***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: Two meals of mashed-bean or potato flakes and meat were served in r and om order to six healthy male subjects to determine effects on gastric emptying and glycemic reactions . The meals had comparable physical appearance and contained similar amounts of digestible carbohydrate , fat , and protein . No difference in gastric emptying , recorded by gamma camera after mixing 51Cr with the meals , was found between the meals . The bean-flakes meal gave significantly lower blood glucose ( p less than 0.01 ) and serum insulin ( p less than 0.05 ) concentrations than did the potato-flakes meal . The overall blood glucose response , calculated as incremental area under the curves for 2 h , also differed between the meals ( p less than 0.05 ) whereas the overall insulin response did not differ significantly . The low glycemic response after bean flakes could not be explained by the gastric emptying rate , which provides additional evidence for the slow digestion of bean starch in the small intestine BACKGROUND Legumes are recommended for better glucose control in persons with diabetes . Whether subjects with normal insulin sensitivity would also benefit from legume consumption is not clear . OBJECTIVE Our goal was to compare the effects on insulin sensitivity of chickpea-based and wheat-based foods when eaten as single meals or over 6 wk . DESIGN Acute and long-term studies were conducted in healthy middle-aged men and women . In the acute study ( n = 19 ) , plasma glucose , insulin , and calculated homeostasis model assessment ( HOMA ; an index of insulin sensitivity ) were measured on 3 separated days over 3 h after the subjects consumed 50-g available carbohydrate loads from either chickpeas , wheat-based foods , or white bread . The long-term comparison ( n = 20 ) was a r and omized , crossover study in which chickpea-based and wheat-based foods were eaten for 6 wk each . Plasma glucose , insulin , and HOMA were measured in the fasting state and 2 h after a 75-g glucose load . RESULTS After single meals , plasma glucose was substantially lower 30 and 60 min after the chickpea meal than after the other 2 meals ( P < 0.05 ) , and plasma insulin and HOMA were lower at 120 min ( P < 0.05 for both ) . Despite this , the long-term study failed to show significant differences in plasma glucose , insulin , or HOMA either in the fasting state or after a glucose load . CONCLUSION Compared with a wheat-based meal , a single chickpea-based meal led to a lesser response in plasma glucose and insulin concentrations , but this was not translated into long-term improvement in insulin sensitivity over 6 wk , at least in healthy subjects The effects of the glycemic index ( GI ) of carbohydrate eaten the previous night on the glycemic response to a st and ard test meal eaten subsequently in the morning ( breakfast ) was studied . On separate evenings normal subjects ate low- or high-GI test meals of the same nutrient composition . The dinners consisted of single foods in two experiments and mixed meals containing several foods in the third . The differences between the observed glycemic responses to low- and high-GI dinners were predicted by their GIs . The glycemic responses to breakfast were significantly lower on mornings after low-GI dinners than after high-GI dinners . Eating , at dinner , foods with different fiber contents but the same GI had no effect on postbreakfast glycemia . We conclude that the GI predicts the difference between glycemic responses of mixed dinner meals ; breakfast carbohydrate tolerance is improved when low-GI foods are eaten the previous evening Reliable tables of glycemic index ( GI ) compiled from the scientific literature are instrumental in improving the quality of research examining the relation between GI , glycemic load , and health . The GI has proven to be a more useful nutritional concept than is the chemical classification of carbohydrate ( as simple or complex , as sugars or starches , or as available or unavailable ) , permitting new insights into the relation between the physiologic effects of carbohydrate-rich foods and health . Several prospect i ve observational studies have shown that the chronic consumption of a diet with a high glycemic load ( GI x dietary carbohydrate content ) is independently associated with an increased risk of developing type 2 diabetes , cardiovascular disease , and certain cancers . This revised table contains almost 3 times the number of foods listed in the original table ( first published in this Journal in 1995 ) and contains nearly 1300 data entries derived from published and unpublished verified sources , representing > 750 different types of foods tested with the use of st and ard methods . The revised table also lists the glycemic load associated with the consumption of specified serving sizes of different foods BACKGROUND Systems to calculate metabolizable energy ( ME ) in foods and diets are often based on Atwater factors . The accuracy of these factors with low-fat diets high in fiber is unknown when food intake is reduced spontaneously . OBJECTIVE The objective was to evaluate the accuracy of Atwater factors and other systems for calculating ME available from low-fat , high-fiber diets when food intake was reduced spontaneously . DESIGN The ME contents of a high-fat , low-fiber diet and 2 low-fat diets , one high in fruit and vegetable fiber and the other high in cereal fiber , were determined in a r and omized parallel study in humans ( n = 27 ) and compared with various factorial and empirical models for calculating ME . RESULTS Food intakes decreased with both the high fruit and vegetable fiber and cereal fiber diets . The difference between ME calculated by using Atwater and similar factors and determined ME values was up to 4 % for the refined diet and up to 11 % for the low-fat , high-fiber diets . Various factorial and empirical systems for calculating food energy failed to reflect the results of the direct determinations . CONCLUSION Atwater factors were inaccurate with low-fat , high-fiber diets . Although modified Atwater factors may be accurate under st and ardized conditions of zero-nitrogen and zero-energy balance , they overestimate energy availability from high-fiber fruit and vegetable and cereal diets when food intake is reduced spontaneously in addition to when intake is reduced voluntarily BACKGROUND Dietary carbohydrates may influence the development of  type 2 ( non-insulin-dependent ) diabetes  , for example , through effects on blood glucose and insulin concentrations . OBJECTIVE We examined the relations of baseline intake of carbohydrates , dietary fiber , dietary magnesium , and carbohydrate-rich foods and the glycemic index with incidence of diabetes . DESIGN This was a prospect i ve cohort study of 35988 older Iowa women initially free of diabetes . During 6 y of follow-up , 1141 incident cases of diabetes were reported . RESULTS  Total grain , whole-grain , total dietary fiber , cereal fiber , and dietary magnesium intakes  showed strong inverse associations with incidence of diabetes after adjustment for potential nondietary confounding variables . Multivariate-adjusted relative risks of diabetes were 1.0 , 0.99 , 0.98 , 0.92 , and 0.79 ( P for trend : 0.0089 ) across quintiles of whole-grain intake ; 1.0 , 1.09 , 1.00 , 0.94 , and 0.78 ( P for trend : 0.005 ) across quintiles of total dietary fiber intake ; and 1.0 , 0.81 , 0.82 , 0.81 , and 0.67 ( P for trend : 0.0003 ) across quintiles of dietary magnesium intake . Intakes of total carbohydrates , refined grains , fruit and vegetables , and soluble fiber and the glycemic index were unrelated to diabetes risk . CONCLUSION These data support a protective role for grains ( particularly whole grains ) , cereal fiber , and dietary magnesium in the development of diabetes in older women BACKGROUND High-fibre and low-carbohydrate diets may enhance satiety and promote weight loss . We compared a diet rich in beans aim ing to increase dietary fibre and promote weight loss with a low-carbohydrate diet in a r and omised controlled trial to assess effect and tolerability of the high-fibre bean-rich diet . METHODS AND RESULTS One hundred and seventy-three women and men , with a mean body mass index of approximately 36 kg m(-2 ) ( one-fifth with diabetes type 2 ) were r and omised to a high-fibre bean-rich diet that achieved mean ( SD ) fibre intakes of 35.5 ( 18.6 ) g day(-1 ) for women and 42.5 ( 30.3 ) g day(-1 ) for men , or a low-carbohydrate diet . Both diets were induced gradually over 4 weeks and included a 3-day feeding phase . Among 123 ( 71.1 % ) completers at 16 weeks , mean ( SD ) weight loss was 4.1 ( 4.0 ) kg in the high-fibre versus 5.2 ( 4.5 ) kg in the low-carbohydrate group [ difference , 1.1 kg , 95 % confidence interval ( CI ) = -2.6 to -0.5 ; P = 0.2 ] , with results similar to the intent-to-treat population . Low-density lipoprotein (LDL)-cholesterol levels decreased with the high-fibre diet ( difference in LDL-cholesterol versus low-carbohydrate diet , 0.2 mmol L(-1 ) , 95 % CI = 0.01 - 0.44 mmol L(-1 ) ; P = 0.045 ) , as did total cholesterol ( P = 0.038 ) , whereas changes in other lipids and glucose did not differ . After 52 weeks , the low-carbohydrate ( n = 24 ) group tended to retain weight loss better than the high-fibre group ( P = 0.06 ) , although total cholesterol remained lower with the bean-rich diet ( P = 0.049 ) . CONCLUSIONS A high-fibre bean-rich diet was as effective as a low-carbohydrate diet for weight loss , although only the bean-rich diet lowered atherogenic lipids Background : Regular consumption of diets with increased protein or fibre intakes may benefit body weight and composition and cardiovascular disease risk factors .  Lupin flour is a novel food ingredient high in protein and fibre . Objective : To investigate the effects of a lupin-enriched diet , during and following energy restriction , on body weight and composition and cardiovascular disease risk factors  in overweight individuals . Design : Participants ( n=131 ) were recruited to a 12-month parallel- design trial . They were r and omly assigned to consume lupin-enriched foods or matching high-carbohydrate control foods . All participants underwent 3 months of weight loss , 1 month of weight stabilization and 8 months of weight maintenance . Body weight and composition and cardiovascular disease risk factors were assessed at baseline , 4 and 12 months . Results : Lupin , relative to control , did not significantly influence ( mean difference ( 95 % CI ) ) weight loss at 4 months ( 0.1 kg ( −1.2 , 1.4 ) ) and 12 months ( −0.6 kg ( −2.0 , 0.8 ) ) , maintenance of weight loss from 4 to 12 months ( −0.7 kg ( −1.83 , 0.48 ) ) or measures of body fat and fat-free mass . Relative to control , 24-h ambulatory systolic ( −1.3 mm Hg ( −2.4 , −0.3 ) , P=0.016 ) and diastolic ( −1.0 mm Hg ( −1.9 , −0.2 ) , P=0.021 ) blood pressures were lower at 12 months but not at 4 months ; fasting insulin concentrations and homeostasis model assessment ( HOMA ) scores were significantly lower at 4 months ( −1.2 mU l–1 ( −1.3 , −1.1 ) , P=0.004 and −0.6 units ( −1.0 , −0.19 ) , P=0.004 ) and 12 months ( −1.3 mU l–1 ( −1.4 , −1.1 ) , P<0.001 and −0.7 units ( −1.1 , −0.24 ) , P=0.002 ) . Conclusions : A diet higher in protein and fibre derived from lupin-enriched foods does not enhance weight loss or improve the maintenance of weight loss . However , such a diet may provide cardiovascular health benefits in terms of insulin sensitivity and blood pressure To define the type of dietary fibre of fibre analogue with the greatest potential use in diabetic treatment , groups of four to six volunteers underwent 50-g glucose tolerance tests ( GTT ) with and without the addition of either guar , pectin , gum tragacanth , methylcellulose , wheat bran , or cholestyramine equivalent to 12 g fibre . The addition of each substance significantly reduced blood glucose concentration at one or more points during the GTT and generally reduced serum insulin concentrations . The greatest flattening of the glucose 
    Output:
    
We conclude that systematic review s and meta-analyses of prospect i ve cohort studies assessing the relationship between legumes and the risk of coronary heart disease appear to provide moderate- quality evidence of a benefit , and several systematic review s and meta-analyses of r and omized controlled trials assessing the effect of pulses on cardiometabolic risk factors provide low- to moderate- quality evidence of a benefit .