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 & AIMS Data regarding the role of kidney adiposity , its clinical implication s , and its dynamics during weight-loss are sparse . We investigated the effect of long-term weight-loss induced intervention diets on dynamics of renal-sinus-fat , an ectopic fat depot , and % renal-parenchymal-fat , lipid accumulation within the renal parenchyma . METHODS We r and omized 278 participants with abdominal obesity/dyslipidemia to low-fat or Mediterranean/low-carbohydrate diets , with or without exercise .  We quantified renal-sinus-fat and % renal-parenchymal-fat by whole body magnetic-resonance-imaging .  RESULTS Participants ( age = 48 years ; 89 % men ; body-mass-index = 31 kg/m2 ) had 86 % retention to the trial after 18 months . Both increased renal-sinus-fat and % renal-parenchymal-fat were directly associated with hypertension , and with higher abdominal deep-subcutaneous-adipose-tissue and visceral-adipose-tissue ( p of trend < 0.05 for all ) after adjustment for body weight . Higher renal-sinus-fat was associated with lower estimated-glomerular-filtration-rate and with higher microalbuminuria and % HbA1C beyond body weight . After 18 months of intervention , overall renal-sinus-fat ( -9 % ; p < 0.05 vs. baseline ) but not % renal-parenchymal-fat ( -1.7 % ; p = 0.13 vs. baseline ) significantly decreased , and similarly across the intervention groups . Renal-sinus-fat and % renal-parenchymal-fat changes were correlated with weight-loss per-se ( p < 0.05 ) . In a model adjusted for age , sex , and visceral-adipose-tissue changes , 18 months reduction in renal-sinus-fat associated with decreased pancreatic , hepatic and cardiac fats ( p < 0.05 for all ) and with decreased cholesterol/high-density lipoprotein-cholesterol ( HDL-c ) ( β = 0.13 ; p = 0.05 ) , triglycerides/HDL-c ( β = 0.13 ; p = 0.05 ) , insulin ( β = 0.12 ; p = 0.05 ) and gamma glutamyl transpeptidase ( β = 0.24 ; p = 0.001 ) , but not with improved renal function parameters or blood pressure . Decreased intake of sodium was associated with a reduction in % renal-parenchymal-fat , after adjustment for 18 months weight-loss ( β = 0.15 ; p = 0.026 ) and hypertension ( β = 0.14 ; p = 0.04 ) . CONCLUSIONS Renal-sinus-fat and renal-parenchymal-fat are fairly related to weight-loss . Decreased renal-sinus-fat is associated with improved hepatic parameters , independent of changes in weight or hepatic fat , rather than with improved renal function or blood pressure parameters . CLINICAL TRIALS . GOVIDENTIFIER NCT01530724 CONTEXT Popular diets , particularly those low in carbohydrates , have challenged current recommendations advising a low-fat , high-carbohydrate diet for weight loss . Potential benefits and risks have not been tested adequately . OBJECTIVE To compare 4 weight-loss diets representing a spectrum of low to high carbohydrate intake for effects on weight loss and related metabolic variables . DESIGN , SETTING , AND PARTICIPANTS Twelve-month r and omized trial conducted in the United States from February 2003 to October 2005 among 311 free-living , overweight/obese ( body mass index , 27 - 40 ) nondiabetic , premenopausal women . INTERVENTION Participants were r and omly assigned to follow the Atkins ( n = 77 ) , Zone ( n = 79 ) , LEARN ( n = 79 ) , or Ornish ( n = 76 ) diets and received weekly instruction for 2 months , then an additional 10-month follow-up . MAIN OUTCOME MEASURES Weight loss at 12 months was the primary outcome . Secondary outcomes included lipid profile ( low-density lipoprotein , high-density lipoprotein , and non-high-density lipoprotein cholesterol , and triglyceride levels ) , percentage of body fat , waist-hip ratio , fasting insulin and glucose levels , and blood pressure . Outcomes were assessed at months 0 , 2 , 6 , and 12 . The Tukey studentized range test was used to adjust for multiple testing . RESULTS Weight loss was greater for women in the Atkins diet group compared with the other diet groups at 12 months , and mean 12-month weight loss was significantly different between the Atkins and Zone diets ( P<.05 ) . Mean 12-month weight loss was as follows : Atkins , -4.7 kg ( 95 % confidence interval [ CI ] , -6.3 to -3.1 kg ) , Zone , -1.6 kg ( 95 % CI , -2.8 to -0.4 kg ) , LEARN , -2.6 kg ( -3.8 to -1.3 kg ) , and Ornish , -2.2 kg ( -3.6 to -0.8 kg ) . Weight loss was not statistically different among the Zone , LEARN , and Ornish groups . At 12 months , secondary outcomes for the Atkins group were comparable with or more favorable than the other diet groups . CONCLUSIONS In this study , premenopausal overweight and obese women assigned to follow the Atkins diet , which had the lowest carbohydrate intake , lost more weight at 12 months than women assigned to follow the Zone diet , and had experienced comparable or more favorable metabolic effects than those assigned to the Zone , Ornish , or LEARN diets [ corrected ] While questions remain about long-term effects and mechanisms , a low-carbohydrate , high-protein , high-fat diet may be considered a feasible alternative recommendation for weight loss . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00079573 Background / objectives : Small dense low-density lipoprotein ( LDL ) particles and apolipoprotein ( apo ) CIII are risk factors for cardiovascular disease ( CVD ) that can be modulated by diet , but there is little information regarding the effects of dietary saturated fat on their plasma levels . We tested the effects of high vs low saturated fat intake in the context of a high beef protein diet on levels and composition of LDL subclasses and on apoCIII levels in plasma and LDL.Subjects/ methods : Following consumption of a baseline diet ( 50 % carbohydrate ( CHO ) , 13 % protein , 38 % total fat , 15 % saturated fat ) for 3 weeks , 14 healthy men were r and omly assigned to two reduced CHO high beef protein diets ( 31 % CHO , 31 % protein , 38 % fat ) that differed in saturated fat content ( 15 % vs 8 % ) for 3 weeks each in a crossover design . Results : The high saturated fat ( HSF ) diet result ed in higher mass concentrations of buoyant LDL I , medium density LDL II and dense LDL III , but not the very dense LDL IV ; and significant increases in plasma and LDL apoCIII concentration of 9.4 % and 33.5 % , respectively . The saturated fat-induced changes in LDL apoCIII were specifically correlated with changes in apoCIII content of LDL IV . Conclusions : Taken together with previous observations , these findings suggest that , at least in the context of a lower CHO high beef protein diet , HSF intake may increase CVD risk by metabolic processes that involve apoCIII BACKGROUND The effects of a carbohydrate-restricted diet on weight loss and risk factors for atherosclerosis have been incompletely assessed . METHODS We r and omly assigned 132 severely obese subjects ( including 77 blacks and 23 women ) with a mean body-mass index of 43 and a high prevalence of diabetes ( 39 percent ) or the metabolic syndrome ( 43 percent ) to a carbohydrate-restricted ( low-carbohydrate ) diet or  a calorie- and fat-restricted ( low-fat ) diet . RESULTS Seventy-nine subjects completed the six-month study . An analysis including all subjects , with the last observation carried forward for those who dropped out , showed that subjects on the low-carbohydrate diet lost more weight than those on the low-fat diet ( mean [ + /-SD ] , -5.8+/-8.6 kg vs. -1.9+/-4.2 kg ; P=0.002 ) and had greater decreases in triglyceride levels ( mean , -20+/-43 percent vs. -4+/-31 percent ; P=0.001 ) , irrespective of the use or nonuse of hypoglycemic or lipid-lowering medications . Insulin sensitivity , measured only in subjects without diabetes , also improved more among subjects on the low-carbohydrate diet ( 6+/-9 percent vs. -3+/-8 percent , P=0.01 ) . The amount of weight lost ( P<0.001 ) and assignment to the low-carbohydrate diet ( P=0.01 ) were independent predictors of improvement in triglyceride levels and insulin sensitivity . CONCLUSIONS Severely obese subjects with a high prevalence of diabetes or the metabolic syndrome lost more weight during six months on a carbohydrate-restricted diet than on a calorie- and fat-restricted diet , with a relative improvement in insulin sensitivity and triglyceride levels , even after adjustment for the amount of weight lost . This finding should be interpreted with caution , given the small magnitude of overall and between-group differences in weight loss in these markedly obese subjects and the short duration of the study . Future studies evaluating long-term cardiovascular outcomes are needed before a carbohydrate-restricted diet can be endorsed Background — Nuclear magnetic resonance ( NMR ) spectroscopy measures the number and size of lipoprotein particles instead of their cholesterol or triglyceride content , but its clinical utility is uncertain . Methods and Results — Baseline lipoproteins were measured by NMR in 27 673 initially healthy women followed up for incident cardiovascular disease ( n=1015 ) over an 11-year period . After adjustment for nonlipid risk factors , hazard ratios and 95 % confidence intervals for the top versus the bottom quintile of NMR-measured lipoprotein particle concentration ( measured in particles per liter ) were 2.51 ( 1.91 to 3.30 ) for low-density lipoprotein ( LDLNMR ) , 0.91 ( 0.75 to 1.12 ) for high-density lipoprotein ( HDLNMR ) , 1.71 ( 1.38 to 2.12 ) for very low – density lipoprotein ( VLDLNMR ) , and 2.25 ( 1.80 to 2.81 ) for the LDLNMR/HDLNMR ratio . Similarly adjusted results for NMR-measured lipoprotein particle size ( measured in nanometers ) were 0.64 ( 0.52 to 0.79 ) for LDLNMR size , 0.65 ( 0.51 to 0.81 ) for HDLNMR size , and 1.37 ( 1.10 to 1.70 ) for VLDLNMR size . Hazard ratios for NMR measures were comparable but not superior to st and ard lipids ( total cholesterol 2.08 [ 1.63 to 2.67 ] , LDL cholesterol 1.74 [ 1.40 to 2.16 ] , HDL cholesterol 0.52 [ 0.42 to 0.64 ] , triglycerides 2.58 [ 1.95 to 3.41 ] , non-HDL cholesterol 2.52 [ 1.95 to 3.25 ] , total/HDL cholesterol ratio 2.82 [ 2.23 to 3.58 ] ) and apolipoproteins ( B100 2.57 [ 1.98 to 3.33 ] , A-1 0.63 [ 0.52 to 0.77 ] , and B100/A-1 ratio 2.79 [ 2.21 to 3.54 ] ) . Essentially no reclassification improvement was found with the addition of the LDLNMR particle concentration or apolipoprotein B100 to a model that already included the total/HDL cholesterol ratio and nonlipid risk factors ( net reclassification index 0 % and 1.9 % , respectively ) , nor did the addition of either variable result in a statistically significant improvement in the c-index . Conclusions — In this prospect i ve study of healthy women , cardiovascular disease risk prediction associated with lipoprotein profiles evaluated by NMR was comparable but not superior to that of st and ard lipids or apolipoproteins Context In 2003 , the authors reported that severely obese adults lost more weight and had better serum lipid patterns after 6 months of a low 
    Output:
    
agent
Conclusions Large r and omized controlled trials of at least 6 months duration with carbohydrate restriction appear superior in improving lipid markers when compared with low-fat diets .
***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 & AIMS Data regarding the role of kidney adiposity , its clinical implication s , and its dynamics during weight-loss are sparse . We investigated the effect of long-term weight-loss induced intervention diets on dynamics of renal-sinus-fat , an ectopic fat depot , and % renal-parenchymal-fat , lipid accumulation within the renal parenchyma . METHODS We r and omized 278 participants with abdominal obesity/dyslipidemia to low-fat or Mediterranean/low-carbohydrate diets , with or without exercise .  We quantified renal-sinus-fat and % renal-parenchymal-fat by whole body magnetic-resonance-imaging .  RESULTS Participants ( age = 48 years ; 89 % men ; body-mass-index = 31 kg/m2 ) had 86 % retention to the trial after 18 months . Both increased renal-sinus-fat and % renal-parenchymal-fat were directly associated with hypertension , and with higher abdominal deep-subcutaneous-adipose-tissue and visceral-adipose-tissue ( p of trend < 0.05 for all ) after adjustment for body weight . Higher renal-sinus-fat was associated with lower estimated-glomerular-filtration-rate and with higher microalbuminuria and % HbA1C beyond body weight . After 18 months of intervention , overall renal-sinus-fat ( -9 % ; p < 0.05 vs. baseline ) but not % renal-parenchymal-fat ( -1.7 % ; p = 0.13 vs. baseline ) significantly decreased , and similarly across the intervention groups . Renal-sinus-fat and % renal-parenchymal-fat changes were correlated with weight-loss per-se ( p < 0.05 ) . In a model adjusted for age , sex , and visceral-adipose-tissue changes , 18 months reduction in renal-sinus-fat associated with decreased pancreatic , hepatic and cardiac fats ( p < 0.05 for all ) and with decreased cholesterol/high-density lipoprotein-cholesterol ( HDL-c ) ( β = 0.13 ; p = 0.05 ) , triglycerides/HDL-c ( β = 0.13 ; p = 0.05 ) , insulin ( β = 0.12 ; p = 0.05 ) and gamma glutamyl transpeptidase ( β = 0.24 ; p = 0.001 ) , but not with improved renal function parameters or blood pressure . Decreased intake of sodium was associated with a reduction in % renal-parenchymal-fat , after adjustment for 18 months weight-loss ( β = 0.15 ; p = 0.026 ) and hypertension ( β = 0.14 ; p = 0.04 ) . CONCLUSIONS Renal-sinus-fat and renal-parenchymal-fat are fairly related to weight-loss . Decreased renal-sinus-fat is associated with improved hepatic parameters , independent of changes in weight or hepatic fat , rather than with improved renal function or blood pressure parameters . CLINICAL TRIALS . GOVIDENTIFIER NCT01530724 CONTEXT Popular diets , particularly those low in carbohydrates , have challenged current recommendations advising a low-fat , high-carbohydrate diet for weight loss . Potential benefits and risks have not been tested adequately . OBJECTIVE To compare 4 weight-loss diets representing a spectrum of low to high carbohydrate intake for effects on weight loss and related metabolic variables . DESIGN , SETTING , AND PARTICIPANTS Twelve-month r and omized trial conducted in the United States from February 2003 to October 2005 among 311 free-living , overweight/obese ( body mass index , 27 - 40 ) nondiabetic , premenopausal women . INTERVENTION Participants were r and omly assigned to follow the Atkins ( n = 77 ) , Zone ( n = 79 ) , LEARN ( n = 79 ) , or Ornish ( n = 76 ) diets and received weekly instruction for 2 months , then an additional 10-month follow-up . MAIN OUTCOME MEASURES Weight loss at 12 months was the primary outcome . Secondary outcomes included lipid profile ( low-density lipoprotein , high-density lipoprotein , and non-high-density lipoprotein cholesterol , and triglyceride levels ) , percentage of body fat , waist-hip ratio , fasting insulin and glucose levels , and blood pressure . Outcomes were assessed at months 0 , 2 , 6 , and 12 . The Tukey studentized range test was used to adjust for multiple testing . RESULTS Weight loss was greater for women in the Atkins diet group compared with the other diet groups at 12 months , and mean 12-month weight loss was significantly different between the Atkins and Zone diets ( P<.05 ) . Mean 12-month weight loss was as follows : Atkins , -4.7 kg ( 95 % confidence interval [ CI ] , -6.3 to -3.1 kg ) , Zone , -1.6 kg ( 95 % CI , -2.8 to -0.4 kg ) , LEARN , -2.6 kg ( -3.8 to -1.3 kg ) , and Ornish , -2.2 kg ( -3.6 to -0.8 kg ) . Weight loss was not statistically different among the Zone , LEARN , and Ornish groups . At 12 months , secondary outcomes for the Atkins group were comparable with or more favorable than the other diet groups . CONCLUSIONS In this study , premenopausal overweight and obese women assigned to follow the Atkins diet , which had the lowest carbohydrate intake , lost more weight at 12 months than women assigned to follow the Zone diet , and had experienced comparable or more favorable metabolic effects than those assigned to the Zone , Ornish , or LEARN diets [ corrected ] While questions remain about long-term effects and mechanisms , a low-carbohydrate , high-protein , high-fat diet may be considered a feasible alternative recommendation for weight loss . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00079573 Background / objectives : Small dense low-density lipoprotein ( LDL ) particles and apolipoprotein ( apo ) CIII are risk factors for cardiovascular disease ( CVD ) that can be modulated by diet , but there is little information regarding the effects of dietary saturated fat on their plasma levels . We tested the effects of high vs low saturated fat intake in the context of a high beef protein diet on levels and composition of LDL subclasses and on apoCIII levels in plasma and LDL.Subjects/ methods : Following consumption of a baseline diet ( 50 % carbohydrate ( CHO ) , 13 % protein , 38 % total fat , 15 % saturated fat ) for 3 weeks , 14 healthy men were r and omly assigned to two reduced CHO high beef protein diets ( 31 % CHO , 31 % protein , 38 % fat ) that differed in saturated fat content ( 15 % vs 8 % ) for 3 weeks each in a crossover design . Results : The high saturated fat ( HSF ) diet result ed in higher mass concentrations of buoyant LDL I , medium density LDL II and dense LDL III , but not the very dense LDL IV ; and significant increases in plasma and LDL apoCIII concentration of 9.4 % and 33.5 % , respectively . The saturated fat-induced changes in LDL apoCIII were specifically correlated with changes in apoCIII content of LDL IV . Conclusions : Taken together with previous observations , these findings suggest that , at least in the context of a lower CHO high beef protein diet , HSF intake may increase CVD risk by metabolic processes that involve apoCIII BACKGROUND The effects of a carbohydrate-restricted diet on weight loss and risk factors for atherosclerosis have been incompletely assessed . METHODS We r and omly assigned 132 severely obese subjects ( including 77 blacks and 23 women ) with a mean body-mass index of 43 and a high prevalence of diabetes ( 39 percent ) or the metabolic syndrome ( 43 percent ) to a carbohydrate-restricted ( low-carbohydrate ) diet or  a calorie- and fat-restricted ( low-fat ) diet . RESULTS Seventy-nine subjects completed the six-month study . An analysis including all subjects , with the last observation carried forward for those who dropped out , showed that subjects on the low-carbohydrate diet lost more weight than those on the low-fat diet ( mean [ + /-SD ] , -5.8+/-8.6 kg vs. -1.9+/-4.2 kg ; P=0.002 ) and had greater decreases in triglyceride levels ( mean , -20+/-43 percent vs. -4+/-31 percent ; P=0.001 ) , irrespective of the use or nonuse of hypoglycemic or lipid-lowering medications . Insulin sensitivity , measured only in subjects without diabetes , also improved more among subjects on the low-carbohydrate diet ( 6+/-9 percent vs. -3+/-8 percent , P=0.01 ) . The amount of weight lost ( P<0.001 ) and assignment to the low-carbohydrate diet ( P=0.01 ) were independent predictors of improvement in triglyceride levels and insulin sensitivity . CONCLUSIONS Severely obese subjects with a high prevalence of diabetes or the metabolic syndrome lost more weight during six months on a carbohydrate-restricted diet than on a calorie- and fat-restricted diet , with a relative improvement in insulin sensitivity and triglyceride levels , even after adjustment for the amount of weight lost . This finding should be interpreted with caution , given the small magnitude of overall and between-group differences in weight loss in these markedly obese subjects and the short duration of the study . Future studies evaluating long-term cardiovascular outcomes are needed before a carbohydrate-restricted diet can be endorsed Background — Nuclear magnetic resonance ( NMR ) spectroscopy measures the number and size of lipoprotein particles instead of their cholesterol or triglyceride content , but its clinical utility is uncertain . Methods and Results — Baseline lipoproteins were measured by NMR in 27 673 initially healthy women followed up for incident cardiovascular disease ( n=1015 ) over an 11-year period . After adjustment for nonlipid risk factors , hazard ratios and 95 % confidence intervals for the top versus the bottom quintile of NMR-measured lipoprotein particle concentration ( measured in particles per liter ) were 2.51 ( 1.91 to 3.30 ) for low-density lipoprotein ( LDLNMR ) , 0.91 ( 0.75 to 1.12 ) for high-density lipoprotein ( HDLNMR ) , 1.71 ( 1.38 to 2.12 ) for very low – density lipoprotein ( VLDLNMR ) , and 2.25 ( 1.80 to 2.81 ) for the LDLNMR/HDLNMR ratio . Similarly adjusted results for NMR-measured lipoprotein particle size ( measured in nanometers ) were 0.64 ( 0.52 to 0.79 ) for LDLNMR size , 0.65 ( 0.51 to 0.81 ) for HDLNMR size , and 1.37 ( 1.10 to 1.70 ) for VLDLNMR size . Hazard ratios for NMR measures were comparable but not superior to st and ard lipids ( total cholesterol 2.08 [ 1.63 to 2.67 ] , LDL cholesterol 1.74 [ 1.40 to 2.16 ] , HDL cholesterol 0.52 [ 0.42 to 0.64 ] , triglycerides 2.58 [ 1.95 to 3.41 ] , non-HDL cholesterol 2.52 [ 1.95 to 3.25 ] , total/HDL cholesterol ratio 2.82 [ 2.23 to 3.58 ] ) and apolipoproteins ( B100 2.57 [ 1.98 to 3.33 ] , A-1 0.63 [ 0.52 to 0.77 ] , and B100/A-1 ratio 2.79 [ 2.21 to 3.54 ] ) . Essentially no reclassification improvement was found with the addition of the LDLNMR particle concentration or apolipoprotein B100 to a model that already included the total/HDL cholesterol ratio and nonlipid risk factors ( net reclassification index 0 % and 1.9 % , respectively ) , nor did the addition of either variable result in a statistically significant improvement in the c-index . Conclusions — In this prospect i ve study of healthy women , cardiovascular disease risk prediction associated with lipoprotein profiles evaluated by NMR was comparable but not superior to that of st and ard lipids or apolipoproteins Context In 2003 , the authors reported that severely obese adults lost more weight and had better serum lipid patterns after 6 months of a low 
    Output:
    