***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 This study assessed the effect of a 1-year internet-based weight loss intervention  for men . Methods Four hundred forty-one overweight and obese men were r and omized to intervention or delayed treatment . Participants completed a Web-based assessment of diet and physical activity behaviors and weekly tailored Web modules addressing weight-related behaviors . Results At 12 months compared to controls , intervention men decreased percent of energy from saturated fat and increased grams of fiber and fruit/vegetable servings per 1.000 kcal ( p values < 0.001 ) and walked 16 min more per day ( p < 0.05 ) . No between-group differences in body mass index ( BMI ) , weight , or waist circumference were seen , but among completers , men in the highest tertile of intervention participation had lower weight ( 98.74 vs. 102.37 kg ) , BMI ( 32.38 vs. 33.46 ) , and waist circumference ( 42.17 vs. 43.47 cm ) compared to men who participated less often . Conclusions The intervention improved diet and activity behaviors , but weight loss occurred only for those with the highest adherence This article reports the 12-month follow-up results and process evaluation of the SHED-IT ( Self-Help , Exercise , and Diet using Information Technology ) trial , an Internet-based weight loss program exclusively for men . Sixty-five overweight/obese male staff and students at the University of Newcastle ( Callaghan , Australia ) ( mean ( s.d . ) age = 35.9 ( 11.1 ) years ; BMI = 30.6 ( 2.8 ) ) were r and omly assigned to either ( i ) Internet group ( n = 34 ) or ( ii ) Information only control group ( n = 31 ) . Both received one face-to-face information session and a program booklet . Internet group participants were instructed to use the study website for 3 months . Participants were assessed at baseline , 3- , 6- , and 12-month follow-up for weight , waist circumference , BMI , blood pressure , and resting heart rate . Retention at 3- and 12-months was 85 % and 71 % , respectively . Intention-to-treat ( ITT ) analysis using linear mixed models revealed significant and sustained weight loss of -5.3 kg ( 95 % confidence interval ( CI ) : -7.5 , -3.0 ) at 12 months for the Internet group and -3.1 kg ( 95 % CI : -5.4 , -0.7 ) for the control group with no group difference . A significant time effect was found for all outcomes ( P < 0.001 ) . Per- protocol analysis revealed a significant group-by-time interaction for weight , waist circumference , BMI , and systolic blood pressure . Internet group compliers ( who self-monitored as instructed ) maintained greater weight loss at 12 months ( -8.8 kg ; 95 % CI -11.8 , -5.9 ) than noncompliers ( -1.9 kg ; 95 % CI -4.8 , 1.0 ) and controls ( -3.0 kg ; 95 % CI -5.2 , -0.9 ) . Qualitative analysis by question naire and interview highlighted the acceptability and satisfaction with SHED-IT . Low-dose approaches to weight loss are feasible , acceptable , and can achieve clinical ly important weight loss in men after 1-year follow-up BACKGROUND The prevalence of male obesity is increasing but few men take part in weight loss programmes . We assessed the effect of a weight loss and healthy living programme on weight loss in football ( soccer ) fans . METHODS We did a two-group , pragmatic , r and omised controlled trial of 747 male football fans aged 35 - 65 years with a body-mass index ( BMI ) of 28 kg/m(2 ) or higher from 13 Scottish professional football clubs . Participants were r and omly assigned with SAS ( version 9·2 , block size 2 - 9 ) in a 1:1 ratio , stratified by club , to a weight loss programme delivered by community coaching staff in 12 sessions held every week . The intervention group started a weight loss programme within 3 weeks , and the comparison group were put on a 12 month waiting list . All participants received a weight management booklet . Primary outcome was mean difference in weight loss between groups at 12 months , expressed as absolute weight and a percentage of their baseline weight . Primary outcome assessment was masked . Analyses were based on intention to treat . The trial is registered with Current Controlled Trials , number IS RCT N32677491 . FINDINGS 374 men were allocated to the intervention group and 374 to the comparison group . 333 ( 89 % ) of the intervention group and 355 ( 95 % ) of the comparison group completed 12 month assessment s. At 12 months the mean difference in weight loss between groups , adjusted for baseline weight and club , was 4·94 kg ( 95 % CI 3·95 - 5·94 ) and percentage weight loss , similarly adjusted , was 4·36 % ( 3·64 - 5·08 ) , both in favour of the intervention ( p<0·0001 ) . Eight serious adverse events were reported , five in the intervention group ( lost consciousness due to drugs for pre-existing angina , gallbladder removal , hospital admission with suspected heart attack , ruptured gut , and ruptured Achilles tendon ) and three in the comparison group ( transient ischaemic attack , and two deaths ) . Of these , two adverse events were reported as related to participation in the programme ( gallbladder removal and ruptured Achilles tendon ) . INTERPRETATION The FFIT programme can help a large proportion of men to lose a clinical ly important amount of weight ; it offers one effective strategy to challenge male obesity . FUNDING Scottish Government and The UK Football Pools funded delivery of the programme through a grant to the Scottish Premier League Trust . The National Institute for Health Research Public Health Research Programme funded the assessment ( 09/3010/06 ) Objective To assess the effectiveness of a range of weight management programmes in terms of weight loss . Design Eight arm r and omised controlled trial . Setting Primary care trust in Birmingham , Engl and . Participants 740 obese or overweight men and women with a comorbid disorder identified from general practice records . Interventions Weight loss programmes of 12 weeks ’ duration : Weight Watchers ; Slimming World ; Rosemary Conley ; group based , dietetics led programme ; general practice one to one counselling ; pharmacy led one to one counselling ; choice of any of the six programmes . The comparator group was provided with 12 vouchers enabling free entrance to a local leisure ( fitness ) centre . Main outcome measures The primary outcome was weight loss at programme end ( 12 weeks ) . Secondary outcomes were weight loss at one year , self reported physical activity , and percentage weight loss at programme end and one year . Results Follow-up data were available for 658 ( 88.9 % ) participants at programme end and 522 ( 70.5 % ) at one year . All programmes achieved significant weight loss from baseline to programme end ( range 1.37 kg ( general practice ) to 4.43 kg ( Weight Watchers ) ) , and all except general practice and pharmacy provision result ed in significant weight loss at one year . At one year , only the Weight Watchers group had significantly greater weight loss than did the comparator group ( 2.5 ( 95 % confidence interval 0.8 to 4.2 ) kg greater loss , ) . The commercial programmes achieved significantly greater weight loss than did the primary care programmes at programme end ( mean difference 2.3 ( 1.3 to 3.4 ) kg ) . The primary care programmes were the most costly to provide . Participants allocated to the choice arm did not have better outcomes than those r and omly allocated to a programme . Conclusions Commercially provided weight management services are more effective and cheaper than primary care based services led by specially trained staff , which are ineffective . Trial registration Current Controlled Trials IS RCT N25072883 Obesity and physical inactivity are associated with both elevated cardiovascular risk and blood pressure ( BP ) , but the interrelation of exercise , weight loss and BP is poorly understood . This study examines the independent effects of exercise and weight loss on both st and ard clinic and automated , ambulatory BP in 115 overweight , sedentary , normotensive men ( aged 30 to 59 years ) who were r and omly assigned to control status or to lose weight over 1 year by moderate caloric restriction ( dieting ) or by increased caloric expenditure ( exercise ) .  Median daytime and evening BP were determined from measurements made every 20 minutes while the subjects were awake . After 1 year , the control group gained ( mean + /- st and ard deviation ) 0.5 + /- 3.8 kg while the diet group lost 6.9 + /- 4.4 kg and the exercise group lost 4.6 + /- 3.5 kg . Clinic BP decreased similarly in all 3 groups , but daytime and evening ambulatory BP decreased in both intervention groups and increased in the control group . Relative to the 1-year change in control subjects , net change in daytime ambulatory BP averaged -2 to -3 mm Hg in both dieters and exercisers , while net change in evening ambulatory BP averaged -3 to -4 mm Hg . These changes were all statistically significant ( p less than 0.05 ) when compared with control subjects except for daytime systolic BP in both intervention groups and evening diastolic BP in dieters . Weight loss achieved through caloric restriction or expenditure may cause important decreases in BP in normotensive men ; exercise appears to confer no unique benefit . If confirmed , these results have important public health implication s for the prevention of cardiovascular disease Summary Background The main associations of body-mass index ( BMI ) with overall and cause-specific mortality can best be assessed by long-term prospect i ve follow-up of large numbers of people . The Prospect i ve Studies Collaboration aim ed to investigate these associations by sharing data from many studies . Methods Collaborative analyses were undertaken of  baseline BMI versus mortality  in 57 prospect i ve studies with 894 576 participants , mostly in western Europe and North America ( 61 % [ n=541 452 ] male , mean recruitment age 46 [ SD 11 ] years , median recruitment year 1979 [ IQR 1975–85 ] , mean BMI 25 [ SD 4 ] kg/m2 ) . The analyses were adjusted for age , sex , smoking status , and study . To limit reverse causality , the first 5 years of follow-up were excluded , leaving 66 552 deaths of known cause during a mean of 8 ( SD 6 ) further years of follow-up ( mean age at death 67 [ SD 10 ] years ) : 30 416 vascular ; 2070 diabetic , renal or hepatic ; 22 592 neoplastic ; 3770 respiratory ; 7704 other . Findings In both sexes , mortality was lowest at about 22·5–25 kg/m2 . Above this range , positive associations were recorded for several specific causes and inverse associations for none , the absolute excess risks for higher BMI and smoking were roughly additive , and each 5 kg/m2 higher BMI was on average associated with about 30 % higher overall mortality ( hazard ratio per 5 kg/m2 [ HR ] 1·29 [ 95 % CI 1·27–1·32 ] ) : 40 % for vascular mortality ( HR 1·41 [ 1·37–1·45 ] ) ; 60–120 % for diabetic , renal , and hepatic mortality ( HRs 2·16 [ 1·89–2·46 ] , 1·59 [ 1·27–1·99 ] , and 1·82 [ 1·59–2·09 ] , respectively ) ; 10 % for neoplastic mortality ( HR 1·10 [ 1·06–1·15 ] ) ; and 20 % for respiratory and for all other mortality ( HRs 1·20 [ 1·07–1·34 ] and 1·20 [ 1·16–1·25 ] , respectively ) . Below the range 22·5–25 kg/m2 , BMI was associated inversely with overall mortality , mainly because of strong inverse associations with respiratory disease and lung cancer . These inverse associations were much stronger for smokers than for non-smokers , despite cigarette consumption per smoker varying little with BMI . Interpretation Although other anthropometric measures ( eg , waist circumference , waist-to-hip ratio ) could well add extra information to BMI , and BMI to them , BMI is in itself a strong predictor of overall mortality both above and below the apparent optimum of about 22·5–25 kg/m2 . The progressive excess mortality above this range is due mainly to vascular disease and is probably largely causal . At 30–35 kg/m2 , median survival is reduced by 2–4 years ; at 40–45 kg/m2 , it is reduced by 8–10 years ( which is comparable with the effects of smoking ) . The definite excess mortality below 22·5 kg/m2 is due mainly to smoking-related diseases , and is not fully explained . Funding UK Medical Research Council , British Heart Foundation , Cancer Research UK , EU BIOMED programme , US National Institute on Aging , and Clinical Trial Service Unit ( Oxford , UK ) Objective : To investigate the relationship of body weight and its changes over time with  physical activity ( PA ) . Design : Population -based prospect i ve cohort study ( Norfolk cohort of the European Prospect i ve Investigation into Cancer and Nutrition , EPIC-Norfolk , United Kingdom).Subjects : A total 
    Output:
    
Weight loss for men is best achieved and maintained with the combination of a reducing diet , increased physical activity , and behavior change techniques .