human
***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: The effect of a 3-tier intervention including dietary modifications ( ie , moderate energy restriction , decreased carbohydrate , increased protein ) , increased physical activity , and the use of carnitine as a dietary supplement was evaluated on plasma lipids and the atherogenicity of low-density lipoprotein ( LDL ) particles in a population of overweight and obese premenopausal ( aged 20 - 45 years ) women .  Carnitine or a placebo ( cellulose ) was r and omly assigned to the participants using a double-blind design . Carnitine supplementation was postulated to enhance fat oxidation result ing in lower concentrations of plasma triglycerides . Seventy women completed the 10-week protocol , which followed a reduction in their energy intake by 15 % and a macronutrient energy distribution of 30 % protein , 30 % fat , and 40 % carbohydrate . In addition , subjects increased the number of steps taken per day by 4500 . As no differences were observed between the carnitine and placebo groups in all the measured parameters , all subjects were pooled together for statistical analysis . Participants decreased ( P<.01 ) their caloric intake ( between 4132.8 and 7770 kJ ) and followed prescribed dietary modifications as assessed by dietary records . The average number of steps increased from 8950+/-3432 to 12764+/-4642 ( P<.001 ) . Body weight , plasma total cholesterol , LDL cholesterol , and triglyceride were decreased by 4.5 % , 8.0 % , 12.3 % , and 19.2 % ( P<.0001 ) , respectively , after the intervention . Likewise , apolipoproteins B and E decreased by 4.5 % and 15 % ( P<.05 ) after 10 weeks . The LDL mean particle size was increased from 26.74 to 26.86 nm ( P<.01 ) , and the percent of the smaller LDL subfraction ( P<.05 ) was decreased by 26.5 % ( P<.05 ) after 10 weeks . In addition , LDL lag time increased by 9.3 % ( P<.01 ) , and LDL conjugated diene formation decreased by 23 % ( P<.01 ) , indicating that the susceptibility of LDL to oxidation was decreased after the intervention . This study suggests that moderate weight loss ( < 5 % of body weight ) associated with reduced caloric intake , lower dietary carbohydrate , and increased physical activity impacts the atherogenicity of LDL BACKGROUND Current interest in the role of functional foods in weight control has focused on plant ingredients capable of interfering with the sympathoadrenal system . OBJECTIVE We investigated whether a green tea extract , by virtue of its high content of caffeine and catechin polyphenols , could increase 24-h energy expenditure ( EE ) and fat oxidation in humans . DESIGN Twenty-four-hour EE , the respiratory quotient ( RQ ) , and the urinary excretion of nitrogen and catecholamines were measured in a respiratory chamber in 10 healthy men . On 3 separate occasions , subjects were r and omly assigned among 3 treatments : green tea extract ( 50 mg caffeine and 90 mg epigallocatechin gallate ) , caffeine ( 50 mg ) , and placebo , which they ingested at breakfast , lunch , and dinner . RESULTS Relative to placebo , treatment with the green tea extract result ed in a significant increase in 24-h EE ( 4 % ; P < 0.01 ) and a significant decrease in 24-h RQ ( from 0.88 to 0.85 ; P < 0.001 ) without any change in urinary nitrogen . Twenty-four-hour urinary norepinephrine excretion was higher during treatment with the green tea extract than with the placebo ( 40 % , P < 0.05 ) . Treatment with caffeine in amounts equivalent to those found in the green tea extract had no effect on EE and RQ nor on urinary nitrogen or catecholamines . CONCLUSIONS Green tea has thermogenic properties and promotes fat oxidation beyond that explained by its caffeine content per se . The green tea extract may play a role in the control of body composition via sympathetic activation of thermogenesis , fat oxidation , or both Alpha-linolenic acid ( ALA ) is a major dietary ( n-3 ) fatty acid . ALA is converted to longer-chain ( n-3 ) PUFA , such as eicosapentaenoic acid ( EPA ) and possibly docosahexaenoic acid ( DHA ) . EPA and DHA are fish-based ( n-3 ) fatty acids that have proven cardioprotective properties . We studied the effect of daily supplementation with 3 g of ALA on the plasma concentration of long-chain ( n-3 ) fatty acids in a predominantly African-American population with chronic illness . In a r and omized , double-blind trial , 56 participants were given 3 g ALA/d from flaxseed oil capsules ( n = 31 ) or olive oil placebo capsules ( n = 25 ) . Plasma EPA levels at 12 wk in the flaxseed oil group increased by 60 % , from 24.09 + /- 16.71 to 38.56 + /- 28.92 micromol/L ( P = 0.004 ) , whereas no change occurred in the olive oil group . Plasma docosapentaenoic acid ( DPA ) levels in the flaxseed oil group increased by 25 % from 19.94 + /- 9.22 to 27.03 + /- 17.17 micromol/L ( P = 0.03 ) with no change in the olive oil group . Plasma DHA levels did not change in either group . This study demonstrates the efficacy of the conversion of ALA to EPA and DPA in a minority population with chronic disease . ALA may be an alternative to fish oil ; however , additional clinical trials with ALA are warranted We assessed the effect of ingestion of green tea ( GT ) extract along with a low-energy diet ( LED ) on resting energy expenditure ( REE ) , substrate oxidation and body weight as GT has been shown to increase energy expenditure and fat oxidation in the short term in both animals and people . Forty-six overweight women ( BMI 27.6 ( sd 1.8 ) kg/m2 ) were fed in energy balance from day 1 to day 3 , followed by a LED with GT ( 1125 mg tea catechins + 225 mg caffeine/d ) or placebo ( PLAC ) from day 4 to day 87 . Caffeine intake was st and ardised to 300 mg/d . Energy expenditure was measured on days 4 and 32 . Reductions in weight ( 4.19 ( sd 2.0 ) kg PLAC , 4.21 ( sd 2.7 ) kg GT ) , BMI , waist : hip ratio , fat mass and fat-free mass were not statistically different between treatments . REE as a function of fat-free mass and fat mass was significantly reduced over 32 d in the PLAC group ( P<0.05 ) but not in the GT group . Dietary restraint increased over time ( P<0.001 ) in both groups , whereas disinhibition and general hunger decreased ( P<0.05 ) . The GT group became more hungry over time and less thirsty , and showed increased prospect i ve food consumption compared with PLAC ( P<0.05 ) . Taken together , the ingestion of GT along with a LED had no additional benefit for any measures of body weight or body composition . Although the decrease in REE as a function of fat-free mass and fat mass was not significant with GT treatment , whereas it was with PLAC treatment , no significant effect of treatment over time was seen , suggesting that a robust limitation of REE reduction during a LED was not achieved by GT OBJECTIVES Carnitine deficiency impairs fatty acid beta-oxidation and may partly explain weight gain in valproate-treated patients . The aim of this study was to determine whether l-carnitine supplementation improves weight loss outcomes in bipolar patients taking sodium valproate .  METHODS Sixty bipolar patients with clinical ly significant weight gain thought to be related to sodium valproate , who had been taking sodium valproate for > or=6 months , were r and omized to l-carnitine ( 15 mg/kg/day ) or placebo for 26 weeks , in conjunction with a moderately energy-restricted , low-fat diet . The primary outcome measure was weight change . RESULTS l-carnitine had no effect on mean weight loss compared with placebo ( -1.9 kg versus - 0.9 kg ) ( F = 0.778 , df = 1,58 , p = 0.381 ) . The number of people in each group able to lose any weight was identical ( = 0 , p = 1.0 ) ; more patients in the carnitine group ( nine versus five ) achieved a clinical ly significant weight loss ( > or=5 % ) but this was not statistically significant ( p = 1.0 , Fisher 's exact test ) . CONCLUSIONS At the dose prescribed in this study carnitine supplementation did not improve weight loss outcomes in valproate-treated bipolar patients consuming an energy-restricted , low-fat diet OBJECTIVE : Assessment of the effect of 2-week supplementation with (−)-hydroxycitrate ( HCA ) and HCA combined with medium-chain triglycerides ( MCT ) on satiety , fat oxidation , energy expenditure ( EE ) and body weight ( BW ) loss . DESIGN : Three intervention periods of 2 weeks separated by washout periods of 4 weeks . Double-blind , placebo-controlled , r and omised and cross-over design .SUBJECTS : Eleven overweight male subjects ( mean±s.d . ; age , 47±16 y ; body mass index , 27.4 ± 8.2 kg/m2).INTERVENTION : Subjects consumed three self-selected meals and four iso-energetic ( 420 kJ ) snacks daily with either no supplementation ( PLA ) , 500 mg HCA ( HCA ) or 500 mg HCA and 3 g MCT ( HCA+MCT ) . Each intervention ended with a 36 h stay in the respiration chamber . RESULTS : There was a significant BW loss during the 2 weeks of intervention ( PLA , −1.0 ± 0.4 kg , P<0.05 ; HCA , −1.5 ± 0.5 kg , P<0.01 ; HCA+MCT , −1.3 ± 0.2 kg , P<0.001 ) , but this reduction was not different between treatments . 24 h EE  ( PLA , 11.8 ± 0.2 MJ ; HCA , 11.7 ± 0.1 MJ ; HCA+MCT , 11.5 ± 0.1 MJ ) , 24 h RQ ( 0.85 ± 0.00 in all treatments ) and the area under the curve of the appetite-related parameters were not different between treatments . CONCLUSION : Two-week supplementation with HCA and HCA combined with MCT did not result in increased satiety , fat oxidation , 24 h EE or BW loss  compared to PLA , in subjects losing BW Objectives : To study the effects of green tea on body weight , and biochemical and hormonal profiles in obese Chinese women with polycystic ovary syndrome ( PCOS ) . Methods : Thirty-four obese Chinese women with PCOS were r and omized into either treatment with green tea capsules or placebo for 3 months . The anthropomentric measurements , and biochemical and hormonal profiles before and after treatment in each group were compared . Results : The body weight of the green tea group decreased by a nonsignificant 2.4 % after treatment ; whereas the body weight , body mass index ( BMI ) , and body fat content of the control group were significantly higher after 3 months . There were no differences in any of the hormone levels measured in either group . The biochemical profiles of the two groups were also similar except that there was a small but significant rise in the triglyceride level in the green tea group . Fewer patients in the green tea group remained amenorrhoeic , but this was not significantly different from the control group . Conclusions : Green tea supplementation did not significantly reduce body weight in obese women with PCOS , nor did it alter the glucose or lipid metabolism BACKGROUND A previous study has demonstrated that L-carnitine reduces plasma lipoprotein(a ) ( Lp[a ] ) levels in patients with hypercholesterolemia . OBJECTIVE To test a tolerable Lp(a)-reducing agent in diabetic patients , we assessed the effect of a dietary supplementation of L-carnitine on plasma lipid levels , particularly Lp(a ) , of patients with type 2 diabetes mellitus ( DM ) and hypercholesterolemia . METHODS In this 6-month , r and omized , double-masked , placebo-controlled clinical trial , patients were enrolled , assessed , and followed up at the Diabetic and Metabolic Diseases Center of the Department of Internal Medicine and Therapeutics at the University of Pavia , Pavia , Italy . All study patients had newly diagnosed type 2 DM that was managed through dietary restriction alone throughout the study , as well as hypercholesterolemia . Patients were r and omized to 1 of 2 groups . One group received L-carnitine , one 1-g tablet BID . The other group received a corresponding placebo . We assessed body mass index , fasting 
    Output:
    
agent
There was no significant difference between the groups in the studies regarding L-carnitina and flaxseed .
There is a lack of evidence regarding quality studies justifying the use of alternative products for weight loss
***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: The effect of a 3-tier intervention including dietary modifications ( ie , moderate energy restriction , decreased carbohydrate , increased protein ) , increased physical activity , and the use of carnitine as a dietary supplement was evaluated on plasma lipids and the atherogenicity of low-density lipoprotein ( LDL ) particles in a population of overweight and obese premenopausal ( aged 20 - 45 years ) women .  Carnitine or a placebo ( cellulose ) was r and omly assigned to the participants using a double-blind design . Carnitine supplementation was postulated to enhance fat oxidation result ing in lower concentrations of plasma triglycerides . Seventy women completed the 10-week protocol , which followed a reduction in their energy intake by 15 % and a macronutrient energy distribution of 30 % protein , 30 % fat , and 40 % carbohydrate . In addition , subjects increased the number of steps taken per day by 4500 . As no differences were observed between the carnitine and placebo groups in all the measured parameters , all subjects were pooled together for statistical analysis . Participants decreased ( P<.01 ) their caloric intake ( between 4132.8 and 7770 kJ ) and followed prescribed dietary modifications as assessed by dietary records . The average number of steps increased from 8950+/-3432 to 12764+/-4642 ( P<.001 ) . Body weight , plasma total cholesterol , LDL cholesterol , and triglyceride were decreased by 4.5 % , 8.0 % , 12.3 % , and 19.2 % ( P<.0001 ) , respectively , after the intervention . Likewise , apolipoproteins B and E decreased by 4.5 % and 15 % ( P<.05 ) after 10 weeks . The LDL mean particle size was increased from 26.74 to 26.86 nm ( P<.01 ) , and the percent of the smaller LDL subfraction ( P<.05 ) was decreased by 26.5 % ( P<.05 ) after 10 weeks . In addition , LDL lag time increased by 9.3 % ( P<.01 ) , and LDL conjugated diene formation decreased by 23 % ( P<.01 ) , indicating that the susceptibility of LDL to oxidation was decreased after the intervention . This study suggests that moderate weight loss ( < 5 % of body weight ) associated with reduced caloric intake , lower dietary carbohydrate , and increased physical activity impacts the atherogenicity of LDL BACKGROUND Current interest in the role of functional foods in weight control has focused on plant ingredients capable of interfering with the sympathoadrenal system . OBJECTIVE We investigated whether a green tea extract , by virtue of its high content of caffeine and catechin polyphenols , could increase 24-h energy expenditure ( EE ) and fat oxidation in humans . DESIGN Twenty-four-hour EE , the respiratory quotient ( RQ ) , and the urinary excretion of nitrogen and catecholamines were measured in a respiratory chamber in 10 healthy men . On 3 separate occasions , subjects were r and omly assigned among 3 treatments : green tea extract ( 50 mg caffeine and 90 mg epigallocatechin gallate ) , caffeine ( 50 mg ) , and placebo , which they ingested at breakfast , lunch , and dinner . RESULTS Relative to placebo , treatment with the green tea extract result ed in a significant increase in 24-h EE ( 4 % ; P < 0.01 ) and a significant decrease in 24-h RQ ( from 0.88 to 0.85 ; P < 0.001 ) without any change in urinary nitrogen . Twenty-four-hour urinary norepinephrine excretion was higher during treatment with the green tea extract than with the placebo ( 40 % , P < 0.05 ) . Treatment with caffeine in amounts equivalent to those found in the green tea extract had no effect on EE and RQ nor on urinary nitrogen or catecholamines . CONCLUSIONS Green tea has thermogenic properties and promotes fat oxidation beyond that explained by its caffeine content per se . The green tea extract may play a role in the control of body composition via sympathetic activation of thermogenesis , fat oxidation , or both Alpha-linolenic acid ( ALA ) is a major dietary ( n-3 ) fatty acid . ALA is converted to longer-chain ( n-3 ) PUFA , such as eicosapentaenoic acid ( EPA ) and possibly docosahexaenoic acid ( DHA ) . EPA and DHA are fish-based ( n-3 ) fatty acids that have proven cardioprotective properties . We studied the effect of daily supplementation with 3 g of ALA on the plasma concentration of long-chain ( n-3 ) fatty acids in a predominantly African-American population with chronic illness . In a r and omized , double-blind trial , 56 participants were given 3 g ALA/d from flaxseed oil capsules ( n = 31 ) or olive oil placebo capsules ( n = 25 ) . Plasma EPA levels at 12 wk in the flaxseed oil group increased by 60 % , from 24.09 + /- 16.71 to 38.56 + /- 28.92 micromol/L ( P = 0.004 ) , whereas no change occurred in the olive oil group . Plasma docosapentaenoic acid ( DPA ) levels in the flaxseed oil group increased by 25 % from 19.94 + /- 9.22 to 27.03 + /- 17.17 micromol/L ( P = 0.03 ) with no change in the olive oil group . Plasma DHA levels did not change in either group . This study demonstrates the efficacy of the conversion of ALA to EPA and DPA in a minority population with chronic disease . ALA may be an alternative to fish oil ; however , additional clinical trials with ALA are warranted We assessed the effect of ingestion of green tea ( GT ) extract along with a low-energy diet ( LED ) on resting energy expenditure ( REE ) , substrate oxidation and body weight as GT has been shown to increase energy expenditure and fat oxidation in the short term in both animals and people . Forty-six overweight women ( BMI 27.6 ( sd 1.8 ) kg/m2 ) were fed in energy balance from day 1 to day 3 , followed by a LED with GT ( 1125 mg tea catechins + 225 mg caffeine/d ) or placebo ( PLAC ) from day 4 to day 87 . Caffeine intake was st and ardised to 300 mg/d . Energy expenditure was measured on days 4 and 32 . Reductions in weight ( 4.19 ( sd 2.0 ) kg PLAC , 4.21 ( sd 2.7 ) kg GT ) , BMI , waist : hip ratio , fat mass and fat-free mass were not statistically different between treatments . REE as a function of fat-free mass and fat mass was significantly reduced over 32 d in the PLAC group ( P<0.05 ) but not in the GT group . Dietary restraint increased over time ( P<0.001 ) in both groups , whereas disinhibition and general hunger decreased ( P<0.05 ) . The GT group became more hungry over time and less thirsty , and showed increased prospect i ve food consumption compared with PLAC ( P<0.05 ) . Taken together , the ingestion of GT along with a LED had no additional benefit for any measures of body weight or body composition . Although the decrease in REE as a function of fat-free mass and fat mass was not significant with GT treatment , whereas it was with PLAC treatment , no significant effect of treatment over time was seen , suggesting that a robust limitation of REE reduction during a LED was not achieved by GT OBJECTIVES Carnitine deficiency impairs fatty acid beta-oxidation and may partly explain weight gain in valproate-treated patients . The aim of this study was to determine whether l-carnitine supplementation improves weight loss outcomes in bipolar patients taking sodium valproate .  METHODS Sixty bipolar patients with clinical ly significant weight gain thought to be related to sodium valproate , who had been taking sodium valproate for > or=6 months , were r and omized to l-carnitine ( 15 mg/kg/day ) or placebo for 26 weeks , in conjunction with a moderately energy-restricted , low-fat diet . The primary outcome measure was weight change . RESULTS l-carnitine had no effect on mean weight loss compared with placebo ( -1.9 kg versus - 0.9 kg ) ( F = 0.778 , df = 1,58 , p = 0.381 ) . The number of people in each group able to lose any weight was identical ( = 0 , p = 1.0 ) ; more patients in the carnitine group ( nine versus five ) achieved a clinical ly significant weight loss ( > or=5 % ) but this was not statistically significant ( p = 1.0 , Fisher 's exact test ) . CONCLUSIONS At the dose prescribed in this study carnitine supplementation did not improve weight loss outcomes in valproate-treated bipolar patients consuming an energy-restricted , low-fat diet OBJECTIVE : Assessment of the effect of 2-week supplementation with (−)-hydroxycitrate ( HCA ) and HCA combined with medium-chain triglycerides ( MCT ) on satiety , fat oxidation , energy expenditure ( EE ) and body weight ( BW ) loss . DESIGN : Three intervention periods of 2 weeks separated by washout periods of 4 weeks . Double-blind , placebo-controlled , r and omised and cross-over design .SUBJECTS : Eleven overweight male subjects ( mean±s.d . ; age , 47±16 y ; body mass index , 27.4 ± 8.2 kg/m2).INTERVENTION : Subjects consumed three self-selected meals and four iso-energetic ( 420 kJ ) snacks daily with either no supplementation ( PLA ) , 500 mg HCA ( HCA ) or 500 mg HCA and 3 g MCT ( HCA+MCT ) . Each intervention ended with a 36 h stay in the respiration chamber . RESULTS : There was a significant BW loss during the 2 weeks of intervention ( PLA , −1.0 ± 0.4 kg , P<0.05 ; HCA , −1.5 ± 0.5 kg , P<0.01 ; HCA+MCT , −1.3 ± 0.2 kg , P<0.001 ) , but this reduction was not different between treatments . 24 h EE  ( PLA , 11.8 ± 0.2 MJ ; HCA , 11.7 ± 0.1 MJ ; HCA+MCT , 11.5 ± 0.1 MJ ) , 24 h RQ ( 0.85 ± 0.00 in all treatments ) and the area under the curve of the appetite-related parameters were not different between treatments . CONCLUSION : Two-week supplementation with HCA and HCA combined with MCT did not result in increased satiety , fat oxidation , 24 h EE or BW loss  compared to PLA , in subjects losing BW Objectives : To study the effects of green tea on body weight , and biochemical and hormonal profiles in obese Chinese women with polycystic ovary syndrome ( PCOS ) . Methods : Thirty-four obese Chinese women with PCOS were r and omized into either treatment with green tea capsules or placebo for 3 months . The anthropomentric measurements , and biochemical and hormonal profiles before and after treatment in each group were compared . Results : The body weight of the green tea group decreased by a nonsignificant 2.4 % after treatment ; whereas the body weight , body mass index ( BMI ) , and body fat content of the control group were significantly higher after 3 months . There were no differences in any of the hormone levels measured in either group . The biochemical profiles of the two groups were also similar except that there was a small but significant rise in the triglyceride level in the green tea group . Fewer patients in the green tea group remained amenorrhoeic , but this was not significantly different from the control group . Conclusions : Green tea supplementation did not significantly reduce body weight in obese women with PCOS , nor did it alter the glucose or lipid metabolism BACKGROUND A previous study has demonstrated that L-carnitine reduces plasma lipoprotein(a ) ( Lp[a ] ) levels in patients with hypercholesterolemia . OBJECTIVE To test a tolerable Lp(a)-reducing agent in diabetic patients , we assessed the effect of a dietary supplementation of L-carnitine on plasma lipid levels , particularly Lp(a ) , of patients with type 2 diabetes mellitus ( DM ) and hypercholesterolemia . METHODS In this 6-month , r and omized , double-masked , placebo-controlled clinical trial , patients were enrolled , assessed , and followed up at the Diabetic and Metabolic Diseases Center of the Department of Internal Medicine and Therapeutics at the University of Pavia , Pavia , Italy . All study patients had newly diagnosed type 2 DM that was managed through dietary restriction alone throughout the study , as well as hypercholesterolemia . Patients were r and omized to 1 of 2 groups . One group received L-carnitine , one 1-g tablet BID . The other group received a corresponding placebo . We assessed body mass index , fasting 
    Output:
    