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: Blood pressure was measured in the prospect i ve r and omized Special Turku Coronary Risk Factor Intervention Project Study with an oscillometric method every year from 7 months to 15 years of age in 540 children receiving a low-saturated-fat , low-cholesterol diet and in 522 control children . Dietary intakes , family history of parental hypertension , and gr and parental vascular disease were recorded . Systolic and diastolic blood pressures were 1.0 mm Hg lower ( 95 % CI for systolic : −1.7 to −0.2 mm Hg ; 95 % CI for diastolic : −1.5 to −0.4 mm Hg ) in children receiving low-saturated-fat counseling through childhood than in control children . Intakes of saturated fat  were lower ( P<0.001 ) , those of  polyunsaturated fat  higher ( P<0.001 ) , and intakes of potassium  slightly higher ( P=0.002 ) in the intervention group , but sodium intakes were not influenced by the intervention ( P=0.76 ) . Children whose parents were hypertensive had 4- to 6-mm Hg higher systolic and 3- to 4-mm Hg higher diastolic blood pressures than children of normotensive parents ( P<0.001 ) . Diastolic blood pressure of children with gr and  parental vascular disease , ie , early cardiovascular or cerebrovascular disease , tended to be higher than that of children with no gr and parental disease ( P=0.051 ) . We conclude that restriction of saturated fat from infancy until 15 years of age decreases childhood and adolescent blood pressure with a meaningful population -attributable amount . The importance of childhood lifestyle counseling and primary prevention of hypertension should be emphasized , especially in those children with a family history of hypertension or atherosclerotic vascular disease PURPOSE To examine the feasibility and efficacy of a theory-driven and family-based program delivered online to promote healthy lifestyles and weights in Chinese American adolescents . METHODS A r and omized controlled study of a web-based intervention was developed and conducted in 54 Chinese American adolescents ( ages , 12 - 15 years ) and their families .  Data on anthropometry , blood pressure , dietary intake , physical activity , and knowledge and self-efficacy regarding physical activity and nutrition were collected at baseline and 2 , 6 , and 8 months after the baseline assessment . Data were analyzed using linear mixed modeling . RESULTS The intervention result ed in significant decreases in waist-to-hip ratio and diastolic blood pressure and increases in vegetable and fruit intake , level of physical activity , and knowledge about physical activity and nutrition . CONCLUSION This web-based behavior program for Chinese American adolescents and their families seems feasible and effective in the short-term . Long-term effects remain to be determined . This type of program can be adapted for other minority ethnic groups who are at high-risk for overweight and obesity and have limited access to programs that promote healthy lifestyles Social support experiences vary markedly across gender groups , and little is known about the role of social support in promoting healthy dietary compliance in African American adolescents who are at increased risk for developing hypertension . This study examined the relation between gender , dietary social support  , and compliance to a low sodium diet .  Casual blood pressures were also examined in relation to dietary compliance and gender . One hundred eighty-four healthy African American adolescents ( 83 boys , 101 girls ) participated in an intensive 5-day low sodium diet ( 50 mEq/24 hr ) as part of a hypertension prevention program . Emotional dietary social support from family members and friends was measured at baseline . Compliance was defined as urinary sodium excretion of≤ 50 mEq/24 hr at postsodium restriction . The results indicated a significant Gender × Compliance effect for positive family support ( p > .05 ) . Girls who were compliant reported higher levels of dietary support from family members ( 19.2 ± 7.8 ) than boys who were compliant ( 16.9 ± 7.0 ) . In contrast , boys who were compliant reported lower levels of dietary support from family members ( 16.9 ± 7.0 ) than boys who were not compliant ( 20.2 ± 7.5 ) . Systolic blood pressure showed a trend toward decreasing in compliant participants ( 104.4 ± 8.4 vs. 101.7 ± 8.0 , mm Hg , p > .06 ) , but the effect diminished when Quetelet Index ( kg/m2 ) was controlled for in the analyses ( p > .12 ) . These results suggest that higher levels of emotional dietary support from family members are associated with better adherence to short-term sodium restriction for African American girls as compared to boys . Further research is needed to determine the long-term impact of social support on sodium restriction in adolescent population Objective This study investigated the effects of moderate doses of caffeine on ambulatory blood pressure and heart rate , urinary excretion of epinephrine , norepinephrine , and cortisol , and subjective measures of stress during normal activities at work and at home in the evening . Methods Healthy , nonsmoking , habitual coffee drinkers ( N = 47 ) participated in 3 days of ambulatory study . After a day of ad lib caffeine consumption , caffeine ( 500 mg ) and placebo were administered double-blind in counter-balanced order on separate workdays . Ambulatory blood pressure and heart rate were monitored from the start of the workday until bedtime . Urinary excretion of catecholamines and cortisol was assessed during the workday and evening . Results Caffeine administration significantly raised average ambulatory blood pressure during the workday and evening by 4/3 mm Hg and reduced average heart rate by 2 bpm . Caffeine also increased by 32 % the levels of free epinephrine excreted during the workday and the evening . In addition , caffeine amplified the increases in blood pressure and heart rate associated with higher levels of self-reported stress during the activities of the day . Effects were undiminished through the evening until bedtime . Conclusions Caffeine has significant hemodynamic and humoral effects in habitual coffee drinkers that persist for many hours during the activities of everyday life . Furthermore , caffeine may exaggerate sympathetic adrenal-medullary responses to the stressful events of normal daily life . Repeated daily blood pressure elevations and increases in stress reactivity caused by caffeine consumption could contribute to an increased risk of coronary heart disease in the adult population BACKGROUND Some observational studies have shown a beneficial effect of dairy consumption on blood pressure , especially in overweight and relatively young ( < 40 y ) persons . However , no results from prospect i ve studies conducted in a free-living population exist that show this association in middle-aged adults . OBJECTIVE The aim of the present study was to assess whether total , low-fat , and whole-fat dairy consumption was associated prospect ively with the risk of hypertension . DESIGN This was a prospect i ve study conducted in 5880 university graduates in Spain , aged > 20 y in 2000 ( mean age : 37 y ) , free of hypertension and cardiovascular disease at baseline , and followed-up with mailed question naires for a median of 27 mo .  Dairy consumption was assessed with a previously vali date d semiquantitative food-frequency question naire . RESULTS One hundred eighty new cases of hypertension were identified . The hazard ratio of hypertension between extreme quintiles of low-fat dairy product consumption was 0.46 ( 95 % CI : 0.26 , 0.84 ; P for trend = 0.02 ) after adjustment for the main known risk factors for hypertension and several dietary factors . No significant association between  whole-fat dairy products or total calcium intake and incident hypertension was seen . CONCLUSION In this Mediterranean cohort , low-fat dairy consumption , but not whole-fat dairy consumption , was associated with a lower risk of incident hypertension BACKGROUND Epidemiologic and experimental studies suggest that higher intake of dairy products could be associated with lower risk of hypertension and obesity . Differences in nutrient composition of distinct dairy products suggest that their effect on these outcomes might be heterogeneous . However , little experimental research has examined the potentially different effects of low- and whole-fat dairy products on blood pressure ( BP ) and weight change . The present study aim ed to assess whether supplementing diets with low- or whole-fat dairy products would differentially affect BP levels and weight . METHODS A r and omised crossover trial in 45 normotensive volunteers ( 18 - 24 years old , 49 % female ) was conducted . Participants alternatively received 3.5 servings/day of whole-fat or low-fat dairy products ( milk and yogurt ) in addition to their usual diet during two 8-week periods , with a 4-week washout period between both interventions . Weight and BP were measured at the beginning and end of each intervention . RESULTS Whole-fat dairy supplementation significantly increased systolic BP [ 2.1 mmHg , 95 % confidence interval ( CI ) = 0.1 - 4.0 , P = 0.04 ] and weight ( 1.0 kg , 95 % CI = 0.5 - 1.5 , P = 0.0002 ) , but not diastolic BP ( P = 0.34 ) . Weight and BP did not change significantly after the low-fat dairy intervention ( P > 0.10 ) . There were no significant differences in the effect of low-fat or whole-fat dairy products on BP ( P > 0.60 ) , but whole-fat dairy increased weight significantly compared to low-fat dairy ( 1.2 kg , 95 % CI = 0.5 - 1.8 , P = 0.0007 ) . CONCLUSIONS In a young nonhypertensive population , dietary supplementation with whole-fat dairy products , compared to low-fat dairy , was associated with weight gain . No differential effects were observed for levels of BP BACKGROUND The effect of dietary composition on blood pressure is a subject of public health importance . We studied the effect of different levels of dietary sodium , in conjunction with the Dietary Approaches to Stop Hypertension ( DASH ) diet , which is rich in vegetables , fruits , and low-fat dairy products , in persons with and in those without hypertension . METHODS A total of 412 participants were r and omly assigned to eat either a control diet typical of intake in the United States or the DASH diet . Within the assigned diet , participants ate foods with high , intermediate , and low levels of sodium for 30 consecutive days each , in r and om order . RESULTS Reducing the sodium intake from the high to the intermediate level reduced the systolic blood pressure by 2.1 mm Hg ( P<0.001 ) during the control diet and by 1.3 mm Hg ( P=0.03 ) during the DASH diet . Reducing the sodium intake from the intermediate to the low level caused additional reductions of 4.6 mm Hg during the control diet ( P<0.001 ) and 1.7 mm Hg during the DASH diet ( P<0.01 ) . The effects of sodium were observed in participants with and in those without hypertension , blacks and those of other races , and women and men . The DASH diet was associated with a significantly lower systolic blood pressure at each sodium level ; and the difference was greater with high sodium levels than with low ones . As compared with the control diet with a high sodium level , the DASH diet with a low sodium level led to a mean systolic blood pressure that was 7.1 mm Hg lower in participants without hypertension , and 11.5 mm Hg lower in participants with hypertension . CONCLUSIONS The reduction of sodium intake to levels below the current recommendation of 100 mmol per day and the DASH diet both lower blood pressure substantially , with greater effects in combination than singly . Long-term health benefits will depend on the ability of people to make long-lasting dietary changes and the increased availability of lower-sodium foods OBJECTIVE African-American adolescents are twice as likely to develop hypertension in early adulthood than adolescents from other racial groups . The purpose of this study was to determine the efficacy of a school-based health promotion intervention . METHOD Participants were African-American adolescents aged between 14 and 17 years attending an urban high school . The 9-week intervention program focused on the participants ' knowledge , diet , exercise , and blood pressure . CONCLUSIONS The intervention program was efficacious in knowledge ( p = .0001 ) , exercise ( p = .0001 ) , as well as fruit and vegetable intake ( p = .0001 ) . Differences in systolic ( p = .5548 ) and diastolic ( p = .9719 ) blood pressure levels were not significant BACKGROUND Despite data relating body size in early life to later cardiovascular outcomes , the hypothesis that nutrition affects such outcomes has not been established . Breastfeeding has been associated with lower blood pressure in later life , but previous studies have not controlled for possible confounding factors by using a r and omised design with prospect i ve follow-up . We undertook such a study to test the hypothesis that early diet programmes blood pressure in later life in children r and omly assigned different diets at birth . METHODS Blood pressure was measured at age 13 - 16 years in 216 ( 23 % ) of a cohort of 926 children who were born prematurely and had participated at birth in two parallel r and omised trials in five neonatal units in the UK . Diet 
    Output:
    
agent
Results of the analysis indicated that increased consumption of unsaturated fats , fruits , vegetables and low-fat dietary products  , decreased consumption of dietary sodium and beverages containing caffeine , and breastfeeding were found to have preventive effects against high blood pressure in later years of life .
The effects of training given during youth to encourage a healthy lifestyle and behavior changes based on diet and physical activity were also noted
***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: Blood pressure was measured in the prospect i ve r and omized Special Turku Coronary Risk Factor Intervention Project Study with an oscillometric method every year from 7 months to 15 years of age in 540 children receiving a low-saturated-fat , low-cholesterol diet and in 522 control children . Dietary intakes , family history of parental hypertension , and gr and parental vascular disease were recorded . Systolic and diastolic blood pressures were 1.0 mm Hg lower ( 95 % CI for systolic : −1.7 to −0.2 mm Hg ; 95 % CI for diastolic : −1.5 to −0.4 mm Hg ) in children receiving low-saturated-fat counseling through childhood than in control children . Intakes of saturated fat  were lower ( P<0.001 ) , those of  polyunsaturated fat  higher ( P<0.001 ) , and intakes of potassium  slightly higher ( P=0.002 ) in the intervention group , but sodium intakes were not influenced by the intervention ( P=0.76 ) . Children whose parents were hypertensive had 4- to 6-mm Hg higher systolic and 3- to 4-mm Hg higher diastolic blood pressures than children of normotensive parents ( P<0.001 ) . Diastolic blood pressure of children with gr and  parental vascular disease , ie , early cardiovascular or cerebrovascular disease , tended to be higher than that of children with no gr and parental disease ( P=0.051 ) . We conclude that restriction of saturated fat from infancy until 15 years of age decreases childhood and adolescent blood pressure with a meaningful population -attributable amount . The importance of childhood lifestyle counseling and primary prevention of hypertension should be emphasized , especially in those children with a family history of hypertension or atherosclerotic vascular disease PURPOSE To examine the feasibility and efficacy of a theory-driven and family-based program delivered online to promote healthy lifestyles and weights in Chinese American adolescents . METHODS A r and omized controlled study of a web-based intervention was developed and conducted in 54 Chinese American adolescents ( ages , 12 - 15 years ) and their families .  Data on anthropometry , blood pressure , dietary intake , physical activity , and knowledge and self-efficacy regarding physical activity and nutrition were collected at baseline and 2 , 6 , and 8 months after the baseline assessment . Data were analyzed using linear mixed modeling . RESULTS The intervention result ed in significant decreases in waist-to-hip ratio and diastolic blood pressure and increases in vegetable and fruit intake , level of physical activity , and knowledge about physical activity and nutrition . CONCLUSION This web-based behavior program for Chinese American adolescents and their families seems feasible and effective in the short-term . Long-term effects remain to be determined . This type of program can be adapted for other minority ethnic groups who are at high-risk for overweight and obesity and have limited access to programs that promote healthy lifestyles Social support experiences vary markedly across gender groups , and little is known about the role of social support in promoting healthy dietary compliance in African American adolescents who are at increased risk for developing hypertension . This study examined the relation between gender , dietary social support  , and compliance to a low sodium diet .  Casual blood pressures were also examined in relation to dietary compliance and gender . One hundred eighty-four healthy African American adolescents ( 83 boys , 101 girls ) participated in an intensive 5-day low sodium diet ( 50 mEq/24 hr ) as part of a hypertension prevention program . Emotional dietary social support from family members and friends was measured at baseline . Compliance was defined as urinary sodium excretion of≤ 50 mEq/24 hr at postsodium restriction . The results indicated a significant Gender × Compliance effect for positive family support ( p > .05 ) . Girls who were compliant reported higher levels of dietary support from family members ( 19.2 ± 7.8 ) than boys who were compliant ( 16.9 ± 7.0 ) . In contrast , boys who were compliant reported lower levels of dietary support from family members ( 16.9 ± 7.0 ) than boys who were not compliant ( 20.2 ± 7.5 ) . Systolic blood pressure showed a trend toward decreasing in compliant participants ( 104.4 ± 8.4 vs. 101.7 ± 8.0 , mm Hg , p > .06 ) , but the effect diminished when Quetelet Index ( kg/m2 ) was controlled for in the analyses ( p > .12 ) . These results suggest that higher levels of emotional dietary support from family members are associated with better adherence to short-term sodium restriction for African American girls as compared to boys . Further research is needed to determine the long-term impact of social support on sodium restriction in adolescent population Objective This study investigated the effects of moderate doses of caffeine on ambulatory blood pressure and heart rate , urinary excretion of epinephrine , norepinephrine , and cortisol , and subjective measures of stress during normal activities at work and at home in the evening . Methods Healthy , nonsmoking , habitual coffee drinkers ( N = 47 ) participated in 3 days of ambulatory study . After a day of ad lib caffeine consumption , caffeine ( 500 mg ) and placebo were administered double-blind in counter-balanced order on separate workdays . Ambulatory blood pressure and heart rate were monitored from the start of the workday until bedtime . Urinary excretion of catecholamines and cortisol was assessed during the workday and evening . Results Caffeine administration significantly raised average ambulatory blood pressure during the workday and evening by 4/3 mm Hg and reduced average heart rate by 2 bpm . Caffeine also increased by 32 % the levels of free epinephrine excreted during the workday and the evening . In addition , caffeine amplified the increases in blood pressure and heart rate associated with higher levels of self-reported stress during the activities of the day . Effects were undiminished through the evening until bedtime . Conclusions Caffeine has significant hemodynamic and humoral effects in habitual coffee drinkers that persist for many hours during the activities of everyday life . Furthermore , caffeine may exaggerate sympathetic adrenal-medullary responses to the stressful events of normal daily life . Repeated daily blood pressure elevations and increases in stress reactivity caused by caffeine consumption could contribute to an increased risk of coronary heart disease in the adult population BACKGROUND Some observational studies have shown a beneficial effect of dairy consumption on blood pressure , especially in overweight and relatively young ( < 40 y ) persons . However , no results from prospect i ve studies conducted in a free-living population exist that show this association in middle-aged adults . OBJECTIVE The aim of the present study was to assess whether total , low-fat , and whole-fat dairy consumption was associated prospect ively with the risk of hypertension . DESIGN This was a prospect i ve study conducted in 5880 university graduates in Spain , aged > 20 y in 2000 ( mean age : 37 y ) , free of hypertension and cardiovascular disease at baseline , and followed-up with mailed question naires for a median of 27 mo .  Dairy consumption was assessed with a previously vali date d semiquantitative food-frequency question naire . RESULTS One hundred eighty new cases of hypertension were identified . The hazard ratio of hypertension between extreme quintiles of low-fat dairy product consumption was 0.46 ( 95 % CI : 0.26 , 0.84 ; P for trend = 0.02 ) after adjustment for the main known risk factors for hypertension and several dietary factors . No significant association between  whole-fat dairy products or total calcium intake and incident hypertension was seen . CONCLUSION In this Mediterranean cohort , low-fat dairy consumption , but not whole-fat dairy consumption , was associated with a lower risk of incident hypertension BACKGROUND Epidemiologic and experimental studies suggest that higher intake of dairy products could be associated with lower risk of hypertension and obesity . Differences in nutrient composition of distinct dairy products suggest that their effect on these outcomes might be heterogeneous . However , little experimental research has examined the potentially different effects of low- and whole-fat dairy products on blood pressure ( BP ) and weight change . The present study aim ed to assess whether supplementing diets with low- or whole-fat dairy products would differentially affect BP levels and weight . METHODS A r and omised crossover trial in 45 normotensive volunteers ( 18 - 24 years old , 49 % female ) was conducted . Participants alternatively received 3.5 servings/day of whole-fat or low-fat dairy products ( milk and yogurt ) in addition to their usual diet during two 8-week periods , with a 4-week washout period between both interventions . Weight and BP were measured at the beginning and end of each intervention . RESULTS Whole-fat dairy supplementation significantly increased systolic BP [ 2.1 mmHg , 95 % confidence interval ( CI ) = 0.1 - 4.0 , P = 0.04 ] and weight ( 1.0 kg , 95 % CI = 0.5 - 1.5 , P = 0.0002 ) , but not diastolic BP ( P = 0.34 ) . Weight and BP did not change significantly after the low-fat dairy intervention ( P > 0.10 ) . There were no significant differences in the effect of low-fat or whole-fat dairy products on BP ( P > 0.60 ) , but whole-fat dairy increased weight significantly compared to low-fat dairy ( 1.2 kg , 95 % CI = 0.5 - 1.8 , P = 0.0007 ) . CONCLUSIONS In a young nonhypertensive population , dietary supplementation with whole-fat dairy products , compared to low-fat dairy , was associated with weight gain . No differential effects were observed for levels of BP BACKGROUND The effect of dietary composition on blood pressure is a subject of public health importance . We studied the effect of different levels of dietary sodium , in conjunction with the Dietary Approaches to Stop Hypertension ( DASH ) diet , which is rich in vegetables , fruits , and low-fat dairy products , in persons with and in those without hypertension . METHODS A total of 412 participants were r and omly assigned to eat either a control diet typical of intake in the United States or the DASH diet . Within the assigned diet , participants ate foods with high , intermediate , and low levels of sodium for 30 consecutive days each , in r and om order . RESULTS Reducing the sodium intake from the high to the intermediate level reduced the systolic blood pressure by 2.1 mm Hg ( P<0.001 ) during the control diet and by 1.3 mm Hg ( P=0.03 ) during the DASH diet . Reducing the sodium intake from the intermediate to the low level caused additional reductions of 4.6 mm Hg during the control diet ( P<0.001 ) and 1.7 mm Hg during the DASH diet ( P<0.01 ) . The effects of sodium were observed in participants with and in those without hypertension , blacks and those of other races , and women and men . The DASH diet was associated with a significantly lower systolic blood pressure at each sodium level ; and the difference was greater with high sodium levels than with low ones . As compared with the control diet with a high sodium level , the DASH diet with a low sodium level led to a mean systolic blood pressure that was 7.1 mm Hg lower in participants without hypertension , and 11.5 mm Hg lower in participants with hypertension . CONCLUSIONS The reduction of sodium intake to levels below the current recommendation of 100 mmol per day and the DASH diet both lower blood pressure substantially , with greater effects in combination than singly . Long-term health benefits will depend on the ability of people to make long-lasting dietary changes and the increased availability of lower-sodium foods OBJECTIVE African-American adolescents are twice as likely to develop hypertension in early adulthood than adolescents from other racial groups . The purpose of this study was to determine the efficacy of a school-based health promotion intervention . METHOD Participants were African-American adolescents aged between 14 and 17 years attending an urban high school . The 9-week intervention program focused on the participants ' knowledge , diet , exercise , and blood pressure . CONCLUSIONS The intervention program was efficacious in knowledge ( p = .0001 ) , exercise ( p = .0001 ) , as well as fruit and vegetable intake ( p = .0001 ) . Differences in systolic ( p = .5548 ) and diastolic ( p = .9719 ) blood pressure levels were not significant BACKGROUND Despite data relating body size in early life to later cardiovascular outcomes , the hypothesis that nutrition affects such outcomes has not been established . Breastfeeding has been associated with lower blood pressure in later life , but previous studies have not controlled for possible confounding factors by using a r and omised design with prospect i ve follow-up . We undertook such a study to test the hypothesis that early diet programmes blood pressure in later life in children r and omly assigned different diets at birth . METHODS Blood pressure was measured at age 13 - 16 years in 216 ( 23 % ) of a cohort of 926 children who were born prematurely and had participated at birth in two parallel r and omised trials in five neonatal units in the UK . Diet 
    Output:
    