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: Objectives To investigate the association between long term intake of individual saturated fatty acids ( SFAs ) and the  risk of coronary heart disease  , in two large cohort studies . Design Prospect i ve , longitudinal cohort study . Setting Health professionals in the United States . Participants 73 147 women in the Nurses ’ Health Study ( 1984 - 2012 ) and 42 635 men in the Health Professionals Follow-up Study ( 1986 - 2010 ) , who were free of major chronic diseases at baseline . Main outcome measure Incidence of coronary heart disease ( n=7035 ) was self-reported , and related deaths were identified by search ing National Death Index or through report of next of kin or postal authority . Cases were confirmed by medical records review . Results Mean intake of SFAs  accounted for 9.0 - 11.3 % energy intake over time , and was mainly composed of lauric acid ( 12:0 ) , myristic acid ( 14:0 ) , palmitic acid ( 16:0 ) , and stearic acid ( 18:0 ; 8.8 - 10.7 % energy ) . Intake of 12:0 , 14:0 , 16:0 and 18:0 were highly correlated , with Spearman correlation coefficients between 0.38 and 0.93 ( all P<0.001 ) . Comparing the highest to the lowest groups of individual SFA intakes , hazard ratios of coronary heart disease were 1.07 ( 95 % confidence interval 0.99 to 1.15 ; Ptrend=0.05 ) for 12:0 , 1.13 ( 1.05 to 1.22 ; Ptrend<0.001 ) for 14:0 , 1.18 ( 1.09 to 1.27 ; Ptrend<0.001 ) for 16:0 , 1.18 ( 1.09 to 1.28 ; Ptrend<0.001 ) for 18:0 , and 1.18 ( 1.09 to 1.28 ; Ptrend<0.001 ) for all four SFAs combined ( 12:0 - 18:0 ) , after multivariate adjustment of lifestyle factors and total energy intake . Hazard ratios of coronary heart disease for isocaloric replacement of 1 % energy from 12:0 - 18:0 were 0.92 ( 95 % confidence interval 0.89 to 0.96 ; P<0.001 ) for polyunsaturated fat , 0.95 ( 0.90 to 1.01 ; P=0.08 ) for monounsaturated fat , 0.94 ( 0.91 to 0.97 ; P<0.001 ) for whole grain carbohydrates , and 0.93 ( 0.89 to 0.97 ; P=0.001 ) for plant proteins . For individual SFAs , the lowest risk of coronary heart disease was observed when the most abundant SFA , 16:0 , was replaced . Hazard ratios of coronary heart disease for replacing 1 % energy from 16:0 were 0.88 ( 95 % confidence interval 0.81 to 0.96 ; P=0.002 ) for polyunsaturated fat , 0.92 ( 0.83 to 1.02 ; P=0.10 ) for monounsaturated fat , 0.90 ( 0.83 to 0.97 ; P=0.01 ) for whole grain carbohydrates , and 0.89 ( 0.82 to 0.97 ; P=0.01 ) for plant proteins . Conclusions Higher dietary intakes of major SFAs are associated with an increased risk of coronary heart disease . Owing to similar associations and high correlations among individual SFAs , dietary recommendations for the prevention of coronary heart disease should continue to focus on replacing total saturated fat with more healthy sources of energy Although dietary trans fatty acids can affect  plasma lipoproteins negatively in humans , no direct comparison with specific saturated fatty acids has been reported , even though trans fatty acids were design ed to replace saturates in foods and food processing . In this study , dietary trans 18:1 [ elaidic acid at 5.5 % energy ( en ) ] was specifically exchanged for cis 18:1 , 16:0 or 12:0 + 14:0 in 27 male and female subjects consuming moderate fat ( 31 % en ) , low cholesterol ( < 225 mg/d ) whole food diets  during 4-wk diet periods in a crossover design . The trans-rich fat significantly elevated total cholesterol and LDL cholesterol relative to the 16:0-rich and 18:1-rich fats and uniquely depressed HDL cholesterol relative to all of the fats tested . Trans fatty acids also elevated lipoprotein ( a ) [ Lp(a ) ] values relative to all dietary treatments . Furthermore , identical effects on lipoproteins were elicited by 16:0 and cis 18:1 in these subjects . The current results suggest that elaidic acid , one of the principal trans isomers produced during industrial hydrogenation of edible oils , adversely affects plasma lipoproteins . Thus , the negative effect of elaidic acid on the lipoprotein profile of humans appears to be unmatched by any other natural fatty acid(s ) Twenty-one healthy normocholesterolemic young adults , men and women , completed a r and omized 30-d/30-d crossover comparison of the effect of palmolein and olive oil on plasma lipids . The subjects were free-living volunteers who changed to low-fat diets  to which one of the test oils was added ( used as a spread , for baking , or for frying ) in turn . Complete food records were kept throughout : the test oils were compared at 17 % of total dietary energy . Under the conditions of this experiment plasma total and low-density-lipoprotein ( LDL ) cholesterol were almost identical with the two oils , so that when the palmitic acid ( 16:0 ) in palm oil replaced oleic acid ( 18:1 ) in olive oil the expected increase in LDL cholesterol was not seen . These results indicate that 16:0 , though saturated , is not always a plasma cholesterol-raising fatty acid . Palmolein is rich in vitamin E , alpha-tocopherol , and especially tocotrienols , but the latter were barely detectable in plasma The degree to which different saturated fatty acids exert their cholesterol-raising effects is still unknown . Therefore , we studied the effect on serum lipids and lipoproteins of diets rich in lauric , palmitic , or oleic acids .  Eighteen women and 14 men consumed in r and om order three experimental diets , each for 6 wk . The diets consisted of solid foods and contained 40 % of energy as fat , of which 28 % was supplied by the experimental fats . The fat high in lauric acid was a mixture of palm kernel oil ( 75 % ) and a high-oleic acid sunflower oil ( 25 % ) ; the fat high in palmitic acid consisted of dairy fat ( 55 % ) , palmstearin ( 36 % ) , and sunflower oil ( 9 % ) ; and the fat high in oleic acid consisted of dairy fat ( 37 % ) and sunflower oil ( 63 % ) . The calculated nutrient composition was the same in each diet except for approximately equal to 8.5 % of energy , which was provided by lauric , palmitic , or oleic acids . With the lauric acid diet the subjects ' serum total cholesterol concentration increased by 0.22 mmol/L ( P = 0.0121 ; 95 % CI : 0.02 , 0.41 mmol/L ) as compared with the palmitic acid diet and by 0.48 mmol/L ( P < 0.0001 ; 95 % CI : 0.29 , 0.67 mmol/L ) compared with the oleic acid diet .  Total cholesterol concentrations with the palmitic acid diet were 0.26 mmol/L ( P = 0.0012 ; 95 % CI : 0.07 , 0.46 mmol/L ) higher than with the oleic acid diet .  High-density-lipoprotein (HDL)-cholesterol concentrations increased by 0.12 mmol/L ( P = 0.006 ; 95 % CI : 0.04 , 0.20 mmol/L ) with the lauric acid compared with the palmitic acid diet and by 0.14 mmol/L ( P < 0.001 ; 95 % CI : 0.07 , 0.22 mmol/L ) compared with the oleic acid diet .  HDL-cholesterol concentrations with the palmitic acid and the oleic acid diet were the same . No effects were seen in serum triacylglycerol and lipoprotein(a ) concentrations . We conclude that both lauric and palmitic acids are hypercholesterolemic compared with oleic acid . Lauric acid raises total cholesterol concentrations more than palmitic acid , which is partly due to a stronger rise in HDL cholesterol The effects on serum lipids of palm oil ( PA ) used in Chinese diets were compared with those of soybean oil ( SO ) , peanut oil ( PE ) and lard ( LA ) in normocholesterolemic subjects and with that of PE in hypercholesterolemic subjects . Normocholesterolemic subjects [ 120 men , 18 - 25 y , total cholesterol ( TC ) 2.8 - 5.0 mmol/L ] were assigned to four groups to consume test diets for six consecutive weeks after a run-in period of 3 wk . About 30 % of dietary energy was derived from fat , 75 - 80 % of which came from test oils . In comparison with the entry level , the average serum TC and LDL cholesterol ( LDL-C ) were 6.7 and 13.1 % lower , respectively , in the PA group and 22.8 and 30.7 % higher , respectively , ( P < 0.05 ) in the LA group . At the end of the test , serum TC , LDL-C and the ratio of TC/HDL cholesterol ( HDL-C ) in the PA group were significantly lower than those of the LA group . Hypercholesterolemic subjects ( 31 men , 20 women , 32 - 68 y , TC 5.5 - 7.0 mmol/L ) were divided into two groups . For 6 wk , one group ( 15 men , 10 women ) consumed the PA diet ; another group ( 16 men , 9 women ) consumed the PE diet . After a 3-wk interval , the two groups interchanged diets for another 6 wk . The test diets again contained about 30 % energy from fat , 60 - 65 % of which came from test oils . Compared with entry values , the PA diet caused significant reductions in serum TC , LDL-C and TC/HDL-C during the first 6 wk and also a significant reduction in TC/HDL-C during the second 6 wk . The PE diet had no significant influence on serum lipids in either experimental period BACKGROUND Despite the high content of palmitic acid , palm olein has been shown to have a neutral effect on plasma cholesterol concentrations when compared with olive oil , which is suggested to be attributable to palmitic acid in the sn-1 and sn-3 position . In contrast , palmitic acid is in the sn-2 position in lard . OBJECTIVE The objective was to investigate the effects of a diet rich in palm olein , fractionated palm oil , olive oil , and lard on plasma blood lipids , inflammatory markers , glucose , and insulin . DESIGN A controlled double-blinded , r and omized 3 × 3 wk crossover dietary intervention study included 32 healthy men who daily replaced part of their habitual dietary fat intake with ~ 17 % of energy from palm olein , olive oil , or lard , respectively . RESULTS Compared with intake of olive oil , palm olein and lard  increased total cholesterol and LDL cholesterol ( P < 0.0001 ) . Palm olein result ed in a lower plasma triacylglycerol concentration than did olive oil ( P < 0.01 ) . No difference in effects was observed in plasma HDL-cholesterol , high-sensitivity C-reactive protein , plasminogen activator-1 , insulin , and glucose concentrations . CONCLUSIONS The current study did not support the previous finding that the effect of palm olein on total plasma cholesterol and LDL cholesterol in healthy individuals with normal plasma cholesterol concentrations is neutral compared with that of olive oil . Thus , sn-positioning was not confirmed to be important with regard to the effect on plasma cholesterol . The relatively lower plasma triacylglycerol concentration  after the palm olein diet than after the olive oil diet was unexpected . This trial is registered at clinical trials.gov as NCT00743301 The cholesterol-raising effect of dietary saturated fatty acids is largely accounted for by lauric , myristic , and palmitic acids . Dairy fat is a major source of myristic acid , and palm oil is especially rich in pal 
    Output:
    
agent
Subgroup analyses revealed that palm oil has a beneficial effect on High-density lipoprotein cholesterol levels when more than 30 % of total dietary energy was constituted by fat .
This review revealed that palm oil does not induce increases in cardiovascular disease risk risk-related biomarkers relative to unsaturated fatty acids .
***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: Objectives To investigate the association between long term intake of individual saturated fatty acids ( SFAs ) and the  risk of coronary heart disease  , in two large cohort studies . Design Prospect i ve , longitudinal cohort study . Setting Health professionals in the United States . Participants 73 147 women in the Nurses ’ Health Study ( 1984 - 2012 ) and 42 635 men in the Health Professionals Follow-up Study ( 1986 - 2010 ) , who were free of major chronic diseases at baseline . Main outcome measure Incidence of coronary heart disease ( n=7035 ) was self-reported , and related deaths were identified by search ing National Death Index or through report of next of kin or postal authority . Cases were confirmed by medical records review . Results Mean intake of SFAs  accounted for 9.0 - 11.3 % energy intake over time , and was mainly composed of lauric acid ( 12:0 ) , myristic acid ( 14:0 ) , palmitic acid ( 16:0 ) , and stearic acid ( 18:0 ; 8.8 - 10.7 % energy ) . Intake of 12:0 , 14:0 , 16:0 and 18:0 were highly correlated , with Spearman correlation coefficients between 0.38 and 0.93 ( all P<0.001 ) . Comparing the highest to the lowest groups of individual SFA intakes , hazard ratios of coronary heart disease were 1.07 ( 95 % confidence interval 0.99 to 1.15 ; Ptrend=0.05 ) for 12:0 , 1.13 ( 1.05 to 1.22 ; Ptrend<0.001 ) for 14:0 , 1.18 ( 1.09 to 1.27 ; Ptrend<0.001 ) for 16:0 , 1.18 ( 1.09 to 1.28 ; Ptrend<0.001 ) for 18:0 , and 1.18 ( 1.09 to 1.28 ; Ptrend<0.001 ) for all four SFAs combined ( 12:0 - 18:0 ) , after multivariate adjustment of lifestyle factors and total energy intake . Hazard ratios of coronary heart disease for isocaloric replacement of 1 % energy from 12:0 - 18:0 were 0.92 ( 95 % confidence interval 0.89 to 0.96 ; P<0.001 ) for polyunsaturated fat , 0.95 ( 0.90 to 1.01 ; P=0.08 ) for monounsaturated fat , 0.94 ( 0.91 to 0.97 ; P<0.001 ) for whole grain carbohydrates , and 0.93 ( 0.89 to 0.97 ; P=0.001 ) for plant proteins . For individual SFAs , the lowest risk of coronary heart disease was observed when the most abundant SFA , 16:0 , was replaced . Hazard ratios of coronary heart disease for replacing 1 % energy from 16:0 were 0.88 ( 95 % confidence interval 0.81 to 0.96 ; P=0.002 ) for polyunsaturated fat , 0.92 ( 0.83 to 1.02 ; P=0.10 ) for monounsaturated fat , 0.90 ( 0.83 to 0.97 ; P=0.01 ) for whole grain carbohydrates , and 0.89 ( 0.82 to 0.97 ; P=0.01 ) for plant proteins . Conclusions Higher dietary intakes of major SFAs are associated with an increased risk of coronary heart disease . Owing to similar associations and high correlations among individual SFAs , dietary recommendations for the prevention of coronary heart disease should continue to focus on replacing total saturated fat with more healthy sources of energy Although dietary trans fatty acids can affect  plasma lipoproteins negatively in humans , no direct comparison with specific saturated fatty acids has been reported , even though trans fatty acids were design ed to replace saturates in foods and food processing . In this study , dietary trans 18:1 [ elaidic acid at 5.5 % energy ( en ) ] was specifically exchanged for cis 18:1 , 16:0 or 12:0 + 14:0 in 27 male and female subjects consuming moderate fat ( 31 % en ) , low cholesterol ( < 225 mg/d ) whole food diets  during 4-wk diet periods in a crossover design . The trans-rich fat significantly elevated total cholesterol and LDL cholesterol relative to the 16:0-rich and 18:1-rich fats and uniquely depressed HDL cholesterol relative to all of the fats tested . Trans fatty acids also elevated lipoprotein ( a ) [ Lp(a ) ] values relative to all dietary treatments . Furthermore , identical effects on lipoproteins were elicited by 16:0 and cis 18:1 in these subjects . The current results suggest that elaidic acid , one of the principal trans isomers produced during industrial hydrogenation of edible oils , adversely affects plasma lipoproteins . Thus , the negative effect of elaidic acid on the lipoprotein profile of humans appears to be unmatched by any other natural fatty acid(s ) Twenty-one healthy normocholesterolemic young adults , men and women , completed a r and omized 30-d/30-d crossover comparison of the effect of palmolein and olive oil on plasma lipids . The subjects were free-living volunteers who changed to low-fat diets  to which one of the test oils was added ( used as a spread , for baking , or for frying ) in turn . Complete food records were kept throughout : the test oils were compared at 17 % of total dietary energy . Under the conditions of this experiment plasma total and low-density-lipoprotein ( LDL ) cholesterol were almost identical with the two oils , so that when the palmitic acid ( 16:0 ) in palm oil replaced oleic acid ( 18:1 ) in olive oil the expected increase in LDL cholesterol was not seen . These results indicate that 16:0 , though saturated , is not always a plasma cholesterol-raising fatty acid . Palmolein is rich in vitamin E , alpha-tocopherol , and especially tocotrienols , but the latter were barely detectable in plasma The degree to which different saturated fatty acids exert their cholesterol-raising effects is still unknown . Therefore , we studied the effect on serum lipids and lipoproteins of diets rich in lauric , palmitic , or oleic acids .  Eighteen women and 14 men consumed in r and om order three experimental diets , each for 6 wk . The diets consisted of solid foods and contained 40 % of energy as fat , of which 28 % was supplied by the experimental fats . The fat high in lauric acid was a mixture of palm kernel oil ( 75 % ) and a high-oleic acid sunflower oil ( 25 % ) ; the fat high in palmitic acid consisted of dairy fat ( 55 % ) , palmstearin ( 36 % ) , and sunflower oil ( 9 % ) ; and the fat high in oleic acid consisted of dairy fat ( 37 % ) and sunflower oil ( 63 % ) . The calculated nutrient composition was the same in each diet except for approximately equal to 8.5 % of energy , which was provided by lauric , palmitic , or oleic acids . With the lauric acid diet the subjects ' serum total cholesterol concentration increased by 0.22 mmol/L ( P = 0.0121 ; 95 % CI : 0.02 , 0.41 mmol/L ) as compared with the palmitic acid diet and by 0.48 mmol/L ( P < 0.0001 ; 95 % CI : 0.29 , 0.67 mmol/L ) compared with the oleic acid diet .  Total cholesterol concentrations with the palmitic acid diet were 0.26 mmol/L ( P = 0.0012 ; 95 % CI : 0.07 , 0.46 mmol/L ) higher than with the oleic acid diet .  High-density-lipoprotein (HDL)-cholesterol concentrations increased by 0.12 mmol/L ( P = 0.006 ; 95 % CI : 0.04 , 0.20 mmol/L ) with the lauric acid compared with the palmitic acid diet and by 0.14 mmol/L ( P < 0.001 ; 95 % CI : 0.07 , 0.22 mmol/L ) compared with the oleic acid diet .  HDL-cholesterol concentrations with the palmitic acid and the oleic acid diet were the same . No effects were seen in serum triacylglycerol and lipoprotein(a ) concentrations . We conclude that both lauric and palmitic acids are hypercholesterolemic compared with oleic acid . Lauric acid raises total cholesterol concentrations more than palmitic acid , which is partly due to a stronger rise in HDL cholesterol The effects on serum lipids of palm oil ( PA ) used in Chinese diets were compared with those of soybean oil ( SO ) , peanut oil ( PE ) and lard ( LA ) in normocholesterolemic subjects and with that of PE in hypercholesterolemic subjects . Normocholesterolemic subjects [ 120 men , 18 - 25 y , total cholesterol ( TC ) 2.8 - 5.0 mmol/L ] were assigned to four groups to consume test diets for six consecutive weeks after a run-in period of 3 wk . About 30 % of dietary energy was derived from fat , 75 - 80 % of which came from test oils . In comparison with the entry level , the average serum TC and LDL cholesterol ( LDL-C ) were 6.7 and 13.1 % lower , respectively , in the PA group and 22.8 and 30.7 % higher , respectively , ( P < 0.05 ) in the LA group . At the end of the test , serum TC , LDL-C and the ratio of TC/HDL cholesterol ( HDL-C ) in the PA group were significantly lower than those of the LA group . Hypercholesterolemic subjects ( 31 men , 20 women , 32 - 68 y , TC 5.5 - 7.0 mmol/L ) were divided into two groups . For 6 wk , one group ( 15 men , 10 women ) consumed the PA diet ; another group ( 16 men , 9 women ) consumed the PE diet . After a 3-wk interval , the two groups interchanged diets for another 6 wk . The test diets again contained about 30 % energy from fat , 60 - 65 % of which came from test oils . Compared with entry values , the PA diet caused significant reductions in serum TC , LDL-C and TC/HDL-C during the first 6 wk and also a significant reduction in TC/HDL-C during the second 6 wk . The PE diet had no significant influence on serum lipids in either experimental period BACKGROUND Despite the high content of palmitic acid , palm olein has been shown to have a neutral effect on plasma cholesterol concentrations when compared with olive oil , which is suggested to be attributable to palmitic acid in the sn-1 and sn-3 position . In contrast , palmitic acid is in the sn-2 position in lard . OBJECTIVE The objective was to investigate the effects of a diet rich in palm olein , fractionated palm oil , olive oil , and lard on plasma blood lipids , inflammatory markers , glucose , and insulin . DESIGN A controlled double-blinded , r and omized 3 × 3 wk crossover dietary intervention study included 32 healthy men who daily replaced part of their habitual dietary fat intake with ~ 17 % of energy from palm olein , olive oil , or lard , respectively . RESULTS Compared with intake of olive oil , palm olein and lard  increased total cholesterol and LDL cholesterol ( P < 0.0001 ) . Palm olein result ed in a lower plasma triacylglycerol concentration than did olive oil ( P < 0.01 ) . No difference in effects was observed in plasma HDL-cholesterol , high-sensitivity C-reactive protein , plasminogen activator-1 , insulin , and glucose concentrations . CONCLUSIONS The current study did not support the previous finding that the effect of palm olein on total plasma cholesterol and LDL cholesterol in healthy individuals with normal plasma cholesterol concentrations is neutral compared with that of olive oil . Thus , sn-positioning was not confirmed to be important with regard to the effect on plasma cholesterol . The relatively lower plasma triacylglycerol concentration  after the palm olein diet than after the olive oil diet was unexpected . This trial is registered at clinical trials.gov as NCT00743301 The cholesterol-raising effect of dietary saturated fatty acids is largely accounted for by lauric , myristic , and palmitic acids . Dairy fat is a major source of myristic acid , and palm oil is especially rich in pal 
    Output:
    