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 study the prevalence of hypovitaminosis D , the effect of vitamin D supplementation on serum 25-hydroxyvitamin D [ S-25(OH)D ] , and the intakes of vitamin D and calcium in Finnish 9− to 15-year-old athletic and nonathletic girls . Design : 1-year follow-up study ( February 1997-March 1998 ) with three months of vitamin D supplementation ( 10 μg/d ) from October to January . Setting : Turku University Central Hospital , Finl and .Subjects : 191 female volunteers aged 9–15 y ( 131 athletes and 60 controls ) . Methods :  Vitamin D and calcium intakes were estimated by a four-day food recording and a semi-quantitative food frequency question naire ( FFQ ) . S-25(OH)D was followed by radioimmunoassay ( RIA ) . Results : At baseline the mean S-25(OH)D concentration was 33.9 nmol/l among all girls . In winter severe hypovitaminosis D ( S-25(OH)D<20 nmol/l ) occurred in 13.4 % of the participants and in 67.7 % S-25(OH)D was below 37.5 nmol/l . By the next summer the mean S-25(OH)D concentration was 62.9 nmol/l and in 1.6 % of the subjects it was below 37.5 nmol/l . The prevalence of severe hypovitaminosis D was not significantly reduced by three months of vitamin D ( 10 μg/d ) supplementation . At baseline , the mean intake of vitamin  D was 2.9 μg/d by food recording and 4.3 μg/d by FFQ . The mean calcium intake was 1256 mg/d and 1580 mg/d , respectively . The intakes of vitamin D and calcium remained unchanged during the follow-up period . The athletes consumed more calcium than nonathletic controls , whereas the intake of vitamin D was quite similar among both groups . The vitamin D intake by FFQ correlated with the S-25(OH)D concentration in wintertime ( r=0.28 , P<0.01 ) . Conclusion : Hypovitaminosis D is fairly common in growing Finnish girls in the wintertime , and three months of vitamin D supplementation with 10 μg/d was insufficient in preventing hypovitaminosis D. The daily dietary vitamin D intake was insufficient ( < 5 μg/d ) in the majority of participants , while the calcium intake was usually sufficient . Sponsorship : Supported by the Yrjö Jahnsson Foundation , The Turku University Foundation , and the Medical Research Foundation of the Turku University Central Hospital The hypothesis that breastfed infants in Beijing , China , have low vitamin D status and that sunshine exposure increases serum 25-hydroxyvitamin D ( 25-OHD ) concentrations was tested in a r and omized prospect i ve study involving 42 healthy infants 1 - 8 months of age . 24 controls were exposed to the usual amount of sunshine , while the 18 cases were provided with 2 hours of sunshine/day . All infants were being breastfed without vitamin D supplementation .  Serum 25-OHD concentrations at entry into the study ranged from 3 - 61 ng/ml and increased with age . 3 infants in each group were diagnosed as having rickets . Serum 25-OHD concentrations did not change significantly during the 2-month study period among controls , while serum 25-OHD values increased significantly in the experimental group . Final infant serum 25-OHD concentrations correlated with ultraviolet exposure scores ( p.001 ) . The estimate of ultraviolet score needed to maintain a serum 25-OHD of 11 ng/ml was 2.4 ( 24 minutes/day with only the face uncovered ) . Rickets has been reported in as many as 18 % of Chinese infants and seems to especially affect those 2 - 4 months of age . The fact that not all infants with rickets in this study had low 25-OHD concentrations suggests 2 possibilities : 1 ) not all rickets is necessarily related to a vitamin D deficiency , or 2 ) serum 25-OHD concentrations are not the best indicator of vitamin D status . The low serum 25-OHD concentrations in many Chinese infants may be related to low maternal milk vitamin D content result ing from the lack of vitamin D food fortification . Overall , these results suggest that the diet of breastfed Chinese infants should be supplemented with orally administered vitamin A 14-y follow-up of 581 children who took part in a r and omized controlled trial of the effect of a milk supplement on growth of children was conducted to investigate the supplement 's effect on adult bone mineral content ( BMC ) and density ( BMD ) . BMC and BMD of the nondominant forearm were measured by single-photon absorptiometry in 371 subjects ( 64 % ) aged 20 - 23 y , at a proximal site ( shaft of radius and ulna ) and at a distal site near the wrist .  BMC s and BMDs tended to be higher in the intervention group ( NS ) . Cross-sectionally , BMD was positively associated with body weight ( P less than 0.01 ) in both sexes ; inversely associated with alcohol consumption ( P less than 0.05 ) , and positively with manual occupation ( NS ) in men ; positively associated with current intakes of calcium ( P less than 0.05 ) , vitamin D ( P less than 0.01 ) , and sports activity during adolescence ( P less than 0.01 ) , and inversely with parity ( NS ) in women . In multiple linear-regression analysis body weight and sports activity during adolescence were stronger determinants of female BMD than was diet New Zeal and children , particularly those of Māori and Pacific ethnicity , may be at risk for low vitamin D status because of low vitamin D intakes , the country 's latitude ( 35 - 46 degrees S ) , and skin color . The aim of this study was to determine 25-hydroxyvitamin D concentrations and their determinants in a national sample of New Zeal and children aged 5 - 14 y. The 2002 National Children 's Nutrition Survey was design ed to survey New Zeal and children , including oversampling of Māori and Pacific children to allow ethnic-specific analyses . A 2-stage recruitment process occurred using a r and om selection of schools , and children within each school .  Serum 25-hydroxyvitamin D concentration [ mean ( 99 % CI ) nmol/L ] in Māori children ( n = 456 ) was 43 ( 38,49 ) , in Pacific ( n = 646 ) 36 ( 31,42 ) , and in New Zeal and European and Others ( NZEO ) ( n = 483 ) 53 ( 47,59 ) . Among Māori , Pacific , and NZEO , the prevalence ( % , 99 % CI ) of serum 25-hydroxyvitamin D deficiency ( < 17.5 nmol/L ) was 5 ( 2,12 ) , 8 ( 5,14 ) , and 3 ( 1,7 ) , respectively . The prevalence of insufficiency ( < 37.5 nmol/L ) was 41 ( 29,53 ) , 59 ( 42,75 ) , and 25 ( 15,35 ) , respectively . Multiple regression analysis found that 25-hydroxyvitamin D concentrations were lower in winter than summer [ adjusted mean difference ( 99 % CI ) nmol/L ; 15 ( 8,22 ) ] , lower in girls than boys [ 5 ( 1,10 ) ] , and lower in obese children than in those of " normal " weight [ 6 ( 1,11 ) ] . Relative to NZEO , 25-hydroxyvitamin D concentrations were lower in Māori [ 9 ( 3,15 ) ] and Pacific children [ 16 ( 10,22 ) ] . Ethnicity and season are major determinants of serum 25-hydroxyvitamin D. There is a high prevalence of vitamin D insufficiency in New Zeal and children , which may or may not contribute to increased risk of osteoporosis and other chronic disease . There is a pressing need for more convincing evidence concerning the health risks associated with the low  vitamin D status in New Zeal and children BACKGROUND Little is known about the relative effectiveness of calcium supplementation from food or pills with or without vitamin D supplementation for bone mass accrual during the rapid growth period . OBJECTIVE The purpose was to examine the effects of both food-based and pill supplements of calcium and vitamin D on bone mass and body composition  in girls aged 10 - 12 y. DESIGN This placebo-controlled intervention trial r and omly assigned 195 healthy girls at Tanner stage I-II , aged 10 - 12 y , with dietary calcium intakes < 900 mg/d to 1 of 4 groups : calcium ( 1000 mg ) + vitamin D3 ( 200 IU ) , calcium ( 1000 mg ) , cheese ( 1000 mg calcium ) , and placebo . Primary outcomes were bone indexes of the hip , spine , and whole body by dual-energy X-ray absorptiometry and of the radius and tibia by peripheral quantitative computed tomography . RESULTS With the use of intention-to-treat or efficacy analysis , calcium supplementation with cheese result ed in a higher percentage change in cortical thickness of the tibia than did placebo , calcium , or calcium + vitamin D treatment ( P = 0.01 , 0.038 , and 0.004 , respectively ) and in higher whole-body bone mineral density than did placebo treatment ( P = 0.044 ) when compliance was > 50 % . With the use of a hierarchical linear model with r and om effects to control for growth velocity , these differences disappeared . CONCLUSIONS Increasing calcium intake by consuming cheese appears to be more beneficial for cortical bone mass accrual than the consumption of tablets containing a similar amount of calcium . Diverse patterns of growth velocity may mask the efficacy of supplementation in a short-term trial of children transiting through puberty ABSTRACT . Fifty‐one healthy prepubertal schoolchildren were followed for 13 months in a double blind study . Twenty‐four of them were supplemented with 400 IU of vitamin D2 5–7 times weekly , while 27 received a placebo . The children were examined in winter both at the beginning and at the end of the study , and in the middle of the study in autumn . Mean 25‐hydroxyvitamin D levels in the supplemented group were significantly higher than those in the placebo group both in autumn and in winter , when the study ended . The vitamin D supplementation did not , however , affect other vitamin D metabolites , serum calcium , albumin , inorganic phosphorus , parathyroid hormone concentrations or alkaline phosphatase activity . Moreover , the supplementation caused no alterations in the weight or height gain or bone mineral content of the distal radius of the children , and thus sub clinical rickets could not be shown The objective of this study was to determine whether vitamin D supplementation of breast-fed infants during the first year of life is associated with greater bone mineral content and /or areal bone mineral density ( aBMD ) in later childhood . The design was a retrospective cohort study . One hundred and six healthy prepubertal Caucasian girls ( median age , 8 yr ; range , 7 - 9 yr ) were classified as vitamin D supplemented or unsupplemented during the first year of life on the basis of a question naire sent to participating families and their pediatricians . Bone area ( square centimeters ) and bone mineral content ( grams ) were determined by dual energy x-ray absorptiometry at six skeletal sites . Vitamin D receptor ( VDR ) 3'-gene polymorphisms ( BsmI ) were also determined . The supplemented ( n = 91 ) and unsupplemented ( n = 15 ) groups were similar in terms of season of birth , growth in the first year of life , age , anthropometric parameters , and calcium intake at time of dual energy x-ray absorptiometry . The supplemented group had higher aBMD at the level of radial metaphysis ( mean + /- SEM , 0.301+/-0.003 vs. 0.283+/-0.008 ; P = 0.03 ) , femoral neck ( 0.638+/-0.007 vs. 0.584+/-0.021 ; P = 0.01 ) , and femoral trochanter ( 0.508+/-0.006 vs. 0.474+/-0.016 ; P = 0.04 ) . At the lumbar spine level aBMD values were similar ( 0.626+/-0.006 vs. 0.598+/-0.019 ; P = 0.1 ) . In a multiple regression model taking into account the effects of vitamin D supplementation , height , and VDR genotype on aBMD ( dependent variable ) , femoral neck aBMD remained higher by 0.045 g/cm2 in the supplemented group ( P = 0.02 ) . Vitamin D supplementation in infancy was found to be associated with increased aBMD at specific skeletal sites later in childhood in prepubertal Caucasian girls 
    Output:
    
agent
Vitamin D supplementation had no statistically significant effects on total body bone mineral content or on bone mineral density of the hip or forearm .
It is unlikely that vitamin D supplements are beneficial in children and adolescents with normal vitamin D levels .
***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 study the prevalence of hypovitaminosis D , the effect of vitamin D supplementation on serum 25-hydroxyvitamin D [ S-25(OH)D ] , and the intakes of vitamin D and calcium in Finnish 9− to 15-year-old athletic and nonathletic girls . Design : 1-year follow-up study ( February 1997-March 1998 ) with three months of vitamin D supplementation ( 10 μg/d ) from October to January . Setting : Turku University Central Hospital , Finl and .Subjects : 191 female volunteers aged 9–15 y ( 131 athletes and 60 controls ) . Methods :  Vitamin D and calcium intakes were estimated by a four-day food recording and a semi-quantitative food frequency question naire ( FFQ ) . S-25(OH)D was followed by radioimmunoassay ( RIA ) . Results : At baseline the mean S-25(OH)D concentration was 33.9 nmol/l among all girls . In winter severe hypovitaminosis D ( S-25(OH)D<20 nmol/l ) occurred in 13.4 % of the participants and in 67.7 % S-25(OH)D was below 37.5 nmol/l . By the next summer the mean S-25(OH)D concentration was 62.9 nmol/l and in 1.6 % of the subjects it was below 37.5 nmol/l . The prevalence of severe hypovitaminosis D was not significantly reduced by three months of vitamin D ( 10 μg/d ) supplementation . At baseline , the mean intake of vitamin  D was 2.9 μg/d by food recording and 4.3 μg/d by FFQ . The mean calcium intake was 1256 mg/d and 1580 mg/d , respectively . The intakes of vitamin D and calcium remained unchanged during the follow-up period . The athletes consumed more calcium than nonathletic controls , whereas the intake of vitamin D was quite similar among both groups . The vitamin D intake by FFQ correlated with the S-25(OH)D concentration in wintertime ( r=0.28 , P<0.01 ) . Conclusion : Hypovitaminosis D is fairly common in growing Finnish girls in the wintertime , and three months of vitamin D supplementation with 10 μg/d was insufficient in preventing hypovitaminosis D. The daily dietary vitamin D intake was insufficient ( < 5 μg/d ) in the majority of participants , while the calcium intake was usually sufficient . Sponsorship : Supported by the Yrjö Jahnsson Foundation , The Turku University Foundation , and the Medical Research Foundation of the Turku University Central Hospital The hypothesis that breastfed infants in Beijing , China , have low vitamin D status and that sunshine exposure increases serum 25-hydroxyvitamin D ( 25-OHD ) concentrations was tested in a r and omized prospect i ve study involving 42 healthy infants 1 - 8 months of age . 24 controls were exposed to the usual amount of sunshine , while the 18 cases were provided with 2 hours of sunshine/day . All infants were being breastfed without vitamin D supplementation .  Serum 25-OHD concentrations at entry into the study ranged from 3 - 61 ng/ml and increased with age . 3 infants in each group were diagnosed as having rickets . Serum 25-OHD concentrations did not change significantly during the 2-month study period among controls , while serum 25-OHD values increased significantly in the experimental group . Final infant serum 25-OHD concentrations correlated with ultraviolet exposure scores ( p.001 ) . The estimate of ultraviolet score needed to maintain a serum 25-OHD of 11 ng/ml was 2.4 ( 24 minutes/day with only the face uncovered ) . Rickets has been reported in as many as 18 % of Chinese infants and seems to especially affect those 2 - 4 months of age . The fact that not all infants with rickets in this study had low 25-OHD concentrations suggests 2 possibilities : 1 ) not all rickets is necessarily related to a vitamin D deficiency , or 2 ) serum 25-OHD concentrations are not the best indicator of vitamin D status . The low serum 25-OHD concentrations in many Chinese infants may be related to low maternal milk vitamin D content result ing from the lack of vitamin D food fortification . Overall , these results suggest that the diet of breastfed Chinese infants should be supplemented with orally administered vitamin A 14-y follow-up of 581 children who took part in a r and omized controlled trial of the effect of a milk supplement on growth of children was conducted to investigate the supplement 's effect on adult bone mineral content ( BMC ) and density ( BMD ) . BMC and BMD of the nondominant forearm were measured by single-photon absorptiometry in 371 subjects ( 64 % ) aged 20 - 23 y , at a proximal site ( shaft of radius and ulna ) and at a distal site near the wrist .  BMC s and BMDs tended to be higher in the intervention group ( NS ) . Cross-sectionally , BMD was positively associated with body weight ( P less than 0.01 ) in both sexes ; inversely associated with alcohol consumption ( P less than 0.05 ) , and positively with manual occupation ( NS ) in men ; positively associated with current intakes of calcium ( P less than 0.05 ) , vitamin D ( P less than 0.01 ) , and sports activity during adolescence ( P less than 0.01 ) , and inversely with parity ( NS ) in women . In multiple linear-regression analysis body weight and sports activity during adolescence were stronger determinants of female BMD than was diet New Zeal and children , particularly those of Māori and Pacific ethnicity , may be at risk for low vitamin D status because of low vitamin D intakes , the country 's latitude ( 35 - 46 degrees S ) , and skin color . The aim of this study was to determine 25-hydroxyvitamin D concentrations and their determinants in a national sample of New Zeal and children aged 5 - 14 y. The 2002 National Children 's Nutrition Survey was design ed to survey New Zeal and children , including oversampling of Māori and Pacific children to allow ethnic-specific analyses . A 2-stage recruitment process occurred using a r and om selection of schools , and children within each school .  Serum 25-hydroxyvitamin D concentration [ mean ( 99 % CI ) nmol/L ] in Māori children ( n = 456 ) was 43 ( 38,49 ) , in Pacific ( n = 646 ) 36 ( 31,42 ) , and in New Zeal and European and Others ( NZEO ) ( n = 483 ) 53 ( 47,59 ) . Among Māori , Pacific , and NZEO , the prevalence ( % , 99 % CI ) of serum 25-hydroxyvitamin D deficiency ( < 17.5 nmol/L ) was 5 ( 2,12 ) , 8 ( 5,14 ) , and 3 ( 1,7 ) , respectively . The prevalence of insufficiency ( < 37.5 nmol/L ) was 41 ( 29,53 ) , 59 ( 42,75 ) , and 25 ( 15,35 ) , respectively . Multiple regression analysis found that 25-hydroxyvitamin D concentrations were lower in winter than summer [ adjusted mean difference ( 99 % CI ) nmol/L ; 15 ( 8,22 ) ] , lower in girls than boys [ 5 ( 1,10 ) ] , and lower in obese children than in those of " normal " weight [ 6 ( 1,11 ) ] . Relative to NZEO , 25-hydroxyvitamin D concentrations were lower in Māori [ 9 ( 3,15 ) ] and Pacific children [ 16 ( 10,22 ) ] . Ethnicity and season are major determinants of serum 25-hydroxyvitamin D. There is a high prevalence of vitamin D insufficiency in New Zeal and children , which may or may not contribute to increased risk of osteoporosis and other chronic disease . There is a pressing need for more convincing evidence concerning the health risks associated with the low  vitamin D status in New Zeal and children BACKGROUND Little is known about the relative effectiveness of calcium supplementation from food or pills with or without vitamin D supplementation for bone mass accrual during the rapid growth period . OBJECTIVE The purpose was to examine the effects of both food-based and pill supplements of calcium and vitamin D on bone mass and body composition  in girls aged 10 - 12 y. DESIGN This placebo-controlled intervention trial r and omly assigned 195 healthy girls at Tanner stage I-II , aged 10 - 12 y , with dietary calcium intakes < 900 mg/d to 1 of 4 groups : calcium ( 1000 mg ) + vitamin D3 ( 200 IU ) , calcium ( 1000 mg ) , cheese ( 1000 mg calcium ) , and placebo . Primary outcomes were bone indexes of the hip , spine , and whole body by dual-energy X-ray absorptiometry and of the radius and tibia by peripheral quantitative computed tomography . RESULTS With the use of intention-to-treat or efficacy analysis , calcium supplementation with cheese result ed in a higher percentage change in cortical thickness of the tibia than did placebo , calcium , or calcium + vitamin D treatment ( P = 0.01 , 0.038 , and 0.004 , respectively ) and in higher whole-body bone mineral density than did placebo treatment ( P = 0.044 ) when compliance was > 50 % . With the use of a hierarchical linear model with r and om effects to control for growth velocity , these differences disappeared . CONCLUSIONS Increasing calcium intake by consuming cheese appears to be more beneficial for cortical bone mass accrual than the consumption of tablets containing a similar amount of calcium . Diverse patterns of growth velocity may mask the efficacy of supplementation in a short-term trial of children transiting through puberty ABSTRACT . Fifty‐one healthy prepubertal schoolchildren were followed for 13 months in a double blind study . Twenty‐four of them were supplemented with 400 IU of vitamin D2 5–7 times weekly , while 27 received a placebo . The children were examined in winter both at the beginning and at the end of the study , and in the middle of the study in autumn . Mean 25‐hydroxyvitamin D levels in the supplemented group were significantly higher than those in the placebo group both in autumn and in winter , when the study ended . The vitamin D supplementation did not , however , affect other vitamin D metabolites , serum calcium , albumin , inorganic phosphorus , parathyroid hormone concentrations or alkaline phosphatase activity . Moreover , the supplementation caused no alterations in the weight or height gain or bone mineral content of the distal radius of the children , and thus sub clinical rickets could not be shown The objective of this study was to determine whether vitamin D supplementation of breast-fed infants during the first year of life is associated with greater bone mineral content and /or areal bone mineral density ( aBMD ) in later childhood . The design was a retrospective cohort study . One hundred and six healthy prepubertal Caucasian girls ( median age , 8 yr ; range , 7 - 9 yr ) were classified as vitamin D supplemented or unsupplemented during the first year of life on the basis of a question naire sent to participating families and their pediatricians . Bone area ( square centimeters ) and bone mineral content ( grams ) were determined by dual energy x-ray absorptiometry at six skeletal sites . Vitamin D receptor ( VDR ) 3'-gene polymorphisms ( BsmI ) were also determined . The supplemented ( n = 91 ) and unsupplemented ( n = 15 ) groups were similar in terms of season of birth , growth in the first year of life , age , anthropometric parameters , and calcium intake at time of dual energy x-ray absorptiometry . The supplemented group had higher aBMD at the level of radial metaphysis ( mean + /- SEM , 0.301+/-0.003 vs. 0.283+/-0.008 ; P = 0.03 ) , femoral neck ( 0.638+/-0.007 vs. 0.584+/-0.021 ; P = 0.01 ) , and femoral trochanter ( 0.508+/-0.006 vs. 0.474+/-0.016 ; P = 0.04 ) . At the lumbar spine level aBMD values were similar ( 0.626+/-0.006 vs. 0.598+/-0.019 ; P = 0.1 ) . In a multiple regression model taking into account the effects of vitamin D supplementation , height , and VDR genotype on aBMD ( dependent variable ) , femoral neck aBMD remained higher by 0.045 g/cm2 in the supplemented group ( P = 0.02 ) . Vitamin D supplementation in infancy was found to be associated with increased aBMD at specific skeletal sites later in childhood in prepubertal Caucasian girls 
    Output:
    