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 Our aim was to compare the effects of a Paleolithic ( ' Old Stone Age ' ) diet and a diabetes diet as generally recommended on risk factors for cardiovascular disease in patients with type 2 diabetes not treated with insulin . Methods In a r and omized cross-over study , 13 patients with type 2 diabetes , 3 women and 10 men , were instructed to eat a Paleolithic diet based on lean meat , fish , fruits , vegetables , root vegetables , eggs and nuts ; and a Diabetes diet design ed in accordance with dietary guidelines during two consecutive 3-month periods . Outcome variables included changes in weight , waist circumference , serum lipids , C-reactive protein , blood pressure , glycated haemoglobin ( HbA1c ) , and areas under the curve for plasma glucose and plasma insulin  in the 75 g oral glucose tolerance test . Dietary intake was evaluated by use of 4-day weighed food records . Results Study participants had on average a diabetes duration of 9 years , a mean HbA1c of 6,6 % units by Mono-S st and ard and were usually treated with metformin alone ( 3 subjects ) or metformin in combination with a sulfonylurea ( 3 subjects ) or a thiazolidinedione ( 3 subjects ) . Mean average dose of metformin was 1031 mg per day . Compared to the diabetes diet , the Paleolithic diet result ed in lower mean values of HbA1c ( -0.4 % units , p = 0.01 ) , triacylglycerol ( -0.4 mmol/L , p = 0.003 ) , diastolic blood pressure ( -4 mmHg , p = 0.03 ) , weight ( -3 kg , p = 0.01 ) , BMI ( -1 kg/m2 , p = 0.04 ) and waist circumference ( -4 cm , p = 0.02 ) , and higher mean values of high density lipoprotein cholesterol ( + 0.08 mmol/L , p = 0.03 ) . The Paleolithic diet was mainly lower in cereals and dairy products , and higher in fruits , vegetables , meat and eggs , as compared with the Diabetes diet . Further , the Paleolithic diet was lower in total energy , energy density , carbohydrate , dietary glycemic load , saturated fatty acids and calcium , and higher in unsaturated fatty acids , dietary cholesterol and several vitamins . Dietary GI was slightly lower in the Paleolithic diet ( GI = 50 ) than in the Diabetic diet ( GI = 55 ) . Conclusion Over a 3-month study period , a Paleolithic diet improved glycemic control and several cardiovascular risk factors compared to a Diabetes diet in patients with type 2 diabetes . Trial registration Clinical Trials.gov NCT00435240 AIMS The aim of this study is to compare the efficacy of low glycaemic index ( GI ) vs. conventional carbohydrate exchange ( CCE ) dietary advice on glycaemic control and metabolic parameters in patients with type 2 diabetes . METHODS A total of 104 patients with type 2 diabetes were r and omly assigned to either a low GI ( GI ) or CCE dietary advice over a 12-week period . The primary end-point was glycaemic control as assessed by glycated haemoglobin A1c ( HbA1c ) , fructosamine level and plasma glucose . The secondary end-points were anthropometric measurements and metabolic parameters that include blood pressure , lipid profile and insulin levels . The oral antidiabetic medications remained unchanged throughout the duration of the study . RESULTS A low-GI diet was associated with significant changes in the fructosamine level ( DeltaGI = -0.20 + /- 0.03 ; DeltaCCE = -0.08 + /- 0.03 mmol/l , p < 0.01 ) and waist circumference ( DeltaGI group = -1.88 + /- 0.30 cm ; DeltaCCE group : -0.36 + /- 0.4 cm , p < 0.05 ) at week 4 . At week 12 , the changes in fasting glucose ( DeltaGI = -0.03 + /- 0.3 ; DeltaCCE = 0.7 + /- 0.3 mmol/l ; p < 0.05 ) and waist circumference ( DeltaGI = -2.35 + /- 0.47 cm ; DeltaCCE group = -0.66 + /- 0.46 cm ; p < 0.05 ) in the GI group was significantly lower than the CCE group . With the low-GI diet , the changes in postpr and ial glycaemia at time 0 , 60 , 150 and 180 min after consuming the st and ard test meal was lower than with the CCE diet ( p < 0.05 ) . No significant differences were found between the groups for the remaining parameters that were measured . CONCLUSIONS Use of a low-GI diet result ed in significant changes of serum fructosamine level , plasma glucose and waist circumference in Asian patients with type 2 diabetes over a 12-week period compared with those following a CCE diet . The effect on HbA1c and other metabolic parameters was not significantly different between the two study groups but the improvement within the GI group was more pronounced and of clinical benefit OBJECTIVE To examine whether a worksite nutrition programme using a low-fat vegan diet could significantly improve nutritional intake . DESIGN At two corporate sites of the Government Employees Insurance Company , employees who were either overweight ( BMI > or = 25 kg/m2 ) and /or had type 2 diabetes participated in a 22-week worksite-based dietary intervention study . SETTING At the intervention site , participants were asked to follow a low-fat vegan diet and participate in weekly group meetings that included instruction and group support ( intervention group ) . At the control site , participants received no instruction ( control group ) . At weeks 0 and 22 , participants completed 3 d dietary records to assess energy and nutrient intake . SUBJECTS A total of 109 participants ( sixty-five intervention and forty-four control ) . RESULTS In the intervention group , reported intake of total fat , trans fat , saturated fat and cholesterol decreased significantly ( P < or = 0.001 ) , as did energy and protein ( P = 0.01 ) , and vitamin B12 ( P = 0.002 ) , compared with the control group . Intake ( exclusive of any use of nutritional supplements ) of carbohydrate , fibre , vitamin C , magnesium and potassium increased significantly ( P < or = 0.0001 ) , as did that for beta-carotene ( P = 0.0004 ) , total vitamin A activity ( P = 0.004 ) , vitamin K ( P = 0.01 ) and sodium ( P = 0.04 ) in the intervention group , compared with the control group . CONCLUSIONS The present study suggests that a worksite vegan nutrition programme increases intakes of protective nutrients , such as fibre , folate and vitamin C , and decreases intakes of total fat , saturated fat and cholesterol Abstract Evidence has shown that long-term sodium reduction can not only reduce blood pressure , but also provide cardiovascular benefits . To date , there is little evidence related to the effects of salt reduction on isolated systolic hypertension ( ISH ) . A total of 126 hypertensive patients were divided into an ISH group ( n = 51 ) and a non-ISH ( NISH ) group ( n = 75 ) . The members of each group were then r and omly assigned to low sodium salt ( LSSalt ) or normal salt ( NSalt ) diets for 6 months . Their blood pressure was measured every 2 months . Serum plasma renin-angiotensin activity , blood biochemical assays and urinary measurements were determined at the baseline and at the end of the 6 months . At the end of the study , the mean systolic blood pressure ( SBP ) of the ISH LSSalt group had significantly decreased by 10.18 mm Hg ( 95 % confidence interval ( CI ) : 3.13 to 17.2 , P = .006 ) compared with that of the ISH NSalt group , while the mean SBP only decreased by 5.10 mm Hg ( 95 % CI : −2.02 to 12.2 , P = .158 ) in the NISH LSSalt group compared with that of the NISH NSalt group . The mean diastolic blood pressure ( DBP ) had no significant differences in the ISH and NISH groups . No obvious renin angiotensin system activation was found after LSSalt intervention . Regarding the urinary excretion of electrolytes and blood biochemical assays , the LSSalt treatment had the same effects on the ISH group as on the NISH group . The present study showed that the SBP of ISH patients was significantly decreased with the LSSalt intervention , while neither the SBP of the NISH patients nor the DBP of either group were similarly decreased , which indicated that ISH patients were more sensitive to salt restriction OBJECTIVE To determine the effects of the Dietary Approaches to Stop Hypertension ( DASH ) eating pattern on cardiometabolic risks in type 2 diabetic patients . RESEARCH DESIGN AND METHODS A r and omized crossover clinical trial was undertaken in 31 type 2 diabetic patients . For 8 weeks , participants were r and omly assigned to a control diet or the DASH eating pattern . RESULTS After following the DASH eating pattern , body weight ( P = 0.007 ) and waist circumference ( P = 0.002 ) reduced significantly . Fasting blood glucose levels and A1C decreased after adoption of the DASH diet ( −29.4 ± 6.3 mg/dl ; P = 0.04 and −1.7 ± 0.1 % ; P = 0.04 , respectively ) . After the DASH diet , the mean change for HDL cholesterol levels was higher ( 4.3 ± 0.9 mg/dl ; P = 0.001 ) and LDL cholesterol was reduced ( −17.2 ± 3.5 mg/dl ; P = 0.02 ) . Additionally , DASH had beneficial effects on systolic ( −13.6 ± 3.5 vs. −3.1 ± 2.7 mmHg ; P = 0.02 ) and diastolic blood pressure ( −9.5 ± 2.6 vs. −0.7 ± 3.3 mmHg ; P = 0.04 ) . CONCLUSIONS Among diabetic patients , the DASH diet had beneficial effects on cardiometabolic risks Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Summary Fifty hypertensive Type 2 ( non-insulin-dependent ) diabetic patients were allocated , in a controlled trial , to a treatment diet of high fibre , low fat and low sodium composition , or to a control diet by the hospital dietitian . After 3 months treatment , the modified diet-treated group showed a highly significant reduction in mean systolic ( 180.5±19.0 to 165.0±20.7 mmHg ) and diastolic blood pressure ( 96.6±9.3 to 88.0±10.5 mmHg ) , accompanied by significant reductions in urinary sodium excretion ( 183.0±62.1 to 121.7 + 65.8 mmol/day ) glycosylated haemoglobin ( 12.4±3.1 to 10.5±2.9 % ) , weight ( 74.6s±13.5 to 71.7±12.1 kg ) and serum triglyceride levels ( p<0.05 ) . The mean values of diastolic pressure ( p<0.01 ) , urinary sodium/potassium ratio ( p < 0.001 ) , urinary potassium ( p<0.01 ) was significantly reduced at 3 months compared to control . No changes in serum HDL-cholesterol levels were observed . The number of patients with normal blood pressure at 3 months was greater in the modified diet-treated group ( ten versus five ) . Treatment of mild hypertension in diabetic subjects with this form of dietary regimen has a hypotensive response , with improvement in glycaemic control and no side effects . This modified diet may be an attractive alternative to anti-hypertensive drug therapy as a first line treatment Objective Several intervention studies have suggested that vegetarian or vegan diets have clinical benefits , particularly in terms of glycemic control , in patients with type 2 diabetes ( T2D ) ; however , no r and omized controlled trial has been conducted in Asians who more commonly depend on plant-based foods , as compared to Western population s. Here , we aim ed to compare the effect of a vegan diet and conventional diabetic diet on glycemic control among Korean individuals . Material s and Methods Participants diagnosed with T2D were r and omly assigned to follow either a vegan diet ( excluding animal-based food including fish ; n = 46 ) or a conventional diet recommended by the Korean Diabetes Association 2011 ( n = 47 ) for 12 weeks . HbA1c levels were 
    Output:
    
agent
The dietary modifications were more effective in reducing both SBP and DBP vs. control diet .
The Low-sodium , High-fiber , DASH , Low-fat , Low-protein and Vegan dietary approach were significantly more effective in reducing SBP compared to a control diet .
The High-fiber , Low-fat , Low-protein and Vegan diet were significantly more effective in reducing DBP .
The Low-sodium and High fiber diets had the greatest lowering effect on SBP and DBP in T2D patients .
CONCLUSIONS Adopting healthful dietary modifications were more effective in reducing both SBP and DBP vs. control .
The High-fiber and Low-sodium diets had the greatest lowering effect on SBP and DBP in T2D
***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 Our aim was to compare the effects of a Paleolithic ( ' Old Stone Age ' ) diet and a diabetes diet as generally recommended on risk factors for cardiovascular disease in patients with type 2 diabetes not treated with insulin . Methods In a r and omized cross-over study , 13 patients with type 2 diabetes , 3 women and 10 men , were instructed to eat a Paleolithic diet based on lean meat , fish , fruits , vegetables , root vegetables , eggs and nuts ; and a Diabetes diet design ed in accordance with dietary guidelines during two consecutive 3-month periods . Outcome variables included changes in weight , waist circumference , serum lipids , C-reactive protein , blood pressure , glycated haemoglobin ( HbA1c ) , and areas under the curve for plasma glucose and plasma insulin  in the 75 g oral glucose tolerance test . Dietary intake was evaluated by use of 4-day weighed food records . Results Study participants had on average a diabetes duration of 9 years , a mean HbA1c of 6,6 % units by Mono-S st and ard and were usually treated with metformin alone ( 3 subjects ) or metformin in combination with a sulfonylurea ( 3 subjects ) or a thiazolidinedione ( 3 subjects ) . Mean average dose of metformin was 1031 mg per day . Compared to the diabetes diet , the Paleolithic diet result ed in lower mean values of HbA1c ( -0.4 % units , p = 0.01 ) , triacylglycerol ( -0.4 mmol/L , p = 0.003 ) , diastolic blood pressure ( -4 mmHg , p = 0.03 ) , weight ( -3 kg , p = 0.01 ) , BMI ( -1 kg/m2 , p = 0.04 ) and waist circumference ( -4 cm , p = 0.02 ) , and higher mean values of high density lipoprotein cholesterol ( + 0.08 mmol/L , p = 0.03 ) . The Paleolithic diet was mainly lower in cereals and dairy products , and higher in fruits , vegetables , meat and eggs , as compared with the Diabetes diet . Further , the Paleolithic diet was lower in total energy , energy density , carbohydrate , dietary glycemic load , saturated fatty acids and calcium , and higher in unsaturated fatty acids , dietary cholesterol and several vitamins . Dietary GI was slightly lower in the Paleolithic diet ( GI = 50 ) than in the Diabetic diet ( GI = 55 ) . Conclusion Over a 3-month study period , a Paleolithic diet improved glycemic control and several cardiovascular risk factors compared to a Diabetes diet in patients with type 2 diabetes . Trial registration Clinical Trials.gov NCT00435240 AIMS The aim of this study is to compare the efficacy of low glycaemic index ( GI ) vs. conventional carbohydrate exchange ( CCE ) dietary advice on glycaemic control and metabolic parameters in patients with type 2 diabetes . METHODS A total of 104 patients with type 2 diabetes were r and omly assigned to either a low GI ( GI ) or CCE dietary advice over a 12-week period . The primary end-point was glycaemic control as assessed by glycated haemoglobin A1c ( HbA1c ) , fructosamine level and plasma glucose . The secondary end-points were anthropometric measurements and metabolic parameters that include blood pressure , lipid profile and insulin levels . The oral antidiabetic medications remained unchanged throughout the duration of the study . RESULTS A low-GI diet was associated with significant changes in the fructosamine level ( DeltaGI = -0.20 + /- 0.03 ; DeltaCCE = -0.08 + /- 0.03 mmol/l , p < 0.01 ) and waist circumference ( DeltaGI group = -1.88 + /- 0.30 cm ; DeltaCCE group : -0.36 + /- 0.4 cm , p < 0.05 ) at week 4 . At week 12 , the changes in fasting glucose ( DeltaGI = -0.03 + /- 0.3 ; DeltaCCE = 0.7 + /- 0.3 mmol/l ; p < 0.05 ) and waist circumference ( DeltaGI = -2.35 + /- 0.47 cm ; DeltaCCE group = -0.66 + /- 0.46 cm ; p < 0.05 ) in the GI group was significantly lower than the CCE group . With the low-GI diet , the changes in postpr and ial glycaemia at time 0 , 60 , 150 and 180 min after consuming the st and ard test meal was lower than with the CCE diet ( p < 0.05 ) . No significant differences were found between the groups for the remaining parameters that were measured . CONCLUSIONS Use of a low-GI diet result ed in significant changes of serum fructosamine level , plasma glucose and waist circumference in Asian patients with type 2 diabetes over a 12-week period compared with those following a CCE diet . The effect on HbA1c and other metabolic parameters was not significantly different between the two study groups but the improvement within the GI group was more pronounced and of clinical benefit OBJECTIVE To examine whether a worksite nutrition programme using a low-fat vegan diet could significantly improve nutritional intake . DESIGN At two corporate sites of the Government Employees Insurance Company , employees who were either overweight ( BMI > or = 25 kg/m2 ) and /or had type 2 diabetes participated in a 22-week worksite-based dietary intervention study . SETTING At the intervention site , participants were asked to follow a low-fat vegan diet and participate in weekly group meetings that included instruction and group support ( intervention group ) . At the control site , participants received no instruction ( control group ) . At weeks 0 and 22 , participants completed 3 d dietary records to assess energy and nutrient intake . SUBJECTS A total of 109 participants ( sixty-five intervention and forty-four control ) . RESULTS In the intervention group , reported intake of total fat , trans fat , saturated fat and cholesterol decreased significantly ( P < or = 0.001 ) , as did energy and protein ( P = 0.01 ) , and vitamin B12 ( P = 0.002 ) , compared with the control group . Intake ( exclusive of any use of nutritional supplements ) of carbohydrate , fibre , vitamin C , magnesium and potassium increased significantly ( P < or = 0.0001 ) , as did that for beta-carotene ( P = 0.0004 ) , total vitamin A activity ( P = 0.004 ) , vitamin K ( P = 0.01 ) and sodium ( P = 0.04 ) in the intervention group , compared with the control group . CONCLUSIONS The present study suggests that a worksite vegan nutrition programme increases intakes of protective nutrients , such as fibre , folate and vitamin C , and decreases intakes of total fat , saturated fat and cholesterol Abstract Evidence has shown that long-term sodium reduction can not only reduce blood pressure , but also provide cardiovascular benefits . To date , there is little evidence related to the effects of salt reduction on isolated systolic hypertension ( ISH ) . A total of 126 hypertensive patients were divided into an ISH group ( n = 51 ) and a non-ISH ( NISH ) group ( n = 75 ) . The members of each group were then r and omly assigned to low sodium salt ( LSSalt ) or normal salt ( NSalt ) diets for 6 months . Their blood pressure was measured every 2 months . Serum plasma renin-angiotensin activity , blood biochemical assays and urinary measurements were determined at the baseline and at the end of the 6 months . At the end of the study , the mean systolic blood pressure ( SBP ) of the ISH LSSalt group had significantly decreased by 10.18 mm Hg ( 95 % confidence interval ( CI ) : 3.13 to 17.2 , P = .006 ) compared with that of the ISH NSalt group , while the mean SBP only decreased by 5.10 mm Hg ( 95 % CI : −2.02 to 12.2 , P = .158 ) in the NISH LSSalt group compared with that of the NISH NSalt group . The mean diastolic blood pressure ( DBP ) had no significant differences in the ISH and NISH groups . No obvious renin angiotensin system activation was found after LSSalt intervention . Regarding the urinary excretion of electrolytes and blood biochemical assays , the LSSalt treatment had the same effects on the ISH group as on the NISH group . The present study showed that the SBP of ISH patients was significantly decreased with the LSSalt intervention , while neither the SBP of the NISH patients nor the DBP of either group were similarly decreased , which indicated that ISH patients were more sensitive to salt restriction OBJECTIVE To determine the effects of the Dietary Approaches to Stop Hypertension ( DASH ) eating pattern on cardiometabolic risks in type 2 diabetic patients . RESEARCH DESIGN AND METHODS A r and omized crossover clinical trial was undertaken in 31 type 2 diabetic patients . For 8 weeks , participants were r and omly assigned to a control diet or the DASH eating pattern . RESULTS After following the DASH eating pattern , body weight ( P = 0.007 ) and waist circumference ( P = 0.002 ) reduced significantly . Fasting blood glucose levels and A1C decreased after adoption of the DASH diet ( −29.4 ± 6.3 mg/dl ; P = 0.04 and −1.7 ± 0.1 % ; P = 0.04 , respectively ) . After the DASH diet , the mean change for HDL cholesterol levels was higher ( 4.3 ± 0.9 mg/dl ; P = 0.001 ) and LDL cholesterol was reduced ( −17.2 ± 3.5 mg/dl ; P = 0.02 ) . Additionally , DASH had beneficial effects on systolic ( −13.6 ± 3.5 vs. −3.1 ± 2.7 mmHg ; P = 0.02 ) and diastolic blood pressure ( −9.5 ± 2.6 vs. −0.7 ± 3.3 mmHg ; P = 0.04 ) . CONCLUSIONS Among diabetic patients , the DASH diet had beneficial effects on cardiometabolic risks Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Summary Fifty hypertensive Type 2 ( non-insulin-dependent ) diabetic patients were allocated , in a controlled trial , to a treatment diet of high fibre , low fat and low sodium composition , or to a control diet by the hospital dietitian . After 3 months treatment , the modified diet-treated group showed a highly significant reduction in mean systolic ( 180.5±19.0 to 165.0±20.7 mmHg ) and diastolic blood pressure ( 96.6±9.3 to 88.0±10.5 mmHg ) , accompanied by significant reductions in urinary sodium excretion ( 183.0±62.1 to 121.7 + 65.8 mmol/day ) glycosylated haemoglobin ( 12.4±3.1 to 10.5±2.9 % ) , weight ( 74.6s±13.5 to 71.7±12.1 kg ) and serum triglyceride levels ( p<0.05 ) . The mean values of diastolic pressure ( p<0.01 ) , urinary sodium/potassium ratio ( p < 0.001 ) , urinary potassium ( p<0.01 ) was significantly reduced at 3 months compared to control . No changes in serum HDL-cholesterol levels were observed . The number of patients with normal blood pressure at 3 months was greater in the modified diet-treated group ( ten versus five ) . Treatment of mild hypertension in diabetic subjects with this form of dietary regimen has a hypotensive response , with improvement in glycaemic control and no side effects . This modified diet may be an attractive alternative to anti-hypertensive drug therapy as a first line treatment Objective Several intervention studies have suggested that vegetarian or vegan diets have clinical benefits , particularly in terms of glycemic control , in patients with type 2 diabetes ( T2D ) ; however , no r and omized controlled trial has been conducted in Asians who more commonly depend on plant-based foods , as compared to Western population s. Here , we aim ed to compare the effect of a vegan diet and conventional diabetic diet on glycemic control among Korean individuals . Material s and Methods Participants diagnosed with T2D were r and omly assigned to follow either a vegan diet ( excluding animal-based food including fish ; n = 46 ) or a conventional diet recommended by the Korean Diabetes Association 2011 ( n = 47 ) for 12 weeks . HbA1c levels were 
    Output:
    