***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: AIM To examine whether peanut consumption is associated with a reduced risk of colorectal cancer  in a prospect i ve cohort with a 10-year follow-up . METHODS In 1990 - 1992 , residents ( 12026 men and 11917 women aged 30 to 65 years ) in 7 townships , Taiwan , were interviewed and recruited into a cancer-screening cohort and annually followed up . Colorectal cancer cases in this cohort were identified from cancer registry and death certificates . Incidence rates of this disease by the end of 2001 were calculated by gender for the primary study variable and covariates . The  dietary intake  was assessed by means of weekly food frequency measures , including frequently consumed food groups and folk dishes including sweet potato , bean products , peanut products , pickled foodstuffs , nitrated or smoked foodstuffs . RESULTS During the study period , 107 new colorectal cancer cases ( 68 men and 39 women ) were confirmed . The multivariate Cox 's proportional hazard model showed that the relative risk ( RR ) of peanut consumption was 0.73 [ 95 % confidence interval ( CI ) = 0.44 - 1.21 ] for men and 0.42 ( 95 % CI = 0.21 - 0.84 ) for women . However , frequent intake of pickled foodstuffs was harmful for women ( RR = 2.15 , 95 % CI = 0.99 - 4.65 ) . The risk of colorectal cancer was also elevated among cigarette smokers but not significant ( P<0.05 ) . CONCLUSION This study suggests that frequent intake of peanut and its products may reduce colorectal cancer risk in women , demonstrating the anti-proliferating effect of peanut intake Background : Increasing nut intake has been associated with reduced risk of diabetes mellitus , which is a risk factor for pancreatic cancer . Methods : We prospect ively followed 75 680 women in the Nurses ’ Health Study , and examined the association between nut consumption and pancreatic cancer risk . Participants with a previous history of cancer were excluded .  Nut consumption was assessed at baseline and up date d every 2 to 4 years . Relative risks ( RRs ) and 95 % confidence intervals ( 95 % CIs ) were estimated using Cox proportional hazards models . Results : We documented 466 incident cases of pancreatic cancer . After adjusting for age , height , smoking , physical activity , and total energy intake , women who consumed a 28-g ( 1 oz ) serving size of nuts ⩾2 times per week experienced a significantly lower risk of pancreatic cancer ( RR , 0.65 ; 95 % CI , 0.47–0.92 ; P for trend=0.007 ) when compared with those who largely abstained from nuts . The results did not appreciably change after further adjustment for body mass index ( BMI ) and history of diabetes mellitus ( RR , 0.68 ; 95 % CI , 0.48–0.95 ; P for trend=0.01 ) . The inverse association persisted within strata defined by BMI , physical activity , smoking , and intakes of red meat , fruits , and vegetables . Conclusion : Frequent nut consumption is inversely associated with risk of pancreatic cancer in this large prospect i ve cohort of women , independent of other potential risk factors for pancreatic cancer OBJECTIVE Fat intake , especially monounsaturated fatty acid ( MUFA ) , has been liberalized in diabetic diets to preserve HDL cholesterol and improve glycemic control , yet the exact sources have not been clearly defined . Therefore , we assessed the effect of mixed nut consumption as a source of vegetable fat on serum lipids and HbA1c in type 2 diabetes . RESEARCH DESIGN AND METHODS A total of 117 type 2 diabetic subjects were r and omized to one of three treatments for 3 months . Supplements were provided at 475 kcal per 2,000-kcal diet as mixed nuts ( 75 g/day ) , muffins , or half portions of both . The primary outcome was change in HbA1c . RESULTS The relative increase in MUFAs was 8.7 % energy on the full-nut dose compared with muffins . Using an intention-to-treat analysis ( n = 117 ) , full-nut dose ( mean intake 73 g/day ) reduced HbA1c ( −0.21 % absolute HbA1c units , 95 % CI −0.30 to −0.11 , P < 0.001 ) with no change after half-nut dose or muffin . Full-nut dose was significantly different from half-nut dose ( P = 0.004 ) and muffin ( P = 0.001 ) , but no difference was seen between half-nut dose and muffins . LDL cholesterol also decreased significantly after full-nut dose compared with muffin . The LDL cholesterol reduction after half-nut dose was intermediate and not significantly different from the other treatments . Apolipoprotein ( apo ) B and the apoB : apoA1 ratio behaved similarly . Nut intake related negatively to changes in HbA1c ( r = −0.20 , P = 0.033 ) and LDL cholesterol ( r = −0.24 , P = 0.011 ) . CONCLUSIONS Two ounces of nuts daily as a replacement for carbohydrate foods improved both glycemic control and serum lipids in type 2 diabetes BACKGROUND Although dietary factors are suspected to be important determinants of coronary heart disease ( CHD ) risk , the direct evidence is relatively sparse . METHODS The Adventist Health Study is a prospect i ve cohort investigation of 31,208 non-Hispanic white California Seventh-Day Adventists . Extensive dietary information was obtained at baseline , along with the values of traditional coronary risk factors . These were related to risk of definite fatal CHD or definite nonfatal myocardial infa rct ion . RESULTS Subjects who consumed nuts frequently ( more than four times per week ) experienced substantially fewer definite fatal CHD events ( relative risk , 0.52 ; 95 % confidence interval [ CI ] , 0.36 to 0.76 ) and definite nonfatal myocardial infa rct ions ( relative risk , 0.49 ; 95 % CI , 0.28 to 0.85 ) , when compared with those who consumed nuts less than once per week . These findings persisted on covariate adjustment and were seen in almost all of 16 different subgroups of the population . Subjects who usually consumed whole wheat bread also experienced lower rates of definite nonfatal myocardial infa rct ion ( relative risk , 0.56 ; 95 % CI , 0.35 to 0.89 ) and definite fatal CHD ( relative risk , 0.89 ; 95 % CI , 0.60 to 1.33 ) when compared with those who usually ate white bread . Men who ate beef at least three times each week had a higher risk of definite fatal CHD ( relative risk , 2.31 ; 95 % CI , 1.11 to 4.78 ) , but this effect was not seen in women or for the nonfatal myocardial infa rct ion end point . CONCLUSION Our data strongly suggest that the frequent consumption of nuts may protect against risk of CHD events . The favorable fatty acid profile of many nuts is one possible explanation for such an effect Background Prospect i ve studies in non-Mediterranean population s have consistently related increasing nut consumption to lower coronary heart disease mortality . A small protective effect on all-cause and cancer mortality has also been suggested . To examine the association between frequency of nut consumption and mortality in individuals at high cardiovascular risk from Spain , a Mediterranean country with a relatively high average nut intake per person . Methods We evaluated 7,216 men and women aged 55 to 80 years r and omized to 1 of 3 interventions ( Mediterranean diets supplemented with nuts or olive oil and control diet ) in the PREDIMED ( ‘ PREvención con DIeta MEDiterránea ’ ) study .  Nut consumption was assessed at baseline and mortality was ascertained by medical records and linkage to the National Death Index . Multivariable-adjusted Cox regression and multivariable analyses with generalized estimating equation models were used to assess the association between yearly repeated measurements of nut consumption and mortality . Results During a median follow-up of 4.8 years , 323 total deaths , 81 cardiovascular deaths and 130 cancer deaths occurred . Nut consumption was associated with a significantly reduced risk of all-cause mortality ( P for trend < 0.05 , all ) . Compared to non-consumers , subjects consuming nuts > 3 servings/week ( 32 % of the cohort ) had a 39 % lower mortality risk ( hazard ratio ( HR ) 0.61 ; 95 % CI 0.45 to 0.83 ) . A similar protective effect against cardiovascular and cancer mortality was observed . Participants allocated to the Mediterranean diet with nuts group who consumed nuts > 3 servings/week at baseline had the lowest total mortality risk ( HR 0.37 ; 95 % CI 0.22 to 0.66 ) . Conclusions Increased frequency of nut consumption was associated with a significantly reduced risk of mortality in a Mediterranean population at high cardiovascular risk . Please see related commentary : http://www.biomed central .com/1741 - 7015/11/165.Trial registration Clinical trials.gov . International St and ard R and omized Controlled Trial Number ( IS RCT N ) : 35739639 . Registration date : 5 October 2005 Epidemiological data on most cancer sites suggest that consumption of plant foods , which contain high levels of antioxidants , might slow or prevent the appearance of cancer . We used data from three case-control studies to test this hypothesis . The total study population consisted of 617 incident cases of prostate cancer and 636 population controls from Ontario , Quebec , and British Columbia . Dietary information was collected by an in-person interview with a detailed quantitative dietary history . Unconditional logistic regression analyses were performed to estimate odds ratios ( ORs ) and 95 % confidence intervals ( CIs ) . A decreasing , statistically significant association was found with increasing intakes of green vegetables ( OR = 0.54 , 95 % CI = 0.40 - 0.71 for 4th quartile ) , tomatoes ( OR = 0.64 , 95 % CI = 0.45 - 0.91 ) , beans/lentils/nuts ( OR = 0.69 , 95 % CI = 0.53 - 0.91 ) , and cruciferous vegetables ( OR = 0.69 , 95 % CI = 0.52 - 0.91 for 3rd quartile ) . Higher intakes of fruit were associated with higher ORs ( OR = 1.51 , 95 % CI = 1.14 - 2.01 for 4th quartile ) , an effect that was seen for total fruit and citrus fruit , as well as for all other noncitrus fruits . Among the grains , refined-grain bread intake was associated with a decrease in risk ( OR = 0.65 for 4th quartile ) , whereas whole-grain breakfast cereals were associated with a higher risk for prostate cancer . Of all the antioxidant nutrients studied , the ORs were higher with higher intakes of cryptoxanthin ( OR = 1.44 , 95 % CI = 1.09 - 1.89 for 4th quartile ) . Exposure to certain dietary components of plant origin , which are potentially modifiable , indicates the theoretical scope for reducing the risk from prostate cancer . Future experimental studies or trials are warranted for further underst and ing BACKGROUND Dietary nut intake has been associated with a reduced risk of coronary heart disease mortality ; however , the mechanism is unclear . Since components of nuts may have antiarrhythmic properties , part of the benefit may be due to a reduction in sudden cardiac death . METHODS We prospect ively assessed whether increasing frequency of nut consumption , as ascertained by an abbreviated food frequency question naire at 12 months of follow-up , was associated with a lower risk of sudden cardiac death and other coronary heart disease end points among 21 454 male participants enrolled in the US Physicians ' Health Study . Participants were followed up for an average of 17 years . RESULTS Dietary nut intake was associated with a significantly reduced risk of sudden cardiac death after controlling for known cardiac risk factors and other dietary habits ( P for trend,.01 ) . Compared with men who rarely or never consumed nuts , those who consumed nuts 2 or more times per week had reduced risks of sudden cardiac death ( relative risk , 0.53 ; 95 % confidence interval , 0.30 - 0.92 ) and total coronary heart disease death ( relative risk , 0.70 ; 95 % confidence interval , 0.50 - 0.98 ) . In contrast , nut intake was not associated with significantly reduced risks of nonsudden coronary heart disease death or nonfatal myocardial infa rct ion . CONCLUSION These prospect i ve data in US male physicians suggest that the inverse association between nut consumption and total coronary heart disease death is primarily due to a reduction in the risk of sudden cardiac death A link between unsaturated fatty acids or phytonutrients and reduced risk of colorectal cancer  has been suggested . However , the effects of higher intake of dietary sources of these nutrients , such as the nuts and seeds food group , are less 
    Output:
    
Effects were primarily driven by decreased coronary artery disease deaths rather than stroke deaths .