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: To assess age and gender differences in muscle strength , isometric , concentric ( Con ) , and eccentric ( Ecc ) peak torque was measured in the knee extensors at a slow ( 0.52 rad/s ) and fast ( 3.14 rad/s ) velocity in 654 subjects ( 346 men and 308 women , aged 20 - 93 yr ) from the Baltimore Longitudinal Study of Aging . Regression analysis revealed significant ( P < 0.001 ) age-related reductions in Con and Ecc peak torque for men and women at both velocities , but no differences were observed between the gender groups or velocities . Age explained losses in Con better than Ecc peak torque , accounting for 30 % ( Con ) vs. 19 % ( Ecc ) of the variance in men and 28 % ( Con ) vs. 11 % ( Ecc ) in women . To assess age and gender differences in the ability to store and utilize elastic energy , the stretch-shortening cycle was determined in a subset of subjects ( n = 47 ) . The older women ( mean age = 70 yr ) showed a significantly greater enhancement in the stretch-shortening cycle , compared with men of similar age ( P < 0.01 ) and compared with younger men and women ( each P < 0.05 ) . Both men and women showed significant declines in muscle quality for Con peak torque ( P < 0.01 ) , but no gender differences were observed . Only the men showed a significant decline in muscle quality ( P < 0.001 ) for Ecc peak torque . Thus both men and women experience age-related losses in isometric , Con , and Ecc knee extensor peak torque ; however , age accounted for less of the variance in Ecc peak torque in women , and women tend to better preserve muscle quality with age for Ecc peak torque . In addition , older women have an enhanced capacity to store and utilize elastic energy compared with similarly aged men as well as with younger women and men Insulin resistance is one of the most common features of polycystic ovary syndrome ( PCOS ) . Some studies suggest that vitamin D deficiency may have a role in insulin resistance ; thus , the aim of the current study was to determine the effect of vitamin D supplementation on insulin resistance in women with PCOS and a vitamin D deficiency . We hypothesized that vitamin D supplementation would lower the glucose level and insulin resistance in women with PCOS and a vitamin D deficiency . The current study was a r and omized , placebo-controlled , double-blinded trial with 50 women with PCOS and a vitamin D deficiency , 20 to 40 years old , assigned to receive 3 oral treatments consisting of 50,000 IU of vitamin D₃ or a placebo ( 1 every 20 days ) for 2 months ( vitamin D , n = 24 ; placebo , n = 26 ) . The fasting blood glucose , insulin , 25-hydroxyvitamin D , and parathyroid hormone levels , as well as the homeostasis model assessment of insulin resistance and quantitative insulin sensitivity check index were measured at baseline and after treatment . In the vitamin D group , the serum level of 25-hydroxyvitamin D increased ( 6.9 ± 2.8 to 23.4 ± 6.1 ng/mL , P < .0001 ) , and the parathyroid hormone level decreased ( 70.02 ± 43.04 to 50.33 ± 21.99 μ IU/mL , P = .02 ) . There were no significant changes in the placebo group . There was a significant increase in insulin secretion in the vitamin D group ( P = .01 ) , but this was not significant compared with the placebo group . The fasting serum insulin and glucose levels and the insulin sensitivity and homeostasis model assessment of insulin resistance did not change significantly by the end of the study . We were not able to demonstrate the effect of vitamin D supplementation on insulin sensitivity and insulin resistance in women with PCOS and vitamin D deficiency Muscle mass decreases with age , leading to " sarcopenia , " or low relative muscle mass , in elderly people . Sarcopenia is believed to be associated with metabolic , physiologic , and functional impairments and disability . Methods of estimating the prevalence of sarcopenia and its associated risks in elderly population s are lacking . Data from a  population -based survey of 883 elderly Hispanic and non-Hispanic white men and women living in New Mexico ( the New Mexico Elder Health Survey , 1993 - 1995 ) were analyzed to develop a method for estimating the prevalence of sarcopenia . An anthropometric equation for predicting appendicular skeletal muscle mass was developed from a r and om sub sample ( n = 199 ) of participants and was extended to the total sample . Sarcopenia was defined as appendicular skeletal muscle mass (kg)/height2 ( m2 ) being less than two st and ard deviations below the mean of a young reference group . Prevalences increased from 13 - 24 % in persons under 70 years of age to > 50 % in persons over 80 years of age , and were slightly greater in Hispanics than in non-Hispanic whites . Sarcopenia was significantly associated with self-reported physical disability in both men and women , independent of ethnicity , age , morbidity , obesity , income , and health behaviors . This study provides some of the first estimates of the extent of the public health problem posed by sarcopenia BACKGROUND Very limited data suggest that meat consumption by older people may promote skeletal muscle hypertrophy in response to resistance training ( RT ) . OBJECTIVE The objective of this study was to assess whether the consumption of an omnivorous ( meat-containing ) diet would influence RT-induced changes in whole-body composition and skeletal muscle size in older men compared with a lactoovovegetarian ( LOV ) ( meat-free ) diet . DESIGN Nineteen men aged 51 - 69 y participated in the study . During a 12-wk period of RT , 9 men consumed their habitual omnivorous diets , which provided approximately 50 % of total dietary protein from meat sources ( beef , poultry , pork , and fish ) ( mixed-diet group ) . Another 10 men were counseled to self-select an LOV diet ( LOV-diet group ) . RESULTS Maximal strength of the upper- and lower-body muscle groups that were exercised during RT increased by 10 - 38 % ( P < 0.001 ) , independent of diet . The RT-induced changes in whole-body composition and skeletal muscle size differed significantly between the mixed- and LOV-diet groups ( time-by-group interactions , P < 0 . 05 ) . With RT , whole-body density , fat-free mass , and whole-body muscle mass increased in the mixed diet group but decreased in the LOV- diet group . Type II muscle fiber area of the vastus lateralis muscle increased with RT for all men combined ( P < 0.01 ) , and the increase tended to be greater in the mixed-diet group ( 16.2 + /- 4.4 % ) than in the LOV diet group ( 7.3 + /- 5.1 % ) . Type I fiber area was unchanged with RT in both diet groups . CONCLUSION Consumption of a meat-containing diet contributed to greater gains in fat-free mass and skeletal muscle mass with RT in older men than did an LOV diet Background At present , it is unknown whether the use of nutrient-rich dairy proteins improves the markers of sarcopenia syndrome . Therefore , our proposal was to investigate whether adding 210 g of ricotta cheese daily would improve skeletal muscle mass , h and grip strength , and physical performance in non-sarcopenic older subjects . Subjects and methods This was a single-blind r and omized clinical trial that included two homogeneous , r and omized groups of men and women over 60 years of age . Participants in the intervention group were asked to consume their habitual diet but add 210 g of ricotta cheese ( IG/HD + RCH ) , while the control group was instructed to consume only their habitual diet ( CG/HD ) . Basal and 12-week follow-up measurements included appendicular skeletal muscle mass ( ASMM ) by dual-energy X-ray absorptiometry , h and grip strength by a h and held dynamometer , and physical performance using the short physical performance battery ( SPPB ) and the stair-climb power test ( SCPT ) . The main outcomes were relative changes in ASMM , strength , SPPB , and SCPT . Results ASMM increased in the IG/HD + RCH ( 0.6±3.5 kg ) , but decreased in the CG/HD ( −1.0±2.6 ) . The relative change between groups was statistically significant ( P=0.009 ) . The relative change in strength in both groups was negative , but the loss of muscle strength was more pronounced in CG/HD , though in this regard statistical analysis found only a tendency ( P=0.07 ) . The relative change in the balance-test scores was positive for the IG/HD + RCH , while in the CG/HD it was negative , as those individuals had poorer balance . In this case , the relative change between groups did reach statistical significance . Conclusion The addition of 210 g of ricotta cheese improves ASMM and balance-test scores , while attenuating the loss of muscle strength . These results suggest that adding ricotta cheese to the habitual diet is a promising dietetic strategy that may improve the markers of sarcopenia in subjects without a pronounced loss of ASMM or sarcopenia A 9-wk study of adaptation to marginal protein intakes was conducted in 12 elderly women . Subjects were r and omly assigned to two groups fed a weight-maintenance diet containing either 1.47 ( low ) or 2.94 ( adequate ) g protein.kg body cell mass-1.d-1 ( 0.45 and 0.92 g.kg body wt-1.d-1 , respectively ) . Mean nitrogen balance in the low-protein group remained negative throughout the study . These subjects experienced significant losses in lean tissue , immune response , and muscle function . The adequate-protein group was in nitrogen balance throughout the study , without changes in lean tissue , and with improvements in immune response , serum immunoglobulins , albumin , total protein values , and muscle function . Thus , elderly women fed the low-protein diet accommo date d to the diet by compromising functional capacity , whereas those fed the adequate diet maintained functional capacity Low protein intake can lead to declined lean mass ( LM ) in elderly . We examined the associations of total protein ( TP ) , animal protein ( AP ) and plant protein ( PP ) intakes with LM . The association of TP intake with LM change was further evaluated according to weight change status . This cross-sectional and prospect i ve cohort study included 554 women aged 68 ( sd 1·9 ) years from the Osteoporosis Risk Factor and Prevention – Fracture Prevention Study ( OSTPRE-FPS ) . The intervention group ( n 270 ) received daily cholecalciferol ( 800 IU ; 20 μg ) and Ca ( 1000 mg ) for 3 years while the control group received neither supplementation nor placebo ( n 282 ) . Participants filled out a question naire on lifestyle factors and a 3-d food record in 2002 and underwent dual-energy X-ray absorptiometry for body composition measurements at baseline and 3 years . Multiple linear regressions evaluated the association between protein intake and LM , adjusting for relevant covariates . At the baseline TP and AP intakes were positively associated with LM and trunk LM , TP was associated also with appendicular LM ( aLM ) . Follow-up results showed that in the total population and the intervention group  , higher TP and AP were associated with increased LM and aLM ( P ≤ 0·050 ) . No such associations were observed in the control  group . PP intake was also associated with aLM change in the total population . Overall , the associations were independent of fat mass . Further , among weight maintainers , TP intake was positively associated with LM , aLM and trunk LM changes ( P ≤ 0·020 ) . In conclusion , dietary  TP , especially AP , intake may be a modifiable risk factor for sarcopenia by preserving LM in the elderly BACKGROUND AND OBJECTIVES Higher phosphate is associated with mortality in dialysis patients but few prospect i ve studies assess this in nondialysis patients managed in an outpatient nephrology clinic . This prospect i ve longitudinal study examined whether phosphate level was associated with death in a referred population . DESIGN , SETTING , PARTICIPANTS & MEASUREMENTS Patients ( 1203 ) of nondialysis chronic kidney disease ( CKD ) in the Chronic Renal Insufficiency St and ards Implementation Study were assessed .  Survival analyses were performed for quartiles of baseline phosphate relative to GFR , 12-month time-averaged phosphate , and baseline phosphate according to published phosphate targets . RESULTS  Mean ( SD ) eGFR was 32 ( 15 ) ml/min per 1.73 m(2 ) , age 64 ( 14 ) years , and phosphate 1.2 ( 0.30 ) mmol/L. Cox multivariate adjusted regression in CKD stages 3 to 4 patients showed an increased risk of all-cause and cardiovascular mortality in the highest quartile compared with that in the lowest quartile of phosphate . No association was found in CKD stage 5 patients . Patients who had values above recommended targets for phosphate control had increased risk of all-cause and cardiovascular death compared with patients below 
    Output:
    
agent
This systematic review highlights the effects of dairy products on muscle mass , muscle strength and body performance in the elderly population in the perspective of Ca , P , vitamin D and protein
***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: To assess age and gender differences in muscle strength , isometric , concentric ( Con ) , and eccentric ( Ecc ) peak torque was measured in the knee extensors at a slow ( 0.52 rad/s ) and fast ( 3.14 rad/s ) velocity in 654 subjects ( 346 men and 308 women , aged 20 - 93 yr ) from the Baltimore Longitudinal Study of Aging . Regression analysis revealed significant ( P < 0.001 ) age-related reductions in Con and Ecc peak torque for men and women at both velocities , but no differences were observed between the gender groups or velocities . Age explained losses in Con better than Ecc peak torque , accounting for 30 % ( Con ) vs. 19 % ( Ecc ) of the variance in men and 28 % ( Con ) vs. 11 % ( Ecc ) in women . To assess age and gender differences in the ability to store and utilize elastic energy , the stretch-shortening cycle was determined in a subset of subjects ( n = 47 ) . The older women ( mean age = 70 yr ) showed a significantly greater enhancement in the stretch-shortening cycle , compared with men of similar age ( P < 0.01 ) and compared with younger men and women ( each P < 0.05 ) . Both men and women showed significant declines in muscle quality for Con peak torque ( P < 0.01 ) , but no gender differences were observed . Only the men showed a significant decline in muscle quality ( P < 0.001 ) for Ecc peak torque . Thus both men and women experience age-related losses in isometric , Con , and Ecc knee extensor peak torque ; however , age accounted for less of the variance in Ecc peak torque in women , and women tend to better preserve muscle quality with age for Ecc peak torque . In addition , older women have an enhanced capacity to store and utilize elastic energy compared with similarly aged men as well as with younger women and men Insulin resistance is one of the most common features of polycystic ovary syndrome ( PCOS ) . Some studies suggest that vitamin D deficiency may have a role in insulin resistance ; thus , the aim of the current study was to determine the effect of vitamin D supplementation on insulin resistance in women with PCOS and a vitamin D deficiency . We hypothesized that vitamin D supplementation would lower the glucose level and insulin resistance in women with PCOS and a vitamin D deficiency . The current study was a r and omized , placebo-controlled , double-blinded trial with 50 women with PCOS and a vitamin D deficiency , 20 to 40 years old , assigned to receive 3 oral treatments consisting of 50,000 IU of vitamin D₃ or a placebo ( 1 every 20 days ) for 2 months ( vitamin D , n = 24 ; placebo , n = 26 ) . The fasting blood glucose , insulin , 25-hydroxyvitamin D , and parathyroid hormone levels , as well as the homeostasis model assessment of insulin resistance and quantitative insulin sensitivity check index were measured at baseline and after treatment . In the vitamin D group , the serum level of 25-hydroxyvitamin D increased ( 6.9 ± 2.8 to 23.4 ± 6.1 ng/mL , P < .0001 ) , and the parathyroid hormone level decreased ( 70.02 ± 43.04 to 50.33 ± 21.99 μ IU/mL , P = .02 ) . There were no significant changes in the placebo group . There was a significant increase in insulin secretion in the vitamin D group ( P = .01 ) , but this was not significant compared with the placebo group . The fasting serum insulin and glucose levels and the insulin sensitivity and homeostasis model assessment of insulin resistance did not change significantly by the end of the study . We were not able to demonstrate the effect of vitamin D supplementation on insulin sensitivity and insulin resistance in women with PCOS and vitamin D deficiency Muscle mass decreases with age , leading to " sarcopenia , " or low relative muscle mass , in elderly people . Sarcopenia is believed to be associated with metabolic , physiologic , and functional impairments and disability . Methods of estimating the prevalence of sarcopenia and its associated risks in elderly population s are lacking . Data from a  population -based survey of 883 elderly Hispanic and non-Hispanic white men and women living in New Mexico ( the New Mexico Elder Health Survey , 1993 - 1995 ) were analyzed to develop a method for estimating the prevalence of sarcopenia . An anthropometric equation for predicting appendicular skeletal muscle mass was developed from a r and om sub sample ( n = 199 ) of participants and was extended to the total sample . Sarcopenia was defined as appendicular skeletal muscle mass (kg)/height2 ( m2 ) being less than two st and ard deviations below the mean of a young reference group . Prevalences increased from 13 - 24 % in persons under 70 years of age to > 50 % in persons over 80 years of age , and were slightly greater in Hispanics than in non-Hispanic whites . Sarcopenia was significantly associated with self-reported physical disability in both men and women , independent of ethnicity , age , morbidity , obesity , income , and health behaviors . This study provides some of the first estimates of the extent of the public health problem posed by sarcopenia BACKGROUND Very limited data suggest that meat consumption by older people may promote skeletal muscle hypertrophy in response to resistance training ( RT ) . OBJECTIVE The objective of this study was to assess whether the consumption of an omnivorous ( meat-containing ) diet would influence RT-induced changes in whole-body composition and skeletal muscle size in older men compared with a lactoovovegetarian ( LOV ) ( meat-free ) diet . DESIGN Nineteen men aged 51 - 69 y participated in the study . During a 12-wk period of RT , 9 men consumed their habitual omnivorous diets , which provided approximately 50 % of total dietary protein from meat sources ( beef , poultry , pork , and fish ) ( mixed-diet group ) . Another 10 men were counseled to self-select an LOV diet ( LOV-diet group ) . RESULTS Maximal strength of the upper- and lower-body muscle groups that were exercised during RT increased by 10 - 38 % ( P < 0.001 ) , independent of diet . The RT-induced changes in whole-body composition and skeletal muscle size differed significantly between the mixed- and LOV-diet groups ( time-by-group interactions , P < 0 . 05 ) . With RT , whole-body density , fat-free mass , and whole-body muscle mass increased in the mixed diet group but decreased in the LOV- diet group . Type II muscle fiber area of the vastus lateralis muscle increased with RT for all men combined ( P < 0.01 ) , and the increase tended to be greater in the mixed-diet group ( 16.2 + /- 4.4 % ) than in the LOV diet group ( 7.3 + /- 5.1 % ) . Type I fiber area was unchanged with RT in both diet groups . CONCLUSION Consumption of a meat-containing diet contributed to greater gains in fat-free mass and skeletal muscle mass with RT in older men than did an LOV diet Background At present , it is unknown whether the use of nutrient-rich dairy proteins improves the markers of sarcopenia syndrome . Therefore , our proposal was to investigate whether adding 210 g of ricotta cheese daily would improve skeletal muscle mass , h and grip strength , and physical performance in non-sarcopenic older subjects . Subjects and methods This was a single-blind r and omized clinical trial that included two homogeneous , r and omized groups of men and women over 60 years of age . Participants in the intervention group were asked to consume their habitual diet but add 210 g of ricotta cheese ( IG/HD + RCH ) , while the control group was instructed to consume only their habitual diet ( CG/HD ) . Basal and 12-week follow-up measurements included appendicular skeletal muscle mass ( ASMM ) by dual-energy X-ray absorptiometry , h and grip strength by a h and held dynamometer , and physical performance using the short physical performance battery ( SPPB ) and the stair-climb power test ( SCPT ) . The main outcomes were relative changes in ASMM , strength , SPPB , and SCPT . Results ASMM increased in the IG/HD + RCH ( 0.6±3.5 kg ) , but decreased in the CG/HD ( −1.0±2.6 ) . The relative change between groups was statistically significant ( P=0.009 ) . The relative change in strength in both groups was negative , but the loss of muscle strength was more pronounced in CG/HD , though in this regard statistical analysis found only a tendency ( P=0.07 ) . The relative change in the balance-test scores was positive for the IG/HD + RCH , while in the CG/HD it was negative , as those individuals had poorer balance . In this case , the relative change between groups did reach statistical significance . Conclusion The addition of 210 g of ricotta cheese improves ASMM and balance-test scores , while attenuating the loss of muscle strength . These results suggest that adding ricotta cheese to the habitual diet is a promising dietetic strategy that may improve the markers of sarcopenia in subjects without a pronounced loss of ASMM or sarcopenia A 9-wk study of adaptation to marginal protein intakes was conducted in 12 elderly women . Subjects were r and omly assigned to two groups fed a weight-maintenance diet containing either 1.47 ( low ) or 2.94 ( adequate ) g protein.kg body cell mass-1.d-1 ( 0.45 and 0.92 g.kg body wt-1.d-1 , respectively ) . Mean nitrogen balance in the low-protein group remained negative throughout the study . These subjects experienced significant losses in lean tissue , immune response , and muscle function . The adequate-protein group was in nitrogen balance throughout the study , without changes in lean tissue , and with improvements in immune response , serum immunoglobulins , albumin , total protein values , and muscle function . Thus , elderly women fed the low-protein diet accommo date d to the diet by compromising functional capacity , whereas those fed the adequate diet maintained functional capacity Low protein intake can lead to declined lean mass ( LM ) in elderly . We examined the associations of total protein ( TP ) , animal protein ( AP ) and plant protein ( PP ) intakes with LM . The association of TP intake with LM change was further evaluated according to weight change status . This cross-sectional and prospect i ve cohort study included 554 women aged 68 ( sd 1·9 ) years from the Osteoporosis Risk Factor and Prevention – Fracture Prevention Study ( OSTPRE-FPS ) . The intervention group ( n 270 ) received daily cholecalciferol ( 800 IU ; 20 μg ) and Ca ( 1000 mg ) for 3 years while the control group received neither supplementation nor placebo ( n 282 ) . Participants filled out a question naire on lifestyle factors and a 3-d food record in 2002 and underwent dual-energy X-ray absorptiometry for body composition measurements at baseline and 3 years . Multiple linear regressions evaluated the association between protein intake and LM , adjusting for relevant covariates . At the baseline TP and AP intakes were positively associated with LM and trunk LM , TP was associated also with appendicular LM ( aLM ) . Follow-up results showed that in the total population and the intervention group  , higher TP and AP were associated with increased LM and aLM ( P ≤ 0·050 ) . No such associations were observed in the control  group . PP intake was also associated with aLM change in the total population . Overall , the associations were independent of fat mass . Further , among weight maintainers , TP intake was positively associated with LM , aLM and trunk LM changes ( P ≤ 0·020 ) . In conclusion , dietary  TP , especially AP , intake may be a modifiable risk factor for sarcopenia by preserving LM in the elderly BACKGROUND AND OBJECTIVES Higher phosphate is associated with mortality in dialysis patients but few prospect i ve studies assess this in nondialysis patients managed in an outpatient nephrology clinic . This prospect i ve longitudinal study examined whether phosphate level was associated with death in a referred population . DESIGN , SETTING , PARTICIPANTS & MEASUREMENTS Patients ( 1203 ) of nondialysis chronic kidney disease ( CKD ) in the Chronic Renal Insufficiency St and ards Implementation Study were assessed .  Survival analyses were performed for quartiles of baseline phosphate relative to GFR , 12-month time-averaged phosphate , and baseline phosphate according to published phosphate targets . RESULTS  Mean ( SD ) eGFR was 32 ( 15 ) ml/min per 1.73 m(2 ) , age 64 ( 14 ) years , and phosphate 1.2 ( 0.30 ) mmol/L. Cox multivariate adjusted regression in CKD stages 3 to 4 patients showed an increased risk of all-cause and cardiovascular mortality in the highest quartile compared with that in the lowest quartile of phosphate . No association was found in CKD stage 5 patients . Patients who had values above recommended targets for phosphate control had increased risk of all-cause and cardiovascular death compared with patients below 
    Output:
    