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: Aims To assess the relationship between oral health status and Body Mass Index . Material and methods This paper relates to the free-living sample ( participants who lived in their own home , rather than an institution ) of the National Diet and Nutrition Survey : people aged 65 years and older . Subjects 629 adults . Data collection A probability r and om national sample of adults who had a dental examination , an interview and an anthropometric examination .  Data analysis Fisher 's exact test and multivariate logistic modeling . Findings Being underweight was relatively uncommon in this population . People without teeth were significantly ( P=0.05 ) more likely to be underweight than those with 11 or more teeth ; 12.3 % and 2.9 % . A highly statistically significant ( P=0.001 ) difference was observed in BMI between dentate people with 1 - 10 teeth and with more than 10 teeth ; 24 % and 2.9 % were underweight . Dentate people with less than 21 natural teeth were on average more than 3 times more likely to be obese than those with 21 - 32 teeth ( P=0.036 ) . There was no significant difference in both the proportion of overweight and obese adults between those who were edentulous and dentate with 21 or more teeth . A similar pattern was observed when the number of posterior occluding pairs was compared with BMI categories . Results of multiple logistic regression were adjusted for the confounding effects of age , social class , region of origin and partial denture wearing . Conclusions Older people in Britain with more than 20 teeth are more likely to have a normal Body Mass Index OBJECTIVE Many cross-sectional studies have reported a relationship between overweight/obesity and eating quickly , but there have been few longitudinal studies to address this relationship in younger population s. The purpose of this prospect i ve longitudinal study was to investigate whether eating quickly was related to being overweight in Japanese university students . METHODS Of 1,396 students who underwent a general examination and completed question naires at the start of university and before graduation , 1,314 students ( 676 male and 638 female ) of normal body composition [ body mass index ( BMI ) < 25 kg m(-2 ) ] at baseline were included in the analysis . The question naires included  speed of eating and other lifestyle factors . After a 3-year follow-up , the students whose BMI s were ≥ 25 kg m(-2 ) were defined as overweight . RESULTS In this study , 38 participants ( 2.9 % ) became overweight . In the logistic regression analysis , the risk of being overweight was increased in males [ adjusted odds ratio ( OR ) : 2.77 ; 95 % confidence interval ( CI ) : 1.33 - 5.79 ; P < 0.01 ] and in those who ate quickly at baseline ( OR : 4.40 ; 95 % CI : 2.22 - 8.75 ; P < 0.001 ) . CONCLUSIONS Eating quickly may predict risk of being overweight in Japanese university students Background In western Sweden , the aim was to study the associations between oral health variables and total and central adiposity , respectively , and to investigate the influence of socio-economic factors ( SES ) , lifestyle , dental anxiety and co-morbidity . Methods The subjects constituted a r and omised sample from the 1992 data collection in the Prospect i ve Population Study of Women in Gothenburg , Sweden ( n = 999 , 38- > = 78 yrs ) . The study comprised a clinical and radiographic examination , together with a self-administered question naire . Obesity was defined as body mass index ( BMI ) > = 30 kg/m2 , waist-hip ratio ( WHR ) > = 0.80 , and waist circumference > 0.88 m. Associations were estimated using logistic regression including adjustments for possible confounders . Results The mean BMI value was 25.96 kg/m2 , the mean WHR 0.83 , and the mean waist circumference 0.83 m. The number of teeth , the number of restored teeth , xerostomia , dental visiting habits and self-perceived health were associated with both total and central adiposity , independent of age and SES . For instance , there were statistically significant associations between a small number of teeth ( < 20 ) and obesity : BMI ( OR 1.95 ; 95 % CI 1.40 - 2.73 ) , WHR ( 1.67 ; 1.28 - 2.19 ) and waist circumference ( 1.94 ; 1.47 - 2.55 ) , respectively . The number of carious lesions and masticatory function showed no associations with obesity . The obesity measure was of significance , particularly with regard to behaviour , such as irregular dental visits , with a greater risk associated with BMI ( 1.83 ; 1.23 - 2.71 ) and waist circumference ( 1.96 ; 1.39 - 2.75 ) , but not with WHR ( 1.29 ; 0.90 - 1.85 ) . Conclusions Associations were found between oral health and obesity . The choice of obesity measure in oral health studies should be carefully considered BACKGROUND AND OBJECTIVE The loss of a functional dentition imposes eating difficulties and food avoidance , which may be detrimental in terms of nutritional status and health . The objective of this study was to investigate whether tooth loss and edentulism that were not rehabilitated with dental prostheses were associated with obesity among elderly in Southern Brazil . MATERIAL S AND METHODS A r and om sample of 872 independently living elderly was evaluated by means of a cross-sectional study . Socio-demographic , medical history and behaviour data were assessed using a st and ardised question naire . Two trained dentists assessed the  number of teeth and use of prostheses  in accordance with the WHO criteria . Height and weight were assessed and used to generate body mass index ( BMI = weight (kilos)/height (cm)(2 ) ) data . Participants were categorised into non-obese ( BMI < or= 30 ) or obese ( BMI > 30 ) . Multivariate logistic regression was used to model the relationship between number of teeth and use of dental prostheses with obesity adjusting for confounders . RESULTS Multivariate logistic regression revealed that edentulous persons wearing only upper dentures ( OR = 2.34 , 95 % CI 1.18 - 4.27 ) and dentate participants with one to eight teeth wearing 0-to-1 prosthesis ( OR = 2.96 , 95 % CI 1.68 - 5.19 ) were more likely to be obese . CONCLUSION The results show that a poorer oral status , represented by having fewer teeth that were not replaced by dental prostheses , was associated with obesity in Southern Brazil older people , suggesting a close relationship between poor oral status and systemic conditions that may have important clinical implication Chewing reportedly contributes to satiation and satiety signals . Attempts to document and quantify this have led to small and inconsistent effects . The present trial manipulated oral processing effort though required chewing of gums of different hardness and measured appetitive sensations , energy intake , gastric emptying , GI transit time , and concentrations of glucose , insulin , GLP-1 , ghrelin and pancreatic polypeptide . Sixty adults classified by sex and BMI ( 15 each of lean females , obese females , lean males and obese males ) were tested in a r and omized , controlled , cross-over trial with three arms . They chewed nothing , soft gum or hard gum for 15 min while sipping grape juice ( 10 % of individual energy needs ) containing acetaminophen and lactulose on one day each separated by 7 days . Electromyographic recordings and self-reports were obtained during and after chewing to quantify oral processing effort . Blood was sample d through an indwelling catheter and appetite ratings were obtained at baseline and at 0 , 15 , 30 , 45 , 60 , 90 , 120 , 180 and 240 min after chewing initiation . Breath sample s were collected at 10 min intervals for the first 2h and at 30 min intervals for the next 2h . No effects of chewing were observed for appetitive sensations or gut peptide concentrations . Energy intake tended to decline in lean and increase in obese participants so that daily energy intake differed significantly between the two groups when chewing either gum , while no difference was observed on the non-chewing day . Serum glucose and insulin were significantly lower at selected time points 90 - 240 min after chewing compared to baseline and the non-chewing day . These data indicate chewing effort does not affect appetitive sensations or gut peptide secretion , but may exert a small differential effect on acute energy intake in lean and obese individuals and lead to greater post-pr and ial declines of serum glucose and insulin . The efficacy of gum chewing as a substitute for eating for weight management remains uncertain OBJECTIVE To evaluate if poor oral status was associated with percentage body fat in a representative sample of south Brazilian community-dwelling elderly . BACKGROUND Evidence suggests that elders with extensive tooth loss and edentulism present with compromised chewing function , which results in dietary changes . However , few studies have assessed whether poor oral status is associated with percentage body fat in community-dwelling elderly . MATERIAL S AND METHODS A r and om sample of 471 south Brazilians = > 60 years of age was evaluated . Measurements included a question naire to assess socio-demographic , behavioural , general , and oral health data . Percentage body fat was measured with a Tanita TBF 612 digital scale , which measures foot-to-foot bioelectrical impedance ; and  oral status assessment  , by means of oral examinations assessing the number of teeth and use of dental prostheses . Correlates of risk of inadequate percentage body fat were assessed by means of multinomial logistic regression . RESULTS Edentulous participants were more likely to be underfat [ OR : 3.11 ( 1.27 - 7.61 ) ] or overfat/obese [ OR : 1.82 ( 1.05 - 3.16 ) ] . CONCLUSION The present study shows that edentulous older people had higher odds for inadequate percentage body fat . The maintenance of teeth had a crucial role in increasing the chance of having an adequate body fat percentage in the study population The possible effects on body weight of chewing gum on a regular schedule have not been tested in a r and omized controlled trial ( RCT ) . We conducted an 8-week RCT in 201 overweight and obese adults to test the hypothesis that receiving printed material on good nutrition and chewing gum for a minimum of 90 min/day ( n = 102 ) would lead to greater weight loss than receiving printed nutrition information only ( n = 99 ) . Changes in BMI , waist circumference , and blood pressure were secondary outcomes . Adherence to the gum-chewing protocol in the intervention group was > 95 % . In the intention-to-treat analysis , there were virtually no changes in weight or BMI in either group between baseline and the end of the intervention at 8 weeks . Waist circumference decreased significantly in the intervention group between baseline and 8 weeks ( mean ± SD change = -1.4 ± 5.3 cm ; P = 0.0128 ) ; however , there was no significant difference in change in waist circumference comparing the groups . Similarly , systolic and diastolic blood pressure decreased significantly in the intervention group between baseline and 8 weeks ( -3.0 ± 9.9 mm Hg ; P = 0.0032 and -3.2 ± 7.3 mm Hg ; P = 0.0001 , respectively ) ; however , there were no significant differences in the changes in systolic or diastolic blood pressure between the groups . Analyses including completers only produced essentially the same results . We conclude that chewing gum on a regular schedule for 8 weeks did not facilitate weight loss in these overweight and obese adults OBJECTIVE To analyze if differences according to gender exists in the association between  tooth loss and obesity among older adults . METHODS We analyzed data on 1,704 older adults ( 60 years and over ) from the baseline of a prospect i ve cohort study conducted in Florianopolis , SC , Southern Brazil .  Multivariable logistic regression models were used to assess the association between tooth loss and general and central obesity after adjustment for confounders ( age , gender , skin color , educational attainment , income , smoking , physical activity , use of dentures , hypertension , and diabetes ) . Linear regressions were also assessed with body mass index and waist circumference as continuous outcomes . Interaction between gender and tooth loss was further assessed . RESULTS Overall mean body mass index was 28.0 kg/m2 . Mean waist circumference was 96.8 cm for males and 92.6 cm for females . Increasing tooth loss was positively associated with increased body mass index and waist circumference after adjustment for confounders . Edentates had 1.4 ( 95%CI 1.1;1.9 ) times higher odds of being central ly obese than individuals with a higher number of teeth ; however , the association lost significance after adjustment for confounders . In comparison with edentate males , edentate females presented a twofold higher adjusted prevalence of general and central obesity . In the joint effects model , edentate females had a 3.8 ( 95%CI 2.2;6.6 ) times higher odds to be central ly obese in comparison with males with more than 10 teeth present in both the arches . Similarly , females with less than 10 teeth in at least one arch had a 2.7 ( 95%CI 1.6;4. 
    Output:
    
agent
Conclusions Most studies revealed a positive association between mastication and obesity among adults .
***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: Aims To assess the relationship between oral health status and Body Mass Index . Material and methods This paper relates to the free-living sample ( participants who lived in their own home , rather than an institution ) of the National Diet and Nutrition Survey : people aged 65 years and older . Subjects 629 adults . Data collection A probability r and om national sample of adults who had a dental examination , an interview and an anthropometric examination .  Data analysis Fisher 's exact test and multivariate logistic modeling . Findings Being underweight was relatively uncommon in this population . People without teeth were significantly ( P=0.05 ) more likely to be underweight than those with 11 or more teeth ; 12.3 % and 2.9 % . A highly statistically significant ( P=0.001 ) difference was observed in BMI between dentate people with 1 - 10 teeth and with more than 10 teeth ; 24 % and 2.9 % were underweight . Dentate people with less than 21 natural teeth were on average more than 3 times more likely to be obese than those with 21 - 32 teeth ( P=0.036 ) . There was no significant difference in both the proportion of overweight and obese adults between those who were edentulous and dentate with 21 or more teeth . A similar pattern was observed when the number of posterior occluding pairs was compared with BMI categories . Results of multiple logistic regression were adjusted for the confounding effects of age , social class , region of origin and partial denture wearing . Conclusions Older people in Britain with more than 20 teeth are more likely to have a normal Body Mass Index OBJECTIVE Many cross-sectional studies have reported a relationship between overweight/obesity and eating quickly , but there have been few longitudinal studies to address this relationship in younger population s. The purpose of this prospect i ve longitudinal study was to investigate whether eating quickly was related to being overweight in Japanese university students . METHODS Of 1,396 students who underwent a general examination and completed question naires at the start of university and before graduation , 1,314 students ( 676 male and 638 female ) of normal body composition [ body mass index ( BMI ) < 25 kg m(-2 ) ] at baseline were included in the analysis . The question naires included  speed of eating and other lifestyle factors . After a 3-year follow-up , the students whose BMI s were ≥ 25 kg m(-2 ) were defined as overweight . RESULTS In this study , 38 participants ( 2.9 % ) became overweight . In the logistic regression analysis , the risk of being overweight was increased in males [ adjusted odds ratio ( OR ) : 2.77 ; 95 % confidence interval ( CI ) : 1.33 - 5.79 ; P < 0.01 ] and in those who ate quickly at baseline ( OR : 4.40 ; 95 % CI : 2.22 - 8.75 ; P < 0.001 ) . CONCLUSIONS Eating quickly may predict risk of being overweight in Japanese university students Background In western Sweden , the aim was to study the associations between oral health variables and total and central adiposity , respectively , and to investigate the influence of socio-economic factors ( SES ) , lifestyle , dental anxiety and co-morbidity . Methods The subjects constituted a r and omised sample from the 1992 data collection in the Prospect i ve Population Study of Women in Gothenburg , Sweden ( n = 999 , 38- > = 78 yrs ) . The study comprised a clinical and radiographic examination , together with a self-administered question naire . Obesity was defined as body mass index ( BMI ) > = 30 kg/m2 , waist-hip ratio ( WHR ) > = 0.80 , and waist circumference > 0.88 m. Associations were estimated using logistic regression including adjustments for possible confounders . Results The mean BMI value was 25.96 kg/m2 , the mean WHR 0.83 , and the mean waist circumference 0.83 m. The number of teeth , the number of restored teeth , xerostomia , dental visiting habits and self-perceived health were associated with both total and central adiposity , independent of age and SES . For instance , there were statistically significant associations between a small number of teeth ( < 20 ) and obesity : BMI ( OR 1.95 ; 95 % CI 1.40 - 2.73 ) , WHR ( 1.67 ; 1.28 - 2.19 ) and waist circumference ( 1.94 ; 1.47 - 2.55 ) , respectively . The number of carious lesions and masticatory function showed no associations with obesity . The obesity measure was of significance , particularly with regard to behaviour , such as irregular dental visits , with a greater risk associated with BMI ( 1.83 ; 1.23 - 2.71 ) and waist circumference ( 1.96 ; 1.39 - 2.75 ) , but not with WHR ( 1.29 ; 0.90 - 1.85 ) . Conclusions Associations were found between oral health and obesity . The choice of obesity measure in oral health studies should be carefully considered BACKGROUND AND OBJECTIVE The loss of a functional dentition imposes eating difficulties and food avoidance , which may be detrimental in terms of nutritional status and health . The objective of this study was to investigate whether tooth loss and edentulism that were not rehabilitated with dental prostheses were associated with obesity among elderly in Southern Brazil . MATERIAL S AND METHODS A r and om sample of 872 independently living elderly was evaluated by means of a cross-sectional study . Socio-demographic , medical history and behaviour data were assessed using a st and ardised question naire . Two trained dentists assessed the  number of teeth and use of prostheses  in accordance with the WHO criteria . Height and weight were assessed and used to generate body mass index ( BMI = weight (kilos)/height (cm)(2 ) ) data . Participants were categorised into non-obese ( BMI < or= 30 ) or obese ( BMI > 30 ) . Multivariate logistic regression was used to model the relationship between number of teeth and use of dental prostheses with obesity adjusting for confounders . RESULTS Multivariate logistic regression revealed that edentulous persons wearing only upper dentures ( OR = 2.34 , 95 % CI 1.18 - 4.27 ) and dentate participants with one to eight teeth wearing 0-to-1 prosthesis ( OR = 2.96 , 95 % CI 1.68 - 5.19 ) were more likely to be obese . CONCLUSION The results show that a poorer oral status , represented by having fewer teeth that were not replaced by dental prostheses , was associated with obesity in Southern Brazil older people , suggesting a close relationship between poor oral status and systemic conditions that may have important clinical implication Chewing reportedly contributes to satiation and satiety signals . Attempts to document and quantify this have led to small and inconsistent effects . The present trial manipulated oral processing effort though required chewing of gums of different hardness and measured appetitive sensations , energy intake , gastric emptying , GI transit time , and concentrations of glucose , insulin , GLP-1 , ghrelin and pancreatic polypeptide . Sixty adults classified by sex and BMI ( 15 each of lean females , obese females , lean males and obese males ) were tested in a r and omized , controlled , cross-over trial with three arms . They chewed nothing , soft gum or hard gum for 15 min while sipping grape juice ( 10 % of individual energy needs ) containing acetaminophen and lactulose on one day each separated by 7 days . Electromyographic recordings and self-reports were obtained during and after chewing to quantify oral processing effort . Blood was sample d through an indwelling catheter and appetite ratings were obtained at baseline and at 0 , 15 , 30 , 45 , 60 , 90 , 120 , 180 and 240 min after chewing initiation . Breath sample s were collected at 10 min intervals for the first 2h and at 30 min intervals for the next 2h . No effects of chewing were observed for appetitive sensations or gut peptide concentrations . Energy intake tended to decline in lean and increase in obese participants so that daily energy intake differed significantly between the two groups when chewing either gum , while no difference was observed on the non-chewing day . Serum glucose and insulin were significantly lower at selected time points 90 - 240 min after chewing compared to baseline and the non-chewing day . These data indicate chewing effort does not affect appetitive sensations or gut peptide secretion , but may exert a small differential effect on acute energy intake in lean and obese individuals and lead to greater post-pr and ial declines of serum glucose and insulin . The efficacy of gum chewing as a substitute for eating for weight management remains uncertain OBJECTIVE To evaluate if poor oral status was associated with percentage body fat in a representative sample of south Brazilian community-dwelling elderly . BACKGROUND Evidence suggests that elders with extensive tooth loss and edentulism present with compromised chewing function , which results in dietary changes . However , few studies have assessed whether poor oral status is associated with percentage body fat in community-dwelling elderly . MATERIAL S AND METHODS A r and om sample of 471 south Brazilians = > 60 years of age was evaluated . Measurements included a question naire to assess socio-demographic , behavioural , general , and oral health data . Percentage body fat was measured with a Tanita TBF 612 digital scale , which measures foot-to-foot bioelectrical impedance ; and  oral status assessment  , by means of oral examinations assessing the number of teeth and use of dental prostheses . Correlates of risk of inadequate percentage body fat were assessed by means of multinomial logistic regression . RESULTS Edentulous participants were more likely to be underfat [ OR : 3.11 ( 1.27 - 7.61 ) ] or overfat/obese [ OR : 1.82 ( 1.05 - 3.16 ) ] . CONCLUSION The present study shows that edentulous older people had higher odds for inadequate percentage body fat . The maintenance of teeth had a crucial role in increasing the chance of having an adequate body fat percentage in the study population The possible effects on body weight of chewing gum on a regular schedule have not been tested in a r and omized controlled trial ( RCT ) . We conducted an 8-week RCT in 201 overweight and obese adults to test the hypothesis that receiving printed material on good nutrition and chewing gum for a minimum of 90 min/day ( n = 102 ) would lead to greater weight loss than receiving printed nutrition information only ( n = 99 ) . Changes in BMI , waist circumference , and blood pressure were secondary outcomes . Adherence to the gum-chewing protocol in the intervention group was > 95 % . In the intention-to-treat analysis , there were virtually no changes in weight or BMI in either group between baseline and the end of the intervention at 8 weeks . Waist circumference decreased significantly in the intervention group between baseline and 8 weeks ( mean ± SD change = -1.4 ± 5.3 cm ; P = 0.0128 ) ; however , there was no significant difference in change in waist circumference comparing the groups . Similarly , systolic and diastolic blood pressure decreased significantly in the intervention group between baseline and 8 weeks ( -3.0 ± 9.9 mm Hg ; P = 0.0032 and -3.2 ± 7.3 mm Hg ; P = 0.0001 , respectively ) ; however , there were no significant differences in the changes in systolic or diastolic blood pressure between the groups . Analyses including completers only produced essentially the same results . We conclude that chewing gum on a regular schedule for 8 weeks did not facilitate weight loss in these overweight and obese adults OBJECTIVE To analyze if differences according to gender exists in the association between  tooth loss and obesity among older adults . METHODS We analyzed data on 1,704 older adults ( 60 years and over ) from the baseline of a prospect i ve cohort study conducted in Florianopolis , SC , Southern Brazil .  Multivariable logistic regression models were used to assess the association between tooth loss and general and central obesity after adjustment for confounders ( age , gender , skin color , educational attainment , income , smoking , physical activity , use of dentures , hypertension , and diabetes ) . Linear regressions were also assessed with body mass index and waist circumference as continuous outcomes . Interaction between gender and tooth loss was further assessed . RESULTS Overall mean body mass index was 28.0 kg/m2 . Mean waist circumference was 96.8 cm for males and 92.6 cm for females . Increasing tooth loss was positively associated with increased body mass index and waist circumference after adjustment for confounders . Edentates had 1.4 ( 95%CI 1.1;1.9 ) times higher odds of being central ly obese than individuals with a higher number of teeth ; however , the association lost significance after adjustment for confounders . In comparison with edentate males , edentate females presented a twofold higher adjusted prevalence of general and central obesity . In the joint effects model , edentate females had a 3.8 ( 95%CI 2.2;6.6 ) times higher odds to be central ly obese in comparison with males with more than 10 teeth present in both the arches . Similarly , females with less than 10 teeth in at least one arch had a 2.7 ( 95%CI 1.6;4. 
    Output:
    