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 & AIMS Indirect comparisons suggest that alternate-day fasting ( ADF ) may produce greater improvements in body composition , fat distribution , and /or the adipokine profile compared to daily calorie restriction ( CR ) , but this has not been tested directly . In a pre-planned secondary analysis of a r and omized controlled trial , we compared changes in the VAT : SAT ratio , FFM : total mass ratio , and the adipokine profile between ADF and CR . METHODS Overweight and obese participants ( n = 100 ) were r and omized to 1 ) ADF ( alternating every 24-h between consuming 25 % or 125 % of energy needs ) ; 2 ) CR ( consuming 75 % of needs every day ) ; or 3 ) control ( consuming 100 % of needs every day ) for 24 wk . RESULTS The VAT : SAT ratio did not change in any group . The FFM : total mass ratio increased in both ADF ( 0.03 ± 0.00 ) and CR ( 0.03 ± 0.01 ) compared to the control group ( P < 0.01 ) , with no differences between the intervention groups . Circulating leptin decreased in both the ADF group ( -18 ± 6 % ) and CR group ( -31 ± 10 % ) relative to the control group ( P < 0.05 ) , with no differences between the intervention groups . Circulating levels of adiponectin , resistin , IL-6 , and TNF-α did not change in either intervention group relative to the control group . CONCLUSION ADF and CR similarly improve the FFM : total mass ratio and reduce leptin after a 24-wk intervention . TRIAL REGISTRATION Clinical trials.gov , number NCT00960505 ABSTRACT Background : There are no investigations regarding the effects of consuming low-energy-dense diets rich in multiple functional foods on weight-loss maintenance , inflammatory markers , and cardiovascular disease ( CVD ) risk factors simultaneously . Method : This r and omized controlled trial design was conducted on 90 men and women who were under a previous weight loss diet . Three months of intervention with recruitment at Allzahra Hospital , Isfahan , Iran , was done . Intervention was conducted following achieving 7–11 kg weight loss . Participants were encouraged to consumed these three : an isocaloric control diet ( 50 % of energy from carbohydrate , 35 % from fat , 15 % from protein ) , a low-glycemic-index diet ( LE ) ( 60 % from carbohydrate , 25 % from fat , and 15 % from protein ) , and a low-glycemic-index diet rich in multiple functional foods ( LE + FF ) ( 60 % from carbohydrate , 25 % from fat , and 15 % from protein ) . Fasting blood glucose , serum insulin level , lipid profiles , inflammatory markers , adiponectin , systolic and diastolic blood pressure , and anthropometric measurements were assessed using st and ard guidelines . Results : The percent changes of weight , waist , and body mass index ( BMI ) , systolic and diastolic blood pressure , malondialdehyde ( MDA ) , high-sensitivity C-reactive protein ( hs-CRP ) , tumor necrosis factor ( TNF ) α , total cholesterol , low-density lipoprotein ( LDL ) cholesterol , triglyceride , and fasting blood glucose ( FBS ) were substantially more decreased in the LE + FF group compared to the LE and control groups ( p ≤ 0.03 ) . Percent change of adiponectin among the LE + FF group was significantly more enhanced ( 7.29 ± 0.10 ) compared with the LE group ( 1.28 ± 0.20 ) ( p = 0.001 ) . Significantly more increment in the percent change of total antioxidant capacity ( TAC ) ( 6.91 ± 0.10 ) was obtained among the LE + FF group compared to the LE group ( 1.79 ± 0.04 ) . Conclusions : This study provides established evidence supporting the beneficial effects of a low-energy-dense diet rich in multiple functional foods diet on improving weight-loss maintenance , inflammation , and cardiovascular risk factors Background : Little is known about the effects of a low energy dense diet on weight maintenance and cardiovascular risks following a recent weight reduction . Therefore , we assessed if weight maintenance , lipid profiles , and glycemic control differ between low energy density ( LED ) diet and usual diet consumers following a recent weight reduction . Material s and Methods : In this r and omized controlled clinical trial study in a parallel design , we recruited 70 patients with the history of weight reduction in the recent 1 year .  LED diet contained 30 % fat , 15 % protein , and 55 % carbohydrate was administered to the test group , and a usual diet including 35 % fat , 15 % protein , and 50 % carbohydrate was prescribed to the control group for 7 months . Dietary intake was assessed by using 3 days food records . Biochemical markers and anthropometric measures were done according to the st and ard protocol . Results : Weight reduced in LED diet consumers compared to usual diet consumers ( −0.3 ± 0.2 vs. 1.3 ± 0.4 % , P = 0.002 ) . The results was the same regarding waist circumference ( −0.4 ± 0.2 vs. 0.3 ± 0.1 % , P = 0.004 ) . Fasting blood sugar also decreased in LED diet group ( −9.5 ± 0.8 vs. 0.4 ± 1.0 % , P = 0.0001 ) . LED diet group had a drop in percent change of their total cholesterol ( −0.4 ± 0.5 vs. 2.05 ± 0.4 % , P = 0.04 ) and low-density lipoprotein-cholesterol ( 4.8 ± 0.9 vs. −0.3 ± 0.9 % , P = 0.002 ) . Conclusion : Our findings confirmed beneficial effects of LED diet on attenuating weight regain in subjects with history of recent weight reduction . It might be derived from higher consumption of fruits , vegetables , and fiber among LED diet than usual diet consumers A periodic fasting diet improves markers of metabolic dysfunction , particularly in people already at risk .  Fasting : More than a fad Mice that fast periodically are healthier , metabolically speaking . To explore whether fasting can help people as well , Wei et al. studied 71 people who either consumed a fasting-mimicking diet for 5 days each month for 3 months or maintained their normal diet for 3 months and then switched to the fasting schedule .  The fasting-like diet reduced body weight and body fat , lowered blood pressure , and decreased the hormone IGF-1 , which has been implicated in aging and disease . A post hoc analysis replicated these results and also showed that fasting decreased BMI , glucose , triglycerides , cholesterol , and C-reactive protein ( a marker for inflammation ) . These effects were generally larger in the subjects who were at greater risk of disease at the start of the study . A larger study is needed to replicate these results , but they raise the possibility that fasting may be a practical road to a healthy metabolic system . Calorie restriction or changes in dietary composition can enhance healthy aging , but the inability of most subjects to adhere to chronic and extreme diets , as well as potentially adverse effects , limits their application . We r and omized 100 generally healthy participants from the United States into two study arms and tested the effects of a fasting-mimicking diet (FMD)—low in calories , sugars , and protein but high in unsaturated fats — on markers/risk factors associated with aging and age-related diseases . We compared subjects who followed 3 months of an unrestricted diet to subjects who consumed the FMD for 5 consecutive days per month for 3 months . Three FMD cycles reduced body weight , trunk , and total body fat ; lowered blood pressure ; and decreased insulin-like growth factor 1 ( IGF-1 ) . No serious adverse effects were reported . After 3 months , control diet subjects were crossed over to the FMD program , result ing in a total of 71 subjects completing three FMD cycles . A post hoc analysis of subjects from both FMD arms showed that body mass index , blood pressure , fasting glucose , IGF-1 , triglycerides , total and low-density lipoprotein cholesterol , and C-reactive protein were more beneficially affected in participants at risk for disease than in subjects who were not at risk . Thus , cycles of a 5-day FMD are safe , feasible , and effective in reducing markers/risk factors for aging and age-related diseases . Larger studies in patients with diagnosed diseases or selected on the basis of risk factors are warranted to confirm the effect of the FMD on disease prevention and treatment Nutritional intervention for weight loss is one of the treatment options for  obstructive sleep apnoea ( OSA ) in patients with overweight or obesity . However , the effects of moderate energy restriction on OSA severity are not yet known . The present study aim ed to evaluate the effects of moderate energy restriction on OSA severity and CVD risk factors  in obese patients with OSA . In this 16-week r and omised clinical trial , twenty-one obese subjects aged 20 - 55 years and presenting an apnoea/hypopnoea index (AHI)≥5 events/h were r and omised into two groups : the energy restriction group ( ERG ) and the control group ( CG ) . The ERG was instructed to follow an energy-restricted diet -3347·2 kJ/d ( -800 kcal/d ) and the CG was advised not to change their food intake . At the beginning and at the end of the study , participants underwent evaluation of the following : OSA ( Watch-PAT200 ® ) , nutritional parameters , blood pressure , sympathetic activity , inflammatory biomarkers , metabolic profile and endothelial function . The ERG ( n 11 ) , compared with the CG ( n 10 ) , had a significantly greater reduction in body weight ( Cohen 's d=-1·19 ; P<0·001 ) , in AHI ( Cohen 's d=-0·95 ; P=0·04 ) and in plasma concentrations of adrenaline ( Cohen 's d=-1·02 ; P=0·04 ) as well as a significantly greater increase in minimum O2 saturation ( Cohen 's d=1·08 ; P=0·03 ) . Although energy restriction was not associated with significant improvements in CVD risk factors , medium-to-large effect sizes were observed , suggesting that the statistically non-significant difference between groups may be due to the small sample size . This study suggests that in obese patients with OSA , moderate energy restriction is able to reduce the parameters of OSA severity and sympathetic activity Abstract Overweight and obesity lead to changes in adipose tissue such as inflammation and reduced insulin sensitivity . The aim of this study was to assess how altered energy balance by reduced food intake or enhanced physical activity affect these processes . We studied sedentary subjects with overweight/obesity in two intervention studies , each lasting 12 weeks affecting energy balance either by energy restriction ( ~20 % reduced intake of energy from food ) in one group , or by enhanced energy expenditure due to physical exercise ( combined endurance‐ and strength‐training ) in the other group . We monitored mRNA expression by microarray and mRNA sequencing from adipose tissue biopsies . We also measured several plasma parameters as well as fat distribution with magnetic resonance imaging and spectroscopy . Comparison of microarray and mRNA sequencing showed strong correlations , which were also confirmed using RT‐PCR . In the energy restricted subjects ( body weight reduced by 5 % during a 12 weeks intervention ) , there were clear signs of enhanced lipolysis as monitored by mRNA in adipose tissue as well as plasma concentration of free‐fatty acids . This increase was strongly related to increased expression of markers for M1‐like macrophages in adipose tissue . In the exercising subjects ( glucose infusion rate increased by 29 % during a 12‐week intervention ) , there was a marked reduction in the expression of markers of M2‐like macrophages and T cells , suggesting that physical exercise was especially important for reducing inflammation in adipose tissue with insignificant reduction in total body weight . Our data indicate that energy restriction and physical exercise affect energy‐related pathways as well as inflammatory processes in different ways , probably related to macrophages in adipose tissue Background Alternate day fasting ( ADF ; ad libitum “ feed day ” , alternated with 25 % energy intake “ fast day ” ) , is effective for weight loss and cardio-protection in obese individuals . Whether these effects occur in normal weight and overweight individuals remains unknown . This study examined the effect of ADF on body weight and coronary heart disease risk in non-obese subjects . Methods Thirty-two subjects ( BMI 20–29.9 kg/m2 ) were r and omized to either an ADF group or a control group for 12 weeks . Results Body weight decreased ( P < 0.001 ) by 5.2 ± 0.9 kg ( 6.5 ± 1.0 % ) in the ADF group , relative to the control group , by week 12 . Fat mass was reduced ( P < 0.001 ) by 3.6 ± 0.7 kg , and fat free mass did not change , versus controls . Triacylglycerol concentrations decreased ( 20 ± 8 % , P < 0.05 ) and LDL particle size increased ( 4 ± 1 Å , P < 0.01 ) in the ADF group relative to controls . CRP decreased ( 1 
    Output:
    
agent
Relative to a non-diet control , IF and ERD are effective for the improvement of circulating TC , LDL-C , and TG concentrations , but have no meaningful effects on HDL-C concentration .
The present results suggest that these dietary practice s are a means of enhancing the lipid profile in humans
***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 & AIMS Indirect comparisons suggest that alternate-day fasting ( ADF ) may produce greater improvements in body composition , fat distribution , and /or the adipokine profile compared to daily calorie restriction ( CR ) , but this has not been tested directly . In a pre-planned secondary analysis of a r and omized controlled trial , we compared changes in the VAT : SAT ratio , FFM : total mass ratio , and the adipokine profile between ADF and CR . METHODS Overweight and obese participants ( n = 100 ) were r and omized to 1 ) ADF ( alternating every 24-h between consuming 25 % or 125 % of energy needs ) ; 2 ) CR ( consuming 75 % of needs every day ) ; or 3 ) control ( consuming 100 % of needs every day ) for 24 wk . RESULTS The VAT : SAT ratio did not change in any group . The FFM : total mass ratio increased in both ADF ( 0.03 ± 0.00 ) and CR ( 0.03 ± 0.01 ) compared to the control group ( P < 0.01 ) , with no differences between the intervention groups . Circulating leptin decreased in both the ADF group ( -18 ± 6 % ) and CR group ( -31 ± 10 % ) relative to the control group ( P < 0.05 ) , with no differences between the intervention groups . Circulating levels of adiponectin , resistin , IL-6 , and TNF-α did not change in either intervention group relative to the control group . CONCLUSION ADF and CR similarly improve the FFM : total mass ratio and reduce leptin after a 24-wk intervention . TRIAL REGISTRATION Clinical trials.gov , number NCT00960505 ABSTRACT Background : There are no investigations regarding the effects of consuming low-energy-dense diets rich in multiple functional foods on weight-loss maintenance , inflammatory markers , and cardiovascular disease ( CVD ) risk factors simultaneously . Method : This r and omized controlled trial design was conducted on 90 men and women who were under a previous weight loss diet . Three months of intervention with recruitment at Allzahra Hospital , Isfahan , Iran , was done . Intervention was conducted following achieving 7–11 kg weight loss . Participants were encouraged to consumed these three : an isocaloric control diet ( 50 % of energy from carbohydrate , 35 % from fat , 15 % from protein ) , a low-glycemic-index diet ( LE ) ( 60 % from carbohydrate , 25 % from fat , and 15 % from protein ) , and a low-glycemic-index diet rich in multiple functional foods ( LE + FF ) ( 60 % from carbohydrate , 25 % from fat , and 15 % from protein ) . Fasting blood glucose , serum insulin level , lipid profiles , inflammatory markers , adiponectin , systolic and diastolic blood pressure , and anthropometric measurements were assessed using st and ard guidelines . Results : The percent changes of weight , waist , and body mass index ( BMI ) , systolic and diastolic blood pressure , malondialdehyde ( MDA ) , high-sensitivity C-reactive protein ( hs-CRP ) , tumor necrosis factor ( TNF ) α , total cholesterol , low-density lipoprotein ( LDL ) cholesterol , triglyceride , and fasting blood glucose ( FBS ) were substantially more decreased in the LE + FF group compared to the LE and control groups ( p ≤ 0.03 ) . Percent change of adiponectin among the LE + FF group was significantly more enhanced ( 7.29 ± 0.10 ) compared with the LE group ( 1.28 ± 0.20 ) ( p = 0.001 ) . Significantly more increment in the percent change of total antioxidant capacity ( TAC ) ( 6.91 ± 0.10 ) was obtained among the LE + FF group compared to the LE group ( 1.79 ± 0.04 ) . Conclusions : This study provides established evidence supporting the beneficial effects of a low-energy-dense diet rich in multiple functional foods diet on improving weight-loss maintenance , inflammation , and cardiovascular risk factors Background : Little is known about the effects of a low energy dense diet on weight maintenance and cardiovascular risks following a recent weight reduction . Therefore , we assessed if weight maintenance , lipid profiles , and glycemic control differ between low energy density ( LED ) diet and usual diet consumers following a recent weight reduction . Material s and Methods : In this r and omized controlled clinical trial study in a parallel design , we recruited 70 patients with the history of weight reduction in the recent 1 year .  LED diet contained 30 % fat , 15 % protein , and 55 % carbohydrate was administered to the test group , and a usual diet including 35 % fat , 15 % protein , and 50 % carbohydrate was prescribed to the control group for 7 months . Dietary intake was assessed by using 3 days food records . Biochemical markers and anthropometric measures were done according to the st and ard protocol . Results : Weight reduced in LED diet consumers compared to usual diet consumers ( −0.3 ± 0.2 vs. 1.3 ± 0.4 % , P = 0.002 ) . The results was the same regarding waist circumference ( −0.4 ± 0.2 vs. 0.3 ± 0.1 % , P = 0.004 ) . Fasting blood sugar also decreased in LED diet group ( −9.5 ± 0.8 vs. 0.4 ± 1.0 % , P = 0.0001 ) . LED diet group had a drop in percent change of their total cholesterol ( −0.4 ± 0.5 vs. 2.05 ± 0.4 % , P = 0.04 ) and low-density lipoprotein-cholesterol ( 4.8 ± 0.9 vs. −0.3 ± 0.9 % , P = 0.002 ) . Conclusion : Our findings confirmed beneficial effects of LED diet on attenuating weight regain in subjects with history of recent weight reduction . It might be derived from higher consumption of fruits , vegetables , and fiber among LED diet than usual diet consumers A periodic fasting diet improves markers of metabolic dysfunction , particularly in people already at risk .  Fasting : More than a fad Mice that fast periodically are healthier , metabolically speaking . To explore whether fasting can help people as well , Wei et al. studied 71 people who either consumed a fasting-mimicking diet for 5 days each month for 3 months or maintained their normal diet for 3 months and then switched to the fasting schedule .  The fasting-like diet reduced body weight and body fat , lowered blood pressure , and decreased the hormone IGF-1 , which has been implicated in aging and disease . A post hoc analysis replicated these results and also showed that fasting decreased BMI , glucose , triglycerides , cholesterol , and C-reactive protein ( a marker for inflammation ) . These effects were generally larger in the subjects who were at greater risk of disease at the start of the study . A larger study is needed to replicate these results , but they raise the possibility that fasting may be a practical road to a healthy metabolic system . Calorie restriction or changes in dietary composition can enhance healthy aging , but the inability of most subjects to adhere to chronic and extreme diets , as well as potentially adverse effects , limits their application . We r and omized 100 generally healthy participants from the United States into two study arms and tested the effects of a fasting-mimicking diet (FMD)—low in calories , sugars , and protein but high in unsaturated fats — on markers/risk factors associated with aging and age-related diseases . We compared subjects who followed 3 months of an unrestricted diet to subjects who consumed the FMD for 5 consecutive days per month for 3 months . Three FMD cycles reduced body weight , trunk , and total body fat ; lowered blood pressure ; and decreased insulin-like growth factor 1 ( IGF-1 ) . No serious adverse effects were reported . After 3 months , control diet subjects were crossed over to the FMD program , result ing in a total of 71 subjects completing three FMD cycles . A post hoc analysis of subjects from both FMD arms showed that body mass index , blood pressure , fasting glucose , IGF-1 , triglycerides , total and low-density lipoprotein cholesterol , and C-reactive protein were more beneficially affected in participants at risk for disease than in subjects who were not at risk . Thus , cycles of a 5-day FMD are safe , feasible , and effective in reducing markers/risk factors for aging and age-related diseases . Larger studies in patients with diagnosed diseases or selected on the basis of risk factors are warranted to confirm the effect of the FMD on disease prevention and treatment Nutritional intervention for weight loss is one of the treatment options for  obstructive sleep apnoea ( OSA ) in patients with overweight or obesity . However , the effects of moderate energy restriction on OSA severity are not yet known . The present study aim ed to evaluate the effects of moderate energy restriction on OSA severity and CVD risk factors  in obese patients with OSA . In this 16-week r and omised clinical trial , twenty-one obese subjects aged 20 - 55 years and presenting an apnoea/hypopnoea index (AHI)≥5 events/h were r and omised into two groups : the energy restriction group ( ERG ) and the control group ( CG ) . The ERG was instructed to follow an energy-restricted diet -3347·2 kJ/d ( -800 kcal/d ) and the CG was advised not to change their food intake . At the beginning and at the end of the study , participants underwent evaluation of the following : OSA ( Watch-PAT200 ® ) , nutritional parameters , blood pressure , sympathetic activity , inflammatory biomarkers , metabolic profile and endothelial function . The ERG ( n 11 ) , compared with the CG ( n 10 ) , had a significantly greater reduction in body weight ( Cohen 's d=-1·19 ; P<0·001 ) , in AHI ( Cohen 's d=-0·95 ; P=0·04 ) and in plasma concentrations of adrenaline ( Cohen 's d=-1·02 ; P=0·04 ) as well as a significantly greater increase in minimum O2 saturation ( Cohen 's d=1·08 ; P=0·03 ) . Although energy restriction was not associated with significant improvements in CVD risk factors , medium-to-large effect sizes were observed , suggesting that the statistically non-significant difference between groups may be due to the small sample size . This study suggests that in obese patients with OSA , moderate energy restriction is able to reduce the parameters of OSA severity and sympathetic activity Abstract Overweight and obesity lead to changes in adipose tissue such as inflammation and reduced insulin sensitivity . The aim of this study was to assess how altered energy balance by reduced food intake or enhanced physical activity affect these processes . We studied sedentary subjects with overweight/obesity in two intervention studies , each lasting 12 weeks affecting energy balance either by energy restriction ( ~20 % reduced intake of energy from food ) in one group , or by enhanced energy expenditure due to physical exercise ( combined endurance‐ and strength‐training ) in the other group . We monitored mRNA expression by microarray and mRNA sequencing from adipose tissue biopsies . We also measured several plasma parameters as well as fat distribution with magnetic resonance imaging and spectroscopy . Comparison of microarray and mRNA sequencing showed strong correlations , which were also confirmed using RT‐PCR . In the energy restricted subjects ( body weight reduced by 5 % during a 12 weeks intervention ) , there were clear signs of enhanced lipolysis as monitored by mRNA in adipose tissue as well as plasma concentration of free‐fatty acids . This increase was strongly related to increased expression of markers for M1‐like macrophages in adipose tissue . In the exercising subjects ( glucose infusion rate increased by 29 % during a 12‐week intervention ) , there was a marked reduction in the expression of markers of M2‐like macrophages and T cells , suggesting that physical exercise was especially important for reducing inflammation in adipose tissue with insignificant reduction in total body weight . Our data indicate that energy restriction and physical exercise affect energy‐related pathways as well as inflammatory processes in different ways , probably related to macrophages in adipose tissue Background Alternate day fasting ( ADF ; ad libitum “ feed day ” , alternated with 25 % energy intake “ fast day ” ) , is effective for weight loss and cardio-protection in obese individuals . Whether these effects occur in normal weight and overweight individuals remains unknown . This study examined the effect of ADF on body weight and coronary heart disease risk in non-obese subjects . Methods Thirty-two subjects ( BMI 20–29.9 kg/m2 ) were r and omized to either an ADF group or a control group for 12 weeks . Results Body weight decreased ( P < 0.001 ) by 5.2 ± 0.9 kg ( 6.5 ± 1.0 % ) in the ADF group , relative to the control group , by week 12 . Fat mass was reduced ( P < 0.001 ) by 3.6 ± 0.7 kg , and fat free mass did not change , versus controls . Triacylglycerol concentrations decreased ( 20 ± 8 % , P < 0.05 ) and LDL particle size increased ( 4 ± 1 Å , P < 0.01 ) in the ADF group relative to controls . CRP decreased ( 1 
    Output:
    