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 The prevalence of micronutrient deficiencies is higher in obese individuals compared to normal-weight people , probably because of inadequate eating habits but also due to increased dem and s among overweight persons , which are underestimated by dietary reference intakes ( DRI ) intended for the general population . We therefore evaluated the dietary micronutrient intake in obese individuals compared to a reference population and DRI recommendations . Furthermore , we determined the micronutrient status in obese subjects undergoing a st and ardized DRI-covering low-calorie formula diet  to analyze if the DRI meet the micronutrient requirements of obese individuals . Methods In 104 subjects baseline micronutrient intake was determined by dietary record collection .  A r and omly assigned subgroup of subjects ( n = 32 ) underwent a st and ardized DRI-covering low-calorie formula diet over a period of three months . Pre- and post-interventional intracellular micronutrient status in buccal mucosa cells ( BMC ) was analyzed , as well as additional micronutrient serum concentrations in 14 of the subjects . Results Prior to dietetic intervention , nutrition was calorie-rich and micronutrient-poor . Baseline deficiencies in serum concentrations were observed for 25-hydroxyvitamin-D , vitamin C , selenium , iron , as well as ß-carotene , vitamin C , and lycopene in BMC . After a three-month period of formula diet even more subjects had reduced micronutrient levels of vitamin C ( serum , BMC ) , zinc , and lycopene . There was a significant negative correlation between lipophilic serum vitamin concentrations and body fat , as well as between iron and C-reactive protein . Conclusions The present pilot study shows that micronutrient deficiency occurring in obese individuals is not corrected by protein-rich formula diet containing vitamins and minerals according to DRI . In contrast , micronutrient levels remain low or become even lower , which might be explained by insufficient intake , increased dem and and unbalanced dispersal of lipophilic compounds in the body . Trial registration The study was registered at Clinical Trials.gov ( NCT01344525 ) . The study protocol comprises only a part of the approved trial protocol BACKGROUND Weight loss is associated with bone loss , but this has not been examined in overweight premenopausal women . OBJECTIVE The aim of this study was to assess whether overweight premenopausal women lose bone with moderate weight loss at recommended or higher than recommended calcium intakes . DESIGN Overweight premenopausal women [ n = 44 ; x ( + /-SD ) age : 38 + /- 6.4 y ; body mass index ( BMI ): 27.7 + /- 2.1 kg/m(2 ) ] were r and omly assigned to either a normal ( 1 g/d ) or high ( 1.8 g/d ) calcium intake during 6 mo of energy restriction [ weight loss ( WL ) groups ] or were recruited for weight maintenance at 1 g Ca/d intake .  Regional bone mineral density and content were measured by dual-energy X-ray absorptiometry , and markers of bone turnover were measured before and after weight loss . True fractional calcium absorption ( TFCA ) was measured at baseline and during caloric restriction by using a dual-stable calcium isotope method . RESULTS The WL groups lost 7.2 + /- 3.3 % of initial body weight . No significant decrease in BMD or rise in bone turnover was observed with weight loss at normal or high calcium intake . The group that consumed high calcium showed a strong relation ( r = 0.71 ) between increased femoral neck bone mineral density and increased serum 25-hydroxyvitamin D. No significant effect of weight loss on TFCA was observed , and the total calcium absorbed was adequate at 238 + /- 81 and 310 + /- 91 mg/d for the normal- and high-calcium WL groups , respectively . CONCLUSION Overweight premenopausal women do not lose bone during weight loss at the recommended calcium intake , which may be explained by sufficient amounts of absorbed calcium BACKGROUND Overweight and obesity are increasing in young adults . However , moderate energy restriction aim ed at lowering body weight may promote bone turnover and bone loss . Inclusion of fish or fish oils in a weight-loss diet may attenuate these adverse skeletal effects . OBJECTIVE We examined the effects of incorporating fish or fish oil into an energy-restricted diet on bone turnover markers in young overweight adults . DESIGN While following a strict hypoenergetic ( -30 % relative to estimated requirements ) diet for 8 wk , 276 overweight men and women [ body mass index ( in kg/m(2 ) ) : 27.5 - 32.5 ; age : 20 - 40 y ) were r and omly assigned to 1 of 4 dietary groups : sunflower-oil capsules ( 3 g/d ; control ) , cod ( 3 x 150 g/wk ) , salmon ( 3 x 150 g/wk ) , and fish-oil capsules ( 3 g/d ) . Body weight , bone biomarkers , and 25-hydroxyvitamin D were measured at baseline and endpoint . Data were analyzed with repeated- measures analysis of variance and general linear models . RESULTS The mean ( + /-SD ) weight loss was 5.14 + /- 3.0 kg ( 5.8 % + /- 3.2 % body weight ) during the 8 wk in the 4 dietary groups combined . Urinary N-telopeptides of type I collagen and serum C-terminal telopeptide of type I collagen increased ( P < 0.05 ) , whereas serum osteocalcin ( but not bone-specific alkaline phosphatase ) decreased ( P < 0.05 ) from baseline to endpoint . Increased fish or fish-oil consumption had no effect ( P > 0.1 ) on the changes in bone markers induced by weight loss . In contrast , increased salmon consumption increased serum 25-hydroxyvitamin D ( P < 0.01 ) . CONCLUSIONS A nutritionally adequate but energy-restricted diet , with different contents of n-3 fatty acids , which result ed in modest weight loss , unfavorably altered bone turnover markers  in young overweight adults . Such changes were not prevented by increased fish or fish-oil consumption Experimental studies suggest that vitamin D modulates the activity of adipocytes . The authors examined baseline serum 25-hydroxyvitamin D ( 25(OH)D )  level in relation to prevalent and cumulative incident obesity in Norway . A cohort of 25,616 adults aged 19 - 55 years participated in both the second and third surveys of the Nord-Trøndelag Health Study ( HUNT 2 ( 1995 - 1997 ) and HUNT 3 ( 2006 - 2008 ) ) .  Serum 25(OH)D levels measured at baseline and  anthropometric measurements  taken at both baseline and follow-up were available for a r and om sample of 2,460 subjects . Overall , 40 % of the 2,460 subjects had a serum 25(OH)D level less than 50.0 nmol/L , and 37 % had a level of 50.0 - 74.9 nmol/L. The prevalence and cumulative incidence of obesity , defined as body mass index ( weight (kg)/height (m)(2 ) ) ≥30 , were 12 % and 15 % , respectively . Lower serum 25(OH)D level was associated with a higher prevalence of obesity . In the 2,165 subjects with baseline BMI less than 30 , a serum 25(OH)D level less than 50.0 nmol/L was associated with a significantly increased odds ratio for incident obesity during follow-up ( adjusted odds ratio = 1.73 , 95 % confidence interval : 1.24 , 2.41 ) . When prevalent and incident obesity were classified according to waist circumference ( ≥88 cm for women , ≥102 cm for men ) , similar results were obtained . In addition to prevalent obesity , a serum 25(OH)D level less than 50.0 nmol/L was significantly associated with new-onset obesity in adults BACKGROUND The role of dairy calcium intake and serum vitamin D concentrations in weight loss is controversial . OBJECTIVE The objective was to assess the association of dairy calcium intake and serum vitamin D with weight loss . DESIGN We analyzed data from participants in the 2-y Dietary Intervention R and omized Controlled Trial ( DIRECT ) [ n = 322 ; mean body mass index ( BMI ; in kg/m² ) : 31 ; mean age : 52 y ] . A representative sample ( n = 126 ) was followed for 6 mo for serum vitamin D changes . RESULTS Baseline serum 25-hydroxyvitamin D [ 25(OH)D ] concentrations decreased significantly across the tertiles of baseline BMI ( 25.6 ± 8.0 , 24.1 ± 8.9 , and 22.9 ± 6.8 ng/mL , respectively ; P for trend = 0.02 ) . Baseline concentrations of vitamin D and dairy calcium  intake were not associated with subsequent weight loss . However , in repeated- measures models adjusted for age , sex , baseline BMI , total fat intake , and diet group assignment , higher 6-mo tertile levels of dairy calcium intake ( median for tertiles : 156.5 , 358.0 , and 582.9 mg/d , respectively ) and serum 25(OH)D ( 14.5 , 21.2 , and 30.2 ng/mL , respectively ) were associated with increased weight loss across the 2-y intervention ( -3.3 , -3.5 , and -5.3 kg , respectively , for dairy calcium ; P = 0.043 ; -3.1 , -3.8 , and -5.6 kg , respectively , for vitamin D ; P = 0.013 ) . In a multivariate logistic regression adjusted simultaneously for age , sex , baseline BMI , total fat intake , diet group , vitamin D concentration , and dairy calcium , an increase of 1 SD in  dairy calcium intake increased the likelihood of weight loss of > 4.5 kg in the preceding 6 mo [ odds ratio ( OR ) : 1.45 ; P = 0.046 ] . A similar increase was seen for serum 25(OH)D at the 6-mo point ( OR : 1.7 ; P = 0.009 ) . CONCLUSION Our study suggests that both higher dairy calcium intake and increased serum vitamin D are related to greater diet-induced weight loss . This trial was registered at clinical trials.gov as NCT00160108 OBJECTIVE The objective of the study was to examine changes of 25-hydroxy-vitamin D ( 25OHD ) and PTH blood levels 4 and 20 wk after low-calorie diet-induced weight loss . METHODS Forty-four obese women [ aged 40.6 + /- 11.4 yr , body mass index ( BMI ) 36.7 + /- 4.9 kg/m(2 ) ] and 25 controls ( BMI 22.9 + /- 1.5 kg/m(2 ) ) were examined .  Anthropometric and cardiometabolic parameters and 25OHD and PTH levels  were determined at baseline and 4 and 20 wk after a low-calorie diet . RESULTS At baseline , 25OHD levels were lower in obese compared with control subjects ( 17 + /- 6.0 vs. 23.8 + /- 8.7 ng/ml , P < 0.001 ) , whereas no differences were found in PTH levels . In all women , a negative correlation was found between 25OHD levels and body weight ( BW ) ( r -0.32 , P < 0.001 ) , BMI ( r -0.37 , P < 0.001 ) , waist circumference ( r -0.26 , P < 0.05 ) , and percent fat mass ( r -0.38 , P = 0.001 ) as determined by bioelectrical impedance analysis . The 4-wk low-calorie diet ( n = 37 ) reduced BW and led to significant improvements in the homeostasis model assessment ( HOMA ) index and lipid levels . The 20-wk low-calorie diet ( n = 26 ) result ed in reduction of BW and BMI by 10 % , HOMA index ( 4.7 + /- 3.8 vs. 3.10 + /- 1.7 , P < 0.01 ) , and lipids levels ( except high density lipoprotein cholesterol ) and increase in 25OHD ( 15.4 + /- 6.0 vs. 18.3 + /- 5.1 ng/ml , P < 0.05 ) , compared with baseline . PTH levels were unchanged . The increase of 25OHD levels was associated with the reduction of insulin levels and HOMA index ( r -0.43 , P < 0.05 ) . CONCLUSIONS Blood 25OHD levels were low in obese women and correlated inversely with severity measures of obesity . Weight loss of 10 % after low-calorie diet increased 25OHD levels , and this 
    Output:
    
agent
Collectively , these outcomes support a volumetric dilution of vitamin D. The slopes of the respective regression lines , however , indicate a smaller increase in 25OHD than would be expected from a direct mobilization of stores into the circulation .
Hence , sequestration of 25OHD and its conversion to inactive metabolites would also play a role .
***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 The prevalence of micronutrient deficiencies is higher in obese individuals compared to normal-weight people , probably because of inadequate eating habits but also due to increased dem and s among overweight persons , which are underestimated by dietary reference intakes ( DRI ) intended for the general population . We therefore evaluated the dietary micronutrient intake in obese individuals compared to a reference population and DRI recommendations . Furthermore , we determined the micronutrient status in obese subjects undergoing a st and ardized DRI-covering low-calorie formula diet  to analyze if the DRI meet the micronutrient requirements of obese individuals . Methods In 104 subjects baseline micronutrient intake was determined by dietary record collection .  A r and omly assigned subgroup of subjects ( n = 32 ) underwent a st and ardized DRI-covering low-calorie formula diet over a period of three months . Pre- and post-interventional intracellular micronutrient status in buccal mucosa cells ( BMC ) was analyzed , as well as additional micronutrient serum concentrations in 14 of the subjects . Results Prior to dietetic intervention , nutrition was calorie-rich and micronutrient-poor . Baseline deficiencies in serum concentrations were observed for 25-hydroxyvitamin-D , vitamin C , selenium , iron , as well as ß-carotene , vitamin C , and lycopene in BMC . After a three-month period of formula diet even more subjects had reduced micronutrient levels of vitamin C ( serum , BMC ) , zinc , and lycopene . There was a significant negative correlation between lipophilic serum vitamin concentrations and body fat , as well as between iron and C-reactive protein . Conclusions The present pilot study shows that micronutrient deficiency occurring in obese individuals is not corrected by protein-rich formula diet containing vitamins and minerals according to DRI . In contrast , micronutrient levels remain low or become even lower , which might be explained by insufficient intake , increased dem and and unbalanced dispersal of lipophilic compounds in the body . Trial registration The study was registered at Clinical Trials.gov ( NCT01344525 ) . The study protocol comprises only a part of the approved trial protocol BACKGROUND Weight loss is associated with bone loss , but this has not been examined in overweight premenopausal women . OBJECTIVE The aim of this study was to assess whether overweight premenopausal women lose bone with moderate weight loss at recommended or higher than recommended calcium intakes . DESIGN Overweight premenopausal women [ n = 44 ; x ( + /-SD ) age : 38 + /- 6.4 y ; body mass index ( BMI ): 27.7 + /- 2.1 kg/m(2 ) ] were r and omly assigned to either a normal ( 1 g/d ) or high ( 1.8 g/d ) calcium intake during 6 mo of energy restriction [ weight loss ( WL ) groups ] or were recruited for weight maintenance at 1 g Ca/d intake .  Regional bone mineral density and content were measured by dual-energy X-ray absorptiometry , and markers of bone turnover were measured before and after weight loss . True fractional calcium absorption ( TFCA ) was measured at baseline and during caloric restriction by using a dual-stable calcium isotope method . RESULTS The WL groups lost 7.2 + /- 3.3 % of initial body weight . No significant decrease in BMD or rise in bone turnover was observed with weight loss at normal or high calcium intake . The group that consumed high calcium showed a strong relation ( r = 0.71 ) between increased femoral neck bone mineral density and increased serum 25-hydroxyvitamin D. No significant effect of weight loss on TFCA was observed , and the total calcium absorbed was adequate at 238 + /- 81 and 310 + /- 91 mg/d for the normal- and high-calcium WL groups , respectively . CONCLUSION Overweight premenopausal women do not lose bone during weight loss at the recommended calcium intake , which may be explained by sufficient amounts of absorbed calcium BACKGROUND Overweight and obesity are increasing in young adults . However , moderate energy restriction aim ed at lowering body weight may promote bone turnover and bone loss . Inclusion of fish or fish oils in a weight-loss diet may attenuate these adverse skeletal effects . OBJECTIVE We examined the effects of incorporating fish or fish oil into an energy-restricted diet on bone turnover markers in young overweight adults . DESIGN While following a strict hypoenergetic ( -30 % relative to estimated requirements ) diet for 8 wk , 276 overweight men and women [ body mass index ( in kg/m(2 ) ) : 27.5 - 32.5 ; age : 20 - 40 y ) were r and omly assigned to 1 of 4 dietary groups : sunflower-oil capsules ( 3 g/d ; control ) , cod ( 3 x 150 g/wk ) , salmon ( 3 x 150 g/wk ) , and fish-oil capsules ( 3 g/d ) . Body weight , bone biomarkers , and 25-hydroxyvitamin D were measured at baseline and endpoint . Data were analyzed with repeated- measures analysis of variance and general linear models . RESULTS The mean ( + /-SD ) weight loss was 5.14 + /- 3.0 kg ( 5.8 % + /- 3.2 % body weight ) during the 8 wk in the 4 dietary groups combined . Urinary N-telopeptides of type I collagen and serum C-terminal telopeptide of type I collagen increased ( P < 0.05 ) , whereas serum osteocalcin ( but not bone-specific alkaline phosphatase ) decreased ( P < 0.05 ) from baseline to endpoint . Increased fish or fish-oil consumption had no effect ( P > 0.1 ) on the changes in bone markers induced by weight loss . In contrast , increased salmon consumption increased serum 25-hydroxyvitamin D ( P < 0.01 ) . CONCLUSIONS A nutritionally adequate but energy-restricted diet , with different contents of n-3 fatty acids , which result ed in modest weight loss , unfavorably altered bone turnover markers  in young overweight adults . Such changes were not prevented by increased fish or fish-oil consumption Experimental studies suggest that vitamin D modulates the activity of adipocytes . The authors examined baseline serum 25-hydroxyvitamin D ( 25(OH)D )  level in relation to prevalent and cumulative incident obesity in Norway . A cohort of 25,616 adults aged 19 - 55 years participated in both the second and third surveys of the Nord-Trøndelag Health Study ( HUNT 2 ( 1995 - 1997 ) and HUNT 3 ( 2006 - 2008 ) ) .  Serum 25(OH)D levels measured at baseline and  anthropometric measurements  taken at both baseline and follow-up were available for a r and om sample of 2,460 subjects . Overall , 40 % of the 2,460 subjects had a serum 25(OH)D level less than 50.0 nmol/L , and 37 % had a level of 50.0 - 74.9 nmol/L. The prevalence and cumulative incidence of obesity , defined as body mass index ( weight (kg)/height (m)(2 ) ) ≥30 , were 12 % and 15 % , respectively . Lower serum 25(OH)D level was associated with a higher prevalence of obesity . In the 2,165 subjects with baseline BMI less than 30 , a serum 25(OH)D level less than 50.0 nmol/L was associated with a significantly increased odds ratio for incident obesity during follow-up ( adjusted odds ratio = 1.73 , 95 % confidence interval : 1.24 , 2.41 ) . When prevalent and incident obesity were classified according to waist circumference ( ≥88 cm for women , ≥102 cm for men ) , similar results were obtained . In addition to prevalent obesity , a serum 25(OH)D level less than 50.0 nmol/L was significantly associated with new-onset obesity in adults BACKGROUND The role of dairy calcium intake and serum vitamin D concentrations in weight loss is controversial . OBJECTIVE The objective was to assess the association of dairy calcium intake and serum vitamin D with weight loss . DESIGN We analyzed data from participants in the 2-y Dietary Intervention R and omized Controlled Trial ( DIRECT ) [ n = 322 ; mean body mass index ( BMI ; in kg/m² ) : 31 ; mean age : 52 y ] . A representative sample ( n = 126 ) was followed for 6 mo for serum vitamin D changes . RESULTS Baseline serum 25-hydroxyvitamin D [ 25(OH)D ] concentrations decreased significantly across the tertiles of baseline BMI ( 25.6 ± 8.0 , 24.1 ± 8.9 , and 22.9 ± 6.8 ng/mL , respectively ; P for trend = 0.02 ) . Baseline concentrations of vitamin D and dairy calcium  intake were not associated with subsequent weight loss . However , in repeated- measures models adjusted for age , sex , baseline BMI , total fat intake , and diet group assignment , higher 6-mo tertile levels of dairy calcium intake ( median for tertiles : 156.5 , 358.0 , and 582.9 mg/d , respectively ) and serum 25(OH)D ( 14.5 , 21.2 , and 30.2 ng/mL , respectively ) were associated with increased weight loss across the 2-y intervention ( -3.3 , -3.5 , and -5.3 kg , respectively , for dairy calcium ; P = 0.043 ; -3.1 , -3.8 , and -5.6 kg , respectively , for vitamin D ; P = 0.013 ) . In a multivariate logistic regression adjusted simultaneously for age , sex , baseline BMI , total fat intake , diet group , vitamin D concentration , and dairy calcium , an increase of 1 SD in  dairy calcium intake increased the likelihood of weight loss of > 4.5 kg in the preceding 6 mo [ odds ratio ( OR ) : 1.45 ; P = 0.046 ] . A similar increase was seen for serum 25(OH)D at the 6-mo point ( OR : 1.7 ; P = 0.009 ) . CONCLUSION Our study suggests that both higher dairy calcium intake and increased serum vitamin D are related to greater diet-induced weight loss . This trial was registered at clinical trials.gov as NCT00160108 OBJECTIVE The objective of the study was to examine changes of 25-hydroxy-vitamin D ( 25OHD ) and PTH blood levels 4 and 20 wk after low-calorie diet-induced weight loss . METHODS Forty-four obese women [ aged 40.6 + /- 11.4 yr , body mass index ( BMI ) 36.7 + /- 4.9 kg/m(2 ) ] and 25 controls ( BMI 22.9 + /- 1.5 kg/m(2 ) ) were examined .  Anthropometric and cardiometabolic parameters and 25OHD and PTH levels  were determined at baseline and 4 and 20 wk after a low-calorie diet . RESULTS At baseline , 25OHD levels were lower in obese compared with control subjects ( 17 + /- 6.0 vs. 23.8 + /- 8.7 ng/ml , P < 0.001 ) , whereas no differences were found in PTH levels . In all women , a negative correlation was found between 25OHD levels and body weight ( BW ) ( r -0.32 , P < 0.001 ) , BMI ( r -0.37 , P < 0.001 ) , waist circumference ( r -0.26 , P < 0.05 ) , and percent fat mass ( r -0.38 , P = 0.001 ) as determined by bioelectrical impedance analysis . The 4-wk low-calorie diet ( n = 37 ) reduced BW and led to significant improvements in the homeostasis model assessment ( HOMA ) index and lipid levels . The 20-wk low-calorie diet ( n = 26 ) result ed in reduction of BW and BMI by 10 % , HOMA index ( 4.7 + /- 3.8 vs. 3.10 + /- 1.7 , P < 0.01 ) , and lipids levels ( except high density lipoprotein cholesterol ) and increase in 25OHD ( 15.4 + /- 6.0 vs. 18.3 + /- 5.1 ng/ml , P < 0.05 ) , compared with baseline . PTH levels were unchanged . The increase of 25OHD levels was associated with the reduction of insulin levels and HOMA index ( r -0.43 , P < 0.05 ) . CONCLUSIONS Blood 25OHD levels were low in obese women and correlated inversely with severity measures of obesity . Weight loss of 10 % after low-calorie diet increased 25OHD levels , and this 
    Output:
    