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: Non-alcoholic fatty liver disease is associated with insulin resistance and dyslipidaemia and can progress to steatohepatitis and cirrhosis . We sought to determine whether dietary fat and saturated fat content alter liver fat in the absence of weight change in an older population . Liver fat was quantified by magnetic resonance spectroscopy before and after 4 weeks on an isoenergetic low-fat/low-saturated fat/low-glycaemic index ( LGI ) ( LSAT : 23 % fat/7 % saturated fat/GI < 55 ) or a high-fat/high-saturated fat/high-GI ( HSAT : 43 % fat/24 % saturated fat/GI>70 ) diet in older subjects . In the present study , twenty subjects ( seven males/thirteen females ; age 69.3 ( SEM 1.6 ) years , BMI 26.9 ( SEM 0.8 ) kg/m2 ) were r and omised to the LSAT diet and fifteen subjects ( six males/nine females ; age 68.6 ( SEM 1.8 ) years , BMI 28.1 ( SEM 0.9 ) kg/m2 ) to the HSAT diet .  Weight remained stable . Liver fat decreased significantly on the LSAT diet ( median 2.2 ( interquartile range ( IQR ) 3.1 ) to 1.7 ( IQR 1.8 ) % , P= 0.002 ) but did not change on the HSAT diet ( median 1.2 ( IQR 4.1 ) to 1.6 ( IQR 3.9 ) % ) . The LSAT diet  lowered fasting glucose and total cholesterol , HDL-cholesterol and LDL-cholesterol and raised TAG ( P < 0.05 ) , while the HSAT diet had no effect on glucose or HDL-cholesterol but increased total cholesterol and LDL-cholesterol ( P < 0.05 ) . Fasting insulin and homeostasis model of insulin resistance did not change significantly on either diet , but the Matsuda index of insulin sensitivity improved on the LSAT diet ( P < 0.05 ) . Assignment to the LSAT v. HSAT diet was a predictor of changes in lipid parameters but not liver fat . We conclude that diet composition may be an important factor in the accumulation of liver fat , with a low-fat/low-saturated fat/LGI diet being beneficial OBJECTIVE We investigated the effects of dietary intervention with canola or olive oil in comparison with commonly used refined oil in Asian Indians with nonalcoholic fatty liver disease ( NAFLD ) . SUBJECTS AND METHODS This was a 6-month intervention study including 93 males with NAFLD , matched for age and body mass index ( BMI ) . Subjects were r and omized into three groups to receive olive oil ( n=30 ) , canola oil ( n=33 ) , and commonly used soyabean/safflower oil ( control ; n=30 ) as cooking medium ( not exceeding 20 g/day ) along with counseling for therapeutic lifestyle changes . The BMI , fasting blood glucose ( FBG ) and insulin levels , lipids , homeostasis model of assessment for insulin resistance ( HOMA-IR ) , HOMA denoting β-cell function ( HOMA-βCF ) , and disposition index ( DI ) were measured at pre- and post-intervention . Data were analyzed with one-way analysis of variance ( ANOVA ) and Tukey 's Honestly Significant Difference multiple comparison test procedures . RESULTS Olive oil intervention led to a significant decrease in weight and BMI ( ANOVA , P=0.01 ) compared with the control oil group . In a comparison of olive and canola oil , a significant decrease in fasting insulin level , HOMA-IR , HOMA-βCF , and DI ( P<0.001 ) was observed in the olive oil group . Pre- and post-intervention analysis revealed a significant increase in high-density lipoprotein level ( P=0.004 ) in the olive oil group and a significant decrease in FBG ( P=0.03 ) and triglyceride ( P=0.02 ) levels in the canola oil group . The pre- and post-intervention difference in liver span was significant only in the olive ( 1.14 ± 2 cm ; P<0.05 ) and canola ( 0.66 ± 0.33 cm ; P<0.05 ) oil groups . In the olive and canola oil  groups , post-intervention grading of fatty liver was reduced significantly ( grade I , from 73.3 % to 23.3 % and from 60.5 % to 20 % , respectively [ P<0.01 ] ; grade II , from 20 % to 10 % and from 33.4 % to 3.3 % , respectively [ P<0.01 ] ; and grade III , from 6.7 % to none and from 6.1 % to none , respectively ) . In contrast , in the control oil group no significant change was observed . CONCLUSIONS Results suggest significant improvements in grading of fatty liver , liver span , measures of insulin resistance , and lipids with use of canola and olive oil compared with control oils in Asian Indians with NAFLD OBJECTIVE The aim of our study was to examine the changes in hypertransaminasemia after weight reduction in obese patients with and without NAFLD and the relation with insulin resistance . RESEARCH METHODS A population of 162 obese patients was r and omly allocated to two groups : a ) diet I ( low fat ) and b ) diet II ( low carbohydrate ) , dieting along 3 months .  Patients were classified as group I ( n=112 ) when serum ALT activity was normal or group II ( NAFLD , n=30 ) when serum ALT activity was ( > or=43 UI/L ) . RESULTS In control group with diet I , BMI , weight , fat mass , waist to hip ratio , waist circumference , systolic pressure , total cholesterol , LDL cholesterol , HOMA and insulin levels decreased . In NAFLD group with diet I improved the same parameters and glucose , triglycerides , ALT , AST , gamaglutamine transferase levels , too . In control group with diet II , BMI , weight , fat mass , waist to hip ratio , waist circumference , systolic pressure , total cholesterol , LDL cholesterol , HOMA and insulin levels decreased . In NAFLD group with diet II improved the same parameters and glucose , triglycerides , ALT and gamaglutamine transferase levels , without statistical changes in AST . CONCLUSION We showed that weight reduction secondary to two hypocaloric diets was associated with improvement in hipertransaminasemia and insulin resistance in NAFLD patients Background Non-alcoholic fatty liver disease , the most prevalent liver disease in developed countries , remains difficult to manage with no proven safe and effective pharmacotherapy available . While weight reduction is the most commonly practice d treatment strategy , this is difficult to both achieve and /or maintain in the majority . Furthermore evidence -based dietary recommendations to guide the nutritional management of these patients are lacking . Using a r and omised controlled trial design , this study compares the effectiveness of the Mediterranean diet to a st and ard low fat diet in terms of differences in insulin sensitivity , hepatic steatosis and metabolic outcomes in participants with non-alcoholic fatty liver disease . Methods Ninety four eligible patients who have non-alcoholic fatty liver disease and who are insulin resistant , will be r and omised into either a Mediterranean or low fat diet group for a 3 month intervention period . Insulin sensitivity will be measured on peripheral blood using Homeostatic Model Assessment and liver fat content quantified using Magnetic Resonance Spectroscopy . Both arms will consist of three face to face and three telephone call follow up consultations delivered by an Accredited Practicing Dietitian . The intervention arm focuses on recommendations from the traditional Mediterranean diet which have been tailored for use in the Australian population The st and ard arm uses the Australian Guide to Healthy Eating and the Australian National Heart Foundation dietary guidelines . Study recruitment will take place at four major metropolitan hospitals in Melbourne , Australia . Data collection will occur at all face to face review s including baseline , 6 , and 12 weeks . A follow up assessment to measure sustainability will take place at 6 and 12 months . The primary end point is improved insulin sensitivity scores at the 12 week time point . Discussion This trial aims to demonstrate in a large cohort of participants with NALFD that a Mediterranean diet independent of weight loss can result in significant benefits in liver fat and insulin sensitivity and that these changes are sustained at 12 months . These metabolic changes would potentially lead to reductions in the risk of chronic liver disease , heart disease , type 2 diabetes and liver cancer . Trial registration Australia and New Zeal and Clinical Trials Register ACTRN : ACTRN12615001010583 OBJECTIVE To evaluate the effects of qualitative dietary changes and the interaction with aerobic exercise training on liver fat content independent of weight loss in patients with type 2 diabetes . RESEARCH DESIGN AND METHODS With use of a factorial 2 × 2 r and omized parallel-group design , 37 men and 8 women , aged 35–70 years , with type 2 diabetes in satisfactory blood glucose control on diet or diet plus metformin treatment  were assigned to one of the following groups for an 8-week period : 1 ) high-carbohydrate/high-fiber/low – glycemic index diet ( CHO/fiber group ) , 2 ) high-MUFA diet ( MUFA group ) , 3 ) high-carbohydrate/high-fiber/low – glycemic index diet plus physical activity program ( CHO/fiber+Ex group ) , and 4 ) high-MUFA diet plus physical activity program ( MUFA+Ex group ) . Before and after intervention , hepatic fat content was measured by 1H NMR . RESULTS Dietary compliance was optimal and body weight remained stable in all groups . Liver fat content decreased more in MUFA ( −29 % ) and MUFA+Ex ( −25 % ) groups than in CHO/fiber ( −4 % ) and CHO/fiber+Ex groups ( −6 % ) . Two-way repeated- measures ANOVA , including baseline values as covariate , showed a significant effect on liver fat content for diet ( P = 0.006 ) , with no effects for exercise training ( P = 0.789 ) or diet-exercise interaction ( P = 0.712 ) . CONCLUSIONS An isocaloric diet enriched in MUFA compared with a diet higher in carbohydrate and fiber was associated with a clinical ly relevant reduction of hepatic fat content in type 2 diabetic patients independent of an aerobic training program and should be considered for the nutritional management of hepatic steatosis in people with type 2 diabetes OBJECTIVE Hyperaminotransferasemia is an important problem in obese patients . We decide to examine the changes in hyperaminotransferasemia after weight reduction in obese patients with and without NAFLD secondary to a high monounsaturated fat vs. a high polyunsaturated fat hypocaloric diets . PATIENTS AND METHODS A population of 306 obese patients was r and omly allocated to two groups : Diet M ( high monounsaturated fat hypocaloric diet ) and Diet P ( high polyunsaturated fat hypocaloric diet ) . Patients were classified as group I ( obese subjects ; n=262 ) when serum ALT activity was normal or group II ( NAFLD patients ; n=44 ) when serum ALT activity was ( ≥ 43 UI/L ) . RESULTS In NAFLD group with diet M , BMI , weight , fat mass , waist circumference , systolic blood pressure , total cholesterol , LDL cholesterol ) , insulin and HOMA-R decreased . In NAFLD group with diet P , BMI , weight , fat mass , waist circumference , systolic blood pressure , total cholesterol , LDL cholesterol ) , insulin and HOMA-R decreased , too . In NAFLD group , alanine aminotransferase [ ( diet M ) -20.3±19.2 UI/L vs. ( diet P ) -14.2±20.1 UI/L ] , aspartate aminotransferase [ ( diet M ) -11.3±12.2 UI/L vs. ( diet P ) -11.1±10.1 UI/L ] , and gammaglutamyl transferase [ ( diet M ) -18.1±12.2 UI/L vs. ( diet P ) -10.9±20.1 UI/L ] improved with both diets . CONCLUSIONS We showed that weight reduction secondary to two hypocaloric diets was associated with improvement in hypertransaminasemia and insulin resistance in NAFLD patients OBJECTIVE We evaluated the effect of diet therapy as exclusive treatment on insulin resistance , biochemical parameters of metabolic syndrome , and degree of hepatic steatosis in patients with non-alcoholic fatty liver disease . METHODS Thirty-one patients with non-alcoholic fatty liver disease received a diet with a reduction of 500 to 1000 cal/d , containing 15 % protein , 55 % carbohydrates , and 30 % fat , for 6 mo . At entry and 6 mo after dietary instructions , degrees of hepatic steatosis and visceral obesity were assessed by computed tom 
    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: Non-alcoholic fatty liver disease is associated with insulin resistance and dyslipidaemia and can progress to steatohepatitis and cirrhosis . We sought to determine whether dietary fat and saturated fat content alter liver fat in the absence of weight change in an older population . Liver fat was quantified by magnetic resonance spectroscopy before and after 4 weeks on an isoenergetic low-fat/low-saturated fat/low-glycaemic index ( LGI ) ( LSAT : 23 % fat/7 % saturated fat/GI < 55 ) or a high-fat/high-saturated fat/high-GI ( HSAT : 43 % fat/24 % saturated fat/GI>70 ) diet in older subjects . In the present study , twenty subjects ( seven males/thirteen females ; age 69.3 ( SEM 1.6 ) years , BMI 26.9 ( SEM 0.8 ) kg/m2 ) were r and omised to the LSAT diet and fifteen subjects ( six males/nine females ; age 68.6 ( SEM 1.8 ) years , BMI 28.1 ( SEM 0.9 ) kg/m2 ) to the HSAT diet .  Weight remained stable . Liver fat decreased significantly on the LSAT diet ( median 2.2 ( interquartile range ( IQR ) 3.1 ) to 1.7 ( IQR 1.8 ) % , P= 0.002 ) but did not change on the HSAT diet ( median 1.2 ( IQR 4.1 ) to 1.6 ( IQR 3.9 ) % ) . The LSAT diet  lowered fasting glucose and total cholesterol , HDL-cholesterol and LDL-cholesterol and raised TAG ( P < 0.05 ) , while the HSAT diet had no effect on glucose or HDL-cholesterol but increased total cholesterol and LDL-cholesterol ( P < 0.05 ) . Fasting insulin and homeostasis model of insulin resistance did not change significantly on either diet , but the Matsuda index of insulin sensitivity improved on the LSAT diet ( P < 0.05 ) . Assignment to the LSAT v. HSAT diet was a predictor of changes in lipid parameters but not liver fat . We conclude that diet composition may be an important factor in the accumulation of liver fat , with a low-fat/low-saturated fat/LGI diet being beneficial OBJECTIVE We investigated the effects of dietary intervention with canola or olive oil in comparison with commonly used refined oil in Asian Indians with nonalcoholic fatty liver disease ( NAFLD ) . SUBJECTS AND METHODS This was a 6-month intervention study including 93 males with NAFLD , matched for age and body mass index ( BMI ) . Subjects were r and omized into three groups to receive olive oil ( n=30 ) , canola oil ( n=33 ) , and commonly used soyabean/safflower oil ( control ; n=30 ) as cooking medium ( not exceeding 20 g/day ) along with counseling for therapeutic lifestyle changes . The BMI , fasting blood glucose ( FBG ) and insulin levels , lipids , homeostasis model of assessment for insulin resistance ( HOMA-IR ) , HOMA denoting β-cell function ( HOMA-βCF ) , and disposition index ( DI ) were measured at pre- and post-intervention . Data were analyzed with one-way analysis of variance ( ANOVA ) and Tukey 's Honestly Significant Difference multiple comparison test procedures . RESULTS Olive oil intervention led to a significant decrease in weight and BMI ( ANOVA , P=0.01 ) compared with the control oil group . In a comparison of olive and canola oil , a significant decrease in fasting insulin level , HOMA-IR , HOMA-βCF , and DI ( P<0.001 ) was observed in the olive oil group . Pre- and post-intervention analysis revealed a significant increase in high-density lipoprotein level ( P=0.004 ) in the olive oil group and a significant decrease in FBG ( P=0.03 ) and triglyceride ( P=0.02 ) levels in the canola oil group . The pre- and post-intervention difference in liver span was significant only in the olive ( 1.14 ± 2 cm ; P<0.05 ) and canola ( 0.66 ± 0.33 cm ; P<0.05 ) oil groups . In the olive and canola oil  groups , post-intervention grading of fatty liver was reduced significantly ( grade I , from 73.3 % to 23.3 % and from 60.5 % to 20 % , respectively [ P<0.01 ] ; grade II , from 20 % to 10 % and from 33.4 % to 3.3 % , respectively [ P<0.01 ] ; and grade III , from 6.7 % to none and from 6.1 % to none , respectively ) . In contrast , in the control oil group no significant change was observed . CONCLUSIONS Results suggest significant improvements in grading of fatty liver , liver span , measures of insulin resistance , and lipids with use of canola and olive oil compared with control oils in Asian Indians with NAFLD OBJECTIVE The aim of our study was to examine the changes in hypertransaminasemia after weight reduction in obese patients with and without NAFLD and the relation with insulin resistance . RESEARCH METHODS A population of 162 obese patients was r and omly allocated to two groups : a ) diet I ( low fat ) and b ) diet II ( low carbohydrate ) , dieting along 3 months .  Patients were classified as group I ( n=112 ) when serum ALT activity was normal or group II ( NAFLD , n=30 ) when serum ALT activity was ( > or=43 UI/L ) . RESULTS In control group with diet I , BMI , weight , fat mass , waist to hip ratio , waist circumference , systolic pressure , total cholesterol , LDL cholesterol , HOMA and insulin levels decreased . In NAFLD group with diet I improved the same parameters and glucose , triglycerides , ALT , AST , gamaglutamine transferase levels , too . In control group with diet II , BMI , weight , fat mass , waist to hip ratio , waist circumference , systolic pressure , total cholesterol , LDL cholesterol , HOMA and insulin levels decreased . In NAFLD group with diet II improved the same parameters and glucose , triglycerides , ALT and gamaglutamine transferase levels , without statistical changes in AST . CONCLUSION We showed that weight reduction secondary to two hypocaloric diets was associated with improvement in hipertransaminasemia and insulin resistance in NAFLD patients Background Non-alcoholic fatty liver disease , the most prevalent liver disease in developed countries , remains difficult to manage with no proven safe and effective pharmacotherapy available . While weight reduction is the most commonly practice d treatment strategy , this is difficult to both achieve and /or maintain in the majority . Furthermore evidence -based dietary recommendations to guide the nutritional management of these patients are lacking . Using a r and omised controlled trial design , this study compares the effectiveness of the Mediterranean diet to a st and ard low fat diet in terms of differences in insulin sensitivity , hepatic steatosis and metabolic outcomes in participants with non-alcoholic fatty liver disease . Methods Ninety four eligible patients who have non-alcoholic fatty liver disease and who are insulin resistant , will be r and omised into either a Mediterranean or low fat diet group for a 3 month intervention period . Insulin sensitivity will be measured on peripheral blood using Homeostatic Model Assessment and liver fat content quantified using Magnetic Resonance Spectroscopy . Both arms will consist of three face to face and three telephone call follow up consultations delivered by an Accredited Practicing Dietitian . The intervention arm focuses on recommendations from the traditional Mediterranean diet which have been tailored for use in the Australian population The st and ard arm uses the Australian Guide to Healthy Eating and the Australian National Heart Foundation dietary guidelines . Study recruitment will take place at four major metropolitan hospitals in Melbourne , Australia . Data collection will occur at all face to face review s including baseline , 6 , and 12 weeks . A follow up assessment to measure sustainability will take place at 6 and 12 months . The primary end point is improved insulin sensitivity scores at the 12 week time point . Discussion This trial aims to demonstrate in a large cohort of participants with NALFD that a Mediterranean diet independent of weight loss can result in significant benefits in liver fat and insulin sensitivity and that these changes are sustained at 12 months . These metabolic changes would potentially lead to reductions in the risk of chronic liver disease , heart disease , type 2 diabetes and liver cancer . Trial registration Australia and New Zeal and Clinical Trials Register ACTRN : ACTRN12615001010583 OBJECTIVE To evaluate the effects of qualitative dietary changes and the interaction with aerobic exercise training on liver fat content independent of weight loss in patients with type 2 diabetes . RESEARCH DESIGN AND METHODS With use of a factorial 2 × 2 r and omized parallel-group design , 37 men and 8 women , aged 35–70 years , with type 2 diabetes in satisfactory blood glucose control on diet or diet plus metformin treatment  were assigned to one of the following groups for an 8-week period : 1 ) high-carbohydrate/high-fiber/low – glycemic index diet ( CHO/fiber group ) , 2 ) high-MUFA diet ( MUFA group ) , 3 ) high-carbohydrate/high-fiber/low – glycemic index diet plus physical activity program ( CHO/fiber+Ex group ) , and 4 ) high-MUFA diet plus physical activity program ( MUFA+Ex group ) . Before and after intervention , hepatic fat content was measured by 1H NMR . RESULTS Dietary compliance was optimal and body weight remained stable in all groups . Liver fat content decreased more in MUFA ( −29 % ) and MUFA+Ex ( −25 % ) groups than in CHO/fiber ( −4 % ) and CHO/fiber+Ex groups ( −6 % ) . Two-way repeated- measures ANOVA , including baseline values as covariate , showed a significant effect on liver fat content for diet ( P = 0.006 ) , with no effects for exercise training ( P = 0.789 ) or diet-exercise interaction ( P = 0.712 ) . CONCLUSIONS An isocaloric diet enriched in MUFA compared with a diet higher in carbohydrate and fiber was associated with a clinical ly relevant reduction of hepatic fat content in type 2 diabetic patients independent of an aerobic training program and should be considered for the nutritional management of hepatic steatosis in people with type 2 diabetes OBJECTIVE Hyperaminotransferasemia is an important problem in obese patients . We decide to examine the changes in hyperaminotransferasemia after weight reduction in obese patients with and without NAFLD secondary to a high monounsaturated fat vs. a high polyunsaturated fat hypocaloric diets . PATIENTS AND METHODS A population of 306 obese patients was r and omly allocated to two groups : Diet M ( high monounsaturated fat hypocaloric diet ) and Diet P ( high polyunsaturated fat hypocaloric diet ) . Patients were classified as group I ( obese subjects ; n=262 ) when serum ALT activity was normal or group II ( NAFLD patients ; n=44 ) when serum ALT activity was ( ≥ 43 UI/L ) . RESULTS In NAFLD group with diet M , BMI , weight , fat mass , waist circumference , systolic blood pressure , total cholesterol , LDL cholesterol ) , insulin and HOMA-R decreased . In NAFLD group with diet P , BMI , weight , fat mass , waist circumference , systolic blood pressure , total cholesterol , LDL cholesterol ) , insulin and HOMA-R decreased , too . In NAFLD group , alanine aminotransferase [ ( diet M ) -20.3±19.2 UI/L vs. ( diet P ) -14.2±20.1 UI/L ] , aspartate aminotransferase [ ( diet M ) -11.3±12.2 UI/L vs. ( diet P ) -11.1±10.1 UI/L ] , and gammaglutamyl transferase [ ( diet M ) -18.1±12.2 UI/L vs. ( diet P ) -10.9±20.1 UI/L ] improved with both diets . CONCLUSIONS We showed that weight reduction secondary to two hypocaloric diets was associated with improvement in hypertransaminasemia and insulin resistance in NAFLD patients OBJECTIVE We evaluated the effect of diet therapy as exclusive treatment on insulin resistance , biochemical parameters of metabolic syndrome , and degree of hepatic steatosis in patients with non-alcoholic fatty liver disease . METHODS Thirty-one patients with non-alcoholic fatty liver disease received a diet with a reduction of 500 to 1000 cal/d , containing 15 % protein , 55 % carbohydrates , and 30 % fat , for 6 mo . At entry and 6 mo after dietary instructions , degrees of hepatic steatosis and visceral obesity were assessed by computed tom 
    Output:
    