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: CONTEXT Reduced intake of saturated fat is widely recommended for prevention of cardiovascular disease . The type of macronutrient that should replace saturated fat remains uncertain . OBJECTIVE To compare the effects of 3 healthful diets , each with reduced saturated fat intake , on blood pressure and serum lipids . DESIGN , SETTING , AND PARTICIPANTS R and omized , 3-period , crossover feeding study ( April 2003 to June 2005 ) conducted in Baltimore , Md , and Boston , Mass. Participants were 164 adults with prehypertension or stage 1 hypertension . Each feeding period lasted 6 weeks and body weight was kept constant . INTERVENTIONS A diet rich in carbohydrates ; a diet rich in protein , about half from plant sources ; and a diet rich in unsaturated fat , predominantly monounsaturated fat . MAIN OUTCOME MEASURES Systolic blood pressure and low-density lipoprotein cholesterol . RESULTS Blood pressure , low-density lipoprotein cholesterol , and estimated coronary heart disease risk were lower on each diet compared with baseline . Compared with the carbohydrate diet , the protein diet further decreased mean systolic blood pressure by 1.4 mm Hg ( P = .002 ) and by 3.5 mm Hg ( P = .006 ) among those with hypertension and decreased low-density lipoprotein cholesterol by 3.3 mg/dL ( 0.09 mmol/L ; P = .01 ) , high-density lipoprotein cholesterol by 1.3 mg/dL ( 0.03 mmol/L ; P = .02 ) , and triglycerides by 15.7 mg/dL ( 0.18 mmol/L ; P<.001 ) . Compared with the carbohydrate diet , the unsaturated fat diet decreased systolic blood pressure by 1.3 mm Hg ( P = .005 ) and by 2.9 mm Hg among those with hypertension ( P = .02 ) , had no significant effect on low-density lipoprotein cholesterol , increased high-density lipoprotein cholesterol by 1.1 mg/dL ( 0.03 mmol/L ; P = .03 ) , and lowered triglycerides by 9.6 mg/dL ( 0.11 mmol/L ; P = .02 ) . Compared with the carbohydrate diet , estimated 10-year coronary heart disease risk was lower and similar on the protein and unsaturated fat diets . CONCLUSION In the setting of a healthful diet , partial substitution of carbohydrate with either protein or monounsaturated fat can further lower blood pressure , improve lipid levels , and reduce estimated cardiovascular risk . Clinical Trials Registration Clinical Trials.gov Identifier : NCT00051350 BACKGROUND Hemostasis is the result of a complex equilibrium between coagulation and fibrinolysis , and the influence of different dietary models on this equilibrium is not entirely known . OBJECTIVE The objective was to compare the effects of the chronic intake of different dietary models on postpr and ial hemostasis . DESIGN In a r and omized crossover design , 20 healthy men consumed for 28 d each diets rich in monounsaturated fatty acids ( MUFAs ) , saturated fatty acids ( SFAs ) , and carbohydrates plus n-3 fatty acids ( CHO/N3 ) .  Fasting and postpr and ial hemostatic factors ( factor VII coagulant activity , plasminogen activator inhibitor-1 , tissue-type plasminogen activator , d-dimer , and thromboxane B(2 ) ) were measured ; meal tests for the postpr and ial measures were based on butter , virgin olive oil , and walnuts for the SFA , MUFA , and CHO/N3 diets , respectively . RESULTS There were no differences in the fasting variables after the dietary periods . After the 3 fatty meals were consumed , we observed an increase in thromboxane B(2 ) and d-dimer and a reduction in tissue plasminogen activator , irrespective of the dietary model . The MUFA or CHO/N3 meals lowered postpr and ial concentrations of factor VII coagulant activity , although the reduction was greater after the MUFA-enriched meal . The concentration of plasminogen activator inhibitor-1 was greater after the SFA meal than after the other 2 meals . CONCLUSIONS The administration of a fatty meal induces a postpr and ial procoagulant tendency , irrespective of the type of fat consumed . However , the use of a dietary model rich in SFA creates a more procoagulant environment than does a model that includes MUFA or CHO/N3 as the source of fatty acids The effects of a low-fat , carbohydrate-rich and a high-fat , olive-oil-rich diet on blood pressure were studied under strict dietary control . Forty-seven healthy normotensive men and women were fed a diet high in saturated fatty acids ( 20 en% ) and total fat ( 38 en% ) for 17 d. Twenty-four subjects then received a low-fat , carbohydrate-rich diet ( total fat 22 en% ) and the other 23 a high-fat , olive-oil-rich diet ( oleic acid 24 en% , total fat 41 en% ) for 36 d. Both test diets had the same level of saturated fatty acids ( 7 - 10 en% ) and linoleic acid ( 4 en% ) . Systolic blood pressure fell by 2.3 and diastolic by 4.7 mm Hg in the carbohydrate group and by 2.7 and 4.4 mm Hg in the olive-oil group , respectively ( differences between diets groups not significant ) . These results suggest that a high-fat diet rich in monounsaturated fatty acids has no deleterious effect on blood pressure in healthy normotensive subjects in comparison with a low-fat , carbohydrate-rich diet Background —Although recent studies have indicated that nut consumption may improve levels of blood lipids , nuts are not generally recommended as snacks for hyperlipidemic subjects because of their high fat content . Furthermore , the effective dose is still unknown . Methods and Results —The dose-response effects of whole almonds , taken as snacks , were compared with low-saturated fat ( < 5 % energy ) whole-wheat muffins ( control ) in the therapeutic diets of hyperlipidemic subjects . In a r and omized crossover study , 27 hyperlipidemic men and women consumed 3  isoenergetic ( mean 423 kcal/d ) supplements each for 1 month . Supplements provided 22.2 % of energy and consisted of full-dose almonds ( 73±3 g/d ) , half-dose almonds plus half-dose muffins , and full-dose muffins  . Fasting blood , expired air , blood pressure , and body weight measurements were obtained at weeks 0 , 2 , and 4 . Mean body weights differed < 300 g between treatments . The full-dose almonds produced the greatest reduction in levels of blood lipids . Significant reductions from baseline were seen on both half- and full-dose almonds for LDL cholesterol ( 4.4±1.7 % , P = 0.018 , and 9.4±1.9 % , P < 0.001 , respectively ) and LDL : HDL cholesterol ( 7.8±2.2 % , P = 0.001 , and 12.0±2.1 % , P < 0.001 , respectively ) and on full-dose almonds alone for lipoprotein(a ) ( 7.8±3.5 % , P = 0.034 ) and oxidized LDL concentrations ( 14.0±3.8 % , P < 0.001 ) , with no significant reductions on the control diet . No difference was seen in pulmonary nitric oxide between treatments . Conclusions —Almonds used as snacks in the diets of hyperlipidemic subjects significantly reduce coronary heart disease risk factors , probably in part because of the nonfat ( protein and fiber ) and monounsaturated fatty acid components of the nut Background : It is uncertain whether saturated fatty acids ( SFAs ) impair endothelial function and contribute to arterial stiffening . Objective : We tested the effects of replacing SFAs with monounsaturated fatty acids ( MUFAs ) or carbohydrates on endothelial function and arterial stiffness . Design : With the use of a parallel- design ed r and omized controlled trial in 121 insulin-resistant men and women , we measured vascular function after 1 mo of consumption of a high-SFA ( HS ) diet and after 24 wk after r and om assignment to the HS diet or diets that contained < 10 % SFAs and were high in either MUFAs or carbohydrates . The primary outcome was a change in flow-mediated dilation ( FMD ) , and secondary outcomes were changes in carotid to femoral pulse wave velocity ( PWV ) and plasma 8-isoprostane F2α-III concentrations . Results : For 112 participants with data available for analysis on the specified outcomes , no significant differences were shown . FMD with the HS reference diet was 6.7 ± 2.2 % , and changes ( 95 % CIs ) after 6 mo of intervention were + 0.3 ( −0.4 , 1.1 ) , −0.2 ( −0.8 , 0.5 ) , and −0.1 ( −0.6 , 0.7 ) with HS , high-MUFA ( HM ) , and high-carbohydrate ( HC ) diets , respectively . After consumption of the HS reference diet , the geometric mean ( ±SD ) PWV was 7.67 ± 1.62 m/s , and mean percentages of changes ( 95 % CIs ) were −1.0 ( −6.2 , 4.3 ) with the HS diet , 2.7 ( −1.4 , 6.9 ) with the HM diet , and −1.0 ( −5.5 , 3.4 ) with the HC diet . With the HS reference diet , the geometric mean ( ±SD ) plasma 8-isoprostane F2α-III concentration was 176 ± 85 pmol/L , and mean percentage of changes ( 95 % CIs ) were 1 ( −12 , 14 ) with the HS diet , 6 ( −5 , 16 ) with the HM diet , and 4 ( −7 , 16 ) with the HC diet . Conclusion : The replacement of SFAs with MUFAs or carbohydrates in healthy subjects does not affect vascular function . This trial was registered at Current Controlled Trials ( http://www.controlled-trials.com/IS RCT N ) as IS RCT N 29111298 A currently ongoing r and omized trial has revealed that the Mediterranean diet , rich in virgin olive oil or nuts , reduces systolic blood pressure in high-risk cardiovascular patients . Here , we present a structural sub study to assess the effect of a Mediterranean-style diet supplemented with nuts or virgin olive oil on erythrocyte membrane properties in 36 hypertensive participants after 1 year of intervention .  Erythrocyte membrane lipid composition , structural properties of reconstituted erythrocyte membranes , and serum concentrations of inflammatory markers are reported . After the intervention , the membrane cholesterol content decreased , whereas that of phospholipids increased in all of the dietary groups ; the diminishing cholesterol : phospholipid ratio could be associated with an increase in the membrane fluidity . Moreover , reconstituted membranes from the nuts and virgin olive oil groups showed a higher propensity to form a nonlamellar inverted hexagonal phase structure that was related to an increase in phosphatidylethanolamine lipid class . These data suggest that the Mediterranean-style diet affects the lipid metabolism that is altered in hypertensive patients , influencing the structural membrane properties . The erythrocyte membrane modulation described provides insight in the structural bases underlying the beneficial effect of a Mediterranean-style diet in hypertensive subjects Context Some experts attribute a low incidence of heart disease in Mediterranean countries to dietary habits . Contribution In this multicenter , 3-group trial , investigators r and omly assigned 772 adults at high risk for cardiovascular disease to a low-fat diet or to a Mediterranean diet supplemented with either virgin olive oil ( 1 L per week ) or nuts ( 30 g per day ) . After 3 months , the Mediterranean diet groups had lower mean plasma glucose level , systolic blood pressure , and total cholesterolhigh-density lipoprotein cholesterol ratio than the low-fat diet group . Caution s The Mediterranean diet groups received more nutritional education than the low-fat diet group . Implication s Mediterranean diets supplemented with olive oil or nuts may improve cardiovascular risk factors . The Editors Cardiovascular disease is the main cause of death in industrialized countries , but incidence rates have marked geographic differences . The low incidence of coronary heart disease ( CHD ) in Mediterranean countries has been partly ascribed to dietary habits ( 1 - 3 ) . Recent findings from large European cohort studies ( 4 - 6 ) suggest that 
    Output:
    
agent
Conclusions In the context of low SFAs , high-MUFA diets in isocaloric substitution for high-CHO diets did not affect blood pressure in individuals with and without hypertension .
***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: CONTEXT Reduced intake of saturated fat is widely recommended for prevention of cardiovascular disease . The type of macronutrient that should replace saturated fat remains uncertain . OBJECTIVE To compare the effects of 3 healthful diets , each with reduced saturated fat intake , on blood pressure and serum lipids . DESIGN , SETTING , AND PARTICIPANTS R and omized , 3-period , crossover feeding study ( April 2003 to June 2005 ) conducted in Baltimore , Md , and Boston , Mass. Participants were 164 adults with prehypertension or stage 1 hypertension . Each feeding period lasted 6 weeks and body weight was kept constant . INTERVENTIONS A diet rich in carbohydrates ; a diet rich in protein , about half from plant sources ; and a diet rich in unsaturated fat , predominantly monounsaturated fat . MAIN OUTCOME MEASURES Systolic blood pressure and low-density lipoprotein cholesterol . RESULTS Blood pressure , low-density lipoprotein cholesterol , and estimated coronary heart disease risk were lower on each diet compared with baseline . Compared with the carbohydrate diet , the protein diet further decreased mean systolic blood pressure by 1.4 mm Hg ( P = .002 ) and by 3.5 mm Hg ( P = .006 ) among those with hypertension and decreased low-density lipoprotein cholesterol by 3.3 mg/dL ( 0.09 mmol/L ; P = .01 ) , high-density lipoprotein cholesterol by 1.3 mg/dL ( 0.03 mmol/L ; P = .02 ) , and triglycerides by 15.7 mg/dL ( 0.18 mmol/L ; P<.001 ) . Compared with the carbohydrate diet , the unsaturated fat diet decreased systolic blood pressure by 1.3 mm Hg ( P = .005 ) and by 2.9 mm Hg among those with hypertension ( P = .02 ) , had no significant effect on low-density lipoprotein cholesterol , increased high-density lipoprotein cholesterol by 1.1 mg/dL ( 0.03 mmol/L ; P = .03 ) , and lowered triglycerides by 9.6 mg/dL ( 0.11 mmol/L ; P = .02 ) . Compared with the carbohydrate diet , estimated 10-year coronary heart disease risk was lower and similar on the protein and unsaturated fat diets . CONCLUSION In the setting of a healthful diet , partial substitution of carbohydrate with either protein or monounsaturated fat can further lower blood pressure , improve lipid levels , and reduce estimated cardiovascular risk . Clinical Trials Registration Clinical Trials.gov Identifier : NCT00051350 BACKGROUND Hemostasis is the result of a complex equilibrium between coagulation and fibrinolysis , and the influence of different dietary models on this equilibrium is not entirely known . OBJECTIVE The objective was to compare the effects of the chronic intake of different dietary models on postpr and ial hemostasis . DESIGN In a r and omized crossover design , 20 healthy men consumed for 28 d each diets rich in monounsaturated fatty acids ( MUFAs ) , saturated fatty acids ( SFAs ) , and carbohydrates plus n-3 fatty acids ( CHO/N3 ) .  Fasting and postpr and ial hemostatic factors ( factor VII coagulant activity , plasminogen activator inhibitor-1 , tissue-type plasminogen activator , d-dimer , and thromboxane B(2 ) ) were measured ; meal tests for the postpr and ial measures were based on butter , virgin olive oil , and walnuts for the SFA , MUFA , and CHO/N3 diets , respectively . RESULTS There were no differences in the fasting variables after the dietary periods . After the 3 fatty meals were consumed , we observed an increase in thromboxane B(2 ) and d-dimer and a reduction in tissue plasminogen activator , irrespective of the dietary model . The MUFA or CHO/N3 meals lowered postpr and ial concentrations of factor VII coagulant activity , although the reduction was greater after the MUFA-enriched meal . The concentration of plasminogen activator inhibitor-1 was greater after the SFA meal than after the other 2 meals . CONCLUSIONS The administration of a fatty meal induces a postpr and ial procoagulant tendency , irrespective of the type of fat consumed . However , the use of a dietary model rich in SFA creates a more procoagulant environment than does a model that includes MUFA or CHO/N3 as the source of fatty acids The effects of a low-fat , carbohydrate-rich and a high-fat , olive-oil-rich diet on blood pressure were studied under strict dietary control . Forty-seven healthy normotensive men and women were fed a diet high in saturated fatty acids ( 20 en% ) and total fat ( 38 en% ) for 17 d. Twenty-four subjects then received a low-fat , carbohydrate-rich diet ( total fat 22 en% ) and the other 23 a high-fat , olive-oil-rich diet ( oleic acid 24 en% , total fat 41 en% ) for 36 d. Both test diets had the same level of saturated fatty acids ( 7 - 10 en% ) and linoleic acid ( 4 en% ) . Systolic blood pressure fell by 2.3 and diastolic by 4.7 mm Hg in the carbohydrate group and by 2.7 and 4.4 mm Hg in the olive-oil group , respectively ( differences between diets groups not significant ) . These results suggest that a high-fat diet rich in monounsaturated fatty acids has no deleterious effect on blood pressure in healthy normotensive subjects in comparison with a low-fat , carbohydrate-rich diet Background —Although recent studies have indicated that nut consumption may improve levels of blood lipids , nuts are not generally recommended as snacks for hyperlipidemic subjects because of their high fat content . Furthermore , the effective dose is still unknown . Methods and Results —The dose-response effects of whole almonds , taken as snacks , were compared with low-saturated fat ( < 5 % energy ) whole-wheat muffins ( control ) in the therapeutic diets of hyperlipidemic subjects . In a r and omized crossover study , 27 hyperlipidemic men and women consumed 3  isoenergetic ( mean 423 kcal/d ) supplements each for 1 month . Supplements provided 22.2 % of energy and consisted of full-dose almonds ( 73±3 g/d ) , half-dose almonds plus half-dose muffins , and full-dose muffins  . Fasting blood , expired air , blood pressure , and body weight measurements were obtained at weeks 0 , 2 , and 4 . Mean body weights differed < 300 g between treatments . The full-dose almonds produced the greatest reduction in levels of blood lipids . Significant reductions from baseline were seen on both half- and full-dose almonds for LDL cholesterol ( 4.4±1.7 % , P = 0.018 , and 9.4±1.9 % , P < 0.001 , respectively ) and LDL : HDL cholesterol ( 7.8±2.2 % , P = 0.001 , and 12.0±2.1 % , P < 0.001 , respectively ) and on full-dose almonds alone for lipoprotein(a ) ( 7.8±3.5 % , P = 0.034 ) and oxidized LDL concentrations ( 14.0±3.8 % , P < 0.001 ) , with no significant reductions on the control diet . No difference was seen in pulmonary nitric oxide between treatments . Conclusions —Almonds used as snacks in the diets of hyperlipidemic subjects significantly reduce coronary heart disease risk factors , probably in part because of the nonfat ( protein and fiber ) and monounsaturated fatty acid components of the nut Background : It is uncertain whether saturated fatty acids ( SFAs ) impair endothelial function and contribute to arterial stiffening . Objective : We tested the effects of replacing SFAs with monounsaturated fatty acids ( MUFAs ) or carbohydrates on endothelial function and arterial stiffness . Design : With the use of a parallel- design ed r and omized controlled trial in 121 insulin-resistant men and women , we measured vascular function after 1 mo of consumption of a high-SFA ( HS ) diet and after 24 wk after r and om assignment to the HS diet or diets that contained < 10 % SFAs and were high in either MUFAs or carbohydrates . The primary outcome was a change in flow-mediated dilation ( FMD ) , and secondary outcomes were changes in carotid to femoral pulse wave velocity ( PWV ) and plasma 8-isoprostane F2α-III concentrations . Results : For 112 participants with data available for analysis on the specified outcomes , no significant differences were shown . FMD with the HS reference diet was 6.7 ± 2.2 % , and changes ( 95 % CIs ) after 6 mo of intervention were + 0.3 ( −0.4 , 1.1 ) , −0.2 ( −0.8 , 0.5 ) , and −0.1 ( −0.6 , 0.7 ) with HS , high-MUFA ( HM ) , and high-carbohydrate ( HC ) diets , respectively . After consumption of the HS reference diet , the geometric mean ( ±SD ) PWV was 7.67 ± 1.62 m/s , and mean percentages of changes ( 95 % CIs ) were −1.0 ( −6.2 , 4.3 ) with the HS diet , 2.7 ( −1.4 , 6.9 ) with the HM diet , and −1.0 ( −5.5 , 3.4 ) with the HC diet . With the HS reference diet , the geometric mean ( ±SD ) plasma 8-isoprostane F2α-III concentration was 176 ± 85 pmol/L , and mean percentage of changes ( 95 % CIs ) were 1 ( −12 , 14 ) with the HS diet , 6 ( −5 , 16 ) with the HM diet , and 4 ( −7 , 16 ) with the HC diet . Conclusion : The replacement of SFAs with MUFAs or carbohydrates in healthy subjects does not affect vascular function . This trial was registered at Current Controlled Trials ( http://www.controlled-trials.com/IS RCT N ) as IS RCT N 29111298 A currently ongoing r and omized trial has revealed that the Mediterranean diet , rich in virgin olive oil or nuts , reduces systolic blood pressure in high-risk cardiovascular patients . Here , we present a structural sub study to assess the effect of a Mediterranean-style diet supplemented with nuts or virgin olive oil on erythrocyte membrane properties in 36 hypertensive participants after 1 year of intervention .  Erythrocyte membrane lipid composition , structural properties of reconstituted erythrocyte membranes , and serum concentrations of inflammatory markers are reported . After the intervention , the membrane cholesterol content decreased , whereas that of phospholipids increased in all of the dietary groups ; the diminishing cholesterol : phospholipid ratio could be associated with an increase in the membrane fluidity . Moreover , reconstituted membranes from the nuts and virgin olive oil groups showed a higher propensity to form a nonlamellar inverted hexagonal phase structure that was related to an increase in phosphatidylethanolamine lipid class . These data suggest that the Mediterranean-style diet affects the lipid metabolism that is altered in hypertensive patients , influencing the structural membrane properties . The erythrocyte membrane modulation described provides insight in the structural bases underlying the beneficial effect of a Mediterranean-style diet in hypertensive subjects Context Some experts attribute a low incidence of heart disease in Mediterranean countries to dietary habits . Contribution In this multicenter , 3-group trial , investigators r and omly assigned 772 adults at high risk for cardiovascular disease to a low-fat diet or to a Mediterranean diet supplemented with either virgin olive oil ( 1 L per week ) or nuts ( 30 g per day ) . After 3 months , the Mediterranean diet groups had lower mean plasma glucose level , systolic blood pressure , and total cholesterolhigh-density lipoprotein cholesterol ratio than the low-fat diet group . Caution s The Mediterranean diet groups received more nutritional education than the low-fat diet group . Implication s Mediterranean diets supplemented with olive oil or nuts may improve cardiovascular risk factors . The Editors Cardiovascular disease is the main cause of death in industrialized countries , but incidence rates have marked geographic differences . The low incidence of coronary heart disease ( CHD ) in Mediterranean countries has been partly ascribed to dietary habits ( 1 - 3 ) . Recent findings from large European cohort studies ( 4 - 6 ) suggest that 
    Output:
    