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: Association between white rice intake and risk factors of cardiovascular diseases remained uncertain . Most of the previous published studies have been done in western countries with different lifestyles , and scant data are available from the Middle East region , including Iran . This cross-sectional study was conducted in the structure of Isfahan Healthy Heart Program ( IHHP ) to assess the association between white rice consumption and risk factors of cardiovascular diseases . In the present study , 3,006 men were included from three counties of Isfahan , Najafabad , and Arak by multistage cluster r and om-sampling method .  Dietary intake was assessed with a 49-item food frequency question naire ( FFQ ) . Laboratory assessment was done in a st and ardized central laboratory . Outcome variables were fasting blood glucose , serum lipid levels , and anthropometric variables . Socioeconomic and demographic data , physical activity , and body mass index ( BMI ) were considered covariates and were adjusted in analysis . In this study , Student 's t-test , chi-square test , and logistic regression were used for statistical analyses . Means of BMI among those subjects who consumed white rice less than 7 times per week and people who consumed 7 - 14 times per week were almost similar—24.8±4.3 vs 24.5±4.7 kg/m2 . There was no significant association between white rice  consumption and risk factors of cardiovascular diseases , such as fasting blood sugar and serum lipid profiles . Although whole grain consumption has undeniable effect on preventing cardiovascular disease risk , white rice consumption was not associated with cardiovascular risks among Iranian men in the present study . Further prospect i ve studies with a semi-quantitative FFQ or dietary record question naire , representing type and portion-size of rice intake as well as cooking methods and other foods consumed with rice that affect glycaemic index ( GI ) of rice , are required to support our finding and to illustrate the probable mechanism BACKGROUND Cardiovascular diseases ( CVD ) are a set of metabolic disorders affecting heart and blood vessels . Green tea and sour tea ( Hibiscus sabdariffa L. ) have attracted significant attention recently due to their high popularity , nutrient profile and therapeutic effects . The aim of the present study was to compare the effects of green tea and sour tea supplementation on blood pressure and lipid profile in healthy adult men . METHODS This r and omized , double-blind , placebo-controlled trial included 54 healthy adult men . The participants were r and omly assigned to two intervention groups receiving 450 mg green tea or sour tea and one placebo group which consumed 450 mg placebo ( maltodextrin ) for 6 weeks . Blood pressure , lipid profile , dietary intake and physical activity were measured pre- and post-intervention and compared . RESULTS After 6 weeks of intervention , sour tea supplementation led to a significant decrease in systolic blood pressure ( SBP ) compared with the placebo group . However , we faild to find any significant difference in SBP between green tea and control groups . Also , no significant changes were observed in diastolic blood pressure ( DBP ) and lipid profile between the three groups . In comparison with baseline , there was a significant increase in the mean level of serum high-density lipoprotein cholesterol ( HDL-C ) in green tea and sour tea groups . Also , the interventions result ed in significant decrease in the mean levels of serum total cholesterol ( TC ) and low-density lipoprotein cholesterol ( LDL-C ) and DBP in the sour tea group compared with the pre-intervention value . CONCLUSION On the basis of our findings , sour tea supplementation led to decreased SBP  in healthy men compared with the placebo , but there was no significant difference between their effects on DBP and lipid profile Pycnogenol ® ( PYC ) , an extract of French maritime pine bark ( Pinus pinaster ) , is a potent antioxidant with potential health benefits . Its bioavailabilty has previously been shown by urinary excretion studies of constituents and metabolites of PYC . The aim of this study was to test the effect of PYC supplementation on measures of oxidative stress and the lipid profile in humans . Twenty-five healthy subjects received  PYC  ( 150 mg/d ) for 6 wk . Fasting blood was collected at baseline , after 3 and 6 wk of supplementation , and again after a 4-wk washout period . After 6 wk of supplementation with PYC , a significant increase in plasma polyphenol levels was detectable , which was reversed after the 4-wk washout phase . The antioxidant effect of PYC was demonstrated by a significant increase in oxygen radical absorbance capacity ( ORAC ) in plasma throughout the supplementation period ( P<0.05 ) . The ORAC value returned to baseline after the 4-wk washout period . Moreover , in addition to its antioxidant effects  , PYC significantly reduced LDL-cholesterol levels and increased HDL-cholesterol levels in plasma of two-thirds of the subjects . While the LDL changes reversed during washout , the HDL increase did not . There was no significant difference in LDL oxidizability or plasma lipid peroxides following PYC supplementation . Hence , following oral supplementation in humans  , PYC significantly increases antioxidant capacity of plasma , as determined by ORAC , and exerts favorable effects on the lipid profile BACKGROUND Orange juice-a rich source of vitamin C , folate , and flavonoids such as hesperidin-induces hypocholesterolemic responses in animals . OBJECTIVE We determined whether orange juice beneficially altered blood lipids in subjects with moderate hypercholesterolemia . DESIGN The sample consisted of 16 healthy men and 9 healthy women with elevated plasma total and LDL-cholesterol and normal plasma triacylglycerol concentrations . Participants incorporated 1 , 2 , or 3 cups ( 250 mL each ) of orange juice sequentially into their diets , each dose over a period of 4 wk . This was followed by a 5-wk washout period . Plasma lipid , folate , homocyst(e)ine , and vitamin C ( a compliance marker ) concentrations were measured at baseline , after each treatment , and after the washout period . RESULTS Consumption of 750 mL but not of 250 or 500 mL orange juice daily increased HDL-cholesterol concentrations by 21 % ( P : < 0.001 ) , triacylglycerol concentrations by 30 % ( from 1.56 + /- 0.72 to 2.03 + /- 0.91 mmol/L ; P : < 0.02 ) , and folate concentrations by 18 % ( P : < 0.01 ) ; decreased the LDL-HDL cholesterol ratio by 16 % ( P : < 0.005 ) ; and did not affect homocyst(e)ine concentrations . Plasma vitamin C concentrations increased significantly during each dietary period ( 2.1 , 3.1 , and 3.8 times , respectively ) . CONCLUSIONS Orange juice ( 750 mL/d ) improved blood lipid profiles in hypercholesterolemic subjects , confirming recommendations to consume > /=5 - 10 servings of fruit and vegetables daily BACKGROUND Although modifiable cardiovascular disease risk factors are common , some patients eschew conventional drug treatments in favor of natural alternatives . Pine bark extract , a dietary supplement source of antioxidant oligomeric proanthocyanidin complexes , has multiple putative cardiovascular benefits . Studies published to date about the supplement have notable method ological limitations . METHODS We r and omized 130 individuals with increased cardiovascular disease risk to take 200 mg of a water-based extract of pine bark  ( n = 64 ; Toyo-FVG , Toyo Bio-Pharma , Torrance , California ; Shinyaku Co , Ltd , Saga , Japan ; also marketed as Flavagenol in Japan ) or placebo ( n = 66 ) once per day . Blood pressure , our primary outcome , and other cardiovascular disease risk factors were measured at baseline and at 6 and 12 weeks . Statistical analyses were conducted using regression models . RESULTS Baseline characteristics did not differ between the study groups . Over the 12-week intervention , the sum of systolic and diastolic blood pressures decreased by 1.0 mm Hg ( 95 % confidence interval , -4.2 to 2.1 mm Hg ) in the pine bark extract-treated group and by 1.9 mm Hg ( -5.5 to 1.7 mm Hg ) in the placebo group ( P = .87 ) . Other outcomes were likewise not significantly different , including body mass index , lipid panel measures , liver transaminase test results , lipoprotein cholesterol particle size , and levels of insulin , lipoprotein(a ) , fasting glucose , and high-sensitivity C-reactive protein . There were no subgroups for whom intake of pine bark extract affected cardiovascular disease risk factors . CONCLUSIONS This pine bark extract ( at a dosage of 200 mg/d ) was safe but was not associated with improvement in cardiovascular disease risk factors . Although variations among participants , dosages , and chemical preparations could contribute to different findings compared with past studies , our results are consistent with a general failure of antioxidants to demonstrate cardiovascular benefits . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00425945 The aim of this study was to compare the efficacy of Venostasin ( horse chestnut seed extract ) and Pycnogenol ( French maritime pine bark extract ) in the treatment of chronic venous insufficiency ( CVI ) . In an open , controlled comparative study 40 patients with diagnosed CVI were treated either with 600 mg chestnut seed extract per day or 360 mg Pycnogenol per day over a period of 4 weeks . The following parameters were investigated before the start of treatment and after 2 and 4 weeks of treatment : circumference of the lower legs and rating of subjective symptoms ( scores ) of pain , cramps , night-time swelling , feeling of " heaviness " , and reddening of the skin . In addition , blood levels of cholesterol LDL and HDL were determined before and at the end of treatment . Pycnogenol significantly reduced the circumference of the lower limbs and significantly improved subjective symptoms . Furthermore , Pycnogenol significantly decreased cholesterol and LDL values in the blood , whereas HDL remained unaffected . Venostasin only moderately but not significantly , reduced the circumference of the lower limbs and marginally improved symptoms .  Venostasin had no influence on the determined lipid values . Both medications were equally well tolerated . In conclusion , Pycnogenol was found to be more efficacious than Venostasin for the treatment of CVI AIMS Extracts from pine tree bark containing a variety of flavonoids have been used in traditional medicine . Pycnogenol is a proprietary bark extract of the French maritime pine tree ( Pinus pinaster ssp . atlantica ) that exerts antioxidative , anti-inflammatory , and anti-platelet effects . However , the effects of Pycnogenol on endothelial dysfunction , a precursor of atherosclerosis and cardiovascular events , remain still elusive . METHODS AND RESULTS Twenty-three patients with coronary artery disease ( CAD ) completed this r and omized , double-blind , placebo-controlled cross-over study . Patients received Pycnogenol ( 200 mg/day ) for 8 weeks followed by placebo or vice versa on top of st and ard cardiovascular therapy . Between the two treatment periods , a 2-week washout period was scheduled . At baseline and after each treatment period , endothelial function , non-invasively assessed by flow-mediated dilatation ( FMD ) of the brachial artery using high-resolution ultrasound , biomarkers of oxidative stress and inflammation , platelet adhesion , and 24 h blood pressure monitoring were evaluated . In CAD  patients , Pycnogenol treatment was associated with an improvement of FMD from 5.3 ± 2.6 to 7.0 ± 3.1 ( P < 0.0001 ) , while no change was observed with placebo ( 5.4 ± 2.4 to 4.7 ± 2.0 ; P = 0.051 ) . This difference between study groups was significant [ estimated treatment effect 2.75 ; 95 % confidence interval ( CI ) : 1.75 , 3.75 , P < 0.0001 ] . 15-F(2t)-Isoprostane , an index of oxidative stress , significantly decreased from 0.71 ± 0.09 to 0.66 ± 0.13 after Pycnogenol treatment , while no change was observed in the placebo group ( mean difference 0.06 pg/mL with an associated 95 % CI ( 0.01 , 0.11 ) , P = 0.012 ] . Inflammation markers , platelet adhesion , and blood pressure did not change after treatment with Pycnogenol or placebo . CONCLUSION This study provides the first evidence that the antioxidant Pycnogenol improves endothelial function in patients with CAD by reducing oxidative stress The aim of this study was to investigate the clinical efficacy of oral Pycnogenol ® ( Horphag Research Ltd , United Kingdom ) in patients with diabetic microangiopathy . Patients without a history of diabetic ulcerations were treated with Pycnogenol . Patients received oral Pycnogenol ( 50 mg capsules , 3 times daily for a total of 150 
    Output:
    
agent
The results indicate that pycnogenol supplementation improves levels of HDL-C ; however , the changes in TC , TAG , and LDL-C were not clinical ly relevant .
Since there are few phytochemicals that have a significant increasing effect on HDL-C levels  , pycnogenol may have important role in prevention of cardiovascular diseases
***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: Association between white rice intake and risk factors of cardiovascular diseases remained uncertain . Most of the previous published studies have been done in western countries with different lifestyles , and scant data are available from the Middle East region , including Iran . This cross-sectional study was conducted in the structure of Isfahan Healthy Heart Program ( IHHP ) to assess the association between white rice consumption and risk factors of cardiovascular diseases . In the present study , 3,006 men were included from three counties of Isfahan , Najafabad , and Arak by multistage cluster r and om-sampling method .  Dietary intake was assessed with a 49-item food frequency question naire ( FFQ ) . Laboratory assessment was done in a st and ardized central laboratory . Outcome variables were fasting blood glucose , serum lipid levels , and anthropometric variables . Socioeconomic and demographic data , physical activity , and body mass index ( BMI ) were considered covariates and were adjusted in analysis . In this study , Student 's t-test , chi-square test , and logistic regression were used for statistical analyses . Means of BMI among those subjects who consumed white rice less than 7 times per week and people who consumed 7 - 14 times per week were almost similar—24.8±4.3 vs 24.5±4.7 kg/m2 . There was no significant association between white rice  consumption and risk factors of cardiovascular diseases , such as fasting blood sugar and serum lipid profiles . Although whole grain consumption has undeniable effect on preventing cardiovascular disease risk , white rice consumption was not associated with cardiovascular risks among Iranian men in the present study . Further prospect i ve studies with a semi-quantitative FFQ or dietary record question naire , representing type and portion-size of rice intake as well as cooking methods and other foods consumed with rice that affect glycaemic index ( GI ) of rice , are required to support our finding and to illustrate the probable mechanism BACKGROUND Cardiovascular diseases ( CVD ) are a set of metabolic disorders affecting heart and blood vessels . Green tea and sour tea ( Hibiscus sabdariffa L. ) have attracted significant attention recently due to their high popularity , nutrient profile and therapeutic effects . The aim of the present study was to compare the effects of green tea and sour tea supplementation on blood pressure and lipid profile in healthy adult men . METHODS This r and omized , double-blind , placebo-controlled trial included 54 healthy adult men . The participants were r and omly assigned to two intervention groups receiving 450 mg green tea or sour tea and one placebo group which consumed 450 mg placebo ( maltodextrin ) for 6 weeks . Blood pressure , lipid profile , dietary intake and physical activity were measured pre- and post-intervention and compared . RESULTS After 6 weeks of intervention , sour tea supplementation led to a significant decrease in systolic blood pressure ( SBP ) compared with the placebo group . However , we faild to find any significant difference in SBP between green tea and control groups . Also , no significant changes were observed in diastolic blood pressure ( DBP ) and lipid profile between the three groups . In comparison with baseline , there was a significant increase in the mean level of serum high-density lipoprotein cholesterol ( HDL-C ) in green tea and sour tea groups . Also , the interventions result ed in significant decrease in the mean levels of serum total cholesterol ( TC ) and low-density lipoprotein cholesterol ( LDL-C ) and DBP in the sour tea group compared with the pre-intervention value . CONCLUSION On the basis of our findings , sour tea supplementation led to decreased SBP  in healthy men compared with the placebo , but there was no significant difference between their effects on DBP and lipid profile Pycnogenol ® ( PYC ) , an extract of French maritime pine bark ( Pinus pinaster ) , is a potent antioxidant with potential health benefits . Its bioavailabilty has previously been shown by urinary excretion studies of constituents and metabolites of PYC . The aim of this study was to test the effect of PYC supplementation on measures of oxidative stress and the lipid profile in humans . Twenty-five healthy subjects received  PYC  ( 150 mg/d ) for 6 wk . Fasting blood was collected at baseline , after 3 and 6 wk of supplementation , and again after a 4-wk washout period . After 6 wk of supplementation with PYC , a significant increase in plasma polyphenol levels was detectable , which was reversed after the 4-wk washout phase . The antioxidant effect of PYC was demonstrated by a significant increase in oxygen radical absorbance capacity ( ORAC ) in plasma throughout the supplementation period ( P<0.05 ) . The ORAC value returned to baseline after the 4-wk washout period . Moreover , in addition to its antioxidant effects  , PYC significantly reduced LDL-cholesterol levels and increased HDL-cholesterol levels in plasma of two-thirds of the subjects . While the LDL changes reversed during washout , the HDL increase did not . There was no significant difference in LDL oxidizability or plasma lipid peroxides following PYC supplementation . Hence , following oral supplementation in humans  , PYC significantly increases antioxidant capacity of plasma , as determined by ORAC , and exerts favorable effects on the lipid profile BACKGROUND Orange juice-a rich source of vitamin C , folate , and flavonoids such as hesperidin-induces hypocholesterolemic responses in animals . OBJECTIVE We determined whether orange juice beneficially altered blood lipids in subjects with moderate hypercholesterolemia . DESIGN The sample consisted of 16 healthy men and 9 healthy women with elevated plasma total and LDL-cholesterol and normal plasma triacylglycerol concentrations . Participants incorporated 1 , 2 , or 3 cups ( 250 mL each ) of orange juice sequentially into their diets , each dose over a period of 4 wk . This was followed by a 5-wk washout period . Plasma lipid , folate , homocyst(e)ine , and vitamin C ( a compliance marker ) concentrations were measured at baseline , after each treatment , and after the washout period . RESULTS Consumption of 750 mL but not of 250 or 500 mL orange juice daily increased HDL-cholesterol concentrations by 21 % ( P : < 0.001 ) , triacylglycerol concentrations by 30 % ( from 1.56 + /- 0.72 to 2.03 + /- 0.91 mmol/L ; P : < 0.02 ) , and folate concentrations by 18 % ( P : < 0.01 ) ; decreased the LDL-HDL cholesterol ratio by 16 % ( P : < 0.005 ) ; and did not affect homocyst(e)ine concentrations . Plasma vitamin C concentrations increased significantly during each dietary period ( 2.1 , 3.1 , and 3.8 times , respectively ) . CONCLUSIONS Orange juice ( 750 mL/d ) improved blood lipid profiles in hypercholesterolemic subjects , confirming recommendations to consume > /=5 - 10 servings of fruit and vegetables daily BACKGROUND Although modifiable cardiovascular disease risk factors are common , some patients eschew conventional drug treatments in favor of natural alternatives . Pine bark extract , a dietary supplement source of antioxidant oligomeric proanthocyanidin complexes , has multiple putative cardiovascular benefits . Studies published to date about the supplement have notable method ological limitations . METHODS We r and omized 130 individuals with increased cardiovascular disease risk to take 200 mg of a water-based extract of pine bark  ( n = 64 ; Toyo-FVG , Toyo Bio-Pharma , Torrance , California ; Shinyaku Co , Ltd , Saga , Japan ; also marketed as Flavagenol in Japan ) or placebo ( n = 66 ) once per day . Blood pressure , our primary outcome , and other cardiovascular disease risk factors were measured at baseline and at 6 and 12 weeks . Statistical analyses were conducted using regression models . RESULTS Baseline characteristics did not differ between the study groups . Over the 12-week intervention , the sum of systolic and diastolic blood pressures decreased by 1.0 mm Hg ( 95 % confidence interval , -4.2 to 2.1 mm Hg ) in the pine bark extract-treated group and by 1.9 mm Hg ( -5.5 to 1.7 mm Hg ) in the placebo group ( P = .87 ) . Other outcomes were likewise not significantly different , including body mass index , lipid panel measures , liver transaminase test results , lipoprotein cholesterol particle size , and levels of insulin , lipoprotein(a ) , fasting glucose , and high-sensitivity C-reactive protein . There were no subgroups for whom intake of pine bark extract affected cardiovascular disease risk factors . CONCLUSIONS This pine bark extract ( at a dosage of 200 mg/d ) was safe but was not associated with improvement in cardiovascular disease risk factors . Although variations among participants , dosages , and chemical preparations could contribute to different findings compared with past studies , our results are consistent with a general failure of antioxidants to demonstrate cardiovascular benefits . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00425945 The aim of this study was to compare the efficacy of Venostasin ( horse chestnut seed extract ) and Pycnogenol ( French maritime pine bark extract ) in the treatment of chronic venous insufficiency ( CVI ) . In an open , controlled comparative study 40 patients with diagnosed CVI were treated either with 600 mg chestnut seed extract per day or 360 mg Pycnogenol per day over a period of 4 weeks . The following parameters were investigated before the start of treatment and after 2 and 4 weeks of treatment : circumference of the lower legs and rating of subjective symptoms ( scores ) of pain , cramps , night-time swelling , feeling of " heaviness " , and reddening of the skin . In addition , blood levels of cholesterol LDL and HDL were determined before and at the end of treatment . Pycnogenol significantly reduced the circumference of the lower limbs and significantly improved subjective symptoms . Furthermore , Pycnogenol significantly decreased cholesterol and LDL values in the blood , whereas HDL remained unaffected . Venostasin only moderately but not significantly , reduced the circumference of the lower limbs and marginally improved symptoms .  Venostasin had no influence on the determined lipid values . Both medications were equally well tolerated . In conclusion , Pycnogenol was found to be more efficacious than Venostasin for the treatment of CVI AIMS Extracts from pine tree bark containing a variety of flavonoids have been used in traditional medicine . Pycnogenol is a proprietary bark extract of the French maritime pine tree ( Pinus pinaster ssp . atlantica ) that exerts antioxidative , anti-inflammatory , and anti-platelet effects . However , the effects of Pycnogenol on endothelial dysfunction , a precursor of atherosclerosis and cardiovascular events , remain still elusive . METHODS AND RESULTS Twenty-three patients with coronary artery disease ( CAD ) completed this r and omized , double-blind , placebo-controlled cross-over study . Patients received Pycnogenol ( 200 mg/day ) for 8 weeks followed by placebo or vice versa on top of st and ard cardiovascular therapy . Between the two treatment periods , a 2-week washout period was scheduled . At baseline and after each treatment period , endothelial function , non-invasively assessed by flow-mediated dilatation ( FMD ) of the brachial artery using high-resolution ultrasound , biomarkers of oxidative stress and inflammation , platelet adhesion , and 24 h blood pressure monitoring were evaluated . In CAD  patients , Pycnogenol treatment was associated with an improvement of FMD from 5.3 ± 2.6 to 7.0 ± 3.1 ( P < 0.0001 ) , while no change was observed with placebo ( 5.4 ± 2.4 to 4.7 ± 2.0 ; P = 0.051 ) . This difference between study groups was significant [ estimated treatment effect 2.75 ; 95 % confidence interval ( CI ) : 1.75 , 3.75 , P < 0.0001 ] . 15-F(2t)-Isoprostane , an index of oxidative stress , significantly decreased from 0.71 ± 0.09 to 0.66 ± 0.13 after Pycnogenol treatment , while no change was observed in the placebo group ( mean difference 0.06 pg/mL with an associated 95 % CI ( 0.01 , 0.11 ) , P = 0.012 ] . Inflammation markers , platelet adhesion , and blood pressure did not change after treatment with Pycnogenol or placebo . CONCLUSION This study provides the first evidence that the antioxidant Pycnogenol improves endothelial function in patients with CAD by reducing oxidative stress The aim of this study was to investigate the clinical efficacy of oral Pycnogenol ® ( Horphag Research Ltd , United Kingdom ) in patients with diabetic microangiopathy . Patients without a history of diabetic ulcerations were treated with Pycnogenol . Patients received oral Pycnogenol ( 50 mg capsules , 3 times daily for a total of 150 
    Output:
    