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 effect of nasogastric feeding with high- and low-fat , peptide-based diets on body composition and disease activity was studied in adolescents with active Crohn 's disease . METHODS Fourteen patients with active Crohn 's disease ( 12 to 17 years ) were fed exclusively through nasogastric feedings with two isocaloric , isonitrogenous , peptide-based diets , either with low- or high-fat content , for 3 weeks each in a r and omized manner then were " crossed over " to the other diet for another 3 weeks of feeding . At the end of each 3-week period , urine and stools were collected for 72 hours for measuring energy absorption and nitrogen utilization ( n = 6 ) . Weight , height , triceps skin folds , fat free body mass , and disease activity were also monitored ( n = 14 ) . RESULTS There was no difference in any parameter of energy absorption or nitrogen utilization between the two formulas irrespective of the order in which they were administered . The changes in nutritional parameters were also comparable with both formulas . There was a significant increase in weight , fat free body mass and triceps skinfold thickness during both the 3-week periods of feeding ( p < .05 ) . This was accompanied by a significant reduction in the pediatric Crohn 's disease activity index ( p < .05 ) . CONCLUSIONS Peptide-based diets may be useful in restoring the fat free body mass and improving the disease activity in patients with Crohn 's disease . A high fat ( high medium-chain triglycerides ) diet did not offer any nutritional advantage over a similar but low-fat diet . The improvement in disease activity during feeding with a low-fat diet was comparable to that with a high-fat diet . The improvement in disease activity seems to be associated with improvement in lean body mass irrespective of the type of diet used to achieve it BACKGROUND & AIMS N-3 fatty acids from fish oil , antioxidants , and short-chain fatty acids ( SCFAs ) produced during the fermentation of soluble fiber may attenuate inflammation associated with ulcerative colitis ( UC ) . We assessed the efficacy of a nutritionally balanced oral supplement enriched with fish oil , fructooligosaccharides , gum arabic , vitamin E , vitamin C , and selenium on disease activity and medication use in adults with mild to moderate UC . METHODS A total of 121 patients with UC and a disease activity index ( DAI ) from 3 - 9 on a 12-point scale were block r and omized for extent of disease and smoking status . In addition to their usual diet , patients consumed 18 oz of the oral supplement or a carbohydrate-based placebo formula each day for 6 months . Clinical and histologic responses were assessed at 3 and 6 months or at the final visit . A change in average prednisone use between groups was tested by using a linear mixed-effects model . RESULTS Eighty-six patients completed the study . Baseline characteristics were not different between groups except for a higher total DAI score in the oral supplement group ( 7.3 + /- 1.3 ; n = 36 ) compared with the placebo group ( 6.2 + /- 2.0 ; n = 50 ) ( P < .05 ) . Both groups showed significant and similar degree of improvement at 6 months in DAI ( -2.5 for oral supplement and -2.8 for placebo ) and histologic index ( -1.9 for oral supplement vs. -2.0 for placebo ) . Both intent-to-treat and completed patients given oral supplement had a significantly greater rate of decrease in the dose of prednisone required to control clinical symptoms over 6 months as compared with the placebo group ( P < .001 ) . CONCLUSIONS The improvement in clinical response combined with a decreased requirement for corticosteroids suggest that this enriched oral supplement can be a useful adjuvant therapy in patients with UC BACKGROUND Patients with Crohn 's disease may have periods of remission , interrupted by relapses . Because fish oil has antiinflammatory actions , it could reduce the frequency of relapses , but it is often poorly tolerated because of its unpleasant taste and gastrointestinal side effects . METHODS We performed a one-year , double-blind , placebo-controlled study to investigate the effects of a new fish-oil preparation in the maintenance of remission in 78 patients with Crohn 's disease who had a high risk of relapse . The patients received either nine fish-oil capsules containing a total of 2.7 g of n-3 fatty acids or nine placebo capsules daily . A special coating protected the capsules against gastric acidity for at least 30 minutes . RESULTS Among the 39 patients in the fish-oil group , 11 ( 28 percent ) had relapses , 4 dropped out because of diarrhea , and 1 withdrew for other reasons . In contrast , among the 39 patients in the placebo group , 27 ( 69 percent ) had relapses , 1 dropped out because of diarrhea , and 1 withdrew for other reasons ( difference in relapse rate , 41 percentage points ; 95 percent confidence interval , 21 to 61 ; P < 0.001 ) . After one year , 23 patients ( 59 percent ) in the fish-oil group remained in remission , as compared with 10 ( 26 percent ) in the placebo group ( P = 0.003 ) . Logistic-regression analysis indicated that only fish oil and not sex , age , previous surgery , duration of disease , or smoking status affected the likelihood of relapse ( odds ratio for the placebo group as compared with the fish-oil group , 4.2 ; 95 percent confidence interval , 1.6 to 10.7 ) . CONCLUSIONS In patients with Crohn 's disease in remission , a novel enteric-coated fish-oil preparation is effective in reducing the rate of relapse The effect of fish oil on the course of ulcerative colitis was investigated in a r and omised blinded controlled study . Eighty seven patients received supplements of 20 ml  HiEPA fish oil as triglyceride ( 4.5 g of eicosapentaenoic acid ) or olive oil placebo daily for one year . The oils were given in addition to st and ard drug therapy and trial entry was stratified for disease activity . Fish oil significantly increased the eicosapentaenoic acid content of rectal mucosa to 3.2 % of total fatty acids at six months , compared with 0.63 % for patients on olive oil . This was associated with increased synthesis of leukotriene B5 , and 53 % suppression of leukotriene B4 synthesis by ionophore -- stimulated neutrophils . Leukotriene B4 suppression persisted for at least two months after treatment was stopped . Treatment with fish oil result ed in measurable , but only limited clinical benefit . For patients entering the trial in relapse ( n = 53 ) , there was a significant reduction in corticosteroid requirement after one and two months treatment . There was a trend towards achieving remission ( off corticosteroids ) faster in the patients on fish oil , although differences were not significant . For patients in remission at trial entry or during the trial ( n = 69 ) , there was no significant difference in the rate of relapse by log rank analysis . We conclude that fish oil supplementation produces a modest corticosteroid sparing effect in active disease , but there is no benefit in maintenance therapy Crohn 's disease is associated with altered bone turnover that may be influenced by nutritional status , the systemic inflammatory response , cytokine production by circulating ( peripheral blood ) mononuclear cells ( P BMC ) and antioxidant micronutrient intake . High-dose fish oil is associated with reductions in disease relapse and inflammatory markers , and modulates P BMC function . The effect of fish oil plus antioxidants on bone turnover and P BMC function ( the production of interferon-gamma and prostagl and in E2 ) in Crohn 's disease was investigated in a r and omised-controlled trial . Patients with currently or recently raised biochemical markers of inflammation ( C-reactive protein > or = 6.9 mg/l or erythrocyte sedimentation rate > or = 18 mm/h ) received fish oil ( providing 2.7 g/d EPA and DHA ) and antioxidants ( vitamins A , C and E , and Se ) ( n 31 ) or placebo ( n 30 ) for 24 weeks . Bone turnover was assessed by measuring the concentrations of urinary deoxypyridinoline ( bone resorption ) and serum osteocalcin ( bone formation ) .  Fish oil plus antioxidants were associated with increases in EPA , DHA Se in plasma ( all P < 0.01 ) , and with a reduction in interferon-gamma production by mitogen-stimulated P BMC , which demonstrated a negative correlation with deoxypyridinoline/creatinine : osteocalcin ratio ( r - 0.33 , P = 0.009 ) . There were no differences between the groups at 24 weeks in the response of deoxypyridinoline or osteocalcin or their ratio , or in nutritional status . Dietary supplementation in Crohn 's disease with high intakes of EPA and DHA , as fish oil , plus antioxidants was associated with a modulated production of interferon-gamma by P BMC but not altered indices of bone turnover After administering the equivalent of 1 g of eicosapentaenoic acid ( EPA ) in four different chemical forms , the kinetics of EPA incorporation into plasma triglycerides ( TG ) were compared by gas liquid chromatography on a capillary column following separation of the lipid fraction by thin layer chromatography . EPA incorporation into plasma TG was markedly smaller and later when EPA was administered as an ethyl ester rather than as EPA free fatty acid , EPA arginine salt or 1,3-dioctanoyl-2-eicosapentaenoyl glycerol ( 2-EPA ) . Our results and the data in the literature are compatible with the hypothesis that 2-EPA is absorbed with minimum hydrolysis and escapes r and om distribution between the other positions of the glycerol molecule during the absorption process BACKGROUND Crohn disease ( CD ) is associated with osteoporosis and other extraintestinal manifestations that might be mediated by cytokines from circulating ( peripheral blood ) mononuclear cells ( P BMC s ) . Fish oil rich in eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ) reduces disease activity in patients with CD with raised laboratory markers of inflammation and in healthy subjects alters P BMC function . OBJECTIVE We investigated the effect of fish oil plus antioxidants on cytokine production by P BMC s from patients with CD with raised C-reactive protein concentrations ( > /=6.9 mg/L ) or erythrocyte sedimentation rates ( > /=18 mm/h ) . DESIGN A r and omized placebo-controlled trial of fish oil ( 2.7 g EPA and DHA/d ; n = 31 ) or placebo ( olive oil ; n = 31 ) for 24 wk was conducted in patients with CD . The fish-oil group additionally received an antioxidant preparation ( vitamins A , C , and E and selenium ) . Exclusion criteria included corticosteroid use . Fatty acid composition was measured by gas chromatography . Production of tumor necrosis factor alpha , interferon gamma ( IFN-gamma ) , and prostagl and in E(2 ) ( PGE(2 ) ) was measured by enzyme-linked immunosorbent assays after stimulation with mitogen and endotoxin ( lipopolysaccharide ) . RESULTS Fish-oil plus antioxidant dietary supplementation was associated with higher EPA and DHA incorporation into P BMC s ( P < 0.001 ) and lower arachidonic acid ( P = 0.006 ) and lower production of IFN-gamma by mitogen-stimulated P BMC s ( P = 0.012 ) and of PGE(2 ) by lipopolysaccharide-stimulated P BMC s ( P = 0.047 ) . CONCLUSION Dietary supplementation with fish oil plus antioxidants is associated with modified P BMC composition and lower production of PGE(2 ) and IFN-gamma by circulating monocytes or macrophages . The response of extraintestinal manifestations of CD should be investigated in a r and omized controlled trial Enteral nutrition has a primary therapeutic effect in active Crohn 's disease . It is unknown which nutrient(s ) account for this action , but a role for both the amount and type of dietary fat has been postulated . Some clinical and experimental data suggest that medium-chain triglycerides ( MCT ) may reduce intestinal inflammation . We aim ed to assess the effect of replacing part of the dietary fat with MCT on the incidence and severity of colitis in interleukin (IL)-10(-/- ) mice under specific pathogen-free conditions . Twenty-four IL-10(-/- ) 4-wk-old mice were r and omized to receive a control diet based on sunflower oil [ ( n-6 ) fatty acids ( FA ) ] and an experimental isocaloric , isonitrogenous diet with 50 % sunflower and 50 % coconut oil ( MCT diet ) . When the mice were 12 wk old , they were killed and the colon was examined for the presence of colitis , lymphocyte sub population s and apoptosis , ex vivo cytokine production in supernatant of colon explants , toll-like receptor (TLR)-2 and TLR-9 mRNA , and FA profile in colonic tissue homogenates . Colitis incidence was lower in the IL 
    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 effect of nasogastric feeding with high- and low-fat , peptide-based diets on body composition and disease activity was studied in adolescents with active Crohn 's disease . METHODS Fourteen patients with active Crohn 's disease ( 12 to 17 years ) were fed exclusively through nasogastric feedings with two isocaloric , isonitrogenous , peptide-based diets , either with low- or high-fat content , for 3 weeks each in a r and omized manner then were " crossed over " to the other diet for another 3 weeks of feeding . At the end of each 3-week period , urine and stools were collected for 72 hours for measuring energy absorption and nitrogen utilization ( n = 6 ) . Weight , height , triceps skin folds , fat free body mass , and disease activity were also monitored ( n = 14 ) . RESULTS There was no difference in any parameter of energy absorption or nitrogen utilization between the two formulas irrespective of the order in which they were administered . The changes in nutritional parameters were also comparable with both formulas . There was a significant increase in weight , fat free body mass and triceps skinfold thickness during both the 3-week periods of feeding ( p < .05 ) . This was accompanied by a significant reduction in the pediatric Crohn 's disease activity index ( p < .05 ) . CONCLUSIONS Peptide-based diets may be useful in restoring the fat free body mass and improving the disease activity in patients with Crohn 's disease . A high fat ( high medium-chain triglycerides ) diet did not offer any nutritional advantage over a similar but low-fat diet . The improvement in disease activity during feeding with a low-fat diet was comparable to that with a high-fat diet . The improvement in disease activity seems to be associated with improvement in lean body mass irrespective of the type of diet used to achieve it BACKGROUND & AIMS N-3 fatty acids from fish oil , antioxidants , and short-chain fatty acids ( SCFAs ) produced during the fermentation of soluble fiber may attenuate inflammation associated with ulcerative colitis ( UC ) . We assessed the efficacy of a nutritionally balanced oral supplement enriched with fish oil , fructooligosaccharides , gum arabic , vitamin E , vitamin C , and selenium on disease activity and medication use in adults with mild to moderate UC . METHODS A total of 121 patients with UC and a disease activity index ( DAI ) from 3 - 9 on a 12-point scale were block r and omized for extent of disease and smoking status . In addition to their usual diet , patients consumed 18 oz of the oral supplement or a carbohydrate-based placebo formula each day for 6 months . Clinical and histologic responses were assessed at 3 and 6 months or at the final visit . A change in average prednisone use between groups was tested by using a linear mixed-effects model . RESULTS Eighty-six patients completed the study . Baseline characteristics were not different between groups except for a higher total DAI score in the oral supplement group ( 7.3 + /- 1.3 ; n = 36 ) compared with the placebo group ( 6.2 + /- 2.0 ; n = 50 ) ( P < .05 ) . Both groups showed significant and similar degree of improvement at 6 months in DAI ( -2.5 for oral supplement and -2.8 for placebo ) and histologic index ( -1.9 for oral supplement vs. -2.0 for placebo ) . Both intent-to-treat and completed patients given oral supplement had a significantly greater rate of decrease in the dose of prednisone required to control clinical symptoms over 6 months as compared with the placebo group ( P < .001 ) . CONCLUSIONS The improvement in clinical response combined with a decreased requirement for corticosteroids suggest that this enriched oral supplement can be a useful adjuvant therapy in patients with UC BACKGROUND Patients with Crohn 's disease may have periods of remission , interrupted by relapses . Because fish oil has antiinflammatory actions , it could reduce the frequency of relapses , but it is often poorly tolerated because of its unpleasant taste and gastrointestinal side effects . METHODS We performed a one-year , double-blind , placebo-controlled study to investigate the effects of a new fish-oil preparation in the maintenance of remission in 78 patients with Crohn 's disease who had a high risk of relapse . The patients received either nine fish-oil capsules containing a total of 2.7 g of n-3 fatty acids or nine placebo capsules daily . A special coating protected the capsules against gastric acidity for at least 30 minutes . RESULTS Among the 39 patients in the fish-oil group , 11 ( 28 percent ) had relapses , 4 dropped out because of diarrhea , and 1 withdrew for other reasons . In contrast , among the 39 patients in the placebo group , 27 ( 69 percent ) had relapses , 1 dropped out because of diarrhea , and 1 withdrew for other reasons ( difference in relapse rate , 41 percentage points ; 95 percent confidence interval , 21 to 61 ; P < 0.001 ) . After one year , 23 patients ( 59 percent ) in the fish-oil group remained in remission , as compared with 10 ( 26 percent ) in the placebo group ( P = 0.003 ) . Logistic-regression analysis indicated that only fish oil and not sex , age , previous surgery , duration of disease , or smoking status affected the likelihood of relapse ( odds ratio for the placebo group as compared with the fish-oil group , 4.2 ; 95 percent confidence interval , 1.6 to 10.7 ) . CONCLUSIONS In patients with Crohn 's disease in remission , a novel enteric-coated fish-oil preparation is effective in reducing the rate of relapse The effect of fish oil on the course of ulcerative colitis was investigated in a r and omised blinded controlled study . Eighty seven patients received supplements of 20 ml  HiEPA fish oil as triglyceride ( 4.5 g of eicosapentaenoic acid ) or olive oil placebo daily for one year . The oils were given in addition to st and ard drug therapy and trial entry was stratified for disease activity . Fish oil significantly increased the eicosapentaenoic acid content of rectal mucosa to 3.2 % of total fatty acids at six months , compared with 0.63 % for patients on olive oil . This was associated with increased synthesis of leukotriene B5 , and 53 % suppression of leukotriene B4 synthesis by ionophore -- stimulated neutrophils . Leukotriene B4 suppression persisted for at least two months after treatment was stopped . Treatment with fish oil result ed in measurable , but only limited clinical benefit . For patients entering the trial in relapse ( n = 53 ) , there was a significant reduction in corticosteroid requirement after one and two months treatment . There was a trend towards achieving remission ( off corticosteroids ) faster in the patients on fish oil , although differences were not significant . For patients in remission at trial entry or during the trial ( n = 69 ) , there was no significant difference in the rate of relapse by log rank analysis . We conclude that fish oil supplementation produces a modest corticosteroid sparing effect in active disease , but there is no benefit in maintenance therapy Crohn 's disease is associated with altered bone turnover that may be influenced by nutritional status , the systemic inflammatory response , cytokine production by circulating ( peripheral blood ) mononuclear cells ( P BMC ) and antioxidant micronutrient intake . High-dose fish oil is associated with reductions in disease relapse and inflammatory markers , and modulates P BMC function . The effect of fish oil plus antioxidants on bone turnover and P BMC function ( the production of interferon-gamma and prostagl and in E2 ) in Crohn 's disease was investigated in a r and omised-controlled trial . Patients with currently or recently raised biochemical markers of inflammation ( C-reactive protein > or = 6.9 mg/l or erythrocyte sedimentation rate > or = 18 mm/h ) received fish oil ( providing 2.7 g/d EPA and DHA ) and antioxidants ( vitamins A , C and E , and Se ) ( n 31 ) or placebo ( n 30 ) for 24 weeks . Bone turnover was assessed by measuring the concentrations of urinary deoxypyridinoline ( bone resorption ) and serum osteocalcin ( bone formation ) .  Fish oil plus antioxidants were associated with increases in EPA , DHA Se in plasma ( all P < 0.01 ) , and with a reduction in interferon-gamma production by mitogen-stimulated P BMC , which demonstrated a negative correlation with deoxypyridinoline/creatinine : osteocalcin ratio ( r - 0.33 , P = 0.009 ) . There were no differences between the groups at 24 weeks in the response of deoxypyridinoline or osteocalcin or their ratio , or in nutritional status . Dietary supplementation in Crohn 's disease with high intakes of EPA and DHA , as fish oil , plus antioxidants was associated with a modulated production of interferon-gamma by P BMC but not altered indices of bone turnover After administering the equivalent of 1 g of eicosapentaenoic acid ( EPA ) in four different chemical forms , the kinetics of EPA incorporation into plasma triglycerides ( TG ) were compared by gas liquid chromatography on a capillary column following separation of the lipid fraction by thin layer chromatography . EPA incorporation into plasma TG was markedly smaller and later when EPA was administered as an ethyl ester rather than as EPA free fatty acid , EPA arginine salt or 1,3-dioctanoyl-2-eicosapentaenoyl glycerol ( 2-EPA ) . Our results and the data in the literature are compatible with the hypothesis that 2-EPA is absorbed with minimum hydrolysis and escapes r and om distribution between the other positions of the glycerol molecule during the absorption process BACKGROUND Crohn disease ( CD ) is associated with osteoporosis and other extraintestinal manifestations that might be mediated by cytokines from circulating ( peripheral blood ) mononuclear cells ( P BMC s ) . Fish oil rich in eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ) reduces disease activity in patients with CD with raised laboratory markers of inflammation and in healthy subjects alters P BMC function . OBJECTIVE We investigated the effect of fish oil plus antioxidants on cytokine production by P BMC s from patients with CD with raised C-reactive protein concentrations ( > /=6.9 mg/L ) or erythrocyte sedimentation rates ( > /=18 mm/h ) . DESIGN A r and omized placebo-controlled trial of fish oil ( 2.7 g EPA and DHA/d ; n = 31 ) or placebo ( olive oil ; n = 31 ) for 24 wk was conducted in patients with CD . The fish-oil group additionally received an antioxidant preparation ( vitamins A , C , and E and selenium ) . Exclusion criteria included corticosteroid use . Fatty acid composition was measured by gas chromatography . Production of tumor necrosis factor alpha , interferon gamma ( IFN-gamma ) , and prostagl and in E(2 ) ( PGE(2 ) ) was measured by enzyme-linked immunosorbent assays after stimulation with mitogen and endotoxin ( lipopolysaccharide ) . RESULTS Fish-oil plus antioxidant dietary supplementation was associated with higher EPA and DHA incorporation into P BMC s ( P < 0.001 ) and lower arachidonic acid ( P = 0.006 ) and lower production of IFN-gamma by mitogen-stimulated P BMC s ( P = 0.012 ) and of PGE(2 ) by lipopolysaccharide-stimulated P BMC s ( P = 0.047 ) . CONCLUSION Dietary supplementation with fish oil plus antioxidants is associated with modified P BMC composition and lower production of PGE(2 ) and IFN-gamma by circulating monocytes or macrophages . The response of extraintestinal manifestations of CD should be investigated in a r and omized controlled trial Enteral nutrition has a primary therapeutic effect in active Crohn 's disease . It is unknown which nutrient(s ) account for this action , but a role for both the amount and type of dietary fat has been postulated . Some clinical and experimental data suggest that medium-chain triglycerides ( MCT ) may reduce intestinal inflammation . We aim ed to assess the effect of replacing part of the dietary fat with MCT on the incidence and severity of colitis in interleukin (IL)-10(-/- ) mice under specific pathogen-free conditions . Twenty-four IL-10(-/- ) 4-wk-old mice were r and omized to receive a control diet based on sunflower oil [ ( n-6 ) fatty acids ( FA ) ] and an experimental isocaloric , isonitrogenous diet with 50 % sunflower and 50 % coconut oil ( MCT diet ) . When the mice were 12 wk old , they were killed and the colon was examined for the presence of colitis , lymphocyte sub population s and apoptosis , ex vivo cytokine production in supernatant of colon explants , toll-like receptor (TLR)-2 and TLR-9 mRNA , and FA profile in colonic tissue homogenates . Colitis incidence was lower in the IL 
    Output:
    