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: OBJECTIVE High intake of trans fatty acids and saturated fatty acids ( SFAs ) is known to increase the risk of coronary heart disease . We studied the effects of diets enriched in various fatty acids on postpr and ial insulinemia and fasting serum levels of lipids and lipoproteins in obese patients with NIDDM . RESEARCH DESIGN AND METHODS Sixteen obese NIDDM patients were studied in a free-living outpatient regimen . After a run-in period , the patients received three different isocaloric diets for 6 weeks using a r and omized crossover design . The patients were instructed to keep the energy intake from carbohydrate and protein constant at 50 and 20 E% ( percent of energy intake ) , respectively , on all three diets . The fat composition of the diets differed : saturated fat ( SAT ) diet ( 20 E% SFAs , 5 E% polyunsaturated fatty acids [ PUFAs ] , and 5 E% monounsaturated fatty acids [ MUFAs ] ) versus cis monounsaturated fatty acid ( CMUFA ) diet ( 20 E% cis-MUFAs , 5 E% PUFAs , and 5 E% SFAs ) versus trans monounsaturated fatty acid ( TMUFA ) diet ( 20 E% trans-MUFAs , 5 E% PUFAs , and 5 E% SFAs ) . Fasting serum levels of lipids and lipoproteins were measured at baseline and in the fasting state before meal tolerance tests at the end of each study period . Insulin secretion was assessed from incremental serum insulin and C-peptide responses during the meal tests . RESULTS BMI , waist-to-hip ratio , and glycemic control remained stable throughout the study . After meal stimulation , postpr and ial glycemic responses were similar on all diets ; however , serum insulin and C-peptide responses were greater following the TMUFA and SAT diets than following the baseline or CMUFA diets ( P < 0.05 ) . No statistical difference was found in fasting levels of serum lipids ( total cholesterol , triglyceride , phospholipid , and nonesterified fatty acids ) or lipoproteins of HDL cholesterol , VLDL cholesterol , LDL cholesterol , and apolipoprotein B between diets . CONCLUSIONS In the presence of unchanged glycemia , both dietary trans fatty acids and SFAs induce an increase in postpr and ial insulinemia in obese patients with NIDDM BACKGROUND Dietary trans fatty acids ( FAs ) , which are formed during the process of hydrogenating vegetable oil , are known to increase plasma LDL-cholesterol concentrations . However , their effect on LDL particle size has yet to be investigated . OBJECTIVE We investigated the effect of trans FA consumption on the electrophoretic characteristics of LDL particles . DESIGN Eighteen women and 18 men each consumed 5 experimental diets in r and om order for 35-d periods . Fat represented 30 % of total energy intake in each diet , with two-thirds of the fat in the form of semiliquid margarine ( 0.6 g trans FAs/100 g fat ) , soft margarine ( 9.4 g trans FAs/100 g fat ) , shortening ( 13.6 g trans FAs/100 g fat ) , stick margarine ( 26.1 g trans FAs/100 g fat ) , or butter , which was low in trans FAs ( 2.6 g trans FAs/100 g fat ) but rich in saturated fat . LDL particle size and distribution were characterized by nondenaturing , 2 - 16 % polyacrylamide gradient gel electrophoresis . RESULTS Relative to the LDL particle size observed after consumption of the butter-enriched diet , LDL particle size decreased significantly and in a dose-dependent fashion with increasing amounts of dietary trans FAs ( P < 0.001 ) . Cholesterol concentrations in large ( > 260 A ) and medium-sized ( 255 - 260 A ) LDL particles also increased proportionately to the amount of trans FAs in the diet . CONCLUSION Consumption of dietary trans FAs is associated with a deleterious increase in small , dense LDL , which further reinforces the importance of promoting diets low in trans FAs to favorably affect the lipoprotein profile BACKGROUND The effect of individual dietary fatty acids on emerging risk factors for cardiovascular disease that are associated with sub clinical inflammation is unknown . OBJECTIVE The goal was to evaluate the role of dietary fat and specific fatty acids , especially trans fatty acids , in altering concentrations of markers of inflammation in humans fed controlled diets . DESIGN In a r and omized crossover design , 50 men consumed controlled diets for 5 wk that provided 15 % of energy from protein , 39 % of energy from fat , and 46 % of energy from carbohydrate . Eight percent of fat or fatty acids was replaced across diets with the following : cholesterol , oleic acid , trans fatty acids ( TFAs ) , stearic acid ( STE ) , TFA+STE ( 4 % of energy each ) , and 12:0 - 16:0 saturated fatty acids ( LMP ) . RESULTS Fibrinogen concentrations were higher after consumption of the diet enriched in stearic acid than after consumption of the carbohydrate diet . C-reactive protein concentrations were higher after consumption of the TFA diet than after consumption of the carbohydrate diet , but were not significantly different after consumption of the TFA and TFA+STE diets than after consumption of the LMP diet .  Interleukin 6 concentrations were lower after consumption of the oleic acid diet than after consumption of the LMP , TFA , and STE diets .  E-selectin concentrations were higher after consumption of the TFA diet than after consumption of the carbohydrate diet . Consumption of the TFA but not the TFA+STE diet result ed in higher E-selectin concentrations than did the LMP diet . CONCLUSIONS These data provide evidence that dietary fatty acids can modulate markers of inflammation . Although stearic acid minimally affects LDL cholesterol , it does appear to increase fibrinogen concentrations Epidemiological and experimental studies suggest that a diet rich in saturated fat affects insulin sensitivity . Monoenes and dienes that have an usaturated bond with the trans configuration ( trans fatty acids ) resemble saturated fatty acids with respect to structure , but no published data are available on the effect of trans fatty acids on insulin sensitivity . Therefore , the effects of diets high in trans fatty acids ( TFA diet ) and oleic acid ( monounsaturated fat [ MUFA ] diet ) on glucose and lipid metabolism were studied in 14 healthy women . Subjects consumed both experimental diets for 4 weeks according to a r and omized crossover study design . Both experimental diet periods were preceded by consumption of a st and ardized baseline diet for 2 weeks . The diets provided 36.6 % to 37.9 % of energy ( E% ) as fat . In the TFA diet , there was 5.1 E% trans fatty acids , and in the MUFA diet , 5.2 E% oleic acid , substituted for saturated fatty acids in the baseline diet . A frequently sample d intravenous glucose tolerance test ( FSIGT ) was performed at the end of the experimental diet periods . Glucose effectiveness ( S(G ) ) and the insulin sensitivity index ( S(I ) ) did not differ after the two experimental diet periods . There was also no difference in the acute insulin response between the diets . The total cholesterol to high-density lipoprotein ( HDL ) cholesterol ratio and serum total triglyceride , HDL , and low-density lipoprotein ( LDL ) triglyceride and apolipoprotein B ( apoB ) concentrations were higher ( P < .05 ) after the TFA diet . In conclusion , in young healthy women , the TFA diet result ed in a higher total/HDL cholesterol ratio and an elevation in triglyceride and apo B concentrations but had no effect on glucose and insulin metabolism compared with the MUFA diet The objective of this study was to compare the effects of linoleic acid ( cis , cis-C18:2(n-6 ) ) and its hydrogenation products elaidic ( trans-C18:1(n-9 ) ) and stearic acid ( C18:0 ) on serum lipoprotein levels in humans . Twenty-six men and 30 women , all normolipemic and apparently healthy , completed the trial . Three experimental diets were supplied to every subject for 3 weeks each , in r and om order ( multiple cross-over ) . The Linoleate-diet provided 12.0 % of total energy intake as linoleic acid , 2.8 % as stearic acid , and 0.1 % as trans fatty acids . The Stearate-diet supplied 3.9 energy % as linoleic acid , 11.8 % stearic acid , and 0.3 % trans fatty acids . The Trans-diet provided 3.8 energy % as linoleic acid , 3.0 % stearic acid , and 7.7 % as monounsaturated trans fatty acids , largely elaidic acid ( trans-C18:1(n-9 ) ) . Other nutrients were constant . Fasting blood was sample d at the end of each dietary period . Mean ( + /- SD ) serum LDL cholesterol was 109 + /- 24 mg/dl ( 2.83 + /- 0.63 mmol/l ) on the Linoleate-diet . It rose to 116 + /- 27 mg/dl ( 3.00 + /- 0.71 mmol/l ) on the Stearate-diet ( change , 7 mg/dl or 0.17 mmol/l , P = 0.0008 ) and to 119 + /- 25 mg/dl ( 3.07 + /- 0.65 mmol/l ) on the Trans-diet ( change , 9 mg/dl or 0.24 mmol/l , P less than 0.0001 ) . High density lipoprotein ( HDL ) cholesterol decreased by 2 mg/dl ( 0.06 mmol/l , P less than 0.0001 ) on the Stearate-diet and by 4 mg/dl ( 0.10 mmol/l , P less than 0.0001 ) on the Trans-diet , both relative to linoleic acid . Our findings show that 7.7 % of energy ( mean , 24 g/day ) of trans fatty acids in the diet significantly lowered HDL cholesterol and raised LDL cholesterol relative to linoleic acid . Combination with earlier results ( Mensink , R. P. , and M. B. Katan . 1990 . N. Engl . J. Med . 323 : 439 - 445 ) suggests a linear dose-response relation . Replacement of linoleic acid by stearic acid also caused somewhat lower HDL cholesterol and higher LDL cholesterol levels . Hydrogenation of linoleic acid to either stearic or trans fatty acids produces fatty acids that may increase LDL and decrease HDL cholesterol relative to linoleic acid itself The authors investigated the association of dietary patterns and  type 2 diabetes  in a 4-year prospect i ve study of 36,787 adults in the Melbourne Collaborative Cohort Study ( 1990 - 1994 ) . A total of 31,641 ( 86 % ) participants completed follow-up , and 365 cases were identified . Four factors with eigenvalues of greater than 2 were identified using the principal factor method with 124 foods/beverages , followed by orthogonal rotation . Variables with factor loadings having absolute values of 0.3 or greater were used in interpreting the factors . Odds ratios for diabetes incidence across quintiles of factor scores were computed by use of logistic regression , adjusting for age , energy intake , family history of diabetes , country of birth , and other factor scores . Factor 1 , characterized by olive oil , salad vegetables , and legumes and by avoidance of sweet bakery items , margarine , and tea , was associated with country of birth but not with diabetes . Factor 2 , characterized by salad and cooked vegetables , was inversely associated with diabetes . Factor 3 , characterized by meats and fatty foods , was associated with increased diabetes risk . A range of fruits loaded strongly on factor 4 , which showed little association with diabetes . Avoidance of a dietary pattern including meats and fatty foods , as well as adherence to a pattern including salad and cooked vegetables , is recommended Background Dietary trans-rich and interesterified fats were compared to an unmodified saturated fat for their relative impact on blood lipids and plasma glucose . Each fat had melting characteristics , plasticity and solids fat content suitable for use as hardstock in margarine and other solid fat formulations . Methods Thirty human volunteers were fed complete , whole food diets during 4 wk periods , where total fat ( ~31 % daily energy , > 70 % from the test fats ) and fatty acid composition were tightly controlled . A crossover design was used with 3 r and omly-assigned diet rotations and repeated- measures analysis . One test fat rotation was based on palm olein ( POL ) and provided 12.0 percent of energy ( 
    Output:
    
agent
RESULTS Increased TFA intake did not result in significant changes in glucose or insulin concentrations .
Our analysis also showed the absence of publication bias and any dose-response relations between the ES and TFA intake .
Increased TFA intake does not result in changes in glucose , insulin , or triglyceride concentrations but leads to an increase in total and LDL-cholesterol and a decrease in HDL-cholesterol concentrations .
There is no evidence to support a potential benefit of the reduction of dietary TFA intake on glucose homeostasis
***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: OBJECTIVE High intake of trans fatty acids and saturated fatty acids ( SFAs ) is known to increase the risk of coronary heart disease . We studied the effects of diets enriched in various fatty acids on postpr and ial insulinemia and fasting serum levels of lipids and lipoproteins in obese patients with NIDDM . RESEARCH DESIGN AND METHODS Sixteen obese NIDDM patients were studied in a free-living outpatient regimen . After a run-in period , the patients received three different isocaloric diets for 6 weeks using a r and omized crossover design . The patients were instructed to keep the energy intake from carbohydrate and protein constant at 50 and 20 E% ( percent of energy intake ) , respectively , on all three diets . The fat composition of the diets differed : saturated fat ( SAT ) diet ( 20 E% SFAs , 5 E% polyunsaturated fatty acids [ PUFAs ] , and 5 E% monounsaturated fatty acids [ MUFAs ] ) versus cis monounsaturated fatty acid ( CMUFA ) diet ( 20 E% cis-MUFAs , 5 E% PUFAs , and 5 E% SFAs ) versus trans monounsaturated fatty acid ( TMUFA ) diet ( 20 E% trans-MUFAs , 5 E% PUFAs , and 5 E% SFAs ) . Fasting serum levels of lipids and lipoproteins were measured at baseline and in the fasting state before meal tolerance tests at the end of each study period . Insulin secretion was assessed from incremental serum insulin and C-peptide responses during the meal tests . RESULTS BMI , waist-to-hip ratio , and glycemic control remained stable throughout the study . After meal stimulation , postpr and ial glycemic responses were similar on all diets ; however , serum insulin and C-peptide responses were greater following the TMUFA and SAT diets than following the baseline or CMUFA diets ( P < 0.05 ) . No statistical difference was found in fasting levels of serum lipids ( total cholesterol , triglyceride , phospholipid , and nonesterified fatty acids ) or lipoproteins of HDL cholesterol , VLDL cholesterol , LDL cholesterol , and apolipoprotein B between diets . CONCLUSIONS In the presence of unchanged glycemia , both dietary trans fatty acids and SFAs induce an increase in postpr and ial insulinemia in obese patients with NIDDM BACKGROUND Dietary trans fatty acids ( FAs ) , which are formed during the process of hydrogenating vegetable oil , are known to increase plasma LDL-cholesterol concentrations . However , their effect on LDL particle size has yet to be investigated . OBJECTIVE We investigated the effect of trans FA consumption on the electrophoretic characteristics of LDL particles . DESIGN Eighteen women and 18 men each consumed 5 experimental diets in r and om order for 35-d periods . Fat represented 30 % of total energy intake in each diet , with two-thirds of the fat in the form of semiliquid margarine ( 0.6 g trans FAs/100 g fat ) , soft margarine ( 9.4 g trans FAs/100 g fat ) , shortening ( 13.6 g trans FAs/100 g fat ) , stick margarine ( 26.1 g trans FAs/100 g fat ) , or butter , which was low in trans FAs ( 2.6 g trans FAs/100 g fat ) but rich in saturated fat . LDL particle size and distribution were characterized by nondenaturing , 2 - 16 % polyacrylamide gradient gel electrophoresis . RESULTS Relative to the LDL particle size observed after consumption of the butter-enriched diet , LDL particle size decreased significantly and in a dose-dependent fashion with increasing amounts of dietary trans FAs ( P < 0.001 ) . Cholesterol concentrations in large ( > 260 A ) and medium-sized ( 255 - 260 A ) LDL particles also increased proportionately to the amount of trans FAs in the diet . CONCLUSION Consumption of dietary trans FAs is associated with a deleterious increase in small , dense LDL , which further reinforces the importance of promoting diets low in trans FAs to favorably affect the lipoprotein profile BACKGROUND The effect of individual dietary fatty acids on emerging risk factors for cardiovascular disease that are associated with sub clinical inflammation is unknown . OBJECTIVE The goal was to evaluate the role of dietary fat and specific fatty acids , especially trans fatty acids , in altering concentrations of markers of inflammation in humans fed controlled diets . DESIGN In a r and omized crossover design , 50 men consumed controlled diets for 5 wk that provided 15 % of energy from protein , 39 % of energy from fat , and 46 % of energy from carbohydrate . Eight percent of fat or fatty acids was replaced across diets with the following : cholesterol , oleic acid , trans fatty acids ( TFAs ) , stearic acid ( STE ) , TFA+STE ( 4 % of energy each ) , and 12:0 - 16:0 saturated fatty acids ( LMP ) . RESULTS Fibrinogen concentrations were higher after consumption of the diet enriched in stearic acid than after consumption of the carbohydrate diet . C-reactive protein concentrations were higher after consumption of the TFA diet than after consumption of the carbohydrate diet , but were not significantly different after consumption of the TFA and TFA+STE diets than after consumption of the LMP diet .  Interleukin 6 concentrations were lower after consumption of the oleic acid diet than after consumption of the LMP , TFA , and STE diets .  E-selectin concentrations were higher after consumption of the TFA diet than after consumption of the carbohydrate diet . Consumption of the TFA but not the TFA+STE diet result ed in higher E-selectin concentrations than did the LMP diet . CONCLUSIONS These data provide evidence that dietary fatty acids can modulate markers of inflammation . Although stearic acid minimally affects LDL cholesterol , it does appear to increase fibrinogen concentrations Epidemiological and experimental studies suggest that a diet rich in saturated fat affects insulin sensitivity . Monoenes and dienes that have an usaturated bond with the trans configuration ( trans fatty acids ) resemble saturated fatty acids with respect to structure , but no published data are available on the effect of trans fatty acids on insulin sensitivity . Therefore , the effects of diets high in trans fatty acids ( TFA diet ) and oleic acid ( monounsaturated fat [ MUFA ] diet ) on glucose and lipid metabolism were studied in 14 healthy women . Subjects consumed both experimental diets for 4 weeks according to a r and omized crossover study design . Both experimental diet periods were preceded by consumption of a st and ardized baseline diet for 2 weeks . The diets provided 36.6 % to 37.9 % of energy ( E% ) as fat . In the TFA diet , there was 5.1 E% trans fatty acids , and in the MUFA diet , 5.2 E% oleic acid , substituted for saturated fatty acids in the baseline diet . A frequently sample d intravenous glucose tolerance test ( FSIGT ) was performed at the end of the experimental diet periods . Glucose effectiveness ( S(G ) ) and the insulin sensitivity index ( S(I ) ) did not differ after the two experimental diet periods . There was also no difference in the acute insulin response between the diets . The total cholesterol to high-density lipoprotein ( HDL ) cholesterol ratio and serum total triglyceride , HDL , and low-density lipoprotein ( LDL ) triglyceride and apolipoprotein B ( apoB ) concentrations were higher ( P < .05 ) after the TFA diet . In conclusion , in young healthy women , the TFA diet result ed in a higher total/HDL cholesterol ratio and an elevation in triglyceride and apo B concentrations but had no effect on glucose and insulin metabolism compared with the MUFA diet The objective of this study was to compare the effects of linoleic acid ( cis , cis-C18:2(n-6 ) ) and its hydrogenation products elaidic ( trans-C18:1(n-9 ) ) and stearic acid ( C18:0 ) on serum lipoprotein levels in humans . Twenty-six men and 30 women , all normolipemic and apparently healthy , completed the trial . Three experimental diets were supplied to every subject for 3 weeks each , in r and om order ( multiple cross-over ) . The Linoleate-diet provided 12.0 % of total energy intake as linoleic acid , 2.8 % as stearic acid , and 0.1 % as trans fatty acids . The Stearate-diet supplied 3.9 energy % as linoleic acid , 11.8 % stearic acid , and 0.3 % trans fatty acids . The Trans-diet provided 3.8 energy % as linoleic acid , 3.0 % stearic acid , and 7.7 % as monounsaturated trans fatty acids , largely elaidic acid ( trans-C18:1(n-9 ) ) . Other nutrients were constant . Fasting blood was sample d at the end of each dietary period . Mean ( + /- SD ) serum LDL cholesterol was 109 + /- 24 mg/dl ( 2.83 + /- 0.63 mmol/l ) on the Linoleate-diet . It rose to 116 + /- 27 mg/dl ( 3.00 + /- 0.71 mmol/l ) on the Stearate-diet ( change , 7 mg/dl or 0.17 mmol/l , P = 0.0008 ) and to 119 + /- 25 mg/dl ( 3.07 + /- 0.65 mmol/l ) on the Trans-diet ( change , 9 mg/dl or 0.24 mmol/l , P less than 0.0001 ) . High density lipoprotein ( HDL ) cholesterol decreased by 2 mg/dl ( 0.06 mmol/l , P less than 0.0001 ) on the Stearate-diet and by 4 mg/dl ( 0.10 mmol/l , P less than 0.0001 ) on the Trans-diet , both relative to linoleic acid . Our findings show that 7.7 % of energy ( mean , 24 g/day ) of trans fatty acids in the diet significantly lowered HDL cholesterol and raised LDL cholesterol relative to linoleic acid . Combination with earlier results ( Mensink , R. P. , and M. B. Katan . 1990 . N. Engl . J. Med . 323 : 439 - 445 ) suggests a linear dose-response relation . Replacement of linoleic acid by stearic acid also caused somewhat lower HDL cholesterol and higher LDL cholesterol levels . Hydrogenation of linoleic acid to either stearic or trans fatty acids produces fatty acids that may increase LDL and decrease HDL cholesterol relative to linoleic acid itself The authors investigated the association of dietary patterns and  type 2 diabetes  in a 4-year prospect i ve study of 36,787 adults in the Melbourne Collaborative Cohort Study ( 1990 - 1994 ) . A total of 31,641 ( 86 % ) participants completed follow-up , and 365 cases were identified . Four factors with eigenvalues of greater than 2 were identified using the principal factor method with 124 foods/beverages , followed by orthogonal rotation . Variables with factor loadings having absolute values of 0.3 or greater were used in interpreting the factors . Odds ratios for diabetes incidence across quintiles of factor scores were computed by use of logistic regression , adjusting for age , energy intake , family history of diabetes , country of birth , and other factor scores . Factor 1 , characterized by olive oil , salad vegetables , and legumes and by avoidance of sweet bakery items , margarine , and tea , was associated with country of birth but not with diabetes . Factor 2 , characterized by salad and cooked vegetables , was inversely associated with diabetes . Factor 3 , characterized by meats and fatty foods , was associated with increased diabetes risk . A range of fruits loaded strongly on factor 4 , which showed little association with diabetes . Avoidance of a dietary pattern including meats and fatty foods , as well as adherence to a pattern including salad and cooked vegetables , is recommended Background Dietary trans-rich and interesterified fats were compared to an unmodified saturated fat for their relative impact on blood lipids and plasma glucose . Each fat had melting characteristics , plasticity and solids fat content suitable for use as hardstock in margarine and other solid fat formulations . Methods Thirty human volunteers were fed complete , whole food diets during 4 wk periods , where total fat ( ~31 % daily energy , > 70 % from the test fats ) and fatty acid composition were tightly controlled . A crossover design was used with 3 r and omly-assigned diet rotations and repeated- measures analysis . One test fat rotation was based on palm olein ( POL ) and provided 12.0 percent of energy ( 
    Output:
    