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: Background : Design ing the effective and early interventions can prevent progression of prediabetes to diabetes . Few studies have shown the effect of flaxseed on glycemic control . This study aim ed to assess the effect of flaxseed powder on insulin resistance ( IR ) indices and blood pressure in prediabetic individuals . Material s and Methods : In a r and omized clinical trial , 99 prediabetic individuals were r and omly divided into three groups : two groups received 40 g ( FG40 ) and 20 g ( FG20 ) flaxseed powder daily for 12 weeks and the third group was the control ( CG ) . Before and after the intervention , anthropometric measurements , blood pressure , fasting serum glucose ( FSG ) , insulin , homeostasis model assessment IR index ( HOMA-IR ) , beta-cell function , and insulin sensitivity were measured . Results : FSG significantly declined overall in all groups compared to the baseline ( P = 0.002 in CG and FG20 groups and P = 0.001 in FG40 ) . In contrast , mean of the changes in FSG was not significantly different between groups . Insulin concentration did not change significantly within and between the investigated groups . Although HOMA-IR reduced in FG20 ( P = 0.033 ) , the mean of changes was not significant between the three groups . Mean of beta-cell function increased in CG and FG40 groups compared to the baseline ( P = 0.044 and P = 0.018 , respectively ) , but mean of its changes did not show any difference between the three groups . The mean of changes in IR indices was not significant between the three groups . FG40 group had significantly lowered systolic blood pressure after the intervention ( P = 0.005 ) . Conclusion : Daily intake of flaxseed powder lowered blood pressure in prediabetes but did not improve glycemic and IR indices The study hypothesis was that fasting glucose , insulin , fructosamine , C-reactive protein , and interleukin-6 decrease and adiponectin increases with daily flaxseed consumption in overweight or obese individuals with pre-diabetes . In this r and omized , cross-over study overweight or obese men and postmenopausal women ( n = 25 ) with pre-diabetes consumed 0 , 13 , or 26 g ground flaxseed for 12 weeks . Glucose , insulin , homeostatic model assessment ( HOMA-IR ) , and normalized percent of α-linolenic fatty acid ( ALA ) were significantly different by treatment ( multiple analysis of variance , P = .036 , P = .013 , P = .008 , P = .024 respectively ) . Paired t tests showed glucose decreased on the 13 g intervention compared to the 0 g period [ 13 g = -2.10 ± 1.66 mg/L ( mean ± SEM ) , 0 g = 9.22 ± 4.44 mg/L , P = .036 ] . Insulin decreased on the 13 g intervention but not the 26 g ( P = .021 ) and 0 g ( P = .013 ) periods ( 13 g = -2.12 ± 1.00 mU/L , 26 g = 0.67 ± 0.84 mU/L , 0 g = 1.20 ± 1.16 mU/L ) . HOMA-IR decreased on the 13 g period but not on the 26 g ( P = .012 ) and 0 g ( P = .008 ) periods ( 13 g = -0.71 ± 0.31 , 26 g = 0.27 ± 0.24 , 0 g = 0.51 ± 0.35 ) . The α-linolenic fatty acid decrease for the 0 g period was different than the 13 g ( P = .024 ) and 26 g ( P = .000 ) periods ( 13 g = 0.20 ± 0.04 , 26 g = 0.35 ± 0.07 , 0 g = -0.01 ± 0.07 ) . Fructosamine , high sensitivity C-reactive protein , adiponectin , and high-sensitivity interleukin-6 had no significant  differences . Flaxseed intake  decreased glucose and insulin and improved insulin sensitivity as part of a habitual diet in overweight or obese individuals with pre-diabetes Background Flaxseed has received attention for its anti-inflammatory and antioxidant role . The present study hypothesizes if flaxseed added to a weight loss diet could improve the lipid and metabolic profiles and decrease risk factors related to cardiovascular disease . Methods In a prospect i ve , single blinded 42 days protocol , subjects were allocated into two groups with low carbohydrates intake : GriceLC ( 35 % of carbohydrate and 60 g of raw rice powder per day ) and GflaxLC ( 32 % of carbohydrate and 60 g of flaxseed powder per day ) . Blood pressure , anthropometric measures and serum levels of isoprostane , C-reactive protein , Tumor Necrosis Factor-alpha , glucose , lipidic profile , uric acid , adiponectin , leptin and insulin were measured at baseline and at the end of interventions . Serum and urinary enterodiol and enterolactione were also measured . Results A total of 27 men with cardiovascular risk factors were evaluated , with mean age of 33 ± 10 years to GriceLC and 40 ± 9 years to GflaxLC . Both groups experienced weight loss and systolic blood pressure reduction . A decrease in inflammatory markers ( CRP and TNF-α ) was observed after flaxseed intake ( mean decrease of 25 % and 46 % for GflaxLC respectively ) . All groups also showed improvement in levels of total cholesterol , LDL-c , uric acid and adiponectin . Only GflaxLC group showed a decrease in triglyceride levels . Conclusion This study suggests that flaxseed added to a weight loss diet could be an important nutritional strategy to reduce inflammation markers such as CRP and TNF-α . Trial registration Clinical Trials.gov NCT02132728 The n-6/n-3 fatty acid ( FA ) ratio has increased in the Western-style diet to ~10–15:1 during the last century , which may have contributed to the rise in cardiovascular disease ( CVD ) . Prior studies have evaluated the effects on CVD risk factors of manipulating the levels of n-6 and n-3 FA using food and supplements or investigated the metabolic fate of linoleic acid ( LNA ) and α-linolenic acid ( ALA ) by varying the n-6/n-3 ratios . However , no previous studies have investigated the potential interaction between diet ratios and supplementation with eicosapentaenoic acid ( EPA , 20:5n-3 ) and docosahexaenoic acid ( DHA , 22:6n-3 ) . We used a factorial design approach with adults ( n = 24 ) in a controlled feeding trial to compare the accretion of EPA and DHA into red blood cell membranes ( RBC ) by adding a direct source ( algal oil supplement ) of EPA and DHA in a diet with a 10:1 versus 2:1 ratio of n-6/n-3 FA . Subjects were r and omized into 8-week crossover diet sequences and each subject consumed three of four diets [ 10:1 , 10:1 plus supplement ( 10:1 + S ) , 2:1 and 2:1 + S ] . LNA and ALA intakes were 9.4 and 7.7 % , and 1.0 and 3.0 % during the low and high ALA diets , respectively . Compared to the Western-style 10:1 diet , the 2:1 diet increased EPA by 60 % ( P < 0.0001 ) in RBC membranes without the direct EPA source and a 34 % increase ( P = 0.027 ) was observed with the 10:1 + S diet ; however , DHA levels increased in both diet ratios only with a direct DHA source . Shifting towards a 2:1 diet is a valid alternative to taking EPA-containing supplements Phytoestrogens are increasingly incorporated into the diet of menopausal women . However , there are limited data on the efficacy of flaxseed on the consequences of estrogen deficiency in menopausal women . The purpose of the study was to assess the effects of flaxseed incorporation into the diet of healthy menopausal women . One hundred and ninety-nine menopausal women were r and omly assigned to consume 40 g flaxseed/d ( n = 101 ) or wheat germ placebo ( n = 98 ) for 12 months . At baseline and at month 12 , serum levels of lipids , bone mineral density ( BMD ) , and menopausal symptoms were evaluated . Statistical analysis was performed under the intention to treat principle . Flaxseed reduced serum total ( -0.20 + /- 0.51 mmol/liter ; P = 0.012 ) and high-density lipoprotein ( -0.08 + /- 0.24 mmol/liter ; P = 0.031 ) cholesterol concentrations compared with wheat germ placebo .  BMD did not differ significantly between the two arms . Both flaxseed and wheat germ reduced ( P < 0.0001 ) the severity scores of menopausal symptoms , but no statistical difference was found between the two arms . Our findings suggest that 1-yr incorporation of flaxseed into the diet produced a favorable , but not clinical ly significant , effect on blood cholesterol and caused no significant change in BMD or symptoms in healthy menopausal women Background Obesity leads to an increase in inflammation and insulin resistance . This study determined antioxidant activity of flaxseed and its role in inflammation and insulin resistance in obese glucose intolerant people . Methods Using a r and omized crossover design , nine obese glucose intolerant people consumed 40 g ground flaxseed or 40 g wheat bran daily for 12 weeks with a 4-week washout period . Plasma inflammation biomarkers ( CRP , TNF-α , and IL-6 ) , glucose , insulin , and thiobaribituric acid reactive substance ( TBARS ) were measured before and after of each supplementation . Results Flaxseed supplementation  decreased TBARS ( p = 0.0215 ) and HOMA-IR ( p = 0.0382 ) . Flaxseed or wheat bran supplementation did not change plasma inflammatory biomarkers . A positive relationship was found between TBARS and HOMA-IR ( r = 0.62 , p = 0.0003 ) . Conclusions The results of the study weakly support that decreased insulin resistance might have been secondary to antioxidant activity of flaxseed . However , the mechanism(s ) of decreased insulin resistance by flaxseed should be further determined using flaxseed lignan ABSTRACT Diabetes mellitus is characterized by hyperglycemia and associated with aberrations in the metabolism of carbohydrate , protein , and lipid that result in development of secondary complications . Extensive studies have indicated that nutritional therapy plays a pivotal role in the controlling or postponing of development of these secondary complications . Several functional foods have been shown to possess hypoglycemic and hypolipidemic properties . Flax seed ( FS ) is a functional food that is rich in omega 3 fatty acids and antioxidants and is low in carbohydrates . In exploratory studies , FS was incorporated in recipes , which result ed in a reduction in the glycemic index of the food items . These observations prompted us to investigate the efficacy of FS supplementation in type 2 diabetics ( n = 29 ) . Subjects were assigned to the experimental ( n = 18 ) or the control group ( n = 11 ) on the basis of their desire to participate in the study . The experimental group 's diet was supplemented daily with 10 g of FS powder for a period of 1 month . The control group received no supplementation or placebo . During the study , diet and drug intake of the subjects remained unaltered . The efficacy of supplementation with FS was evaluated through a battery of clinico-biochemical parameters . Supplementation with FS  reduced fasting blood glucose by 19.7 % and glycated hemoglobin by 15.6 % . A favorable reduction in total cholesterol ( 14.3 % ) , triglycerides ( 17.5 % ) , low-density lipoprotein cholesterol ( 21.8 % ) , and apolipoprotein B and an increase in high-density lipoprotein cholesterol ( 11.9 % ) were also noticed . These observations suggest the therapeutic potential of FS in the management of diabetes mellitus Abstract Context : The natural health product , BeneFlax , is a st and ardized flaxseed [ Linum usitatissimum L. ( Linaceae ) ] lignan enriched product with evidence of product quality and known quantity of the bioactive component , lignan . The acceptance of this natural health product for its various health benefits requires greater evidence of its safety in the general population . Objective : We determined whether flaxseed lignan causes clinical hypoglycemia or hypotension in healthy older adults as an important aspect of safety . Material s and methods : Participants aged 49–87 years were r and omized in a double-blind trial to receive flaxseed lignan ( 543 
    Output:
    
agent
Conclusions Whole flaxseed , but not flaxseed oil and lignan extract , has significant effects on improving glycemic control .
***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: Background : Design ing the effective and early interventions can prevent progression of prediabetes to diabetes . Few studies have shown the effect of flaxseed on glycemic control . This study aim ed to assess the effect of flaxseed powder on insulin resistance ( IR ) indices and blood pressure in prediabetic individuals . Material s and Methods : In a r and omized clinical trial , 99 prediabetic individuals were r and omly divided into three groups : two groups received 40 g ( FG40 ) and 20 g ( FG20 ) flaxseed powder daily for 12 weeks and the third group was the control ( CG ) . Before and after the intervention , anthropometric measurements , blood pressure , fasting serum glucose ( FSG ) , insulin , homeostasis model assessment IR index ( HOMA-IR ) , beta-cell function , and insulin sensitivity were measured . Results : FSG significantly declined overall in all groups compared to the baseline ( P = 0.002 in CG and FG20 groups and P = 0.001 in FG40 ) . In contrast , mean of the changes in FSG was not significantly different between groups . Insulin concentration did not change significantly within and between the investigated groups . Although HOMA-IR reduced in FG20 ( P = 0.033 ) , the mean of changes was not significant between the three groups . Mean of beta-cell function increased in CG and FG40 groups compared to the baseline ( P = 0.044 and P = 0.018 , respectively ) , but mean of its changes did not show any difference between the three groups . The mean of changes in IR indices was not significant between the three groups . FG40 group had significantly lowered systolic blood pressure after the intervention ( P = 0.005 ) . Conclusion : Daily intake of flaxseed powder lowered blood pressure in prediabetes but did not improve glycemic and IR indices The study hypothesis was that fasting glucose , insulin , fructosamine , C-reactive protein , and interleukin-6 decrease and adiponectin increases with daily flaxseed consumption in overweight or obese individuals with pre-diabetes . In this r and omized , cross-over study overweight or obese men and postmenopausal women ( n = 25 ) with pre-diabetes consumed 0 , 13 , or 26 g ground flaxseed for 12 weeks . Glucose , insulin , homeostatic model assessment ( HOMA-IR ) , and normalized percent of α-linolenic fatty acid ( ALA ) were significantly different by treatment ( multiple analysis of variance , P = .036 , P = .013 , P = .008 , P = .024 respectively ) . Paired t tests showed glucose decreased on the 13 g intervention compared to the 0 g period [ 13 g = -2.10 ± 1.66 mg/L ( mean ± SEM ) , 0 g = 9.22 ± 4.44 mg/L , P = .036 ] . Insulin decreased on the 13 g intervention but not the 26 g ( P = .021 ) and 0 g ( P = .013 ) periods ( 13 g = -2.12 ± 1.00 mU/L , 26 g = 0.67 ± 0.84 mU/L , 0 g = 1.20 ± 1.16 mU/L ) . HOMA-IR decreased on the 13 g period but not on the 26 g ( P = .012 ) and 0 g ( P = .008 ) periods ( 13 g = -0.71 ± 0.31 , 26 g = 0.27 ± 0.24 , 0 g = 0.51 ± 0.35 ) . The α-linolenic fatty acid decrease for the 0 g period was different than the 13 g ( P = .024 ) and 26 g ( P = .000 ) periods ( 13 g = 0.20 ± 0.04 , 26 g = 0.35 ± 0.07 , 0 g = -0.01 ± 0.07 ) . Fructosamine , high sensitivity C-reactive protein , adiponectin , and high-sensitivity interleukin-6 had no significant  differences . Flaxseed intake  decreased glucose and insulin and improved insulin sensitivity as part of a habitual diet in overweight or obese individuals with pre-diabetes Background Flaxseed has received attention for its anti-inflammatory and antioxidant role . The present study hypothesizes if flaxseed added to a weight loss diet could improve the lipid and metabolic profiles and decrease risk factors related to cardiovascular disease . Methods In a prospect i ve , single blinded 42 days protocol , subjects were allocated into two groups with low carbohydrates intake : GriceLC ( 35 % of carbohydrate and 60 g of raw rice powder per day ) and GflaxLC ( 32 % of carbohydrate and 60 g of flaxseed powder per day ) . Blood pressure , anthropometric measures and serum levels of isoprostane , C-reactive protein , Tumor Necrosis Factor-alpha , glucose , lipidic profile , uric acid , adiponectin , leptin and insulin were measured at baseline and at the end of interventions . Serum and urinary enterodiol and enterolactione were also measured . Results A total of 27 men with cardiovascular risk factors were evaluated , with mean age of 33 ± 10 years to GriceLC and 40 ± 9 years to GflaxLC . Both groups experienced weight loss and systolic blood pressure reduction . A decrease in inflammatory markers ( CRP and TNF-α ) was observed after flaxseed intake ( mean decrease of 25 % and 46 % for GflaxLC respectively ) . All groups also showed improvement in levels of total cholesterol , LDL-c , uric acid and adiponectin . Only GflaxLC group showed a decrease in triglyceride levels . Conclusion This study suggests that flaxseed added to a weight loss diet could be an important nutritional strategy to reduce inflammation markers such as CRP and TNF-α . Trial registration Clinical Trials.gov NCT02132728 The n-6/n-3 fatty acid ( FA ) ratio has increased in the Western-style diet to ~10–15:1 during the last century , which may have contributed to the rise in cardiovascular disease ( CVD ) . Prior studies have evaluated the effects on CVD risk factors of manipulating the levels of n-6 and n-3 FA using food and supplements or investigated the metabolic fate of linoleic acid ( LNA ) and α-linolenic acid ( ALA ) by varying the n-6/n-3 ratios . However , no previous studies have investigated the potential interaction between diet ratios and supplementation with eicosapentaenoic acid ( EPA , 20:5n-3 ) and docosahexaenoic acid ( DHA , 22:6n-3 ) . We used a factorial design approach with adults ( n = 24 ) in a controlled feeding trial to compare the accretion of EPA and DHA into red blood cell membranes ( RBC ) by adding a direct source ( algal oil supplement ) of EPA and DHA in a diet with a 10:1 versus 2:1 ratio of n-6/n-3 FA . Subjects were r and omized into 8-week crossover diet sequences and each subject consumed three of four diets [ 10:1 , 10:1 plus supplement ( 10:1 + S ) , 2:1 and 2:1 + S ] . LNA and ALA intakes were 9.4 and 7.7 % , and 1.0 and 3.0 % during the low and high ALA diets , respectively . Compared to the Western-style 10:1 diet , the 2:1 diet increased EPA by 60 % ( P < 0.0001 ) in RBC membranes without the direct EPA source and a 34 % increase ( P = 0.027 ) was observed with the 10:1 + S diet ; however , DHA levels increased in both diet ratios only with a direct DHA source . Shifting towards a 2:1 diet is a valid alternative to taking EPA-containing supplements Phytoestrogens are increasingly incorporated into the diet of menopausal women . However , there are limited data on the efficacy of flaxseed on the consequences of estrogen deficiency in menopausal women . The purpose of the study was to assess the effects of flaxseed incorporation into the diet of healthy menopausal women . One hundred and ninety-nine menopausal women were r and omly assigned to consume 40 g flaxseed/d ( n = 101 ) or wheat germ placebo ( n = 98 ) for 12 months . At baseline and at month 12 , serum levels of lipids , bone mineral density ( BMD ) , and menopausal symptoms were evaluated . Statistical analysis was performed under the intention to treat principle . Flaxseed reduced serum total ( -0.20 + /- 0.51 mmol/liter ; P = 0.012 ) and high-density lipoprotein ( -0.08 + /- 0.24 mmol/liter ; P = 0.031 ) cholesterol concentrations compared with wheat germ placebo .  BMD did not differ significantly between the two arms . Both flaxseed and wheat germ reduced ( P < 0.0001 ) the severity scores of menopausal symptoms , but no statistical difference was found between the two arms . Our findings suggest that 1-yr incorporation of flaxseed into the diet produced a favorable , but not clinical ly significant , effect on blood cholesterol and caused no significant change in BMD or symptoms in healthy menopausal women Background Obesity leads to an increase in inflammation and insulin resistance . This study determined antioxidant activity of flaxseed and its role in inflammation and insulin resistance in obese glucose intolerant people . Methods Using a r and omized crossover design , nine obese glucose intolerant people consumed 40 g ground flaxseed or 40 g wheat bran daily for 12 weeks with a 4-week washout period . Plasma inflammation biomarkers ( CRP , TNF-α , and IL-6 ) , glucose , insulin , and thiobaribituric acid reactive substance ( TBARS ) were measured before and after of each supplementation . Results Flaxseed supplementation  decreased TBARS ( p = 0.0215 ) and HOMA-IR ( p = 0.0382 ) . Flaxseed or wheat bran supplementation did not change plasma inflammatory biomarkers . A positive relationship was found between TBARS and HOMA-IR ( r = 0.62 , p = 0.0003 ) . Conclusions The results of the study weakly support that decreased insulin resistance might have been secondary to antioxidant activity of flaxseed . However , the mechanism(s ) of decreased insulin resistance by flaxseed should be further determined using flaxseed lignan ABSTRACT Diabetes mellitus is characterized by hyperglycemia and associated with aberrations in the metabolism of carbohydrate , protein , and lipid that result in development of secondary complications . Extensive studies have indicated that nutritional therapy plays a pivotal role in the controlling or postponing of development of these secondary complications . Several functional foods have been shown to possess hypoglycemic and hypolipidemic properties . Flax seed ( FS ) is a functional food that is rich in omega 3 fatty acids and antioxidants and is low in carbohydrates . In exploratory studies , FS was incorporated in recipes , which result ed in a reduction in the glycemic index of the food items . These observations prompted us to investigate the efficacy of FS supplementation in type 2 diabetics ( n = 29 ) . Subjects were assigned to the experimental ( n = 18 ) or the control group ( n = 11 ) on the basis of their desire to participate in the study . The experimental group 's diet was supplemented daily with 10 g of FS powder for a period of 1 month . The control group received no supplementation or placebo . During the study , diet and drug intake of the subjects remained unaltered . The efficacy of supplementation with FS was evaluated through a battery of clinico-biochemical parameters . Supplementation with FS  reduced fasting blood glucose by 19.7 % and glycated hemoglobin by 15.6 % . A favorable reduction in total cholesterol ( 14.3 % ) , triglycerides ( 17.5 % ) , low-density lipoprotein cholesterol ( 21.8 % ) , and apolipoprotein B and an increase in high-density lipoprotein cholesterol ( 11.9 % ) were also noticed . These observations suggest the therapeutic potential of FS in the management of diabetes mellitus Abstract Context : The natural health product , BeneFlax , is a st and ardized flaxseed [ Linum usitatissimum L. ( Linaceae ) ] lignan enriched product with evidence of product quality and known quantity of the bioactive component , lignan . The acceptance of this natural health product for its various health benefits requires greater evidence of its safety in the general population . Objective : We determined whether flaxseed lignan causes clinical hypoglycemia or hypotension in healthy older adults as an important aspect of safety . Material s and methods : Participants aged 49–87 years were r and omized in a double-blind trial to receive flaxseed lignan ( 543 
    Output:
    