***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: A new guar-containing wheatflake product was developed to assess its effect on carbohydrate tolerance in normal-weight , healthy subjects . The extruded wheatflake breakfast cereals containing 0 ( control ) or approximately 90 g guar gum/kg DM were fed to ten fasting , normal-weight , healthy subjects using a repeated measures design . The meals were similar in energy ( approximately 1.8 MJ ) , available carbohydrate ( 78 g ) , protein ( 15 g ) and fat ( 5.4 g ) content . The guar gum content of the test meals was 6.3 g. Venous blood sample s were taken fasting and at 15 , 30 , 45 , 60 , 90 , 120 , 150 and 240 min after commencing each breakfast and analysed for plasma glucose , insulin and C-peptide . The guar wheatflake meal produced a significant main effect for glucose and insulin at 0 - 60 min and 0 - 240 min time intervals respectively , but not for the C-peptide levels compared with the control meal . Significant reductions in postpr and ial glucose and insulin responses were seen following the guar wheatflake meal compared with the control meal at 15 and 60 min ( glucose ) and 15 , 60 , 90 and 120 min ( insulin ) . The 60 and 120 min areas under the curve for glucose and insulin were significantly reduced by the guar gum meal , as was the 240 min area under the curve for insulin . Thus , it can be concluded that the use of a severe method of heat extrusion to produce guar wheatflakes does not diminish the physiological activity of the guar gum The effects of an enzyme-hydrolyzed arabinoxylan from wheat ( AXOS ) versus an intact arabinoxylan from flax ( FLAX ) added to a ready-to-eat cereal ( RTEC ) on the postpr and ial appetitive , hormonal , and metabolic responses in overweight women ( BMI 25.0–29.9 kg/m2 ) were evaluated . Subsequent meal energy intake was also assessed . Two r and omized , double-blind , crossover design studies were completed . For trial 1 , the participants consumed the following RTEC breakfast , matched for total weight and varied in energy content : low-fiber ( LF , 4 g ) ; high-fiber ( HF , 15 g ) as either AXOS or FLAX . For trial 2 , the participants consumed LF , HF-AXOS , and HF-FLAX RTECs but also consumed another LF breakfast that was isocaloric ( LF-iso ) to that of the HF breakfasts . Perceived appetite and blood sample s ( trial 2 only ) were assessed before and after breakfast . An ad libitum lunch was offered 4 h post-breakfast . No differences in postpr and ial appetite responses were observed among any breakfasts in either trial . The HF-AXOS and HF-FLAX led to increased postpr and ial GLP-1 and peptide YY ( PYY ) concentrations vs. LF-iso . No differences were observed in lunch meal energy intake among breakfast meals in either trial . Collectively , these data suggest that 15 g of low molecular weight fiber added to RTECs did not affect perceived appetite or subsequent energy intake despite differences in satiety hormone signaling in overweight females Background — Among adults , skipping meals is associated with excess body weight , hypertension , insulin resistance , and elevated fasting lipid concentrations . However , it remains unknown whether specific eating habits regardless of dietary composition influence coronary heart disease ( CHD ) risk . The objective of this study was to prospect ively examine eating habits and risk of CHD . Methods and Results — Eating habits , including breakfast eating , were assessed in 1992 in 26 902 American men 45 to 82 years of age from the Health Professionals Follow-up Study who were free of cardiovascular disease and cancer . During 16 years of follow-up , 1527 incident CHD cases were diagnosed . Cox proportional hazards models were used to estimate relative risks and 95 % confidence intervals for CHD , adjusted for demographic , diet , lifestyle , and other CHD risk factors . Men who skipped breakfast had a 27 % higher risk of CHD compared with men who did not ( relative risk , 1.27 ; 95 % confidence interval , 1.06–1.53 ) . Compared with men who did not eat late at night , those who ate late at night had a 55 % higher CHD risk ( relative risk , 1.55 ; 95 % confidence interval , 1.05–2.29 ) . These associations were mediated by body mass index , hypertension , hypercholesterolemia , and diabetes mellitus . No association was observed between eating frequency ( times per day ) and risk of CHD . Conclusions — Eating breakfast was associated with significantly lower CHD risk in this cohort of male health professionals Objective : To test the hypothesis that a high carbohydrate breakfast with breakfast cereal leads to a meaningful reduction in dietary energy intake from fat , especially from saturated fat , and thus lower serum cholesterol levels . Design : An open r and omized controlled cross-over trial . The subjects were r and omized into intervention breakfast cereal or usual breakfast ( control ) groups . Setting : Free-living subjects aged 29–71 y in Eastern Finl and Subjects : 224 enrolled , 209 completed the study . The subjects were recruited from a survey of a r and om population sample and from other sources , and their serum cholesterol was not lower than 5.0 mmol/l . Recruited persons did not have any chronic disease or very low saturated fat intake . Intervention : The cereal group consumed 80 g ( men ) or 60 g ( women ) cereal at breakfast and the control group continued their usual dietary habits for six weeks . After a wash out of six weeks , a cross-over with another six week trial period took place . Measurements ( including serum sample s and a 3 d food record ) took place before and after the two trial periods . Results : The intervention period led to 2.5 en% ( energy percent units ) reduction in saturated fatty acids intake . The reduction in total fat intake was 5.5 en% . This was compensated for by increased intake of carbohydrates . The reduction in saturated fatty acids intake led to modest ( but in group 1 significant ) 0.15 mmol/l ( 2.5 % ) reduction in total serum cholesterol level . Conclusions : The trial showed that regular cereal breakfast can lead to reduced intake of total and saturated fatty acids of the daily diet and consequently to reduction in serum cholesterol level . Sponsorship : Supported by the Kellogg Company of Great Britain BACKGROUND Certain dietary components may play a role in the prevention of type 2 diabetes . OBJECTIVE We examined prospect ively the associations between whole- and refined-grain intake and the risk of type 2 diabetes  in a large cohort of men . DESIGN Men from the Health Professionals Follow-up Study without a history of diabetes or cardiovascular disease in 1986 ( n = 42898 ) were followed for < /=12 y. Intakes of whole and refined grains , measured every 4 y by use of food-frequency question naires , were used to predict subsequent type 2 diabetes risk through multivariate analysis . RESULTS We ascertained 1197 cases of incident type 2 diabetes . After adjustment for age ; physical activity ; cigarette smoking ; alcohol consumption ; family history of diabetes ; and fruit , vegetable , and energy intakes , the relative risk of type 2 diabetes was 0.58 ( 95 % CI : 0.47 , 0.70 ; P for trend < 0.0001 ) comparing the highest with the lowest quintile of whole-grain intake . The association was moderately attenuated when additionally adjusted for body mass index ( relative risk : 0.70 ; 95 % CI : 0.57 , 0.85 ; P for trend = 0.0006 ) . Intake of refined grains was not significantly associated with risk of type 2 diabetes . After further adjustment for magnesium intake , cereal fiber intake , and glycemic load , the association between whole grains and type 2 diabetes was attenuated and the trend no longer significant . CONCLUSIONS In men , a diet high in whole grains is associated with a reduced risk of type 2 diabetes in men that may be mediated by cereal fiber . Efforts should be made to replace refined-grain with whole-grain foods Epidemiological studies have shown an inverse association between dietary intake of whole grains and the risk of chronic disease . This may be related to the ability to mediate a prebiotic modulation of gut microbiota . However , no studies have been conducted on the microbiota modulatory capability of whole-grain ( WG ) cereals . In the present study , the impact of WG wheat on the human intestinal microbiota compared to wheat bran ( WB ) was determined . A double-blind , r and omised , crossover study was carried out in thirty-one volunteers who were r and omised into two groups and consumed daily 48 g breakfast cereals , either WG or WB , in two 3-week study periods , separated by a 2-week washout period . Numbers of faecal bifidobacteria and lactobacilli ( the target genera for prebiotic intake ) , were significantly higher upon WG ingestion compared with WB . Ingestion of both breakfast cereals result ed in a significant increase in ferulic acid concentrations in blood but no discernible difference in faeces or urine . No significant differences in faecal SCFA , fasting blood glucose , insulin , total cholesterol ( TC ) , TAG or HDL-cholesterol were observed upon ingestion of WG compared with WB . However , a significant reduction in TC was observed in volunteers in the top quartile of TC concentrations upon ingestion of either cereal . No adverse intestinal symptoms were reported and WB ingestion increased stool frequency . Daily consumption of WG wheat exerted a pronounced prebiotic effect on the human gut microbiota composition . This prebiotic activity may contribute towards the beneficial physiological effects of WG wheat BACKGROUND The glycemic index ( GI ) of a food is thought to directly reflect the rate of digestion and entry of glucose into the systemic circulation . The blood glucose concentration , however , represents a balance of both the entry and the removal of glucose into and from the blood , respectively . Such direct quantification of the postpr and ial glucose curve with respect to interpreting the GI is lacking in the literature . OBJECTIVE We compared the plasma glucose kinetics of low- and high-GI breakfast cereals . DESIGN On 2 occasions , plasma insulin concentrations and plasma glucose kinetics ( by constant-rate infusion of [6,6-(2)H(2)]glucose ) were measured in 6 healthy males for 180 min after they fasted overnight and then consumed an amount of corn flakes ( CF ) or bran cereal ( BC ) containing 50 g available carbohydrate . RESULTS The GI of CF was more than twice that of BC ( 131.5 + /- 33.0 compared with 54.5 + /- 7.2 ; P < 0.05 ) , despite no significant differences in the rate of appearance of glucose into the plasma during the 180-min period . Postpr and ial hyperinsulinemia occurred earlier with BC than with CF , result ing in a 76 % higher plasma insulin concentration at 20 min ( 20.4 + /- 4.5 compared with 11.6 + /- 2.1 micro U/mL ; P < 0.05 ) . This was associated with a 31 % higher rate of disappearance of glucose with BC than with CF during the 30 - 60-min period ( 28.7 + /- 3.1 compared with 21.9 + /- 3.1 micro mol . kg(-)(1 ) . min(-)(1 ) ; P < 0.05 ) . CONCLUSION The lower GI of BC than of CF was not due to a lower rate of appearance of glucose but instead to an earlier postpr and ial hyperinsulinemia and an earlier increase in the rate of disappearance of glucose , which attenuated the increase in the plasma glucose concentration BACKGROUND High homocysteine and low B vitamin concentrations have been linked to the risk of vascular disease , stroke , and dementia and are relatively common in older adults . OBJECTIVE We assessed the effect of breakfast cereal fortified with folic acid , vitamin B-6 , and vitamin B-12 on vitamin and homocysteine status . DESIGN A r and omized , double-blind trial was conducted in 189 volunteers aged 50 - 85 y. The subjects had no history of hypertension , anemia , asthma , cancer , or cardiovascular or digestive disease and did not regularly consume multiple or B vitamin supplements or highly fortified breakfast cereal . Subjects were r and omly assigned to consume 1 cup ( 0.24 L ) breakfast cereal fortified with 440 microg folic acid , 1.8 mg vitamin B-6 , and 4.8 microg vitamin B-12 or placebo cereal for 12 wk . Blood was drawn at 0 , 2 , 12 , and 14 wk . Methionine-loading tests were conducted at baseline and week 
    Output:
    
Consumption of RTEC is associated with a healthier dietary pattern , concerning intake of carbohydrates , dietary fiber , fat and micronutrients , however total sugar intake is higher .
Persons consuming RTEC frequently ( ≥ 5 times/week ) have a lower risk of inadequate micronutrient intake especially for vitamin A , calcium , folate , vitamin B 6 , magnesium and zinc .
Evidence from prospect i ve studies suggests that whole grain RTEC may have beneficial effects on hypertension and type 2 diabetes .
Consumption of RTEC with soluble fiber helps to reduce LDL cholesterol in hypercholesterolemic men  and RTEC fortified with folate can reduce plasma homocysteine .
Consumption of RTEC , especially of fiber-rich or whole grain RTEC , is implicated with several beneficial nutritional and health outcomes .
Of concern is the higher total sugar intake associated with frequent RTEC consumption