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 The association between birthweight and subsequent blood pressure levels  has been considered to provide some of the strongest , and most consistent , support for the " fetal origins " hypothesis of adult disease . It had been estimated that a 1 kg higher birthweight is typically associated with a 2 - 4 mm Hg lower systolic blood pressure . METHODS 55 studies that had reported regression coefficients of systolic blood pressure on birthweight ( with 48 further studies that reported only the direction of this association ) , and seven such studies within twin pairs , were identified . Each study was weighted according to the inverse of the variance of the regression coefficient ( ie , " statistical size " ) , and combined using a " fixed effects " approach . FINDINGS Among the 55 studies that reported regression coefficients , there was a clear trend ( p<0.0001 ) towards weaker associations in the larger studies : -1.9 mm Hg/kg in those with less than about 1000 participants ; -1.5 mm Hg/kg with about 1000 - 3000 participants ; and -0.6 mm Hg/kg with more than 3000 participants . By contrast with the inverse associations reported in 52 of these 55 studies , only 25 of the 48 studies that did not report regression coefficients found an inverse association ( p<0.0001 for heterogeneity ) . Almost all of these regression coefficients had been adjusted for current weight ( whereas few were adjusted for potential confounding factors ) , and removal of this adjustment in the larger studies reduced the estimated association to -0.4 mm Hg/kg . For studies within monozygotic twin pairs , the combined estimate was -0.6 mm Hg/kg with adjustment for current weight , and was also reduced without this adjustment . INTERPRETATION Cl aims of a strong inverse association between birthweight and subsequent blood pressure may chiefly reflect the impact of r and om error , selective emphasis of particular results , and inappropriate adjustment for current weight and for confounding factors . These findings suggest that birthweight is of little relevance to blood pressure levels in later life Our purpose in this study was to examine whole body composition , using dual energy x-ray absorptiometry ( DEXA ) during dietary intervention in preterm infants ( ≤1750 g birthweight , ≤34 wk gestation ) . At discharge , infants were r and omized to be fed either a preterm infant formula ( discharge–6 mo ; group A ) or a term formula ( discharge–6 mo ; group B ) , or the preterm formula ( discharge – term ) and the term formula ( term–6 mo ; group C ) .  Nutrient intake was measured between each clinic visit . To measure body composition , DEXA was used at discharge , term , 12 wk , 6 mo , and 12 mo corrected age . The data were analyzed by ANOVA . At discharge , no differences were noted in patient characteristics between groups A , B , and C. Although energy intakes were similar , protein and mineral intakes differed between groups ( A > C > B;p < 0.0001 ) . During the study , weight gain and LM gain were greater in group A than B. At 12 mo , weight , LM , FM , and BMM but not % FM or BMD were greater in group A than B. However , the effects of diet were confined to boys , with no lasting effects seen in girls . In summary , therefore , DEXA was precise enough to detect differences in whole body composition during dietary intervention . Increased weight gain primarily reflected an increase in LM and is consistent with the idea that the preterm formula more closely met protein and /or protein-energy needs in rapidly growing preterm male infants OBJECTIVE Intrauterine and neonatal growth failure of very low birth weight ( VLBW ; < 1500 g ) infants may influence adult growth attainment and have long-term implication s for adult health . As part of a longitudinal study of VLBW infants , we sought to examine gender-specific changes in growth from birth to 20 years old and to identify the correlates of growth attainment at 20 years old . DESIGN , SETTING , PARTICIPANTS A cohort of 103 male and 92 female VLBW infants who had a mean birth weight of 1189 g and mean gestational age of 29.8 weeks , were born from 1977 through 1979 and treated at Rainbow Babies and Children 's Hospital in Clevel and , Ohio , and were free of neurosensory impairment were followed prospect ively from birth and compared with a population -based sample of 101 male and 107 female normal birth weight ( NBW ) controls selected at 8 years old .  Maternal sociodemographic status and infant birth and neonatal data did not differ significantly between male and female VLBW subjects . However , male VLBW subjects had significantly higher rates of rehospitalization during infancy than female VLBW ( 39 % vs 21 % ) . At 20 years , their rates of chronic illness were similar ( 18 % vs 24 % ) . MAIN OUTCOME MEASURES Weight and height z scores were computed at birth , 40 weeks , 8 and 20 months , and 8 and 20 years among the VLBW subjects , and at 8 and 20 years among the NBW controls . Body mass index ( BMI ) z scores were computed at 8 and 20 years . Among the VLBW subjects , gender-specific longitudinal growth measures were examined at birth , at the expected term date ( 40 weeks corrected age ) , and at 8 and 20 months , and 8 and 20 years of age . In addition , we compared the weight , height , and BMI of the VLBW and NBW controls at 8 and 20 years . Predictors of 20-year growth were examined via multivariate analyses . RESULTS Among the VLBW males , mean weight for age z scores at birth , 40 weeks , and 8 years were -0.7 , -1.8 , and -0.5 ; and height for age z scores were -1.2 , -2.6 , and -0.5 , respectively . For VLBW females , mean weight for age z scores were -1.1 , -2.0 , and -0.2 and height for age z scores were -1.2 , -2.4 , and -0.2 , respectively . At 8 years of age , VLBW males had a significantly lower mean weight , height , and BMI than NBW controls , whereas VLBW females differed significantly from their NBW controls in mean weight and BMI but not in height . Catch-up growth in weight , height , and BMI occurred between 8 and 20 years among VLBW females but not among VLBW males who remained significantly smaller than their controls at 20 years old . At 20 years mean weight of VLBW males was 69 kg versus 80 kg for controls ( z score -0.4 vs + 0.5 ) ; mean height was 174 cm versus 177 cm ( z score -0.4 vs + 0.03 ) and mean BMI was 23 versus 26 , respectively . For VLBW females , mean weight was 65 kg versus 68 kg for controls ( z score + 0.3 vs + 0.5 ) , mean height was 162 versus 163 cm ( z score -0.3 vs -0.1 ) and mean BMI was 25 versus 25 , respectively . Rates of obesity ( BMI > 30 ) for VLBW males were 7 % compared with 15 % for controls and for VLBW females 15 % compared with 18 % for controls . Age of menarche was 12.4 years for VLBW females and 12.3 years for controls . Nineteen ( 18 % ) male and 20 ( 22 % ) female VLBW subjects were born small for gestational age ( SGA ; weight less than -2 st and ard deviation for gestational age ) . At 20 years , significantly more SGA than appropriate for gestational age VLBW males remained subnormal ( less than -2 st and ard deviation ) in weight ( 32 % vs 6 % ) and height ( 21 % vs 4 % ) , whereas rates of subnormal growth did not differ significantly between SGA and appropriate for gestational age females ( weight 5 % vs 1 % , height 0 % vs 7 % ) . Predictor variables included in the multivariate analyses of 20-year growth attainment were maternal education and height , race , birth weight z score ( a measure of intrauterine growth failure ) , neonatal hospital stay ( a measure of neonatal illness ) , and chronic illness at 20 years . Twenty-year weight was predicted by black race and chronic illness among females . Twenty-year height was predicted by maternal height and birth weight z score among both males and females and by duration of neonatal hospital stay among males only . In a separate model , when we examined the effect of being SGA at birth instead of the effect of birth weight z score , SGA birth was predictive of 20-year height among males but not among females . CONCLUSIONS VLBW females catch up in growth by 20 years of age whereas VLBW males remain significantly shorter and lighter than controls . Since catch-up growth may be associated with metabolic and cardiovascular risk later in life , these findings may have implication s for the future adult health of VLBW survivors Background and Objectives : Postdischarge formulas with extra energy and protein improve short-term growth but may also influence long-term body composition in an unwanted manner . Energy- and protein-enriched formulas with an increased protein-to-energy ratio improves gain of lean mass . The objective of the study was to investigate whether feeding a nutrient-enriched formula without extra energy after term , usually 3 to 4 weeks after discharge , would influence growth and body composition in infancy . Methods : In this r and omized controlled trial preterm infants were fed fortified human milk or preterm formula until term . At term , 102 infants were r and omized to a nutrient-enriched formula without extra energy or st and ard formula until 6 months corrected age . Twenty-six infants received unfortified human milk after term . At term and 6 months corrected age , anthropometry and a dual-energy x-ray absorptiometry ( DEXA ) scan were performed . Lean and fat mass ( FM ) were corrected for height . Results : There were no differences in growth or body size between the feeding groups . Infants fed the enriched formula gained less FM and had lower FM corrected for body size at 6 months corrected age than infants fed st and ard formula . Infants fed human milk had lower lean mass and higher FM corrected for body size at 6 months corrected age than formula-fed infants . Conclusions : Feeding nutrient-enriched formula without extra energy after term does not change quantity of growth but does influence type of weight gain and body composition of preterm infants . Infants fed the nutrient-enriched formula had lower FM corrected for body size at 6 months corrected age than infants fed st and ard formula or human milk Background Preterm infants are at risk for adverse neurodevelopment . Furthermore , nutrition may play a key role in supporting neurodevelopment . The aim of this study was to evaluate whether a nutrient-enriched formula fed to preterm infants after hospital discharge could improve their neurodevelopment at 24 months ( term-corrected age ) . Methods We conducted an observer-blinded , single-center , r and omized controlled trial in infants admitted to the Fondazione IRCCS Cà Gr and a Ospedale Maggiore Policlinico , University of Milan , Italy between 2009 and 2011 . Inclusion criteria were gestational age < 32 weeks and /or birth weight < 1500 g , and being fed human milk for < 20 % of the total milk intake . Exclusion criteria were congenital malformations or conditions that could interfere with growth or body composition . Included infants were r and omized to  receive a st and ard full-term formula or a nutrient-enriched formula  up until 6 months of corrected age , using two computer-generated r and omization lists ; one appropriate for gestational age ( AGA ) and one for small for gestational age ( SGA ) infants . We assessed neurodevelopment at 24 months of corrected age using the Griffiths Mental Development Scale and related subscales ( locomotor , personal-social , hearing and speech , h and and eye coordination , and performance ) . Results Of the 207 r and omized infants , 181 completed the study . 52 AGA and 35 SGA infants were fed a nutrient-enriched formula , whereas 56 AGA and 38 SGA infants were fed a st and ard full-term formula . The general quotient at 24 months of corrected age was not significantly different between infants r and omized to receive a nutrient-enriched formula compared with a st and ard term formula up until 6 months of corrected age ( AGA infants : 93.8 ± 12.6 vs. 92.4 ± 10.4 , respectively ; SGA infants : 96.1 ± 9.9 vs. 98.2 ± 9 , respectively ) . The scores of related subscales were also similar among groups . Conclusions This study found that feeding preterm infants a nutrient-enriched formula after discharge does not affect neurodevelopment at 24 months of corrected age , in either AGA or SGA infants , free from major comorbidities . Trial registration Current Controlled Trials ( http://www.controlled-trials.com/IS RCT N30189842 ) London , UK BACKGROUND Preterm children are at high risk of poor growth performance . In 2 r and omized trials , preterm infants fed preterm formula grew better in the neonatal period than those fed banked donor breast milk or st and ard term formula . OBJECTIVE Our objective was to test the hypothesis that for preterm infants , the neonatal period is a critical one for programming growth performance and that early diet influences long-term growth . DESIGN A total of 926 preterm infants were recruited into 2 parallel , r and omized trials of neonatal diet . In trial 1 , infants were fed either banked donor breast milk or preterm formula whereas in trial 2 , infants were fed either st and ar 
    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 The association between birthweight and subsequent blood pressure levels  has been considered to provide some of the strongest , and most consistent , support for the " fetal origins " hypothesis of adult disease . It had been estimated that a 1 kg higher birthweight is typically associated with a 2 - 4 mm Hg lower systolic blood pressure . METHODS 55 studies that had reported regression coefficients of systolic blood pressure on birthweight ( with 48 further studies that reported only the direction of this association ) , and seven such studies within twin pairs , were identified . Each study was weighted according to the inverse of the variance of the regression coefficient ( ie , " statistical size " ) , and combined using a " fixed effects " approach . FINDINGS Among the 55 studies that reported regression coefficients , there was a clear trend ( p<0.0001 ) towards weaker associations in the larger studies : -1.9 mm Hg/kg in those with less than about 1000 participants ; -1.5 mm Hg/kg with about 1000 - 3000 participants ; and -0.6 mm Hg/kg with more than 3000 participants . By contrast with the inverse associations reported in 52 of these 55 studies , only 25 of the 48 studies that did not report regression coefficients found an inverse association ( p<0.0001 for heterogeneity ) . Almost all of these regression coefficients had been adjusted for current weight ( whereas few were adjusted for potential confounding factors ) , and removal of this adjustment in the larger studies reduced the estimated association to -0.4 mm Hg/kg . For studies within monozygotic twin pairs , the combined estimate was -0.6 mm Hg/kg with adjustment for current weight , and was also reduced without this adjustment . INTERPRETATION Cl aims of a strong inverse association between birthweight and subsequent blood pressure may chiefly reflect the impact of r and om error , selective emphasis of particular results , and inappropriate adjustment for current weight and for confounding factors . These findings suggest that birthweight is of little relevance to blood pressure levels in later life Our purpose in this study was to examine whole body composition , using dual energy x-ray absorptiometry ( DEXA ) during dietary intervention in preterm infants ( ≤1750 g birthweight , ≤34 wk gestation ) . At discharge , infants were r and omized to be fed either a preterm infant formula ( discharge–6 mo ; group A ) or a term formula ( discharge–6 mo ; group B ) , or the preterm formula ( discharge – term ) and the term formula ( term–6 mo ; group C ) .  Nutrient intake was measured between each clinic visit . To measure body composition , DEXA was used at discharge , term , 12 wk , 6 mo , and 12 mo corrected age . The data were analyzed by ANOVA . At discharge , no differences were noted in patient characteristics between groups A , B , and C. Although energy intakes were similar , protein and mineral intakes differed between groups ( A > C > B;p < 0.0001 ) . During the study , weight gain and LM gain were greater in group A than B. At 12 mo , weight , LM , FM , and BMM but not % FM or BMD were greater in group A than B. However , the effects of diet were confined to boys , with no lasting effects seen in girls . In summary , therefore , DEXA was precise enough to detect differences in whole body composition during dietary intervention . Increased weight gain primarily reflected an increase in LM and is consistent with the idea that the preterm formula more closely met protein and /or protein-energy needs in rapidly growing preterm male infants OBJECTIVE Intrauterine and neonatal growth failure of very low birth weight ( VLBW ; < 1500 g ) infants may influence adult growth attainment and have long-term implication s for adult health . As part of a longitudinal study of VLBW infants , we sought to examine gender-specific changes in growth from birth to 20 years old and to identify the correlates of growth attainment at 20 years old . DESIGN , SETTING , PARTICIPANTS A cohort of 103 male and 92 female VLBW infants who had a mean birth weight of 1189 g and mean gestational age of 29.8 weeks , were born from 1977 through 1979 and treated at Rainbow Babies and Children 's Hospital in Clevel and , Ohio , and were free of neurosensory impairment were followed prospect ively from birth and compared with a population -based sample of 101 male and 107 female normal birth weight ( NBW ) controls selected at 8 years old .  Maternal sociodemographic status and infant birth and neonatal data did not differ significantly between male and female VLBW subjects . However , male VLBW subjects had significantly higher rates of rehospitalization during infancy than female VLBW ( 39 % vs 21 % ) . At 20 years , their rates of chronic illness were similar ( 18 % vs 24 % ) . MAIN OUTCOME MEASURES Weight and height z scores were computed at birth , 40 weeks , 8 and 20 months , and 8 and 20 years among the VLBW subjects , and at 8 and 20 years among the NBW controls . Body mass index ( BMI ) z scores were computed at 8 and 20 years . Among the VLBW subjects , gender-specific longitudinal growth measures were examined at birth , at the expected term date ( 40 weeks corrected age ) , and at 8 and 20 months , and 8 and 20 years of age . In addition , we compared the weight , height , and BMI of the VLBW and NBW controls at 8 and 20 years . Predictors of 20-year growth were examined via multivariate analyses . RESULTS Among the VLBW males , mean weight for age z scores at birth , 40 weeks , and 8 years were -0.7 , -1.8 , and -0.5 ; and height for age z scores were -1.2 , -2.6 , and -0.5 , respectively . For VLBW females , mean weight for age z scores were -1.1 , -2.0 , and -0.2 and height for age z scores were -1.2 , -2.4 , and -0.2 , respectively . At 8 years of age , VLBW males had a significantly lower mean weight , height , and BMI than NBW controls , whereas VLBW females differed significantly from their NBW controls in mean weight and BMI but not in height . Catch-up growth in weight , height , and BMI occurred between 8 and 20 years among VLBW females but not among VLBW males who remained significantly smaller than their controls at 20 years old . At 20 years mean weight of VLBW males was 69 kg versus 80 kg for controls ( z score -0.4 vs + 0.5 ) ; mean height was 174 cm versus 177 cm ( z score -0.4 vs + 0.03 ) and mean BMI was 23 versus 26 , respectively . For VLBW females , mean weight was 65 kg versus 68 kg for controls ( z score + 0.3 vs + 0.5 ) , mean height was 162 versus 163 cm ( z score -0.3 vs -0.1 ) and mean BMI was 25 versus 25 , respectively . Rates of obesity ( BMI > 30 ) for VLBW males were 7 % compared with 15 % for controls and for VLBW females 15 % compared with 18 % for controls . Age of menarche was 12.4 years for VLBW females and 12.3 years for controls . Nineteen ( 18 % ) male and 20 ( 22 % ) female VLBW subjects were born small for gestational age ( SGA ; weight less than -2 st and ard deviation for gestational age ) . At 20 years , significantly more SGA than appropriate for gestational age VLBW males remained subnormal ( less than -2 st and ard deviation ) in weight ( 32 % vs 6 % ) and height ( 21 % vs 4 % ) , whereas rates of subnormal growth did not differ significantly between SGA and appropriate for gestational age females ( weight 5 % vs 1 % , height 0 % vs 7 % ) . Predictor variables included in the multivariate analyses of 20-year growth attainment were maternal education and height , race , birth weight z score ( a measure of intrauterine growth failure ) , neonatal hospital stay ( a measure of neonatal illness ) , and chronic illness at 20 years . Twenty-year weight was predicted by black race and chronic illness among females . Twenty-year height was predicted by maternal height and birth weight z score among both males and females and by duration of neonatal hospital stay among males only . In a separate model , when we examined the effect of being SGA at birth instead of the effect of birth weight z score , SGA birth was predictive of 20-year height among males but not among females . CONCLUSIONS VLBW females catch up in growth by 20 years of age whereas VLBW males remain significantly shorter and lighter than controls . Since catch-up growth may be associated with metabolic and cardiovascular risk later in life , these findings may have implication s for the future adult health of VLBW survivors Background and Objectives : Postdischarge formulas with extra energy and protein improve short-term growth but may also influence long-term body composition in an unwanted manner . Energy- and protein-enriched formulas with an increased protein-to-energy ratio improves gain of lean mass . The objective of the study was to investigate whether feeding a nutrient-enriched formula without extra energy after term , usually 3 to 4 weeks after discharge , would influence growth and body composition in infancy . Methods : In this r and omized controlled trial preterm infants were fed fortified human milk or preterm formula until term . At term , 102 infants were r and omized to a nutrient-enriched formula without extra energy or st and ard formula until 6 months corrected age . Twenty-six infants received unfortified human milk after term . At term and 6 months corrected age , anthropometry and a dual-energy x-ray absorptiometry ( DEXA ) scan were performed . Lean and fat mass ( FM ) were corrected for height . Results : There were no differences in growth or body size between the feeding groups . Infants fed the enriched formula gained less FM and had lower FM corrected for body size at 6 months corrected age than infants fed st and ard formula . Infants fed human milk had lower lean mass and higher FM corrected for body size at 6 months corrected age than formula-fed infants . Conclusions : Feeding nutrient-enriched formula without extra energy after term does not change quantity of growth but does influence type of weight gain and body composition of preterm infants . Infants fed the nutrient-enriched formula had lower FM corrected for body size at 6 months corrected age than infants fed st and ard formula or human milk Background Preterm infants are at risk for adverse neurodevelopment . Furthermore , nutrition may play a key role in supporting neurodevelopment . The aim of this study was to evaluate whether a nutrient-enriched formula fed to preterm infants after hospital discharge could improve their neurodevelopment at 24 months ( term-corrected age ) . Methods We conducted an observer-blinded , single-center , r and omized controlled trial in infants admitted to the Fondazione IRCCS Cà Gr and a Ospedale Maggiore Policlinico , University of Milan , Italy between 2009 and 2011 . Inclusion criteria were gestational age < 32 weeks and /or birth weight < 1500 g , and being fed human milk for < 20 % of the total milk intake . Exclusion criteria were congenital malformations or conditions that could interfere with growth or body composition . Included infants were r and omized to  receive a st and ard full-term formula or a nutrient-enriched formula  up until 6 months of corrected age , using two computer-generated r and omization lists ; one appropriate for gestational age ( AGA ) and one for small for gestational age ( SGA ) infants . We assessed neurodevelopment at 24 months of corrected age using the Griffiths Mental Development Scale and related subscales ( locomotor , personal-social , hearing and speech , h and and eye coordination , and performance ) . Results Of the 207 r and omized infants , 181 completed the study . 52 AGA and 35 SGA infants were fed a nutrient-enriched formula , whereas 56 AGA and 38 SGA infants were fed a st and ard full-term formula . The general quotient at 24 months of corrected age was not significantly different between infants r and omized to receive a nutrient-enriched formula compared with a st and ard term formula up until 6 months of corrected age ( AGA infants : 93.8 ± 12.6 vs. 92.4 ± 10.4 , respectively ; SGA infants : 96.1 ± 9.9 vs. 98.2 ± 9 , respectively ) . The scores of related subscales were also similar among groups . Conclusions This study found that feeding preterm infants a nutrient-enriched formula after discharge does not affect neurodevelopment at 24 months of corrected age , in either AGA or SGA infants , free from major comorbidities . Trial registration Current Controlled Trials ( http://www.controlled-trials.com/IS RCT N30189842 ) London , UK BACKGROUND Preterm children are at high risk of poor growth performance . In 2 r and omized trials , preterm infants fed preterm formula grew better in the neonatal period than those fed banked donor breast milk or st and ard term formula . OBJECTIVE Our objective was to test the hypothesis that for preterm infants , the neonatal period is a critical one for programming growth performance and that early diet influences long-term growth . DESIGN A total of 926 preterm infants were recruited into 2 parallel , r and omized trials of neonatal diet . In trial 1 , infants were fed either banked donor breast milk or preterm formula whereas in trial 2 , infants were fed either st and ar 
    Output:
    