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: A study was made of the effect of high or low intake of sucrose for periods of 14 days in a group of nineteen apparently healthy men . The high sucrose diet produced no change in blood levels of cholesterol or phospholipids , or in glucose tolerance , but it produced a significant rise in triglycerides in all nineteen men . In six of them , there was in addition a rise in serum immunoreactive insulin , especially during the glucose tolerance test , and these same six subjects also showed a considerable increase in weight and a significant increase in platelet adhesiveness . There was no difference between the six subjects and the remaining thirteen in any of the other measurements , or in the diets they consumed during the experiment . The changes produced by sucrose had disappeared , or nearly so , after 14 days of normal diet . It is suggested that the effect of sucrose in producing hyperinsulinism may be more relevant to its possible role in the aetiology of ischaemic heart disease than its effect on blood lipids . It is further suggested that only some individuals are susceptible to the development of ischaemic heart disease by dietary sucrose , and that these may be identified as those that show ‘ sucrose-induced hyperinsulinism ’ The effects of several high carbohydrate foods on fasting serum cholesterol , phospholipids , and triglyceride levels were tested in 12 young men . The men were distributed into four groups , each of which was given a diet containing a different supplement . The four supplements ( 500 kcal of carbohydrate each ) contained , respectively , sucrose , wheat flour , mixed fruits , and mixed vegetables . Egg white was added as needed to equalize protein in all the supplements . In consecutive 2-week periods , the supplements were exchanged so that in four periods each group received every supplement . Fasting blood sample s were taken on the last 3 days of each period . There was no significant difference in serum cholesterol levels except for the vegetable diet , which produced much lower serum cholesterol than any of the other three diets . The serum phospholipids were also lower with the vegetable diet than with any of the other diets . No significant difference in serum triglycerides was found between the four diets . In a second similar experiment , diets containing sucrose , wheat flour , chickpeas , and a mixture of dry peas and beans were compared . No significant between-diets difference was found for either cholesterol , phospholipids , or triglycerides in this experiment . These results indicate that in 2-week dietary periods sucrose does not cause higher fasting serum cholesterol , phospholipids , or triglycerides than either wheat flour or dry leguminous seeds in amounts containing isocaloric quantities of starch . Am . J. Clin . Nutr . 27 : 1043 - 105 1 , 1974 Twelve carbohydrate-sensitive men selected due to their abnormally high insulin responses to a sucrose load and 12 men with normal insulin responses were fed diets containing 0 , 7.5 , and 15 % fructose for 5 wk each in a cross-over design . The diets contained 43 % total carbohydrate , 42 % fat , and 15 % protein . Initial fasting total cholesterol and low-density lipoprotein cholesterol were higher in the hyperinsulinemic men than in the controls . Diastolic blood pressure was not affected by diet , but systolic blood pressure was slightly higher after the men consumed the 0 % fructose diet . Free fatty acids were not different . Total plasma cholesterol and low-density lipoprotein cholesterol were higher after the men consumed 7.5 and 15 % fructose than when they consumed the 0 % fructose diet . Plasma triglyceride increased significantly as fructose in the diets of the hyperinsulinemics increased , but was not affected in the controls . These changes in blood lipids are associated with heart disease Ten hyperinsulinemic and 11 nonhyperinsulinemic men consumed for 5 wk each in a cross-over design a diet , similar to one currently consumed in the United States , with 20 % of the kilocalories from either fructose or high-amylose cornstarch to determine the effects of the two diets on various blood metabolites considered to be risk factors associated with heart disease . In the hyperinsulinemic men the intake of fructose as compared with cornstarch significantly increased total triglycerides and their lipoprotein distribution ; total and very-low-density lipoprotein cholesterol ; apoproteins B-100 , C-II , C-III ; and uric acid . In the nonhyperinsulinemic men  total triglycerides , total and low-density lipoprotein cholesterol and uric acid were significantly greater after the consumption of fructose than after cornstarch . The results indicate that in a diet high in saturated fatty acids and cholesterol , fructose increases the levels of risk factors associated with heart disease , especially in hyperinsulinemic men OBJECTIVE To test the hypothesis that family dietary coaching would improve nutritional intakes and weight control in free-living ( noninstitutionalized ) children and parents . DESIGN R and omized controlled trial . SETTING Fifty-four elementary schools in Paris , France . PARTICIPANTS One thous and thirteen children ( mean age , 7.7 years ) and 1013 parents ( mean age , 40.5 years ) . INTERVENTION Families were r and omly assigned to group A ( advised to reduce fat and to increase complex carbohydrate intake ) , group B ( advised to reduce both fat and sugar and to increase complex carbohydrate intake ) , or a control group ( given no advice ) . Groups A and B received monthly phone counseling and Internet-based monitoring for 8 months . OUTCOME MEASURES Changes in nutritional intake , body mass index ( calculated as weight in kilograms divided by height in meters squared ) , fat mass , physical activity , blood indicators , and quality of life . RESULTS Compared with controls , participants in the intervention groups achieved their nutritional targets for fat intake and to a smaller extent for sugar and complex carbohydrate intake , leading to a decrease in energy intake ( children , P < .001 ; parents , P = .02 ) . Mean changes in body mass index were similar among children ( group A , + 0.05 , 95 % confidence interval [ CI ] , - 0.06 to 0.16 ; group B , + 0.10 , 95 % CI , - 0.03 to 0.23 ; control group , + 0.13 , 95 % CI , 0.04 - 0.22 ; P = .45 ) , but differed in parents ( group A , + 0.13 , 95 % CI , - 0.01 to 0.27 ; group B , - 0.02 , 95 % CI , - 0.14 to 0.11 ; control group , + 0.24 , 95 % CI , 0.13 - 0.34 ; P = .001 ) , with a significant difference between group B and the control group ( P = .01 ) . CONCLUSIONS Family dietary coaching improves nutritional intake in free-living children and parents , with beneficial effects on weight control in parents . Trial Registration clinical trials.gov Identifier : NCT00456911 BACKGROUND The consumption of sucrose-sweetened soft drinks ( SSSDs ) has been associated with obesity , the metabolic syndrome , and cardiovascular disorders in observational and short-term intervention studies . Too few long-term intervention studies in humans have examined the effects of soft drinks . OBJECTIVE We compared the effects of SSSDs with those of isocaloric milk and a noncaloric soft drink on changes in total fat mass and ectopic fat deposition ( in liver and muscle tissue ) . DESIGN Overweight subjects ( n = 47 ) were r and omly assigned to 4 different test drinks ( 1 L/d for 6 mo ) : SSSD ( regular cola ) , isocaloric semiskim milk , aspartame-sweetened diet cola , and water . The amount of intrahepatic fat and intramyocellular fat was measured with (1)H-magnetic resonance spectroscopy . Other endpoints were fat mass , fat distribution ( dual-energy X-ray absorptiometry and magnetic resonance imaging ) , and metabolic risk factors . RESULTS The relative changes between baseline and the end of 6-mo intervention were significantly higher in the regular cola group than in the 3 other groups for liver fat ( 132 - 143 % , sex-adjusted mean ; P < 0.01 ) , skeletal muscle fat ( 117 - 221 % ; P < 0.05 ) , visceral fat ( 24 - 31 % ; P < 0.05 ) , blood triglycerides ( 32 % ; P < 0.01 ) , and total cholesterol ( 11 % ; P < 0.01 ) . Total fat mass was not significantly different between the 4 beverage groups . Milk and diet cola reduced systolic blood pressure by 10 - 15 % compared with regular cola ( P < 0.05 ) . Otherwise , diet cola had effects similar to those of water . CONCLUSION Daily intake of SSSDs for 6 mo increases ectopic fat accumulation and lipids compared with milk , diet cola , and water . Thus , daily intake of SSSDs is likely to enhance the risk of cardiovascular and metabolic diseases . This trial is registered at clinical trials.gov as NCT00777647 IMPORTANCE Epidemiologic studies have suggested that higher intake of added sugar is associated with cardiovascular disease ( CVD ) risk factors . Few prospect i ve studies have examined the association of added sugar intake with CVD mortality . OBJECTIVE To examine time trends of added sugar consumption as percentage of daily calories in the United States and investigate the association of this consumption with CVD mortality . DESIGN , SETTING , AND PARTICIPANTS National Health and Nutrition Examination Survey ( NHANES , 1988 - 1994 [ III ] , 1999 - 2004 , and 2005 - 2010 [ n = 31,147 ] ) for the time trend analysis and NHANES III Linked Mortality cohort ( 1988 - 2006 [ n = 11 733 ] ) , a prospect i ve cohort of a nationally representative sample of US adults for the association study . MAIN OUTCOMES AND MEASURES Cardiovascular disease mortality . RESULTS Among US adults , the adjusted mean percentage of daily calories from added sugar  increased from 15.7 % ( 95 % CI , 15.0%-16.4 % ) in 1988 - 1994 to 16.8 % ( 16.0%-17.7 % ; P = .02 ) in 1999 - 2004 and decreased to 14.9 % ( 14.2%-15.5 % ; P < .001 ) in 2005 - 2010 . Most adults consumed 10 % or more of calories from added sugar ( 71.4 % ) and approximately 10 % consumed 25 % or more in 2005 - 2010 . During a median follow-up period of 14.6 years , we documented 831 CVD deaths during 163,039 person-years . Age- , sex- , and race/ethnicity-adjusted hazard ratios ( HRs ) of CVD mortality across quintiles of the percentage of daily calories consumed from added sugar were 1.00 ( reference ) , 1.09 ( 95 % CI , 1.05 - 1.13 ) , 1.23 ( 1.12 - 1.34 ) , 1.49 ( 1.24 - 1.78 ) , and 2.43 ( 1.63 - 3.62 ; P < .001 ) , respectively . After additional adjustment for sociodemographic , behavioral , and clinical characteristics , HRs were 1.00 ( reference ) , 1.07 ( 1.02 - 1.12 ) , 1.18 ( 1.06 - 1.31 ) , 1.38 ( 1.11 - 1.70 ) , and 2.03 ( 1.26 - 3.27 ; P = .004 ) , respectively . Adjusted HRs were 1.30 ( 95 % CI , 1.09 - 1.55 ) and 2.75 ( 1.40 - 5.42 ; P = .004 ) , respectively , comparing participants who consumed 10.0 % to 24.9 % or 25.0 % or more calories from added sugar with those who consumed less than 10.0 % of calories from added sugar . These findings were largely consistent across age group , sex , race/ethnicity ( except among non-Hispanic blacks ) , educational attainment , physical activity , health eating index , and body mass index . CONCLUSIONS AND RELEVANCE Most US adults consume more added sugar than is recommended for a healthy diet . We observed a significant relationship between added sugar consumption and increased risk for CVD mortality Background The replacement of sucrose with HFCS in food products has been suggested as playing a role in the development of obesity as a public health issue . The objective of this study was to examine the effects of four equally hypocaloric diets containing different levels of sucrose or high fructose corn syrup ( HFCS ) . Methods This was a r and omized , prospect i 
    Output:
    
agent
Subgroup analyses showed the most marked relation between sugar intakes and lipids in studies in which efforts were made to ensure an energy balance and when no difference in weight change was reported .
CONCLUSIONS Dietary sugars  influence blood pressure and serum lipids .
The relation is independent of effects of  sugars on body weight .
***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: A study was made of the effect of high or low intake of sucrose for periods of 14 days in a group of nineteen apparently healthy men . The high sucrose diet produced no change in blood levels of cholesterol or phospholipids , or in glucose tolerance , but it produced a significant rise in triglycerides in all nineteen men . In six of them , there was in addition a rise in serum immunoreactive insulin , especially during the glucose tolerance test , and these same six subjects also showed a considerable increase in weight and a significant increase in platelet adhesiveness . There was no difference between the six subjects and the remaining thirteen in any of the other measurements , or in the diets they consumed during the experiment . The changes produced by sucrose had disappeared , or nearly so , after 14 days of normal diet . It is suggested that the effect of sucrose in producing hyperinsulinism may be more relevant to its possible role in the aetiology of ischaemic heart disease than its effect on blood lipids . It is further suggested that only some individuals are susceptible to the development of ischaemic heart disease by dietary sucrose , and that these may be identified as those that show ‘ sucrose-induced hyperinsulinism ’ The effects of several high carbohydrate foods on fasting serum cholesterol , phospholipids , and triglyceride levels were tested in 12 young men . The men were distributed into four groups , each of which was given a diet containing a different supplement . The four supplements ( 500 kcal of carbohydrate each ) contained , respectively , sucrose , wheat flour , mixed fruits , and mixed vegetables . Egg white was added as needed to equalize protein in all the supplements . In consecutive 2-week periods , the supplements were exchanged so that in four periods each group received every supplement . Fasting blood sample s were taken on the last 3 days of each period . There was no significant difference in serum cholesterol levels except for the vegetable diet , which produced much lower serum cholesterol than any of the other three diets . The serum phospholipids were also lower with the vegetable diet than with any of the other diets . No significant difference in serum triglycerides was found between the four diets . In a second similar experiment , diets containing sucrose , wheat flour , chickpeas , and a mixture of dry peas and beans were compared . No significant between-diets difference was found for either cholesterol , phospholipids , or triglycerides in this experiment . These results indicate that in 2-week dietary periods sucrose does not cause higher fasting serum cholesterol , phospholipids , or triglycerides than either wheat flour or dry leguminous seeds in amounts containing isocaloric quantities of starch . Am . J. Clin . Nutr . 27 : 1043 - 105 1 , 1974 Twelve carbohydrate-sensitive men selected due to their abnormally high insulin responses to a sucrose load and 12 men with normal insulin responses were fed diets containing 0 , 7.5 , and 15 % fructose for 5 wk each in a cross-over design . The diets contained 43 % total carbohydrate , 42 % fat , and 15 % protein . Initial fasting total cholesterol and low-density lipoprotein cholesterol were higher in the hyperinsulinemic men than in the controls . Diastolic blood pressure was not affected by diet , but systolic blood pressure was slightly higher after the men consumed the 0 % fructose diet . Free fatty acids were not different . Total plasma cholesterol and low-density lipoprotein cholesterol were higher after the men consumed 7.5 and 15 % fructose than when they consumed the 0 % fructose diet . Plasma triglyceride increased significantly as fructose in the diets of the hyperinsulinemics increased , but was not affected in the controls . These changes in blood lipids are associated with heart disease Ten hyperinsulinemic and 11 nonhyperinsulinemic men consumed for 5 wk each in a cross-over design a diet , similar to one currently consumed in the United States , with 20 % of the kilocalories from either fructose or high-amylose cornstarch to determine the effects of the two diets on various blood metabolites considered to be risk factors associated with heart disease . In the hyperinsulinemic men the intake of fructose as compared with cornstarch significantly increased total triglycerides and their lipoprotein distribution ; total and very-low-density lipoprotein cholesterol ; apoproteins B-100 , C-II , C-III ; and uric acid . In the nonhyperinsulinemic men  total triglycerides , total and low-density lipoprotein cholesterol and uric acid were significantly greater after the consumption of fructose than after cornstarch . The results indicate that in a diet high in saturated fatty acids and cholesterol , fructose increases the levels of risk factors associated with heart disease , especially in hyperinsulinemic men OBJECTIVE To test the hypothesis that family dietary coaching would improve nutritional intakes and weight control in free-living ( noninstitutionalized ) children and parents . DESIGN R and omized controlled trial . SETTING Fifty-four elementary schools in Paris , France . PARTICIPANTS One thous and thirteen children ( mean age , 7.7 years ) and 1013 parents ( mean age , 40.5 years ) . INTERVENTION Families were r and omly assigned to group A ( advised to reduce fat and to increase complex carbohydrate intake ) , group B ( advised to reduce both fat and sugar and to increase complex carbohydrate intake ) , or a control group ( given no advice ) . Groups A and B received monthly phone counseling and Internet-based monitoring for 8 months . OUTCOME MEASURES Changes in nutritional intake , body mass index ( calculated as weight in kilograms divided by height in meters squared ) , fat mass , physical activity , blood indicators , and quality of life . RESULTS Compared with controls , participants in the intervention groups achieved their nutritional targets for fat intake and to a smaller extent for sugar and complex carbohydrate intake , leading to a decrease in energy intake ( children , P < .001 ; parents , P = .02 ) . Mean changes in body mass index were similar among children ( group A , + 0.05 , 95 % confidence interval [ CI ] , - 0.06 to 0.16 ; group B , + 0.10 , 95 % CI , - 0.03 to 0.23 ; control group , + 0.13 , 95 % CI , 0.04 - 0.22 ; P = .45 ) , but differed in parents ( group A , + 0.13 , 95 % CI , - 0.01 to 0.27 ; group B , - 0.02 , 95 % CI , - 0.14 to 0.11 ; control group , + 0.24 , 95 % CI , 0.13 - 0.34 ; P = .001 ) , with a significant difference between group B and the control group ( P = .01 ) . CONCLUSIONS Family dietary coaching improves nutritional intake in free-living children and parents , with beneficial effects on weight control in parents . Trial Registration clinical trials.gov Identifier : NCT00456911 BACKGROUND The consumption of sucrose-sweetened soft drinks ( SSSDs ) has been associated with obesity , the metabolic syndrome , and cardiovascular disorders in observational and short-term intervention studies . Too few long-term intervention studies in humans have examined the effects of soft drinks . OBJECTIVE We compared the effects of SSSDs with those of isocaloric milk and a noncaloric soft drink on changes in total fat mass and ectopic fat deposition ( in liver and muscle tissue ) . DESIGN Overweight subjects ( n = 47 ) were r and omly assigned to 4 different test drinks ( 1 L/d for 6 mo ) : SSSD ( regular cola ) , isocaloric semiskim milk , aspartame-sweetened diet cola , and water . The amount of intrahepatic fat and intramyocellular fat was measured with (1)H-magnetic resonance spectroscopy . Other endpoints were fat mass , fat distribution ( dual-energy X-ray absorptiometry and magnetic resonance imaging ) , and metabolic risk factors . RESULTS The relative changes between baseline and the end of 6-mo intervention were significantly higher in the regular cola group than in the 3 other groups for liver fat ( 132 - 143 % , sex-adjusted mean ; P < 0.01 ) , skeletal muscle fat ( 117 - 221 % ; P < 0.05 ) , visceral fat ( 24 - 31 % ; P < 0.05 ) , blood triglycerides ( 32 % ; P < 0.01 ) , and total cholesterol ( 11 % ; P < 0.01 ) . Total fat mass was not significantly different between the 4 beverage groups . Milk and diet cola reduced systolic blood pressure by 10 - 15 % compared with regular cola ( P < 0.05 ) . Otherwise , diet cola had effects similar to those of water . CONCLUSION Daily intake of SSSDs for 6 mo increases ectopic fat accumulation and lipids compared with milk , diet cola , and water . Thus , daily intake of SSSDs is likely to enhance the risk of cardiovascular and metabolic diseases . This trial is registered at clinical trials.gov as NCT00777647 IMPORTANCE Epidemiologic studies have suggested that higher intake of added sugar is associated with cardiovascular disease ( CVD ) risk factors . Few prospect i ve studies have examined the association of added sugar intake with CVD mortality . OBJECTIVE To examine time trends of added sugar consumption as percentage of daily calories in the United States and investigate the association of this consumption with CVD mortality . DESIGN , SETTING , AND PARTICIPANTS National Health and Nutrition Examination Survey ( NHANES , 1988 - 1994 [ III ] , 1999 - 2004 , and 2005 - 2010 [ n = 31,147 ] ) for the time trend analysis and NHANES III Linked Mortality cohort ( 1988 - 2006 [ n = 11 733 ] ) , a prospect i ve cohort of a nationally representative sample of US adults for the association study . MAIN OUTCOMES AND MEASURES Cardiovascular disease mortality . RESULTS Among US adults , the adjusted mean percentage of daily calories from added sugar  increased from 15.7 % ( 95 % CI , 15.0%-16.4 % ) in 1988 - 1994 to 16.8 % ( 16.0%-17.7 % ; P = .02 ) in 1999 - 2004 and decreased to 14.9 % ( 14.2%-15.5 % ; P < .001 ) in 2005 - 2010 . Most adults consumed 10 % or more of calories from added sugar ( 71.4 % ) and approximately 10 % consumed 25 % or more in 2005 - 2010 . During a median follow-up period of 14.6 years , we documented 831 CVD deaths during 163,039 person-years . Age- , sex- , and race/ethnicity-adjusted hazard ratios ( HRs ) of CVD mortality across quintiles of the percentage of daily calories consumed from added sugar were 1.00 ( reference ) , 1.09 ( 95 % CI , 1.05 - 1.13 ) , 1.23 ( 1.12 - 1.34 ) , 1.49 ( 1.24 - 1.78 ) , and 2.43 ( 1.63 - 3.62 ; P < .001 ) , respectively . After additional adjustment for sociodemographic , behavioral , and clinical characteristics , HRs were 1.00 ( reference ) , 1.07 ( 1.02 - 1.12 ) , 1.18 ( 1.06 - 1.31 ) , 1.38 ( 1.11 - 1.70 ) , and 2.03 ( 1.26 - 3.27 ; P = .004 ) , respectively . Adjusted HRs were 1.30 ( 95 % CI , 1.09 - 1.55 ) and 2.75 ( 1.40 - 5.42 ; P = .004 ) , respectively , comparing participants who consumed 10.0 % to 24.9 % or 25.0 % or more calories from added sugar with those who consumed less than 10.0 % of calories from added sugar . These findings were largely consistent across age group , sex , race/ethnicity ( except among non-Hispanic blacks ) , educational attainment , physical activity , health eating index , and body mass index . CONCLUSIONS AND RELEVANCE Most US adults consume more added sugar than is recommended for a healthy diet . We observed a significant relationship between added sugar consumption and increased risk for CVD mortality Background The replacement of sucrose with HFCS in food products has been suggested as playing a role in the development of obesity as a public health issue . The objective of this study was to examine the effects of four equally hypocaloric diets containing different levels of sucrose or high fructose corn syrup ( HFCS ) . Methods This was a r and omized , prospect i 
    Output:
    