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: BACKGROUND Provision of fortified juices may provide a convenient method to maintain and increase blood fat-soluble vitamins . OBJECTIVE To determine whether children consuming orange juice fortified with calcium and combinations of vitamins D , E , and A  could increase serum 25-hydroxyvitamin D [ 25(OH)D ] , α-tocopherol , and retinol levels . DESIGN A 12-week r and omized , double-blind , controlled trial . PARTICIPANTS / SETTING One hundred eighty participants ( aged 8.04±1.42 years ) were recruited at Tufts ( n=70 ) and Boston University ( n=110 ) during 2005 - 2006 . Of those recruited , 176 children were r and omized into three groups : CaD ( 700 mg calcium+200 IU vitamin D ) , CaDEA ( 700 mg calcium+200 IU vitamin D+12 IU vitamin E+2,000 IU vitamin A as beta carotene ) , or Ca ( 700 mg calcium ) . Children consumed two 240-mL glasses of CaD , CaDEA , or Ca fortified orange juice daily for 12 weeks . MAIN OUTCOME MEASURES Serum 25(OH)D , α-tocopherol , and retinol concentrations . STATISTICAL ANALYSES Changes in 25(OH)D , α-tocopherol , retinol , and parathyroid hormone concentrations were examined . Covariates included sex , age , race/ethnicity , body mass index , and baseline 25(OH)D , α-tocopherol , retinol , or parathyroid hormone levels . Multivariate models and repeated measures analysis of variance tested for group differences with pre-post measures ( n=141 ) . RESULTS Baseline 25(OH)D was 68.4±27.7 nmol/L ( 27.4±11.10 ng/mL ) ) , with 21.7 % of participants having inadequate 25(OH)D ( < 50 nmol/L [ 20.03 ng/mL ] ) . The CaD group 's 25(OH)D increase was greater than that of the Ca group ( 12.7 nmol/L [ 5.09 ng/mL ] , 95 % CI 1.3 to 24.1 ; P=0.029 ) . The CaDEA group 's increase in α-tocopherol concentration was greater than that in the Ca or CaD groups ( 3.79 μmol/L [ 0.16 μg/mL ] , 95 % CI 2.5 to 5.1 and 3.09 μmol/L [ 0.13 μg/mL ] , 95 % CI -1.8 to 4.3 ) , respectively ( P<0.0001 ) . Retinol levels did not change , and body weight remained as expected for growth . CONCLUSIONS Daily consumption of orange juice providing 200 IU vitamin D and 12 IU vitamin E increased 25(OH)D and α-tocopherol concentrations in young children within 12 weeks OBJECTIVE To assess the effect of an improved local ingredient-based gruel fortified or not with selected multiple micronutrients ( MM ) on  Hb concentration of young children . DESIGN In a nutrition centre that we opened in their villages , children received either MM supplement ( containing iron , zinc , vitamin A , vitamin C and iodine ) with the improved gruel ( MMGG ) or the improved gruel only ( GG ) , twice daily , 6 d/week , for 6 months . We assessed baseline and endpoint Hb concentration and anthropometric indices . SETTING Kongoussi , a rural and poor district of Burkina Faso . SUBJECTS In a community-based trial , we r and omly assigned 131 children aged 6 - 23 months with Hb concentrations in the range of 80 - 109 g/l into two groups . RESULTS The groups did not differ significantly at baseline . Mean baseline Hb concentration was 89·2 ( sd 6·5 ) g/l and 90·3 ( sd 8·4 ) g/l in the GG and the MMGG , respectively ( P = 0·42 ) . It increased to 104·1 ( sd 11·4 ) g/l in the GG ( P < 0·001 ) and 107·6 ( sd 14·7 ) g/l in the MMGG ( P < 0·001 ) . The between-group difference of 3·5 ( 95 % CI -1·0 , 8·1 ) g/l in mean ( sd ) endpoint Hb concentration was not significant ( P = 0·13 ) . The endpoint anthropometric indices were not different between the groups . CONCLUSIONS This MM supplement  had no additional effect on Hb concentration . Thorough studies are needed to evaluate the actual efficacy of the gruel before its introduction into household routine Objective : ( 1 ) To determine whether nutritional supplementation ( energy and micronutrients ) in institutionalised elderly has a positive effect on dietary intake and nutritional status . ( 2 ) To investigate whether individuals tend to compensate for the energy content of the intervention product by decreasing their habitual food consumption . Methods : A 24-week , r and omised , double-blind , placebo-controlled , intervention trial in homes for the elderly ( n=3 ) , in nursing homes ( n=3 ) and ‘ mixed ’ homes ( n=3 ) in The Netherl and s. Institutionalised elderly people ( n=176 ) older than 60 years of age , with a body mass index ⩽30 kg/m2 and a Mini-Mental State Examination score of 10 points or higher , r and omly received a nutrient-enriched drink or a placebo drink twice a day during 24 weeks in addition to their usual diet . Allocation to treatment took into account of sex , the Mini-Mental State Examination score and the plasma homocysteine level . Body weight and several nutrition-related analyses in fasting blood sample s were measured in all participants . Data on dietary intake were collected in a sub sample ( n=66 ) . Results : A significantly favourable effect ( P<0.001 ) of the intervention drink was observed on vitamin intake , mineral intake and vitamin status in blood ( for example , homocysteine decreased from 14.7 to 9.5 μmol/l in the intervention group as compared with that in the placebo group ( 17.2–15.9 ) ) . The difference in change in total energy intake between the two treatment groups was 0.8 MJ/day ( P=0.166 ) . Energy intake from food decreased in both groups to the same extent ( −0.5 MJ/day ) . Therefore , this decrease can not be considered as compensation for the energy content of the product . Conclusions : This group of institutionalised elderly people does not compensate for the energy content of a concentrated nutritional supplement . Therefore , this supplement is effective for counteracting the development of malnutrition in this population Objective To investigate the effects of delayed umbilical cord clamping , compared with early clamping , on infant iron status at 4 months of age in a European setting . Design R and omised controlled trial . Setting Swedish county hospital . Participants 400 full term infants born after a low risk pregnancy . Intervention Infants were r and omised to  delayed umbilical cord clamping ( ≥180 seconds after delivery )  or early clamping ( ≤10 seconds after delivery ) . Main outcome measures Haemoglobin and iron status at 4 months of age with the power estimate based on serum ferritin levels . Secondary outcomes included neonatal anaemia , early respiratory symptoms , polycythaemia , and need for phototherapy . Results At 4 months of age , infants showed no significant differences in haemoglobin concentration between the groups , but infants subjected to delayed cord clamping had 45 % ( 95 % confidence interval 23 % to 71 % ) higher mean ferritin concentration ( 117 μg/L v 81 μg/L , P<0.001 ) and a lower prevalence of iron deficiency ( 1 ( 0.6 % ) v 10 ( 5.7 % ) , P=0.01 , relative risk reduction 0.90 ; number needed to treat=20 ( 17 to 67 ) ) . As for secondary outcomes , the delayed cord clamping group had lower prevalence of neonatal anaemia at 2 days of age ( 2 ( 1.2 % ) v 10 ( 6.3 % ) , P=0.02 , relative risk reduction 0.80 , number needed to treat 20 ( 15 to 111 ) ) . There were no significant differences between groups in postnatal respiratory symptoms , polycythaemia , or hyperbilirubinaemia requiring phototherapy . Conclusions Delayed cord clamping , compared with early clamping , result ed in improved iron status and reduced prevalence of iron deficiency at 4 months of age , and reduced prevalence of neonatal anaemia , without demonstrable adverse effects . As iron deficiency in infants even without anaemia has been associated with impaired development , delayed cord clamping seems to benefit full term infants even in regions with a relatively low prevalence of iron deficiency anaemia . Trial registration Clinical Trials NCT01245296 BACKGROUND Dietary supplements providing physiologic amounts of several micronutrients simultaneously have not been thoroughly tested for combating micronutrient deficiencies . OBJECTIVE We determined whether a beverage fortified with 10 micronutrients at physiologic doses influenced the iron and vitamin A status and growth of rural children ( aged 6 - 11 y ) attending primary schools . DESIGN In this r and omized , double-blind , placebo-controlled efficacy trial , children were assigned to receive the fortified beverage or an unfortified beverage at school for 6 mo . RESULTS There were nonsignificant differences at baseline between children in the fortified and nonfortified groups in iron status , serum retinol , and anthropometry . At the 6-mo follow-up , among children with anemia ( hemoglobin < 110 g/L ) , there was a significantly larger increase in hemoglobin concentration in the fortified group than in the nonfortified group ( 9.2 and 0.2 g/L , respectively ) . Of those who were anemic at baseline , 69.4 % in the nonfortified group and 55.1 % in the fortified group remained anemic at follow-up ( RR : 0.79 ) , a cure rate of 21 % . The prevalence of children with low serum retinol concentrations ( < 200 microg/L ) dropped significantly from 21.4 % to 11.3 % in the fortified group compared with a nonsignificant change ( 20.6 % to 19.7 % ) in the nonfortified group . At follow-up , mean incremental changes in weight ( 1.79 compared with 1.24 kg ) , height ( 3.2 compared with 2.6 cm ) , and BMI ( 0.88 compared with 0.53 ) were significantly higher in the fortified group than in the nonfortified group . CONCLUSION The fortified beverage significantly improved hematologic and anthropometric measurements and significantly lowered the overall prevalence of anemia and vitamin A deficiency Objective : To determine the effect of a biscuit with red palm oil as a source of β-carotene on the vitamin A status of primary school children and to compare this with the effect of a biscuit with β-carotene from a synthetic source . Design : R and omised controlled trial . Setting : A rural community in KwaZulu-Natal , South Africa . Subjects : A total of 437 primary school children , aged 5–11 y ; 400 completed the study .Intervention : Subjects were r and omly assigned to one of three groups , receiving , respectively : ( i ) a placebo biscuit ; ( ii ) a biscuit with synthetic β-carotene as a vitamin A fortificant ( SB ) ; ( iii ) a biscuit with red palm oil as a source of β-carotene ( PB ) ; SB and PB supplied 30 % of the RDA for vitamin A per serving of three biscuits . Biscuits were distributed daily during the school week ; vitamin A status was assessed at baseline and after 3 months . Results : There was a significant improvement in serum retinol compared to the control group in both the SB and PB groups ( P<0.005 ) ; the treatment effect for the two groups was equivalent ( difference in treatment effect 0.62 µg/dl , with a 90 % CI−0.33–1.57 ) . Conclusions : A biscuit with red palm oil as a source of β-carotene is as effective as a biscuit with synthetic β-carotene in improving the vitamin A status of primary school children . The additional qualities of red palm oil ( ie no trans fatty acids ; rich source of antioxidants ) make it an excellent alternative fortificant for addressing vitamin A deficiency . Sponsorship : Financial support from Palm Oil Research Institute of Malaysia (PORIM).European Journal of Clinical Nutrition ( 2001 ) 55 , Anemia and co-existing deficiencies of zinc , iron , iodine , and vitamin A occur among children in many developing countries including NE Thail and , probably contributing to impairments in growth , immune competence , and cognition . Sustainable strategies are urgently required to combat these deficiencies . We assessed the efficacy of a micronutrient-fortified seasoning pow 
    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: BACKGROUND Provision of fortified juices may provide a convenient method to maintain and increase blood fat-soluble vitamins . OBJECTIVE To determine whether children consuming orange juice fortified with calcium and combinations of vitamins D , E , and A  could increase serum 25-hydroxyvitamin D [ 25(OH)D ] , α-tocopherol , and retinol levels . DESIGN A 12-week r and omized , double-blind , controlled trial . PARTICIPANTS / SETTING One hundred eighty participants ( aged 8.04±1.42 years ) were recruited at Tufts ( n=70 ) and Boston University ( n=110 ) during 2005 - 2006 . Of those recruited , 176 children were r and omized into three groups : CaD ( 700 mg calcium+200 IU vitamin D ) , CaDEA ( 700 mg calcium+200 IU vitamin D+12 IU vitamin E+2,000 IU vitamin A as beta carotene ) , or Ca ( 700 mg calcium ) . Children consumed two 240-mL glasses of CaD , CaDEA , or Ca fortified orange juice daily for 12 weeks . MAIN OUTCOME MEASURES Serum 25(OH)D , α-tocopherol , and retinol concentrations . STATISTICAL ANALYSES Changes in 25(OH)D , α-tocopherol , retinol , and parathyroid hormone concentrations were examined . Covariates included sex , age , race/ethnicity , body mass index , and baseline 25(OH)D , α-tocopherol , retinol , or parathyroid hormone levels . Multivariate models and repeated measures analysis of variance tested for group differences with pre-post measures ( n=141 ) . RESULTS Baseline 25(OH)D was 68.4±27.7 nmol/L ( 27.4±11.10 ng/mL ) ) , with 21.7 % of participants having inadequate 25(OH)D ( < 50 nmol/L [ 20.03 ng/mL ] ) . The CaD group 's 25(OH)D increase was greater than that of the Ca group ( 12.7 nmol/L [ 5.09 ng/mL ] , 95 % CI 1.3 to 24.1 ; P=0.029 ) . The CaDEA group 's increase in α-tocopherol concentration was greater than that in the Ca or CaD groups ( 3.79 μmol/L [ 0.16 μg/mL ] , 95 % CI 2.5 to 5.1 and 3.09 μmol/L [ 0.13 μg/mL ] , 95 % CI -1.8 to 4.3 ) , respectively ( P<0.0001 ) . Retinol levels did not change , and body weight remained as expected for growth . CONCLUSIONS Daily consumption of orange juice providing 200 IU vitamin D and 12 IU vitamin E increased 25(OH)D and α-tocopherol concentrations in young children within 12 weeks OBJECTIVE To assess the effect of an improved local ingredient-based gruel fortified or not with selected multiple micronutrients ( MM ) on  Hb concentration of young children . DESIGN In a nutrition centre that we opened in their villages , children received either MM supplement ( containing iron , zinc , vitamin A , vitamin C and iodine ) with the improved gruel ( MMGG ) or the improved gruel only ( GG ) , twice daily , 6 d/week , for 6 months . We assessed baseline and endpoint Hb concentration and anthropometric indices . SETTING Kongoussi , a rural and poor district of Burkina Faso . SUBJECTS In a community-based trial , we r and omly assigned 131 children aged 6 - 23 months with Hb concentrations in the range of 80 - 109 g/l into two groups . RESULTS The groups did not differ significantly at baseline . Mean baseline Hb concentration was 89·2 ( sd 6·5 ) g/l and 90·3 ( sd 8·4 ) g/l in the GG and the MMGG , respectively ( P = 0·42 ) . It increased to 104·1 ( sd 11·4 ) g/l in the GG ( P < 0·001 ) and 107·6 ( sd 14·7 ) g/l in the MMGG ( P < 0·001 ) . The between-group difference of 3·5 ( 95 % CI -1·0 , 8·1 ) g/l in mean ( sd ) endpoint Hb concentration was not significant ( P = 0·13 ) . The endpoint anthropometric indices were not different between the groups . CONCLUSIONS This MM supplement  had no additional effect on Hb concentration . Thorough studies are needed to evaluate the actual efficacy of the gruel before its introduction into household routine Objective : ( 1 ) To determine whether nutritional supplementation ( energy and micronutrients ) in institutionalised elderly has a positive effect on dietary intake and nutritional status . ( 2 ) To investigate whether individuals tend to compensate for the energy content of the intervention product by decreasing their habitual food consumption . Methods : A 24-week , r and omised , double-blind , placebo-controlled , intervention trial in homes for the elderly ( n=3 ) , in nursing homes ( n=3 ) and ‘ mixed ’ homes ( n=3 ) in The Netherl and s. Institutionalised elderly people ( n=176 ) older than 60 years of age , with a body mass index ⩽30 kg/m2 and a Mini-Mental State Examination score of 10 points or higher , r and omly received a nutrient-enriched drink or a placebo drink twice a day during 24 weeks in addition to their usual diet . Allocation to treatment took into account of sex , the Mini-Mental State Examination score and the plasma homocysteine level . Body weight and several nutrition-related analyses in fasting blood sample s were measured in all participants . Data on dietary intake were collected in a sub sample ( n=66 ) . Results : A significantly favourable effect ( P<0.001 ) of the intervention drink was observed on vitamin intake , mineral intake and vitamin status in blood ( for example , homocysteine decreased from 14.7 to 9.5 μmol/l in the intervention group as compared with that in the placebo group ( 17.2–15.9 ) ) . The difference in change in total energy intake between the two treatment groups was 0.8 MJ/day ( P=0.166 ) . Energy intake from food decreased in both groups to the same extent ( −0.5 MJ/day ) . Therefore , this decrease can not be considered as compensation for the energy content of the product . Conclusions : This group of institutionalised elderly people does not compensate for the energy content of a concentrated nutritional supplement . Therefore , this supplement is effective for counteracting the development of malnutrition in this population Objective To investigate the effects of delayed umbilical cord clamping , compared with early clamping , on infant iron status at 4 months of age in a European setting . Design R and omised controlled trial . Setting Swedish county hospital . Participants 400 full term infants born after a low risk pregnancy . Intervention Infants were r and omised to  delayed umbilical cord clamping ( ≥180 seconds after delivery )  or early clamping ( ≤10 seconds after delivery ) . Main outcome measures Haemoglobin and iron status at 4 months of age with the power estimate based on serum ferritin levels . Secondary outcomes included neonatal anaemia , early respiratory symptoms , polycythaemia , and need for phototherapy . Results At 4 months of age , infants showed no significant differences in haemoglobin concentration between the groups , but infants subjected to delayed cord clamping had 45 % ( 95 % confidence interval 23 % to 71 % ) higher mean ferritin concentration ( 117 μg/L v 81 μg/L , P<0.001 ) and a lower prevalence of iron deficiency ( 1 ( 0.6 % ) v 10 ( 5.7 % ) , P=0.01 , relative risk reduction 0.90 ; number needed to treat=20 ( 17 to 67 ) ) . As for secondary outcomes , the delayed cord clamping group had lower prevalence of neonatal anaemia at 2 days of age ( 2 ( 1.2 % ) v 10 ( 6.3 % ) , P=0.02 , relative risk reduction 0.80 , number needed to treat 20 ( 15 to 111 ) ) . There were no significant differences between groups in postnatal respiratory symptoms , polycythaemia , or hyperbilirubinaemia requiring phototherapy . Conclusions Delayed cord clamping , compared with early clamping , result ed in improved iron status and reduced prevalence of iron deficiency at 4 months of age , and reduced prevalence of neonatal anaemia , without demonstrable adverse effects . As iron deficiency in infants even without anaemia has been associated with impaired development , delayed cord clamping seems to benefit full term infants even in regions with a relatively low prevalence of iron deficiency anaemia . Trial registration Clinical Trials NCT01245296 BACKGROUND Dietary supplements providing physiologic amounts of several micronutrients simultaneously have not been thoroughly tested for combating micronutrient deficiencies . OBJECTIVE We determined whether a beverage fortified with 10 micronutrients at physiologic doses influenced the iron and vitamin A status and growth of rural children ( aged 6 - 11 y ) attending primary schools . DESIGN In this r and omized , double-blind , placebo-controlled efficacy trial , children were assigned to receive the fortified beverage or an unfortified beverage at school for 6 mo . RESULTS There were nonsignificant differences at baseline between children in the fortified and nonfortified groups in iron status , serum retinol , and anthropometry . At the 6-mo follow-up , among children with anemia ( hemoglobin < 110 g/L ) , there was a significantly larger increase in hemoglobin concentration in the fortified group than in the nonfortified group ( 9.2 and 0.2 g/L , respectively ) . Of those who were anemic at baseline , 69.4 % in the nonfortified group and 55.1 % in the fortified group remained anemic at follow-up ( RR : 0.79 ) , a cure rate of 21 % . The prevalence of children with low serum retinol concentrations ( < 200 microg/L ) dropped significantly from 21.4 % to 11.3 % in the fortified group compared with a nonsignificant change ( 20.6 % to 19.7 % ) in the nonfortified group . At follow-up , mean incremental changes in weight ( 1.79 compared with 1.24 kg ) , height ( 3.2 compared with 2.6 cm ) , and BMI ( 0.88 compared with 0.53 ) were significantly higher in the fortified group than in the nonfortified group . CONCLUSION The fortified beverage significantly improved hematologic and anthropometric measurements and significantly lowered the overall prevalence of anemia and vitamin A deficiency Objective : To determine the effect of a biscuit with red palm oil as a source of β-carotene on the vitamin A status of primary school children and to compare this with the effect of a biscuit with β-carotene from a synthetic source . Design : R and omised controlled trial . Setting : A rural community in KwaZulu-Natal , South Africa . Subjects : A total of 437 primary school children , aged 5–11 y ; 400 completed the study .Intervention : Subjects were r and omly assigned to one of three groups , receiving , respectively : ( i ) a placebo biscuit ; ( ii ) a biscuit with synthetic β-carotene as a vitamin A fortificant ( SB ) ; ( iii ) a biscuit with red palm oil as a source of β-carotene ( PB ) ; SB and PB supplied 30 % of the RDA for vitamin A per serving of three biscuits . Biscuits were distributed daily during the school week ; vitamin A status was assessed at baseline and after 3 months . Results : There was a significant improvement in serum retinol compared to the control group in both the SB and PB groups ( P<0.005 ) ; the treatment effect for the two groups was equivalent ( difference in treatment effect 0.62 µg/dl , with a 90 % CI−0.33–1.57 ) . Conclusions : A biscuit with red palm oil as a source of β-carotene is as effective as a biscuit with synthetic β-carotene in improving the vitamin A status of primary school children . The additional qualities of red palm oil ( ie no trans fatty acids ; rich source of antioxidants ) make it an excellent alternative fortificant for addressing vitamin A deficiency . Sponsorship : Financial support from Palm Oil Research Institute of Malaysia (PORIM).European Journal of Clinical Nutrition ( 2001 ) 55 , Anemia and co-existing deficiencies of zinc , iron , iodine , and vitamin A occur among children in many developing countries including NE Thail and , probably contributing to impairments in growth , immune competence , and cognition . Sustainable strategies are urgently required to combat these deficiencies . We assessed the efficacy of a micronutrient-fortified seasoning pow 
    Output:
    