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 : To assess if active commuting with an electrically assisted bicycle ( e-bike ) during a 4-week period can induce increases in cardiorespiratory fitness measured as peak oxygen uptake ( V[Combining Dot Above]O2peak ) in untrained , overweight individuals , and if these changes are comparable with those induced by a conventional bicycle . Design : Four-week r and omized pilot study . Setting : Controlled laboratory . Participants : Thirty-two volunteers ( 28 men ) participated . Seventeen { median age 37 years [ interquartile range ( IQR ) 34 , 45 ] , median body mass index [ BMI ] 29 kg/m2 [ IQR 27 , 31 ] } were r and omized to the E-Bike group and 15 [ median age 43 years ( IQR 38 , 45 ) , median BMI 28 kg/m2 ( IQR 26 , 29 ) ] to the Bike group . Interventions : Participants in both groups were instructed to use the bicycle allocated to them ( e-bike or conventional bicycle ) for an active commute to work in the Basel ( Switzerl and ) area at a self-chosen speed on at least 3 days per week during the 4-week intervention period . Main Outcome Measures : V[Combining Dot Above]O2peak was assessed before and after the intervention in an all-out exercise test on a bicycle ergometer . Results : V[Combining Dot Above]O2peak increased by an average of 3.6 mL/(kg·min ) [ SD 3.6 mL/(kg·min ) ] in the E-Bike group and by 2.2 mL/(kg·min ) [ SD 3.5 mL/(kg·min ) ] in the Bike group , with an adjusted difference between the 2 groups of 1.4 mL/(kg·min ) [ 95 % confidence interval , −1.4 - 4.1 ; P = 0.327 ] . Conclusions : E-bikes may have the potential to improve cardiorespiratory fitness similar to conventional bicycles despite the available power assist , as they enable higher biking speeds and greater elevation gain Introduction Pedelecs are bicycles that provide electric assistance only when a rider is pedaling and have become increasingly popular . Purpose Our purpose was to quantify usage patterns over 4 weeks of real-world commuting with a pedelec and to determine if pedelec use would improve cardiometabolic risk factors . Methods Twenty sedentary commuters visited the laboratory for baseline physiological measurements [ body composition , maximum oxygen consumption ( $ $ \dot{V}{\text{O } } _ { 2 } { \hbox{max } } $ $ V˙O2max ) , mean arterial blood pressure ( MAP ) , blood lipid profile , and 2-h oral glucose tolerance test ( OGTT ) ] . The following 4 weeks , participants were instructed to commute using a pedelec at least 3 days week−1 for 40 min day−1 while wearing a heart rate monitor and a GPS device . Metabolic equivalents ( METS ) were estimated from heart rate data . Following the intervention , we repeated the physiological measurements . Results Average total distance and time were 317.9 ± 113.8 km and 15.9 ± 3.4 h , respectively . Participants averaged 4.9 ± 1.2 METS when riding . Four weeks of pedelec commuting significantly improved 2-h post-OGTT glucose ( 5.53 ± 1.18–5.03 ± 0.91 mmol L−1 , p < 0.05 ) , $ $ \dot{V}{\text{O } } _ { 2 } { \hbox{max } } $ $ V˙O2max ( 2.21 ± 0.48–2.39 ± 0.52 L min−1 , p < 0.05 ) , and end of $ $ \dot{V}{\text{O } } _ { 2 } { \hbox{max } } $ $ V˙O2max test power output ( 165.1 ± 37.1–189.3 ± 38.2 W , p < 0.05 ) . There were trends for improvements in MAP ( 84.6 ± 10.5–83.2 ± 9.4 mmHg , p = 0.15 ) and fat mass ( 28.6 ± 11.3–28.2 ± 11.4 kg , p = 0.07 ) . Conclusion  Participants rode a pedelec in the real world at a self-selected moderate intensity , which helped them meet physical activity recommendations . Pedelec commuting also result ed in significant improvements in 2-h post-OGTT glucose , $ $ \dot{V}{\text{O } } _ { 2 } { \hbox{max } } $ $ V˙O2max , and power output . Pedelecs are an effective form of active transportation that can improve some cardiometabolic risk factors within only 4 weeks BACKGROUND A single bout of exercise improves postpr and ial glycemia and insulin sensitivity in prediabetic patients ; however , the impact of exercise intensity is not well understood . The present study compared the effects of acute isocaloric moderate ( MIE ) and high-intensity ( HIE ) exercise on glucose disposal and insulin sensitivity in prediabetic adults . METHODS Subjects ( n=18 ; age 49±14 y ; fasting glucose 105±11 mg/dL ; 2 h glucose 170±32 mg/dL ) completed a peak O2 consumption/lactate threshold ( LT ) protocol plus three r and omly assigned conditions : 1 ) control , 1 hour of seated rest , 2 ) MIE ( at LT ) , and 3 ) HIE ( 75 % of difference between LT and peak O2 consumption ) . One hour after exercise , subjects received an  oral glucose tolerance test  ( OGTT ) . Plasma glucose , insulin , and C-peptide concentrations were sample d at 5- to 10-minute intervals at baseline , during exercise , after exercise , and for 3 hours after glucose ingestion . Total , early-phase , and late-phase area under the glucose and insulin response curves were compared between conditions . Indices of insulin sensitivity ( SI ) were derived from OGTT data using the oral minimal model . RESULTS Compared with control , SI improved by 51 % ( P=.02 ) and 85 % ( P<.001 ) on the MIE and HIE days , respectively . No differences in SI were observed between the exercise conditions ( P=.62 ) . Improvements in SI corresponded to significant reductions in the glucose , insulin , and C-peptide area under the curve values during the late phase of the OGTT after HIE ( P<.05 ) , with only a trend for reductions after MIE . CONCLUSION These results suggest that in prediabetic adults  , acute exercise has an immediate and intensity-dependent effect on improving postpr and ial glycemia and insulin sensitivity Objective To investigate the association between active commuting and  incident cardiovascular disease ( CVD ) , cancer , and all cause mortality .  Design Prospect i ve population based study . Setting UK Biobank . Participants 263 450 participants ( 106 674 ( 52 % ) women ; mean age 52.6 ) , recruited from 22 sites across the UK . The exposure variable was the mode of transport used ( walking , cycling , mixed mode v non-active ( car or public transport ) ) to commute to and from work on a typical day . Main outcome measures Incident ( fatal and non-fatal ) CVD and cancer , and deaths from CVD , cancer , or any causes . Results 2430 participants died ( 496 were related to CVD and 1126 to cancer ) over a median of 5.0 years ( interquartile range 4.3 - 5.5 ) follow-up . There were 3748 cancer and 1110 CVD events . In maximally adjusted models , commuting by cycle and by mixed mode including cycling were associated with lower risk of all cause mortality ( cycling hazard ratio 0.59 , 95 % confidence interval 0.42 to 0.83 , P=0.002 ; mixed mode cycling 0.76 , 0.58 to 1.00 , P<0.05 ) , cancer incidence ( cycling 0.55 , 0.44 to 0.69 , P<0.001 ; mixed mode cycling 0.64 , 0.45 to 0.91 , P=0.01 ) , and cancer mortality ( cycling 0.60 , 0.40 to 0.90 , P=0.01 ; mixed mode cycling 0.68 , 0.57 to 0.81 , P<0.001 ) . Commuting by cycling and walking were associated with a lower risk of CVD incidence ( cycling 0.54 , 0.33 to 0.88 , P=0.01 ; walking 0.73 , 0.54 to 0.99 , P=0.04 ) and CVD mortality ( cycling 0.48 , 0.25 to 0.92 , P=0.03 ; walking 0.64 , 0.45 to 0.91 , P=0.01 ) . No statistically significant associations were observed for walking commuting and all cause mortality or cancer outcomes . Mixed mode commuting including walking was not noticeably associated with any of the measured outcomes . Conclusions Cycle commuting was associated with a lower risk of CVD , cancer , and all cause mortality .  Walking commuting was associated with a lower risk of CVD independent of major measured confounding factors . Initiatives to encourage and support active commuting could reduce risk of death and the burden of important chronic conditions The American College of Sports Medicine ( ACSM ) recommends adults participate in weekly aerobic activity for a minimum of 30 minutes moderate intensity exercise 5 days per week or 20 minutes of vigorous activity 3 days per week . The electrically assisted bicycle may help individuals achieve the ACSM ’s aerobic recommendations and introduce inactive individuals to physical activity . To compare the physiological requirements of riding a bicycle with electric pedal assist versus non-assist among healthy active young adults . 6 males and 6 females completed two r and omized cycling trials using electric pedal assist ( PAB ) and non-assist ( NON ) . Cycling trials were completed over a 3.54 km course with varying terrain . Time to completion was faster in the PAB ( 12.5 ± 0.3 min ) than the NON ( 13.8 ± 0.3 min , p=0.01 ) . Rating of Perceived Exertion ( RPE ) was lower in the PAB ( 12.0 ± 0.4 ) than the NON ( 14.8 ± 0.5 , p < 0.001 ) . There was no difference in mean VO2 between PAB ( 2.3 ± 0.1 L·min−1 ) and NON ( 2.5 ± 0.1 L·min−1 , p=0.45 ) . There was no difference in mean power output when comparing PAB ( 115 ± 11 Watts ) to NON ( 128 ± 11 Watts , p=0.38 ) . There was no difference in heart rate between PAB ( 147 ± 5 bpm ) and NON ( 149 ± 5 bpm , p=0.77 ) . Recreationally active younger ( college age ) individuals may self-select a similar physiological intensity of physical activity regardless of mechanical assistance , result ing in quicker completion of a commuting task with PAB . Both the PAB and NON exercise bouts met ACSM criteria for vigorous exercise The purpose of this study was to examine the impact of acute high-intensity interval training ( HIIT ) compared with continuous moderate-intensity ( CMI ) exercise on postpr and ial hyperglycemia in overweight or obese adults . Ten inactive , overweight or obese adults ( 41 ± 11 yrs , BMI = 36 ± 7 kg/m(2 ) ) performed an acute bout of HIIT ( 10 × 1 min at approximately 90 % peak heart rate ( HRpeak ) with 1-min recovery periods ) or matched work CMI ( 30 min at approximately 65 % HRpeak ) in a r and omized , counterbalanced fashion . Exercise was performed 2 h after breakfast , and glucose control was assessed by continuous glucose monitoring under st and ardized dietary conditions over 24 h. Postpr and ial glucose ( PPG ) responses to lunch , dinner , and the following day 's breakfast were analyzed and compared with a no-exercise control day . Exercise did not affect the PPG responses to lunch , but performing both HIIT and CMI in the morning significantly reduced the PPG incremental area under the curve ( AUC ) following dinner when compared with control ( HIIT = 110 ± 35 , CMI = 125 ± 34 , control = 162 ± 46 mmol/L × 2 h , p < 0.05 ) . The PPG AUC ( HIIT = 125 ± 53 , CMI = 186 ± 55 , control = 194 ± 96 mmol/L × 2 h ) and the PPG spike ( HIIT = Δ2.1 ± 0.9 , CMI = Δ3.0 ± 0.9 , control = Δ3.0 ± 1.5 mmol/l ) following breakfast on the following 
    Output:
    
agent
There was moderate evidence that  e-cycling provided physical activity of at least moderate intensity , which was lower than the intensity elicited during conventional cycling , but higher than that during walking .
There was also moderate evidence that  e-cycling can improve cardiorespiratory fitness in physically inactive individuals .
Evidence of the impact of e-cycling  on metabolic and psychological health outcomes was inconclusive .
Conclusion E-cycling can contribute to meeting physical activity recommendations and increasing physical fitness .
As such , e-bikes offer a potential alternative to conventional cycling .
***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 : To assess if active commuting with an electrically assisted bicycle ( e-bike ) during a 4-week period can induce increases in cardiorespiratory fitness measured as peak oxygen uptake ( V[Combining Dot Above]O2peak ) in untrained , overweight individuals , and if these changes are comparable with those induced by a conventional bicycle . Design : Four-week r and omized pilot study . Setting : Controlled laboratory . Participants : Thirty-two volunteers ( 28 men ) participated . Seventeen { median age 37 years [ interquartile range ( IQR ) 34 , 45 ] , median body mass index [ BMI ] 29 kg/m2 [ IQR 27 , 31 ] } were r and omized to the E-Bike group and 15 [ median age 43 years ( IQR 38 , 45 ) , median BMI 28 kg/m2 ( IQR 26 , 29 ) ] to the Bike group . Interventions : Participants in both groups were instructed to use the bicycle allocated to them ( e-bike or conventional bicycle ) for an active commute to work in the Basel ( Switzerl and ) area at a self-chosen speed on at least 3 days per week during the 4-week intervention period . Main Outcome Measures : V[Combining Dot Above]O2peak was assessed before and after the intervention in an all-out exercise test on a bicycle ergometer . Results : V[Combining Dot Above]O2peak increased by an average of 3.6 mL/(kg·min ) [ SD 3.6 mL/(kg·min ) ] in the E-Bike group and by 2.2 mL/(kg·min ) [ SD 3.5 mL/(kg·min ) ] in the Bike group , with an adjusted difference between the 2 groups of 1.4 mL/(kg·min ) [ 95 % confidence interval , −1.4 - 4.1 ; P = 0.327 ] . Conclusions : E-bikes may have the potential to improve cardiorespiratory fitness similar to conventional bicycles despite the available power assist , as they enable higher biking speeds and greater elevation gain Introduction Pedelecs are bicycles that provide electric assistance only when a rider is pedaling and have become increasingly popular . Purpose Our purpose was to quantify usage patterns over 4 weeks of real-world commuting with a pedelec and to determine if pedelec use would improve cardiometabolic risk factors . Methods Twenty sedentary commuters visited the laboratory for baseline physiological measurements [ body composition , maximum oxygen consumption ( $ $ \dot{V}{\text{O } } _ { 2 } { \hbox{max } } $ $ V˙O2max ) , mean arterial blood pressure ( MAP ) , blood lipid profile , and 2-h oral glucose tolerance test ( OGTT ) ] . The following 4 weeks , participants were instructed to commute using a pedelec at least 3 days week−1 for 40 min day−1 while wearing a heart rate monitor and a GPS device . Metabolic equivalents ( METS ) were estimated from heart rate data . Following the intervention , we repeated the physiological measurements . Results Average total distance and time were 317.9 ± 113.8 km and 15.9 ± 3.4 h , respectively . Participants averaged 4.9 ± 1.2 METS when riding . Four weeks of pedelec commuting significantly improved 2-h post-OGTT glucose ( 5.53 ± 1.18–5.03 ± 0.91 mmol L−1 , p < 0.05 ) , $ $ \dot{V}{\text{O } } _ { 2 } { \hbox{max } } $ $ V˙O2max ( 2.21 ± 0.48–2.39 ± 0.52 L min−1 , p < 0.05 ) , and end of $ $ \dot{V}{\text{O } } _ { 2 } { \hbox{max } } $ $ V˙O2max test power output ( 165.1 ± 37.1–189.3 ± 38.2 W , p < 0.05 ) . There were trends for improvements in MAP ( 84.6 ± 10.5–83.2 ± 9.4 mmHg , p = 0.15 ) and fat mass ( 28.6 ± 11.3–28.2 ± 11.4 kg , p = 0.07 ) . Conclusion  Participants rode a pedelec in the real world at a self-selected moderate intensity , which helped them meet physical activity recommendations . Pedelec commuting also result ed in significant improvements in 2-h post-OGTT glucose , $ $ \dot{V}{\text{O } } _ { 2 } { \hbox{max } } $ $ V˙O2max , and power output . Pedelecs are an effective form of active transportation that can improve some cardiometabolic risk factors within only 4 weeks BACKGROUND A single bout of exercise improves postpr and ial glycemia and insulin sensitivity in prediabetic patients ; however , the impact of exercise intensity is not well understood . The present study compared the effects of acute isocaloric moderate ( MIE ) and high-intensity ( HIE ) exercise on glucose disposal and insulin sensitivity in prediabetic adults . METHODS Subjects ( n=18 ; age 49±14 y ; fasting glucose 105±11 mg/dL ; 2 h glucose 170±32 mg/dL ) completed a peak O2 consumption/lactate threshold ( LT ) protocol plus three r and omly assigned conditions : 1 ) control , 1 hour of seated rest , 2 ) MIE ( at LT ) , and 3 ) HIE ( 75 % of difference between LT and peak O2 consumption ) . One hour after exercise , subjects received an  oral glucose tolerance test  ( OGTT ) . Plasma glucose , insulin , and C-peptide concentrations were sample d at 5- to 10-minute intervals at baseline , during exercise , after exercise , and for 3 hours after glucose ingestion . Total , early-phase , and late-phase area under the glucose and insulin response curves were compared between conditions . Indices of insulin sensitivity ( SI ) were derived from OGTT data using the oral minimal model . RESULTS Compared with control , SI improved by 51 % ( P=.02 ) and 85 % ( P<.001 ) on the MIE and HIE days , respectively . No differences in SI were observed between the exercise conditions ( P=.62 ) . Improvements in SI corresponded to significant reductions in the glucose , insulin , and C-peptide area under the curve values during the late phase of the OGTT after HIE ( P<.05 ) , with only a trend for reductions after MIE . CONCLUSION These results suggest that in prediabetic adults  , acute exercise has an immediate and intensity-dependent effect on improving postpr and ial glycemia and insulin sensitivity Objective To investigate the association between active commuting and  incident cardiovascular disease ( CVD ) , cancer , and all cause mortality .  Design Prospect i ve population based study . Setting UK Biobank . Participants 263 450 participants ( 106 674 ( 52 % ) women ; mean age 52.6 ) , recruited from 22 sites across the UK . The exposure variable was the mode of transport used ( walking , cycling , mixed mode v non-active ( car or public transport ) ) to commute to and from work on a typical day . Main outcome measures Incident ( fatal and non-fatal ) CVD and cancer , and deaths from CVD , cancer , or any causes . Results 2430 participants died ( 496 were related to CVD and 1126 to cancer ) over a median of 5.0 years ( interquartile range 4.3 - 5.5 ) follow-up . There were 3748 cancer and 1110 CVD events . In maximally adjusted models , commuting by cycle and by mixed mode including cycling were associated with lower risk of all cause mortality ( cycling hazard ratio 0.59 , 95 % confidence interval 0.42 to 0.83 , P=0.002 ; mixed mode cycling 0.76 , 0.58 to 1.00 , P<0.05 ) , cancer incidence ( cycling 0.55 , 0.44 to 0.69 , P<0.001 ; mixed mode cycling 0.64 , 0.45 to 0.91 , P=0.01 ) , and cancer mortality ( cycling 0.60 , 0.40 to 0.90 , P=0.01 ; mixed mode cycling 0.68 , 0.57 to 0.81 , P<0.001 ) . Commuting by cycling and walking were associated with a lower risk of CVD incidence ( cycling 0.54 , 0.33 to 0.88 , P=0.01 ; walking 0.73 , 0.54 to 0.99 , P=0.04 ) and CVD mortality ( cycling 0.48 , 0.25 to 0.92 , P=0.03 ; walking 0.64 , 0.45 to 0.91 , P=0.01 ) . No statistically significant associations were observed for walking commuting and all cause mortality or cancer outcomes . Mixed mode commuting including walking was not noticeably associated with any of the measured outcomes . Conclusions Cycle commuting was associated with a lower risk of CVD , cancer , and all cause mortality .  Walking commuting was associated with a lower risk of CVD independent of major measured confounding factors . Initiatives to encourage and support active commuting could reduce risk of death and the burden of important chronic conditions The American College of Sports Medicine ( ACSM ) recommends adults participate in weekly aerobic activity for a minimum of 30 minutes moderate intensity exercise 5 days per week or 20 minutes of vigorous activity 3 days per week . The electrically assisted bicycle may help individuals achieve the ACSM ’s aerobic recommendations and introduce inactive individuals to physical activity . To compare the physiological requirements of riding a bicycle with electric pedal assist versus non-assist among healthy active young adults . 6 males and 6 females completed two r and omized cycling trials using electric pedal assist ( PAB ) and non-assist ( NON ) . Cycling trials were completed over a 3.54 km course with varying terrain . Time to completion was faster in the PAB ( 12.5 ± 0.3 min ) than the NON ( 13.8 ± 0.3 min , p=0.01 ) . Rating of Perceived Exertion ( RPE ) was lower in the PAB ( 12.0 ± 0.4 ) than the NON ( 14.8 ± 0.5 , p < 0.001 ) . There was no difference in mean VO2 between PAB ( 2.3 ± 0.1 L·min−1 ) and NON ( 2.5 ± 0.1 L·min−1 , p=0.45 ) . There was no difference in mean power output when comparing PAB ( 115 ± 11 Watts ) to NON ( 128 ± 11 Watts , p=0.38 ) . There was no difference in heart rate between PAB ( 147 ± 5 bpm ) and NON ( 149 ± 5 bpm , p=0.77 ) . Recreationally active younger ( college age ) individuals may self-select a similar physiological intensity of physical activity regardless of mechanical assistance , result ing in quicker completion of a commuting task with PAB . Both the PAB and NON exercise bouts met ACSM criteria for vigorous exercise The purpose of this study was to examine the impact of acute high-intensity interval training ( HIIT ) compared with continuous moderate-intensity ( CMI ) exercise on postpr and ial hyperglycemia in overweight or obese adults . Ten inactive , overweight or obese adults ( 41 ± 11 yrs , BMI = 36 ± 7 kg/m(2 ) ) performed an acute bout of HIIT ( 10 × 1 min at approximately 90 % peak heart rate ( HRpeak ) with 1-min recovery periods ) or matched work CMI ( 30 min at approximately 65 % HRpeak ) in a r and omized , counterbalanced fashion . Exercise was performed 2 h after breakfast , and glucose control was assessed by continuous glucose monitoring under st and ardized dietary conditions over 24 h. Postpr and ial glucose ( PPG ) responses to lunch , dinner , and the following day 's breakfast were analyzed and compared with a no-exercise control day . Exercise did not affect the PPG responses to lunch , but performing both HIIT and CMI in the morning significantly reduced the PPG incremental area under the curve ( AUC ) following dinner when compared with control ( HIIT = 110 ± 35 , CMI = 125 ± 34 , control = 162 ± 46 mmol/L × 2 h , p < 0.05 ) . The PPG AUC ( HIIT = 125 ± 53 , CMI = 186 ± 55 , control = 194 ± 96 mmol/L × 2 h ) and the PPG spike ( HIIT = Δ2.1 ± 0.9 , CMI = Δ3.0 ± 0.9 , control = Δ3.0 ± 1.5 mmol/l ) following breakfast on the following 
    Output:
    