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 present study investigated the extent of expectancy in the ability of glucose to affect cognitive performance . Using a within-subjects design , subjects ( n 26 ) completed four experimental sessions ( in counterbalanced order and after an initial practice session ) during which they were given a 500 ml drink 30 min prior to completing a cognitive assessment battery . In addition , all subjects completed a baseline practice session during which they were given no drink . During two of the sessions , subjects were given a drink containing 50 g glucose and on the other two they were given a drink containing aspartame . A balanced placebo design was used , such that for half the sessions subjects were accurately informed as to the content of the drink ( glucose or aspartame ) , whereas in the other two sessions they were misinformed as to the content of the drink . The task battery comprised a 6 min visual analogue of the  Bakan vigilance task  , an immediate verbal free-recall task , an immediate verbal recognition memory task and a measure of motor speed ( two-finger tapping ) . Blood glucose and self-reported mood were also recorded at several time points during each session . Glucose administration was found to improve recognition memory times , in direct contrast to previous findings in the literature . Glucose administration also improved performance on the Bakan task ( relative to the control drink ) , but only in sessions where subjects were informed that they would receive glucose and not when they were told that they would receive aspartame . There were no effects either of the nature of the drink or expectancy on the other measures . These results are interpreted in terms of there being some contribution of expectancy concerning the positive effects of glucose on cognition in studies which have not used an equi-sweet dose of aspartame as a control drink To assess whether acute hyperglycemia affects fibrinolytic balance in elderly subjects with normal glucose tolerance ( NGT ) or impaired glucose tolerance ( IGT ) , 40 non-obese elderly subjects ( 20 NGT , age 68 ± 8 years ; and 20 IGT , age 69 ± 11 years ) were studied . On two experimental days , r and omly allocated and spaced 1 week apart , plasma concentrations of glucose , insulin , fibrinogen , tissue plasminogen activator , plasminogen activator inhibitor type 1 and von Willebr and factor ( vWF ) were measured in each subject at baseline ( 0 ) and 30 , 60 , 90 , 120 min after the ingestion of 75 g glucose or a similarly sweet dose of aspartame ( 250 mg ) ( control test ) . In both NGT and IGT elderly subjects , tissue plasminogen activator , plasminogen activator inhibitor type 1 and fibrinogen plasma levels did not significantly change after both oral aspartame and glucose load . In IGT subjects , vWF plasmatic levels decreased after glucose ( not aspartame ) oral load , reaching the minimum level at 90 min after load ( 82.7 ± 7.8 versus 93.7 ± 10.2 , P < 0.01 ) . These results demonstrate that acute hyperglycemia does not modify plasma fibrinolysis in elderly subjects . The decrease of plasma concentration of vWF in IGT elderly subjects requires cautious interpretation and further extensive investigations The objective was to compare the effects of ad libitum consumption of commonly consumed meal-time beverages on energy and fluid intakes and post-meal average subjective appetite and blood glucose in healthy adults . In a r and omized controlled design , 29 males and females consumed to satiation an ad libitum pizza meal with one of five beverages in unlimited amount including water ( 0 kcal ) , 1 % milk ( 44 kcal/100 ml ) , regular cola ( 44 kcal/100 ml ) , orange juice ( 44 kcal/100 ml ) and diet cola ( 0 kcal ) . Food and fluid intakes were measured at the meal . Average subjective appetite and blood glucose were measured before and for 2h after the meal . Although energy intake from pizza was similar among all beverage treatments , the amount of fluid consumed ( g ) varied among the beverages with intake of orange juice higher than regular and diet cola , but not different from water or milk . Meal-time ingestion of caloric beverages , milk , orange juice and regular cola , led to higher total meal-time energy intakes compared to either water or diet cola .  Post-meal blood glucose area under the curve ( AUC ) was lower after milk than after meals with water , orange juice and regular cola and post-meal average subjective appetite AUC was lower after milk than after meals with water . Meal intakes of nutrients including protein , calcium , phosphorus , zinc , vitamins B12 , A and D were higher at the meal with milk compared to the other beverages . Thus , caloric beverages consumed ad libitum during a meal add to total meal-time energy intake , but 1 % milk favors a lower post-meal blood glucose and average subjective appetite score and adds to nutrient intake OBJECTIVE The goal of this study was to determine the effect of artificial sweeteners on glucose , insulin , and glucagon-like peptide (GLP)-1 in humans . RESEARCH DESIGN AND METHODS For this study , 22 healthy volunteers ( mean age 18.5 ± 4.2 years ) underwent two 75-g oral glucose tolerance tests with frequent measurements of glucose , insulin , and GLP-1 for 180 min . Subjects drank 240 ml of diet soda or carbonated water , in r and omized order , 10 min prior to the glucose load . RESULTS Glucose excursions were similar after ingestion of carbonated water and diet soda  . Serum insulin levels tended to be higher after diet soda , without statistical significance . GLP-1 peak and area under the curve ( AUC ) were significantly higher with diet soda ( AUC 24.0 ± 15.2 pmol/l per 180 min ) versus carbonated water ( AUC 16.2 ± 9.0 pmol/l per 180 min ; P = 0.003 ) . CONCLUSIONS Artificial sweeteners synergize with glucose to enhance GLP-1 release in humans . This increase in GLP-1 secretion may be mediated via stimulation of sweet-taste receptors on L-cells by artificial sweetener Background : Substituting sweeteners with non-nutritive sweeteners ( NNS ) may aid in glycaemic control and body weight management . Limited studies have investigated energy compensation , glycaemic and insulinaemic responses to artificial and natural NNS . Objectives : This study compared the effects of consuming NNS ( artificial versus natural ) and sucrose ( 65 g ) on energy intake , blood glucose and insulin responses . Methods : Thirty healthy male subjects took part in this r and omised , crossover study with four treatments : aspartame- , monk fruit- , stevia- and sucrose-sweetened beverages . On each test day , participants were asked to consume a st and ardised breakfast in the morning , and they were provided with test beverage as a preload in mid-morning and ad libitum lunch was provided an hour after test beverage consumption . Blood glucose and insulin concentrations were measured every 15 min within the first hour of preload consumption and every 30 min for the subsequent 2 h. Participants left the study site 3 h after preload consumption and completed a food diary for the rest of the day . Results : Ad libitum lunch intake was significantly higher for the NNS treatments compared with sucrose ( P=0.010 ) . The energy ' saved ' from replacing sucrose with NNS was fully compensated for at subsequent meals ; hence , no difference in total daily energy intake was found between the treatments ( P=0.831 ) . The sucrose-sweetened beverage led to large spikes in blood glucose and insulin responses within the first hour , whereas these responses were higher for all three NNS beverages following the test lunch . Thus , there were no differences in total area under the curve ( AUC ) for glucose ( P=0.960 ) and insulin ( P=0.216 ) over 3 h between the four test beverages . Conclusions : The consumption of calorie-free beverages sweetened with artificial and natural NNS have minimal influences on total daily energy intake , postpr and ial glucose and insulin compared with a sucrose-sweetened beverage BACKGROUND Macronutrient " preloads " can stimulate glucagon-like peptide 1 ( GLP-1 ) and glucose-dependent insulinotropic polypeptide ( GIP ) , slow gastric emptying , and reduce postpr and ial glycemic excursions . After sweet preloads , these effects may be signaled by sodium-glucose cotransporter-1 ( SGLT1 ) , sweet taste receptors , or both . OBJECTIVE We determined the effects of 4 sweet preloads on GIP and GLP-1 release , gastric emptying , and postpr and ial glycemia . DESIGN Ten healthy subjects were studied on 4 separate occasions each . A preload drink containing 40 g glucose , 40 g tagatose/isomalt mixture ( TIM ) , 40 g 3-O-methylglucose ( 3OMG ; a nonmetabolized substrate of SGLT1 ) , or 60 mg sucralose was consumed 15 min before a (13)C-octanoic acid-labeled mashed potato meal .  Blood glucose , plasma total GLP-1 and GIP , serum insulin , and gastric emptying were determined . RESULTS Both glucose and 3OMG stimulated GLP-1 and GIP release in advance of the meal ( each P < 0.05 ) , whereas TIM and sucralose did not . The overall postpr and ial GLP-1 response was greater after glucose , 3OMG , and TIM than after sucralose ( P < 0.05 ) , albeit later after TIM than the other preloads . The blood glucose and insulin responses in the first 30 min after the meal were greatest after glucose ( each P < 0.05 ) . Gastric emptying was slower after both 3OMG and TIM than after sucralose ( each P < 0.05 ) . CONCLUSIONS In healthy humans , SGLT1 substrates stimulate GLP-1 and GIP and slow gastric emptying , regardless of whether they are metabolized , whereas the artificial sweetener sucralose does not . Poorly absorbed sweet tastants ( TIM ) , which probably expose a greater length of gut to nutrients , result in delayed GLP-1 secretion but not in delayed GIP release . These observations have the potential to optimize the use of preloads for glycemic control . This trial was registered at www.actr.org.au as ACTRN12611000775910 Blood glucose ( BG ) is usually measured after a caloric restriction of at least 8 h ; however evidence -based recommendations for the duration of a fasting status are missing . Here we analyze the effect of fasting duration on levels of BG to determine the minimal fasting duration to achieve comparable BG levels to conventional fasting measurements . We used data of a cross-sectional study on primary care patients , performed in October 2005 . We included 28,024 individuals ( age-range 18–99 years ; 63 % women ) without known diabetes mellitus and without missing data for BG and fasting status . We computed general linear models , adjusting for age , sex , time of blood withdrawal , systolic blood pressure , waist circumference , total- and HDL-cholesterol , physical activity , smoking , intake of beta-blocker and alcohol . We tested the intra-individual variability with respect to fasting status . Overall , the mean BG differed only slightly between individuals fasting ≥8 h and those fasting < 8 h ( men : 5.1 ± 0.8 mmol/L versus 5.2 ± 1.2 mmol/L ; women : 4.9 ± 0.7 mmol/L , 5.0 ± 1.0 mmol/L ) . After 3 h of fasting differences of BG diminished in men to −0.08 mmol/L ( 95%-CI : −0.15 ; −0.01 mmol/L ) , in women to −0.07 mmol/L ( −0.12 ; −0.03 mmol/L ) compared to individuals fasting ≥8 h. Noteworthy , age , time of day of blood withdrawal , physical activity , and intake of hard liquor influenced BG levels considerably . Our data challenge the necessity for a fasting duration of ≥8 h when measuring blood glucose , suggesting a r and om sampling or a fasting duration of 3 h as sufficient . Rather , our study indicates that essentially more effort on the assessment of additional external/internal factors on BG levels is necessary OBJECTIVE In patients with type 2 diabetes , but not type 1 diabetes , abnormal secretion of incretins in response to oral nutrients has been described . In healthy youths , we recently reported accentuated glucagon-like peptide 1 ( GLP-1 ) secretion in response to a diet soda sweetened with sucralose and acesulfame-K. In this study , we examined the effect of diet soda on gut hormones in youths with diabetes . RESEARCH DESIGN AND METHODS Subjects aged 12–25 years with type 1 diabetes ( n = 9 ) or type 2 diabetes ( n = 10 ) , or healthy control participants ( n = 25 ) drank 240 mL cola-flavored caffeine 
    Output:
    
agent
In comparison with the baseline , NNS consumption was not found to increase blood glucose level , and its concentration gradually declined over the course of observation following NNS consumption .
The glycemic impact of NNS consumption did not differ by type of NNS but to some extent varied by participants ’ age , body weight , and diabetic status .
Conclusions NNS consumption was not found to elevate blood glucose level .
***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 present study investigated the extent of expectancy in the ability of glucose to affect cognitive performance . Using a within-subjects design , subjects ( n 26 ) completed four experimental sessions ( in counterbalanced order and after an initial practice session ) during which they were given a 500 ml drink 30 min prior to completing a cognitive assessment battery . In addition , all subjects completed a baseline practice session during which they were given no drink . During two of the sessions , subjects were given a drink containing 50 g glucose and on the other two they were given a drink containing aspartame . A balanced placebo design was used , such that for half the sessions subjects were accurately informed as to the content of the drink ( glucose or aspartame ) , whereas in the other two sessions they were misinformed as to the content of the drink . The task battery comprised a 6 min visual analogue of the  Bakan vigilance task  , an immediate verbal free-recall task , an immediate verbal recognition memory task and a measure of motor speed ( two-finger tapping ) . Blood glucose and self-reported mood were also recorded at several time points during each session . Glucose administration was found to improve recognition memory times , in direct contrast to previous findings in the literature . Glucose administration also improved performance on the Bakan task ( relative to the control drink ) , but only in sessions where subjects were informed that they would receive glucose and not when they were told that they would receive aspartame . There were no effects either of the nature of the drink or expectancy on the other measures . These results are interpreted in terms of there being some contribution of expectancy concerning the positive effects of glucose on cognition in studies which have not used an equi-sweet dose of aspartame as a control drink To assess whether acute hyperglycemia affects fibrinolytic balance in elderly subjects with normal glucose tolerance ( NGT ) or impaired glucose tolerance ( IGT ) , 40 non-obese elderly subjects ( 20 NGT , age 68 ± 8 years ; and 20 IGT , age 69 ± 11 years ) were studied . On two experimental days , r and omly allocated and spaced 1 week apart , plasma concentrations of glucose , insulin , fibrinogen , tissue plasminogen activator , plasminogen activator inhibitor type 1 and von Willebr and factor ( vWF ) were measured in each subject at baseline ( 0 ) and 30 , 60 , 90 , 120 min after the ingestion of 75 g glucose or a similarly sweet dose of aspartame ( 250 mg ) ( control test ) . In both NGT and IGT elderly subjects , tissue plasminogen activator , plasminogen activator inhibitor type 1 and fibrinogen plasma levels did not significantly change after both oral aspartame and glucose load . In IGT subjects , vWF plasmatic levels decreased after glucose ( not aspartame ) oral load , reaching the minimum level at 90 min after load ( 82.7 ± 7.8 versus 93.7 ± 10.2 , P < 0.01 ) . These results demonstrate that acute hyperglycemia does not modify plasma fibrinolysis in elderly subjects . The decrease of plasma concentration of vWF in IGT elderly subjects requires cautious interpretation and further extensive investigations The objective was to compare the effects of ad libitum consumption of commonly consumed meal-time beverages on energy and fluid intakes and post-meal average subjective appetite and blood glucose in healthy adults . In a r and omized controlled design , 29 males and females consumed to satiation an ad libitum pizza meal with one of five beverages in unlimited amount including water ( 0 kcal ) , 1 % milk ( 44 kcal/100 ml ) , regular cola ( 44 kcal/100 ml ) , orange juice ( 44 kcal/100 ml ) and diet cola ( 0 kcal ) . Food and fluid intakes were measured at the meal . Average subjective appetite and blood glucose were measured before and for 2h after the meal . Although energy intake from pizza was similar among all beverage treatments , the amount of fluid consumed ( g ) varied among the beverages with intake of orange juice higher than regular and diet cola , but not different from water or milk . Meal-time ingestion of caloric beverages , milk , orange juice and regular cola , led to higher total meal-time energy intakes compared to either water or diet cola .  Post-meal blood glucose area under the curve ( AUC ) was lower after milk than after meals with water , orange juice and regular cola and post-meal average subjective appetite AUC was lower after milk than after meals with water . Meal intakes of nutrients including protein , calcium , phosphorus , zinc , vitamins B12 , A and D were higher at the meal with milk compared to the other beverages . Thus , caloric beverages consumed ad libitum during a meal add to total meal-time energy intake , but 1 % milk favors a lower post-meal blood glucose and average subjective appetite score and adds to nutrient intake OBJECTIVE The goal of this study was to determine the effect of artificial sweeteners on glucose , insulin , and glucagon-like peptide (GLP)-1 in humans . RESEARCH DESIGN AND METHODS For this study , 22 healthy volunteers ( mean age 18.5 ± 4.2 years ) underwent two 75-g oral glucose tolerance tests with frequent measurements of glucose , insulin , and GLP-1 for 180 min . Subjects drank 240 ml of diet soda or carbonated water , in r and omized order , 10 min prior to the glucose load . RESULTS Glucose excursions were similar after ingestion of carbonated water and diet soda  . Serum insulin levels tended to be higher after diet soda , without statistical significance . GLP-1 peak and area under the curve ( AUC ) were significantly higher with diet soda ( AUC 24.0 ± 15.2 pmol/l per 180 min ) versus carbonated water ( AUC 16.2 ± 9.0 pmol/l per 180 min ; P = 0.003 ) . CONCLUSIONS Artificial sweeteners synergize with glucose to enhance GLP-1 release in humans . This increase in GLP-1 secretion may be mediated via stimulation of sweet-taste receptors on L-cells by artificial sweetener Background : Substituting sweeteners with non-nutritive sweeteners ( NNS ) may aid in glycaemic control and body weight management . Limited studies have investigated energy compensation , glycaemic and insulinaemic responses to artificial and natural NNS . Objectives : This study compared the effects of consuming NNS ( artificial versus natural ) and sucrose ( 65 g ) on energy intake , blood glucose and insulin responses . Methods : Thirty healthy male subjects took part in this r and omised , crossover study with four treatments : aspartame- , monk fruit- , stevia- and sucrose-sweetened beverages . On each test day , participants were asked to consume a st and ardised breakfast in the morning , and they were provided with test beverage as a preload in mid-morning and ad libitum lunch was provided an hour after test beverage consumption . Blood glucose and insulin concentrations were measured every 15 min within the first hour of preload consumption and every 30 min for the subsequent 2 h. Participants left the study site 3 h after preload consumption and completed a food diary for the rest of the day . Results : Ad libitum lunch intake was significantly higher for the NNS treatments compared with sucrose ( P=0.010 ) . The energy ' saved ' from replacing sucrose with NNS was fully compensated for at subsequent meals ; hence , no difference in total daily energy intake was found between the treatments ( P=0.831 ) . The sucrose-sweetened beverage led to large spikes in blood glucose and insulin responses within the first hour , whereas these responses were higher for all three NNS beverages following the test lunch . Thus , there were no differences in total area under the curve ( AUC ) for glucose ( P=0.960 ) and insulin ( P=0.216 ) over 3 h between the four test beverages . Conclusions : The consumption of calorie-free beverages sweetened with artificial and natural NNS have minimal influences on total daily energy intake , postpr and ial glucose and insulin compared with a sucrose-sweetened beverage BACKGROUND Macronutrient " preloads " can stimulate glucagon-like peptide 1 ( GLP-1 ) and glucose-dependent insulinotropic polypeptide ( GIP ) , slow gastric emptying , and reduce postpr and ial glycemic excursions . After sweet preloads , these effects may be signaled by sodium-glucose cotransporter-1 ( SGLT1 ) , sweet taste receptors , or both . OBJECTIVE We determined the effects of 4 sweet preloads on GIP and GLP-1 release , gastric emptying , and postpr and ial glycemia . DESIGN Ten healthy subjects were studied on 4 separate occasions each . A preload drink containing 40 g glucose , 40 g tagatose/isomalt mixture ( TIM ) , 40 g 3-O-methylglucose ( 3OMG ; a nonmetabolized substrate of SGLT1 ) , or 60 mg sucralose was consumed 15 min before a (13)C-octanoic acid-labeled mashed potato meal .  Blood glucose , plasma total GLP-1 and GIP , serum insulin , and gastric emptying were determined . RESULTS Both glucose and 3OMG stimulated GLP-1 and GIP release in advance of the meal ( each P < 0.05 ) , whereas TIM and sucralose did not . The overall postpr and ial GLP-1 response was greater after glucose , 3OMG , and TIM than after sucralose ( P < 0.05 ) , albeit later after TIM than the other preloads . The blood glucose and insulin responses in the first 30 min after the meal were greatest after glucose ( each P < 0.05 ) . Gastric emptying was slower after both 3OMG and TIM than after sucralose ( each P < 0.05 ) . CONCLUSIONS In healthy humans , SGLT1 substrates stimulate GLP-1 and GIP and slow gastric emptying , regardless of whether they are metabolized , whereas the artificial sweetener sucralose does not . Poorly absorbed sweet tastants ( TIM ) , which probably expose a greater length of gut to nutrients , result in delayed GLP-1 secretion but not in delayed GIP release . These observations have the potential to optimize the use of preloads for glycemic control . This trial was registered at www.actr.org.au as ACTRN12611000775910 Blood glucose ( BG ) is usually measured after a caloric restriction of at least 8 h ; however evidence -based recommendations for the duration of a fasting status are missing . Here we analyze the effect of fasting duration on levels of BG to determine the minimal fasting duration to achieve comparable BG levels to conventional fasting measurements . We used data of a cross-sectional study on primary care patients , performed in October 2005 . We included 28,024 individuals ( age-range 18–99 years ; 63 % women ) without known diabetes mellitus and without missing data for BG and fasting status . We computed general linear models , adjusting for age , sex , time of blood withdrawal , systolic blood pressure , waist circumference , total- and HDL-cholesterol , physical activity , smoking , intake of beta-blocker and alcohol . We tested the intra-individual variability with respect to fasting status . Overall , the mean BG differed only slightly between individuals fasting ≥8 h and those fasting < 8 h ( men : 5.1 ± 0.8 mmol/L versus 5.2 ± 1.2 mmol/L ; women : 4.9 ± 0.7 mmol/L , 5.0 ± 1.0 mmol/L ) . After 3 h of fasting differences of BG diminished in men to −0.08 mmol/L ( 95%-CI : −0.15 ; −0.01 mmol/L ) , in women to −0.07 mmol/L ( −0.12 ; −0.03 mmol/L ) compared to individuals fasting ≥8 h. Noteworthy , age , time of day of blood withdrawal , physical activity , and intake of hard liquor influenced BG levels considerably . Our data challenge the necessity for a fasting duration of ≥8 h when measuring blood glucose , suggesting a r and om sampling or a fasting duration of 3 h as sufficient . Rather , our study indicates that essentially more effort on the assessment of additional external/internal factors on BG levels is necessary OBJECTIVE In patients with type 2 diabetes , but not type 1 diabetes , abnormal secretion of incretins in response to oral nutrients has been described . In healthy youths , we recently reported accentuated glucagon-like peptide 1 ( GLP-1 ) secretion in response to a diet soda sweetened with sucralose and acesulfame-K. In this study , we examined the effect of diet soda on gut hormones in youths with diabetes . RESEARCH DESIGN AND METHODS Subjects aged 12–25 years with type 1 diabetes ( n = 9 ) or type 2 diabetes ( n = 10 ) , or healthy control participants ( n = 25 ) drank 240 mL cola-flavored caffeine 
    Output:
    