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: BACKGROUND Dietary intake of fish and the omega-3 fatty acids have been associated with lower risk of Alzheimer disease and stroke . OBJECTIVE To examine whether intakes of fish and the omega-3 fatty acids protect against  age-related cognitive decline .  DESIGN Prospect i ve cohort study . SETTING Geographically defined Chicago , Ill , community . PARTICIPANTS Residents , 65 years and older , who participated in the Chicago Health and Aging Project . MAIN OUTCOME MEASURE Change in a global cognitive score estimated from mixed models . The global score was computed by summing scores of 4 st and ardized tests . In-home cognitive assessment  s were performed 3 times over 6 years of follow-up . RESULTS Cognitive scores declined on average at a rate of 0.04 st and ardized units per year ( SU/y ) . Fish intake was associated with a slower rate of cognitive decline in mixed models adjusted for age , sex , race , education , cognitive activity , physical activity , alcohol consumption , and total energy intake . Compared with a decline rate in score of -0.100 SU/y among persons who consumed fish less than weekly , the rate was 10 % slower ( -0.090 SU/y ) among persons who consumed 1 fish meal per week and 13 % slower ( -0.088 SU/y ) among persons who consumed 2 or more fish meals per week . The fish association was not accounted for by cardiovascular-related conditions or fruit and vegetable consumption but was modified after adjustment for intakes of saturated , polyunsaturated , and trans fats . There was little evidence that the omega-3 polyunsaturated fatty acids were associated with cognitive change . CONCLUSIONS Fish consumption may be associated with slower cognitive decline with age . Further study is needed to determine whether fat composition is the relevant dietary constituent OBJECTIVE Cognitive dysfunction and structural brain abnormalities have been observed in obese versus lean individuals , but with variability across age and weight groups . The current study was design ed to clarify the cognitive profile of obesity by examining performance across multiple cognitive domains in adults with wide-ranging age and weight status . METHOD Participants ( N = 732 ; 61 % women ; ages 18 - 88 ; BMI range 19 - 75 ) underwent assessment of cognitive functioning and relevant medical/demographic covariates .  Neuropsychological tests  were grouped by cognitive domain ( via confirmatory factor analysis ) , and st and ardized scores were averaged into composite variables . RESULTS Hierarchical linear regression analyses revealed main effects for BMI on motor ( ΔR2 = .02 , β = -.15 ) and attention/processing speed ( ΔR2 = .01 , β = -.07 ) , whereas a significant interaction between BMI and age was observed ( ΔR2 = .01 , β = -.08 ) for predicting executive functioning ( p < .05 ) . BMI was not independently associated with memory or language functioning and no interaction effects were observed for these variables . Although BMI was not independently related to executive dysfunction , a significant age × BMI interaction suggests that obesity-related executive deficits may increase with age . CONCLUSIONS Overall , these findings may support an independent association between obesity and a frontal-subcortical pathology , though prospect i ve studies are needed to further clarify this possibility Background Previous research has found associations between parental feeding practice s and children 's eating behaviour and weight status .  Prospect i ve research is needed to eluci date these relationships . Methods One hundred and fifty-six mothers of 2- to 4-year-old children completed question naires including measures of maternal feeding practice s ( pressure to eat , restriction , monitoring and modelling of healthy eating )  , child eating behaviour ( food responsiveness , food fussiness and interest in food ) , and mother reported child height and weight . The question naire was repeated 12 months later . Regression analyses were used to find longitudinal associations between maternal feeding practice s , child eating behaviour and child body mass index ( BMI ) . Results Modelling of healthy eating predicted lower child food fussiness and higher interest in food one year later , and pressure to eat predicted lower child interest in food . Restriction did not predict changes in child eating behaviour .  Maternal feeding practice s did not prospect ively predict child food responsiveness or child BMI . Conclusion Maternal feeding practice s appear to influence young children 's  eating behaviour but not weight status in the short term OBJECTIVE Research has indicated that individuals with obesity have neurocognitive deficits , especially in cognitive flexibility that may in turn impact on their weight loss and maintenance . Consequently , we examined the efficacy of a manualised face-to-face cognitive remediation therapy for obesity ( CRT-O ) within a r and omised controlled trial , in terms of improving cognitive flexibility , reducing binge eating behaviour , improving quality of life and helping with weight loss . METHODS 80 adults with obesity ( body mass index > 30 kg/m2 ) , 70 % binge eaters , received three weekly sessions of group Behavioural Weight Loss ( BWL ) and then were r and omised to 8 sessions of individual CRT-O or to a no-treatment control group . RESULTS Mixed-effects model analyses revealed that the CRT-O group had a significant improvement in their cognitive flexibility at post-treatment and 3-month follow-up compared to the control group ( Cohen 's d = 0.96 to 2.1 ) . 68 % of those in the CRT-O group achieved a weight loss of 5 % or more at follow-up compared to only 15 % of the controls ( Cohen 's d = 1.3 ) . Changes in set-shifting predicted changes in weight ( p < .05 ) . Binge eating reduced in the CRT-O group compared to the control ( Cohen 's d = 0.80 ) . DISCUSSION This is the first study showing the efficacy of CRT-O for obesity . Future CRT-O studies with longer follow-ups and pairing it with longer BWL programs are needed . TRIALS REGISTRY ( ANZCTR ) 12613000537752 . DATE OF ANZCTR REGISTRATION 14 May 2013 Background Two primary factors that contribute to obesity are unhealthy eating and sedentary behavior  . These behaviors are particularly difficult to change in the long-term because they are often enacted habitually . Cognitive Remediation Therapy has been modified and applied to the treatment of obesity ( CRT-O ) with preliminary results of a r and omized controlled trial demonstrating significant weight loss and improvements in executive function . The objective of this study was to conduct a secondary data analysis of the CRT-O trial to evaluate whether CRT-O reduces unhealthy habits that contribute to obesity via improvements in executive function . Method Eighty participants with obesity were r and omized to CRT-O or control . Measures of executive function ( Wisconsin Card Sort Task and Trail Making Task ) and unhealthy eating and sedentary behavior habits were administered at baseline , post-intervention and at 3 month follow-up . Results Participants receiving CRT-O demonstrated improvements in both measures of executive function and reductions in both unhealthy habit outcomes compared to control . Mediation analyses revealed that change in one element of executive function performance ( Wisconsin Card Sort Task perseverance errors ) mediated the effect of CRT-O on changes in both habit outcomes . Conclusion These results suggest that the effectiveness of CRT-O may result from the disruption of unhealthy habits made possible by improvements in executive function . In particular , it appears that cognitive flexibility , as measured by the Wisconsin Card Sort task , is a key mechanism in this process . Improving cognitive flexibility may enable individuals to capitalise on interruptions in unhealthy habits by adjusting their behavior in line with their weight loss goals rather than persisting with an unhealthy choice . Trial registration The RCT was registered with the Australian New Zeal and Registry of Clinical Trials ( trial i d : ACTRN12613000537752 ) Little is known about the acute effects of drugs of abuse on impulsivity and self-control . In this study , impulsivity was assessed in humans using a computer task that measured delay and probability discounting . Discounting describes how much the value of a reward ( or punisher ) is decreased when its occurrence is either delayed or uncertain . Twenty-four healthy adult volunteers ingested a moderate dose of ethanol ( 0.5 or 0.8 g/kg ethanol : n = 12 at each dose ) or placebo before completing the discounting task . In the task the participants were given a series of choices between a small , immediate , certain amount of money and $ 10 that was either delayed ( 0 , 2 , 30 , 180 , or 365 days ) or probabilistic ( i.e. , certainty of receipt was 1.0 , .9 , .75 , .5 , or .25 ) . The point at which each individual was indifferent between the smaller immediate or certain reward and the $ 10 delayed or probabilistic reward was identified using an adjusting-amount procedure . The results indicated that ( a ) delay and probability discounting were well described by a hyperbolic function ; ( b ) delay and probability discounting were positively correlated within subjects ; ( c ) delay and probability discounting were moderately correlated with personality measures of impulsivity ; and ( d ) alcohol had no effect on discounting This individual differences study examined the separability of three often postulated executive functions-mental set shifting ( " Shifting " ) , information updating and monitoring ( " Updating " ) , and inhibition of prepotent responses ("Inhibition")- and their roles in complex " frontal lobe " or " executive " tasks . One hundred thirty-seven college students performed a set of relatively simple experimental tasks that are considered to predominantly tap each target executive function as well as a set of frequently used executive tasks : the Wisconsin Card Sorting Test ( WCST ) , Tower of Hanoi ( TOH ) , r and om number generation ( RNG ) , operation span , and dual tasking .  Confirmatory factor analysis indicated that the three target executive functions are moderately correlated with one another , but are clearly separable . Moreover , structural equation modeling suggested that the three functions contribute differentially to performance on complex executive tasks . Specifically , WCST performance was related most strongly to Shifting , TOH to Inhibition , RNG to Inhibition and Updating , and operation span to Updating . Dual task performance was not related to any of the three target functions . These results suggest that it is important to recognize both the unity and diversity of executive functions and that latent variable analysis is a useful approach to study ing the organization and roles of executive functions OBJECTIVE Obesity is as an independent risk factor for poor neurocognitive outcomes , including Alzheimer 's disease .  Bariatric surgery has recently been shown to result in improved memory at 12-weeks postoperatively . However , the long-term effects of bariatric surgery on cognitive function remain unclear . DESIGN AND METHODS Eighty-six individuals ( 63 bariatric surgery patients , 23 obese controls ) were recruited from a prospect i ve study examining the neurocognitive effects of bariatric surgery .  All participants completed  self-report measurements and a computerized cognitive test battery  prior to surgery and at 12-week and 24-month follow-up ; obese controls completed measures at equivalent time points . RESULTS Bariatric surgery patients exhibited high rates of pre-operative cognitive impairments in attention , executive function , memory , and language . Relative to obese controls , repeated measures ANOVA showed improvements in memory from baseline to 12-weeks and 24-months postoperatively ( P < 0.05 ) . Regression analyses controlling for baseline factors revealed that a lower BMI at 24-months demonstrated a trend toward significance for improved memory ( β = -.30 , P = 0.075 ) . CONCLUSION These findings suggest that cognitive benefits of bariatric surgery may extend to 24-months postoperatively . Larger prospect i ve studies with extended follow-up periods are needed to eluci date whether bariatric surgery decreases risk for cognitive decline and possibly the development of dementia OBJECTIVE This experiment tested the hypothesis that exercise would improve executive function . DESIGN Sedentary , overweight 7- to 11-year-old children ( N = 171 , 56 % girls , 61 % Black , M ± SD age = 9.3 ± 1.0 years , body mass index [ BMI ] = 26 ± 4.6 kg/m² , BMI z-score = 2.1 ± 0.4 ) were r and omized to 13 ± 1.6 weeks of an exercise program ( 20 or 40 min/day ) , or a control condition . MAIN OUTCOME MEASURES Blinded , st and ardized psychological evaluations ( Cognitive Assessment System and Woodcock-Johnson Tests of Achievement III ) assessed cognition and academic achievement .  Functional MRI  measured brain activity during executive function tasks . RESULTS Intent to treat analysis revealed dose-response benefits of exercise  on executive function and mathematics achievement . Preliminary evidence of increased bilateral prefrontal cortex activity and reduced bilateral posterior parietal cortex activity attributable to exercise was also observed . CONCLUSION Consistent with results obtained in older adults , a specific improvement on executive function and brain activation changes attributable to exercise were observed . The cognitive and achievement results add evidence of dose-response and extend experimental evidence into childhood . This study provides information on an educational outcome . Besides its importance for maintaining weight and reducing health risks during a childhood obesity epidemic , physical activity may prove to be a simple , important method of enhancing aspects of children 's mental functioning that are central to cognitive development . This information may persuade educators to implement vigorous physical activity BACKGROUND Bariatric surgery is associated with improved cognition , and it is possible that such improvements are found at extended follow-ups . We hypothesized that cognitive improvement would be maintained 3 years after bariatric surgery . METHODS 
    Output:
    
agent
The results confirmed the presence of a relation between executive functions and overweight/obesity , although the directionality of this relation was not clear ; nor did any single executive function emerge as being more involved than others in this relation .
Despite this , there was evidence of a reciprocal influence between executive functions and overweight/obesity .
Conclusions : This systematic review underlines the presence of a relationship between executive functions and overweight/obesity .
Moreover , it seems to suggest a bidirectional trend in this relationship that could be the cause of the failure of interventions for weight reduction .
***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: BACKGROUND Dietary intake of fish and the omega-3 fatty acids have been associated with lower risk of Alzheimer disease and stroke . OBJECTIVE To examine whether intakes of fish and the omega-3 fatty acids protect against  age-related cognitive decline .  DESIGN Prospect i ve cohort study . SETTING Geographically defined Chicago , Ill , community . PARTICIPANTS Residents , 65 years and older , who participated in the Chicago Health and Aging Project . MAIN OUTCOME MEASURE Change in a global cognitive score estimated from mixed models . The global score was computed by summing scores of 4 st and ardized tests . In-home cognitive assessment  s were performed 3 times over 6 years of follow-up . RESULTS Cognitive scores declined on average at a rate of 0.04 st and ardized units per year ( SU/y ) . Fish intake was associated with a slower rate of cognitive decline in mixed models adjusted for age , sex , race , education , cognitive activity , physical activity , alcohol consumption , and total energy intake . Compared with a decline rate in score of -0.100 SU/y among persons who consumed fish less than weekly , the rate was 10 % slower ( -0.090 SU/y ) among persons who consumed 1 fish meal per week and 13 % slower ( -0.088 SU/y ) among persons who consumed 2 or more fish meals per week . The fish association was not accounted for by cardiovascular-related conditions or fruit and vegetable consumption but was modified after adjustment for intakes of saturated , polyunsaturated , and trans fats . There was little evidence that the omega-3 polyunsaturated fatty acids were associated with cognitive change . CONCLUSIONS Fish consumption may be associated with slower cognitive decline with age . Further study is needed to determine whether fat composition is the relevant dietary constituent OBJECTIVE Cognitive dysfunction and structural brain abnormalities have been observed in obese versus lean individuals , but with variability across age and weight groups . The current study was design ed to clarify the cognitive profile of obesity by examining performance across multiple cognitive domains in adults with wide-ranging age and weight status . METHOD Participants ( N = 732 ; 61 % women ; ages 18 - 88 ; BMI range 19 - 75 ) underwent assessment of cognitive functioning and relevant medical/demographic covariates .  Neuropsychological tests  were grouped by cognitive domain ( via confirmatory factor analysis ) , and st and ardized scores were averaged into composite variables . RESULTS Hierarchical linear regression analyses revealed main effects for BMI on motor ( ΔR2 = .02 , β = -.15 ) and attention/processing speed ( ΔR2 = .01 , β = -.07 ) , whereas a significant interaction between BMI and age was observed ( ΔR2 = .01 , β = -.08 ) for predicting executive functioning ( p < .05 ) . BMI was not independently associated with memory or language functioning and no interaction effects were observed for these variables . Although BMI was not independently related to executive dysfunction , a significant age × BMI interaction suggests that obesity-related executive deficits may increase with age . CONCLUSIONS Overall , these findings may support an independent association between obesity and a frontal-subcortical pathology , though prospect i ve studies are needed to further clarify this possibility Background Previous research has found associations between parental feeding practice s and children 's eating behaviour and weight status .  Prospect i ve research is needed to eluci date these relationships . Methods One hundred and fifty-six mothers of 2- to 4-year-old children completed question naires including measures of maternal feeding practice s ( pressure to eat , restriction , monitoring and modelling of healthy eating )  , child eating behaviour ( food responsiveness , food fussiness and interest in food ) , and mother reported child height and weight . The question naire was repeated 12 months later . Regression analyses were used to find longitudinal associations between maternal feeding practice s , child eating behaviour and child body mass index ( BMI ) . Results Modelling of healthy eating predicted lower child food fussiness and higher interest in food one year later , and pressure to eat predicted lower child interest in food . Restriction did not predict changes in child eating behaviour .  Maternal feeding practice s did not prospect ively predict child food responsiveness or child BMI . Conclusion Maternal feeding practice s appear to influence young children 's  eating behaviour but not weight status in the short term OBJECTIVE Research has indicated that individuals with obesity have neurocognitive deficits , especially in cognitive flexibility that may in turn impact on their weight loss and maintenance . Consequently , we examined the efficacy of a manualised face-to-face cognitive remediation therapy for obesity ( CRT-O ) within a r and omised controlled trial , in terms of improving cognitive flexibility , reducing binge eating behaviour , improving quality of life and helping with weight loss . METHODS 80 adults with obesity ( body mass index > 30 kg/m2 ) , 70 % binge eaters , received three weekly sessions of group Behavioural Weight Loss ( BWL ) and then were r and omised to 8 sessions of individual CRT-O or to a no-treatment control group . RESULTS Mixed-effects model analyses revealed that the CRT-O group had a significant improvement in their cognitive flexibility at post-treatment and 3-month follow-up compared to the control group ( Cohen 's d = 0.96 to 2.1 ) . 68 % of those in the CRT-O group achieved a weight loss of 5 % or more at follow-up compared to only 15 % of the controls ( Cohen 's d = 1.3 ) . Changes in set-shifting predicted changes in weight ( p < .05 ) . Binge eating reduced in the CRT-O group compared to the control ( Cohen 's d = 0.80 ) . DISCUSSION This is the first study showing the efficacy of CRT-O for obesity . Future CRT-O studies with longer follow-ups and pairing it with longer BWL programs are needed . TRIALS REGISTRY ( ANZCTR ) 12613000537752 . DATE OF ANZCTR REGISTRATION 14 May 2013 Background Two primary factors that contribute to obesity are unhealthy eating and sedentary behavior  . These behaviors are particularly difficult to change in the long-term because they are often enacted habitually . Cognitive Remediation Therapy has been modified and applied to the treatment of obesity ( CRT-O ) with preliminary results of a r and omized controlled trial demonstrating significant weight loss and improvements in executive function . The objective of this study was to conduct a secondary data analysis of the CRT-O trial to evaluate whether CRT-O reduces unhealthy habits that contribute to obesity via improvements in executive function . Method Eighty participants with obesity were r and omized to CRT-O or control . Measures of executive function ( Wisconsin Card Sort Task and Trail Making Task ) and unhealthy eating and sedentary behavior habits were administered at baseline , post-intervention and at 3 month follow-up . Results Participants receiving CRT-O demonstrated improvements in both measures of executive function and reductions in both unhealthy habit outcomes compared to control . Mediation analyses revealed that change in one element of executive function performance ( Wisconsin Card Sort Task perseverance errors ) mediated the effect of CRT-O on changes in both habit outcomes . Conclusion These results suggest that the effectiveness of CRT-O may result from the disruption of unhealthy habits made possible by improvements in executive function . In particular , it appears that cognitive flexibility , as measured by the Wisconsin Card Sort task , is a key mechanism in this process . Improving cognitive flexibility may enable individuals to capitalise on interruptions in unhealthy habits by adjusting their behavior in line with their weight loss goals rather than persisting with an unhealthy choice . Trial registration The RCT was registered with the Australian New Zeal and Registry of Clinical Trials ( trial i d : ACTRN12613000537752 ) Little is known about the acute effects of drugs of abuse on impulsivity and self-control . In this study , impulsivity was assessed in humans using a computer task that measured delay and probability discounting . Discounting describes how much the value of a reward ( or punisher ) is decreased when its occurrence is either delayed or uncertain . Twenty-four healthy adult volunteers ingested a moderate dose of ethanol ( 0.5 or 0.8 g/kg ethanol : n = 12 at each dose ) or placebo before completing the discounting task . In the task the participants were given a series of choices between a small , immediate , certain amount of money and $ 10 that was either delayed ( 0 , 2 , 30 , 180 , or 365 days ) or probabilistic ( i.e. , certainty of receipt was 1.0 , .9 , .75 , .5 , or .25 ) . The point at which each individual was indifferent between the smaller immediate or certain reward and the $ 10 delayed or probabilistic reward was identified using an adjusting-amount procedure . The results indicated that ( a ) delay and probability discounting were well described by a hyperbolic function ; ( b ) delay and probability discounting were positively correlated within subjects ; ( c ) delay and probability discounting were moderately correlated with personality measures of impulsivity ; and ( d ) alcohol had no effect on discounting This individual differences study examined the separability of three often postulated executive functions-mental set shifting ( " Shifting " ) , information updating and monitoring ( " Updating " ) , and inhibition of prepotent responses ("Inhibition")- and their roles in complex " frontal lobe " or " executive " tasks . One hundred thirty-seven college students performed a set of relatively simple experimental tasks that are considered to predominantly tap each target executive function as well as a set of frequently used executive tasks : the Wisconsin Card Sorting Test ( WCST ) , Tower of Hanoi ( TOH ) , r and om number generation ( RNG ) , operation span , and dual tasking .  Confirmatory factor analysis indicated that the three target executive functions are moderately correlated with one another , but are clearly separable . Moreover , structural equation modeling suggested that the three functions contribute differentially to performance on complex executive tasks . Specifically , WCST performance was related most strongly to Shifting , TOH to Inhibition , RNG to Inhibition and Updating , and operation span to Updating . Dual task performance was not related to any of the three target functions . These results suggest that it is important to recognize both the unity and diversity of executive functions and that latent variable analysis is a useful approach to study ing the organization and roles of executive functions OBJECTIVE Obesity is as an independent risk factor for poor neurocognitive outcomes , including Alzheimer 's disease .  Bariatric surgery has recently been shown to result in improved memory at 12-weeks postoperatively . However , the long-term effects of bariatric surgery on cognitive function remain unclear . DESIGN AND METHODS Eighty-six individuals ( 63 bariatric surgery patients , 23 obese controls ) were recruited from a prospect i ve study examining the neurocognitive effects of bariatric surgery .  All participants completed  self-report measurements and a computerized cognitive test battery  prior to surgery and at 12-week and 24-month follow-up ; obese controls completed measures at equivalent time points . RESULTS Bariatric surgery patients exhibited high rates of pre-operative cognitive impairments in attention , executive function , memory , and language . Relative to obese controls , repeated measures ANOVA showed improvements in memory from baseline to 12-weeks and 24-months postoperatively ( P < 0.05 ) . Regression analyses controlling for baseline factors revealed that a lower BMI at 24-months demonstrated a trend toward significance for improved memory ( β = -.30 , P = 0.075 ) . CONCLUSION These findings suggest that cognitive benefits of bariatric surgery may extend to 24-months postoperatively . Larger prospect i ve studies with extended follow-up periods are needed to eluci date whether bariatric surgery decreases risk for cognitive decline and possibly the development of dementia OBJECTIVE This experiment tested the hypothesis that exercise would improve executive function . DESIGN Sedentary , overweight 7- to 11-year-old children ( N = 171 , 56 % girls , 61 % Black , M ± SD age = 9.3 ± 1.0 years , body mass index [ BMI ] = 26 ± 4.6 kg/m² , BMI z-score = 2.1 ± 0.4 ) were r and omized to 13 ± 1.6 weeks of an exercise program ( 20 or 40 min/day ) , or a control condition . MAIN OUTCOME MEASURES Blinded , st and ardized psychological evaluations ( Cognitive Assessment System and Woodcock-Johnson Tests of Achievement III ) assessed cognition and academic achievement .  Functional MRI  measured brain activity during executive function tasks . RESULTS Intent to treat analysis revealed dose-response benefits of exercise  on executive function and mathematics achievement . Preliminary evidence of increased bilateral prefrontal cortex activity and reduced bilateral posterior parietal cortex activity attributable to exercise was also observed . CONCLUSION Consistent with results obtained in older adults , a specific improvement on executive function and brain activation changes attributable to exercise were observed . The cognitive and achievement results add evidence of dose-response and extend experimental evidence into childhood . This study provides information on an educational outcome . Besides its importance for maintaining weight and reducing health risks during a childhood obesity epidemic , physical activity may prove to be a simple , important method of enhancing aspects of children 's mental functioning that are central to cognitive development . This information may persuade educators to implement vigorous physical activity BACKGROUND Bariatric surgery is associated with improved cognition , and it is possible that such improvements are found at extended follow-ups . We hypothesized that cognitive improvement would be maintained 3 years after bariatric surgery . METHODS 
    Output:
    