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 . The goal was to examine the associations of weight-for-length at birth and at 6 months with obesity at 3 years of age . METHODS . We studied 559 children in Project Viva , an ongoing , prospect i ve , cohort study of pregnant women and their children . We measured length and weight at birth , 6 months , and 3 years . Our main exposures were weight-for-length z score at birth adjusted for gestational age and weight-for-length z score at 6 months adjusted for weight-for-length z score at birth . We used multivariate regression analyses to predict the independent effects of birth weight-for-length z score and , separately , 6-month weight-for-length z score on BMI z score  , the sum of subscapular and triceps skinfold thicknesses  , and obesity ( BMI for age and gender of ≥95th percentile ) at age 3 . RESULTS . Mean weights at birth , 6 months , and 3 years were 3.55 , 8.15 , and 15.67 kg , respectively . Corresponding lengths were 49.9 , 66.9 , and 97.4 cm . At 3 years , 48 children ( 9 % ) were obese . After adjustment for confounding variables and birth weight-for-length z score , each increment in 6-month weight-for-length z score was associated with higher BMI z scores , higher sums of subscapular and triceps skinfold thicknesses , and increased odds of obesity at age 3 . The predicted obesity prevalence among children in the highest quartiles of both birth and 6-month weight-for-length z scores was 40 % , compared with 1 % for children in the lowest quartiles of both . Whereas birth weight-for-length z scores were associated with higher BMI z scores , the magnitude of effect was smaller than that of weight-for-length z scores at 6 months . CONCLUSIONS . More-rapid increases in weight for length in the first 6 months of life were associated with sharply increased risk of obesity at 3 years of age . Changes in weight status in infancy may influence risk of later obesity more than weight status at birth BACKGROUND No evidence -based recommendations exist concerning what dietary macronutrient composition optimizes weight loss during lactation while maintaining milk production . OBJECTIVES The study was design ed to test the following hypotheses : compared with a reduced-calorie , high-carbohydrate ( H-CHO ) diet , an isonitrogenous , isocaloric high-fat ( H-F ) diet will decrease milk production and carbohydrate oxidation , increase gluconeogenesis and hexoneogenesis , and not affect energy balance . DESIGN Seven healthy lactating mothers and their infants were studied on 2 occasions in r and om order for 8 d separated by 1 - 2 wk . On one occasion , the subjects received the H-F ( 30 % of energy as carbohydrate and 55 % as fat ) diet and on the other occasion received the H-CHO ( 60 % of energy as carbohydrate and 25 % as fat ) diet .  Milk production , infant intakes , and substrate and hormone concentrations were measured . Glucose rates of appearance , production , gluconeogenesis , glycogenolysis , and hexoneogenesis were measured by using stable-isotope gas chromatography-mass spectrometric techniques , and energy expenditure and substrate oxidation were measured by using indirect calorimetry . RESULTS Milk volume , lactose , and protein concentrations were unaffected . Milk fat , energy , and infant intakes were higher ( P < 0.05 ) during the H-F diet . Neither gluconeogenesis nor hexoneogenesis was different . During the H-F diet , energy expenditure and fat and protein oxidation rates were higher ( P < 0.05 ) , and the daily energy balance deficit was greater ( P < 0.01 ) . CONCLUSIONS Milk fat , energy output , and energy expenditure were higher during the H-F diet , which result ed in a greater negative energy balance . The lactating mothers adapted to a low carbohydrate intake by decreasing carbohydrate oxidation . Additional studies are warranted to determine whether a hypocaloric H-F diet might promote weight loss to a greater extent than the H-CHO diet while maintaining milk production Background —Accelerated neonatal growth increases the later propensity to cardiovascular disease ( CVD ) in animals , whereas slower growth is thought to have a beneficial effect . To test this hypothesis in humans , we measured flow-mediated endothelium-dependent dilation ( FMD ) in a population subject to slower early growth and in healthy controls . Methods and Results —High-resolution vascular ultrasound was used to measure the change in brachial artery diameter in response to reactive hyperemia in adolescents age 13 to 16 years who were either part of a cohort born preterm and followed up prospect ively ( n=216 ) or controls born at term ( n=61 ) . Greater weight gain or linear growth in the first 2 weeks postnatally was associated with lower FMD at adolescence ( regression coefficient , −0.026-mm change in mean arterial diameter per 100-g increase in weight ; 95 % CI , −0.040 to −0.012 mm ; P = 0.0003 ) independent of birthweight and potential confounding factors . Mean FMD in the half of the preterm population with the lowest rates of early growth was higher than in both the half with the greatest growth ( P = 0.001 ) and subjects born at term ( P = 0.03 ) . Conclusions —FMD was 4 % lower in adolescents with the highest compared with the lowest rate of weight gain in the first 2 weeks after birth , a substantial negative effect similar to that for insulin-dependent diabetes mellitus or smoking in adults . Our findings are consistent with the adverse effects of accelerated neonatal growth on long-term cardiovascular health and suggest that postnatal growth patterns could explain the previously reported association between birthweight and later CVD Objective . Perceived intolerance to infant formula is a frequently reported reason for formula switching . Formula intolerance may be related to perceived symptoms of constipation , fussiness , abdominal cramps , and excessive spit-up or vomit . Commercially available formulas differ from each other in processing and in sources and levels of protein , lipids , and micronutrients . These differences may affect tolerance . The objective of this article was to compare the tolerance of two commercially available powder infant formulas that differ in composition . Measures of tolerance in exclusively breastfed infants weaned to an infant formula and exclusively formula-fed infants were evaluated . Methods . Two clinical studies were conducted . In study 1 , 82 healthy , full-term infants who were exclusively breastfed at the time of enrollment were  r and omized at weaning to formula A ( commercially available Similac With Iron Powder ) or formula B ( previously available Enfamil With Iron Powder ) . Parents completed daily records of tolerance during exclusive breast milk feeding , during the weaning period , and for a 2-week exclusive formula-feeding period . In study 2 , 87 healthy , full-term infants who were exclusively formula-fed at the time of study enrollment ( by 2 weeks of age ) were fed a st and ard cow milk-based formula ( previously commercially available Similac With Iron Powder ) and then r and omized to receive formula A or B for a 2-week period . Parents completed daily records of tolerance throughout the study . Formula A was a cow milk-based formula with a whey : casein ratio of 48:52 and a fat blend of 42 % high-oleic safflower , 30 % coconut , and 28 % soy oils . Formula B was a cow milk-based formula with a whey : casein ratio of 60:40 and a fat blend of 45 % palm olein , 20 % soy , 20 % coconut , and 15 % high-oleic sunflower oils . Both formulas had lactose as the source of carbohydrate and contained 12 mg of iron per liter . Only formula A contained nucleotides at the time of the study . Measures of tolerance included volume of each formula feeding , occurrences of spit-up and /or vomit , and the color ( yellow , green , brown , or black ) and consistency ( water , loose/mushy , soft , formed , or hard ) of each stool . Results . In both studies , volume of formula intake , weight gain , and incidence of spit-up or vomit did not differ between feeding groups . In study 1 , stool frequency decreased significantly from the exclusive breast milk period to weaning . Stools also became firmer as infants moved from breast milk to weaning and to exclusive formula feeding . When formula was introduced into the diet , stools became less yellow and more green . Infants weaned to formula B had less frequent stools , fewer brown stools , and more yellow stools than did infants fed formula A. In both studies , infants fed formula B experienced significantly firmer stools than did those fed formula A. Conclusions . The present clinical studies indicate that the composition and /or processing of milk-based powder iron-fortified infant formulas affect stool characteristics experienced by infants . The inclusion of palm olein oil in formula B may be the reason for the observed differences in stool characteristics . Palm olein is used in infant formulas to provide palmitic acid at a level similar to that found in breast milk . However , palmitic acid from palm olein is arranged differently from that in breast milk triglyceride and is poorly absorbed . Unabsorbed palmitic acid tends to react with calcium to form insoluble soaps , and the level of these soaps is correlated with stool hardness . The pattern of softer stools and greater frequency of stooling associated with formula A is similar to the stool pattern in the exclusively breastfed infant . Thus , the use of formula A may ease the transition from breast milk to formula feeding and ameliorate parents ' perception that constipation is associated with iron-fortified formula This study is the first to report approximations of energy requirements for male and female breast-fed and formula-fed infants based on individual estimates of total daily energy expenditure ( TDEE ) and energy deposition derived from total body fat ( TBF ) and fat-free mass ( FFM ) gain as determined by total-body electrical conductivity . In 46 healthy , full-term infants the effect of > or = 4 mo of exclusive breast-feeding compared with formula feeding on macronutrient and energy intake , TDEE , energy deposition , and growth were investigated prospect ively . Metabolizable energy intake ( MEI ) was assessed from macronutrient intake by test weighing ( MEI-TW ) and from the sum of TDEE and energy deposition  ( MEI-Pred ) . At 1 - 2 , 2 - 4 , 4 - 8 , and 8 - 12 mo of age MEI-Pred averaged 431 + /- 38 , 393 + /- 33 , 372 + /- 33 , and 355 + /- 21 kJ x kg(-1 ) x d(-1 ) for boys , and 401 + /- 59 , 376 + /- 25 , 334 + /- 33 , and 326 + /- 17 kJ x kg(-1 ) x d(-1 ) for girls . No significant difference between breast-fed and formula-fed infants was found with respect to weight , length , head circumference , TBF , FFM , and TDEE at all ages , or for gain in length , weight , TBF , and FFM . MEI-TW was significantly different between feeding groups at 1 - 4 mo of age ( formula-fed being greater than breast-fed , P < 0.005 ) . This feeding effect , however , was not significant for MEI-Pred ( MJ/d ) . MEI-TW differed from MEI-Pred only in breast-fed infants at 1 - 4 mo ( P < 0.05 at 2 - 4 mo ) . The data from this study indicate that energy requirements in infants are lower than the recommendations in guidelines currently in use This study investigated the effect of supplementation with chicken extract on plasma and colostrum protein compositions in lactating women . Thirty healthy pregnant women were evenly divided into the control ( n = 15 ) or chicken extract ( CE ) group ( n = 15 ) . The CE group was given one bottle ( 70 mL/bottle ) of chicken extract three times a day to provide 18 g protein from the 37th week pregnancy to 3 days postpartum . All women in the CE group consumed chicken extract at least for 2 weeks ( 18 + /- 5 days ) . High protein supplement was restricted in the control group . Blood sample s were collected during the 37th week pregnancy and 3-day postpartum , and milk was collected during 3-day postpartum . The results showed that plasma total protein was significantly lower by 14 % in the CE group compared with that in the control group during 3-day postpartum . Plasma epidermal growth factor ( EGF ) significantly elevated by 236 % during 3-day postpartum compared with those during the 37th week pregnancy in the CE group . The levels of lactoferrin , EGF , and transforming growth factor-beta2 ( TGF-beta2 ) in colostrum significantly increased by 34 % , 62 % , and 196 % , respectively , in the CE group compared with those in the control group . However , the levels of total protein , casein , lactalbumin , and secretory immunoglobulin A in colostrum did not significantly differ between two groups . Therefore , supplementation with chicken extract increased colostrum levels of lactoferrin , EGF , and TGF-beta2 , which are important for the growth and immune functions of the infants , in lactating women BACKGROUND Protein intake during infancy was associated with rapid early weight gain and later obesity  in observational 
    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 . The goal was to examine the associations of weight-for-length at birth and at 6 months with obesity at 3 years of age . METHODS . We studied 559 children in Project Viva , an ongoing , prospect i ve , cohort study of pregnant women and their children . We measured length and weight at birth , 6 months , and 3 years . Our main exposures were weight-for-length z score at birth adjusted for gestational age and weight-for-length z score at 6 months adjusted for weight-for-length z score at birth . We used multivariate regression analyses to predict the independent effects of birth weight-for-length z score and , separately , 6-month weight-for-length z score on BMI z score  , the sum of subscapular and triceps skinfold thicknesses  , and obesity ( BMI for age and gender of ≥95th percentile ) at age 3 . RESULTS . Mean weights at birth , 6 months , and 3 years were 3.55 , 8.15 , and 15.67 kg , respectively . Corresponding lengths were 49.9 , 66.9 , and 97.4 cm . At 3 years , 48 children ( 9 % ) were obese . After adjustment for confounding variables and birth weight-for-length z score , each increment in 6-month weight-for-length z score was associated with higher BMI z scores , higher sums of subscapular and triceps skinfold thicknesses , and increased odds of obesity at age 3 . The predicted obesity prevalence among children in the highest quartiles of both birth and 6-month weight-for-length z scores was 40 % , compared with 1 % for children in the lowest quartiles of both . Whereas birth weight-for-length z scores were associated with higher BMI z scores , the magnitude of effect was smaller than that of weight-for-length z scores at 6 months . CONCLUSIONS . More-rapid increases in weight for length in the first 6 months of life were associated with sharply increased risk of obesity at 3 years of age . Changes in weight status in infancy may influence risk of later obesity more than weight status at birth BACKGROUND No evidence -based recommendations exist concerning what dietary macronutrient composition optimizes weight loss during lactation while maintaining milk production . OBJECTIVES The study was design ed to test the following hypotheses : compared with a reduced-calorie , high-carbohydrate ( H-CHO ) diet , an isonitrogenous , isocaloric high-fat ( H-F ) diet will decrease milk production and carbohydrate oxidation , increase gluconeogenesis and hexoneogenesis , and not affect energy balance . DESIGN Seven healthy lactating mothers and their infants were studied on 2 occasions in r and om order for 8 d separated by 1 - 2 wk . On one occasion , the subjects received the H-F ( 30 % of energy as carbohydrate and 55 % as fat ) diet and on the other occasion received the H-CHO ( 60 % of energy as carbohydrate and 25 % as fat ) diet .  Milk production , infant intakes , and substrate and hormone concentrations were measured . Glucose rates of appearance , production , gluconeogenesis , glycogenolysis , and hexoneogenesis were measured by using stable-isotope gas chromatography-mass spectrometric techniques , and energy expenditure and substrate oxidation were measured by using indirect calorimetry . RESULTS Milk volume , lactose , and protein concentrations were unaffected . Milk fat , energy , and infant intakes were higher ( P < 0.05 ) during the H-F diet . Neither gluconeogenesis nor hexoneogenesis was different . During the H-F diet , energy expenditure and fat and protein oxidation rates were higher ( P < 0.05 ) , and the daily energy balance deficit was greater ( P < 0.01 ) . CONCLUSIONS Milk fat , energy output , and energy expenditure were higher during the H-F diet , which result ed in a greater negative energy balance . The lactating mothers adapted to a low carbohydrate intake by decreasing carbohydrate oxidation . Additional studies are warranted to determine whether a hypocaloric H-F diet might promote weight loss to a greater extent than the H-CHO diet while maintaining milk production Background —Accelerated neonatal growth increases the later propensity to cardiovascular disease ( CVD ) in animals , whereas slower growth is thought to have a beneficial effect . To test this hypothesis in humans , we measured flow-mediated endothelium-dependent dilation ( FMD ) in a population subject to slower early growth and in healthy controls . Methods and Results —High-resolution vascular ultrasound was used to measure the change in brachial artery diameter in response to reactive hyperemia in adolescents age 13 to 16 years who were either part of a cohort born preterm and followed up prospect ively ( n=216 ) or controls born at term ( n=61 ) . Greater weight gain or linear growth in the first 2 weeks postnatally was associated with lower FMD at adolescence ( regression coefficient , −0.026-mm change in mean arterial diameter per 100-g increase in weight ; 95 % CI , −0.040 to −0.012 mm ; P = 0.0003 ) independent of birthweight and potential confounding factors . Mean FMD in the half of the preterm population with the lowest rates of early growth was higher than in both the half with the greatest growth ( P = 0.001 ) and subjects born at term ( P = 0.03 ) . Conclusions —FMD was 4 % lower in adolescents with the highest compared with the lowest rate of weight gain in the first 2 weeks after birth , a substantial negative effect similar to that for insulin-dependent diabetes mellitus or smoking in adults . Our findings are consistent with the adverse effects of accelerated neonatal growth on long-term cardiovascular health and suggest that postnatal growth patterns could explain the previously reported association between birthweight and later CVD Objective . Perceived intolerance to infant formula is a frequently reported reason for formula switching . Formula intolerance may be related to perceived symptoms of constipation , fussiness , abdominal cramps , and excessive spit-up or vomit . Commercially available formulas differ from each other in processing and in sources and levels of protein , lipids , and micronutrients . These differences may affect tolerance . The objective of this article was to compare the tolerance of two commercially available powder infant formulas that differ in composition . Measures of tolerance in exclusively breastfed infants weaned to an infant formula and exclusively formula-fed infants were evaluated . Methods . Two clinical studies were conducted . In study 1 , 82 healthy , full-term infants who were exclusively breastfed at the time of enrollment were  r and omized at weaning to formula A ( commercially available Similac With Iron Powder ) or formula B ( previously available Enfamil With Iron Powder ) . Parents completed daily records of tolerance during exclusive breast milk feeding , during the weaning period , and for a 2-week exclusive formula-feeding period . In study 2 , 87 healthy , full-term infants who were exclusively formula-fed at the time of study enrollment ( by 2 weeks of age ) were fed a st and ard cow milk-based formula ( previously commercially available Similac With Iron Powder ) and then r and omized to receive formula A or B for a 2-week period . Parents completed daily records of tolerance throughout the study . Formula A was a cow milk-based formula with a whey : casein ratio of 48:52 and a fat blend of 42 % high-oleic safflower , 30 % coconut , and 28 % soy oils . Formula B was a cow milk-based formula with a whey : casein ratio of 60:40 and a fat blend of 45 % palm olein , 20 % soy , 20 % coconut , and 15 % high-oleic sunflower oils . Both formulas had lactose as the source of carbohydrate and contained 12 mg of iron per liter . Only formula A contained nucleotides at the time of the study . Measures of tolerance included volume of each formula feeding , occurrences of spit-up and /or vomit , and the color ( yellow , green , brown , or black ) and consistency ( water , loose/mushy , soft , formed , or hard ) of each stool . Results . In both studies , volume of formula intake , weight gain , and incidence of spit-up or vomit did not differ between feeding groups . In study 1 , stool frequency decreased significantly from the exclusive breast milk period to weaning . Stools also became firmer as infants moved from breast milk to weaning and to exclusive formula feeding . When formula was introduced into the diet , stools became less yellow and more green . Infants weaned to formula B had less frequent stools , fewer brown stools , and more yellow stools than did infants fed formula A. In both studies , infants fed formula B experienced significantly firmer stools than did those fed formula A. Conclusions . The present clinical studies indicate that the composition and /or processing of milk-based powder iron-fortified infant formulas affect stool characteristics experienced by infants . The inclusion of palm olein oil in formula B may be the reason for the observed differences in stool characteristics . Palm olein is used in infant formulas to provide palmitic acid at a level similar to that found in breast milk . However , palmitic acid from palm olein is arranged differently from that in breast milk triglyceride and is poorly absorbed . Unabsorbed palmitic acid tends to react with calcium to form insoluble soaps , and the level of these soaps is correlated with stool hardness . The pattern of softer stools and greater frequency of stooling associated with formula A is similar to the stool pattern in the exclusively breastfed infant . Thus , the use of formula A may ease the transition from breast milk to formula feeding and ameliorate parents ' perception that constipation is associated with iron-fortified formula This study is the first to report approximations of energy requirements for male and female breast-fed and formula-fed infants based on individual estimates of total daily energy expenditure ( TDEE ) and energy deposition derived from total body fat ( TBF ) and fat-free mass ( FFM ) gain as determined by total-body electrical conductivity . In 46 healthy , full-term infants the effect of > or = 4 mo of exclusive breast-feeding compared with formula feeding on macronutrient and energy intake , TDEE , energy deposition , and growth were investigated prospect ively . Metabolizable energy intake ( MEI ) was assessed from macronutrient intake by test weighing ( MEI-TW ) and from the sum of TDEE and energy deposition  ( MEI-Pred ) . At 1 - 2 , 2 - 4 , 4 - 8 , and 8 - 12 mo of age MEI-Pred averaged 431 + /- 38 , 393 + /- 33 , 372 + /- 33 , and 355 + /- 21 kJ x kg(-1 ) x d(-1 ) for boys , and 401 + /- 59 , 376 + /- 25 , 334 + /- 33 , and 326 + /- 17 kJ x kg(-1 ) x d(-1 ) for girls . No significant difference between breast-fed and formula-fed infants was found with respect to weight , length , head circumference , TBF , FFM , and TDEE at all ages , or for gain in length , weight , TBF , and FFM . MEI-TW was significantly different between feeding groups at 1 - 4 mo of age ( formula-fed being greater than breast-fed , P < 0.005 ) . This feeding effect , however , was not significant for MEI-Pred ( MJ/d ) . MEI-TW differed from MEI-Pred only in breast-fed infants at 1 - 4 mo ( P < 0.05 at 2 - 4 mo ) . The data from this study indicate that energy requirements in infants are lower than the recommendations in guidelines currently in use This study investigated the effect of supplementation with chicken extract on plasma and colostrum protein compositions in lactating women . Thirty healthy pregnant women were evenly divided into the control ( n = 15 ) or chicken extract ( CE ) group ( n = 15 ) . The CE group was given one bottle ( 70 mL/bottle ) of chicken extract three times a day to provide 18 g protein from the 37th week pregnancy to 3 days postpartum . All women in the CE group consumed chicken extract at least for 2 weeks ( 18 + /- 5 days ) . High protein supplement was restricted in the control group . Blood sample s were collected during the 37th week pregnancy and 3-day postpartum , and milk was collected during 3-day postpartum . The results showed that plasma total protein was significantly lower by 14 % in the CE group compared with that in the control group during 3-day postpartum . Plasma epidermal growth factor ( EGF ) significantly elevated by 236 % during 3-day postpartum compared with those during the 37th week pregnancy in the CE group . The levels of lactoferrin , EGF , and transforming growth factor-beta2 ( TGF-beta2 ) in colostrum significantly increased by 34 % , 62 % , and 196 % , respectively , in the CE group compared with those in the control group . However , the levels of total protein , casein , lactalbumin , and secretory immunoglobulin A in colostrum did not significantly differ between two groups . Therefore , supplementation with chicken extract increased colostrum levels of lactoferrin , EGF , and TGF-beta2 , which are important for the growth and immune functions of the infants , in lactating women BACKGROUND Protein intake during infancy was associated with rapid early weight gain and later obesity  in observational 
    Output:
    