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 investigate whether protein intake influences the decline in energy expenditure during energy restriction . DESIGN Cross-over study of three diets of 4.2 MJ/d for 7 days : one diet with 36 % energy as protein and two with 15 % energy as protein , one high in carbohydrate and the other high in fat . SUBJECTS Two men and six women aged 31 - 57 y. BMI 27.B-34.1 kg/m2 . MEASUREMENTS 24-h energy expenditure ( 24-h EE ) , sleeping metabolic rate ( SMR ) and body weight on days 0 and 7 of each diet ; 24-h urinary nitrogen excretion ( 24-h UN ) on days 0 - 7 of each diet . RESULTS 24-h EE and SMR declined on all three diets but the decrease was significantly less on the high protein diet than on the two low protein diets .  Weight loss was similar on all three diets . 24-h UN was less than N intake on the high protein diet but greater than N intake on the two low protein diets . CONCLUSIONS Maintaining protein intake reduces the decrease in energy expenditure during energy restriction BACKGROUND Higher protein diets are promoted for effective weight loss . Striated tissues in omnivorous diets contain high- quality protein , but limited data exist regarding their effects on bone . METHODS To examine the effects of energy restriction-induced weight loss with higher protein omnivorous diets versus lower protein vegetarian diets on  bone mineral density  in overweight postmenopausal women , two r and omized controlled feeding studies were conducted . In Study 1 , 28 women consumed 750 kcal/day energy deficit diets with 18 % energy from protein via lacto-ovo vegetarian sources ( normal protein , n = 15 ) or 30 % energy from protein with 40 % of protein from lean pork ( higher protein , n = 13 , omnivorous ) for 12 weeks . In Study 2 , 54 women consumed their habitual diet ( control , n = 11 ) or 1,250 kcal/day diets with 16 % energy from nonmeat protein sources ( n = 14 ) or 26 % energy from protein , including chicken ( n = 15 ) or beef ( n = 14 ) for 9 weeks . RESULTS Study 1 : With weight loss ( normal protein -11.2 % , higher protein -10.1 % ) , bone mineral density was not significantly changed in normal protein ( -0.003 ± 0.003 g/cm(2 ) , -0.3 % ) but decreased in higher protein ( -0.0167 ± 0.004 g/cm(2 ) , -1 . 4 % , group-by-time p < .05 ) . Study 2 : The control , nonmeat , chicken , and beef groups lost 1.5 % , 7.7 % , 10.4 % , and 8.1 % weight and 0.0 % , 0.4 % , 1.1 % , and 1.4 % bone mineral density , respectively . The change of bone mineral density was significant for chicken and beef compared with the control ( group-by-time , p < .05 ) . Markers of calcium metabolism and bone homeostasis in blood and urine were not changed over time or differentially affected by diet . CONCLUSION Consumption of higher protein omnivorous diets promoted decreased bone mineral density after weight loss in overweight postmenopausal women OBJECTIVE To compare the effects of protein vs. simple sugars on weight loss , body composition , and metabolic and endocrine parameters in polycystic ovary syndrome ( PCOS ) . DESIGN A 2-month , free-living , r and omized , single-blinded study . SETTING University PCOS clinic . PATIENT(S ) Thirty-three patients with PCOS . INTERVENTION(S ) To achieve a final energy reduction of 450 kcal/day , first the daily energy intake was reduced by 700 kcal ; then a 240-kcal supplement containing either whey protein or simple sugars was added . MAIN OUTCOME MEASURE(S ) Changes in weight , fat mass , fasting glucose and insulin , plasma lipoproteins , and sex steroids . RESULT ( S ) Twenty-four subjects ( 13 in the simple sugars group and 11 in the protein group ) completed the study . The protein group lost more weight ( -3.3 + /- 0.8 kg vs. -1.1 + /- 0.6 kg ) and more fat mass ( -3.1 + /- 0.9 kg vs. -0.5 + /- 0.6 kg ) and had larger decreases in serum cholesterol ( -33.0 + /- 8.4 mg/dL vs. -2.3 + /- 6.8 mg/dL ) , high-density lipoprotein cholesterol ( -4.5 + /- 1.3 mg/dL vs. -0.4 + /- 1.3 mg/dL ) , and apoprotein B ( -20 + /- 5 mg/dL vs. 3 + /- 5 mg/dL ) . CONCLUSION ( S ) In patients with PCOS , a hypocaloric diet supplemented with protein reduced body weight , fat mass , serum cholesterol , and apoprotein B more than the diet supplemented with simple sugars BACKGROUND Studies of weight-control diets that are high in protein or low in glycemic index have reached varied conclusions , probably owing to the fact that the studies had insufficient power . METHODS We enrolled overweight adults from eight European countries who had lost at least 8 % of their initial body weight with a 3.3-MJ ( 800-kcal ) low-calorie diet .  Participants were r and omly assigned , in a two-by-two factorial design , to one of five ad libitum diets to prevent weight regain over a 26-week period : a low-protein and low-glycemic-index diet , a low-protein and high-glycemic-index diet , a high-protein and low-glycemic-index diet , a high-protein and high-glycemic-index diet , or a control diet . RESULTS A total of 1209 adults were screened ( mean age , 41 years ; body-mass index [ the weight in kilograms divided by the square of the height in meters ] , 34 ) , of whom 938 entered the low-calorie-diet phase of the study . A total of 773 participants who completed that phase were r and omly assigned to one of the five maintenance diets ; 548 completed the intervention ( 71 % ) . Fewer participants in the high-protein and the low-glycemic-index groups than in the low-protein-high-glycemic-index group dropped out of the study ( 26.4 % and 25.6 % , respectively , vs. 37.4 % ; P=0.02 and P=0.01 for the respective comparisons ) . The mean initial weight loss with the low-calorie diet was 11.0 kg . In the analysis of participants who completed the study , only the low-protein-high-glycemic-index diet was associated with subsequent significant weight regain ( 1.67 kg ; 95 % confidence interval [ CI ] , 0.48 to 2.87 ) . In an intention-to-treat analysis , the weight regain was 0.93 kg less ( 95 % CI , 0.31 to 1.55 ) in the groups assigned to a high-protein diet than in those assigned to a low-protein diet ( P=0.003 ) and 0.95 kg less ( 95 % CI , 0.33 to 1.57 ) in the groups assigned to a low-glycemic-index diet than in those assigned to a high-glycemic-index diet ( P=0.003 ) . The analysis involving participants who completed the intervention produced similar results . The groups did not differ significantly with respect to diet-related adverse events . CONCLUSIONS In this large European study , a modest increase in protein content and a modest reduction in the glycemic index led to an improvement in study completion and maintenance of weight loss . ( Funded by the European Commission ; Clinical Trials.gov number , NCT00390637 . ) Background To evaluate the metabolic effects of two weight loss diets differing in macronutrient composition on features of dyslipidemia and post-pr and ial insulin ( INS ) response to a meal challenge in overweight/obese individuals . Methods This study was a parallel-arm r and omized 4 mo weight loss trial . Adults ( n = 50 , 47 ± 7 y ) matched on BMI ( 33.6 ± 0.6 kg/m2 , P = 0.79 )  consumed energy restricted diets ( deficit ~500 kcal/d ) : PRO ( 1.6 g.kg-1.d-1 protein and < 170 g/d carbohydrate ) or CHO ( 0.8 g.kg-1.d-1 protein and > 220 g/d carbohydrate ) for 4 mos . Meal challenges of respective diets were utilized for determination of blood lipids and post-pr and ial INS and glucose response at the beginning and end of the study . Results There was a trend for PRO to lose more weight ( -9.1 % vs. -7.3 % , P = 0.07 ) with a significant reduction in percent fat mass compared to CHO ( -8.7 % vs. -5.7 % ; P = 0.03 ) . PRO also favored reductions in triacylglycerol ( -34 % vs. -14 % ; P < 0.05 ) and increases in HDL-C ( + 5 % vs. -3 % ; P = 0.05 ) ; however , CHO favored reduction in LDL-C ( -7 % vs. + 2.5 % ; P < 0.05 ) . INS responses to the meal challenge were improved in PRO compared to CHO ( P < 0.05 ) at both 1 hr ( -34.3 % vs. -1.0 % ) and 2 hr ( -9.2 % vs. + 46.2 % ) , an effect that remained significant after controlling for weight or fat loss ( both P < 0.05 ) . Conclusion A weight loss diet with moderate carbohydrate , moderate protein results in more favorable changes in body composition , dyslipidemia , and post-pr and ial INS response compared to a high carbohydrate , low protein diet suggesting an additional benefit beyond weight management to include augmented risk reduction for metabolic disease Although popular and effective for weight loss , low-carbohydrate , high-protein , high-fat ( Atkins ) diets have been associated with adverse changes in blood and renal biomarkers . High-protein diets low in fat may represent an equally appealing diet plan but promote a more healthful weight loss .  Healthy adults ( n = 20 ) were r and omly assigned to 1 of 2 low-fat ( < 30 % energy ) , energy-restricted groups : high-protein ( 30 % energy ) or high-carbohydrate ( 60 % energy ) ; 24-h intakes were strictly controlled during the 6-wk trial . One subject from each group did not complete the trial due to out-of-state travel ; two subjects in the high-carbohydrate group withdrew from the trial due to extreme hunger . Body composition and metabolic indices were assessed pre- and post-trial . Both diets were equally effective at reducing body weight ( -6 % , P < 0.05 ) and fat mass ( -9 to -11 % , P < 0.05 ) ; however , subjects consuming the high-protein diet reported more satisfaction and less hunger in mo 1 of the trial . Both diets significantly lowered total cholesterol ( -10 to -12 % ) , insulin ( -25 % ) , and uric acid ( -22 to -30 % ) concentrations in blood from fasting subjects . Urinary calcium excretion increased 42 % in subjects consuming the high-protein diet , mirroring the 50 % increase in dietary calcium with consumption of this diet ; thus , apparent calcium balance was not adversely affected . Creatinine clearance was not altered by diet treatments , and nitrogen balance was more positive in subjects consuming the high-protein diet vs. the high-carbohydrate diet ( 3.9 + /- 1.4 and 0.7 + /- 1.7 g N/d , respectively , P < 0.05 ) . Thus , low-fat , energy-restricted diets of varying protein content ( 15 or 30 % energy ) promoted healthful weight loss , but diet satisfaction was greater in those consuming the high-protein diet Cl aims about the merits or risks of carbohydrate ( CHO ) vs. protein for weight loss diets are extensive , yet the ideal ratio of dietary carbohydrate to protein for adult health and weight management remains unknown . This study examined the efficacy of two weight loss diets with modified CHO/protein ratios to change body composition and blood lipids in adult women . Women ( n = 24 ; 45 to 56 y old ) with body mass indices > 26 kg/m(2 ) were assigned to either a CHO Group consuming a diet with a CHO/protein ratio of 3.5 ( 68 g protein/d ) or a Protein Group with a ratio of 1.4 ( 125 g protein/d ) . Diets were isoenergetic , providing 7100 kJ/d , and similar amounts of fat ( approximately 50 g/d ) . After consuming the diets for  
    Output:
    
agent
Compared with an energy-restricted SP diet , an isocalorically prescribed HP diet provides modest benefits for reductions in body weight , FM , and triglycerides and for mitigating reductions in FFM and REE
***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 investigate whether protein intake influences the decline in energy expenditure during energy restriction . DESIGN Cross-over study of three diets of 4.2 MJ/d for 7 days : one diet with 36 % energy as protein and two with 15 % energy as protein , one high in carbohydrate and the other high in fat . SUBJECTS Two men and six women aged 31 - 57 y. BMI 27.B-34.1 kg/m2 . MEASUREMENTS 24-h energy expenditure ( 24-h EE ) , sleeping metabolic rate ( SMR ) and body weight on days 0 and 7 of each diet ; 24-h urinary nitrogen excretion ( 24-h UN ) on days 0 - 7 of each diet . RESULTS 24-h EE and SMR declined on all three diets but the decrease was significantly less on the high protein diet than on the two low protein diets .  Weight loss was similar on all three diets . 24-h UN was less than N intake on the high protein diet but greater than N intake on the two low protein diets . CONCLUSIONS Maintaining protein intake reduces the decrease in energy expenditure during energy restriction BACKGROUND Higher protein diets are promoted for effective weight loss . Striated tissues in omnivorous diets contain high- quality protein , but limited data exist regarding their effects on bone . METHODS To examine the effects of energy restriction-induced weight loss with higher protein omnivorous diets versus lower protein vegetarian diets on  bone mineral density  in overweight postmenopausal women , two r and omized controlled feeding studies were conducted . In Study 1 , 28 women consumed 750 kcal/day energy deficit diets with 18 % energy from protein via lacto-ovo vegetarian sources ( normal protein , n = 15 ) or 30 % energy from protein with 40 % of protein from lean pork ( higher protein , n = 13 , omnivorous ) for 12 weeks . In Study 2 , 54 women consumed their habitual diet ( control , n = 11 ) or 1,250 kcal/day diets with 16 % energy from nonmeat protein sources ( n = 14 ) or 26 % energy from protein , including chicken ( n = 15 ) or beef ( n = 14 ) for 9 weeks . RESULTS Study 1 : With weight loss ( normal protein -11.2 % , higher protein -10.1 % ) , bone mineral density was not significantly changed in normal protein ( -0.003 ± 0.003 g/cm(2 ) , -0.3 % ) but decreased in higher protein ( -0.0167 ± 0.004 g/cm(2 ) , -1 . 4 % , group-by-time p < .05 ) . Study 2 : The control , nonmeat , chicken , and beef groups lost 1.5 % , 7.7 % , 10.4 % , and 8.1 % weight and 0.0 % , 0.4 % , 1.1 % , and 1.4 % bone mineral density , respectively . The change of bone mineral density was significant for chicken and beef compared with the control ( group-by-time , p < .05 ) . Markers of calcium metabolism and bone homeostasis in blood and urine were not changed over time or differentially affected by diet . CONCLUSION Consumption of higher protein omnivorous diets promoted decreased bone mineral density after weight loss in overweight postmenopausal women OBJECTIVE To compare the effects of protein vs. simple sugars on weight loss , body composition , and metabolic and endocrine parameters in polycystic ovary syndrome ( PCOS ) . DESIGN A 2-month , free-living , r and omized , single-blinded study . SETTING University PCOS clinic . PATIENT(S ) Thirty-three patients with PCOS . INTERVENTION(S ) To achieve a final energy reduction of 450 kcal/day , first the daily energy intake was reduced by 700 kcal ; then a 240-kcal supplement containing either whey protein or simple sugars was added . MAIN OUTCOME MEASURE(S ) Changes in weight , fat mass , fasting glucose and insulin , plasma lipoproteins , and sex steroids . RESULT ( S ) Twenty-four subjects ( 13 in the simple sugars group and 11 in the protein group ) completed the study . The protein group lost more weight ( -3.3 + /- 0.8 kg vs. -1.1 + /- 0.6 kg ) and more fat mass ( -3.1 + /- 0.9 kg vs. -0.5 + /- 0.6 kg ) and had larger decreases in serum cholesterol ( -33.0 + /- 8.4 mg/dL vs. -2.3 + /- 6.8 mg/dL ) , high-density lipoprotein cholesterol ( -4.5 + /- 1.3 mg/dL vs. -0.4 + /- 1.3 mg/dL ) , and apoprotein B ( -20 + /- 5 mg/dL vs. 3 + /- 5 mg/dL ) . CONCLUSION ( S ) In patients with PCOS , a hypocaloric diet supplemented with protein reduced body weight , fat mass , serum cholesterol , and apoprotein B more than the diet supplemented with simple sugars BACKGROUND Studies of weight-control diets that are high in protein or low in glycemic index have reached varied conclusions , probably owing to the fact that the studies had insufficient power . METHODS We enrolled overweight adults from eight European countries who had lost at least 8 % of their initial body weight with a 3.3-MJ ( 800-kcal ) low-calorie diet .  Participants were r and omly assigned , in a two-by-two factorial design , to one of five ad libitum diets to prevent weight regain over a 26-week period : a low-protein and low-glycemic-index diet , a low-protein and high-glycemic-index diet , a high-protein and low-glycemic-index diet , a high-protein and high-glycemic-index diet , or a control diet . RESULTS A total of 1209 adults were screened ( mean age , 41 years ; body-mass index [ the weight in kilograms divided by the square of the height in meters ] , 34 ) , of whom 938 entered the low-calorie-diet phase of the study . A total of 773 participants who completed that phase were r and omly assigned to one of the five maintenance diets ; 548 completed the intervention ( 71 % ) . Fewer participants in the high-protein and the low-glycemic-index groups than in the low-protein-high-glycemic-index group dropped out of the study ( 26.4 % and 25.6 % , respectively , vs. 37.4 % ; P=0.02 and P=0.01 for the respective comparisons ) . The mean initial weight loss with the low-calorie diet was 11.0 kg . In the analysis of participants who completed the study , only the low-protein-high-glycemic-index diet was associated with subsequent significant weight regain ( 1.67 kg ; 95 % confidence interval [ CI ] , 0.48 to 2.87 ) . In an intention-to-treat analysis , the weight regain was 0.93 kg less ( 95 % CI , 0.31 to 1.55 ) in the groups assigned to a high-protein diet than in those assigned to a low-protein diet ( P=0.003 ) and 0.95 kg less ( 95 % CI , 0.33 to 1.57 ) in the groups assigned to a low-glycemic-index diet than in those assigned to a high-glycemic-index diet ( P=0.003 ) . The analysis involving participants who completed the intervention produced similar results . The groups did not differ significantly with respect to diet-related adverse events . CONCLUSIONS In this large European study , a modest increase in protein content and a modest reduction in the glycemic index led to an improvement in study completion and maintenance of weight loss . ( Funded by the European Commission ; Clinical Trials.gov number , NCT00390637 . ) Background To evaluate the metabolic effects of two weight loss diets differing in macronutrient composition on features of dyslipidemia and post-pr and ial insulin ( INS ) response to a meal challenge in overweight/obese individuals . Methods This study was a parallel-arm r and omized 4 mo weight loss trial . Adults ( n = 50 , 47 ± 7 y ) matched on BMI ( 33.6 ± 0.6 kg/m2 , P = 0.79 )  consumed energy restricted diets ( deficit ~500 kcal/d ) : PRO ( 1.6 g.kg-1.d-1 protein and < 170 g/d carbohydrate ) or CHO ( 0.8 g.kg-1.d-1 protein and > 220 g/d carbohydrate ) for 4 mos . Meal challenges of respective diets were utilized for determination of blood lipids and post-pr and ial INS and glucose response at the beginning and end of the study . Results There was a trend for PRO to lose more weight ( -9.1 % vs. -7.3 % , P = 0.07 ) with a significant reduction in percent fat mass compared to CHO ( -8.7 % vs. -5.7 % ; P = 0.03 ) . PRO also favored reductions in triacylglycerol ( -34 % vs. -14 % ; P < 0.05 ) and increases in HDL-C ( + 5 % vs. -3 % ; P = 0.05 ) ; however , CHO favored reduction in LDL-C ( -7 % vs. + 2.5 % ; P < 0.05 ) . INS responses to the meal challenge were improved in PRO compared to CHO ( P < 0.05 ) at both 1 hr ( -34.3 % vs. -1.0 % ) and 2 hr ( -9.2 % vs. + 46.2 % ) , an effect that remained significant after controlling for weight or fat loss ( both P < 0.05 ) . Conclusion A weight loss diet with moderate carbohydrate , moderate protein results in more favorable changes in body composition , dyslipidemia , and post-pr and ial INS response compared to a high carbohydrate , low protein diet suggesting an additional benefit beyond weight management to include augmented risk reduction for metabolic disease Although popular and effective for weight loss , low-carbohydrate , high-protein , high-fat ( Atkins ) diets have been associated with adverse changes in blood and renal biomarkers . High-protein diets low in fat may represent an equally appealing diet plan but promote a more healthful weight loss .  Healthy adults ( n = 20 ) were r and omly assigned to 1 of 2 low-fat ( < 30 % energy ) , energy-restricted groups : high-protein ( 30 % energy ) or high-carbohydrate ( 60 % energy ) ; 24-h intakes were strictly controlled during the 6-wk trial . One subject from each group did not complete the trial due to out-of-state travel ; two subjects in the high-carbohydrate group withdrew from the trial due to extreme hunger . Body composition and metabolic indices were assessed pre- and post-trial . Both diets were equally effective at reducing body weight ( -6 % , P < 0.05 ) and fat mass ( -9 to -11 % , P < 0.05 ) ; however , subjects consuming the high-protein diet reported more satisfaction and less hunger in mo 1 of the trial . Both diets significantly lowered total cholesterol ( -10 to -12 % ) , insulin ( -25 % ) , and uric acid ( -22 to -30 % ) concentrations in blood from fasting subjects . Urinary calcium excretion increased 42 % in subjects consuming the high-protein diet , mirroring the 50 % increase in dietary calcium with consumption of this diet ; thus , apparent calcium balance was not adversely affected . Creatinine clearance was not altered by diet treatments , and nitrogen balance was more positive in subjects consuming the high-protein diet vs. the high-carbohydrate diet ( 3.9 + /- 1.4 and 0.7 + /- 1.7 g N/d , respectively , P < 0.05 ) . Thus , low-fat , energy-restricted diets of varying protein content ( 15 or 30 % energy ) promoted healthful weight loss , but diet satisfaction was greater in those consuming the high-protein diet Cl aims about the merits or risks of carbohydrate ( CHO ) vs. protein for weight loss diets are extensive , yet the ideal ratio of dietary carbohydrate to protein for adult health and weight management remains unknown . This study examined the efficacy of two weight loss diets with modified CHO/protein ratios to change body composition and blood lipids in adult women . Women ( n = 24 ; 45 to 56 y old ) with body mass indices > 26 kg/m(2 ) were assigned to either a CHO Group consuming a diet with a CHO/protein ratio of 3.5 ( 68 g protein/d ) or a Protein Group with a ratio of 1.4 ( 125 g protein/d ) . Diets were isoenergetic , providing 7100 kJ/d , and similar amounts of fat ( approximately 50 g/d ) . After consuming the diets for  
    Output:
    