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: The effect of caffeine on exercise-induced bronchoconstriction was examined in ten patients with bronchial asthma .  Placebo and caffeine 3.5 mg/kg and 7 mg/kg were given two hours before exercise .  Spirometry was taken at one and two hours following caffeine and at 5 , 15 , and 30 minutes following exercise . Caffeine significantly improved baseline FEV1 and prevented exercise-induced bronchoconstriction only at a dose of 7 mg/kg . Caffeine was well tolerated by the patients . These data suggest that only high doses of caffeine significantly prevent a postexercise drop in FEV1 Objective . The rapidly increasing prevalence of asthma in developed countries suggests an environmental cause . The benefits of Mediterranean diet ( MD ) in cardiovascular disease have been tentatively attributed to its anti-inflammatory properties . Asthma is an inflammatory disease and MD is associated with reduced asthma risk in epidemiological studies , but there are no reported interventional studies of MD in asthma . Methods . In this 12-week open-label r and omized trial , 38 adults with symptomatic asthma were allocated to high-intervention ( HI ) , low-intervention ( LI ) , and control groups . The first two groups were encouraged to adopt an MD and received multiple consultation sessions with a nutritionist , written advice , and vouchers for the purchase of appropriate foods .  Food frequency question naires , asthma control question naires , asthma-related quality of life question naires ( AQLQs ) , and spirometry  were completed at the beginning and at the end of the study . Results : The MDt score increased in the HI group ( p < .001 ) , indicating successful alteration of dietary behavior . Statistically , nonsignificant improvements were seen in spirometry and several AQLQ subdomains in the two intervention groups . No changes were seen in the asthma control or in inflammatory markers . Conclusions : The trial intervention has successfully altered the dietary behavior among adults with asthma . Small but consistent improvements were seen in quality of life and spirometry among the intervention group . The use of the MD to treat asthma is feasible and warrants evaluation in a larger study , powered to examine clinical endpoints BACKGROUND Antioxidant-rich diets are associated with reduced asthma prevalence in epidemiologic studies . We previously showed that short-term manipulation of antioxidant defenses leads to changes in asthma outcomes . OBJECTIVE The objective was to investigate the effects of a high-antioxidant diet compared with those of a low-antioxidant diet , with or without lycopene supplementation , in asthma . DESIGN Asthmatic adults ( n = 137 ) were r and omly assigned to a high-antioxidant diet ( 5 servings of vegetables and 2 servings of fruit daily ; n = 46 ) or a low-antioxidant diet ( ≤2 servings of vegetables and 1 serving of fruit daily ; n = 91 ) for 14 d and then commenced a parallel , r and omized , controlled supplementation trial . Subjects who consumed the high-antioxidant diet received placebo . Subjects who consumed the low-antioxidant diet received placebo or tomato extract ( 45 mg lycopene/d ) . The intervention continued until week 14 or until an exacerbation occurred . RESULTS After 14 d , subjects consuming the low-antioxidant diet had a lower percentage predicted forced expiratory volume in 1 s and percentage predicted forced vital capacity than did those consuming the high-antioxidant diet . Subjects in the low-antioxidant diet group had increased plasma C-reactive protein at week 14 . At the end of the trial , time to exacerbation was greater in the high-antioxidant than in the low-antioxidant diet group , and the low-antioxidant diet group was 2.26 ( 95 % CI : 1.04 , 4.91 ; P = 0.039 ) times as likely to exacerbate . Of the subjects in the low-antioxidant diet group , no difference in airway or systemic inflammation or clinical outcomes was observed between the groups that consumed the tomato extract and those who consumed placebo . CONCLUSIONS Modifying the dietary intake of carotenoids alters clinical asthma outcomes . Improvements were evident only after increased fruit and vegetable intake , which suggests that whole-food interventions are most effective . This trial was registered at http://www.actr.org.au as ACTRN012606000286549 Background : Epidemiological evidence from observational studies has suggested that blood levels and dietary intake of selenium of adults with asthma are lower than those of controls . The only previous trial of selenium supplementation in adults with asthma found no objective evidence of benefit but involved only 24 participants . Methods : A r and omised , double blind , placebo-controlled trial of selenium supplementation was performed in adults with asthma in London , UK , the majority of whom ( 75 % ) reported inhaled steroid use at baseline . 197 participants were r and omised to receive either a high-selenium yeast preparation ( 100 µg daily , n = 99 ) or placebo ( yeast only , n = 98 ) for 24 weeks . The primary outcome was asthma-related quality of life ( QoL ) score . Secondary outcomes included lung function , asthma symptom scores , peak flow and bronchodilator usage . Linear regression was used to analyse the change in outcome between the two treatment arms by “ intention to treat ” . Results : There was a 48 % increase in plasma selenium between baseline and end of trial in the active treatment group but no change in the placebo group . While the QoL score improved more in the active treatment group than in the placebo group , the difference in change in score between the two groups was not significant ( −0.05 ( 95 % CI −0.19 to 0.09 ) ; p = 0.47 ) . Selenium supplementation was not associated with any significant improvement in secondary outcomes compared with placebo . Conclusions : Selenium supplementation had no clinical benefit in adults with asthma , the majority of whom were taking inhaled steroids Objective : Within a prospect i ve study , we explored the associations between dietary intake of fatty acids , antioxidants and relevant food sources of these nutrients on the clinical manifestation of asthma in adulthood . Method : A total of 105 newly physician-diagnosed cases of asthma from the European Prospect i ve Investigation into Cancer and Nutrition (EPIC)-Heidelberg cohort were identified during follow-up and matched with 420 controls .  Baseline dietary intake was obtained by means of vali date d food frequency question naires . The association of dietary intake variables and asthma risk was explored by unconditional logistic regression models . Results : A high intake of oleic acid ( C18:1 n-9 ) was positively associated with asthma ( P-value for trend 0.035 ) , while no significant associations were found for the other dietary fatty acids . Most prominently , a high margarine intake increased the risk of onset of asthma in adulthood ( adjusted odds ratio ( OR ) 3rd tertile : 1.73 ( 95 % confidence interval ( 95 % CI ) : 1.05–2.87 ) , P for trend=0.050 ) , the effect being stronger in men ( 2nd tertile : OR=1.66 , 3rd tertile : OR=2.51 ) than in women ( 2nd tertile : OR=0.91 ; 3rd tertile : OR=1.47 ) . The dietary intake of antioxidants and their main food sources had no effect on asthma risk . Conclusions : In summary , the present results provide evidence that even in adulthood a high margarine intake increases the risk of clinical onset of asthma . Whether oleic acid may serve as a proxy for margarine-derived trans-fatty acids ( C18:1 t9 ) remains to be clarified Abstract Objective : To investigate the influence of weight reduction on obese patients with asthma . Design : Open study , two r and omised parallel groups . Setting : Private out patients centre , Helsinki , Finl and . Participants : Two groups of 19 obese patients with asthma ( body mass index ( kg/m2 ) 30 to 42 ) recruited through newspaper advertisements . Intervention : Supervised weight reduction programme including 8 week very low energy diet . Main outcome measures : Body weight , morning peak expiratory flow ( PEF ) , forced vital capacity ( FVC ) , forced expiratory volume in one second ( FEV1 ) ; and also asthma symptoms , number of acute episodes , courses of oral steroids , health status ( quality of life ) . Results : At the end of the weight reducing programme , the participants in the treatment group had lost a mean of 14.5 % of their pretreatment weight , the controls 0.3 % . The corresponding figures after one year were 11.3 % and a weight gain of 2.2 % . After the 8 week dieting period the difference in changes in percentage of predicted FEV1 from baseline in the treatment and control groups was 7.2 % ( 95 % confidence interval 1.9 % to 12.5 % , P=0.009 ) . The corresponding difference in the changes in FVC was 8.6 % ( 4.8 % to 12.5 % , P<0.0001 ) . After one year the differences in the changes in the two groups were still significant : 7.6 % for FEV1 ( 1.5 % to 13.8 % , P=0.02 ) and 7.6 % for FVC ( 3.5 % to 11.8 % , P=0.001 ) . By the end of the weight reduction programme , reduction in dyspnoea was 13 mm ( on a visual analogue scale 0 mm to 100 mm ) in the treatment group and 1 mm in the control group ( P=0.02 ) . The reduction of rescue medication was 1.2 and 0.1 doses respectively ( P=0.03 ) . After one year the differences in the changes between the two groups were −12 for symptom scores ( range −1 to −22 , P=0.04 ) and −10 for total scores ( −18 to −1 , P=0.02 ) . The median number of exacerbations in the treatment group was 1 ( 0–4 ) and in the controls 4 ( 0–7 ) , P=0.001 . Conclusion : Weight reduction in obese patients with asthma improves lung function , symptoms , morbidity , and health status Studies on the effects of weight loss in patients with asthma are scarce . No studies have been performed in patients with severe asthma . Therefore , the aim of the present study was to assess the impact of weight loss  in patients with severe asthma associated with obesity . This was an open , prospect i ve , r and omised study of two parallel groups , in patients with severe uncontrolled asthma and moderate obesity . The primary outcome was the level of asthma control 6 months after initiation of the  weight reduction programme  , quantified using the Asthma Control Question naire ( ACQ ) . We evaluated clinical parameters , lung function , markers of airway inflammation and circulating cytokines .  22 patients were r and omised to undergo treatment for obesity and 11 to the control group .  The weight reduction programme was associated with significant improvements in asthma control ( mean±se ACQ score 3.02±0.19 to 2.25±0.28 in the treatment group versus 2.91±0.25 to 2.90±0.16 in the controls , p=0.001 ) . This improvement was not accompanied by changes in markers of airway inflammation or bronchial reactivity , but by an increase in forced vital capacity . Our results suggest  that weight reduction in obese patients with severe asthma improves asthma outcomes by mechanisms not related to airway inflammation . Weight loss improves outcomes in severely asthmatic obese patients ; poor control results from obesity-related factors BACKGROUND Previous research has shown that diet can modify the bronchoconstrictor response to exercise in asthmatic subjects . OBJECTIVE Determine the effect of ascorbic acid supplementation on pulmonary function and several urinary markers of airway inflammation in asthmatic subjects with exercise-induced bronchoconstriction ( EIB ) . METHODS Eight asthmatic subjects with documented EIB participated in a r and omized , placebo controlled double-blind crossover trial . Subjects entered the study on their usual diet and were placed on either 2 weeks of ascorbic acid supplementation ( 1500 mg/day ) or placebo , followed by a 1-week washout period , before crossing over to the alternative diet .  Pre- and post-exercise pulmonary function , asthma symptom scores , fraction of exhaled nitric oxide ( FENO ) , and urinary leukotriene ( LT ) C4-E4 and 9alpha , 11beta-prostagladin ( PG ) F2 ] were assessed at the beginning of the trial ( usual diet ) and at the end of each treatment period . RESULTS The ascorbic acid diet significantly reduced ( p < 0.05 ) the maximum fall in post-exercise FEV1 ( -6.4 + /- 2.4 % ) compared to usual ( -14.3 + /- 1.6 % ) and placebo diet ( -12.9 + /- 2.4 % ) . Asthma symptoms scores significantly improved ( p<0.05 ) on the ascorbic acid diet compared to the placebo and usual diet . Post-exercise FENO , LTC4 
    Output:
    
agent
***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: The effect of caffeine on exercise-induced bronchoconstriction was examined in ten patients with bronchial asthma .  Placebo and caffeine 3.5 mg/kg and 7 mg/kg were given two hours before exercise .  Spirometry was taken at one and two hours following caffeine and at 5 , 15 , and 30 minutes following exercise . Caffeine significantly improved baseline FEV1 and prevented exercise-induced bronchoconstriction only at a dose of 7 mg/kg . Caffeine was well tolerated by the patients . These data suggest that only high doses of caffeine significantly prevent a postexercise drop in FEV1 Objective . The rapidly increasing prevalence of asthma in developed countries suggests an environmental cause . The benefits of Mediterranean diet ( MD ) in cardiovascular disease have been tentatively attributed to its anti-inflammatory properties . Asthma is an inflammatory disease and MD is associated with reduced asthma risk in epidemiological studies , but there are no reported interventional studies of MD in asthma . Methods . In this 12-week open-label r and omized trial , 38 adults with symptomatic asthma were allocated to high-intervention ( HI ) , low-intervention ( LI ) , and control groups . The first two groups were encouraged to adopt an MD and received multiple consultation sessions with a nutritionist , written advice , and vouchers for the purchase of appropriate foods .  Food frequency question naires , asthma control question naires , asthma-related quality of life question naires ( AQLQs ) , and spirometry  were completed at the beginning and at the end of the study . Results : The MDt score increased in the HI group ( p < .001 ) , indicating successful alteration of dietary behavior . Statistically , nonsignificant improvements were seen in spirometry and several AQLQ subdomains in the two intervention groups . No changes were seen in the asthma control or in inflammatory markers . Conclusions : The trial intervention has successfully altered the dietary behavior among adults with asthma . Small but consistent improvements were seen in quality of life and spirometry among the intervention group . The use of the MD to treat asthma is feasible and warrants evaluation in a larger study , powered to examine clinical endpoints BACKGROUND Antioxidant-rich diets are associated with reduced asthma prevalence in epidemiologic studies . We previously showed that short-term manipulation of antioxidant defenses leads to changes in asthma outcomes . OBJECTIVE The objective was to investigate the effects of a high-antioxidant diet compared with those of a low-antioxidant diet , with or without lycopene supplementation , in asthma . DESIGN Asthmatic adults ( n = 137 ) were r and omly assigned to a high-antioxidant diet ( 5 servings of vegetables and 2 servings of fruit daily ; n = 46 ) or a low-antioxidant diet ( ≤2 servings of vegetables and 1 serving of fruit daily ; n = 91 ) for 14 d and then commenced a parallel , r and omized , controlled supplementation trial . Subjects who consumed the high-antioxidant diet received placebo . Subjects who consumed the low-antioxidant diet received placebo or tomato extract ( 45 mg lycopene/d ) . The intervention continued until week 14 or until an exacerbation occurred . RESULTS After 14 d , subjects consuming the low-antioxidant diet had a lower percentage predicted forced expiratory volume in 1 s and percentage predicted forced vital capacity than did those consuming the high-antioxidant diet . Subjects in the low-antioxidant diet group had increased plasma C-reactive protein at week 14 . At the end of the trial , time to exacerbation was greater in the high-antioxidant than in the low-antioxidant diet group , and the low-antioxidant diet group was 2.26 ( 95 % CI : 1.04 , 4.91 ; P = 0.039 ) times as likely to exacerbate . Of the subjects in the low-antioxidant diet group , no difference in airway or systemic inflammation or clinical outcomes was observed between the groups that consumed the tomato extract and those who consumed placebo . CONCLUSIONS Modifying the dietary intake of carotenoids alters clinical asthma outcomes . Improvements were evident only after increased fruit and vegetable intake , which suggests that whole-food interventions are most effective . This trial was registered at http://www.actr.org.au as ACTRN012606000286549 Background : Epidemiological evidence from observational studies has suggested that blood levels and dietary intake of selenium of adults with asthma are lower than those of controls . The only previous trial of selenium supplementation in adults with asthma found no objective evidence of benefit but involved only 24 participants . Methods : A r and omised , double blind , placebo-controlled trial of selenium supplementation was performed in adults with asthma in London , UK , the majority of whom ( 75 % ) reported inhaled steroid use at baseline . 197 participants were r and omised to receive either a high-selenium yeast preparation ( 100 µg daily , n = 99 ) or placebo ( yeast only , n = 98 ) for 24 weeks . The primary outcome was asthma-related quality of life ( QoL ) score . Secondary outcomes included lung function , asthma symptom scores , peak flow and bronchodilator usage . Linear regression was used to analyse the change in outcome between the two treatment arms by “ intention to treat ” . Results : There was a 48 % increase in plasma selenium between baseline and end of trial in the active treatment group but no change in the placebo group . While the QoL score improved more in the active treatment group than in the placebo group , the difference in change in score between the two groups was not significant ( −0.05 ( 95 % CI −0.19 to 0.09 ) ; p = 0.47 ) . Selenium supplementation was not associated with any significant improvement in secondary outcomes compared with placebo . Conclusions : Selenium supplementation had no clinical benefit in adults with asthma , the majority of whom were taking inhaled steroids Objective : Within a prospect i ve study , we explored the associations between dietary intake of fatty acids , antioxidants and relevant food sources of these nutrients on the clinical manifestation of asthma in adulthood . Method : A total of 105 newly physician-diagnosed cases of asthma from the European Prospect i ve Investigation into Cancer and Nutrition (EPIC)-Heidelberg cohort were identified during follow-up and matched with 420 controls .  Baseline dietary intake was obtained by means of vali date d food frequency question naires . The association of dietary intake variables and asthma risk was explored by unconditional logistic regression models . Results : A high intake of oleic acid ( C18:1 n-9 ) was positively associated with asthma ( P-value for trend 0.035 ) , while no significant associations were found for the other dietary fatty acids . Most prominently , a high margarine intake increased the risk of onset of asthma in adulthood ( adjusted odds ratio ( OR ) 3rd tertile : 1.73 ( 95 % confidence interval ( 95 % CI ) : 1.05–2.87 ) , P for trend=0.050 ) , the effect being stronger in men ( 2nd tertile : OR=1.66 , 3rd tertile : OR=2.51 ) than in women ( 2nd tertile : OR=0.91 ; 3rd tertile : OR=1.47 ) . The dietary intake of antioxidants and their main food sources had no effect on asthma risk . Conclusions : In summary , the present results provide evidence that even in adulthood a high margarine intake increases the risk of clinical onset of asthma . Whether oleic acid may serve as a proxy for margarine-derived trans-fatty acids ( C18:1 t9 ) remains to be clarified Abstract Objective : To investigate the influence of weight reduction on obese patients with asthma . Design : Open study , two r and omised parallel groups . Setting : Private out patients centre , Helsinki , Finl and . Participants : Two groups of 19 obese patients with asthma ( body mass index ( kg/m2 ) 30 to 42 ) recruited through newspaper advertisements . Intervention : Supervised weight reduction programme including 8 week very low energy diet . Main outcome measures : Body weight , morning peak expiratory flow ( PEF ) , forced vital capacity ( FVC ) , forced expiratory volume in one second ( FEV1 ) ; and also asthma symptoms , number of acute episodes , courses of oral steroids , health status ( quality of life ) . Results : At the end of the weight reducing programme , the participants in the treatment group had lost a mean of 14.5 % of their pretreatment weight , the controls 0.3 % . The corresponding figures after one year were 11.3 % and a weight gain of 2.2 % . After the 8 week dieting period the difference in changes in percentage of predicted FEV1 from baseline in the treatment and control groups was 7.2 % ( 95 % confidence interval 1.9 % to 12.5 % , P=0.009 ) . The corresponding difference in the changes in FVC was 8.6 % ( 4.8 % to 12.5 % , P<0.0001 ) . After one year the differences in the changes in the two groups were still significant : 7.6 % for FEV1 ( 1.5 % to 13.8 % , P=0.02 ) and 7.6 % for FVC ( 3.5 % to 11.8 % , P=0.001 ) . By the end of the weight reduction programme , reduction in dyspnoea was 13 mm ( on a visual analogue scale 0 mm to 100 mm ) in the treatment group and 1 mm in the control group ( P=0.02 ) . The reduction of rescue medication was 1.2 and 0.1 doses respectively ( P=0.03 ) . After one year the differences in the changes between the two groups were −12 for symptom scores ( range −1 to −22 , P=0.04 ) and −10 for total scores ( −18 to −1 , P=0.02 ) . The median number of exacerbations in the treatment group was 1 ( 0–4 ) and in the controls 4 ( 0–7 ) , P=0.001 . Conclusion : Weight reduction in obese patients with asthma improves lung function , symptoms , morbidity , and health status Studies on the effects of weight loss in patients with asthma are scarce . No studies have been performed in patients with severe asthma . Therefore , the aim of the present study was to assess the impact of weight loss  in patients with severe asthma associated with obesity . This was an open , prospect i ve , r and omised study of two parallel groups , in patients with severe uncontrolled asthma and moderate obesity . The primary outcome was the level of asthma control 6 months after initiation of the  weight reduction programme  , quantified using the Asthma Control Question naire ( ACQ ) . We evaluated clinical parameters , lung function , markers of airway inflammation and circulating cytokines .  22 patients were r and omised to undergo treatment for obesity and 11 to the control group .  The weight reduction programme was associated with significant improvements in asthma control ( mean±se ACQ score 3.02±0.19 to 2.25±0.28 in the treatment group versus 2.91±0.25 to 2.90±0.16 in the controls , p=0.001 ) . This improvement was not accompanied by changes in markers of airway inflammation or bronchial reactivity , but by an increase in forced vital capacity . Our results suggest  that weight reduction in obese patients with severe asthma improves asthma outcomes by mechanisms not related to airway inflammation . Weight loss improves outcomes in severely asthmatic obese patients ; poor control results from obesity-related factors BACKGROUND Previous research has shown that diet can modify the bronchoconstrictor response to exercise in asthmatic subjects . OBJECTIVE Determine the effect of ascorbic acid supplementation on pulmonary function and several urinary markers of airway inflammation in asthmatic subjects with exercise-induced bronchoconstriction ( EIB ) . METHODS Eight asthmatic subjects with documented EIB participated in a r and omized , placebo controlled double-blind crossover trial . Subjects entered the study on their usual diet and were placed on either 2 weeks of ascorbic acid supplementation ( 1500 mg/day ) or placebo , followed by a 1-week washout period , before crossing over to the alternative diet .  Pre- and post-exercise pulmonary function , asthma symptom scores , fraction of exhaled nitric oxide ( FENO ) , and urinary leukotriene ( LT ) C4-E4 and 9alpha , 11beta-prostagladin ( PG ) F2 ] were assessed at the beginning of the trial ( usual diet ) and at the end of each treatment period . RESULTS The ascorbic acid diet significantly reduced ( p < 0.05 ) the maximum fall in post-exercise FEV1 ( -6.4 + /- 2.4 % ) compared to usual ( -14.3 + /- 1.6 % ) and placebo diet ( -12.9 + /- 2.4 % ) . Asthma symptoms scores significantly improved ( p<0.05 ) on the ascorbic acid diet compared to the placebo and usual diet . Post-exercise FENO , LTC4 
    Output:
    