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: There is evidence for health benefits from ' Palaeolithic ' diets ; however , there are a few data on the acute effects of rationally design ed Palaeolithic-type meals . In the present study , we used Palaeolithic diet principles to construct meals comprising readily available ingredients : fish and a variety of plants , selected to be rich in fibre and phyto-nutrients . We investigated the acute effects of  two Palaeolithic-type meals ( PAL 1 and PAL 2 ) and a reference meal based on WHO guidelines ( REF ) , on blood glucose control , gut hormone responses and appetite regulation . Using a r and omised cross-over trial design , healthy subjects were given three meals on separate occasions . PAL2 and REF were matched for energy , protein , fat and carbohydrates ; PAL1 contained more protein and energy . Plasma glucose , insulin , glucagon-like peptide-1 ( GLP-1 ) , glucose-dependent insulinotropic peptide ( GIP ) and peptide YY ( PYY ) concentrations were measured over a period of 180 min . Satiation was assessed using electronic visual analogue scale ( EVAS ) scores . GLP-1 and PYY concentrations were significantly increased across 180 min for both PAL1 ( P= 0·001 and P < 0·001 ) and PAL2 ( P= 0·011 and P= 0·003 ) compared with the REF . Concomitant EVAS scores showed increased satiety . By contrast , GIP concentration was significantly suppressed . Positive incremental AUC over 120 min for glucose and insulin did not differ between the meals . Consumption of meals based on Palaeolithic diet principles result ed in significant increases in incretin and anorectic gut hormones and increased perceived satiety . Surprisingly , this was independent of the energy or protein content of the meal and therefore suggests potential benefits for reduced risk of obesity Background We found marked improvement of glucose tolerance and lower dietary  energy  intake in ischemic heart disease ( IHD ) patients after advice to follow a Paleolithic diet  , as compared to a Mediterranean-like diet . We now report findings on subjective ratings of satiety at meals and data on the satiety hormone leptin and the soluble leptin receptor from the same study . Methods Twenty-nine male IHD patients with impaired glucose tolerance or diabetes type 2 , and waist circumference > 94 cm , were r and omized to ad libitum consumption of a Paleolithic diet ( n = 14 ) based on lean meat , fish , fruit , vegetables , root vegetables , eggs , and nuts , or a Mediterranean-like diet ( n = 15 ) based on whole grains , low-fat dairy products , vegetables , fruit , fish , and oils and margarines during 12 weeks . In parallel with a four day weighed food record the participants recorded their subjective rating of satiety . Satiety Quotients were calculated , as the intra-meal quotient of change in satiety during meal and consumed energy or weight of food and drink for that specific meal . Leptin and leptin receptor was measured at baseline and after 6 and 12 weeks . Free leptin index was calculated as the ratio leptin/leptin receptor . Results The Paleolithic group were as satiated as the Mediterranean group but consumed less energy per day ( 5.8 MJ/day vs. 7.6 MJ/day , Paleolithic vs. Mediterranean , p = 0.04 ) . Consequently , the quotients of mean change in satiety during meal and mean consumed energy from food and drink were higher in the Paleolithic group ( p = 0.03 ) . Also , there was a strong trend for greater Satiety Quotient for energy in the Paleolithic group ( p = 0.057 ) . Leptin decreased by 31 % in the Paleolithic group and by 18 % in the Mediterranean group with a trend for greater relative decrease of leptin in the Paleolithic group . Relative changes in leptin and changes in weight and waist circumference correlated significantly in the Paleolithic group ( p < 0.001 ) but not in the Mediterranean group . Changes in leptin receptor and free leptin index were not significant . Conclusions A Paleolithic diet is more satiating per calorie than a Mediterranean-like diet . Trial registration Clinical Trials.gov Background Our aim was to compare the effects of a Paleolithic ( ' Old Stone Age ' ) diet and a diabetes diet as generally recommended on risk factors for cardiovascular disease in patients with type 2 diabetes not treated with insulin . Methods In a r and omized cross-over study , 13 patients with type 2 diabetes , 3 women and 10 men , were instructed to eat a Paleolithic diet based on lean meat , fish , fruits , vegetables , root vegetables , eggs and nuts ; and a Diabetes diet design ed in accordance with dietary guidelines during two consecutive 3-month periods . Outcome variables included changes in weight , waist circumference , serum lipids , C-reactive protein , blood pressure , glycated haemoglobin ( HbA1c ) , and areas under the curve for plasma glucose and plasma insulin  in the 75 g oral glucose tolerance test . Dietary intake was evaluated by use of 4-day weighed food records . Results Study participants had on average a diabetes duration of 9 years , a mean HbA1c of 6,6 % units by Mono-S st and ard and were usually treated with metformin alone ( 3 subjects ) or metformin in combination with a sulfonylurea ( 3 subjects ) or a thiazolidinedione ( 3 subjects ) . Mean average dose of metformin was 1031 mg per day . Compared to the diabetes diet , the Paleolithic diet result ed in lower mean values of HbA1c ( -0.4 % units , p = 0.01 ) , triacylglycerol ( -0.4 mmol/L , p = 0.003 ) , diastolic blood pressure ( -4 mmHg , p = 0.03 ) , weight ( -3 kg , p = 0.01 ) , BMI ( -1 kg/m2 , p = 0.04 ) and waist circumference ( -4 cm , p = 0.02 ) , and higher mean values of high density lipoprotein cholesterol ( + 0.08 mmol/L , p = 0.03 ) . The Paleolithic diet was mainly lower in cereals and dairy products , and higher in fruits , vegetables , meat and eggs , as compared with the Diabetes diet . Further , the Paleolithic diet was lower in total energy , energy density , carbohydrate , dietary glycemic load , saturated fatty acids and calcium , and higher in unsaturated fatty acids , dietary cholesterol and several vitamins . Dietary GI was slightly lower in the Paleolithic diet ( GI = 50 ) than in the Diabetic diet ( GI = 55 ) . Conclusion Over a 3-month study period , a Paleolithic diet improved glycemic control and several cardiovascular risk factors compared to a Diabetes diet in patients with type 2 diabetes . Trial registration Clinical Trials.gov NCT00435240 Objective : It has been suggested that overweight is negatively associated with cognitive functions . The aim of this study was to investigate whether a reduction in body weight by dietary interventions could improve episodic memory performance and alter associated functional brain responses in overweight and obese women . Methods : 20 overweight postmenopausal women were r and omized to either a modified paleolithic diet or a st and ard diet adhering to the Nordic Nutrition Recommendations for 6 months . We used functional magnetic resonance imaging to examine brain function during an episodic memory task as well as anthropometric and biochemical data before and after the interventions . Results : Episodic memory performance improved significantly ( p = 0.010 ) after the dietary interventions . Concomitantly , brain activity increased in the anterior part of the right hippocampus during memory encoding , without differences between diets . This was associated with decreased levels of plasma free fatty acids ( FFA ) . Brain activity increased in pre-frontal cortex and superior/middle temporal gyri . The magnitude of increase correlated with waist circumference reduction . During episodic retrieval , brain activity decreased in inferior and middle frontal gyri , and increased in middle/superior temporal gyri . Conclusions : Diet-induced weight loss , associated with decreased levels of plasma FFA , improves episodic memory linked to increased hippocampal activity Background We found marked improvement of glycemic control and several cardiovascular risk factors in patients with type 2 diabetes given advice to follow a Paleolithic diet  , as compared to a diabetes diet . We now report findings on subjective ratings of satiety at meal times and participants ’ other experiences of the two diets from the same study . Methods In a r and omized cross-over study , 13 patients with type 2 diabetes ( 3 women and 10 men ) , were instructed to eat a Paleolithic diet based on lean meat , fish , fruits , vegetables , root vegetables , eggs and nuts , and a diabetes diet design ed in accordance with dietary guidelines , during two consecutive 3-month periods . In parallel with a four-day weighed food record , the participants recorded their subjective rating of satiety . Satiety quotients were calculated as the intra-meal quotient of change in satiety during a meal and consumed energy or weight of food and drink for that specific meal . All participants answered the same three open-ended questions in a survey following each diet : “ What thoughts do you have about this diet ? ” , “ Describe your positive and negative experiences with this diet ” and “ How do you think this diet has affected your health ? ” . Results The participants were equally satiated on both diets . The Paleolithic diet result ed in greater satiety quotients for energy per meal ( p = 0.004 ) , energy density per meal ( p = 0.01 ) and glycemic load per meal ( p = 0.02 ) . The distribution of positive and negative comments from the survey did not differ between the two diets , and the comments were mostly positive . Among comments relating to recurring topics , there was no difference in distribution between the two diets for comments relating to tastelessness , but there was a trend towards more comments on the Paleolithic diet being satiating and improving blood sugar values , and significantly more comments on weight loss and difficulty adhering to the Paleolithic diet . Conclusions A Paleolithic diet is more satiating per calorie than a diabetes diet in patients with type 2 diabetes . The Paleolithic diet was seen as instrumental in weight loss , albeit it was difficult to adhere to . Trial registration Clinical Trials.gov : Background / objectives : Formulas developed to estimate diet-dependent net acid excretion ( NAE ) generally agree with measured values for typical Western diets . Whether they can also appropriately predict NAE for ‘ Paleolithic-type ’ ( Paleo ) diets — which contain very high amounts of fruits and vegetables ( F&V ) and concurrent high amounts of protein is unknown . Here , we compare measured NAEs with established NAE estimates in subjects with Type 2 diabetes (T2D).Subjects/ methods : Thirteen subjects with well-controlled T2D were r and omized to either a Paleo or American Diabetes Association ( ADA ) diet for 14 days . Twenty-four hour urine collection s were performed at baseline and end of the diet period , and analyzed for titratable acid , bicarbonate and ammonium to calculate measured NAE . Three formulas for estimating NAE from dietary intake were used ; two ( NAE_diet R or L ) that include dietary mineral intake and sulfate- and organic acid ( OA ) production , and one that is empirically derived ( NAE_diet F ) only considering potassium and protein intake . Results : Measured NAE on the Paleo diet was significantly lower than on the ADA-diet ( + 31±22 vs 112±52 mEq/day , P=0.002 ) . Although all formula estimates showed similar and reasonable correlations ( r=0.52–0.76 ) with measured NAE , each one underestimated measured values . The formula with the best correlation did not contain an estimate of dietary OA production . Conclusions : Paleo-diets are lower in NAE than typical Western diets . However , commonly used formulas clearly underestimate NAE , especially for diets with very high F&V ( as the Paleo diet ) , and in subjects with T2D . This may be due to an inappropriate estimation of proton loads stemming from OAs , underlining the necessity for improved measures of OA-related proton sources Background There is a lack of research about the experiences of participating in weight-reducing interventions . The aim of this study was to explore barriers and facilitators to weight-loss experienced by participants in a diet intervention for middle-aged to older women in the general population in Northern Sweden . Method In the intervention the women were r and omised to eat either a Palaeolithic-type diet or a diet according to Nordic Nutrition recommendations for 24 months . A strategic selection was made of women from the two intervention groups as well as from the drop-outs in relation to social class , civil status and age . Thematic structured interviews were performed with twelve women and analysed with qualitative content analyses . Results The results showed that the women in the dietary intervention experienced two main barriers – struggling with self ( related to difficulties in changing food habits , health problems , lack of self-control and insecurity ) and struggling with implementing the diet ( related to social relations and project-related difficulties ) – and two main facilitators– st 
    Output:
    
agent
The analysis showed a positive association of adopting the Paleolithic diet in relation to weight loss .
Conclusion The Paleolithic diet may assist in controlling weight and waist circumference and in the management of chronic diseases .
***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: There is evidence for health benefits from ' Palaeolithic ' diets ; however , there are a few data on the acute effects of rationally design ed Palaeolithic-type meals . In the present study , we used Palaeolithic diet principles to construct meals comprising readily available ingredients : fish and a variety of plants , selected to be rich in fibre and phyto-nutrients . We investigated the acute effects of  two Palaeolithic-type meals ( PAL 1 and PAL 2 ) and a reference meal based on WHO guidelines ( REF ) , on blood glucose control , gut hormone responses and appetite regulation . Using a r and omised cross-over trial design , healthy subjects were given three meals on separate occasions . PAL2 and REF were matched for energy , protein , fat and carbohydrates ; PAL1 contained more protein and energy . Plasma glucose , insulin , glucagon-like peptide-1 ( GLP-1 ) , glucose-dependent insulinotropic peptide ( GIP ) and peptide YY ( PYY ) concentrations were measured over a period of 180 min . Satiation was assessed using electronic visual analogue scale ( EVAS ) scores . GLP-1 and PYY concentrations were significantly increased across 180 min for both PAL1 ( P= 0·001 and P < 0·001 ) and PAL2 ( P= 0·011 and P= 0·003 ) compared with the REF . Concomitant EVAS scores showed increased satiety . By contrast , GIP concentration was significantly suppressed . Positive incremental AUC over 120 min for glucose and insulin did not differ between the meals . Consumption of meals based on Palaeolithic diet principles result ed in significant increases in incretin and anorectic gut hormones and increased perceived satiety . Surprisingly , this was independent of the energy or protein content of the meal and therefore suggests potential benefits for reduced risk of obesity Background We found marked improvement of glucose tolerance and lower dietary  energy  intake in ischemic heart disease ( IHD ) patients after advice to follow a Paleolithic diet  , as compared to a Mediterranean-like diet . We now report findings on subjective ratings of satiety at meals and data on the satiety hormone leptin and the soluble leptin receptor from the same study . Methods Twenty-nine male IHD patients with impaired glucose tolerance or diabetes type 2 , and waist circumference > 94 cm , were r and omized to ad libitum consumption of a Paleolithic diet ( n = 14 ) based on lean meat , fish , fruit , vegetables , root vegetables , eggs , and nuts , or a Mediterranean-like diet ( n = 15 ) based on whole grains , low-fat dairy products , vegetables , fruit , fish , and oils and margarines during 12 weeks . In parallel with a four day weighed food record the participants recorded their subjective rating of satiety . Satiety Quotients were calculated , as the intra-meal quotient of change in satiety during meal and consumed energy or weight of food and drink for that specific meal . Leptin and leptin receptor was measured at baseline and after 6 and 12 weeks . Free leptin index was calculated as the ratio leptin/leptin receptor . Results The Paleolithic group were as satiated as the Mediterranean group but consumed less energy per day ( 5.8 MJ/day vs. 7.6 MJ/day , Paleolithic vs. Mediterranean , p = 0.04 ) . Consequently , the quotients of mean change in satiety during meal and mean consumed energy from food and drink were higher in the Paleolithic group ( p = 0.03 ) . Also , there was a strong trend for greater Satiety Quotient for energy in the Paleolithic group ( p = 0.057 ) . Leptin decreased by 31 % in the Paleolithic group and by 18 % in the Mediterranean group with a trend for greater relative decrease of leptin in the Paleolithic group . Relative changes in leptin and changes in weight and waist circumference correlated significantly in the Paleolithic group ( p < 0.001 ) but not in the Mediterranean group . Changes in leptin receptor and free leptin index were not significant . Conclusions A Paleolithic diet is more satiating per calorie than a Mediterranean-like diet . Trial registration Clinical Trials.gov Background Our aim was to compare the effects of a Paleolithic ( ' Old Stone Age ' ) diet and a diabetes diet as generally recommended on risk factors for cardiovascular disease in patients with type 2 diabetes not treated with insulin . Methods In a r and omized cross-over study , 13 patients with type 2 diabetes , 3 women and 10 men , were instructed to eat a Paleolithic diet based on lean meat , fish , fruits , vegetables , root vegetables , eggs and nuts ; and a Diabetes diet design ed in accordance with dietary guidelines during two consecutive 3-month periods . Outcome variables included changes in weight , waist circumference , serum lipids , C-reactive protein , blood pressure , glycated haemoglobin ( HbA1c ) , and areas under the curve for plasma glucose and plasma insulin  in the 75 g oral glucose tolerance test . Dietary intake was evaluated by use of 4-day weighed food records . Results Study participants had on average a diabetes duration of 9 years , a mean HbA1c of 6,6 % units by Mono-S st and ard and were usually treated with metformin alone ( 3 subjects ) or metformin in combination with a sulfonylurea ( 3 subjects ) or a thiazolidinedione ( 3 subjects ) . Mean average dose of metformin was 1031 mg per day . Compared to the diabetes diet , the Paleolithic diet result ed in lower mean values of HbA1c ( -0.4 % units , p = 0.01 ) , triacylglycerol ( -0.4 mmol/L , p = 0.003 ) , diastolic blood pressure ( -4 mmHg , p = 0.03 ) , weight ( -3 kg , p = 0.01 ) , BMI ( -1 kg/m2 , p = 0.04 ) and waist circumference ( -4 cm , p = 0.02 ) , and higher mean values of high density lipoprotein cholesterol ( + 0.08 mmol/L , p = 0.03 ) . The Paleolithic diet was mainly lower in cereals and dairy products , and higher in fruits , vegetables , meat and eggs , as compared with the Diabetes diet . Further , the Paleolithic diet was lower in total energy , energy density , carbohydrate , dietary glycemic load , saturated fatty acids and calcium , and higher in unsaturated fatty acids , dietary cholesterol and several vitamins . Dietary GI was slightly lower in the Paleolithic diet ( GI = 50 ) than in the Diabetic diet ( GI = 55 ) . Conclusion Over a 3-month study period , a Paleolithic diet improved glycemic control and several cardiovascular risk factors compared to a Diabetes diet in patients with type 2 diabetes . Trial registration Clinical Trials.gov NCT00435240 Objective : It has been suggested that overweight is negatively associated with cognitive functions . The aim of this study was to investigate whether a reduction in body weight by dietary interventions could improve episodic memory performance and alter associated functional brain responses in overweight and obese women . Methods : 20 overweight postmenopausal women were r and omized to either a modified paleolithic diet or a st and ard diet adhering to the Nordic Nutrition Recommendations for 6 months . We used functional magnetic resonance imaging to examine brain function during an episodic memory task as well as anthropometric and biochemical data before and after the interventions . Results : Episodic memory performance improved significantly ( p = 0.010 ) after the dietary interventions . Concomitantly , brain activity increased in the anterior part of the right hippocampus during memory encoding , without differences between diets . This was associated with decreased levels of plasma free fatty acids ( FFA ) . Brain activity increased in pre-frontal cortex and superior/middle temporal gyri . The magnitude of increase correlated with waist circumference reduction . During episodic retrieval , brain activity decreased in inferior and middle frontal gyri , and increased in middle/superior temporal gyri . Conclusions : Diet-induced weight loss , associated with decreased levels of plasma FFA , improves episodic memory linked to increased hippocampal activity Background We found marked improvement of glycemic control and several cardiovascular risk factors in patients with type 2 diabetes given advice to follow a Paleolithic diet  , as compared to a diabetes diet . We now report findings on subjective ratings of satiety at meal times and participants ’ other experiences of the two diets from the same study . Methods In a r and omized cross-over study , 13 patients with type 2 diabetes ( 3 women and 10 men ) , were instructed to eat a Paleolithic diet based on lean meat , fish , fruits , vegetables , root vegetables , eggs and nuts , and a diabetes diet design ed in accordance with dietary guidelines , during two consecutive 3-month periods . In parallel with a four-day weighed food record , the participants recorded their subjective rating of satiety . Satiety quotients were calculated as the intra-meal quotient of change in satiety during a meal and consumed energy or weight of food and drink for that specific meal . All participants answered the same three open-ended questions in a survey following each diet : “ What thoughts do you have about this diet ? ” , “ Describe your positive and negative experiences with this diet ” and “ How do you think this diet has affected your health ? ” . Results The participants were equally satiated on both diets . The Paleolithic diet result ed in greater satiety quotients for energy per meal ( p = 0.004 ) , energy density per meal ( p = 0.01 ) and glycemic load per meal ( p = 0.02 ) . The distribution of positive and negative comments from the survey did not differ between the two diets , and the comments were mostly positive . Among comments relating to recurring topics , there was no difference in distribution between the two diets for comments relating to tastelessness , but there was a trend towards more comments on the Paleolithic diet being satiating and improving blood sugar values , and significantly more comments on weight loss and difficulty adhering to the Paleolithic diet . Conclusions A Paleolithic diet is more satiating per calorie than a diabetes diet in patients with type 2 diabetes . The Paleolithic diet was seen as instrumental in weight loss , albeit it was difficult to adhere to . Trial registration Clinical Trials.gov : Background / objectives : Formulas developed to estimate diet-dependent net acid excretion ( NAE ) generally agree with measured values for typical Western diets . Whether they can also appropriately predict NAE for ‘ Paleolithic-type ’ ( Paleo ) diets — which contain very high amounts of fruits and vegetables ( F&V ) and concurrent high amounts of protein is unknown . Here , we compare measured NAEs with established NAE estimates in subjects with Type 2 diabetes (T2D).Subjects/ methods : Thirteen subjects with well-controlled T2D were r and omized to either a Paleo or American Diabetes Association ( ADA ) diet for 14 days . Twenty-four hour urine collection s were performed at baseline and end of the diet period , and analyzed for titratable acid , bicarbonate and ammonium to calculate measured NAE . Three formulas for estimating NAE from dietary intake were used ; two ( NAE_diet R or L ) that include dietary mineral intake and sulfate- and organic acid ( OA ) production , and one that is empirically derived ( NAE_diet F ) only considering potassium and protein intake . Results : Measured NAE on the Paleo diet was significantly lower than on the ADA-diet ( + 31±22 vs 112±52 mEq/day , P=0.002 ) . Although all formula estimates showed similar and reasonable correlations ( r=0.52–0.76 ) with measured NAE , each one underestimated measured values . The formula with the best correlation did not contain an estimate of dietary OA production . Conclusions : Paleo-diets are lower in NAE than typical Western diets . However , commonly used formulas clearly underestimate NAE , especially for diets with very high F&V ( as the Paleo diet ) , and in subjects with T2D . This may be due to an inappropriate estimation of proton loads stemming from OAs , underlining the necessity for improved measures of OA-related proton sources Background There is a lack of research about the experiences of participating in weight-reducing interventions . The aim of this study was to explore barriers and facilitators to weight-loss experienced by participants in a diet intervention for middle-aged to older women in the general population in Northern Sweden . Method In the intervention the women were r and omised to eat either a Palaeolithic-type diet or a diet according to Nordic Nutrition recommendations for 24 months . A strategic selection was made of women from the two intervention groups as well as from the drop-outs in relation to social class , civil status and age . Thematic structured interviews were performed with twelve women and analysed with qualitative content analyses . Results The results showed that the women in the dietary intervention experienced two main barriers – struggling with self ( related to difficulties in changing food habits , health problems , lack of self-control and insecurity ) and struggling with implementing the diet ( related to social relations and project-related difficulties ) – and two main facilitators– st 
    Output:
    