***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 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 Objective Independently of total caloric intake , a better quality of the diet ( for example , conformity to the Mediterranean diet ) is associated with lower obesity risk . It is unclear whether a brief dietary assessment tool , instead of full-length comprehensive methods , can also capture this association . In addition to reduced costs , a brief tool has the interesting advantage of allowing immediate feedback to participants in interventional studies . Another relevant question is which individual items of such a brief tool are responsible for this association . We examined these associations using a 14-item tool of adherence to the Mediterranean diet as exposure and body mass index , waist circumference and waist-to-height ratio ( WHtR ) as outcomes . Design Cross-sectional assessment of all participants in the “ PREvención con DIeta MEDiterránea ” ( PREDIMED ) trial . Subjects 7,447 participants ( 55–80 years , 57 % women ) free of cardiovascular disease , but with either type 2 diabetes or ≥3 cardiovascular risk factors . Trained dietitians used both a vali date d 14-item question naire and a full-length vali date d 137-item food frequency question naire to assess dietary habits . Trained nurses measured weight , height and waist circumference . Results Strong inverse linear associations between the 14-item tool and all adiposity indexes were found . For a two-point increment in the 14-item score , the multivariable-adjusted differences in WHtR were −0.0066 ( 95 % confidence interval , –0.0088 to −0.0049 ) for women and –0.0059 ( –0.0079 to –0.0038 ) for men . The multivariable-adjusted odds ratio for a WHtR>0.6 in participants scoring ≥10 points versus ≤7 points was 0.68 ( 0.57 to 0.80 ) for women and 0.66 ( 0.54 to 0.80 ) for men . High consumption of nuts and low consumption of sweetened/carbonated beverages presented the strongest inverse associations with abdominal obesity . Conclusions A brief 14-item tool was able to capture a strong monotonic inverse association between adherence to a good quality dietary pattern ( Mediterranean diet ) and obesity indexes in a population of adults at high cardiovascular risk 
    Output:
    
New evidence from prospect i ve cohort studies , cross-sectional studies and clinical trials supports the beneficial role of adherence to the Mediterranean dietary pattern regarding metabolic syndrome presence and progression .