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: CONTEXT To enhance the effectiveness of diet in lowering cholesterol , recommendations of the Adult Treatment Panel III of the National Cholesterol Education Program emphasize diets low in saturated fat together with plant sterols and viscous fibers , and the American Heart Association supports the use of soy protein and nuts . OBJECTIVE To determine whether a diet containing all of these recommended food components leads to cholesterol reduction comparable with that of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors ( statins ) . DESIGN R and omized controlled trial conducted between October and December 2002 . SETTING AND PARTICIPANTS Forty-six healthy , hyperlipidemic adults ( 25 men and 21 postmenopausal women ) with a mean ( SE ) age of 59 ( 1 ) years and body mass index of 27.6 ( 0.5 ) , recruited from a Canadian hospital-affiliated nutrition research center and the community . INTERVENTIONS Participants were r and omly assigned to undergo 1 of 3 interventions on an outpatient basis for 1 month : a diet very low in saturated fat , based on milled whole-wheat cereals and low-fat dairy foods ( n = 16 ; control ) ; the same diet plus lovastatin , 20 mg/d ( n = 14 ) ; or a diet high in plant sterols ( 1.0 g/1000 kcal ) , soy protein ( 21.4 g/1000 kcal ) , viscous fibers ( 9.8 g/1000 kcal ) , and almonds ( 14 g/1000 kcal ) ( n = 16 ; dietary portfolio ) . MAIN OUTCOME MEASURES Lipid and C-reactive protein levels , obtained from fasting blood sample s ; blood pressure ; and body weight ; measured at weeks 0 , 2 , and 4 and compared among the 3 treatment groups . RESULTS The control , statin , and dietary portfolio groups had mean ( SE ) decreases in low-density lipoprotein cholesterol of 8.0 % ( 2.1 % ) ( P = .002 ) , 30.9 % ( 3.6 % ) ( P<.001 ) , and 28.6 % ( 3.2 % ) ( P<.001 ) , respectively . Respective reductions in C-reactive protein were 10.0 % ( 8.6 % ) ( P = .27 ) , 33.3 % ( 8.3 % ) ( P = .002 ) , and 28.2 % ( 10.8 % ) ( P = .02 ) . The significant reductions in the statin and dietary portfolio  groups were all significantly different from changes in the control group . There were no significant differences in efficacy between the statin and dietary portfolio treatments . CONCLUSION In this study , diversifying cholesterol-lowering components in the same dietary portfolio increased the effectiveness of diet as a treatment of hypercholesterolemia Introduction The purpose of this study was to investigate the effects of vegan diet in patients with rheumatoid arthritis ( RA ) on blood lipids oxidized low-density lipoprotein ( oxLDL ) and natural atheroprotective antibodies against phosphorylcholine ( anti-PCs ) . Methods Sixty-six patients with active RA were r and omly assigned to either a vegan diet free of gluten ( 38 patients ) or a well-balanced non-vegan diet ( 28 patients ) for 1 year . Thirty patients in the vegan group completed more than 3 months on the diet regimen . Blood lipids were analyzed by routine methods , and oxLDL and anti-PCs were analyzed by enzyme-linked immunosorbent assay . Data and serum sample s were obtained at baseline and after 3 and 12 months . Results Mean ages were 50.0 years for the vegan group and 50.8 years for controls .  Gluten-free vegan diet induced lower body mass index ( BMI ) and low-density lipoprotein ( LDL ) and higher anti-PC IgM than control diet ( p < 0.005 ) . In the vegan group , BMI , LDL , and cholesterol decreased after both 3 and 12 months ( p < 0.01 ) and oxLDL after 3 months ( p = 0.021 ) and trendwise after 12 months ( p = 0.090 ) . Triglycerides and high-density lipoprotein did not change . IgA anti-PC levels increased after 3 months ( p = 0.027 ) and IgM anti-PC levels increased trendwise after 12 months ( p = 0.057 ) . There was no difference in IgG anti-PC levels . In the control diet group , IgM anti-PC levels decreased both after 3 and 12 months ( p < 0.01 ) . When separating vegan patients into clinical responders and non-responders at 12 months , the effects on oxLDL and anti-PC IgA were seen only in responders ( p < 0.05 ) . Conclusion A gluten-free vegan diet in RA induces changes that are potentially atheroprotective and anti-inflammatory , including decreased LDL and oxLDL levels and raised anti-PC IgM and IgA levels BACKGROUND Replacement of red meat in the diet with chicken has reduced the urinary albumin excretion rate ( UAER ) and serum cholesterol in microalbuminuric type 2 diabetes patients . The effects of withdrawing red meat are unknown in the more advanced stages of diabetic nephropathy . OBJECTIVE Our objective was to assess the effects of replacing red meat in the usual diet ( UD ) with chicken ( CD ) and of consuming a lactovegetarian low-protein diet ( LPD ) on renal function , fatty acid , and lipid profile in macroalbuminuric type 2 diabetes patients . DESIGN A crossover controlled trial was conducted in 17 type 2 diabetes patients with macroalbuminuria ( 24-h UAER > or = 200 microg/min ) . Each patient followed the UD , CD , and LPD in a r and om order for 4 wk . After each diet , glomerular filtration rate , UAER , serum fatty acid , lipid profile , glycemic control , anthropometric indexes , and blood pressure were measured . RESULTS UAER [ median CD : 269.4 ( range : 111 - 1128 ) microg/min ; LPD : 229.3 ( 76.6 - 999.3 ) microg/min ; UD : 312.8 ( 223.7 - 1223.7 ) microg/min ; P < 0.01 ] and mean ( + /-SD ) non-HDL cholesterol ( CD : 3.92 + /- 0.99 mmol/L ; LPD : 3.92 + /- 0.93 mmol/L ; UD : 4.23 + /- 1.06 mmol/L ; P = 0.042 ) were lower after CD and LPD than after UD . Compared with the UD , an increase in serum total polyunsaturated fatty acids was also observed ( CD : 39.8 + /- 2.6 % ; LPD : 39.7 + /- 4.4 % ; UD : 37.3 + /- 3.1 % ; P = 0.029 ) . CONCLUSION In macroalbuminuric patients with type 2 diabetes , withdrawing red meat from the diet reduces the UAER BACKGROUND A vegetarian diet may lead to numerous health benefits , including weight loss . OBJECTIVE We examined the joint effects of personal preference of dietary treatment and a calorie-restricted , low-fat lactoovovegetarian diet ( LOV-D ) compared with a st and ard calorie-restricted , low-fat omnivorous diet ( STD-D ) on changes in weight , total cholesterol , ratio of LDL to HDL cholesterol ( LDL : HDL cholesterol ) , triacylglycerols , insulin resistance , and macronutrient intake during an 18-mo study . DESIGN This was a r and omized clinical trial of 176 overweight and obese adults who were recruited and r and omly assigned first to 1 of 2 preference conditions ( yes or no ) . If assigned to Preference-No , they were r and omly assigned to 1 of the 2 diet conditions ( STD-D or LOV-D ) . If assigned to Preference-Yes , they were assigned to the diet they indicated as preferred at screening . The 12-mo intervention was followed by a 6-mo maintenance phase . RESULTS Participants were mainly women ( 86.9 % ) and white ( 70.5 % ) ; 75 % completed the 18-mo study . A significant interaction between preference and dietary treatment was not observed for any of the outcome variables . However , participants in the Preference-No groups significantly decreased their triacylglycerols ( P = 0.04 ) . The only effect observed for diet was a borderline significant decrease in LDL : HDL cholesterol for the LOV-D group ( P = 0.06 ) . Within the LOV-D groups , those who were 100 % adherent to the LOV-D had significant and marginally significant reductions in monounsaturated fat ( P = 0.02 ) and total fat ( P = 0.05 ) intakes at 18 mo . CONCLUSIONS Our findings suggest that neither prescribing a vegetarian diet nor allowing persons to choose their preferred diet had a significant effect on outcome measures . However , all participants had a significant reduction in total energy and fat intakes and an increase in energy expenditure , which was reflected in reduced body weight . This clinical trial was registered at www . clinical trials.gov as NCT00330629 In general , vegetarians have lower serum lipids and blood pressures than omnivores have . We tested the blood pressure and serum lipid lowering effects of two fat-modified diets differing primarily in their source of protein . Twenty-six men were r and omized in an incomplete block design to two of three diets : a high-fat diet , a fat-modified lactoovovegetarian diet ( LOV ) and a diet in which 60 % of plant protein in the LOV was replaced with lean meat ( LM ) . Compared with the high-fat diet both prudent diets significantly lowered blood pressure , serum total cholesterol ( TC ) , and LDL cholesterol but significantly increased serum triglycerides . The LOV diet had a significantly greater cholesterol-lowering effect than did the LM diet ( 10 % vs 5 % decrease ) but blood pressure reductions were similar . The partial substitution of lean meat for plant protein in a fat-modified diet did not negate the overall cardiovascular-risk lowering of the lactoovovegetarian diet CONTEXT Low levels of high-density lipoprotein ( HDL ) cholesterol are inversely related to cardiovascular risk . Whether this is a causal effect is unclear . OBJECTIVE To determine whether genetically reduced HDL cholesterol due to heterozygosity for 4 loss-of-function mutations in ABCA1 cause increased risk of ischemic heart disease ( IHD ) . DESIGN , SETTING , AND PARTICIPANTS Three studies of white individuals from Copenhagen , Denmark , were used : the Copenhagen City Heart Study ( CCHS ) , a 31-year prospect i ve general population study ( n = 9022 ; 28 heterozygotes ) ; the Copenhagen General Population Study ( CGPS ) , a cross-sectional general population study ( n = 31,241 ; 76 heterozygotes ) ; and the Copenhagen Ischemic Heart Disease Study ( CIHDS ) , a case-control study ( n = 16,623 ; 44 heterozygotes ) . End points in all 3 studies were recorded during the period of January 1 , 1976 , through July 9 , 2007 . MAIN OUTCOME MEASURES Levels of HDL cholesterol in the general population , cellular cholesterol efflux , and the association between IHD and HDL cholesterol and genotype . RESULTS Heterozygotes vs noncarriers for 4 ABCA1 mutations ( P1065S , G1216V , N1800H , R2144X ) had HDL cholesterol levels of 41 mg/dL ( interquartile range , 31 - 50 mg/dL ) vs 58 mg/dL ( interquartile range , 46 - 73 mg/dL ) , corresponding to a reduction in HDL cholesterol of 17 mg/dL ( P < .001 ) . A 17-mg/dL lower HDL cholesterol level in the CCHS was associated with a multifactorially adjusted hazard ratio for IHD of 1.70 ( 95 % confidence interval [ CI ] , 1.57 - 1.85 ) . However , for IHD in heterozygotes vs noncarriers , the multifactorially adjusted hazard ratio was 0.67 ( 95 % CI , 0.28 - 1.61 ; 1741 IHD events ) in the CCHS , the multifactorially adjusted odds ratio was 0.82 ( 95 % CI , 0.34 - 1.96 ; 2427 IHD events ) in the CGPS , and the multifactorially adjusted odds ratio was 0.86 ( 95 % CI , 0.32 
    Output:
    
agent
Conclusions Plant-based diets are associated with decreased total cholesterol , low-density lipoprotein cholesterol , and high-density lipoprotein cholesterol , but not with decreased triglycerides .
***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: CONTEXT To enhance the effectiveness of diet in lowering cholesterol , recommendations of the Adult Treatment Panel III of the National Cholesterol Education Program emphasize diets low in saturated fat together with plant sterols and viscous fibers , and the American Heart Association supports the use of soy protein and nuts . OBJECTIVE To determine whether a diet containing all of these recommended food components leads to cholesterol reduction comparable with that of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors ( statins ) . DESIGN R and omized controlled trial conducted between October and December 2002 . SETTING AND PARTICIPANTS Forty-six healthy , hyperlipidemic adults ( 25 men and 21 postmenopausal women ) with a mean ( SE ) age of 59 ( 1 ) years and body mass index of 27.6 ( 0.5 ) , recruited from a Canadian hospital-affiliated nutrition research center and the community . INTERVENTIONS Participants were r and omly assigned to undergo 1 of 3 interventions on an outpatient basis for 1 month : a diet very low in saturated fat , based on milled whole-wheat cereals and low-fat dairy foods ( n = 16 ; control ) ; the same diet plus lovastatin , 20 mg/d ( n = 14 ) ; or a diet high in plant sterols ( 1.0 g/1000 kcal ) , soy protein ( 21.4 g/1000 kcal ) , viscous fibers ( 9.8 g/1000 kcal ) , and almonds ( 14 g/1000 kcal ) ( n = 16 ; dietary portfolio ) . MAIN OUTCOME MEASURES Lipid and C-reactive protein levels , obtained from fasting blood sample s ; blood pressure ; and body weight ; measured at weeks 0 , 2 , and 4 and compared among the 3 treatment groups . RESULTS The control , statin , and dietary portfolio groups had mean ( SE ) decreases in low-density lipoprotein cholesterol of 8.0 % ( 2.1 % ) ( P = .002 ) , 30.9 % ( 3.6 % ) ( P<.001 ) , and 28.6 % ( 3.2 % ) ( P<.001 ) , respectively . Respective reductions in C-reactive protein were 10.0 % ( 8.6 % ) ( P = .27 ) , 33.3 % ( 8.3 % ) ( P = .002 ) , and 28.2 % ( 10.8 % ) ( P = .02 ) . The significant reductions in the statin and dietary portfolio  groups were all significantly different from changes in the control group . There were no significant differences in efficacy between the statin and dietary portfolio treatments . CONCLUSION In this study , diversifying cholesterol-lowering components in the same dietary portfolio increased the effectiveness of diet as a treatment of hypercholesterolemia Introduction The purpose of this study was to investigate the effects of vegan diet in patients with rheumatoid arthritis ( RA ) on blood lipids oxidized low-density lipoprotein ( oxLDL ) and natural atheroprotective antibodies against phosphorylcholine ( anti-PCs ) . Methods Sixty-six patients with active RA were r and omly assigned to either a vegan diet free of gluten ( 38 patients ) or a well-balanced non-vegan diet ( 28 patients ) for 1 year . Thirty patients in the vegan group completed more than 3 months on the diet regimen . Blood lipids were analyzed by routine methods , and oxLDL and anti-PCs were analyzed by enzyme-linked immunosorbent assay . Data and serum sample s were obtained at baseline and after 3 and 12 months . Results Mean ages were 50.0 years for the vegan group and 50.8 years for controls .  Gluten-free vegan diet induced lower body mass index ( BMI ) and low-density lipoprotein ( LDL ) and higher anti-PC IgM than control diet ( p < 0.005 ) . In the vegan group , BMI , LDL , and cholesterol decreased after both 3 and 12 months ( p < 0.01 ) and oxLDL after 3 months ( p = 0.021 ) and trendwise after 12 months ( p = 0.090 ) . Triglycerides and high-density lipoprotein did not change . IgA anti-PC levels increased after 3 months ( p = 0.027 ) and IgM anti-PC levels increased trendwise after 12 months ( p = 0.057 ) . There was no difference in IgG anti-PC levels . In the control diet group , IgM anti-PC levels decreased both after 3 and 12 months ( p < 0.01 ) . When separating vegan patients into clinical responders and non-responders at 12 months , the effects on oxLDL and anti-PC IgA were seen only in responders ( p < 0.05 ) . Conclusion A gluten-free vegan diet in RA induces changes that are potentially atheroprotective and anti-inflammatory , including decreased LDL and oxLDL levels and raised anti-PC IgM and IgA levels BACKGROUND Replacement of red meat in the diet with chicken has reduced the urinary albumin excretion rate ( UAER ) and serum cholesterol in microalbuminuric type 2 diabetes patients . The effects of withdrawing red meat are unknown in the more advanced stages of diabetic nephropathy . OBJECTIVE Our objective was to assess the effects of replacing red meat in the usual diet ( UD ) with chicken ( CD ) and of consuming a lactovegetarian low-protein diet ( LPD ) on renal function , fatty acid , and lipid profile in macroalbuminuric type 2 diabetes patients . DESIGN A crossover controlled trial was conducted in 17 type 2 diabetes patients with macroalbuminuria ( 24-h UAER > or = 200 microg/min ) . Each patient followed the UD , CD , and LPD in a r and om order for 4 wk . After each diet , glomerular filtration rate , UAER , serum fatty acid , lipid profile , glycemic control , anthropometric indexes , and blood pressure were measured . RESULTS UAER [ median CD : 269.4 ( range : 111 - 1128 ) microg/min ; LPD : 229.3 ( 76.6 - 999.3 ) microg/min ; UD : 312.8 ( 223.7 - 1223.7 ) microg/min ; P < 0.01 ] and mean ( + /-SD ) non-HDL cholesterol ( CD : 3.92 + /- 0.99 mmol/L ; LPD : 3.92 + /- 0.93 mmol/L ; UD : 4.23 + /- 1.06 mmol/L ; P = 0.042 ) were lower after CD and LPD than after UD . Compared with the UD , an increase in serum total polyunsaturated fatty acids was also observed ( CD : 39.8 + /- 2.6 % ; LPD : 39.7 + /- 4.4 % ; UD : 37.3 + /- 3.1 % ; P = 0.029 ) . CONCLUSION In macroalbuminuric patients with type 2 diabetes , withdrawing red meat from the diet reduces the UAER BACKGROUND A vegetarian diet may lead to numerous health benefits , including weight loss . OBJECTIVE We examined the joint effects of personal preference of dietary treatment and a calorie-restricted , low-fat lactoovovegetarian diet ( LOV-D ) compared with a st and ard calorie-restricted , low-fat omnivorous diet ( STD-D ) on changes in weight , total cholesterol , ratio of LDL to HDL cholesterol ( LDL : HDL cholesterol ) , triacylglycerols , insulin resistance , and macronutrient intake during an 18-mo study . DESIGN This was a r and omized clinical trial of 176 overweight and obese adults who were recruited and r and omly assigned first to 1 of 2 preference conditions ( yes or no ) . If assigned to Preference-No , they were r and omly assigned to 1 of the 2 diet conditions ( STD-D or LOV-D ) . If assigned to Preference-Yes , they were assigned to the diet they indicated as preferred at screening . The 12-mo intervention was followed by a 6-mo maintenance phase . RESULTS Participants were mainly women ( 86.9 % ) and white ( 70.5 % ) ; 75 % completed the 18-mo study . A significant interaction between preference and dietary treatment was not observed for any of the outcome variables . However , participants in the Preference-No groups significantly decreased their triacylglycerols ( P = 0.04 ) . The only effect observed for diet was a borderline significant decrease in LDL : HDL cholesterol for the LOV-D group ( P = 0.06 ) . Within the LOV-D groups , those who were 100 % adherent to the LOV-D had significant and marginally significant reductions in monounsaturated fat ( P = 0.02 ) and total fat ( P = 0.05 ) intakes at 18 mo . CONCLUSIONS Our findings suggest that neither prescribing a vegetarian diet nor allowing persons to choose their preferred diet had a significant effect on outcome measures . However , all participants had a significant reduction in total energy and fat intakes and an increase in energy expenditure , which was reflected in reduced body weight . This clinical trial was registered at www . clinical trials.gov as NCT00330629 In general , vegetarians have lower serum lipids and blood pressures than omnivores have . We tested the blood pressure and serum lipid lowering effects of two fat-modified diets differing primarily in their source of protein . Twenty-six men were r and omized in an incomplete block design to two of three diets : a high-fat diet , a fat-modified lactoovovegetarian diet ( LOV ) and a diet in which 60 % of plant protein in the LOV was replaced with lean meat ( LM ) . Compared with the high-fat diet both prudent diets significantly lowered blood pressure , serum total cholesterol ( TC ) , and LDL cholesterol but significantly increased serum triglycerides . The LOV diet had a significantly greater cholesterol-lowering effect than did the LM diet ( 10 % vs 5 % decrease ) but blood pressure reductions were similar . The partial substitution of lean meat for plant protein in a fat-modified diet did not negate the overall cardiovascular-risk lowering of the lactoovovegetarian diet CONTEXT Low levels of high-density lipoprotein ( HDL ) cholesterol are inversely related to cardiovascular risk . Whether this is a causal effect is unclear . OBJECTIVE To determine whether genetically reduced HDL cholesterol due to heterozygosity for 4 loss-of-function mutations in ABCA1 cause increased risk of ischemic heart disease ( IHD ) . DESIGN , SETTING , AND PARTICIPANTS Three studies of white individuals from Copenhagen , Denmark , were used : the Copenhagen City Heart Study ( CCHS ) , a 31-year prospect i ve general population study ( n = 9022 ; 28 heterozygotes ) ; the Copenhagen General Population Study ( CGPS ) , a cross-sectional general population study ( n = 31,241 ; 76 heterozygotes ) ; and the Copenhagen Ischemic Heart Disease Study ( CIHDS ) , a case-control study ( n = 16,623 ; 44 heterozygotes ) . End points in all 3 studies were recorded during the period of January 1 , 1976 , through July 9 , 2007 . MAIN OUTCOME MEASURES Levels of HDL cholesterol in the general population , cellular cholesterol efflux , and the association between IHD and HDL cholesterol and genotype . RESULTS Heterozygotes vs noncarriers for 4 ABCA1 mutations ( P1065S , G1216V , N1800H , R2144X ) had HDL cholesterol levels of 41 mg/dL ( interquartile range , 31 - 50 mg/dL ) vs 58 mg/dL ( interquartile range , 46 - 73 mg/dL ) , corresponding to a reduction in HDL cholesterol of 17 mg/dL ( P < .001 ) . A 17-mg/dL lower HDL cholesterol level in the CCHS was associated with a multifactorially adjusted hazard ratio for IHD of 1.70 ( 95 % confidence interval [ CI ] , 1.57 - 1.85 ) . However , for IHD in heterozygotes vs noncarriers , the multifactorially adjusted hazard ratio was 0.67 ( 95 % CI , 0.28 - 1.61 ; 1741 IHD events ) in the CCHS , the multifactorially adjusted odds ratio was 0.82 ( 95 % CI , 0.34 - 1.96 ; 2427 IHD events ) in the CGPS , and the multifactorially adjusted odds ratio was 0.86 ( 95 % CI , 0.32 
    Output:
    