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 / Objectives : Coffee is the most widely consumed beverage in the world , but its effect on the cardiovascular system has not been fully understood . Coffee contains caffeine and antioxidants , which may influence endothelial function , both of which have not yet been investigated . The objective of this study was to investigate the acute effects of coffee on endothelial function measured by brachial artery flow-mediated dilation (FMD).Subjects/ Methods : A total of 20 ( 10 males and 10 females ) healthy non-obese subjects underwent a double-blind , crossover study . Subjects ingested one cup of caffeinated ( CC ) and one cup of decaffeinated ( DC ) Italian espresso coffee in r and om order at 5- to 7-day intervals . Results : Following CC ingestion , FMD decreased progressively and significantly ( mean±s.e.m . : 0 min , 7.7±0.6 ; 30 min , 6.3±0.7 ; 60 min , 6.0±0.8 % ; ANOVA ( analysis of variance ) , P<0.05 ) , but it did not significantly increase after DC ingestion ( 0 min , 6.9±0.6 ; 30 min , 8.1±0.9 ; 60 min , 8.5±0.9 % ; P=0.115 ) . Similarly , CC significantly increased both systolic and diastolic blood pressure ; this effect was not observed after DC ingestion . Blood glucose concentrations remained unchanged after ingestion of both CC and DC , but insulin ( 0 min , 15.8±0.9 ; 60 min , 15.0±0.8 μU/ml ; P<0.05 ) and C-peptide ( 0 min , 1.25±0.09 ; 60 min , 1.18±0.09 ng/ml ; P<0.01 ) blood concentrations decreased significantly only after CC ingestion . Conclusions : CC acutely induced unfavorable cardiovascular effects , especially on endothelial function . In the fasting state , insulin secretion is also likely reduced after CC ingestion . Future studies will determine whether CC has detrimental clinical ly relevant effects , especially in unhealthy subjects Food and beverages rich in polyphenols with antioxidant activity are highlighted as a potential factor for risk reduction of lifestyle related diseases . This study was conducted to eluci date total polyphenol consumption from beverages in Japanese people .  Total polyphenol ( TP ) contents in beverages were measured using a modified Folin-Ciocalteu method removing the interference of reduced sugars by using reverse-phase column chromatography . A beverage consumption survey was conducted in the Tokyo and Osaka areas in 2004 . R and omly selected male and female subjects ( 10 - 59 years old , n = 8768 ) recorded the amounts and types of all nonalcoholic beverages  consumed in a week . Concentration of TP in coffee , green tea , black tea , Oolong tea , barley tea , fruit juice , tomato/vegetable juice , and cocoa drinks were at 200 , 115 , 96 , 39 , 9 , 34 , 69 , and 62 mg/100 mL , respectively . Total consumption of beverages in a Japanese population was 1.11 + /- 0.51 L/day , and TP contents from beverages was 853 + /- 512 mg/day . Coffee and green tea shared 50 % and 34 % of TP consumption in beverages , respectively , and contribution of each of the other beverages was less than 10 % . TP contents in 20 major vegetables and 5 fruits were 0 - 49 mg and 2 - 55 mg/100 g , respectively . Antioxidant activities , Cu reducing power , and scavenging activities for DPPH and superoxide , of those sample s correlated to the TP contents ( p < 0.001 ) . Beverages , especially coffee , contributed to a large share of the consumption of polyphenols , as antioxidants , in the Japanese diet Epidemiological studies indicate that habitual coffee consumption lowers the risk of diabetes and cardiovascular diseases . Postpr and ial hyperglycemia is a direct and independent risk factor for cardiovascular diseases . We previously demonstrated that coffee polyphenol ingestion increased secretion of Glucagon-like peptide 1 ( GLP-1 ) , which has been shown to exhibit anti-diabetic and cardiovascular effects . We hypothesized coffee polyphenol consumption may improve postpr and ial hyperglycemia and vascular endothelial function by increasing GLP-1 release and /or reducing oxidative stress . To examine this hypothesis , we conducted a r and omized , acute , crossover , intervention study in healthy male adults , measuring blood parameters and flow-mediated dilation ( FMD ) after ingestion of a meal with or without coffee polyphenol extract ( CPE ) .  Nineteen subjects consumed a test meal with either a placebo- or CPE-containing beverage .  Blood biomarkers and FMD were measured at fasting and up to 180 minutes postpr and ially . The CPE beverage led to a significantly lower peak postpr and ial increase in blood glucose and diacron-reactive oxygen metabolite , and significantly higher postpr and ial FMD than the placebo beverage . Postpr and ial blood GLP-1 increase tended to be higher after ingestion of the CPE beverage , compared with placebo . Subclass analysis revealed that the CPE beverage significantly improved postpr and ial blood GLP-1 response and reduced blood glucose increase in the subjects with a lower insulinogenic index . Correlation analysis showed postpr and ial FMD was negatively associated with blood glucose increase after ingestion of the CPE beverage . In conclusion , these results suggest that coffee polyphenol consumption improves postpr and ial hyperglycemia and vascular endothelial function , which is associated with increased GLP-1 secretion and decreased oxidative stress in healthy humans Caffeine acutely increases blood pressure and peripheral vascular resistance , in part because of sympathetic stimulation . Its effects on large artery properties are largely unknown . In a double-blind crossover study , 7 healthy subjects 26±2.6 years of age ( mean±SEM ) were studied for 90 minutes while in the supine position on 2 occasions separated by a week in r and om order after ingestion of 250 mL caffeinated ( 150 mg ) and decaffeinated ( < 2 mg ) coffee . Compared with baseline , arterial stiffness measured by carotid femoral pulse wave velocity increased progressively from 7.2±0.41 to 8.0±0.6 m/s ( P < 0.05 ) at 90 minutes after caffeine intake , an effect that may be independent of changes in blood pressure . In addition , arterial wave reflection , measured by applanation tonometry from the aortic pressure waveform , also increased from −5.7±7.6 % to 5.28%±5.6 ( P < 0.01 ) . No such changes were seen with decaffeinated coffee intake . Although the integral of the brachial systolic and diastolic blood pressure values over the 90 minutes was larger ( P < 0.05 ) after caffeinated than decaffeinated coffee intake , the effect on aortic systolic and diastolic blood pressures was more pronounced ( P < 0.05 ) than on the brachial artery . These results show a significant effect of caffeine intake on arterial tone and function and suggest that caffeine acutely increases arterial stiffness OBJECTIVES We investigated the acute and chronic combined effect of cigarette smoking and caffeine intake on aortic stiffness and wave reflections . BACKGROUND We have shown that smoking and caffeine separately increase arterial stiffness . Aortic stiffness and wave reflections are important determinants of the efficient performance of the cardiovascular system and prognosticators of cardiovascular risk . METHODS The acute effects of smoking ( one cigarette ) , caffeine ( 200 mg , equivalent to 2 cups of coffee ) , and smoking plus caffeine were studied in 24 healthy subjects according to a r and omized , placebo- and sham procedure-controlled crossover design . The chronic effect of smoking and caffeine was studied in a population study that enrolled 160 healthy subjects . RESULTS Acute study : there was a significant interaction between caffeine and smoking with regard to pulse-wave velocity ( p < 0.01 ) and augmentation index ( p < 0.05 ) . When smoking followed caffeine intake , pulse-wave velocity and augmentation index increased further by 0.52 m/s and 13.4 % , respectively , reaching a total of 0.85 m/s and 17.4 % , 0.17 m/s and 9.2 % in excess of the mere sum of caffeine effect ( 0.33 m/s and 4 % ) alone and smoking effect alone ( 0.35 m/s and 4.2 % ) . Population study : there was a significant interaction of chronic coffee consumption and smoking regarding pulse-wave velocity ( p < 0.05 ) and augmentation index ( p = 0.001 ) . CONCLUSIONS The present study shows , for the first time , that when smoking and caffeine intake are combined , they interact and exert a synergistic , unfavorable effect on aortic stiffness and wave reflections on both an acute and chronic basis Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more There is mounting evidence that specific dietary polyphenols can enhance vascular health by augmenting nitric oxide . Our aim was to investigate the acute effects of chlorogenic acid , an important dietary phenolic acid present in coffee ( 400 mg , equivalent to 2 cups of coffee ) , on nitric oxide status , endothelial function , and blood pressure .  Healthy men and women ( n = 23 ) were recruited to a r and omized , double-blind , placebo-controlled , crossover trial . Chlorogenic acid result ed in significantly higher plasma concentrations of chlorogenic acid ( P < 0.001 ) . Relative to control , the mean post-treatment systolic blood pressure ( -2.41 mmHg , 95 % CI : -0.03 , -4.78 ; P = 0.05 ) and diastolic blood pressure ( -1.53 mmHg , 95 % CI : -0.05 , -3.01 ; P = 0.04 ) were significantly lower with chlorogenic acid . Markers of nitric oxide status ( P > 0.10 ) and the measure of endothelial function ( P = 0.60 ) were not significantly influenced . Chlorogenic acid can lower blood pressure acutely , an effect that , if sustained , would benefit cardiovascular health Although coffee is a widely used , pharmacologically active beverage , its impact on the cardiovascular system is controversial . To explore the effect of acute caffeine ingestion on brachial artery flow-mediated dilation ( FMD ) in subjects without coronary artery disease ( CAD ; controls ) and patients with CAD , we prospect ively assessed brachial artery FMD in 40 controls and 40 age- and gender-matched patients with documented stable CAD on 2 separate mornings 1 week to 2 weeks apart . After overnight fasting , discontinuation of all medications for ≥12 hours , and absence of caffeine for > 48 hours , participants received capsules with caffeine 200 mg or placebo . One hour after drug ingestion , participants underwent brachial artery FMD and nitroglycerin-mediated dilation ( NTG ) using high-resolution ultrasound . As expected , patients with CAD were more often diabetic , hypertensive , obese , dyslipidemic , and smoked more than controls ( p < 0.01 for all comparisons ) . Aspirin , Clopidogrel , angiotensin-converting enzyme inhibitors , β blockers , and statins  were significantly more common in patients with CAD than in controls ( p < 0.01 for all comparisons ) . At baseline , FMD , but not NTG , was significantly lower in patients with CAD compared to controls . Acute caffeine ingestion significantly increased FMD ( patients with CAD 5.6 ± 5.0 % vs 14.6 ± 5.0 % , controls 8.4 ± 2.9 % vs 18.6 ± 6.8 % , p < 0.001 for all comparisons ) but not NTG ( patients with CAD 13.0 ± 5.2 % vs 13.8 ± 6.1 % , controls 12.9 ± 3.9 % vs 13.9 ± 5.8 % , p = NS for all comparisons ) and significantly decreased high-sensitivity C-reactive protein ( patients with CAD 2.6 ± 1.4 vs 1.4 ± 1.2 mg/L , controls 3.4 ± 3.0 vs 1.2 ± 1.0 mg/L , p < 0.001 for all comparisons ) in the 2 groups compared to placebo . In conclusion , acute caffeine ingestion significantly improved endothelial function assessed by brachial artery FMD in subjects with and without CAD and was associated with lower plasma markers of inflammation 
    Output:
    
agent
Conclusion : The results from this meta- analysis suggest a beneficial short-term effect of coffee intake on EF as measured by FMD .
Base on systematic review results acute and chronic intake of coffee products may exerts an unfavorable effect on AS .
***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 / Objectives : Coffee is the most widely consumed beverage in the world , but its effect on the cardiovascular system has not been fully understood . Coffee contains caffeine and antioxidants , which may influence endothelial function , both of which have not yet been investigated . The objective of this study was to investigate the acute effects of coffee on endothelial function measured by brachial artery flow-mediated dilation (FMD).Subjects/ Methods : A total of 20 ( 10 males and 10 females ) healthy non-obese subjects underwent a double-blind , crossover study . Subjects ingested one cup of caffeinated ( CC ) and one cup of decaffeinated ( DC ) Italian espresso coffee in r and om order at 5- to 7-day intervals . Results : Following CC ingestion , FMD decreased progressively and significantly ( mean±s.e.m . : 0 min , 7.7±0.6 ; 30 min , 6.3±0.7 ; 60 min , 6.0±0.8 % ; ANOVA ( analysis of variance ) , P<0.05 ) , but it did not significantly increase after DC ingestion ( 0 min , 6.9±0.6 ; 30 min , 8.1±0.9 ; 60 min , 8.5±0.9 % ; P=0.115 ) . Similarly , CC significantly increased both systolic and diastolic blood pressure ; this effect was not observed after DC ingestion . Blood glucose concentrations remained unchanged after ingestion of both CC and DC , but insulin ( 0 min , 15.8±0.9 ; 60 min , 15.0±0.8 μU/ml ; P<0.05 ) and C-peptide ( 0 min , 1.25±0.09 ; 60 min , 1.18±0.09 ng/ml ; P<0.01 ) blood concentrations decreased significantly only after CC ingestion . Conclusions : CC acutely induced unfavorable cardiovascular effects , especially on endothelial function . In the fasting state , insulin secretion is also likely reduced after CC ingestion . Future studies will determine whether CC has detrimental clinical ly relevant effects , especially in unhealthy subjects Food and beverages rich in polyphenols with antioxidant activity are highlighted as a potential factor for risk reduction of lifestyle related diseases . This study was conducted to eluci date total polyphenol consumption from beverages in Japanese people .  Total polyphenol ( TP ) contents in beverages were measured using a modified Folin-Ciocalteu method removing the interference of reduced sugars by using reverse-phase column chromatography . A beverage consumption survey was conducted in the Tokyo and Osaka areas in 2004 . R and omly selected male and female subjects ( 10 - 59 years old , n = 8768 ) recorded the amounts and types of all nonalcoholic beverages  consumed in a week . Concentration of TP in coffee , green tea , black tea , Oolong tea , barley tea , fruit juice , tomato/vegetable juice , and cocoa drinks were at 200 , 115 , 96 , 39 , 9 , 34 , 69 , and 62 mg/100 mL , respectively . Total consumption of beverages in a Japanese population was 1.11 + /- 0.51 L/day , and TP contents from beverages was 853 + /- 512 mg/day . Coffee and green tea shared 50 % and 34 % of TP consumption in beverages , respectively , and contribution of each of the other beverages was less than 10 % . TP contents in 20 major vegetables and 5 fruits were 0 - 49 mg and 2 - 55 mg/100 g , respectively . Antioxidant activities , Cu reducing power , and scavenging activities for DPPH and superoxide , of those sample s correlated to the TP contents ( p < 0.001 ) . Beverages , especially coffee , contributed to a large share of the consumption of polyphenols , as antioxidants , in the Japanese diet Epidemiological studies indicate that habitual coffee consumption lowers the risk of diabetes and cardiovascular diseases . Postpr and ial hyperglycemia is a direct and independent risk factor for cardiovascular diseases . We previously demonstrated that coffee polyphenol ingestion increased secretion of Glucagon-like peptide 1 ( GLP-1 ) , which has been shown to exhibit anti-diabetic and cardiovascular effects . We hypothesized coffee polyphenol consumption may improve postpr and ial hyperglycemia and vascular endothelial function by increasing GLP-1 release and /or reducing oxidative stress . To examine this hypothesis , we conducted a r and omized , acute , crossover , intervention study in healthy male adults , measuring blood parameters and flow-mediated dilation ( FMD ) after ingestion of a meal with or without coffee polyphenol extract ( CPE ) .  Nineteen subjects consumed a test meal with either a placebo- or CPE-containing beverage .  Blood biomarkers and FMD were measured at fasting and up to 180 minutes postpr and ially . The CPE beverage led to a significantly lower peak postpr and ial increase in blood glucose and diacron-reactive oxygen metabolite , and significantly higher postpr and ial FMD than the placebo beverage . Postpr and ial blood GLP-1 increase tended to be higher after ingestion of the CPE beverage , compared with placebo . Subclass analysis revealed that the CPE beverage significantly improved postpr and ial blood GLP-1 response and reduced blood glucose increase in the subjects with a lower insulinogenic index . Correlation analysis showed postpr and ial FMD was negatively associated with blood glucose increase after ingestion of the CPE beverage . In conclusion , these results suggest that coffee polyphenol consumption improves postpr and ial hyperglycemia and vascular endothelial function , which is associated with increased GLP-1 secretion and decreased oxidative stress in healthy humans Caffeine acutely increases blood pressure and peripheral vascular resistance , in part because of sympathetic stimulation . Its effects on large artery properties are largely unknown . In a double-blind crossover study , 7 healthy subjects 26±2.6 years of age ( mean±SEM ) were studied for 90 minutes while in the supine position on 2 occasions separated by a week in r and om order after ingestion of 250 mL caffeinated ( 150 mg ) and decaffeinated ( < 2 mg ) coffee . Compared with baseline , arterial stiffness measured by carotid femoral pulse wave velocity increased progressively from 7.2±0.41 to 8.0±0.6 m/s ( P < 0.05 ) at 90 minutes after caffeine intake , an effect that may be independent of changes in blood pressure . In addition , arterial wave reflection , measured by applanation tonometry from the aortic pressure waveform , also increased from −5.7±7.6 % to 5.28%±5.6 ( P < 0.01 ) . No such changes were seen with decaffeinated coffee intake . Although the integral of the brachial systolic and diastolic blood pressure values over the 90 minutes was larger ( P < 0.05 ) after caffeinated than decaffeinated coffee intake , the effect on aortic systolic and diastolic blood pressures was more pronounced ( P < 0.05 ) than on the brachial artery . These results show a significant effect of caffeine intake on arterial tone and function and suggest that caffeine acutely increases arterial stiffness OBJECTIVES We investigated the acute and chronic combined effect of cigarette smoking and caffeine intake on aortic stiffness and wave reflections . BACKGROUND We have shown that smoking and caffeine separately increase arterial stiffness . Aortic stiffness and wave reflections are important determinants of the efficient performance of the cardiovascular system and prognosticators of cardiovascular risk . METHODS The acute effects of smoking ( one cigarette ) , caffeine ( 200 mg , equivalent to 2 cups of coffee ) , and smoking plus caffeine were studied in 24 healthy subjects according to a r and omized , placebo- and sham procedure-controlled crossover design . The chronic effect of smoking and caffeine was studied in a population study that enrolled 160 healthy subjects . RESULTS Acute study : there was a significant interaction between caffeine and smoking with regard to pulse-wave velocity ( p < 0.01 ) and augmentation index ( p < 0.05 ) . When smoking followed caffeine intake , pulse-wave velocity and augmentation index increased further by 0.52 m/s and 13.4 % , respectively , reaching a total of 0.85 m/s and 17.4 % , 0.17 m/s and 9.2 % in excess of the mere sum of caffeine effect ( 0.33 m/s and 4 % ) alone and smoking effect alone ( 0.35 m/s and 4.2 % ) . Population study : there was a significant interaction of chronic coffee consumption and smoking regarding pulse-wave velocity ( p < 0.05 ) and augmentation index ( p = 0.001 ) . CONCLUSIONS The present study shows , for the first time , that when smoking and caffeine intake are combined , they interact and exert a synergistic , unfavorable effect on aortic stiffness and wave reflections on both an acute and chronic basis Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more There is mounting evidence that specific dietary polyphenols can enhance vascular health by augmenting nitric oxide . Our aim was to investigate the acute effects of chlorogenic acid , an important dietary phenolic acid present in coffee ( 400 mg , equivalent to 2 cups of coffee ) , on nitric oxide status , endothelial function , and blood pressure .  Healthy men and women ( n = 23 ) were recruited to a r and omized , double-blind , placebo-controlled , crossover trial . Chlorogenic acid result ed in significantly higher plasma concentrations of chlorogenic acid ( P < 0.001 ) . Relative to control , the mean post-treatment systolic blood pressure ( -2.41 mmHg , 95 % CI : -0.03 , -4.78 ; P = 0.05 ) and diastolic blood pressure ( -1.53 mmHg , 95 % CI : -0.05 , -3.01 ; P = 0.04 ) were significantly lower with chlorogenic acid . Markers of nitric oxide status ( P > 0.10 ) and the measure of endothelial function ( P = 0.60 ) were not significantly influenced . Chlorogenic acid can lower blood pressure acutely , an effect that , if sustained , would benefit cardiovascular health Although coffee is a widely used , pharmacologically active beverage , its impact on the cardiovascular system is controversial . To explore the effect of acute caffeine ingestion on brachial artery flow-mediated dilation ( FMD ) in subjects without coronary artery disease ( CAD ; controls ) and patients with CAD , we prospect ively assessed brachial artery FMD in 40 controls and 40 age- and gender-matched patients with documented stable CAD on 2 separate mornings 1 week to 2 weeks apart . After overnight fasting , discontinuation of all medications for ≥12 hours , and absence of caffeine for > 48 hours , participants received capsules with caffeine 200 mg or placebo . One hour after drug ingestion , participants underwent brachial artery FMD and nitroglycerin-mediated dilation ( NTG ) using high-resolution ultrasound . As expected , patients with CAD were more often diabetic , hypertensive , obese , dyslipidemic , and smoked more than controls ( p < 0.01 for all comparisons ) . Aspirin , Clopidogrel , angiotensin-converting enzyme inhibitors , β blockers , and statins  were significantly more common in patients with CAD than in controls ( p < 0.01 for all comparisons ) . At baseline , FMD , but not NTG , was significantly lower in patients with CAD compared to controls . Acute caffeine ingestion significantly increased FMD ( patients with CAD 5.6 ± 5.0 % vs 14.6 ± 5.0 % , controls 8.4 ± 2.9 % vs 18.6 ± 6.8 % , p < 0.001 for all comparisons ) but not NTG ( patients with CAD 13.0 ± 5.2 % vs 13.8 ± 6.1 % , controls 12.9 ± 3.9 % vs 13.9 ± 5.8 % , p = NS for all comparisons ) and significantly decreased high-sensitivity C-reactive protein ( patients with CAD 2.6 ± 1.4 vs 1.4 ± 1.2 mg/L , controls 3.4 ± 3.0 vs 1.2 ± 1.0 mg/L , p < 0.001 for all comparisons ) in the 2 groups compared to placebo . In conclusion , acute caffeine ingestion significantly improved endothelial function assessed by brachial artery FMD in subjects with and without CAD and was associated with lower plasma markers of inflammation 
    Output:
    