11 - 25 years at the 5-year assessment . MAIN EXPOSURE Bereavement status , type of parental death ( accident , suicide , or sudden natural death ) , and history of depression in caregivers prior to parental death . OUTCOME MEASURES BMI categories ( normal , overweight , and obese ) , according to International Obesity Task Force guidelines for adults and Centers for Disease Control and Prevention guidelines for children , and DSM-IV psychiatric disorder in offspring and caregivers before and after time of parental death . RESULTS Bereaved offspring were more likely to have a BMI in the obese range compared to nonbereaved controls ( χ2(2 ) = 7.13 , P < .01 ) . There were no differences in BMI category by death type among bereaved offspring . Caregiver history of depression was a significant correlate of offspring obesity in nonbereaved youth but had a protective effect on the BMI of bereaved youth . CONCLUSIONS Bereaved youth were more likely to be obese than nonbereaved youth 5 years after parental death , and caregiver history of depression was associated with increased risk for obesity in nonbereaved youth only . Future studies are necessary to identify mechanisms that increase risk for obesity in parentally bereaved youth Background : Studies of specific groups such as military veterans have found that posttraumatic stress disorder ( PTSD ) is linked to adverse health outcomes including unhealthy weight . The aim of this study was to examine the relationship between PTSD symptoms , experiences of childhood trauma and weight in a community sample . Methods : A stratified r and om probability survey was conducted in Denmark by the Danish National Centre for Social Research between 2008 and 2009 with 2,981 participants born in 1984 , achieving a response rate of 67 % . The participants were interviewed with a structured interview with questions pertaining PTSD symptomatology , exposure to childhood abuse , exposure to potentially traumatizing events , height , and weight  . Underweight was defined by a body mass index ( BMI ) < 18.5 , overweight was defined by a BMI ≥25 and < 30 and obesity was defined by a BMI ≥30 . Results : PTSD symptomatology and childhood abuse were significantly associated with both underweight and overweight/obesity . Childhood emotional abuse was especially associated with underweight , whereas sexual abuse and overall abuse were particularly associated with overweight/obesity . Conclusion : These findings indicate that health care professionals may benefit from assessing PTSD and childhood abuse in the treatment of both overweight and underweight individuals The evidence of increased cardiovascular disease ( CVD ) risk in posttraumatic stress disorder ( PTSD ) is accumulating . The present study aim ed to determine whether chronic , combat-related PTSD is associated with serum lipid and homocysteine concentrations that could indicate higher CVD risk . The authors tested 66 war veterans with PTSD , 33 war veterans without PTSD , and 42 healthy volunteers for serum concentrations of homocysteine , total cholesterol , high density lipoprotein cholesterol ( HDL-C ) , low density lipoprotein cholesterol ( LDL-C ) and triglycerides .  All the subjects were men and the analyses were adjusted for age , body mass index and smoking . Potential influences of depression , anxiety , and psychotic symptoms on the outcome measures were checked by introducing the scores from the Hamilton Depression Rating Scale ( HAM-D-17 ) , the Hamilton Anxiety Scale ( HAMA ) , and the Positive and Negative Syndrome Scale ( PANSS ) into the overall statistical model . No differences in total cholesterol , LDL-C , HDL-C and triglycerides were found between the groups . Non-smoking PTSD war veterans had higher homocysteine concentrations ( mean=10.4 micromol/L , SD=1.7 ) when compared to non-smoking war veterans without PTSD ( mean=8.2 micromol/L , SD=4.0 , P=0.014 ) and both smoking ( mean=8.7 micromol/L , SD=2.3 , P=0.008 ) and non-smoking healthy volunteers ( mean=8.8 micromol/L , SD=2.2 , P=0.021 ) . The results of our cross-sectional study are possibly confounded by many factors , especially behavioral and life-style related which are difficult to control comprehensively and might have influenced serum lipids and homocysteine concentration in a complex manner . An increase in the homocysteine concentration observed in the non-smoking PTSD patients needs further investigation with a carefully design ed prospect i ve study to confirm associated , possibly enhanced CVD risk IMPORTANCE Posttraumatic stress disorder ( PTSD ) has been associated in cross-sectional studies with peripheral inflammation . It is not known whether this observed association is the result of PTSD predisposing to inflammation ( as sometimes postulated ) or to inflammation predisposing to PTSD . OBJECTIVE To determine whether plasma concentration of the inflammatory marker C-reactive protein ( CRP ) helps predict PTSD symptoms . DESIGN , SETTING , AND PARTICIPANTS The Marine Resiliency Study , a prospect i ve study of approximately 2600 war zone-deployed Marines , evaluated PTSD symptoms and various physiological and psychological parameters before deployment and at approximately 3 and 6 months following a 7-month deployment . Participants were recruited from 4 all-male infantry battalions imminently deploying to a war zone . Participation was requested of 2978 individuals ; 2610 people ( 87.6 % ) consented and 2555 ( 85.8 % ) were included in the present analysis . Postdeployment data on combat-related trauma were included for 2208 participants ( 86.4 % of the 2555 included ) and on PTSD symptoms at 3 and 6 months after deployment for 1861 ( 72.8 % ) and 1617 ( 63.3 % ) participants , respectively . MAIN OUTCOMES AND MEASURES Severity of PTSD symptoms 3 months after deployment assessed by the Clinician-Administered PTSD Scale ( CAPS ) . RESULTS We determined the effects of baseline plasma CRP concentration on postdeployment CAPS using zero-inflated negative binomial regression ( ZINBR ) , a procedure design ed for distributions , such as CAPS in this study , that have an excess of zeroes in addition to being positively skewed . Adjusting for the baseline CAPS score , trauma exposure , and other relevant covariates , we found baseline plasma CRP concentration to be a highly significant overall predictor of postdeployment CAPS scores ( P = .002 ) : each 10-fold increment in CRP concentration was associated with an odds ratio of nonzero outcome ( presence vs absence of any PTSD symptoms ) of 1.51 ( 95 % CI , 1.15 - 1.97 ; P = .003 ) and a fold increase in outcome with a nonzero value ( extent of symptoms when present ) of 1.06 ( 95 % CI , 0.99 - 1.14 ; P = .09 ) . CONCLUSIONS AND RELEVANCE A marker of peripheral inflammation , plasma CRP may be prospect ively associated with PTSD symptom emergence , suggesting that inflammation may predispose to PTSD Background : Although overweight and obesity are less prevalent among active-duty military personnel compared with similar persons not serving in the military , no such differences have been observed between veterans and non-veterans . Objectives : To assess the magnitude of weight changes before , concurrent with and following discharge from the military , relative to weight during service , and to determine the demographic , service-related and psychological characteristics associated with clinical ly important weight gain among those who were discharged from military service during follow-up . Methods : Eligible Millennium Cohort Study participants ( n=38 686 ) completed the  question naires  approximately every 3 years ( 2001 , 2004 and 2007 ) that were used to estimate annual weight changes , as well as the percentage experiencing clinical ly important weight gain , defined as ⩾10 % . Analyses were stratified by sex . Results : Weight gain was greatest around the time of discharge from service and in the 3 years before 
    Output:
    
Despite limitations , the findings of this systematic review and meta- analysis suggest an association between PTSD and BMI .
Furthermore , longitudinal studies tentatively indicate that PTSD may lead to an increase in BMI and , as such , to the development of overweight/obesity , particularly in women .