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 the authors used an objective assessment of physical function and a range of sociodemographic , dietary , and health behaviors to explore the possible factors that could explain the association between depression and mortality in community-dwelling elderly participants aged 65 years and older . DESIGN prospect i ve follow-up of the National Diet and Nutrition Survey in older adults . SETTING community sample . PARTICIPANTS a total of 1,007 participants ( 522 men , 485 women ; mean age : 76.4 ± 7.3 years ) . MEASUREMENTS : Depression was assessed from the 15 item Geriatric Depression Scale ( GDS ) and physical function using h and grip strength . Participants were followed up for death over an average of 9.2 years . RESULTS : At baseline , 20.9 % of participants demonstrated depression ( GDS-15 score ≥ 5 ) . Depressed participants were at a higher relative risk of all cause mortality during follow-up ( age- and sex-adjusted hazard ratio = 1.24 , 95 % confidence interval : 1.04 - 1.49 ) . Other risk factors for depression also related to mortality included smoking , physical inactivity , and low grip strength . These factors collectively explained an estimated 54 % of the association between depression and mortality . Low- grade inflammation and low plasma vitamin C were also independently associated with depression and mortality but did not explain any of the association between depression and mortality . CONCLUSION late-life depression is associated with a higher risk of mortality . Physical inactivity and physical dysfunction might partly mediate this association , although further longitudinal studies are required to fully eluci date these mechanisms Nutrients and other bioactive constituents of foods may interact with each other and the surrounding food matrix in complex ways . Therefore , associations between single nutrients and chronic disease may be difficult to identify and interpret , but when dietary patterns ( DPs ) are examined the combination of many food factors will be considered . An explorative literature search of published review articles was conducted to obtain a fuller underst and ing of current DPs in epidemiological research , to discuss pros and cons of DPs in nutrition research , and to identify results of studies linking DPs to chronic disease risk in adults . R and omized feeding trials providing the experimental diets to study participants have repeatedly demonstrated that diets based on current dietary recommendations are associated with important health benefits . Systematic review s of feeding trials and prospect i ve population studies of DPs and chronic disease risk reach similar conclusions regardless of the methodology used to construct DPs . However , to date only a few review articles of DP studies have followed a systematic process using independent review ers with strict inclusion , exclusion , and study quality criteria . Diets with plenty of plants foods , fish , and seafood that preferably include vegetable oils and low-fat dairy products are associated with a lower risk of most chronic diseases . In contrast , Western-type DPs with food products low in essential nutrients and high in energy , like sugar-sweetened beverages , sweets , refined cereals and solid fats ( e.g. butter ) , and high in red and processed meats , are associated with adverse health effects . An emphasis on high- quality original research , and systematic review s following a structured process to objective ly select and judge studies , is needed in order to enforce a strong future knowledge base regarding DPs and chronic disease BACKGROUND Studies of diet and depression have focused primarily on individual nutrients . AIMS To examine the association between dietary patterns and depression using an overall diet approach . METHOD Analyses were carried on data from 3486 participants ( 26.2 % women , mean age 55.6 years ) from the Whitehall II prospect i ve cohort , in which two dietary patterns were identified : ' whole food ' ( heavily loaded by vegetables , fruits and fish ) and ' processed food ' ( heavily loaded by sweetened desserts , fried food , processed meat , refined grains and high-fat dairy products ) . Self-reported depression was assessed 5 years later using the Center for Epidemiologic Studies - Depression ( CES-D ) scale . RESULTS After adjusting for potential confounders , participants in the highest tertile of the whole food pattern had lower odds of CES-D depression ( OR = 0.74 , 95 % CI 0.56 - 0.99 ) than those in the lowest tertile . In contrast , high consumption of processed food was associated with an increased odds of CES-D depression ( OR = 1.58 , 95 % CI 1.11 - 2.23 ) . CONCLUSIONS In middle-aged participants , a processed food dietary pattern is a risk factor for CES-D depression 5 years later , whereas a whole food pattern is protective CONTEXT Higher adherence to a Mediterranean-type diet is linked to lower risk for mortality and chronic diseases , but its association with cognitive decline is unclear . OBJECTIVE To investigate the association of a Mediterranean diet with change in cognitive performance and risk for dementia in elderly French persons . DESIGN , SETTING , AND PARTICIPANTS Prospect i ve cohort study of 1410 adults ( > or = 65 years ) from Bordeaux , France , included in the Three-City cohort in 2001 - 2002 and reexamined at least once over 5 years .  Adherence to a Mediterranean diet ( scored as 0 to 9 ) was computed from a food frequency question naire and 24-hour recall . MAIN OUTCOME MEASURES Cognitive performance was assessed on 4 neuropsychological tests : the Mini-Mental State Examination ( MMSE ) , Isaacs Set Test ( IST ) , Benton Visual Retention Test ( BVRT ) , and Free and Cued Selective Reminding Test ( FCSRT ) . Incident cases of dementia ( n = 99 ) were vali date d by an independent expert committee of neurologists . RESULTS Adjusting for age , sex , education , marital status , energy intake , physical activity , depressive symptomatology , taking 5 medications/d or more , apolipoprotein E genotype , cardiovascular risk factors , and stroke , higher Mediterranean diet score was associated with fewer MMSE errors ( beta = -0.006 ; 95 % confidence interval [ CI ] , -0.01 to -0.0003 ; P = .04 for 1 point of the Mediterranean diet score ) . Performance on the IST , BVRT , or FCSRT over time was not significantly associated with Mediterranean diet adherence . Greater adherence as a categorical variable ( score 6 - 9 ) was not significantly associated with fewer MMSE errors and better FCSRT scores in the entire cohort , but among individuals who remained free from dementia over 5 years , the association for the highest compared with the lowest group was significant ( adjusted for all factors , for MMSE : beta = -0.03 ; 95 % CI , -0.05 to -0.001 ; P = .04 ; for FCSRT : beta = 0.21 ; 95 % CI , 0.008 to 0.41 ; P = .04 ) . Mediterranean diet adherence was not associated with the risk for incident dementia ( fully adjusted model : hazard ratio , 1.12 ; 95 % CI , 0.60 to 2.10 ; P = .72 ) , although power to detect a difference was limited . CONCLUSIONS Higher adherence to a Mediterranean diet was associated with slower MMSE cognitive decline but not consistently with other cognitive tests . Higher adherence was not associated with risk for incident dementia Introduction Dietary patterns are culturally specific and there is limited data on the association of dietary patterns with  late-life depression in Chinese . This study examined the associations between dietary patterns and baseline and subsequent depressive symptoms in community-dwelling Chinese older people in Hong Kong . Methods Participants aged ≥65 year participating in a cohort study examining the risk factors for osteoporosis completed a vali date d food frequency question naire at baseline between 2001 and 2003 . Factor analysis was used to identify three dietary patterns : “ vegetables-fruits ” pattern , “ snacks-drinks-milk products ” pattern , and “ meat-fish ” pattern . Depressive symptoms were measured at baseline and 4-year using the vali date d Geriatric Depression Scale . Multiple logistic regression was used for cross-sectional analysis ( n = 2,902 ) to assess the associations between dietary patterns and the presence of depressive symptoms , and for longitudinal analysis ( n = 2,211 ) on their associations with 4-year depressive symptoms , with adjustment for socio-demographic and lifestyle factors . Results The highest quartile of “ vegetables-fruits ” pattern score was associated with reduced likelihood of depressive symptoms [ Adjusted OR = 0.55 ( 95 % CI : 0.36–0.83 ) , ptrend = 0.017 ] compared to the lowest quartile at baseline . Similar inverse trend was observed for the highest quartile of “ snacks-drinks-milk products ” pattern score [ Adjusted OR = 0.41 ( 95 % CI : 0.26–0.65 ) , ptrend<0.001 ] compared to the lowest quartile . There was no association of “ meat-fish ” pattern with the presence of depressive symptoms at baseline . None of the dietary patterns were associated with subsequent depressive symptoms at 4-year . Conclusion Higher “ vegetables-fruits ” and “ snacks-drinks-milk products ” pattern scores were associated with reduced likelihood of baseline depressive symptoms in Chinese older people in Hong Kong . The longitudinal analyses failed to show any causal relationship between dietary patterns  and depressive symptoms in this population BACKGROUND The etiology of the geriatric syndrome frailty is multifactorial . Besides hormonal and inflammatory processes , nutritional influences may be of major relevance . In this cross-sectional study , the association between dietary quality and frailty was investigated . METHODS In 192 community-dwelling older volunteers ( > 75 years ) , an interview-based food frequency question naire was used to assess nutritional data . A Mediterranean diet ( MED ) score ( maximum 9 points ) was used to evaluate dietary quality . Frailty was defined as the presence of at least three and prefrailty as the presence of one or two of the following criteria : weight loss , exhaustion , low physical activity , low h and grip strength , and slow walking speed . Older adults without any of these attributes were defined as " nonfrail " Binomial logistic regression analysis was used to assess the risk of being frail ( vs prefrail and nonfrail ) in each quartile ( vs lowest quartile ) of the MED score . RESULTS The mean ( SD ) age of the participants was 83 ( 4 ) years ; 41.1 % were prefrail and 15.1 % were frail . The risk of being frail was significantly reduced in the highest quartile of the MED score ( OR 0.26 ; 95 % CI 0.07 - 0.98 ) . CONCLUSIONS A healthy dietary pattern is associated with a lower risk of being frail . Larger , prospect i ve and interventional studies are needed to clarify the association between dietary quality and frailty BACKGROUND To assess the overall influence of diet on health and disease in epidemiological studies , the habitual diet of the study participants has to be captured as a pattern rather than individual foods or nutrients . The simplest way to describe dietary preferences is to separate foods considered beneficial to health from foods considered to promote disease , and separate individuals on the basis of their regular consumption of these foods . METHODS We used data from 59 038 women participating in the prospect i ve Mammography Screening Cohort in Sweden to investigate the influence of variety of healthy and less healthy foods on all-cause and cause-specific mortality . RESULTS Women who followed a healthy diet defined as consumption of a high variety of fruits , vegetables , whole grain breads , cereals , fish , and low fat dairy products had a significantly lower mortality than women who consumed few of these foods ( 3710 deaths total ) . Women who reported regularly consuming 16 - 17 healthy foods had a 42 % lower all-cause mortality ( 95 % CI : 32 - 50 % ) compared to women reporting consumption of 0 - 8 healthy foods with any regularity ( P for trend < 0.0001 ) . For each additional healthy food consumed the risk of death was about 5 % lower ( 95 % CI : 4 - 6 % ) . Cardiovascular mortality was particularly low among women who reported consuming a high variety of healthy foods . A less healthy diet defined as consumption of a high variety of red meats , refined carbohydrates and sugars , and foods high in saturated or trans fats was not directly associated with a higher overall mortality . However , women who reported consuming many less healthy foods were significantly more likely to die from cancer than those who consumed few less healthy foods . CONCLUSIONS A healthy diet can affect longevity . It appears more important to increase the number of healthy foods regularly consumed than to reduce the number of less healthy foods regularly consumed BACKGROUND The Dietary Approaches to Stop Hypertension ( DASH ) diet has been shown to lower blood pressure , but little is known about its long-term effect on cardiovascular end points . Our objective was to assess the association between a DASH-style diet adherence score and risk of coronary heart disease ( CHD ) and stroke in women . METHODS In this prospect i ve cohort study , diet was assessed 7 times during 24 years of follow-up ( 1980 - 2004 ) with vali date d food frequency question naires . A DASH score based on 8 food and nutrient components ( fruits , vegetables , whole grains , nuts and 
    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: OBJECTIVE the authors used an objective assessment of physical function and a range of sociodemographic , dietary , and health behaviors to explore the possible factors that could explain the association between depression and mortality in community-dwelling elderly participants aged 65 years and older . DESIGN prospect i ve follow-up of the National Diet and Nutrition Survey in older adults . SETTING community sample . PARTICIPANTS a total of 1,007 participants ( 522 men , 485 women ; mean age : 76.4 ± 7.3 years ) . MEASUREMENTS : Depression was assessed from the 15 item Geriatric Depression Scale ( GDS ) and physical function using h and grip strength . Participants were followed up for death over an average of 9.2 years . RESULTS : At baseline , 20.9 % of participants demonstrated depression ( GDS-15 score ≥ 5 ) . Depressed participants were at a higher relative risk of all cause mortality during follow-up ( age- and sex-adjusted hazard ratio = 1.24 , 95 % confidence interval : 1.04 - 1.49 ) . Other risk factors for depression also related to mortality included smoking , physical inactivity , and low grip strength . These factors collectively explained an estimated 54 % of the association between depression and mortality . Low- grade inflammation and low plasma vitamin C were also independently associated with depression and mortality but did not explain any of the association between depression and mortality . CONCLUSION late-life depression is associated with a higher risk of mortality . Physical inactivity and physical dysfunction might partly mediate this association , although further longitudinal studies are required to fully eluci date these mechanisms Nutrients and other bioactive constituents of foods may interact with each other and the surrounding food matrix in complex ways . Therefore , associations between single nutrients and chronic disease may be difficult to identify and interpret , but when dietary patterns ( DPs ) are examined the combination of many food factors will be considered . An explorative literature search of published review articles was conducted to obtain a fuller underst and ing of current DPs in epidemiological research , to discuss pros and cons of DPs in nutrition research , and to identify results of studies linking DPs to chronic disease risk in adults . R and omized feeding trials providing the experimental diets to study participants have repeatedly demonstrated that diets based on current dietary recommendations are associated with important health benefits . Systematic review s of feeding trials and prospect i ve population studies of DPs and chronic disease risk reach similar conclusions regardless of the methodology used to construct DPs . However , to date only a few review articles of DP studies have followed a systematic process using independent review ers with strict inclusion , exclusion , and study quality criteria . Diets with plenty of plants foods , fish , and seafood that preferably include vegetable oils and low-fat dairy products are associated with a lower risk of most chronic diseases . In contrast , Western-type DPs with food products low in essential nutrients and high in energy , like sugar-sweetened beverages , sweets , refined cereals and solid fats ( e.g. butter ) , and high in red and processed meats , are associated with adverse health effects . An emphasis on high- quality original research , and systematic review s following a structured process to objective ly select and judge studies , is needed in order to enforce a strong future knowledge base regarding DPs and chronic disease BACKGROUND Studies of diet and depression have focused primarily on individual nutrients . AIMS To examine the association between dietary patterns and depression using an overall diet approach . METHOD Analyses were carried on data from 3486 participants ( 26.2 % women , mean age 55.6 years ) from the Whitehall II prospect i ve cohort , in which two dietary patterns were identified : ' whole food ' ( heavily loaded by vegetables , fruits and fish ) and ' processed food ' ( heavily loaded by sweetened desserts , fried food , processed meat , refined grains and high-fat dairy products ) . Self-reported depression was assessed 5 years later using the Center for Epidemiologic Studies - Depression ( CES-D ) scale . RESULTS After adjusting for potential confounders , participants in the highest tertile of the whole food pattern had lower odds of CES-D depression ( OR = 0.74 , 95 % CI 0.56 - 0.99 ) than those in the lowest tertile . In contrast , high consumption of processed food was associated with an increased odds of CES-D depression ( OR = 1.58 , 95 % CI 1.11 - 2.23 ) . CONCLUSIONS In middle-aged participants , a processed food dietary pattern is a risk factor for CES-D depression 5 years later , whereas a whole food pattern is protective CONTEXT Higher adherence to a Mediterranean-type diet is linked to lower risk for mortality and chronic diseases , but its association with cognitive decline is unclear . OBJECTIVE To investigate the association of a Mediterranean diet with change in cognitive performance and risk for dementia in elderly French persons . DESIGN , SETTING , AND PARTICIPANTS Prospect i ve cohort study of 1410 adults ( > or = 65 years ) from Bordeaux , France , included in the Three-City cohort in 2001 - 2002 and reexamined at least once over 5 years .  Adherence to a Mediterranean diet ( scored as 0 to 9 ) was computed from a food frequency question naire and 24-hour recall . MAIN OUTCOME MEASURES Cognitive performance was assessed on 4 neuropsychological tests : the Mini-Mental State Examination ( MMSE ) , Isaacs Set Test ( IST ) , Benton Visual Retention Test ( BVRT ) , and Free and Cued Selective Reminding Test ( FCSRT ) . Incident cases of dementia ( n = 99 ) were vali date d by an independent expert committee of neurologists . RESULTS Adjusting for age , sex , education , marital status , energy intake , physical activity , depressive symptomatology , taking 5 medications/d or more , apolipoprotein E genotype , cardiovascular risk factors , and stroke , higher Mediterranean diet score was associated with fewer MMSE errors ( beta = -0.006 ; 95 % confidence interval [ CI ] , -0.01 to -0.0003 ; P = .04 for 1 point of the Mediterranean diet score ) . Performance on the IST , BVRT , or FCSRT over time was not significantly associated with Mediterranean diet adherence . Greater adherence as a categorical variable ( score 6 - 9 ) was not significantly associated with fewer MMSE errors and better FCSRT scores in the entire cohort , but among individuals who remained free from dementia over 5 years , the association for the highest compared with the lowest group was significant ( adjusted for all factors , for MMSE : beta = -0.03 ; 95 % CI , -0.05 to -0.001 ; P = .04 ; for FCSRT : beta = 0.21 ; 95 % CI , 0.008 to 0.41 ; P = .04 ) . Mediterranean diet adherence was not associated with the risk for incident dementia ( fully adjusted model : hazard ratio , 1.12 ; 95 % CI , 0.60 to 2.10 ; P = .72 ) , although power to detect a difference was limited . CONCLUSIONS Higher adherence to a Mediterranean diet was associated with slower MMSE cognitive decline but not consistently with other cognitive tests . Higher adherence was not associated with risk for incident dementia Introduction Dietary patterns are culturally specific and there is limited data on the association of dietary patterns with  late-life depression in Chinese . This study examined the associations between dietary patterns and baseline and subsequent depressive symptoms in community-dwelling Chinese older people in Hong Kong . Methods Participants aged ≥65 year participating in a cohort study examining the risk factors for osteoporosis completed a vali date d food frequency question naire at baseline between 2001 and 2003 . Factor analysis was used to identify three dietary patterns : “ vegetables-fruits ” pattern , “ snacks-drinks-milk products ” pattern , and “ meat-fish ” pattern . Depressive symptoms were measured at baseline and 4-year using the vali date d Geriatric Depression Scale . Multiple logistic regression was used for cross-sectional analysis ( n = 2,902 ) to assess the associations between dietary patterns and the presence of depressive symptoms , and for longitudinal analysis ( n = 2,211 ) on their associations with 4-year depressive symptoms , with adjustment for socio-demographic and lifestyle factors . Results The highest quartile of “ vegetables-fruits ” pattern score was associated with reduced likelihood of depressive symptoms [ Adjusted OR = 0.55 ( 95 % CI : 0.36–0.83 ) , ptrend = 0.017 ] compared to the lowest quartile at baseline . Similar inverse trend was observed for the highest quartile of “ snacks-drinks-milk products ” pattern score [ Adjusted OR = 0.41 ( 95 % CI : 0.26–0.65 ) , ptrend<0.001 ] compared to the lowest quartile . There was no association of “ meat-fish ” pattern with the presence of depressive symptoms at baseline . None of the dietary patterns were associated with subsequent depressive symptoms at 4-year . Conclusion Higher “ vegetables-fruits ” and “ snacks-drinks-milk products ” pattern scores were associated with reduced likelihood of baseline depressive symptoms in Chinese older people in Hong Kong . The longitudinal analyses failed to show any causal relationship between dietary patterns  and depressive symptoms in this population BACKGROUND The etiology of the geriatric syndrome frailty is multifactorial . Besides hormonal and inflammatory processes , nutritional influences may be of major relevance . In this cross-sectional study , the association between dietary quality and frailty was investigated . METHODS In 192 community-dwelling older volunteers ( > 75 years ) , an interview-based food frequency question naire was used to assess nutritional data . A Mediterranean diet ( MED ) score ( maximum 9 points ) was used to evaluate dietary quality . Frailty was defined as the presence of at least three and prefrailty as the presence of one or two of the following criteria : weight loss , exhaustion , low physical activity , low h and grip strength , and slow walking speed . Older adults without any of these attributes were defined as " nonfrail " Binomial logistic regression analysis was used to assess the risk of being frail ( vs prefrail and nonfrail ) in each quartile ( vs lowest quartile ) of the MED score . RESULTS The mean ( SD ) age of the participants was 83 ( 4 ) years ; 41.1 % were prefrail and 15.1 % were frail . The risk of being frail was significantly reduced in the highest quartile of the MED score ( OR 0.26 ; 95 % CI 0.07 - 0.98 ) . CONCLUSIONS A healthy dietary pattern is associated with a lower risk of being frail . Larger , prospect i ve and interventional studies are needed to clarify the association between dietary quality and frailty BACKGROUND To assess the overall influence of diet on health and disease in epidemiological studies , the habitual diet of the study participants has to be captured as a pattern rather than individual foods or nutrients . The simplest way to describe dietary preferences is to separate foods considered beneficial to health from foods considered to promote disease , and separate individuals on the basis of their regular consumption of these foods . METHODS We used data from 59 038 women participating in the prospect i ve Mammography Screening Cohort in Sweden to investigate the influence of variety of healthy and less healthy foods on all-cause and cause-specific mortality . RESULTS Women who followed a healthy diet defined as consumption of a high variety of fruits , vegetables , whole grain breads , cereals , fish , and low fat dairy products had a significantly lower mortality than women who consumed few of these foods ( 3710 deaths total ) . Women who reported regularly consuming 16 - 17 healthy foods had a 42 % lower all-cause mortality ( 95 % CI : 32 - 50 % ) compared to women reporting consumption of 0 - 8 healthy foods with any regularity ( P for trend < 0.0001 ) . For each additional healthy food consumed the risk of death was about 5 % lower ( 95 % CI : 4 - 6 % ) . Cardiovascular mortality was particularly low among women who reported consuming a high variety of healthy foods . A less healthy diet defined as consumption of a high variety of red meats , refined carbohydrates and sugars , and foods high in saturated or trans fats was not directly associated with a higher overall mortality . However , women who reported consuming many less healthy foods were significantly more likely to die from cancer than those who consumed few less healthy foods . CONCLUSIONS A healthy diet can affect longevity . It appears more important to increase the number of healthy foods regularly consumed than to reduce the number of less healthy foods regularly consumed BACKGROUND The Dietary Approaches to Stop Hypertension ( DASH ) diet has been shown to lower blood pressure , but little is known about its long-term effect on cardiovascular end points . Our objective was to assess the association between a DASH-style diet adherence score and risk of coronary heart disease ( CHD ) and stroke in women . METHODS In this prospect i ve cohort study , diet was assessed 7 times during 24 years of follow-up ( 1980 - 2004 ) with vali date d food frequency question naires . A DASH score based on 8 food and nutrient components ( fruits , vegetables , whole grains , nuts and 
    Output:
    