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: OBJECTIVE To examine the influence of health behaviours and psychological well-being on  gestational weight gain  using a biopsychosocial model . DESIGN A prospect i ve cohort study of pregnant women consecutively recruited at their first antenatal care visit . A self-administered question naire was used to collect data on health behaviours and psychological well-being in early pregnancy . Linear regression and logistic regression were used to identify predictors of total weight gain in kilograms and weight gain outside the current Institute of Medicine recommendations , respectively . SETTING A maternity hospital in the Republic of Irel and . SUBJECTS Data on 799 women were analysed . RESULTS Pre-pregnant BMI ≥30·0 kg/m2 , short stature , parity > 0 , decreased food intake and absence of health insurance predicted lower absolute gestational weight gain , while foreign nationality , consumption of takeaway meals more than once weekly and increased food intake predicted higher absolute gestational weight gain . Overweight and obesity , foreign nationality , increased food intake and height > 170 cm were risk factors for excessive weight gain , while antenatal depression was protective against excessive weight gain . Notably , physical activity measures were not related to the gestational weight gain outcomes . Pre-pregnancy overweight and increased food intake were the strongest predictors of excessive gestational weight gain . CONCLUSIONS None of the psychological well-being measures examined , with the exception of antenatal depression , was associated with any of the weight gain outcomes . The behavioural predictors of gestational weight gain were increased food intake and takeaway consumption . Public health promotions should target pre-pregnancy BMI and pregnancy-associated change in food intake BACKGROUND Dietary fatty acids that are more prone to oxidation than to storage may be less likely to lead to obesity . OBJECTIVE The aim of this study was to determine the effect of chain length , degree of unsaturation , and stereoisomeric effects of unsaturation on the oxidation of individual fatty acids in normal-weight men . DESIGN Fatty acid oxidation was examined in men consuming a weight-maintenance diet containing 40 % of energy as fat .  After consuming the diet for 1 wk , subjects were fed fatty acids labeled with (13)C in the methyl or carboxyl position ( 10 mg/kg body wt ) . The fatty acids fed in r and om order were laurate , palmitate , stearate , oleate , elai date ( the trans isomer of oleate ) , linoleate , and linolenate blended in a hot liquid meal . Breath sample s were collected for the next 9 h and the oxidation of each fatty acid was assessed by examining liberated (13)CO(2 ) in breath . RESULTS Cumulative oxidation over the 9-h test ranged from a high of 41 % of the dose for laurate to a low of 13 % of the dose for stearate . Of the 18-carbon fatty acids , linolenate was the most highly oxidized and linoleate appeared to be somewhat conserved . (13)C recovery in breath from the methyl-labeled fatty acids was approximately 30 % less than that from the carboxyl-labeled fatty acids . CONCLUSIONS In summary , lauric acid is highly oxidized , whereas the polyunsaturated and monounsaturated fatty acids are fairly well oxidized . Oxidation of the long-chain , saturated fatty acids decreases with increasing carbon number The fetal origins theory of adult disease suggests that term infants who are small for their gestational age have an increased susceptibility to chronic disease in adulthood as a consequence of physiologic adaptations to undernutrition during fetal life . Consistent evidence for an influence of women 's dietary composition during pregnancy on growth of their babies is lacking , despite robust effects in animal experiments . We undertook a prospect i ve observational study of 557 women aged 18 - 41 y , living in Adelaide , South Australia .  Diet was assessed in early and late pregnancy using an FFQ . In early pregnancy , medians for energy intake , the proportion of energy derived from protein and from carbohydrate were 9.0 MJ , 17 and 48 % , respectively . In late pregnancy the corresponding medians were 9.2 MJ , 16 and 49 % . In early pregnancy , the percentage of energy derived from protein was positively associated with birth weight ( P = 0.02 ) and placental weight ( P = 0.07 ) , independently of energy intake and weight gain during pregnancy , and after adjustment for potential confounders , including maternal age , parity , and smoking . Effects were stronger among women ( n = 429 ) who had reliable data , based on prespecified criteria including the plausibility of dietary data when referenced against estimated energy expenditure . In addition , for this subgroup , the percentage of energy from carbohydrate in early and late pregnancy was negatively associated with ponderal index of the baby , and a specific effect of protein from dairy sources was identified . These data support the proposition that maternal dietary composition has an effect on fetal growth . Maternal diet in Western societies may therefore be important for the long-term health of the child The effect of prenatal energy supplementation on  maternal anthropometry was assessed in a controlled , r and omized trial in Madura , East Java . At 26 - 28 wk of gestation women were either given 465 kcal/d ( HE group ) or 52 kcal/d ( LE group ) . Two hundred seventy-six women were enrolled in the HE group and 266 women , in the LE group .  Supplement intake was variable . Testing of effect by treatment and compliance was thus done by subcategories ( HE 1 - 3 and LE 1 - 3 , corresponding to less than 45 , 45 - 89 , and greater than or equal to 90 packets of supplement consumed ) . Analysis of variance did not show significant differences among the six subcategories in third-trimester weight gain , sum of skinfold thicknesses , 4-wk postpartum weight , or body mass index . In this population energy supplementation for the short duration of the last 90 - 110 d of pregnancy was not sufficient to improve maternal nutrition as judged by anthropometry The effects of a fiber-rich , high-carbohydrate , low-fat ( HCLF ) diet and a modified-fat ( MF ) diet high in monounsaturated fat on body fat distribution were examined by dual-energy X-ray absorptiometry ( DXA ) in 16 subjects with non-insulin-dependent diabetes ( NIDDM ) during a r and omized crossover study . Subjects lost similar amounts of body fat consuming the HCLF and MF diets ( -0.83 + /- 0.37 and -0.87 + /- 0.40 kg , respectively ) despite a marked difference in total fat consumption . With the MF diet , the ratio of upper- to lower-body fat ( UF : LF ) remained unchanged because fat was lost proportionately from the upper and lower body . In contrast , with the HCLF diet , a disproportionate loss of lower-body fat caused the UF : LF to increase . The effects of diet on regional body fat loss were significant ( P < 0.05 , two-factor repeated- measures ANOVA ) To improve maternal nutritional status and to ameliorate protein-energy malnutrition in pregnant women and infants , supplementary foods for rural pregnant women were formulated and evaluated . Six formulas with protein and energy contents of 16 - 22 g and 350 - 500 kcal/100 g food , respectively , were developed from locally available raw material s. A field evaluation of formulas I and V was conducted at the regional MCH Center at Rajchaburi , about 120 km from Bangkok .  Formulas providing 13 g protein and 350 kcal per day were given to two groups of mothers in the first or second pregnancy , starting at 28 + /- 2 wk of gestation . A third group , unsupplemented , served as controls .  Maternal weight gain and left mid-arm circumference were measured every 2 wk . Birth weight , length , head and chest circumferences of newborns , and placental weight were significantly higher in both supplemented groups . These findings suggest that among undernourished mothers , supplementation of as little as 13 g protein and 350 kcal daily during the last trimester can significantly improve maternal weight gain and birth weight of newborns BACKGROUND Single-meal tests have shown that protein has greater thermogenic and satiating effects than does carbohydrate , which may be relevant for the prevention and treatment of obesity if these effects can be maintained over 24 h. OBJECTIVE The effects of pork-meat protein , soy protein , and carbohydrate on 24-h energy expenditure were compared . DESIGN Twelve young , healthy , overweight and mildly obese [ body mass index ( in kg/m(2 ) ) : 26 - 32 ] nonsmoking men participated in a r and omized , single-blind , 3-way crossover study lasting 4 d. The intervention had a 1 - 10-wk washout period . The 3 isoenergetic intervention diets were as follows : pork diet ( 29 % of energy as fat and 29 % as protein , mainly from pork meat ) , soy diet ( 29 % of energy as fat and 28 % as protein , mainly from soy ) , and carbohydrate diet ( 28 % of energy as fat and 11 % as protein ) . Twenty-four-hour energy expenditure was measured in a respiratory chamber at baseline and on day 4 of each intervention period . RESULTS Twenty-four-hour energy expenditure was higher with the pork than with the soy ( 248 kJ/d , 1.9 % ; P : = 0.05 ) or carbohydrate ( 492 kJ/d , 3.9 % ; P : < 0.0001 ) diet and higher with the soy than with the carbohydrate ( 244 kJ/d , 1.9 % ; P : < 0.05 ) diet . However , because of a higher satiating effect , energy intake was 10 - 15 % lower during the chamber stay than at baseline ( P : > 0.05 ) with all 3 diets . The differences in energy expenditure remained unchanged after adjustment for differences in 24-h energy balance . CONCLUSIONS Substitution of carbohydrate with 17 - 18 % of energy as either pork-meat or soy protein produced a 3 % higher 24-h energy expenditure . The animal protein in pork meat produced a 2 % higher 24-h energy expenditure than did the vegetable protein in soy A r and omised crossover study of eight overweight or obese men ( aged 24 - 49 years , BMI 25.5 - 31.3 kg/m(2 ) ) , who followed two diets for 4 weeks each , was performed to determine whether substitution of saturated fat with monounsaturated fat affects body weight and composition . Subjects were provided with all food and beverages as modules ( selected ad libitum ) of constant macronutrient composition , but differing energy content . The % total energy from saturated fat , monounsaturated fat and polyunsaturated fat was 24 , 13 and 3 % respectively on the saturated fatty acid (SFA)-rich diet and 11 , 22 and 7 % respectively on the monounsaturated fatty acid (MUFA)-rich diet . MUFA accounted for about 80 % of the unsaturated fats consumed on both diets . Body composition , blood pressure , energy expenditure ( resting and postpr and ial metabolic rates , substrate oxidation rate , physical activity ) , serum lipids , the fatty acid profile of serum cholesteryl esters and plasma glucose and insulin concentrations were measured before and after each diet period . Significant ( P < or = 0.05 ) differences in total cholesterol and the fatty acid composition of serum cholesteryl esters provided evidence of dietary adherence . The men had a lower weight ( -2.1 ( SE 0.4 ) kg , P=0.0015 ) and fat mass ( -2.6 ( SE 0.6 ) kg , P=0.0034 ) at the end of the MUFA-rich diet as compared with values at the end of the SFA-rich diet . No significant differences were detected in energy or fat intake , energy expenditure , substrate oxidation rates or self-reported physical activity . Substituting dietary saturated with unsaturated fat , predominantly MUFA , can induce a small but significant loss of body weight and fat mass without a significant change in total energy or fat intake Background Lifestyle interventions targeting obese pregnant women often result in modest reduction in gestational weight gain , pregnancy complications and related risk factors . Examining adherence to the intervention can , however , provide valuable information on the importance of the different factors targeted . Objective To evaluate improvements and relevance of different dietary factors targeted with respect to gestational weight gain in a 3-arm R and omised Controlled Trial ( n=342 ) among obese pregnant women with BMI ≥30 kg/m2 . Methods R and omisation 1:1:1 to either hypocaloric Mediterranean type of diet and physical activity intervention ( D+PA ) ; physical activity intervention alone ( PA ) ; or control ( C ) . Diet was assessed at baseline ( weeks 11–14 ) and endpoint ( weeks 36–37 ) using a vali date d food frequency question naire . Results During the intervention women in the D+PA group significantly lowered their intakes of added sugars and saturated fat and increased their protein intake by ~ 
    Output:
    
agent
Maternal fat intake ( n = 25 ) might be associated with gestational weight gain as suggested by observational studies , although the direction of this association might depend on specific types of fat ( e.g. , saturated fat ) .
Macronutrient intake was not consistently associated with the prevalence of inadequate or excessive gestational weight gain .
CONCLUSIONS The current literature provides evidence that energy intake is associated with gestational weight gain , but the roles of individual macronutrients are inconsistent .
***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 To examine the influence of health behaviours and psychological well-being on  gestational weight gain  using a biopsychosocial model . DESIGN A prospect i ve cohort study of pregnant women consecutively recruited at their first antenatal care visit . A self-administered question naire was used to collect data on health behaviours and psychological well-being in early pregnancy . Linear regression and logistic regression were used to identify predictors of total weight gain in kilograms and weight gain outside the current Institute of Medicine recommendations , respectively . SETTING A maternity hospital in the Republic of Irel and . SUBJECTS Data on 799 women were analysed . RESULTS Pre-pregnant BMI ≥30·0 kg/m2 , short stature , parity > 0 , decreased food intake and absence of health insurance predicted lower absolute gestational weight gain , while foreign nationality , consumption of takeaway meals more than once weekly and increased food intake predicted higher absolute gestational weight gain . Overweight and obesity , foreign nationality , increased food intake and height > 170 cm were risk factors for excessive weight gain , while antenatal depression was protective against excessive weight gain . Notably , physical activity measures were not related to the gestational weight gain outcomes . Pre-pregnancy overweight and increased food intake were the strongest predictors of excessive gestational weight gain . CONCLUSIONS None of the psychological well-being measures examined , with the exception of antenatal depression , was associated with any of the weight gain outcomes . The behavioural predictors of gestational weight gain were increased food intake and takeaway consumption . Public health promotions should target pre-pregnancy BMI and pregnancy-associated change in food intake BACKGROUND Dietary fatty acids that are more prone to oxidation than to storage may be less likely to lead to obesity . OBJECTIVE The aim of this study was to determine the effect of chain length , degree of unsaturation , and stereoisomeric effects of unsaturation on the oxidation of individual fatty acids in normal-weight men . DESIGN Fatty acid oxidation was examined in men consuming a weight-maintenance diet containing 40 % of energy as fat .  After consuming the diet for 1 wk , subjects were fed fatty acids labeled with (13)C in the methyl or carboxyl position ( 10 mg/kg body wt ) . The fatty acids fed in r and om order were laurate , palmitate , stearate , oleate , elai date ( the trans isomer of oleate ) , linoleate , and linolenate blended in a hot liquid meal . Breath sample s were collected for the next 9 h and the oxidation of each fatty acid was assessed by examining liberated (13)CO(2 ) in breath . RESULTS Cumulative oxidation over the 9-h test ranged from a high of 41 % of the dose for laurate to a low of 13 % of the dose for stearate . Of the 18-carbon fatty acids , linolenate was the most highly oxidized and linoleate appeared to be somewhat conserved . (13)C recovery in breath from the methyl-labeled fatty acids was approximately 30 % less than that from the carboxyl-labeled fatty acids . CONCLUSIONS In summary , lauric acid is highly oxidized , whereas the polyunsaturated and monounsaturated fatty acids are fairly well oxidized . Oxidation of the long-chain , saturated fatty acids decreases with increasing carbon number The fetal origins theory of adult disease suggests that term infants who are small for their gestational age have an increased susceptibility to chronic disease in adulthood as a consequence of physiologic adaptations to undernutrition during fetal life . Consistent evidence for an influence of women 's dietary composition during pregnancy on growth of their babies is lacking , despite robust effects in animal experiments . We undertook a prospect i ve observational study of 557 women aged 18 - 41 y , living in Adelaide , South Australia .  Diet was assessed in early and late pregnancy using an FFQ . In early pregnancy , medians for energy intake , the proportion of energy derived from protein and from carbohydrate were 9.0 MJ , 17 and 48 % , respectively . In late pregnancy the corresponding medians were 9.2 MJ , 16 and 49 % . In early pregnancy , the percentage of energy derived from protein was positively associated with birth weight ( P = 0.02 ) and placental weight ( P = 0.07 ) , independently of energy intake and weight gain during pregnancy , and after adjustment for potential confounders , including maternal age , parity , and smoking . Effects were stronger among women ( n = 429 ) who had reliable data , based on prespecified criteria including the plausibility of dietary data when referenced against estimated energy expenditure . In addition , for this subgroup , the percentage of energy from carbohydrate in early and late pregnancy was negatively associated with ponderal index of the baby , and a specific effect of protein from dairy sources was identified . These data support the proposition that maternal dietary composition has an effect on fetal growth . Maternal diet in Western societies may therefore be important for the long-term health of the child The effect of prenatal energy supplementation on  maternal anthropometry was assessed in a controlled , r and omized trial in Madura , East Java . At 26 - 28 wk of gestation women were either given 465 kcal/d ( HE group ) or 52 kcal/d ( LE group ) . Two hundred seventy-six women were enrolled in the HE group and 266 women , in the LE group .  Supplement intake was variable . Testing of effect by treatment and compliance was thus done by subcategories ( HE 1 - 3 and LE 1 - 3 , corresponding to less than 45 , 45 - 89 , and greater than or equal to 90 packets of supplement consumed ) . Analysis of variance did not show significant differences among the six subcategories in third-trimester weight gain , sum of skinfold thicknesses , 4-wk postpartum weight , or body mass index . In this population energy supplementation for the short duration of the last 90 - 110 d of pregnancy was not sufficient to improve maternal nutrition as judged by anthropometry The effects of a fiber-rich , high-carbohydrate , low-fat ( HCLF ) diet and a modified-fat ( MF ) diet high in monounsaturated fat on body fat distribution were examined by dual-energy X-ray absorptiometry ( DXA ) in 16 subjects with non-insulin-dependent diabetes ( NIDDM ) during a r and omized crossover study . Subjects lost similar amounts of body fat consuming the HCLF and MF diets ( -0.83 + /- 0.37 and -0.87 + /- 0.40 kg , respectively ) despite a marked difference in total fat consumption . With the MF diet , the ratio of upper- to lower-body fat ( UF : LF ) remained unchanged because fat was lost proportionately from the upper and lower body . In contrast , with the HCLF diet , a disproportionate loss of lower-body fat caused the UF : LF to increase . The effects of diet on regional body fat loss were significant ( P < 0.05 , two-factor repeated- measures ANOVA ) To improve maternal nutritional status and to ameliorate protein-energy malnutrition in pregnant women and infants , supplementary foods for rural pregnant women were formulated and evaluated . Six formulas with protein and energy contents of 16 - 22 g and 350 - 500 kcal/100 g food , respectively , were developed from locally available raw material s. A field evaluation of formulas I and V was conducted at the regional MCH Center at Rajchaburi , about 120 km from Bangkok .  Formulas providing 13 g protein and 350 kcal per day were given to two groups of mothers in the first or second pregnancy , starting at 28 + /- 2 wk of gestation . A third group , unsupplemented , served as controls .  Maternal weight gain and left mid-arm circumference were measured every 2 wk . Birth weight , length , head and chest circumferences of newborns , and placental weight were significantly higher in both supplemented groups . These findings suggest that among undernourished mothers , supplementation of as little as 13 g protein and 350 kcal daily during the last trimester can significantly improve maternal weight gain and birth weight of newborns BACKGROUND Single-meal tests have shown that protein has greater thermogenic and satiating effects than does carbohydrate , which may be relevant for the prevention and treatment of obesity if these effects can be maintained over 24 h. OBJECTIVE The effects of pork-meat protein , soy protein , and carbohydrate on 24-h energy expenditure were compared . DESIGN Twelve young , healthy , overweight and mildly obese [ body mass index ( in kg/m(2 ) ) : 26 - 32 ] nonsmoking men participated in a r and omized , single-blind , 3-way crossover study lasting 4 d. The intervention had a 1 - 10-wk washout period . The 3 isoenergetic intervention diets were as follows : pork diet ( 29 % of energy as fat and 29 % as protein , mainly from pork meat ) , soy diet ( 29 % of energy as fat and 28 % as protein , mainly from soy ) , and carbohydrate diet ( 28 % of energy as fat and 11 % as protein ) . Twenty-four-hour energy expenditure was measured in a respiratory chamber at baseline and on day 4 of each intervention period . RESULTS Twenty-four-hour energy expenditure was higher with the pork than with the soy ( 248 kJ/d , 1.9 % ; P : = 0.05 ) or carbohydrate ( 492 kJ/d , 3.9 % ; P : < 0.0001 ) diet and higher with the soy than with the carbohydrate ( 244 kJ/d , 1.9 % ; P : < 0.05 ) diet . However , because of a higher satiating effect , energy intake was 10 - 15 % lower during the chamber stay than at baseline ( P : > 0.05 ) with all 3 diets . The differences in energy expenditure remained unchanged after adjustment for differences in 24-h energy balance . CONCLUSIONS Substitution of carbohydrate with 17 - 18 % of energy as either pork-meat or soy protein produced a 3 % higher 24-h energy expenditure . The animal protein in pork meat produced a 2 % higher 24-h energy expenditure than did the vegetable protein in soy A r and omised crossover study of eight overweight or obese men ( aged 24 - 49 years , BMI 25.5 - 31.3 kg/m(2 ) ) , who followed two diets for 4 weeks each , was performed to determine whether substitution of saturated fat with monounsaturated fat affects body weight and composition . Subjects were provided with all food and beverages as modules ( selected ad libitum ) of constant macronutrient composition , but differing energy content . The % total energy from saturated fat , monounsaturated fat and polyunsaturated fat was 24 , 13 and 3 % respectively on the saturated fatty acid (SFA)-rich diet and 11 , 22 and 7 % respectively on the monounsaturated fatty acid (MUFA)-rich diet . MUFA accounted for about 80 % of the unsaturated fats consumed on both diets . Body composition , blood pressure , energy expenditure ( resting and postpr and ial metabolic rates , substrate oxidation rate , physical activity ) , serum lipids , the fatty acid profile of serum cholesteryl esters and plasma glucose and insulin concentrations were measured before and after each diet period . Significant ( P < or = 0.05 ) differences in total cholesterol and the fatty acid composition of serum cholesteryl esters provided evidence of dietary adherence . The men had a lower weight ( -2.1 ( SE 0.4 ) kg , P=0.0015 ) and fat mass ( -2.6 ( SE 0.6 ) kg , P=0.0034 ) at the end of the MUFA-rich diet as compared with values at the end of the SFA-rich diet . No significant differences were detected in energy or fat intake , energy expenditure , substrate oxidation rates or self-reported physical activity . Substituting dietary saturated with unsaturated fat , predominantly MUFA , can induce a small but significant loss of body weight and fat mass without a significant change in total energy or fat intake Background Lifestyle interventions targeting obese pregnant women often result in modest reduction in gestational weight gain , pregnancy complications and related risk factors . Examining adherence to the intervention can , however , provide valuable information on the importance of the different factors targeted . Objective To evaluate improvements and relevance of different dietary factors targeted with respect to gestational weight gain in a 3-arm R and omised Controlled Trial ( n=342 ) among obese pregnant women with BMI ≥30 kg/m2 . Methods R and omisation 1:1:1 to either hypocaloric Mediterranean type of diet and physical activity intervention ( D+PA ) ; physical activity intervention alone ( PA ) ; or control ( C ) . Diet was assessed at baseline ( weeks 11–14 ) and endpoint ( weeks 36–37 ) using a vali date d food frequency question naire . Results During the intervention women in the D+PA group significantly lowered their intakes of added sugars and saturated fat and increased their protein intake by ~ 
    Output:
    