***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: OBJECTIVE This study examined whether the combination of alternate day fasting ( ADF ) plus exercise produces superior changes in body composition and plasma lipid levels when compared to each intervention alone . DESIGN AND METHODS Obese subjects ( n = 64 ) were r and omized to 1 of 4 groups for 12 weeks : 1 ) combination ( ADF plus endurance exercise ) , 2 ) ADF , 3 ) exercise , or 4 ) control .  RESULTS Body weight was reduced ( P < 0.05 ) by 6 ± 4 kg , 3 ± 1 kg , and 1 ± 0 kg in the combination , ADF , and exercise groups , respectively . Fat mass and waist circumference decreased ( P < 0.001 ) , while lean mass was retained in the combination group . Low-density lipoprotein ( LDL ) cholesterol decreased ( 12 ± 5 % , P < 0.05 ) and high-density lipoprotein ( HDL ) cholesterol increased ( 18 ± 9 % , P < 0.05 ) in the combination group only . LDL particle size increased ( P < 0.001 ) by 4 ± 1 Å and 5 ± 1 Å in the combination and ADF groups , respectively . The proportion of small HDL particles decreased ( P < 0.01 ) in the combination group only . CONCLUSIONS These findings suggest that the combination produces superior changes in body weight , body composition , and lipid indicators of heart disease risk , when compared to individual treatments Obesity has been linked with low levels of ω-3 fatty acids . Generally , intervention studies have failed to establish benefits of supplementation with ω-3PUFA in reducing  body weight or fat mass in humans . The aim of this study was to investigate whether supplementation with LCω-3PUFA alone , then consumed concomitantly with a very low energy diet ( VLED ) , facilitated weight loss , improvements in blood lipids and positive changes to inflammatory mediators . This was a double blind r and omised controlled trial with two parallel groups . For 4 weeks of prior supplementation , one group consumed 6 × 1 g capsules per day monounsaturated oil ( placebo ) , the other group consumed 6 × 1 g capsules per day LCω-3PUFA ( fish oil ) each comprising 70 mg EPA and 270 mg DHA , while consuming their usual diet . Each group continued with their supplements for another 4 weeks while both groups followed a VLED regimen ( n = 19 placebo , n = 20 fish  oil ) . Fasting blood sample s , anthropometric measurements and 3-day food diaries were collected at baseline , at 4 weeks and at 8 weeks . At 4 weeks levels of EPA and DHA increased two-fold in the fish oil group ( P < 0.001 ) , with no significant changes to anthropometric measurements for either group . At 8 weeks a significant 3-way interaction between time , group and gender was observed for percentage reduction in weight , F(1,35 ) = 5.55 , P = 0.024 , and BMI , F(1,35 ) = 5.3 , P = 0.027 with a greater percentage decrease for females in FO compared to PB for weight ( -7.21 % vs.-5.82 % ) and BMI ( -7.43 % vs.-5.91 % ) respectively ( P < 0.05 for both ) . It would appear that supplementation with LCω-3PUFA had a time dependent effect on weight loss in females BACKGROUND : A relatively high percentage of energy intake as protein has been shown to increase satiety and decrease energy efficiency during overfeeding . AIM : To investigate whether addition of protein may improve weight maintenance by preventing or limiting weight regain after weight loss of 5–10 % in moderately obese subjects . DESIGN OF THE STUDY : In a r and omized parallel design , 148 male and female subjects ( age 44.2±10.1 y ; body mass index ( BMI ) 29.5±2.5 kg/m2 ; body fat 37.2±5.0 % ) followed a very low-energy diet ( 2.1 MJ/day ) during 4 weeks . For subsequent 3 months weight-maintenance assessment , they were stratified according to age , BMI , body weight , restrained eating , and resting energy expenditure ( REE ) , and r and omized over two groups . Both groups visited the University with the same frequency , receiving the same counseling on dem and by the dietitian . One group ( n=73 ) received 48.2 g/day additional protein to their diet . Measurements at baseline , after weight loss , and after 3 months weight maintenance were body weight , body composition , metabolic measurements , appetite profile , eating attitude , and relevant blood parameters . RESULTS : Changes in body mass , waist circumference , REE , respiratory quotient ( RQ ) , total energy expenditure ( TEE ) , dietary restraint , fasting blood-glucose , insulin , triacylglycerol , leptin , β-hydroxybutyrate , glycerol , and free fatty acids were significant during weight loss and did not differ between groups . During weight maintenance , the ‘ additional-protein group ’ showed in comparison to the nonadditional-protein group 18 vs 15 en% protein intake , a 50 % lower body weight regain only consisting of fat-free mass , a 50 % decreased energy efficiency , increased satiety while energy intake did not differ , and a lower increase in triacylglycerol and in leptin ; REE , RQ , TEE , and increases in other blood parameters measured did not differ . CONCLUSION : A 20 % higher protein intake , that is , 18 % of energy vs 15 % of energy during weight maintenance after weight loss , result ed in a 50 % lower body weight regain , only consisting of fat-free mass , and related to increased satiety and decreased energy efficiency OBJECTIVE Investigation of the effect of a green tea-caffeine mixture on weight maintenance after body weight loss in moderately obese subjects in relation to habitual caffeine intake . RESEARCH METHODS AND PROCEDURES A r and omized placebo-controlled double blind parallel trial in 76 overweight and moderately obese subjects , ( BMI , 27.5 + /- 2.7 kg/m2 ) matched for sex , age , BMI , height , body mass , and habitual caffeine intake was conducted . A very low energy diet intervention during 4 weeks was followed by 3 months of weight maintenance ( WM ) ; during the WM period , the subjects received a green tea-caffeine mixture ( 270 mg epigallocatechin gallate + 150 mg caffeine per day ) or placebo . RESULTS Subjects lost 5.9 + /-1.8 ( SD ) kg ( 7.0 + /- 2.1 % ) of body weight ( p < 0.001 ) . At baseline , satiety was positively , and in women , leptin was inversely , related to subjects ' habitual caffeine consumption ( p < 0.01 ) . High caffeine consumers reduced weight , fat mass , and waist circumference more than low caffeine consumers ; resting energy expenditure was reduced less and respiratory quotient was reduced more during weight loss ( p < 0.01 ) . In the low caffeine consumers , during WM , green tea still reduced body weight , waist , respiratory quotient and body fat , whereas resting energy expenditure was increased compared with a restoration of these variables with placebo ( p < 0.01 ) . In the high caffeine consumers , no effects of the green tea-caffeine mixture were observed during WM . DISCUSSION High caffeine intake was associated with weight loss through thermogenesis and fat oxidation and with suppressed leptin in women . In habitual low caffeine consumers , the green tea-caffeine mixture improved WM , partly through thermogenesis and fat oxidation The aim of the present study was to investigate whether capsaicin assists weight maintenance by limiting weight regain after weight loss of 5 to 10 % . In this r and omized double-blind placebo-controlled study , ninety-one moderately overweight subjects were r and omly assigned to an intensive group that underwent all the measurements , and an extensive group that underwent the same measurements except the metabolism measurements . After a 4-week very-low-energy diet ( VLED ) intervention , a 3-month weight-maintenance period followed . During weight maintenance , subjects were divided into a capsaicin ( 135 mg capsaicin/d ) and a placebo group .  Body mass was measured before and after the VLED and after 1 , 2 and 3 months of weight maintenance . The mean body-mass loss during the VLED was 6.6 ( SD 2.0 ) kg ( 7.8 ( SD 1.8 ) % initial body mass ) , and was not different between the subsequent treatment and placebo group . During weight maintenance , mean % regain during treatment was not significantly different compared with placebo ( 33.3 ( SD 35.7 ) v. 19.2 ( SD 41.8 ) % , P=0.09 ) . RQ was significantly less increased during weight maintenance in the treatment group compared with placebo ( 0.04 ( SD 0.06 ) v. 0.07 ( SD 0.05 ) , P<0.05 ) , indicating a relatively more sustained fat oxidation . Fat oxidation ( g/h ) after weight maintenance was higher in the capsaicin group compared with placebo ( 4.2 ( SD 1.1 ) v. 3.5 ( SD 0.9 ) , P<0.05 ) . These results indicate that capsaicin treatment caused sustained fat oxidation during weight maintenance compared with placebo . However , capsaicin treatment has no limiting effect on 3-month weight regain after modest weight loss Since long-term weight maintenance ( WM ) is a major problem , interventions to improve WM are needed . The aim of the study was to investigate whether the addition of protein to the diet might limit weight regain after a weight loss of 5 - 10 % in overweight subjects . In a r and omised parallel study design , 113 overweight subjects ( BMI 29.3 ( SD 2.5 ) kg/m2 ) ; age 45.1 ( SD 10.4 ) years ) followed a very-low-energy diet for 4 weeks , after which there was a 6-month period of WM . During WM , subjects were r and omised into either a protein group or a control group . The protein group received 30 g/d protein in addition to their own usual diet . During the very-low-energy diet , no differences were observed between the groups . During WM , the protein group showed a higher protein intake ( 18 % v. 15 % ; P<0.05 ) , a lower weight regain ( 0.8 v. 3.0 kg ; P<0.05 ) , a decreased waist circumference ( -1.2 ( SD 0.7 ) v. 0.5 ( SD 0.5 ) cm ; P<0.05 ) and a smaller increase in respiratory quotient ( 0.03 ( SD 0.01 ) v. 0.07 0.01 ; (SD/)P < 0.05 ) compared with the control group . Weight regain in the protein group consisted of only fat-free mass , whereas the control group gained fat mass as well . Satiety in the fasted state before breakfast increased significantly more in the protein group than in the control group . After 6 months follow-up , body weight showed a significant group x time interaction . A protein intake of 18 % compared with 15 % result ed in improved WM  in overweight subjects after a weight loss of 7.5 % . This improved WM implied several factors , i.e. improved body composition , fat distribution , substrate oxidation and satiety CONTEXT The scarcity of data addressing the health effects of popular diets is an important public health concern , especially since patients and physicians are interested in using popular diets as individualized eating strategies for disease prevention . OBJECTIVE To assess adherence rates and the effectiveness of 4 popular diets ( Atkins , Zone , Weight Watchers , and Ornish ) for weight loss and cardiac risk factor reduction . DESIGN , SETTING , AND PARTICIPANTS A single-center r and omized trial at an academic medical center in Boston , Mass , of overweight or obese ( body mass index : mean , 35 ; range , 27 - 42 ) adults aged 22 to 72 years with known hypertension , dyslipidemia , or fasting hyperglycemia . Participants were enrolled starting July 18 , 2000 , and r and omized to 4 popular diet groups until January 24 , 2002 . INTERVENTION A total of 160 participants were r and omly assigned to either Atkins ( carbohydrate restriction , n=40 ) , Zone ( macronutrient balance , n=40 ) , Weight Watchers ( calorie restriction , n=40 ) , or Ornish ( fat restriction , n=40 ) diet groups . After 2 months of maximum effort , participants selected their own levels of dietary adherence . MAIN OUTCOME MEASURES One-year changes in baseline weight and cardiac risk factors , and self-selected dietary adherence rates per self-report . RESULTS Assuming no change from baseline for participants who discontinued the study , mean ( SD ) weight loss at 1 year was 2.1 ( 4.8 ) kg for Atkins ( 21 [ 53 % ] of 40 participants completed , P = .009 ) , 3.2 ( 6.0 ) kg for Zone ( 26 [ 65 % ] of 40 completed , P = .002 ) , 3.0 ( 4.9 ) kg for Weight Watchers ( 26 [ 65 % ] of 40 completed , P < .001 ) , and 3.3 ( 7.3 ) kg for Ornish ( 20 [ 50 % ] of 40 completed , P = .007 ) . 
    Output:
    
Our results from both the systematic review and the meta- analysis suggest that ADF is an efficacious dietary method , and may be superior to VLCD for some patients because of ease of compliance , greater fat-mass loss and relative preservation of fat-free mass .