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 Overweight and obesity is a significant health concern during pregnancy . Our aim was to investigate the effect of providing antenatal dietary and lifestyle advice to women who are overweight or obese on components of maternal diet and physical activity . Methods We conducted a r and omised controlled trial , in which pregnant women with a body mass index ≥25 kg/m2 , and singleton gestation between 10 + 0 to 20 + 0 weeks were recruited and r and omised to Lifestyle Advice ( involving a comprehensive dietary and lifestyle intervention over their pregnancy ) or St and ard Care . Within the intervention group , we conducted a nested r and omised trial in which a subgroup of women were further r and omised to receive access to supervised group walking sessions in addition to the st and ard information presented during the intervention contacts ( the Walking group ) or st and ard information only . The outcome measures were maternal dietary intake , ( including food groups , macronutrient and micronutrient intake , diet quality ( using the Healthy Eating Index ; HEI ) , dietary glycaemic load , and glycaemic index ) and maternal physical activity . Women completed the Harvard Semi-Structured Food Frequency Question naire , and the Short Question naire to Assess Health-enhancing Physical Activity ( SQUASH ) , at trial entry , 28 and 36 weeks ’ gestational age , and 4 months postpartum . Analyses were performed on an intention-to-treat basis , using linear mixed effects models with adjustment for the stratification variables . Results Women r and omised to Lifestyle Advice demonstrated a statistically significant increase in the number of servings of fruit and vegetables consumed per day , as well as increased consumption of fibre , and reduced percentage energy intake from saturated fats ( P < 0.05 for all ) . Maternal HEI was significantly improved at both 28 ( 73.35 ± 6.62 versus 71.86 ± 7.01 ; adjusted difference in means 1.58 ; 95 % CI 0.89 to 2.27 ; P < 0.0001 ) and 36 ( 72.95 ± 6.82 versus 71.17 ± 7.69 ; adjusted difference in means 1.77 ; 95 % CI 1.01 to 2.53 ; P < 0.0001 ) weeks . There were no differences in dietary glycaemic index or glycaemic load . Women r and omised to Lifestyle Advice also demonstrated greater total physical activity ( adjusted difference in means 359.76 metabolic equivalent task units ( MET ) minutes/week ; 95 % CI 74.87 to 644.65 ; P = 0.01 ) compared with women receiving St and ard Care . The supervised walking group was poorly utilised . Conclusions For women who are overweight or obese , antenatal lifestyle advice improves maternal diet and physical activity during pregnancy . Please see related articles : http://www.biomed central .com/1741 - 7015/12/163 and http://www.biomed central .com/1741 - 7015/12/201.Trial registration Australian and New Zeal and Clinical Trials Registry ( http://ACTRN12607000161426 Background : There is overwhelming evidence that experiences during early life could have long-term health consequences . However , the role of early nutrition in programming obesity and leptin resistance is still poorly understood . Objective : We aim ed at determining whether nutritional intakes in early life are associated with body composition and hormonal status at 20 years . Subjects : Healthy infants participating in the two-decade-long prospect i ve ELANCE ( Etude Longitudinale Alimentation Nutrition Croissance des Enfants ) study were examined at 10 months and 2 years . At 20 years , weight , height , subscapular and triceps skinfold thicknesses , fat mass ( FM ) and fat-free mass ( FFM ) assessed via bioelectrical impedance analysis , and serum leptin concentration were recorded in 73 subjects still participating in the follow-up . Results : In adjusted linear regression models , an increase by 100 kcal in energy intake at 2 years was associated with higher subscapular skinfold thickness ( β=6.4 % SF , 95 % confidence interval 2.53–10.30 , P=0.002 ) and higher FFM ( 0.50 kg , 0.06–0.95 , P=0.03 ) at 20 years . An increase by 1 % energy from fat at 2 years was associated with lower subscapular skinfold thickness ( −2.3 % SF , −4.41 to −0.18 , P=0.03 ) , lower FM ( −0.31 kg , −0.60 to −0.01 , P=0.04 ) and lower serum leptin concentration ( −0.21 μg l−1 , −0.39 to −0.03 , P=0.02 ) at 20 years . Conclusions : Low-fat intake in early life was negatively associated with body fat ( particularly at the trunk site ) and serum leptin concentration at 20 years , suggesting that early low-fat intake could increase the susceptibility to develop overweight and leptin resistance at later ages . These findings substantiate current recommendations against restricting fat intake in early life and open new directions for investigating the origin of obesity Background Sub-Saharan Africa is facing rapidly increasing prevalences of cardiovascular disease , obesity , diabetes and hypertension . Previous and ongoing undernutrition among pregnant women may contribute to this development as suggested by epidemiological studies from high income countries linking undernutrition in fetal life with increased burden of non-communicable diseases in later life . We undertook to study the risks for hypertension , glucose intolerance and overweight  forty years after fetal exposure to famine afflicted Biafra during the Nigerian civil war ( 1967–1970 ) . Methods and Findings Cohort study performed in June 27–July 31 , 2009 in Enugu , Nigeria . Adults ( n = 1,339 ) born before ( 1965–67 ) , during ( 1968–January 1970 ) , or after ( 1971–73 ) the years of famine were included . Blood pressure ( BP ) , r and om plasma glucose ( p-glucose ) and anthropometrics , as well as prevalence of hypertension ( BP>140/90 mmHg ) , impaired glucose tolerance ( IGT ; p-glucose 7.8–11.0 mmol/l ) , diabetes ( DM ; p-glucose ≥11.1 mmol/l ) , or overweight ( BMI > 25 kg/m2 ) were compared between the three groups . Fetal-infant exposure to famine was associated with elevated systolic ( + 7 mmHg ; p<0.001 ) and diastolic ( + 5 mmHg ; p<0.001 ) BP , increased p-glucose ( + 0.3 mmol/L ; p<0.05 ) and waist circumference ( + 3 cm , p<0.001 ) , increased risk of systolic hypertension ( adjusted OR 2.87 ; 95 % CI 1.90–4.34 ) , IGT ( OR 1.65 ; 95 % CI 1.02–2.69 ) and overweight ( OR 1.41 ; 95 % CI 1.03–1.93 ) as compared to people born after the famine . Limitations of this study include the lack of birth weight data and the inability to separate effects of fetal and infant famine . Conclusions Fetal and infant undernutrition is associated with significantly increased risk of hypertension and impaired glucose tolerance in 40-year-old Nigerians . Prevention of undernutrition during pregnancy and in infancy should therefore be given high priority in health , education , and economic agendas Background : High intake of sugar-containing beverages ( SCBs ) has been linked to increased risk of obesity . However , associations of SCB intake during pregnancy with child body composition have been unclear . Objectives : We explored whether SCB intake during pregnancy was associated with children 's body mass index ( BMI ) and detailed measures of body composition . In addition , we examined different types of SCBs ( i.e. , fruit juice , soda , and concentrate ) . Design : We included 3312 mother-child pairs of the Generation R Study , a prospect i ve cohort from fetal life onward in the Netherl and s. Energy-adjusted  SCB  intake was assessed in the first trimester with a food-frequency question naire . Anthropometric data of the children were collected repeatedly ≤6 y of age , and BMI was calculated . At 6 y of age , we further measured fat mass index ( FMI ) and fat-free mass index with dual-energy X-ray absorptiometry . All outcomes were sex- and age-st and ardized . Associations of SCB intake with  children 's BMI trajectories and body composition were analyzed with multivariable linear mixed and regression models . Results : Results from linear mixed models showed that , after adjustment for confounders including the SCB intake of the child itself , mothers ' total SCB intake was positively associated with children 's BMI ≤6 y of age [ per serving per day : 0.04 SD score ( SDS ) ; 95 % CI : 0.00 , 0.07 SDS ] . In addition , intakes of total SCBs and fruit juice , but not of soda or concentrate , were associated with a higher FMI [ total SCBs : 0.05 SDS ( 95 % CI : 0.01 , 0.08 SDS ) ; fruit juice : 0.04 SDS ( 95 % CI : 0.01 , 0.06 SDS ) ] of the 6-y-old children . These associations remained significant ( P < 0.05 ) after additional adjustment for gestational weight gain , birth weight , and children 's insulin concentrations . Conclusion : Our study suggests that maternal SCB intake during pregnancy is positively associated with children 's BMI during early childhood and particularly with higher fat mass OBJECTIVES : To examine the extent to which chronic sleep curtailment from infancy to mid-childhood is associated with total and central adiposity . METHODS : We studied 1046 children participating in a prospect i ve cohort study . At age 6 months and yearly from age 1 to 7 years , mothers reported their children ’s sleep duration in a usual 24-hour period . The main exposure was a sleep curtailment score from age 6 months to 7 years . The range of the total score was 0 to 13 , where 0 indicated the maximal sleep curtailment and 13 indicated never having curtailed sleep . Outcomes in mid-childhood were BMI z score , dual X-ray absorptiometry total and trunk fat mass index ( kg/m2 ) , and waist and hip circumferences ( cm ) . RESULTS : The mean ( SD ) sleep score was 10.2 ( 2.7 ) ; 4.4 % scored a 0 to 4 , indicating multiple exposures to sleep curtailment between age 6 months to 7 years , 12.3 % scored 5 to 7 , 14.1 % scored 8 to 9 , 28.8 % scored 10 to 11 , and 40.3 % scored 12 to 13 . In multivariable models , children who had a sleep score of 0 to 4 had a BMI z score that was 0.48 U ( 95 % confidence interval , 0.13 to 0.83 ) higher than those who had a sleep score of 12 to 13 . We observed similar associations of higher total and trunk fat mass index and waist and hip circumferences , and higher odds of obesity ( odds ratio , 2.62 ; 95 % confidence interval , 0.99 to 6.97 ) among children who had a score of 0 to 4 vs 12 to 13 . CONCLUSIONS : Chronic sleep curtailment from infancy to school age was associated with higher overall and central adiposity in mid-childhood Context : Recent data indicate a marked increase in the prevalence of  obesity among school-aged children . Thus , efficacious programmes that prevent overweight development in children are urgently needed . Objective : To evaluate the impact of repeatedly given , individualised dietary and lifestyle counselling on the prevalence of overweight during the first 10 years of life . Design and participants : This study was a part of the Special Turku Coronary Risk Factor Intervention Project for Children ( STRIP ) , which is a prospect i ve , r and omised trial aim ed at reducing the exposure of the intervention children to the known risk factors of atherosclerosis . At the child 's age of 7 months , 1062 children were assigned to an intervention group ( n=540 ) or to a control group ( n=522 ) . The intervention children received individualised counselling focused on healthy diet and physical activity biannually . Height and weight of the children were measured at least once a year . Main outcome measure : Prevalence of overweight and obesity among the intervention and control children by sex and age . Children were classified as  overweight or  obese if their weight for height was > 20 % or ⩾40 % above the mean weight for height of healthy Finnish children , respectively . Results : After the age of 2 years , there were continuously fewer overweight girls in the intervention group than in the control group . At the age of 10 years , 10.2 % of the intervention girls and 18.8 % of the control girls were 
    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 Overweight and obesity is a significant health concern during pregnancy . Our aim was to investigate the effect of providing antenatal dietary and lifestyle advice to women who are overweight or obese on components of maternal diet and physical activity . Methods We conducted a r and omised controlled trial , in which pregnant women with a body mass index ≥25 kg/m2 , and singleton gestation between 10 + 0 to 20 + 0 weeks were recruited and r and omised to Lifestyle Advice ( involving a comprehensive dietary and lifestyle intervention over their pregnancy ) or St and ard Care . Within the intervention group , we conducted a nested r and omised trial in which a subgroup of women were further r and omised to receive access to supervised group walking sessions in addition to the st and ard information presented during the intervention contacts ( the Walking group ) or st and ard information only . The outcome measures were maternal dietary intake , ( including food groups , macronutrient and micronutrient intake , diet quality ( using the Healthy Eating Index ; HEI ) , dietary glycaemic load , and glycaemic index ) and maternal physical activity . Women completed the Harvard Semi-Structured Food Frequency Question naire , and the Short Question naire to Assess Health-enhancing Physical Activity ( SQUASH ) , at trial entry , 28 and 36 weeks ’ gestational age , and 4 months postpartum . Analyses were performed on an intention-to-treat basis , using linear mixed effects models with adjustment for the stratification variables . Results Women r and omised to Lifestyle Advice demonstrated a statistically significant increase in the number of servings of fruit and vegetables consumed per day , as well as increased consumption of fibre , and reduced percentage energy intake from saturated fats ( P < 0.05 for all ) . Maternal HEI was significantly improved at both 28 ( 73.35 ± 6.62 versus 71.86 ± 7.01 ; adjusted difference in means 1.58 ; 95 % CI 0.89 to 2.27 ; P < 0.0001 ) and 36 ( 72.95 ± 6.82 versus 71.17 ± 7.69 ; adjusted difference in means 1.77 ; 95 % CI 1.01 to 2.53 ; P < 0.0001 ) weeks . There were no differences in dietary glycaemic index or glycaemic load . Women r and omised to Lifestyle Advice also demonstrated greater total physical activity ( adjusted difference in means 359.76 metabolic equivalent task units ( MET ) minutes/week ; 95 % CI 74.87 to 644.65 ; P = 0.01 ) compared with women receiving St and ard Care . The supervised walking group was poorly utilised . Conclusions For women who are overweight or obese , antenatal lifestyle advice improves maternal diet and physical activity during pregnancy . Please see related articles : http://www.biomed central .com/1741 - 7015/12/163 and http://www.biomed central .com/1741 - 7015/12/201.Trial registration Australian and New Zeal and Clinical Trials Registry ( http://ACTRN12607000161426 Background : There is overwhelming evidence that experiences during early life could have long-term health consequences . However , the role of early nutrition in programming obesity and leptin resistance is still poorly understood . Objective : We aim ed at determining whether nutritional intakes in early life are associated with body composition and hormonal status at 20 years . Subjects : Healthy infants participating in the two-decade-long prospect i ve ELANCE ( Etude Longitudinale Alimentation Nutrition Croissance des Enfants ) study were examined at 10 months and 2 years . At 20 years , weight , height , subscapular and triceps skinfold thicknesses , fat mass ( FM ) and fat-free mass ( FFM ) assessed via bioelectrical impedance analysis , and serum leptin concentration were recorded in 73 subjects still participating in the follow-up . Results : In adjusted linear regression models , an increase by 100 kcal in energy intake at 2 years was associated with higher subscapular skinfold thickness ( β=6.4 % SF , 95 % confidence interval 2.53–10.30 , P=0.002 ) and higher FFM ( 0.50 kg , 0.06–0.95 , P=0.03 ) at 20 years . An increase by 1 % energy from fat at 2 years was associated with lower subscapular skinfold thickness ( −2.3 % SF , −4.41 to −0.18 , P=0.03 ) , lower FM ( −0.31 kg , −0.60 to −0.01 , P=0.04 ) and lower serum leptin concentration ( −0.21 μg l−1 , −0.39 to −0.03 , P=0.02 ) at 20 years . Conclusions : Low-fat intake in early life was negatively associated with body fat ( particularly at the trunk site ) and serum leptin concentration at 20 years , suggesting that early low-fat intake could increase the susceptibility to develop overweight and leptin resistance at later ages . These findings substantiate current recommendations against restricting fat intake in early life and open new directions for investigating the origin of obesity Background Sub-Saharan Africa is facing rapidly increasing prevalences of cardiovascular disease , obesity , diabetes and hypertension . Previous and ongoing undernutrition among pregnant women may contribute to this development as suggested by epidemiological studies from high income countries linking undernutrition in fetal life with increased burden of non-communicable diseases in later life . We undertook to study the risks for hypertension , glucose intolerance and overweight  forty years after fetal exposure to famine afflicted Biafra during the Nigerian civil war ( 1967–1970 ) . Methods and Findings Cohort study performed in June 27–July 31 , 2009 in Enugu , Nigeria . Adults ( n = 1,339 ) born before ( 1965–67 ) , during ( 1968–January 1970 ) , or after ( 1971–73 ) the years of famine were included . Blood pressure ( BP ) , r and om plasma glucose ( p-glucose ) and anthropometrics , as well as prevalence of hypertension ( BP>140/90 mmHg ) , impaired glucose tolerance ( IGT ; p-glucose 7.8–11.0 mmol/l ) , diabetes ( DM ; p-glucose ≥11.1 mmol/l ) , or overweight ( BMI > 25 kg/m2 ) were compared between the three groups . Fetal-infant exposure to famine was associated with elevated systolic ( + 7 mmHg ; p<0.001 ) and diastolic ( + 5 mmHg ; p<0.001 ) BP , increased p-glucose ( + 0.3 mmol/L ; p<0.05 ) and waist circumference ( + 3 cm , p<0.001 ) , increased risk of systolic hypertension ( adjusted OR 2.87 ; 95 % CI 1.90–4.34 ) , IGT ( OR 1.65 ; 95 % CI 1.02–2.69 ) and overweight ( OR 1.41 ; 95 % CI 1.03–1.93 ) as compared to people born after the famine . Limitations of this study include the lack of birth weight data and the inability to separate effects of fetal and infant famine . Conclusions Fetal and infant undernutrition is associated with significantly increased risk of hypertension and impaired glucose tolerance in 40-year-old Nigerians . Prevention of undernutrition during pregnancy and in infancy should therefore be given high priority in health , education , and economic agendas Background : High intake of sugar-containing beverages ( SCBs ) has been linked to increased risk of obesity . However , associations of SCB intake during pregnancy with child body composition have been unclear . Objectives : We explored whether SCB intake during pregnancy was associated with children 's body mass index ( BMI ) and detailed measures of body composition . In addition , we examined different types of SCBs ( i.e. , fruit juice , soda , and concentrate ) . Design : We included 3312 mother-child pairs of the Generation R Study , a prospect i ve cohort from fetal life onward in the Netherl and s. Energy-adjusted  SCB  intake was assessed in the first trimester with a food-frequency question naire . Anthropometric data of the children were collected repeatedly ≤6 y of age , and BMI was calculated . At 6 y of age , we further measured fat mass index ( FMI ) and fat-free mass index with dual-energy X-ray absorptiometry . All outcomes were sex- and age-st and ardized . Associations of SCB intake with  children 's BMI trajectories and body composition were analyzed with multivariable linear mixed and regression models . Results : Results from linear mixed models showed that , after adjustment for confounders including the SCB intake of the child itself , mothers ' total SCB intake was positively associated with children 's BMI ≤6 y of age [ per serving per day : 0.04 SD score ( SDS ) ; 95 % CI : 0.00 , 0.07 SDS ] . In addition , intakes of total SCBs and fruit juice , but not of soda or concentrate , were associated with a higher FMI [ total SCBs : 0.05 SDS ( 95 % CI : 0.01 , 0.08 SDS ) ; fruit juice : 0.04 SDS ( 95 % CI : 0.01 , 0.06 SDS ) ] of the 6-y-old children . These associations remained significant ( P < 0.05 ) after additional adjustment for gestational weight gain , birth weight , and children 's insulin concentrations . Conclusion : Our study suggests that maternal SCB intake during pregnancy is positively associated with children 's BMI during early childhood and particularly with higher fat mass OBJECTIVES : To examine the extent to which chronic sleep curtailment from infancy to mid-childhood is associated with total and central adiposity . METHODS : We studied 1046 children participating in a prospect i ve cohort study . At age 6 months and yearly from age 1 to 7 years , mothers reported their children ’s sleep duration in a usual 24-hour period . The main exposure was a sleep curtailment score from age 6 months to 7 years . The range of the total score was 0 to 13 , where 0 indicated the maximal sleep curtailment and 13 indicated never having curtailed sleep . Outcomes in mid-childhood were BMI z score , dual X-ray absorptiometry total and trunk fat mass index ( kg/m2 ) , and waist and hip circumferences ( cm ) . RESULTS : The mean ( SD ) sleep score was 10.2 ( 2.7 ) ; 4.4 % scored a 0 to 4 , indicating multiple exposures to sleep curtailment between age 6 months to 7 years , 12.3 % scored 5 to 7 , 14.1 % scored 8 to 9 , 28.8 % scored 10 to 11 , and 40.3 % scored 12 to 13 . In multivariable models , children who had a sleep score of 0 to 4 had a BMI z score that was 0.48 U ( 95 % confidence interval , 0.13 to 0.83 ) higher than those who had a sleep score of 12 to 13 . We observed similar associations of higher total and trunk fat mass index and waist and hip circumferences , and higher odds of obesity ( odds ratio , 2.62 ; 95 % confidence interval , 0.99 to 6.97 ) among children who had a score of 0 to 4 vs 12 to 13 . CONCLUSIONS : Chronic sleep curtailment from infancy to school age was associated with higher overall and central adiposity in mid-childhood Context : Recent data indicate a marked increase in the prevalence of  obesity among school-aged children . Thus , efficacious programmes that prevent overweight development in children are urgently needed . Objective : To evaluate the impact of repeatedly given , individualised dietary and lifestyle counselling on the prevalence of overweight during the first 10 years of life . Design and participants : This study was a part of the Special Turku Coronary Risk Factor Intervention Project for Children ( STRIP ) , which is a prospect i ve , r and omised trial aim ed at reducing the exposure of the intervention children to the known risk factors of atherosclerosis . At the child 's age of 7 months , 1062 children were assigned to an intervention group ( n=540 ) or to a control group ( n=522 ) . The intervention children received individualised counselling focused on healthy diet and physical activity biannually . Height and weight of the children were measured at least once a year . Main outcome measure : Prevalence of overweight and obesity among the intervention and control children by sex and age . Children were classified as  overweight or  obese if their weight for height was > 20 % or ⩾40 % above the mean weight for height of healthy Finnish children , respectively . Results : After the age of 2 years , there were continuously fewer overweight girls in the intervention group than in the control group . At the age of 10 years , 10.2 % of the intervention girls and 18.8 % of the control girls were 
    Output:
    