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: Aims /hypothesis . The aim of the Diabetes Prevention Study is to assess the efficacy of an intensive diet-exercise programme in preventing or delaying  Type II ( non-insulin-dependent ) diabetes mellitus in subjects with impaired glucose tolerance , to evaluate the effects of the intervention programme on cardiovascular risk factors and to assess the determinants for the progression to diabetes in persons with impaired glucose tolerance . Methods . A total of 523 overweight subjects with impaired glucose tolerance ascertained by two oral glucose tolerance tests were r and omised to either a control or intervention group . The control subjects received general information at the start of the trial about the lifestyle changes necessary to prevent diabetes and about annual follow-up visits . The intervention subjects had seven sessions with a nutritionist during the first year and a visit every 3 months thereafter aim ed at reducing weight , the intake of saturated fat and increasing the intake of dietary fibre . Intervention subjects were also guided individually to increase their physical activity .  Results . During the first year , weight loss in the first 212 study subjects was 4.7 ± 5.5 vs 0.9 ± 4.1 kg in the intervention and control group , respectively ( p < 0.001 ) . The plasma glucose concentrations ( fasting : 5.9 ± 0.7 vs 6.4 ± 0.8 mmol/l , p < 0.001 ; and 2-h 7.8 ± 1.8 vs 8.5 ± 2.3 mmol/l , p < 0.05 ) were significantly lower in the intervention group after the first year of intervention . Favourable changes were also found in blood pressure , serum lipids and anthropometric indices in the intervention group . Conclusion /interpretation . The interim results show the efficacy and feasibility of the lifestyle intervention programme . [ Diabetologia ( 1999 ) 42 : 793–801 Sports- and fitness-themed video games using motion controllers have been found to produce physical activity . It is possible that motion controllers may also enhance energy expenditure when applied to more sedentary games such as action games . Young adults ( N = 100 ) were r and omized to play three games using either motion-based or traditional controllers . No main effect was found for controller or game pair ( P > .12 ) . An interaction was found such that in one pair , motion control ( mean [ SD ] 0.96 [ 0.20 ] kcal · kg−1 · hr−1 ) produced 0.10 kcal · kg−1 · hr−1 ( 95 % confidence interval 0.03 to 0.17 ) greater energy expenditure  than traditional control ( 0.86 [ 0.17 ] kcal · kg−1 · hr−1 , P = .048 ) . All games were sedentary . As currently implemented , motion control is unlikely to produce moderate intensity physical activity in action games . However , some games produce small but significant increases in energy expenditure , which may benefit health by decreasing sedentary behavior Abstract Douris , PC , McDonald , B , Vespi , F , Kelley , NC , and Herman , L. Comparison between Nintendo Wii Fit aerobics and traditional aerobic exercise in sedentary young adults . J Strength Cond Res 26(4 ) : 1052–1057 , 2012—Exergaming is becoming a popular recreational activity for young adults . The purpose was to compare the physiologic and psychological responses of college students playing Nintendo Wii Fit , an active video game console  , vs. an equal duration of moderate-intensity brisk walking .  Twenty-one healthy sedentary college-age students ( mean age 23.2 ± 1.8 years ) participated in a r and omized , double cross-over study , which compared physiologic and psychological responses to 30 minutes of brisk walking exercise on a treadmill vs. 30 minutes playing Nintendo Wii Fit “ Free Run ” program . Physiologic parameters measured included heart rate , rate pressure product , respiratory rate , and rating of perceived exertion . Participants ' positive well-being , psychological distress , and level of fatigue associated with each exercise modality were quantified using the Subjective Exercise Experience Scale . The mean maximum heart rate ( HRmax ) achieved when exercising with Wii Fit ( 142.4 ± 20.5 b·min−1 ) was significantly greater ( p = 0.001 ) compared with exercising on the treadmill ( 123.2 ± 13.7 b·min−1 ) . Rate pressure product was also significantly greater ( p = 0.001 ) during exercise on the Wii Fit . Participants ' rating of perceived exertion when playing Wii Fit ( 12.7 ± 3.0 ) was significantly greater ( p = 0.014 ) when compared with brisk walking on the treadmill ( 10.1 ± 3.3 ) . However , psychologically when playing Wii Fit , participants ' positive well-being decreased significantly ( p = 0.018 ) from preexercise to postexercise when compared with exercising on the treadmill . College students have the potential to surpass exercise intensities achieved when performing a conventional st and ard for moderate-intensity exercise when playing Nintendo Wii Fit “ Free Run ” with a self-selected intensity . We concluded that Nintendo Wii Fit “ Free Run ” may act as an alternative to traditional moderate-intensity aerobic exercise in fulfilling the American College of Sports Medicine requirements for physical activity OBJECTIVES To compare the prevalence and correlates of meeting current recommendations for physical activity  in older adults with and without diabetes mellitus ( DM ) in the United States . DESIGN A cross-sectional , population -based sample . SETTING The 2007 Behavioral Risk Factor Surveillance Survey , which employs r and om-digit dialing to interview noninstitutionalized U.S. adults . PARTICIPANTS Ninety-nine thous and one hundred seventy-two adults ( 18,370 with DM ) aged 65 and older . MEASUREMENTS The age-adjusted prevalence and the odds ratios for physical activity patterns ( defined on the basis of the physical activity guidelines from the American Diabetes Association ( ADA 2007 ) and the Department of Health and Human Services ( DHHS 2008 ) ) were obtained using multiple logistic regression analyses . The correlates of meeting physical activity recommendations were assessed using log-binomial regression analyses . RESULTS Overall , 25 % and 42 % of older adults with diabetes mellitus met recommendations for total physical activity based on the ADA 2007 and the DHHS 2008 guidelines , respectively . Adults with DM were 31 % to 34 % ( P < .001 ) less likely to engage in physical activity at recommended levels and 13 % to 19 % ( P < .001 ) less likely to be physically active at insufficient levels than those without DM . Analyses limited to participants who reported no disability yielded similar results . In adults with DM , older age ( ≥ 75 ) ; being female ; being non-Hispanic black ; and having obesity , coronary heart disease , and disability were associated with less likelihood , whereas advanced educational status was associated with greater likelihood of meeting physical activity recommendations . CONCLUSION In the United States , efforts to boost physical activity participation in older adults with DM are needed Clinical trials have demonstrated that lifestyle changes can prevent type 2 diabetes , but the importance of leisure-time physical activity ( LTPA ) is still unclear . We carried out post hoc analyses on the role of LTPA in preventing type 2 diabetes in 487 men and women with impaired glucose tolerance who had completed 12-month LTPA question naires . The subjects were participants in the Finnish Diabetes Prevention Study , a r and omized controlled trial of lifestyle changes including diet , weight loss , and LTPA .  There were 107 new cases of diabetes during the 4.1-year follow-up period . Individuals who increased moderate-to-vigorous LTPA or strenuous , structured LTPA the most were 63 - 65 % less likely to develop diabetes . Adjustment for changes in diet and body weight during the study attenuated the association somewhat ( upper versus lower third : moderate-to-vigorous LTPA , relative risk 0.51 , 95 % CI 0.26 - 0.97 ; strenuous , structured LTPA , 0.63 , 0.35 - 1.13 ) . Low-intensity and lifestyle LTPA  and walking also conferred benefits , consistent with the finding that the change in total LTPA ( upper versus lower third : 0.34 , 0.19 - 0.62 ) was the most strongly associated with incident diabetes . Thus increasing physical activity may substantially reduce the incidence of type 2 diabetes in high-risk individuals BACKGROUND Type 2 diabetes mellitus is increasingly common , primarily because of increases in the prevalence of a sedentary lifestyle and obesity . Whether type 2 diabetes can be prevented by interventions that affect the lifestyles of subjects at high risk for the disease is not known . METHODS We r and omly assigned 522 middle-aged , overweight subjects ( 172 men and 350 women ; mean age , 55 years ; mean body-mass index [ weight in kilograms divided by the square of the height in meters ] , 31 ) with impaired glucose tolerance to either the intervention group or the control group . Each subject in the intervention group received individualized counseling aim ed at reducing weight , total intake of fat , and intake of saturated fat and increasing intake of fiber and physical activity . An oral glucose-tolerance test was performed annually ; the diagnosis of diabetes was confirmed by a second test . The mean duration of follow-up was 3.2 years . RESULTS The mean ( + /-SD ) amount of weight lost between base line and the end of year 1 was 4.2+/-5.1 kg in the intervention group and 0.8+/-3.7 kg in the control group ; the net loss by the end of year 2 was 3.5+/-5.5 kg in the intervention group and 0.8+/-4.4 kg in the control group ( P<0.001 for both comparisons between the groups ) . The cumulative incidence of diabetes after four years was 11 percent ( 95 percent confidence interval , 6 to 15 percent ) in the intervention group and 23 percent ( 95 percent confidence interval , 17 to 29 percent ) in the control group . During the trial , the risk of diabetes was reduced by 58 percent ( P<0.001 ) in the intervention group . The reduction in the incidence of diabetes was directly associated with changes in lifestyle . CONCLUSIONS Type 2 diabetes can be prevented by changes in the lifestyles of high-risk subjects BACKGROUND Interactive stationary bikes provide positive affective experiences and physiological benefits ; however , research is limited . METHODS This study compared usage of GameBikes to traditional stationary bikes among families in the home following a 6-week r and omized , controlled trial design . Parents completed question naires featuring constructs of the theory of planned behavior ( TPB ) . Usage was tracked by all family members and belief elicitation with GameBike families followed the trial . RESULTS Usage across the trial was significantly different for children in favor of the  GameBike group ( t36 = 2.61 , P = .01 , d = .85 ) . No differences were identified for parents .  Significant time effects for parents '  ( F5,48 = 5.07 , P < .01 ; η2 = .35 ) and  children 's  ( F5,32 = 8.24 , P < .01 ; η2 = .56 ) usage were found with declines across 6 weeks . Affective attitude was the only significant TPB variable between groups at both time one ( t57 = 2.53 , P = .01 ; d = .65 ) and follow-up ( t52 = 2.70 , P = .01 ; d = .74 ) in favor of the GameBike group . Elicited beliefs were primarily affective- and control-based . CONCLUSIONS The results provide support for use of interactive video games to augment current PA initiatives . Larger-scale trials with longer duration s are warranted The purpose of this study was to evaluate the effectiveness of interactive video games ( combined with stationary cycling ) on health-related physical fitness and exercise adherence in comparison with traditional aerobic training ( stationary cycling alone ) . College-aged males were stratified ( aerobic fitness and body mass ) and then assigned r and omly to experimental ( n = 7 ) or control ( n = 7 ) conditions . Program attendance , health-related physical fitness ( including maximal aerobic power ( VO2 max ) , body composition , muscular strength , muscular power , and flexibility ) , and resting blood pressure were measured before and after training ( 60%-75 % heart rate reserve , 3 d/week for 30 min/d for 6 weeks ) . There was a significant difference in the attendance of the interactive video game and traditional training groups ( 78 % + /- 18 % vs. 48 % + /- 29 % , respectively ) . VO2 max was significantly increased after interactive video game ( 11 % + /- 5 % ) but not traditional ( 3 % + /- 6 % ) training . There was a significantly greater reduction in resting systolic blood pressure after interactive video game ( 132 + /- 6 vs. 123 + /- 6 mmHg ) than traditional ( 131 + /- 7 vs. 128 + /- 8 mmHg ) training . There were no significant changes in body composition after either 
    Output:
    
agent
However , effects of exergaming in terms of changes in these intensity parameters varied significantly between game modes and consoles as well as because of the vastly differing duration s of exergame activity between studies .
Conclusion This review suggests that exergames are able to increase PA among overweight individuals .
However , the inconsistent results and the overall poor or moderate method ological quality do not permit judgment on whether exergames are suitable to meet PA guidelines in this target group .
***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: Aims /hypothesis . The aim of the Diabetes Prevention Study is to assess the efficacy of an intensive diet-exercise programme in preventing or delaying  Type II ( non-insulin-dependent ) diabetes mellitus in subjects with impaired glucose tolerance , to evaluate the effects of the intervention programme on cardiovascular risk factors and to assess the determinants for the progression to diabetes in persons with impaired glucose tolerance . Methods . A total of 523 overweight subjects with impaired glucose tolerance ascertained by two oral glucose tolerance tests were r and omised to either a control or intervention group . The control subjects received general information at the start of the trial about the lifestyle changes necessary to prevent diabetes and about annual follow-up visits . The intervention subjects had seven sessions with a nutritionist during the first year and a visit every 3 months thereafter aim ed at reducing weight , the intake of saturated fat and increasing the intake of dietary fibre . Intervention subjects were also guided individually to increase their physical activity .  Results . During the first year , weight loss in the first 212 study subjects was 4.7 ± 5.5 vs 0.9 ± 4.1 kg in the intervention and control group , respectively ( p < 0.001 ) . The plasma glucose concentrations ( fasting : 5.9 ± 0.7 vs 6.4 ± 0.8 mmol/l , p < 0.001 ; and 2-h 7.8 ± 1.8 vs 8.5 ± 2.3 mmol/l , p < 0.05 ) were significantly lower in the intervention group after the first year of intervention . Favourable changes were also found in blood pressure , serum lipids and anthropometric indices in the intervention group . Conclusion /interpretation . The interim results show the efficacy and feasibility of the lifestyle intervention programme . [ Diabetologia ( 1999 ) 42 : 793–801 Sports- and fitness-themed video games using motion controllers have been found to produce physical activity . It is possible that motion controllers may also enhance energy expenditure when applied to more sedentary games such as action games . Young adults ( N = 100 ) were r and omized to play three games using either motion-based or traditional controllers . No main effect was found for controller or game pair ( P > .12 ) . An interaction was found such that in one pair , motion control ( mean [ SD ] 0.96 [ 0.20 ] kcal · kg−1 · hr−1 ) produced 0.10 kcal · kg−1 · hr−1 ( 95 % confidence interval 0.03 to 0.17 ) greater energy expenditure  than traditional control ( 0.86 [ 0.17 ] kcal · kg−1 · hr−1 , P = .048 ) . All games were sedentary . As currently implemented , motion control is unlikely to produce moderate intensity physical activity in action games . However , some games produce small but significant increases in energy expenditure , which may benefit health by decreasing sedentary behavior Abstract Douris , PC , McDonald , B , Vespi , F , Kelley , NC , and Herman , L. Comparison between Nintendo Wii Fit aerobics and traditional aerobic exercise in sedentary young adults . J Strength Cond Res 26(4 ) : 1052–1057 , 2012—Exergaming is becoming a popular recreational activity for young adults . The purpose was to compare the physiologic and psychological responses of college students playing Nintendo Wii Fit , an active video game console  , vs. an equal duration of moderate-intensity brisk walking .  Twenty-one healthy sedentary college-age students ( mean age 23.2 ± 1.8 years ) participated in a r and omized , double cross-over study , which compared physiologic and psychological responses to 30 minutes of brisk walking exercise on a treadmill vs. 30 minutes playing Nintendo Wii Fit “ Free Run ” program . Physiologic parameters measured included heart rate , rate pressure product , respiratory rate , and rating of perceived exertion . Participants ' positive well-being , psychological distress , and level of fatigue associated with each exercise modality were quantified using the Subjective Exercise Experience Scale . The mean maximum heart rate ( HRmax ) achieved when exercising with Wii Fit ( 142.4 ± 20.5 b·min−1 ) was significantly greater ( p = 0.001 ) compared with exercising on the treadmill ( 123.2 ± 13.7 b·min−1 ) . Rate pressure product was also significantly greater ( p = 0.001 ) during exercise on the Wii Fit . Participants ' rating of perceived exertion when playing Wii Fit ( 12.7 ± 3.0 ) was significantly greater ( p = 0.014 ) when compared with brisk walking on the treadmill ( 10.1 ± 3.3 ) . However , psychologically when playing Wii Fit , participants ' positive well-being decreased significantly ( p = 0.018 ) from preexercise to postexercise when compared with exercising on the treadmill . College students have the potential to surpass exercise intensities achieved when performing a conventional st and ard for moderate-intensity exercise when playing Nintendo Wii Fit “ Free Run ” with a self-selected intensity . We concluded that Nintendo Wii Fit “ Free Run ” may act as an alternative to traditional moderate-intensity aerobic exercise in fulfilling the American College of Sports Medicine requirements for physical activity OBJECTIVES To compare the prevalence and correlates of meeting current recommendations for physical activity  in older adults with and without diabetes mellitus ( DM ) in the United States . DESIGN A cross-sectional , population -based sample . SETTING The 2007 Behavioral Risk Factor Surveillance Survey , which employs r and om-digit dialing to interview noninstitutionalized U.S. adults . PARTICIPANTS Ninety-nine thous and one hundred seventy-two adults ( 18,370 with DM ) aged 65 and older . MEASUREMENTS The age-adjusted prevalence and the odds ratios for physical activity patterns ( defined on the basis of the physical activity guidelines from the American Diabetes Association ( ADA 2007 ) and the Department of Health and Human Services ( DHHS 2008 ) ) were obtained using multiple logistic regression analyses . The correlates of meeting physical activity recommendations were assessed using log-binomial regression analyses . RESULTS Overall , 25 % and 42 % of older adults with diabetes mellitus met recommendations for total physical activity based on the ADA 2007 and the DHHS 2008 guidelines , respectively . Adults with DM were 31 % to 34 % ( P < .001 ) less likely to engage in physical activity at recommended levels and 13 % to 19 % ( P < .001 ) less likely to be physically active at insufficient levels than those without DM . Analyses limited to participants who reported no disability yielded similar results . In adults with DM , older age ( ≥ 75 ) ; being female ; being non-Hispanic black ; and having obesity , coronary heart disease , and disability were associated with less likelihood , whereas advanced educational status was associated with greater likelihood of meeting physical activity recommendations . CONCLUSION In the United States , efforts to boost physical activity participation in older adults with DM are needed Clinical trials have demonstrated that lifestyle changes can prevent type 2 diabetes , but the importance of leisure-time physical activity ( LTPA ) is still unclear . We carried out post hoc analyses on the role of LTPA in preventing type 2 diabetes in 487 men and women with impaired glucose tolerance who had completed 12-month LTPA question naires . The subjects were participants in the Finnish Diabetes Prevention Study , a r and omized controlled trial of lifestyle changes including diet , weight loss , and LTPA .  There were 107 new cases of diabetes during the 4.1-year follow-up period . Individuals who increased moderate-to-vigorous LTPA or strenuous , structured LTPA the most were 63 - 65 % less likely to develop diabetes . Adjustment for changes in diet and body weight during the study attenuated the association somewhat ( upper versus lower third : moderate-to-vigorous LTPA , relative risk 0.51 , 95 % CI 0.26 - 0.97 ; strenuous , structured LTPA , 0.63 , 0.35 - 1.13 ) . Low-intensity and lifestyle LTPA  and walking also conferred benefits , consistent with the finding that the change in total LTPA ( upper versus lower third : 0.34 , 0.19 - 0.62 ) was the most strongly associated with incident diabetes . Thus increasing physical activity may substantially reduce the incidence of type 2 diabetes in high-risk individuals BACKGROUND Type 2 diabetes mellitus is increasingly common , primarily because of increases in the prevalence of a sedentary lifestyle and obesity . Whether type 2 diabetes can be prevented by interventions that affect the lifestyles of subjects at high risk for the disease is not known . METHODS We r and omly assigned 522 middle-aged , overweight subjects ( 172 men and 350 women ; mean age , 55 years ; mean body-mass index [ weight in kilograms divided by the square of the height in meters ] , 31 ) with impaired glucose tolerance to either the intervention group or the control group . Each subject in the intervention group received individualized counseling aim ed at reducing weight , total intake of fat , and intake of saturated fat and increasing intake of fiber and physical activity . An oral glucose-tolerance test was performed annually ; the diagnosis of diabetes was confirmed by a second test . The mean duration of follow-up was 3.2 years . RESULTS The mean ( + /-SD ) amount of weight lost between base line and the end of year 1 was 4.2+/-5.1 kg in the intervention group and 0.8+/-3.7 kg in the control group ; the net loss by the end of year 2 was 3.5+/-5.5 kg in the intervention group and 0.8+/-4.4 kg in the control group ( P<0.001 for both comparisons between the groups ) . The cumulative incidence of diabetes after four years was 11 percent ( 95 percent confidence interval , 6 to 15 percent ) in the intervention group and 23 percent ( 95 percent confidence interval , 17 to 29 percent ) in the control group . During the trial , the risk of diabetes was reduced by 58 percent ( P<0.001 ) in the intervention group . The reduction in the incidence of diabetes was directly associated with changes in lifestyle . CONCLUSIONS Type 2 diabetes can be prevented by changes in the lifestyles of high-risk subjects BACKGROUND Interactive stationary bikes provide positive affective experiences and physiological benefits ; however , research is limited . METHODS This study compared usage of GameBikes to traditional stationary bikes among families in the home following a 6-week r and omized , controlled trial design . Parents completed question naires featuring constructs of the theory of planned behavior ( TPB ) . Usage was tracked by all family members and belief elicitation with GameBike families followed the trial . RESULTS Usage across the trial was significantly different for children in favor of the  GameBike group ( t36 = 2.61 , P = .01 , d = .85 ) . No differences were identified for parents .  Significant time effects for parents '  ( F5,48 = 5.07 , P < .01 ; η2 = .35 ) and  children 's  ( F5,32 = 8.24 , P < .01 ; η2 = .56 ) usage were found with declines across 6 weeks . Affective attitude was the only significant TPB variable between groups at both time one ( t57 = 2.53 , P = .01 ; d = .65 ) and follow-up ( t52 = 2.70 , P = .01 ; d = .74 ) in favor of the GameBike group . Elicited beliefs were primarily affective- and control-based . CONCLUSIONS The results provide support for use of interactive video games to augment current PA initiatives . Larger-scale trials with longer duration s are warranted The purpose of this study was to evaluate the effectiveness of interactive video games ( combined with stationary cycling ) on health-related physical fitness and exercise adherence in comparison with traditional aerobic training ( stationary cycling alone ) . College-aged males were stratified ( aerobic fitness and body mass ) and then assigned r and omly to experimental ( n = 7 ) or control ( n = 7 ) conditions . Program attendance , health-related physical fitness ( including maximal aerobic power ( VO2 max ) , body composition , muscular strength , muscular power , and flexibility ) , and resting blood pressure were measured before and after training ( 60%-75 % heart rate reserve , 3 d/week for 30 min/d for 6 weeks ) . There was a significant difference in the attendance of the interactive video game and traditional training groups ( 78 % + /- 18 % vs. 48 % + /- 29 % , respectively ) . VO2 max was significantly increased after interactive video game ( 11 % + /- 5 % ) but not traditional ( 3 % + /- 6 % ) training . There was a significantly greater reduction in resting systolic blood pressure after interactive video game ( 132 + /- 6 vs. 123 + /- 6 mmHg ) than traditional ( 131 + /- 7 vs. 128 + /- 8 mmHg ) training . There were no significant changes in body composition after either 
    Output:
    