***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 study was made of the effect of high or low intake of sucrose for periods of 14 days in a group of nineteen apparently healthy men . The high sucrose diet produced no change in blood levels of cholesterol or phospholipids , or in glucose tolerance , but it produced a significant rise in triglycerides in all nineteen men . In six of them , there was in addition a rise in serum immunoreactive insulin , especially during the glucose tolerance test , and these same six subjects also showed a considerable increase in weight and a significant increase in platelet adhesiveness . There was no difference between the six subjects and the remaining thirteen in any of the other measurements , or in the diets they consumed during the experiment . The changes produced by sucrose had disappeared , or nearly so , after 14 days of normal diet . It is suggested that the effect of sucrose in producing hyperinsulinism may be more relevant to its possible role in the aetiology of ischaemic heart disease than its effect on blood lipids . It is further suggested that only some individuals are susceptible to the development of ischaemic heart disease by dietary sucrose , and that these may be identified as those that show ‘ sucrose-induced hyperinsulinism ’ To examine whether artificial sweeteners aid in the control of long-term food intake and body weight , we gave free-living , normal-weight subjects 1150 g soda sweetened with aspartame ( APM ) or high-fructose corn syrup ( HFCS ) per day . Relative to when no soda was given , drinking APM-sweetened soda for 3 wk significantly reduced calorie intake of both females ( n = 9 ) and males ( n = 21 ) and decreased the body weight of males but not of females . However , drinking HFCS-sweetened soda for 3 wk significantly increased the calorie intake and body weight of both sexes . Ingesting either type of soda reduced intake of sugar from the diet without affecting intake of other nutrients . Drinking large volumes of APM-sweetened soda , in contrast to drinking HFCS-sweetened soda , reduces sugar intake and thus may facilitate the control of calorie intake and body weight BACKGROUND The diet may influence the development of abdominal obesity , but the few studies that have prospect ively examined the relations between diet and changes in waist circumference ( WC ) have given inconsistent results . OBJECTIVE Associations between total energy intake , energy intake from macronutrients , and energy intake from macronutrient subgroups based on different food sources and 5-y differences in WC ( DWC ) were investigated . DESIGN A Danish cohort of 22 570 women and 20 126 men aged 50 - 64 y with baseline data on WC , diet , BMI , and potential confounders reported their WC 5 y later . Associations of baseline diet with DWC were assessed by multiple linear regression analysis . RESULTS Neither total energy intake nor energy intake from each of the macronutrients was associated with DWC , except for an inverse association with protein , especially animal protein . In women , positive associations with DWC were seen for carbohydrate from refined grains and potatoes and from foods with simple sugars , whereas carbohydrate from fruit and vegetables was inversely associated and significantly different from any other carbohydrate subgroup . The results for men resembled those for women , although none were significant . Vegetable fat was positively associated with DWC for both men and women in a combined analysis . A U-shaped association between alcohol from wine and DWC was present for both sexes , and alcohol from spirits was positively associated with DWC in women . CONCLUSIONS Although no significant associations with total energy or energy from fat , carbohydrate , or alcohol were observed , protein intake was inversely related to DWC , and some macronutrient subgroups were significantly associated with DWC Soft drinks and other sweetened beverages may contribute to risk of type 2 diabetes and obesity . However , research has not addressed higher risk and Asian population s. The authors examined the association between soft drinks and juice and the risk of  type 2 diabetes among Chinese Singaporeans enrolled in a prospect i ve cohort study of 43,580 participants aged 45 - 74 years and free of diabetes and other chronic diseases at baseline . The incidence of physician-diagnosed type 2 diabetes was assessed by interview and vali date d ; 2,273 participants developed diabetes during follow-up . After adjustment for potential lifestyle and dietary confounders , participants consuming > or = 2 soft drinks per week had a relative risk of type 2 diabetes of 1.42 ( 95 % confidence interval ( CI ) : 1.25 , 1.62 ) compared with those who rarely consumed soft drinks . Similarly , consumption of > or = 2 juice beverages per week was associated with an increased risk ( relative risk ( RR ) = 1.29 , 95 % CI : 1.05 , 1.58 ) . The association was modified by 5-year weight gain for > or = 2 soft drinks per week among those who gained > or =3 kg ( RR = 1.70 , 95 % CI : 1.34 , 2.16 ) compared with those who gained less weight ( RR = 1.20 , 95 % CI : 1.03 , 1.41 ) . Relatively frequent intake of soft drinks and juice is associated with an increased risk for development of type 2 diabetes in Chinese men and women BACKGROUND The rising prevalence of obesity in children has been linked in part to the consumption of sugar-sweetened drinks . Our aim was to examine this relation . METHODS We enrolled 548 ethnically diverse schoolchildren ( age 11.7 years , SD 0.8 ) from public schools in four Massachusetts communities , and studied them prospect ively for 19 months from October , 1995 , to May , 1997 . We examined the association between baseline and change in consumption of sugar-sweetened drinks ( the independent variables ) , and difference in measures of obesity , with linear and logistic regression analyses adjusted for potentially confounding variables and clustering of results within schools . FINDINGS For each additional serving of sugar-sweetened drink consumed , both body mass index ( BMI ) ( mean 0.24 kg/m2 ; 95 % CI 0.10 - 0.39 ; p=0.03 ) and frequency of obesity ( odds ratio 1.60 ; 95 % CI 1.14 - 2.24 ; p=0.02 ) increased after adjustment for anthropometric , demographic , dietary , and lifestyle variables . Baseline consumption of sugar-sweetened drinks was also independently associated with change in BMI ( mean 0.18 kg/m2 for each daily serving ; 95 % CI 0.09 - 0.27 ; p=0.02 ) . INTERPRETATION Consumption of sugar-sweetened drinks is associated with obesity in children The effect of dietary fructose ( 20 % of carbohydrate calories , 45 - 65 g day-1 for 4 weeks ) on glycaemic control , serum lipid , lipoprotein and apoprotein A-I and A-II concentrations and on insulin sensitivity was studied in 10 type 2 diabetic patients . The study was done in a r and omized , double-blind fashion with crystalline fructose or placebo administered evenly during 4 meals or snacks per day . The patients were hospitalized throughout the study periods . The fasting plasma glucose concentration decreased during the fructose ( from 10.7 + /- 1.4 mmol l-1 to 8.0 + /- 0.8 mmol l-1 , P < 0.02 ) and the control diet ( from 10.1 + /- 0.9 mmol l-1 to 8.0 + /- 0.7 mmol l-1 , P < 0.05 ) . The mean diurnal blood glucose concentration also fell both during the fructose ( from 10.8 + /- 0.5 mmol l-1 to 8.4 + /- 0.3 mmol l-1 , P < 0.001 ) and the control diet ( from 10.3 + /- 0.3 mmol l-1 to 8.8 + /- 0.9 mmol l-1 , P < 0.01 ) . The HbA1 concentration improved ( P < 0.02 ) only during the fructose diet . Insulin sensitivity increased by 34 % ( P < 0.05 ) during the fructose diet , but remained unchanged during the control period . Serum insulin , triglyceride , apoprotein A-I and A-II concentrations , body weight , blood pressure and blood lactate remained unchanged during both diets . In conclusion , substitution of moderate amounts of fructose for complex carbohydrates can improve glycaemic control and insulin sensitivity in patients with type 2 diabetes BACKGROUND & AIMS It has been hypothesized that snacking could be a major factor in the development of obesity . However , the relationship between snacking and the increment in body weight remains controversial . Moreover , longitudinal studies about this issue are scarce . Thus , our objective was to prospect ively assess the relationship between snacking and weight gain and obesity in a middle-aged free-living population . METHODS Longitudinal prospect i ve Spanish dynamic cohort ( 10,162 university graduates ; mean age : 39 years ) followed-up for an average of 4.6 years .  Dietary habits were ascertained through a vali date d 136-item food-frequency question naire . Usual snackers were defined as those participants who answered affirmatively when asked in the baseline assessment if they usually eat between meals . Vali date d self-reported weight and body mass index were collected at baseline and during follow-up . RESULTS After adjusting for potential confounders , self-reported between-meal snacking was significantly associated with a higher risk of substantial weight gain ( > or = 3kg/year ; p<0.001 ; > or = 5kg/year , p<0.001 ; > or = 10 % baseline weight , p<0.001 ) . Among participants with a baseline body mass index lower than 30kg/m(2 ) ( n : 9709 ) we observed 258 new cases of obesity .  Usual snackers presented an adjusted 69 % higher risk of becoming obese during follow-up ( Hazard Ratio : 1.69 ; 95 % confidence interval : 1.30 - 2.20 ) . CONCLUSION Our results support the hypothesis that self-reported between-meal snacking can be a potential risk factor for obesity OBJECTIVE To examine the effect on plasma triglycerides of removing most of the extrinsic sugar from the diet of free living hypertriglyceridaemic individuals while controlling weight loss . DESIGN Free living subjects were r and omly assigned to intervention and control groups . The intervention group undertook to consume a " sugar free ' diet for six months after a three month baseline period . The control group maintained their usual diets for the nine month period . The results from the two groups were compared using repeated measures ANOVA . SUBJECTS Thirty two hypertriglyceridaemic individuals , selected from members of the public in Dunedin , New Zeal and . RESULTS Subjects in the intervention group were able to achieve a mean reduction in sucrose intake of > 70 % , largely extrinsic sucrose , result ing in a group mean reduction in plasma triglyceride levels of > 20 % and a mean weight loss over the six month period of about 2 % . Repeated measures ANOVA on the mean triglyceride figures after the individual figures had been adjusted for this small weight loss , showed that there was a significant fall in triglyceride levels over the study period compared with the baseline . CONCLUSIONS Hypertriglyceridaemia can be reduced in some individuals by the reduction of extrinsic sucrose in the diet . When allowance is made for weight loss the reduction is still significant BACKGROUND Obesity in adolescence has been increasing in the past several decades . Beverage habits among adolescents include increased consumption of sugar-sweetened beverages and decreased consumption of milk . OBJECTIVE This study aim ed to examine the association between beverage consumption and 5-y body weight change  in 2294 adolescents . DESIGN Project EAT ( Eating Among Teens ) is a 5-y longitudinal study of eating patterns among adolescents . Surveys were completed in 1998 - 1999 ( time 1 ) and in 2003 - 2004 ( time 2 ) . Multivariable linear regression was used to examine the association between beverage consumption at time 2 and change in body mass index from time 1 to time 2 , with adjustments for age , socioeconomic status , race , cohort , physical activity , sedentary behavior , coffee , tea , time 1 body mass index , and beverage variables . RESULTS In prospect i ve analyses , consumption of beverages was not associated with weight gain , except for consumption of low-calorie soft drinks ( positive association , P = 0.002 ) and white milk ( inverse association , P = 0.03 ) , but these associations did not appear to be a monotonic linear dose-response relation . The positive association with low-calorie soft drinks was no longer present after adjustment for dieting and parental weight-related concerns , which suggests that the use of low-calorie soft drinks is a marker for more general dietary behaviors and weight concerns . CONCLUSIONS We showed no association between sugar-sweetened beverage consumption , juice consumption , and adolescent weight gain over a 5-y period . A direct association between diet beverages and weight gain appeared to be explained by dieting practice s. Adolescents who consumed little or no white milk gained significantly 
    Output:
    
Among free living people involving ad libitum diets , intake of free sugars or sugar sweetened beverages is a determinant of body weight .
The change in body fatness that occurs with modifying intakes seems to be mediated via changes in energy intakes , since isoenergetic exchange of sugars with other carbohydrates was not associated with weight change