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 Haiti has experienced rapid urbanization that has exacerbated poverty and undernutrition in large slum areas . Stunting affects 1 in 5 young children . OBJECTIVE We aim ed to test the efficacy of a daily lipid-based nutrient supplement ( LNS ) for increased linear growth in  young children . DESIGN Healthy , singleton infants aged 6 - 11 mo ( n = 589 ) were recruited from an urban slum of Cap Haitien and r and omly assigned to receive : 1 ) a control ; 2 ) a 3-mo LNS ; or 3 ) a 6-mo LNS . The LNS provided 108 kcal and other nutrients including vitamin A , vitamin B-12 , iron , and zinc at ≥80 % of the recommended amounts . Infants were followed monthly on growth , morbidity , and developmental outcomes over a 6-mo intervention period and at one additional time point 6 mo postintervention to assess sustained effects . The Bonferroni multiple comparisons test was applied , and generalized least-squares ( GLS ) regressions with mixed effects was used to examine impacts longitudinally . RESULTS Baseline characteristics did not differ by trial arm except for a higher mean age in the 6-mo LNS group . GLS modeling showed LNS supplementation for 6 mo significantly increased the length-for-age z score ( ±SE ) by 0.13 ± 0.05 and the weight-for-age z score by 0.12 ± 0.02 compared with in the control group after adjustment for child age ( P < 0.001 ) . The effects were sustained 6 mo postintervention . Morbidity and developmental outcomes did not differ by trial arm . CONCLUSION A low-energy , fortified product improved the linear growth  of young children in this urban setting . The trial was registered at clinical trials.gov as NCT01552512 OBJECTIVE To determine whether utilization of iron from infant cereal and pureed meat was sufficient to prevent iron depletion and /or anaemia in infants 6 to 12 months old fed whole cow milk ( WCM ) as their primary milk source . DESIGN Six-month-old infants were r and omized into a treatment group ( n = 43 ) receiving iron-fortified infant cereal ( 10.2 mg iron ) , pureed meat ( 0.75 - 1.7 mg iron ) and WCM for six months or a control group ( n = 54 ) receiving no dietary intervention .  Haemoglobin < 110 g/L or ferritin < 10 micrograms/L ( measured bi-monthly ) , confirmed in a second blood sample , defined end-points . RESULTS Proportion reaching end-point was similar between the treatment ( 3/43 ) and control infants ( 5/54 ) ( p = 0.66 ) . Infants not complying with the protocol were at greater risk of reaching end-point ( p = 0.0002 ) . Change in haemoglobin and ferritin across age was similar in both groups . CONCLUSIONS Iron deficiency is not a concern in WCM-fed infants after six months of age if iron-containing complementary foods are concurrently ingested It is unclear whether a substantial decline in malnutrition among infants in developing countries can be achieved by increasing food availability and nutrition counseling without concurrent morbidity-reducing interventions . The study was design ed to determine whether provision of generous amounts of a micronutrient-fortified food supplement supported by counseling or nutritional counseling alone would significantly improve physical growth between 4 and 12 mo of age . In a controlled trial , 418 infants 4 mo of age were individually r and omized to one of the four groups and followed until 12 mo of age . The first group received a milk-based cereal and nutritional counseling ; the second group monthly nutritional counseling alone . To control for the effect of twice-weekly home visits for morbidity ascertainment , similar visits were made in one of the control groups ( visitation group ) ; the fourth group received no intervention . The median energy intake from nonbreast milk sources was higher in the food supplementation group than in the visitation group by 1212 kJ at 26 wk ( P < 0.001 ) , 1739 kJ at 38 wk ( P < 0.001 ) and 2257 kJ at 52 wk ( P < 0.001 ) . The food supplementation infants gained 250 g ( 95 % confidence interval : 20 - -480 g ) more weight than did the visitation group . The difference in the mean increment in length during the study was 0.4 cm ( 95 % confidence interval : -0.1 - -0.9 cm ) . The nutritional counseling group had higher energy intakes ranging from 280 to 752 kJ at different ages ( P < 0.05 at all ages ) but no significant benefit on weight and length increments . Methods to enhance the impact of these interventions need to be identified Does short-term supplementary feeding during infancy and childhood have long-lasting effects ? In 1986 , 334 children aged 6 - 60 mo living on rural tea plantations in West Java , Indonesia , participated in a 3-mo r and omized trial to test the effects of a dietary supplement providing approximately 1672 kJ ( 400 kcal ) energy/d , with about the same nutrient density as local foods . We returned to the same communities in 1994 and enrolled 231 ( 125 supplemented , 106 control ) of the original subjects in a follow-up study of the long-term effects of supplementation . We assessed these subjects by using several measures : anthropometry , iron status , information processing , Peabody Picture Vocabulary Test , word fluency , and an arithmetic test . The supplemented group showed no differences from those in the control group . However , when the analysis was limited to subjects who had received the supplement before the age of 18 mo ( n = 73 ) , the supplemented children performed better than control children on the Sternberg test of working memory ( decision time intercept : probe absent , P = 0.002 ; probe present , P = 0.053 ) . After considering possible confounders , we concluded that the supplementation during infancy was responsible for the difference . This finding shows that supplementation can have long-lasting effects on a specific domain if the child receives it at the appropriate stage of development BACKGROUND Nutritional support is often recommended as part of the treatment of tuberculosis , but it has never been properly tested . OBJECTIVE We assessed the effects of early nutritional intervention on lean mass and physical function in patients with tuberculosis and wasting . DESIGN Patients who started antituberculous therapy within the previous 2 wk were r and omly assigned to receive st and ard nutritional counseling ( control group ) or nutritional counseling to increase their intake through diet and high-energy supplements ( nutritional supplement group ) for 6 wk . Body composition was measured by dual-energy X-ray absorptiometry , and physical function was assessed by maximum grip strength . RESULTS Patients in the nutritional supplement group ( n = 19 ) had a significantly greater increase in body weight ( 2.57 + /- 1.78 compared with 0.84 + /- 0.89 kg , P = 0.001 ) , total lean mass ( 1.17 + /- 0.93 compared with 0.04 + /- 1.26 kg , P = 0.006 ) , and grip strength ( 2.79 + /- 3.11 compared with -0.65 + /- 4.48 kg , P = 0.016 ) than did the control subjects ( n = 17 ) at week 6 . During subsequent follow-up , the increase in body weight remained greater in the nutritional supplement group , but this increase was due mainly to a greater gain in fat mass in the nutritional supplement group than in the control group . CONCLUSIONS Early intervention to increase nutritional intake increases lean mass and physical function . This adjunct to tuberculosis therapy could confer socioeconomic and survival benefits that deserve investigation in large-scale trials . Nutritional intervention after the initial phase of treatment could be less beneficial because it mainly increases fat This study assessed the developmental effects of supplementary feeding over 90 consecutive days on infants aged 6 - 20 mo at six tea plantations in West Java , Indonesia . Every day except Sunday , the infants attended day-care centers distributed throughout the plantations . Twenty centers and 113 infants were selected ; the infants in 9 centers received a dietary supplement , while the infants in 11 centers served as control subjects . Supplements were given twice a day providing , on average , 10.66 kJ ( 400 kcal ) and 5 g protein/d . Measurements of body growth , dietary intake , and mental and motor development were made on all infants . Supplementary feeding had significant effects on weight gain and on motor development . Changes in caloric intake were independently associated with changes in weight and in motor test scores . The data suggest that the effects of the supplement may not have followed a simple mechanistic relationship from intake to weight change to motor development , but , rather , intake may have affected both growth and development domains simultaneously Linear growth retardation and anemia are the most prevalent nutritional problems in the world ; effective interventions are urgently needed . We evaluated Ecuador 's National Food Nutrition Program ( PANN 2000 ) that included a micronutrient-fortified complementary food ( FCF ) , Mi Papilla , in poor periurban and rural communities of Ecuador . The program is preventive and targeted to all infants and young children living in poor communities and receiving government health services . We compared dietary intake , micronutrient status , and growth over 11 mo in a cohort of children from the catchment areas of the PANN 2000 with same-age control children in nearby communities eligible to enter the program 1 y later . PANN 2000 children enrolled in the program when they were age 9 - 14 mo and were age 20 - 25 mo at the final survey . They consumed significantly more energy , protein , fat , iron , zinc , vitamin A , and calcium than control children because of their FCF consumption . Anemia , 76 % in both groups at baseline , fell to 27 % in PANN 2000 children but only to 44 % in control children ( P < 0.001 ) . The odds of being anemic were 58 % lower for PANN 2000 children ( P = 0.003 ) . The effects on linear growth and weight were limited to children who were older when the program began ( 12 - 14 mo ) and were significant for weight ( interaction with age , 0.38 kg ; P = 0.029 ) and positive but not significant for length ( 0.66 cm ; P = 0.08 ) . An FCF , including ferrous sulfate , delivered through public health services , is highly effective in improving weight and hemoglobin and reducing anemia The effect of supplementation on growth was tested by means of four similar controlled r and omized trials in the Congo ( n = 120 ) , Senegal ( n = 110 ) , Bolivia ( n = 127 ) , and New Caledonia ( n = 90 ) . Four-month-old infants were r and omly allocated to supplement or control groups . A cereal-based precooked porridge was offered twice daily for 3 mo and consumption was monitored . Both groups were free to eat local food . At 7 mo of age , all infants were still breast-fed in the Congo , Senegal , and Bolivia compared with 47 % in New Caledonia . Mean daily consumption of the supplement varied among countries ( 558 - 790 kJ/d ) . Mean length at 4 mo was lowest in Bolivia , higher in Senegal and the Congo , and near the National Center for Health Statistics reference in New Caledonia . The mean 4 - 7 mo length increment was 0.48 cm higher for supplemented than for control infants in Senegal ( P < 0.05 ) , whereas weight increments did not differ . No significant effect was found in the other countries It is not known whether nutritional supplementation in early childhood has long-term benefits on  stunted children 's mental development . We followed up 127 7 - 8-y old children who had been stunted in early childhood and received supplementation , stimulation , or both .  At 9 - 24 mo of age , the children had been r and omly assigned to four treatment groups : nutritional supplementation , stimulation , both treatments , and control . After 2 y , supplementation and stimulation had independent benefits on the children 's development and the effects were additive . The group receiving both treatments caught up to a matched group of 32 nonstunted children . Four years after the end of the 2-y intervention 97 % of the children were given a battery of cognitive function , school achievement , and fine motor tests .  An additional 52 nonstunted children were included . Factor analyses of the test scores produced three factors : general cognitive , perceptual-motor , and memory . One , the perceptual-motor factor , showed a significant benefit from stimulation , and supplementation benefited only those children whose mothers had higher verbal intelligence quotients . However , each intervention group had higher scores than the control subjects on more tests than would be expected by chance ( supplemented and both groups on 14 of 15 tests , P = 0.002 ; stimulated group in 13 of 15 tests , P = 0.01 ) , suggesting a very small global benefit . There was no longer an additive effect of combined treatments at the end of the intervention . The stunted control group had significantly lower scores than the nonstunted children on most tests . Stunted children 's heights and head circumferences on enrollment significantly predicted intelligence quotient at follow-up OBJECTIVE To investigate the effects of nutritional supp 
    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 Haiti has experienced rapid urbanization that has exacerbated poverty and undernutrition in large slum areas . Stunting affects 1 in 5 young children . OBJECTIVE We aim ed to test the efficacy of a daily lipid-based nutrient supplement ( LNS ) for increased linear growth in  young children . DESIGN Healthy , singleton infants aged 6 - 11 mo ( n = 589 ) were recruited from an urban slum of Cap Haitien and r and omly assigned to receive : 1 ) a control ; 2 ) a 3-mo LNS ; or 3 ) a 6-mo LNS . The LNS provided 108 kcal and other nutrients including vitamin A , vitamin B-12 , iron , and zinc at ≥80 % of the recommended amounts . Infants were followed monthly on growth , morbidity , and developmental outcomes over a 6-mo intervention period and at one additional time point 6 mo postintervention to assess sustained effects . The Bonferroni multiple comparisons test was applied , and generalized least-squares ( GLS ) regressions with mixed effects was used to examine impacts longitudinally . RESULTS Baseline characteristics did not differ by trial arm except for a higher mean age in the 6-mo LNS group . GLS modeling showed LNS supplementation for 6 mo significantly increased the length-for-age z score ( ±SE ) by 0.13 ± 0.05 and the weight-for-age z score by 0.12 ± 0.02 compared with in the control group after adjustment for child age ( P < 0.001 ) . The effects were sustained 6 mo postintervention . Morbidity and developmental outcomes did not differ by trial arm . CONCLUSION A low-energy , fortified product improved the linear growth  of young children in this urban setting . The trial was registered at clinical trials.gov as NCT01552512 OBJECTIVE To determine whether utilization of iron from infant cereal and pureed meat was sufficient to prevent iron depletion and /or anaemia in infants 6 to 12 months old fed whole cow milk ( WCM ) as their primary milk source . DESIGN Six-month-old infants were r and omized into a treatment group ( n = 43 ) receiving iron-fortified infant cereal ( 10.2 mg iron ) , pureed meat ( 0.75 - 1.7 mg iron ) and WCM for six months or a control group ( n = 54 ) receiving no dietary intervention .  Haemoglobin < 110 g/L or ferritin < 10 micrograms/L ( measured bi-monthly ) , confirmed in a second blood sample , defined end-points . RESULTS Proportion reaching end-point was similar between the treatment ( 3/43 ) and control infants ( 5/54 ) ( p = 0.66 ) . Infants not complying with the protocol were at greater risk of reaching end-point ( p = 0.0002 ) . Change in haemoglobin and ferritin across age was similar in both groups . CONCLUSIONS Iron deficiency is not a concern in WCM-fed infants after six months of age if iron-containing complementary foods are concurrently ingested It is unclear whether a substantial decline in malnutrition among infants in developing countries can be achieved by increasing food availability and nutrition counseling without concurrent morbidity-reducing interventions . The study was design ed to determine whether provision of generous amounts of a micronutrient-fortified food supplement supported by counseling or nutritional counseling alone would significantly improve physical growth between 4 and 12 mo of age . In a controlled trial , 418 infants 4 mo of age were individually r and omized to one of the four groups and followed until 12 mo of age . The first group received a milk-based cereal and nutritional counseling ; the second group monthly nutritional counseling alone . To control for the effect of twice-weekly home visits for morbidity ascertainment , similar visits were made in one of the control groups ( visitation group ) ; the fourth group received no intervention . The median energy intake from nonbreast milk sources was higher in the food supplementation group than in the visitation group by 1212 kJ at 26 wk ( P < 0.001 ) , 1739 kJ at 38 wk ( P < 0.001 ) and 2257 kJ at 52 wk ( P < 0.001 ) . The food supplementation infants gained 250 g ( 95 % confidence interval : 20 - -480 g ) more weight than did the visitation group . The difference in the mean increment in length during the study was 0.4 cm ( 95 % confidence interval : -0.1 - -0.9 cm ) . The nutritional counseling group had higher energy intakes ranging from 280 to 752 kJ at different ages ( P < 0.05 at all ages ) but no significant benefit on weight and length increments . Methods to enhance the impact of these interventions need to be identified Does short-term supplementary feeding during infancy and childhood have long-lasting effects ? In 1986 , 334 children aged 6 - 60 mo living on rural tea plantations in West Java , Indonesia , participated in a 3-mo r and omized trial to test the effects of a dietary supplement providing approximately 1672 kJ ( 400 kcal ) energy/d , with about the same nutrient density as local foods . We returned to the same communities in 1994 and enrolled 231 ( 125 supplemented , 106 control ) of the original subjects in a follow-up study of the long-term effects of supplementation . We assessed these subjects by using several measures : anthropometry , iron status , information processing , Peabody Picture Vocabulary Test , word fluency , and an arithmetic test . The supplemented group showed no differences from those in the control group . However , when the analysis was limited to subjects who had received the supplement before the age of 18 mo ( n = 73 ) , the supplemented children performed better than control children on the Sternberg test of working memory ( decision time intercept : probe absent , P = 0.002 ; probe present , P = 0.053 ) . After considering possible confounders , we concluded that the supplementation during infancy was responsible for the difference . This finding shows that supplementation can have long-lasting effects on a specific domain if the child receives it at the appropriate stage of development BACKGROUND Nutritional support is often recommended as part of the treatment of tuberculosis , but it has never been properly tested . OBJECTIVE We assessed the effects of early nutritional intervention on lean mass and physical function in patients with tuberculosis and wasting . DESIGN Patients who started antituberculous therapy within the previous 2 wk were r and omly assigned to receive st and ard nutritional counseling ( control group ) or nutritional counseling to increase their intake through diet and high-energy supplements ( nutritional supplement group ) for 6 wk . Body composition was measured by dual-energy X-ray absorptiometry , and physical function was assessed by maximum grip strength . RESULTS Patients in the nutritional supplement group ( n = 19 ) had a significantly greater increase in body weight ( 2.57 + /- 1.78 compared with 0.84 + /- 0.89 kg , P = 0.001 ) , total lean mass ( 1.17 + /- 0.93 compared with 0.04 + /- 1.26 kg , P = 0.006 ) , and grip strength ( 2.79 + /- 3.11 compared with -0.65 + /- 4.48 kg , P = 0.016 ) than did the control subjects ( n = 17 ) at week 6 . During subsequent follow-up , the increase in body weight remained greater in the nutritional supplement group , but this increase was due mainly to a greater gain in fat mass in the nutritional supplement group than in the control group . CONCLUSIONS Early intervention to increase nutritional intake increases lean mass and physical function . This adjunct to tuberculosis therapy could confer socioeconomic and survival benefits that deserve investigation in large-scale trials . Nutritional intervention after the initial phase of treatment could be less beneficial because it mainly increases fat This study assessed the developmental effects of supplementary feeding over 90 consecutive days on infants aged 6 - 20 mo at six tea plantations in West Java , Indonesia . Every day except Sunday , the infants attended day-care centers distributed throughout the plantations . Twenty centers and 113 infants were selected ; the infants in 9 centers received a dietary supplement , while the infants in 11 centers served as control subjects . Supplements were given twice a day providing , on average , 10.66 kJ ( 400 kcal ) and 5 g protein/d . Measurements of body growth , dietary intake , and mental and motor development were made on all infants . Supplementary feeding had significant effects on weight gain and on motor development . Changes in caloric intake were independently associated with changes in weight and in motor test scores . The data suggest that the effects of the supplement may not have followed a simple mechanistic relationship from intake to weight change to motor development , but , rather , intake may have affected both growth and development domains simultaneously Linear growth retardation and anemia are the most prevalent nutritional problems in the world ; effective interventions are urgently needed . We evaluated Ecuador 's National Food Nutrition Program ( PANN 2000 ) that included a micronutrient-fortified complementary food ( FCF ) , Mi Papilla , in poor periurban and rural communities of Ecuador . The program is preventive and targeted to all infants and young children living in poor communities and receiving government health services . We compared dietary intake , micronutrient status , and growth over 11 mo in a cohort of children from the catchment areas of the PANN 2000 with same-age control children in nearby communities eligible to enter the program 1 y later . PANN 2000 children enrolled in the program when they were age 9 - 14 mo and were age 20 - 25 mo at the final survey . They consumed significantly more energy , protein , fat , iron , zinc , vitamin A , and calcium than control children because of their FCF consumption . Anemia , 76 % in both groups at baseline , fell to 27 % in PANN 2000 children but only to 44 % in control children ( P < 0.001 ) . The odds of being anemic were 58 % lower for PANN 2000 children ( P = 0.003 ) . The effects on linear growth and weight were limited to children who were older when the program began ( 12 - 14 mo ) and were significant for weight ( interaction with age , 0.38 kg ; P = 0.029 ) and positive but not significant for length ( 0.66 cm ; P = 0.08 ) . An FCF , including ferrous sulfate , delivered through public health services , is highly effective in improving weight and hemoglobin and reducing anemia The effect of supplementation on growth was tested by means of four similar controlled r and omized trials in the Congo ( n = 120 ) , Senegal ( n = 110 ) , Bolivia ( n = 127 ) , and New Caledonia ( n = 90 ) . Four-month-old infants were r and omly allocated to supplement or control groups . A cereal-based precooked porridge was offered twice daily for 3 mo and consumption was monitored . Both groups were free to eat local food . At 7 mo of age , all infants were still breast-fed in the Congo , Senegal , and Bolivia compared with 47 % in New Caledonia . Mean daily consumption of the supplement varied among countries ( 558 - 790 kJ/d ) . Mean length at 4 mo was lowest in Bolivia , higher in Senegal and the Congo , and near the National Center for Health Statistics reference in New Caledonia . The mean 4 - 7 mo length increment was 0.48 cm higher for supplemented than for control infants in Senegal ( P < 0.05 ) , whereas weight increments did not differ . No significant effect was found in the other countries It is not known whether nutritional supplementation in early childhood has long-term benefits on  stunted children 's mental development . We followed up 127 7 - 8-y old children who had been stunted in early childhood and received supplementation , stimulation , or both .  At 9 - 24 mo of age , the children had been r and omly assigned to four treatment groups : nutritional supplementation , stimulation , both treatments , and control . After 2 y , supplementation and stimulation had independent benefits on the children 's development and the effects were additive . The group receiving both treatments caught up to a matched group of 32 nonstunted children . Four years after the end of the 2-y intervention 97 % of the children were given a battery of cognitive function , school achievement , and fine motor tests .  An additional 52 nonstunted children were included . Factor analyses of the test scores produced three factors : general cognitive , perceptual-motor , and memory . One , the perceptual-motor factor , showed a significant benefit from stimulation , and supplementation benefited only those children whose mothers had higher verbal intelligence quotients . However , each intervention group had higher scores than the control subjects on more tests than would be expected by chance ( supplemented and both groups on 14 of 15 tests , P = 0.002 ; stimulated group in 13 of 15 tests , P = 0.01 ) , suggesting a very small global benefit . There was no longer an additive effect of combined treatments at the end of the intervention . The stunted control group had significantly lower scores than the nonstunted children on most tests . Stunted children 's heights and head circumferences on enrollment significantly predicted intelligence quotient at follow-up OBJECTIVE To investigate the effects of nutritional supp 
    Output:
    