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: OBJECTIVE To confirm that early growth is associated with type 1 diabetes risk in European children and eluci date any role of infant feeding . RESEARCH DESIGN AND METHODS Five centers participated , each with a population -based register of type 1 diabetes diagnosed at < 15 years of age . Control subjects were r and omly chosen from population registers , schools , or polyclinics . Growth data were obtained from routine records and infant feeding information from parental question naire or interview . Patient/control subject differences in mean st and ard deviation score ( SDS ) were obtained for each center and pooled . Odds ratios ( ORs ) were pooled by the Mantel-Haenszel method , and logistic regression was used to adjust for confounders . RESULTS Growth data were available for 499 patients and 1,337 control subjects .  Height and weight SDS were significantly increased among patients from 1 month after birth , the maximum differences of 0.32 ( 95 % CI 0.14 - 0.50 ) and 0.41 ( 0.26 - 0.55 ) , respectively , occurring between 1 and 2 years of age . Significant excesses in BMI SDS were observed from 6 months of age , with the largest difference of 0.27 ( 0.10 , 0.44 ) evident between 1 and 2 years . Breast-feeding was associated with reduced disease risk , OR 0.75 ( 0.58 - 0.96 ) . Introduction of cow 's milk , formula , or solid foods before 3 months was not associated with significant risk elevation . CONCLUSION Increased early growth is associated with disease risk in various European population s. Any role of infant feeding in this association remains unclear Eighty-one normal infants were studied between 112 and 196 days of age . Thirty-nine infants were fed pasteurized cow milk and the remainder were fed either Enfamil or heat-treated cow milk . During the age interval of 112 to 140 days , the proportion of infants with guaiac-positive stools was significantly ( P less than 0.01 ) greater among infants fed pasteurized cow milk than among those fed Enfamil or heat-treated cow milk . Similarly , infants fed cow milk had a significantly ( P less than 0.001 ) greater number of guaiac-positive stools than did the other infants . After 140 days of age , there was no difference between feeding groups in the number of guaiac-positive stools . No significant differences were observed in mean hemoglobin , hematocrit , serum iron , total iron-binding capacity , or transferrin saturation between feeding groups nor between infants with and those without guaiac-positive stools , It is concluded that pasteurized cow milk should not be fed before 140 days of age Background : Environment and lifestyle contribute to the development of asthma in children . Underst and ing the relevant factors in this relationship may provide methods of prevention . The role of diet in the development of asthma in pre-school children was investigated . Methods : Data from 2978 children participating in a prospect i ve birth cohort study were used . Food frequency data were collected at the age of 2 years and related to asthma symptoms reported at the age of 3 years . Results : The prevalence of recent asthma at age 3 was lower in children who consumed ( at age 2 ) full cream milk daily ( 3.4 % ) than in those who did not ( 5.6 % ) and in those who consumed butter daily ( 1.5 % ) than in those who did not ( 5.1 % ) . The prevalence of recent wheeze was lower in children who consumed milk products daily ( 13.7 % ) than in those who did not ( 18.4 % ) and in children who consumed butter daily ( 7.7 % ) than in those who did not ( 15.4 % ) . These effects remained in a logistic regression model including different foods and confounders ( adjusted odds ratio ( CI ) for recent asthma : full cream milk daily v rarely 0.59 ( 0.40 to 0.88 ) , butter daily v rarely 0.28 ( 0.09 to 0.88 ) ) . Daily consumption of brown bread was also associated with lower rates of asthma and wheeze , whereas no associations were observed with the consumption of fruits , vegetables , margarine , and fish . Conclusions : In pre-school children , frequent consumption of products containing milk fat is associated with a reduced risk of asthma symptoms In the GRADE approach , r and omized trials start as high- quality evidence and observational studies as low- quality evidence , but both can be rated down if most of the relevant evidence comes from studies that suffer from a high risk of bias . Well-established limitations of r and omized trials include failure to conceal allocation , failure to blind , loss to follow-up , and failure to appropriately consider the intention-to-treat principle . More recently recognized limitations include stopping early for apparent benefit and selective reporting of outcomes according to the results . Key limitations of observational studies include use of inappropriate controls and failure to adequately adjust for prognostic imbalance . Risk of bias may vary across outcomes ( e.g. , loss to follow-up may be far less for all-cause mortality than for quality of life ) , a consideration that many systematic review s ignore . In deciding whether to rate down for risk of bias -- whether for r and omized trials or observational studies -- authors should not take an approach that averages across studies . Rather , for any individual outcome , when there are some studies with a high risk , and some with a low risk of bias , they should consider including only the studies with a lower risk of bias Background Infant feeding practice s , particularly the type of milk feeding , have been associated with the development of type 1 diabetes . Aim of the study We studied the relationship between early infant feeding ( during the first year of life ) and diabetes in a large population -based cohort . Methods In 1994–1995 , 6,209 healthy full-term newborns participated in a study examining the effect of supplementary feeding , on development of allergy to cow ’s milk , in maternity hospitals . All supplements in the maternity hospitals were known . Mothers recorded the feeding of infants prospect ively at home . In August 2006 , from a nationwide diabetes registry , 45 children from our cohort were listed as having type 1 diabetes . Results The distribution of cases was similar in the r and omized feeding groups : 9/1,789 in the group that received adapted cow ’s milk-based formula ; 12/1,737 in those who received extensively hydrolyzed formula ; 16/1,859 in those who received banked human milk ; and 8 among those 824 exclusively breast-fed in the hospital . When children who had received cow ’s milk-based formula in the maternity hospital were compared with those without such exposure , less number of children in the former group had diabetes by age 8 ( P = 0.026 ) , but by the end of the follow-up ( 11.5 years ) the difference disappeared ( P = 0.16 ) . Length of breast-feeding and introduction of cereals and other solid foods were similar among those developing type 1 diabetes and those remaining healthy , while early regular daily feeding with cow ’s milk-based formula tended to associate with lower risk for type 1 diabetes ( OR 0.66 ; 95 % confidence interval 0.38–1.13 ; P = 0.08 ) . Conclusions In an extended , secondary analysis of a population -based cohort , very early exposure to cow ’s milk is not a risk factor for type 1 diabetes ; it may in fact diminish its appearance before age 8 We examined the relationship of diet to the development of atopic manifestations in a group of infants with an immediate family history of atopy , followed prospect ively from birth for up to 20 months of age . There was no relationship between the development of atopic dermatitis , rhinitis and wheeze and either 2 or 4 months exclusive breast feeding , or the introduction of cow 's milk or solids in the first 4 months of life . In addition there was no relationship between the introduction of milk , egg or wheat into the diet and the development of skin‐test positivity to these foods . In fact , five infants developed positive skin tests to the food prior to its introduction into the diet , suggesting exposure via maternal breast milk . Thus we have been unable to show a protective effect of either breast feeding or cow 's milk or solid avoidance on the development of atopic disease in infancy There is concern that whole cow 's milk feedings may be associated with intestinal abnormalities in infants . We studied this issue by measuring r and om fecal sample s for alpha 1-antitrypsin ( FA1AT ) and hemoglobin ( FH ) concentrations in 820 healthy infants up to 12 months of age . Subjects were fed either human milk , formula , or fresh whole cow 's milk . Solid foods were given ad libitum . Fecal sample s were also tested for occult blood with Hematest reagent tablets . None of the infants younger than 6 months of age were receiving fresh whole cow 's milk . We found small but statistically significant differences in mean FA1AT between the three feeding groups ( P less than .0001 ) : human milk ( n = 354 ) greater than formula ( n = 320 ) greater than cow 's milk ( n = 146 ) . The younger subjects fed either formula or human milk tended to have higher FA1AT concentrations than did the age-matched subjects who were not consuming solid foods ( P less than or equal to .005 ) . Daily FA1AT excretion , FA1AT concentration , and daily stool output were subsequently determined on a separate group of 40 infants 8 to 12 months of age to ascertain whether differences in total daily FA1AT excretion occur in children fed different types of milk . Total daily FA1AT excretion was similar in the three milk feeding groups . An inverse correlation between FA1AT concentration and daily stool output was also found ( P less than .001 ) . The overall rate of detectable FH in 792 stool smears was 2.1 % and unrelated to type of milk feeding . Of 705 stool smears , 3.5 % had positive Hematest reactions . ( ABSTRACT TRUNCATED AT 250 WORDS OBJECTIVE The damage of beta cells occurs during the asymptomatic prodromal period called prediabetes before onset of diabetes mellitus . It is characterized by the presence of islet cell autoantibodies ( ICAs ) . The aim of this study was to find out what environmental factors predict ICA seroconversion in healthy schoolchildren in Lithuania . MATERIAL AND METHODS Sera from 3053 nondiabetic schoolchildren living in Lithuania were investigated for ICAs . ICAs were measured in undiluted sera by indirect immunofluorescence method . All ICA-positive and r and omly selected ICA-negative children were invited to participate in the study . Response rate in the families of ICA-positive children was 100 % and in ICA-negative-76.5 % . Data from 13 ICA-positive and 199 ICA-negative schoolchildren were included in the analysis . Information on the environmental factors was collected via question naires . RESULTS Proportions of breastfed children were similar in ICA-positive and ICA-negative schoolchildren . Full cow 's milk was introduced at one month of age or earlier more often in ICA-positive than ICA-negative schoolchildren ( 8.3 % and 1.1 % , respectively ; P=0.05 ) . Cereal before 3 months of age was introduced more often in ICA-positive than ICA-negative schoolchildren ( 7.7 % and 0.5 % , respectively ; P=0.01 ) . The mothers of cases took medicine during pregnancy more often than mothers of controls did ( 61.5 % and 14.1 % , respectively ; P<0.001 ) . More than half ( 53.8 % ) of ICA-positive children lived in homes where family members were smoking indoors , while this was recorded only for 26.6 % of controls ( P=0.04 ) . CONCLUSIONS Early introduction of cow 's milk and cereal , the intake of medicine during pregnancy , and indoor smoking of family members are risk factors that predict the development of prediabetes among Lithuanian children Objective : To investigate effects of growth and food intake in infancy on iron status at the age of 12 months in a population with high birth weight and high frequency of breast-feeding . Design : In a longitudinal observational study infants ' consumption and growth were recorded . Weighed 2 day food records at the ages of 6 , 9 and 12 months were used to analyse food and nutrient intake . Setting : Healthy-born participants were recruited from four maternity wards .  Blood sample s and growth data were collected from healthcare centres and food consumption data at home . Subjects : Newborn infants ( n=180 ) were selected r and omly according to the mother 's domicile and 77 % ( n=138 ) participated , of them , 83 % ( n=114 ) , or 63 % of original sample , came in for blood sampling . Results : Every fifth child was iron-deficient ( serum ferritin<12 µg/l and mean corpuscular volume<74 fl ) and 2.7 % were also anaemic ( Hb<105 g/l ) . Higher weight gain from 0 to 12 months was seen in infants who were iron-deficient at 12 months ( 6.7±0.9 kg ) than in non-iron-deficient infants ( 6.2±0.9 kg ) ( P=0.050 ) . Serum transferrin receptors at 12 months were positively associated with length gain from 0 to 12 months ( adjusted r 2=0.14 ; P=0.045 ) and mean corpuscular volume negatively to ponderal index at birth ( adjusted r 2=0.14 ; P=0. 
    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: OBJECTIVE To confirm that early growth is associated with type 1 diabetes risk in European children and eluci date any role of infant feeding . RESEARCH DESIGN AND METHODS Five centers participated , each with a population -based register of type 1 diabetes diagnosed at < 15 years of age . Control subjects were r and omly chosen from population registers , schools , or polyclinics . Growth data were obtained from routine records and infant feeding information from parental question naire or interview . Patient/control subject differences in mean st and ard deviation score ( SDS ) were obtained for each center and pooled . Odds ratios ( ORs ) were pooled by the Mantel-Haenszel method , and logistic regression was used to adjust for confounders . RESULTS Growth data were available for 499 patients and 1,337 control subjects .  Height and weight SDS were significantly increased among patients from 1 month after birth , the maximum differences of 0.32 ( 95 % CI 0.14 - 0.50 ) and 0.41 ( 0.26 - 0.55 ) , respectively , occurring between 1 and 2 years of age . Significant excesses in BMI SDS were observed from 6 months of age , with the largest difference of 0.27 ( 0.10 , 0.44 ) evident between 1 and 2 years . Breast-feeding was associated with reduced disease risk , OR 0.75 ( 0.58 - 0.96 ) . Introduction of cow 's milk , formula , or solid foods before 3 months was not associated with significant risk elevation . CONCLUSION Increased early growth is associated with disease risk in various European population s. Any role of infant feeding in this association remains unclear Eighty-one normal infants were studied between 112 and 196 days of age . Thirty-nine infants were fed pasteurized cow milk and the remainder were fed either Enfamil or heat-treated cow milk . During the age interval of 112 to 140 days , the proportion of infants with guaiac-positive stools was significantly ( P less than 0.01 ) greater among infants fed pasteurized cow milk than among those fed Enfamil or heat-treated cow milk . Similarly , infants fed cow milk had a significantly ( P less than 0.001 ) greater number of guaiac-positive stools than did the other infants . After 140 days of age , there was no difference between feeding groups in the number of guaiac-positive stools . No significant differences were observed in mean hemoglobin , hematocrit , serum iron , total iron-binding capacity , or transferrin saturation between feeding groups nor between infants with and those without guaiac-positive stools , It is concluded that pasteurized cow milk should not be fed before 140 days of age Background : Environment and lifestyle contribute to the development of asthma in children . Underst and ing the relevant factors in this relationship may provide methods of prevention . The role of diet in the development of asthma in pre-school children was investigated . Methods : Data from 2978 children participating in a prospect i ve birth cohort study were used . Food frequency data were collected at the age of 2 years and related to asthma symptoms reported at the age of 3 years . Results : The prevalence of recent asthma at age 3 was lower in children who consumed ( at age 2 ) full cream milk daily ( 3.4 % ) than in those who did not ( 5.6 % ) and in those who consumed butter daily ( 1.5 % ) than in those who did not ( 5.1 % ) . The prevalence of recent wheeze was lower in children who consumed milk products daily ( 13.7 % ) than in those who did not ( 18.4 % ) and in children who consumed butter daily ( 7.7 % ) than in those who did not ( 15.4 % ) . These effects remained in a logistic regression model including different foods and confounders ( adjusted odds ratio ( CI ) for recent asthma : full cream milk daily v rarely 0.59 ( 0.40 to 0.88 ) , butter daily v rarely 0.28 ( 0.09 to 0.88 ) ) . Daily consumption of brown bread was also associated with lower rates of asthma and wheeze , whereas no associations were observed with the consumption of fruits , vegetables , margarine , and fish . Conclusions : In pre-school children , frequent consumption of products containing milk fat is associated with a reduced risk of asthma symptoms In the GRADE approach , r and omized trials start as high- quality evidence and observational studies as low- quality evidence , but both can be rated down if most of the relevant evidence comes from studies that suffer from a high risk of bias . Well-established limitations of r and omized trials include failure to conceal allocation , failure to blind , loss to follow-up , and failure to appropriately consider the intention-to-treat principle . More recently recognized limitations include stopping early for apparent benefit and selective reporting of outcomes according to the results . Key limitations of observational studies include use of inappropriate controls and failure to adequately adjust for prognostic imbalance . Risk of bias may vary across outcomes ( e.g. , loss to follow-up may be far less for all-cause mortality than for quality of life ) , a consideration that many systematic review s ignore . In deciding whether to rate down for risk of bias -- whether for r and omized trials or observational studies -- authors should not take an approach that averages across studies . Rather , for any individual outcome , when there are some studies with a high risk , and some with a low risk of bias , they should consider including only the studies with a lower risk of bias Background Infant feeding practice s , particularly the type of milk feeding , have been associated with the development of type 1 diabetes . Aim of the study We studied the relationship between early infant feeding ( during the first year of life ) and diabetes in a large population -based cohort . Methods In 1994–1995 , 6,209 healthy full-term newborns participated in a study examining the effect of supplementary feeding , on development of allergy to cow ’s milk , in maternity hospitals . All supplements in the maternity hospitals were known . Mothers recorded the feeding of infants prospect ively at home . In August 2006 , from a nationwide diabetes registry , 45 children from our cohort were listed as having type 1 diabetes . Results The distribution of cases was similar in the r and omized feeding groups : 9/1,789 in the group that received adapted cow ’s milk-based formula ; 12/1,737 in those who received extensively hydrolyzed formula ; 16/1,859 in those who received banked human milk ; and 8 among those 824 exclusively breast-fed in the hospital . When children who had received cow ’s milk-based formula in the maternity hospital were compared with those without such exposure , less number of children in the former group had diabetes by age 8 ( P = 0.026 ) , but by the end of the follow-up ( 11.5 years ) the difference disappeared ( P = 0.16 ) . Length of breast-feeding and introduction of cereals and other solid foods were similar among those developing type 1 diabetes and those remaining healthy , while early regular daily feeding with cow ’s milk-based formula tended to associate with lower risk for type 1 diabetes ( OR 0.66 ; 95 % confidence interval 0.38–1.13 ; P = 0.08 ) . Conclusions In an extended , secondary analysis of a population -based cohort , very early exposure to cow ’s milk is not a risk factor for type 1 diabetes ; it may in fact diminish its appearance before age 8 We examined the relationship of diet to the development of atopic manifestations in a group of infants with an immediate family history of atopy , followed prospect ively from birth for up to 20 months of age . There was no relationship between the development of atopic dermatitis , rhinitis and wheeze and either 2 or 4 months exclusive breast feeding , or the introduction of cow 's milk or solids in the first 4 months of life . In addition there was no relationship between the introduction of milk , egg or wheat into the diet and the development of skin‐test positivity to these foods . In fact , five infants developed positive skin tests to the food prior to its introduction into the diet , suggesting exposure via maternal breast milk . Thus we have been unable to show a protective effect of either breast feeding or cow 's milk or solid avoidance on the development of atopic disease in infancy There is concern that whole cow 's milk feedings may be associated with intestinal abnormalities in infants . We studied this issue by measuring r and om fecal sample s for alpha 1-antitrypsin ( FA1AT ) and hemoglobin ( FH ) concentrations in 820 healthy infants up to 12 months of age . Subjects were fed either human milk , formula , or fresh whole cow 's milk . Solid foods were given ad libitum . Fecal sample s were also tested for occult blood with Hematest reagent tablets . None of the infants younger than 6 months of age were receiving fresh whole cow 's milk . We found small but statistically significant differences in mean FA1AT between the three feeding groups ( P less than .0001 ) : human milk ( n = 354 ) greater than formula ( n = 320 ) greater than cow 's milk ( n = 146 ) . The younger subjects fed either formula or human milk tended to have higher FA1AT concentrations than did the age-matched subjects who were not consuming solid foods ( P less than or equal to .005 ) . Daily FA1AT excretion , FA1AT concentration , and daily stool output were subsequently determined on a separate group of 40 infants 8 to 12 months of age to ascertain whether differences in total daily FA1AT excretion occur in children fed different types of milk . Total daily FA1AT excretion was similar in the three milk feeding groups . An inverse correlation between FA1AT concentration and daily stool output was also found ( P less than .001 ) . The overall rate of detectable FH in 792 stool smears was 2.1 % and unrelated to type of milk feeding . Of 705 stool smears , 3.5 % had positive Hematest reactions . ( ABSTRACT TRUNCATED AT 250 WORDS OBJECTIVE The damage of beta cells occurs during the asymptomatic prodromal period called prediabetes before onset of diabetes mellitus . It is characterized by the presence of islet cell autoantibodies ( ICAs ) . The aim of this study was to find out what environmental factors predict ICA seroconversion in healthy schoolchildren in Lithuania . MATERIAL AND METHODS Sera from 3053 nondiabetic schoolchildren living in Lithuania were investigated for ICAs . ICAs were measured in undiluted sera by indirect immunofluorescence method . All ICA-positive and r and omly selected ICA-negative children were invited to participate in the study . Response rate in the families of ICA-positive children was 100 % and in ICA-negative-76.5 % . Data from 13 ICA-positive and 199 ICA-negative schoolchildren were included in the analysis . Information on the environmental factors was collected via question naires . RESULTS Proportions of breastfed children were similar in ICA-positive and ICA-negative schoolchildren . Full cow 's milk was introduced at one month of age or earlier more often in ICA-positive than ICA-negative schoolchildren ( 8.3 % and 1.1 % , respectively ; P=0.05 ) . Cereal before 3 months of age was introduced more often in ICA-positive than ICA-negative schoolchildren ( 7.7 % and 0.5 % , respectively ; P=0.01 ) . The mothers of cases took medicine during pregnancy more often than mothers of controls did ( 61.5 % and 14.1 % , respectively ; P<0.001 ) . More than half ( 53.8 % ) of ICA-positive children lived in homes where family members were smoking indoors , while this was recorded only for 26.6 % of controls ( P=0.04 ) . CONCLUSIONS Early introduction of cow 's milk and cereal , the intake of medicine during pregnancy , and indoor smoking of family members are risk factors that predict the development of prediabetes among Lithuanian children Objective : To investigate effects of growth and food intake in infancy on iron status at the age of 12 months in a population with high birth weight and high frequency of breast-feeding . Design : In a longitudinal observational study infants ' consumption and growth were recorded . Weighed 2 day food records at the ages of 6 , 9 and 12 months were used to analyse food and nutrient intake . Setting : Healthy-born participants were recruited from four maternity wards .  Blood sample s and growth data were collected from healthcare centres and food consumption data at home . Subjects : Newborn infants ( n=180 ) were selected r and omly according to the mother 's domicile and 77 % ( n=138 ) participated , of them , 83 % ( n=114 ) , or 63 % of original sample , came in for blood sampling . Results : Every fifth child was iron-deficient ( serum ferritin<12 µg/l and mean corpuscular volume<74 fl ) and 2.7 % were also anaemic ( Hb<105 g/l ) . Higher weight gain from 0 to 12 months was seen in infants who were iron-deficient at 12 months ( 6.7±0.9 kg ) than in non-iron-deficient infants ( 6.2±0.9 kg ) ( P=0.050 ) . Serum transferrin receptors at 12 months were positively associated with length gain from 0 to 12 months ( adjusted r 2=0.14 ; P=0.045 ) and mean corpuscular volume negatively to ponderal index at birth ( adjusted r 2=0.14 ; P=0. 
    Output:
    