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: Objective To evaluate the effects of water versus beverages sweetened with non‐nutritive sweeteners ( NNS ) on body weight in subjects enrolled in a year‐long behavioral weight loss treatment program . Methods The study used a r and omized equivalence design with NNS or water beverages as the main factor in a trial among 303 weight‐stable people with overweight and obesity . All participants participated in a weight loss program plus assignment to consume 24 ounces ( 710 ml ) of water or NNS beverages daily for 1 year . Results NNS and water treatments were non‐equivalent , with NNS treatment  showing greater weight loss at the end of 1 year . At 1 year subjects receiving water had maintained a 2.45 ± 5.59 kg weight loss while those receiving NNS beverages maintained a loss of 6.21 ± 7.65 kg ( P < 0.001 for difference ) . Conclusions Water and NNS beverages were not equivalent for weight loss and maintenance during a 1‐year behavioral treatment program . NNS beverages were superior for weight loss and weight maintenance in a population consisting of regular users  of NNS beverages who either maintained or discontinued consumption of these beverages and consumed water during a structured weight loss program . These results suggest that NNS beverages can be an effective tool for weight loss and maintenance within the context of a weight management program To investigate whether obese women can compensate for sucrose added to the diet when it is given blind , rather than gaining weight or exhibiting dysfunctional regulation of intake , in the present study , forty-one healthy obese ( BMI 30–35 kg/m2 ) women ( age 20–50 years ) , not currently dieting , were r and omly assigned to consume sucrose ( n 20 ) or aspartame ( n 21 ) drinks over 4 weeks in a parallel single-blind design . Over the 4 weeks , one group consumed 4 × 250 ml sucrose drinks ( total 1800 kJ/d ) and the other group consumed 4 × 250 ml aspartame drinks . During the baseline week and experimental weeks , body weight and other biometric data were measured and steps per day , food intake using 7 d unweighed food diaries , and mood using ten- or seven-point Likert scales four times a day were recorded . At the end of the experiment , the participants weighed 1·72 ( se 0·47 ) kg less than the value predicted by the National Institute of Diabetes and Digestive and Kidney Diseases ( NIDDK ) model ; the predicted body weight accounted for 94·3 % of the variance in the observed body weight and experimental group accounted for a further 1·1 % of the variance in the observed body weight , showing that women consuming sucrose drinks gained significantly less weight than predicted . The reported daily energy intake did not increase significantly , and sucrose supplements significantly reduced the reported voluntary sugar , starch and fat intake  compared with aspartame . There were no effects on appetite or mood . Over 4 weeks , as part of everyday eating , sucrose given blind in soft drinks was partially compensated for by obese women , as in previous experiments with healthy and overweight participants The long-term physiological effects of refined carbohydrates on appetite and mood remain unclear . Reported effects when subjects are not blind may be due to expectations and have rarely been studied for more than 24 h. The present study compared the effects of supplementary soft drinks added to the diet over 4 weeks on dietary intake , mood and BMI in normal-weight women ( n 133 ) . Subjects were categorised as ' watchers ' or ' non-watchers ' of what they ate then received sucrose or artificially sweetened drinks ( 4 x 250 ml per d ) . Expectancies were varied by labelling drinks ' sugar ' or ' diet ' in a counter-balanced design . Sucrose supplements provided 1800 kJ per d and sweetener supplements provided 67 kJ per d. Food intake was measured with a 7 d diary and mood with ten single Likert scales . By 4 weeks , sucrose supplements significantly reduced total carbohydrate intake ( F(1,129 ) = 53.81 ; P<0.001 ) , fat ( F(2,250 ) = 33.33 ; P<0.001 ) and protein intake ( F(2,250 ) = 28.04 ; P<0 - 001 ) compared with sweetener supplements .  Mean daily energy intake increased by just under 1000 kJ compared with baseline ( t ( 67 df ) = 3.82 ; P < 0.001 ) and was associated with a non-significant trend for those receiving sucrose to gain weight . There were no effects on appetite or mood . Neither dietary restraint status as measured by the Dutch Eating Behaviour Question naire nor the expectancy procedure had effects . Expectancies influenced mood only during baseline week . It is concluded that sucrose satiates , rather than stimulates , appetite or negative mood in normal-weight subjects BACKGROUND The consumption of beverages that contain sugar is associated with overweight , possibly because liquid sugars do not lead to a sense of satiety , so the consumption of other foods is not reduced . However , data are lacking to show that the replacement of sugar-containing beverages with noncaloric beverages diminishes weight gain . METHODS We conducted an 18-month trial involving 641 primarily normal-weight children from 4 years 10 months to 11 years 11 months of age . Participants were r and omly assigned to receive 250 ml ( 8 oz ) per day of a sugar-free , artificially sweetened beverage ( sugar-free group ) or a similar sugar-containing beverage that provided 104 kcal ( sugar group ) . Beverages were distributed through schools . At 18 months , 26 % of the children had stopped consuming the beverages ; the data from children who did not complete the study were imputed . RESULTS The z score for the body-mass index ( BMI , the weight in kilograms divided by the square of the height in meters ) increased on average by 0.02 SD units in the sugar-free group and by 0.15 SD units in the sugar group ; the 95 % confidence interval ( CI ) of the difference was -0.21 to -0.05 . Weight increased by 6.35 kg in the sugar-free group as compared with 7.37 kg in the sugar group ( 95 % CI for the difference , -1.54 to -0.48 ) . The skinfold-thickness measurements , waist-to-height ratio , and fat mass also increased significantly less in the sugar-free group . Adverse events were minor . When we combined measurements at 18 months in 136 children who had discontinued the study with those in 477 children who completed the study , the BMI z score increased by 0.06 SD units in the sugar-free group and by 0.12 SD units in the sugar group ( P=0.06 ) . CONCLUSIONS Masked replacement of sugar-containing beverages with noncaloric beverages reduced weight gain and fat accumulation in normal-weight children . ( Funded by the Netherl and s Organization for Health Research and Development and others ; DRINK Clinical Trials.gov number , NCT00893529 . ) This study investigated whether the addition of the high-intensity sweetener aspartame to a multidisciplinary weight-control program would improve weight loss and long-term control of body weight .  One hundred sixty-three obese women were r and omly assigned to consume or to abstain from aspartame-sweetened foods and beverages during 16 wk of a 19-wk weight-reduction program ( active weight loss ) , a 1-y maintenance program , and a 2-y follow-up period . Women in both treatment groups lost approximately 10 % of initial body weight ( 10 kg ) during active weight loss . Among women assigned to the aspartame-treatment group , aspartame intake was positively correlated with percentage weight loss during active weight loss ( r = 0.32 , P < 0.01 ) . During maintenance and follow-up , participants in the aspartame group experienced a 2.6 % ( 2.6 kg ) and 4.6 % ( 4.6 kg ) regain of initial body weight after 71 and 175 wk , respectively , whereas those in the no-aspartame group gained an average of 5.4 % ( 5.4 kg ) and 9.4 % ( 9.4 kg ) , respectively . The aspartame group lost significantly more weight overall ( P = 0.028 ) and regained significantly less weight during maintenance and follow-up ( P = 0.046 ) than did the no-aspartame group . Percentage weight losses at 71 and 175 wk were also positively correlated with exercise ( r = 0.32 , P < 0.001 ; and r = 0.34 , P < 0.01 , respectively ) and self-reported eating control ( r = 0.37 , P < 0.001 ; and r = 0.33 , P < 0.01 , respectively ) . These data suggest that participation in a multidisciplinary weight-control program that includes aspartame may facilitate the long-term maintenance of reduced body weight Background : Beneficial effects of replacing diet beverages ( DBs ) with water on weight loss , during a 24-week hypoenergetic diet were previously observed . However , it is not known whether this difference is sustained during a subsequent 12-month weight maintenance period . Objective : To evaluate effects of replacing DBs with water on body weight maintenance over a 12-month period in participants who undertook a 6-month weight loss plan . Design : Seventy-one obese and overweight adult women ( body mass index ( BMI ): 27–40 kg m–2 ; age : 18–50 years ) who usually consumed DBs in their diet were r and omly assigned to either substitute water for DBs ( water group : 35 ) or continue drinking DBs five times per week ( DBs group : 36 ) after their lunch for the 6-month weight loss intervention and subsequent 12-month weight maintenance program . Results : A total of 71 participants who were r and omly assigned were included in the study by using an intention-to-treat analysis . Greater additional weight loss ( mean±s.d . ) in the water group was observed compared with the DBs group after the 12-month follow-up period ( −1.7±2.8 vs −0.1±2.7 kg , P=0.001 ) . BMI decreased more in the water group than in the DBs group ( −0.7±1 vs −0.05±1.1 kg m–2 , P=0.003 ) . There was also a greater reduction in fasting insulin levels ( −0.5±1.4 vs −0.02±1.5 mmol l–1 , P=0.023 ) , better improvement in homeostasis model assessment of insulin resistance ( −0.2±0.4 vs −0.1±0.3 , P=0.013 ) and a greater decrease in 2-h postpr and ial plasma glucose ( −0.2±0.3 vs −0.1±0.3 mmol l–1 , P<0.001 ) in the water group compared with the DBs over the 12-month weight maintenance period . Conclusions : Replacement of DBs with water after the main meal in women who were regular users of DBs may cause further weight reduction during a 12-month weight maintenance program . It may also offer benefits in carbohydrate metabolism including improvement of insulin resistance over the long-term weight maintenance period Background Low-calorie sweeteners are often used to moderate energy intake and postpr and ial glycemia , but some evidence indicates that they may exacerbate these aims . Objective The trial 's primary aim was to assess the effect of daily aspartame ingestion for 12 wk on glycemia . Effects on appetite and body weight were secondary aims . Methods One hundred lean [ body mass index ( kg/m2 ) : 18 - 25 ] adults aged 18 - 60 y were r and omly assigned to consume 0 , 350 , or 1050 mg aspartame/d ( ASP groups ) in a beverage for 12 wk in a parallel-arm design . At baseline , body weight and composition were determined , a 240-min oral-glucose-tolerance test ( OGTT ) was administered , and measurements were made of appetite and selected hormones . Participants also collected a 24-h urine sample . During the intervention , the 0-mg/d ASP group consumed capsules containing 680 mg dextrose and 80 mg para-amino benzoic acid . For the 350-mg/d ASP group , the beverage contained 350 mg aspartame and the 1050-mg/d ASP group consumed the same beverage plus capsules containing 680 mg dextrose and 700 mg aspartame .  Body weight , blood pressure , heart rate , and waist circumference were measured weekly . At weeks 4 , 8 , and 12 , participants collected 24-h urine sample s and kept appetite logs . Baseline measurements were repeated at week 12 . Results With the exception of the baseline OGTT glucose concentration at 60 min ( and result ing area under the curve value ) , there were no group differences for glucose , insulin , resting leptin , glucagon-like peptide 1 , or gastric inhibitory peptide at baseline or week 12 . There also were no effects of aspartame ingestion on appetite , body weight , or body composition . Compliance with the beverage intervention was ∼95 % . Conclusions Aspartame ingested at 2 doses for 12 wk had no effect on glycemia , appetite , or body 
    Output:
    
agent
When comparing NNS vs sucrose , significant weight/ BMI differences appeared favouring NNS .
Consumption of NNS led to significantly negative weight/ BMI differences in unrestricted energy diets , but not in weight-reduction diets .
Participants with overweight/obesity and adults showed significant favourable weight/ BMI differences with NNS .
Data suggest that replacing sugar with NNS leads to weight reduction , particularly in participants with overweight/obesity under an unrestricted diet , information that could be utilized for evidence -based public policy decisions
***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: Objective To evaluate the effects of water versus beverages sweetened with non‐nutritive sweeteners ( NNS ) on body weight in subjects enrolled in a year‐long behavioral weight loss treatment program . Methods The study used a r and omized equivalence design with NNS or water beverages as the main factor in a trial among 303 weight‐stable people with overweight and obesity . All participants participated in a weight loss program plus assignment to consume 24 ounces ( 710 ml ) of water or NNS beverages daily for 1 year . Results NNS and water treatments were non‐equivalent , with NNS treatment  showing greater weight loss at the end of 1 year . At 1 year subjects receiving water had maintained a 2.45 ± 5.59 kg weight loss while those receiving NNS beverages maintained a loss of 6.21 ± 7.65 kg ( P < 0.001 for difference ) . Conclusions Water and NNS beverages were not equivalent for weight loss and maintenance during a 1‐year behavioral treatment program . NNS beverages were superior for weight loss and weight maintenance in a population consisting of regular users  of NNS beverages who either maintained or discontinued consumption of these beverages and consumed water during a structured weight loss program . These results suggest that NNS beverages can be an effective tool for weight loss and maintenance within the context of a weight management program To investigate whether obese women can compensate for sucrose added to the diet when it is given blind , rather than gaining weight or exhibiting dysfunctional regulation of intake , in the present study , forty-one healthy obese ( BMI 30–35 kg/m2 ) women ( age 20–50 years ) , not currently dieting , were r and omly assigned to consume sucrose ( n 20 ) or aspartame ( n 21 ) drinks over 4 weeks in a parallel single-blind design . Over the 4 weeks , one group consumed 4 × 250 ml sucrose drinks ( total 1800 kJ/d ) and the other group consumed 4 × 250 ml aspartame drinks . During the baseline week and experimental weeks , body weight and other biometric data were measured and steps per day , food intake using 7 d unweighed food diaries , and mood using ten- or seven-point Likert scales four times a day were recorded . At the end of the experiment , the participants weighed 1·72 ( se 0·47 ) kg less than the value predicted by the National Institute of Diabetes and Digestive and Kidney Diseases ( NIDDK ) model ; the predicted body weight accounted for 94·3 % of the variance in the observed body weight and experimental group accounted for a further 1·1 % of the variance in the observed body weight , showing that women consuming sucrose drinks gained significantly less weight than predicted . The reported daily energy intake did not increase significantly , and sucrose supplements significantly reduced the reported voluntary sugar , starch and fat intake  compared with aspartame . There were no effects on appetite or mood . Over 4 weeks , as part of everyday eating , sucrose given blind in soft drinks was partially compensated for by obese women , as in previous experiments with healthy and overweight participants The long-term physiological effects of refined carbohydrates on appetite and mood remain unclear . Reported effects when subjects are not blind may be due to expectations and have rarely been studied for more than 24 h. The present study compared the effects of supplementary soft drinks added to the diet over 4 weeks on dietary intake , mood and BMI in normal-weight women ( n 133 ) . Subjects were categorised as ' watchers ' or ' non-watchers ' of what they ate then received sucrose or artificially sweetened drinks ( 4 x 250 ml per d ) . Expectancies were varied by labelling drinks ' sugar ' or ' diet ' in a counter-balanced design . Sucrose supplements provided 1800 kJ per d and sweetener supplements provided 67 kJ per d. Food intake was measured with a 7 d diary and mood with ten single Likert scales . By 4 weeks , sucrose supplements significantly reduced total carbohydrate intake ( F(1,129 ) = 53.81 ; P<0.001 ) , fat ( F(2,250 ) = 33.33 ; P<0.001 ) and protein intake ( F(2,250 ) = 28.04 ; P<0 - 001 ) compared with sweetener supplements .  Mean daily energy intake increased by just under 1000 kJ compared with baseline ( t ( 67 df ) = 3.82 ; P < 0.001 ) and was associated with a non-significant trend for those receiving sucrose to gain weight . There were no effects on appetite or mood . Neither dietary restraint status as measured by the Dutch Eating Behaviour Question naire nor the expectancy procedure had effects . Expectancies influenced mood only during baseline week . It is concluded that sucrose satiates , rather than stimulates , appetite or negative mood in normal-weight subjects BACKGROUND The consumption of beverages that contain sugar is associated with overweight , possibly because liquid sugars do not lead to a sense of satiety , so the consumption of other foods is not reduced . However , data are lacking to show that the replacement of sugar-containing beverages with noncaloric beverages diminishes weight gain . METHODS We conducted an 18-month trial involving 641 primarily normal-weight children from 4 years 10 months to 11 years 11 months of age . Participants were r and omly assigned to receive 250 ml ( 8 oz ) per day of a sugar-free , artificially sweetened beverage ( sugar-free group ) or a similar sugar-containing beverage that provided 104 kcal ( sugar group ) . Beverages were distributed through schools . At 18 months , 26 % of the children had stopped consuming the beverages ; the data from children who did not complete the study were imputed . RESULTS The z score for the body-mass index ( BMI , the weight in kilograms divided by the square of the height in meters ) increased on average by 0.02 SD units in the sugar-free group and by 0.15 SD units in the sugar group ; the 95 % confidence interval ( CI ) of the difference was -0.21 to -0.05 . Weight increased by 6.35 kg in the sugar-free group as compared with 7.37 kg in the sugar group ( 95 % CI for the difference , -1.54 to -0.48 ) . The skinfold-thickness measurements , waist-to-height ratio , and fat mass also increased significantly less in the sugar-free group . Adverse events were minor . When we combined measurements at 18 months in 136 children who had discontinued the study with those in 477 children who completed the study , the BMI z score increased by 0.06 SD units in the sugar-free group and by 0.12 SD units in the sugar group ( P=0.06 ) . CONCLUSIONS Masked replacement of sugar-containing beverages with noncaloric beverages reduced weight gain and fat accumulation in normal-weight children . ( Funded by the Netherl and s Organization for Health Research and Development and others ; DRINK Clinical Trials.gov number , NCT00893529 . ) This study investigated whether the addition of the high-intensity sweetener aspartame to a multidisciplinary weight-control program would improve weight loss and long-term control of body weight .  One hundred sixty-three obese women were r and omly assigned to consume or to abstain from aspartame-sweetened foods and beverages during 16 wk of a 19-wk weight-reduction program ( active weight loss ) , a 1-y maintenance program , and a 2-y follow-up period . Women in both treatment groups lost approximately 10 % of initial body weight ( 10 kg ) during active weight loss . Among women assigned to the aspartame-treatment group , aspartame intake was positively correlated with percentage weight loss during active weight loss ( r = 0.32 , P < 0.01 ) . During maintenance and follow-up , participants in the aspartame group experienced a 2.6 % ( 2.6 kg ) and 4.6 % ( 4.6 kg ) regain of initial body weight after 71 and 175 wk , respectively , whereas those in the no-aspartame group gained an average of 5.4 % ( 5.4 kg ) and 9.4 % ( 9.4 kg ) , respectively . The aspartame group lost significantly more weight overall ( P = 0.028 ) and regained significantly less weight during maintenance and follow-up ( P = 0.046 ) than did the no-aspartame group . Percentage weight losses at 71 and 175 wk were also positively correlated with exercise ( r = 0.32 , P < 0.001 ; and r = 0.34 , P < 0.01 , respectively ) and self-reported eating control ( r = 0.37 , P < 0.001 ; and r = 0.33 , P < 0.01 , respectively ) . These data suggest that participation in a multidisciplinary weight-control program that includes aspartame may facilitate the long-term maintenance of reduced body weight Background : Beneficial effects of replacing diet beverages ( DBs ) with water on weight loss , during a 24-week hypoenergetic diet were previously observed . However , it is not known whether this difference is sustained during a subsequent 12-month weight maintenance period . Objective : To evaluate effects of replacing DBs with water on body weight maintenance over a 12-month period in participants who undertook a 6-month weight loss plan . Design : Seventy-one obese and overweight adult women ( body mass index ( BMI ): 27–40 kg m–2 ; age : 18–50 years ) who usually consumed DBs in their diet were r and omly assigned to either substitute water for DBs ( water group : 35 ) or continue drinking DBs five times per week ( DBs group : 36 ) after their lunch for the 6-month weight loss intervention and subsequent 12-month weight maintenance program . Results : A total of 71 participants who were r and omly assigned were included in the study by using an intention-to-treat analysis . Greater additional weight loss ( mean±s.d . ) in the water group was observed compared with the DBs group after the 12-month follow-up period ( −1.7±2.8 vs −0.1±2.7 kg , P=0.001 ) . BMI decreased more in the water group than in the DBs group ( −0.7±1 vs −0.05±1.1 kg m–2 , P=0.003 ) . There was also a greater reduction in fasting insulin levels ( −0.5±1.4 vs −0.02±1.5 mmol l–1 , P=0.023 ) , better improvement in homeostasis model assessment of insulin resistance ( −0.2±0.4 vs −0.1±0.3 , P=0.013 ) and a greater decrease in 2-h postpr and ial plasma glucose ( −0.2±0.3 vs −0.1±0.3 mmol l–1 , P<0.001 ) in the water group compared with the DBs over the 12-month weight maintenance period . Conclusions : Replacement of DBs with water after the main meal in women who were regular users of DBs may cause further weight reduction during a 12-month weight maintenance program . It may also offer benefits in carbohydrate metabolism including improvement of insulin resistance over the long-term weight maintenance period Background Low-calorie sweeteners are often used to moderate energy intake and postpr and ial glycemia , but some evidence indicates that they may exacerbate these aims . Objective The trial 's primary aim was to assess the effect of daily aspartame ingestion for 12 wk on glycemia . Effects on appetite and body weight were secondary aims . Methods One hundred lean [ body mass index ( kg/m2 ) : 18 - 25 ] adults aged 18 - 60 y were r and omly assigned to consume 0 , 350 , or 1050 mg aspartame/d ( ASP groups ) in a beverage for 12 wk in a parallel-arm design . At baseline , body weight and composition were determined , a 240-min oral-glucose-tolerance test ( OGTT ) was administered , and measurements were made of appetite and selected hormones . Participants also collected a 24-h urine sample . During the intervention , the 0-mg/d ASP group consumed capsules containing 680 mg dextrose and 80 mg para-amino benzoic acid . For the 350-mg/d ASP group , the beverage contained 350 mg aspartame and the 1050-mg/d ASP group consumed the same beverage plus capsules containing 680 mg dextrose and 700 mg aspartame .  Body weight , blood pressure , heart rate , and waist circumference were measured weekly . At weeks 4 , 8 , and 12 , participants collected 24-h urine sample s and kept appetite logs . Baseline measurements were repeated at week 12 . Results With the exception of the baseline OGTT glucose concentration at 60 min ( and result ing area under the curve value ) , there were no group differences for glucose , insulin , resting leptin , glucagon-like peptide 1 , or gastric inhibitory peptide at baseline or week 12 . There also were no effects of aspartame ingestion on appetite , body weight , or body composition . Compliance with the beverage intervention was ∼95 % . Conclusions Aspartame ingested at 2 doses for 12 wk had no effect on glycemia , appetite , or body 
    Output:
    