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: Thirty-nine U.S. Air Force enlisted men participated in a r and omized controlled study that evaluated an experimental program design ed to enhance fitness . Subjects were assigned to either a treatment ( access to the program ) or control ( no access to program ) group for 6 months . To improve treatment group fitness ( as measured by VO2 , subjects received individually tailored information ( based on a behavior change model ) via the Internet to encourage adoption of positive diet and exercise behaviors . Results showed no significant effect in improving fitness in treatment . However , significant effects were observed for secondary outcomes such as weight ( controls , + 1.0 kg vs. treatment , -2.2 kg , p < 0.05 ) , body mass index ( + 0.3 kg/m2 vs. -0.7 kg/m2 , p < 0.05 ) , and percent body fat ( + 0.6 % vs. -1.5 % , p < 0.001 ) . The data suggest that the individually tailored exercise information was not effective in encouraging sufficient exercise intensity to impact fitness . However , the dietary tailored information appears to have encouraged the adoption of more positive nutritional practice s as demonstrated by the beneficial effects reflected in secondary outcomes Excess weight is associated with negative health outcomes . Meal replacements are effective in promoting favorable body composition changes in civilian population s ; however , their efficacy with military service members who have unique lifestyles is unknown . The objective of this r and omized controlled trial was to determine the efficacy of the Army 's education-based weight-management program , " Weigh to Stay , " with and without meal replacements for improving blood lipids , and to promote weight and body fat loss in overweight US Army soldiers . Soldiers ( n=113 ; 76 males/37 females ) attending Weigh to Stay at Fort Bragg , NC , in 2006/2007 were r and omized to Weigh to Stay only or a commercially available meal-replacement program ( two meal replacements per day ) in conjunction with Weigh to Stay , and followed until Army body fat st and ards were met or for 6 months if st and ards were not met . Study completers ( n=46 ) in both treatment groups lost weight ( Weigh to Stay : -2.7+/-4.3 kg ; meal replacers : -3.8+/-3.5 kg ) and fat mass ( Weigh to Stay , -2.7+/-3.2 kg ; meal replacers : -2.9+/-2.5 kg ) , and improved high-density lipoprotein cholesterol concentrations ( Weigh to Stay : 13+/-9 mg/dL [ 0.34+/-0.23 mmol/L ] ; meal replacers : 8+/-7 mg/dL [ 0.21+/-0.18 mmol/L ] ; P<0.05 ) ; however , no between-group differences were observed . Attrition was lower ( P=0.009 ) and success in meeting body fat st and ards tended to be higher ( P=0.06 ) for the meal replacers vs Weigh to Stay participants . Intent-to-treat analysis demonstrated that meal replacers lost more weight ( 1.2+/-0.5 kg ) , percent body fat ( 1.0%+/-0.4 % ) , and fat mass ( 0.8+/-0.4 kg ) compared to Weigh to Stay volunteers ( P<0.05 ) . Our findings suggest that meal replacement use can be recommended as a potential adjunct strategy to Weigh to Stay A higher body mass index is associated with exercise-related injuries and increased risk for musculoskeletal and connective tissue disorders , which are relevant to military personnel . Studies show the efficacy of orlistat 60 mg for promoting weight and body fat loss in civilians ; however , its efficacy among predominantly young , male soldiers is unknown . This study 's objective was to examine the effect of a 6-month , st and ard education-based weight-management program with and without orlistat 60 mg on changes in weight and body fat in overweight soldiers . Data were collected for this r and omized , controlled trial from March 2008 to November 2010 at Fort Bragg , NC . Participants were enrolled in an education-based weight management program ( n=435 ; 75 % men ) and were r and omized to placebo or orlistat 60 mg , three capsules daily with meals . All participants were recommended to maintain a reduced-energy , low-fat diet . Among study completers ( 14 % retention rate ; placebo n=22 , orlistat n=35 ) members of both groups lost significant weight from baseline  ( placebo -3.0±5.2 kg ; orlistat -3.2±4.7 kg ; P<0.01 ) , but only the orlistat group lost fat mass ( -2.5±3.9 kg ; P<0.001 ) , whereas the placebo group lost lean mass ( -1.4±2.7 kg ; P < 0.01 ) . An intent-to-treat analysis ( ? 1 follow-up body weight measure ) demonstrated that the orlistat group lost more fat mass vs the placebo group ( -1.3±2.9 kg vs ? 0.6±1.8 kg , respectively ; P<0.05 ) , but less lean mass ( -0.2±2.0 kg vs -0.8±1.8 kg , respectively ; P<0.01 ) . Orlistat 60 mg may be an effective adjunct to an education-based weight management program in a mostly young , male soldier population The aim of the present investigation was to study the effect of a dietary intervention which combined nutrition information with increased availability of vegetables , fruits and wholegrain bread . The effect of the intervention was determined by changes in the intake of vegetables , fruits , wholegrain bread and estimated nutrients . Furthermore , the study investigated whether changes in relative contribution from different food sources of folate were related to changes in the concentration of plasma total homocysteine ( p-tHcy ) . The 5-month intervention study included 376 male recruits from the Norwegian National Guard , Vaernes ( intervention group ) and 105 male recruits from the Norwegian National Guard , Heggelia ( control group ) . The study result ed in an increase in the total consumption of vegetables , fruits , berries and juice  ( P < 0.001 ) and of  wholegrain bread ( P < 0.001 ) . The participants in the intervention group showed a higher increase in the intake of dietary fibre  ( P < 0.001 ) and  folate  ( P < 0.001 ) compared with the control group . The relative contribution of folate intake from fruits , vegetables and wholegrain bread was higher in the intervention group compared with the control group ( P < 0.001 for all ) . The increased intake of folate from wholegrain bread was inversely associated with a reduced concentration of p-tHcy ( P = 0.017 ) . In summary , the dietary intervention result ed in an increased intake of vegetables , fruits and wholegrain bread and a subsequent increase in folate intake from these food components . Reduction in the concentration of p-tHcy was significantly related to an increased folate intake due to an increased consumption of wholegrain bread This study assessed the effects of eight weeks of military training on aerobic fitness indices , military skills and neuropsychological function . Thirty five ( n=35 ) male Irish Defence Forces personnel , divided into training ( n=20 ) and control ( n=15 ) subgroups , completed tests of military aptitude ( Kim ’s games , judging distance , fire order , map reading , weapon assembly ) and neuropsychological function ( Symbol digit modalities test ( SDMT ) , Trail making test , Stroop test and grooved pegboard test ) pre- and post-intervention . The repeated measures study design sought to account for any learning effect . Participants also completed a 10 km route march , a two mile run and three by 20 m shuttle run tests at both time points to quantify changes in fitness variables . The training sub-group significantly ( P<0.001 ) improved mean 20 m shuttle-run distance and consequently estimated VO2 max pre- to post-intervention ( 49.8±1.0 vs. 52.4±0.9 mL.kg-1.min-1 ) . Two mile run time was not significantly improved . Mean % HRmax during the 10 km route march was significantly higher in both training ( P<0.001 ) and control ( P<0.01 ) sub-groups post-intervention ( 71±1 and 83±1 % ) compared to pre-intervention ( 65±1 and 77±1 % ) . However , the training sub-group conducted the route march at a significantly faster speed on the second occasion . Military training significantly improved performance in 3/18 neuropsychological test components and 2/12 military skills test components . Training significantly improved ability to estimate both short ( error ; 36±6 vs. 12±1 % ) and intermediate ( error ; 72±12 vs. 11±3 % ) distances post-intervention . The training sub-group significantly ( P<0.01 ) improved SDMT score and mean Trail 1 time pre- to post-intervention ( 58.0±2.8 vs. 69.5±3.4 ; 18.1±0.8 vs. 14.4±0.8s , respectively ) . In Part 3 of the Stroop test , time mediated a significant ( P<0.05 ) and selective improvement in the training sub-group ( 51.3±3.2 vs. 63.8±5.4 ) . In conclusion , aerobic fitness and a minority of neuropsychological and military skills tests improved following 8 weeks of military training The more consistently someone records their food intake the more likely they are to lose weight . We hypothesized that subjects who kept track via their preferred method would demonstrate higher adherence and therefore improved outcomes compared to those who used a non-preferred method . Participants were r and omly assigned to use a paper , PDA , or Web-based diary and classified as " Preferred " if they used their preferred method and " Non-Preferred " if they did not . Days adherent to diary use were collected for 12 weeks . Weight , % body fat , waist circumference , and self-efficacy scores were measured at baseline , 6 and 12 weeks . Thirty nine participants completed the 12 week study . Fifty nine percent were male . The mean age was 35 and mean baseline BMI was 33 kg/m(2 ) ( + /-3.5 ) . Forty four % ( n=17 ) used their " Preferred "  diary  method and 56 % ( n=22 ) did not . Participants who used their preferred diary were more adherent to recording both food intake ( 64.2 % vs. 43.4 % , p=.015 ) and exercise ( 60.6 % vs. 31.2 % , p=.001 ) . Though no difference was seen between groups on weight management outcomes , these results suggest that diary preference affects adherence to diary use OBJECTIVE To analyse the 5-year sustainability of a  worksite canteen intervention of serving more fruit and vegetables ( F&V ) . DESIGN Average F&V consumption per customer per meal per day was assessed in five worksite canteens by weighing F&V served and subtracting waste . Data were collected by the canteen staff during a 3-week continuous period and compared to data from the same five canteens measured at baseline , at end point and at 1-year follow-up . The intervention used a participatory and empowering approach , self-monitoring and networking among the canteen staff , management and a consultant . The method focused on providing ideas for increased F&V for lunch , making environmental changes in the canteens by giving access to tasteful and healthy food choices and reducing the availability of unhealthy options . SETTING Five Danish worksites serving from 50 to 500 meals a day : a military base , an electronic component distributor , a bank , a town hall and a waste-h and ling facility . SUBJECTS Worksite canteen managers , canteen staff . RESULTS Four of the five worksite canteens were able to either maintain the intervention or even increase the consumption of F&V. The average increase from baseline to 5-year follow-up was 95 g per customer per meal per day ( 18 , 144 , 66 , 105 and 141 g , respectively ) . On average , the five canteens at the long-term follow-up had an F&V consumption of 208 g/meal per customer . CONCLUSIONS The present study indicates that sustainability of F&V is possible in worksites where the participatory and empowering approach , self-monitoring , environmental change , dialogue with suppliers and networking among worksite canteens are applied OBJECTIVE The specific aim was to determine whether a multifaceted approach to weight loss and physical readiness could be implemented onboard a deployed combatant ship of the U.S. Navy . RESEARCH METHODS AND PROCEDURES Thirty-nine men ( 31+/-6 years old , mean+/-st and ard deviation ) assigned to the USS ENTERPRISE ( CVN 65 ) during a 6-month Mediterranean deployment who had failed their previous Physical Readiness Test due to excessive body weight ( 108+/-11 kg overweight ) were r and omly assigned to nutrition , cognitive-behavioral obesity treatment plus exercise or to the Navy 's usual treatment ( control ) , which is exercise alone . RESULTS Outcomes for the treatment group were significantly better than the controls , with 8.6+/-5.0 vs. 5.0+/-4.1 kg weight loss , 8 % vs. 5 % reduction in original body weight , and body fat loss of 7 % vs. 5 % . Triglycerides declined significantly greater in the treatment group than the controls ( 145 mg/dL to 109 mg/dL vs. 146 mg/dL to 145 mg/dL , p<0.05 ) , whereas depression and 
    Output:
    
agent
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
***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: Thirty-nine U.S. Air Force enlisted men participated in a r and omized controlled study that evaluated an experimental program design ed to enhance fitness . Subjects were assigned to either a treatment ( access to the program ) or control ( no access to program ) group for 6 months . To improve treatment group fitness ( as measured by VO2 , subjects received individually tailored information ( based on a behavior change model ) via the Internet to encourage adoption of positive diet and exercise behaviors . Results showed no significant effect in improving fitness in treatment . However , significant effects were observed for secondary outcomes such as weight ( controls , + 1.0 kg vs. treatment , -2.2 kg , p < 0.05 ) , body mass index ( + 0.3 kg/m2 vs. -0.7 kg/m2 , p < 0.05 ) , and percent body fat ( + 0.6 % vs. -1.5 % , p < 0.001 ) . The data suggest that the individually tailored exercise information was not effective in encouraging sufficient exercise intensity to impact fitness . However , the dietary tailored information appears to have encouraged the adoption of more positive nutritional practice s as demonstrated by the beneficial effects reflected in secondary outcomes Excess weight is associated with negative health outcomes . Meal replacements are effective in promoting favorable body composition changes in civilian population s ; however , their efficacy with military service members who have unique lifestyles is unknown . The objective of this r and omized controlled trial was to determine the efficacy of the Army 's education-based weight-management program , " Weigh to Stay , " with and without meal replacements for improving blood lipids , and to promote weight and body fat loss in overweight US Army soldiers . Soldiers ( n=113 ; 76 males/37 females ) attending Weigh to Stay at Fort Bragg , NC , in 2006/2007 were r and omized to Weigh to Stay only or a commercially available meal-replacement program ( two meal replacements per day ) in conjunction with Weigh to Stay , and followed until Army body fat st and ards were met or for 6 months if st and ards were not met . Study completers ( n=46 ) in both treatment groups lost weight ( Weigh to Stay : -2.7+/-4.3 kg ; meal replacers : -3.8+/-3.5 kg ) and fat mass ( Weigh to Stay , -2.7+/-3.2 kg ; meal replacers : -2.9+/-2.5 kg ) , and improved high-density lipoprotein cholesterol concentrations ( Weigh to Stay : 13+/-9 mg/dL [ 0.34+/-0.23 mmol/L ] ; meal replacers : 8+/-7 mg/dL [ 0.21+/-0.18 mmol/L ] ; P<0.05 ) ; however , no between-group differences were observed . Attrition was lower ( P=0.009 ) and success in meeting body fat st and ards tended to be higher ( P=0.06 ) for the meal replacers vs Weigh to Stay participants . Intent-to-treat analysis demonstrated that meal replacers lost more weight ( 1.2+/-0.5 kg ) , percent body fat ( 1.0%+/-0.4 % ) , and fat mass ( 0.8+/-0.4 kg ) compared to Weigh to Stay volunteers ( P<0.05 ) . Our findings suggest that meal replacement use can be recommended as a potential adjunct strategy to Weigh to Stay A higher body mass index is associated with exercise-related injuries and increased risk for musculoskeletal and connective tissue disorders , which are relevant to military personnel . Studies show the efficacy of orlistat 60 mg for promoting weight and body fat loss in civilians ; however , its efficacy among predominantly young , male soldiers is unknown . This study 's objective was to examine the effect of a 6-month , st and ard education-based weight-management program with and without orlistat 60 mg on changes in weight and body fat in overweight soldiers . Data were collected for this r and omized , controlled trial from March 2008 to November 2010 at Fort Bragg , NC . Participants were enrolled in an education-based weight management program ( n=435 ; 75 % men ) and were r and omized to placebo or orlistat 60 mg , three capsules daily with meals . All participants were recommended to maintain a reduced-energy , low-fat diet . Among study completers ( 14 % retention rate ; placebo n=22 , orlistat n=35 ) members of both groups lost significant weight from baseline  ( placebo -3.0±5.2 kg ; orlistat -3.2±4.7 kg ; P<0.01 ) , but only the orlistat group lost fat mass ( -2.5±3.9 kg ; P<0.001 ) , whereas the placebo group lost lean mass ( -1.4±2.7 kg ; P < 0.01 ) . An intent-to-treat analysis ( ? 1 follow-up body weight measure ) demonstrated that the orlistat group lost more fat mass vs the placebo group ( -1.3±2.9 kg vs ? 0.6±1.8 kg , respectively ; P<0.05 ) , but less lean mass ( -0.2±2.0 kg vs -0.8±1.8 kg , respectively ; P<0.01 ) . Orlistat 60 mg may be an effective adjunct to an education-based weight management program in a mostly young , male soldier population The aim of the present investigation was to study the effect of a dietary intervention which combined nutrition information with increased availability of vegetables , fruits and wholegrain bread . The effect of the intervention was determined by changes in the intake of vegetables , fruits , wholegrain bread and estimated nutrients . Furthermore , the study investigated whether changes in relative contribution from different food sources of folate were related to changes in the concentration of plasma total homocysteine ( p-tHcy ) . The 5-month intervention study included 376 male recruits from the Norwegian National Guard , Vaernes ( intervention group ) and 105 male recruits from the Norwegian National Guard , Heggelia ( control group ) . The study result ed in an increase in the total consumption of vegetables , fruits , berries and juice  ( P < 0.001 ) and of  wholegrain bread ( P < 0.001 ) . The participants in the intervention group showed a higher increase in the intake of dietary fibre  ( P < 0.001 ) and  folate  ( P < 0.001 ) compared with the control group . The relative contribution of folate intake from fruits , vegetables and wholegrain bread was higher in the intervention group compared with the control group ( P < 0.001 for all ) . The increased intake of folate from wholegrain bread was inversely associated with a reduced concentration of p-tHcy ( P = 0.017 ) . In summary , the dietary intervention result ed in an increased intake of vegetables , fruits and wholegrain bread and a subsequent increase in folate intake from these food components . Reduction in the concentration of p-tHcy was significantly related to an increased folate intake due to an increased consumption of wholegrain bread This study assessed the effects of eight weeks of military training on aerobic fitness indices , military skills and neuropsychological function . Thirty five ( n=35 ) male Irish Defence Forces personnel , divided into training ( n=20 ) and control ( n=15 ) subgroups , completed tests of military aptitude ( Kim ’s games , judging distance , fire order , map reading , weapon assembly ) and neuropsychological function ( Symbol digit modalities test ( SDMT ) , Trail making test , Stroop test and grooved pegboard test ) pre- and post-intervention . The repeated measures study design sought to account for any learning effect . Participants also completed a 10 km route march , a two mile run and three by 20 m shuttle run tests at both time points to quantify changes in fitness variables . The training sub-group significantly ( P<0.001 ) improved mean 20 m shuttle-run distance and consequently estimated VO2 max pre- to post-intervention ( 49.8±1.0 vs. 52.4±0.9 mL.kg-1.min-1 ) . Two mile run time was not significantly improved . Mean % HRmax during the 10 km route march was significantly higher in both training ( P<0.001 ) and control ( P<0.01 ) sub-groups post-intervention ( 71±1 and 83±1 % ) compared to pre-intervention ( 65±1 and 77±1 % ) . However , the training sub-group conducted the route march at a significantly faster speed on the second occasion . Military training significantly improved performance in 3/18 neuropsychological test components and 2/12 military skills test components . Training significantly improved ability to estimate both short ( error ; 36±6 vs. 12±1 % ) and intermediate ( error ; 72±12 vs. 11±3 % ) distances post-intervention . The training sub-group significantly ( P<0.01 ) improved SDMT score and mean Trail 1 time pre- to post-intervention ( 58.0±2.8 vs. 69.5±3.4 ; 18.1±0.8 vs. 14.4±0.8s , respectively ) . In Part 3 of the Stroop test , time mediated a significant ( P<0.05 ) and selective improvement in the training sub-group ( 51.3±3.2 vs. 63.8±5.4 ) . In conclusion , aerobic fitness and a minority of neuropsychological and military skills tests improved following 8 weeks of military training The more consistently someone records their food intake the more likely they are to lose weight . We hypothesized that subjects who kept track via their preferred method would demonstrate higher adherence and therefore improved outcomes compared to those who used a non-preferred method . Participants were r and omly assigned to use a paper , PDA , or Web-based diary and classified as " Preferred " if they used their preferred method and " Non-Preferred " if they did not . Days adherent to diary use were collected for 12 weeks . Weight , % body fat , waist circumference , and self-efficacy scores were measured at baseline , 6 and 12 weeks . Thirty nine participants completed the 12 week study . Fifty nine percent were male . The mean age was 35 and mean baseline BMI was 33 kg/m(2 ) ( + /-3.5 ) . Forty four % ( n=17 ) used their " Preferred "  diary  method and 56 % ( n=22 ) did not . Participants who used their preferred diary were more adherent to recording both food intake ( 64.2 % vs. 43.4 % , p=.015 ) and exercise ( 60.6 % vs. 31.2 % , p=.001 ) . Though no difference was seen between groups on weight management outcomes , these results suggest that diary preference affects adherence to diary use OBJECTIVE To analyse the 5-year sustainability of a  worksite canteen intervention of serving more fruit and vegetables ( F&V ) . DESIGN Average F&V consumption per customer per meal per day was assessed in five worksite canteens by weighing F&V served and subtracting waste . Data were collected by the canteen staff during a 3-week continuous period and compared to data from the same five canteens measured at baseline , at end point and at 1-year follow-up . The intervention used a participatory and empowering approach , self-monitoring and networking among the canteen staff , management and a consultant . The method focused on providing ideas for increased F&V for lunch , making environmental changes in the canteens by giving access to tasteful and healthy food choices and reducing the availability of unhealthy options . SETTING Five Danish worksites serving from 50 to 500 meals a day : a military base , an electronic component distributor , a bank , a town hall and a waste-h and ling facility . SUBJECTS Worksite canteen managers , canteen staff . RESULTS Four of the five worksite canteens were able to either maintain the intervention or even increase the consumption of F&V. The average increase from baseline to 5-year follow-up was 95 g per customer per meal per day ( 18 , 144 , 66 , 105 and 141 g , respectively ) . On average , the five canteens at the long-term follow-up had an F&V consumption of 208 g/meal per customer . CONCLUSIONS The present study indicates that sustainability of F&V is possible in worksites where the participatory and empowering approach , self-monitoring , environmental change , dialogue with suppliers and networking among worksite canteens are applied OBJECTIVE The specific aim was to determine whether a multifaceted approach to weight loss and physical readiness could be implemented onboard a deployed combatant ship of the U.S. Navy . RESEARCH METHODS AND PROCEDURES Thirty-nine men ( 31+/-6 years old , mean+/-st and ard deviation ) assigned to the USS ENTERPRISE ( CVN 65 ) during a 6-month Mediterranean deployment who had failed their previous Physical Readiness Test due to excessive body weight ( 108+/-11 kg overweight ) were r and omly assigned to nutrition , cognitive-behavioral obesity treatment plus exercise or to the Navy 's usual treatment ( control ) , which is exercise alone . RESULTS Outcomes for the treatment group were significantly better than the controls , with 8.6+/-5.0 vs. 5.0+/-4.1 kg weight loss , 8 % vs. 5 % reduction in original body weight , and body fat loss of 7 % vs. 5 % . Triglycerides declined significantly greater in the treatment group than the controls ( 145 mg/dL to 109 mg/dL vs. 146 mg/dL to 145 mg/dL , p<0.05 ) , whereas depression and 
    Output:
    