American journal of epidemiology
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Randomized Controlled Trial
Effect of reducing indoor air pollution on women's respiratory symptoms and lung function: the RESPIRE Randomized Trial, Guatemala.
Exposure to household wood smoke from cooking is a risk factor for chronic obstructive lung disease among women in developing countries. The Randomized Exposure Study of Pollution Indoors and Respiratory Effects (RESPIRE) is a randomized intervention trial evaluating the respiratory health effects of reducing indoor air pollution from open cooking fires. A total of 504 rural Mayan women in highland Guatemala aged 15-50 years, all using traditional indoor open fires, were randomized to either receive a chimney woodstove (plancha) or continue using the open fire. ⋯ The number of respiratory symptoms reported by the women at each follow-up point was also significantly reduced by the plancha (odds ratio = 0.7, 95% confidence interval: 0.50, 0.97). However, no significant effects on lung function were found after 12-18 months. Reducing indoor air pollution from household biomass burning may relieve symptoms consistent with chronic respiratory tract irritation.
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In this study, the authors aimed to determine whether higher activity energy expenditure, assessed by using doubly labeled water, was associated with a reduced decline in mobility limitation among 248 older community-dwelling US adults aged 70-82 years enrolled in 1998-1999. Activity energy expenditure was calculated as total energy expenditure (assessed over 2 weeks by using doubly labeled water) minus resting metabolic rate (measured with indirect calorimetry), with adjustment for the thermic effect of food. Across sex-specific tertiles of activity energy expenditure, men in the lowest activity group experienced twice the rate of mobility limitation as men in the highest activity group (41% (n = 18) vs. 18% (n = 8)). ⋯ After adjustment for potential confounders, men with higher activity energy expenditure levels continued to show reduced risk of mobility limitation (per standard deviation (284 kcal/day): hazard ratio = 0.61, 95% confidence interval: 0.41, 0.92). Women showed no association (per standard deviation (226 kcal/day): hazard ratio = 1.34, 95% confidence interval: 0.98, 1.85). Greater energy expenditure from any and all physical activity was significantly associated with reduced risk of developing mobility limitation among men, but not among women.
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Review Meta Analysis
Birth weight, early weight gain, and subsequent risk of type 1 diabetes: systematic review and meta-analysis.
Previous studies suggest that birth weight and weight gain during the first year of life are related to later risk of type 1 diabetes. The authors performed a systematic review and meta-analysis on these associations. Twelve studies involving 2,398,150 persons of whom 7,491 had type 1 diabetes provided odds ratios and 95% confidence intervals of type 1 diabetes associated with birth weight. ⋯ Each 1,000-g increase in birth weight was associated with a 7% increase in type 1 diabetes risk. In all studies, patients with type 1 diabetes showed increased weight gain during the first year of life, compared with controls. This meta-analysis indicates that high birth weight and increased early weight gain are risk factors for type 1 diabetes.
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There is concern that the increasing prevalence of type 2 diabetes may diminish improving trends in life expectancy. This study aimed to determine whether the mortality of type 2 diabetes, relative to mortality in the general population, is remaining constant. The study included a cohort of 48,556 subjects with type 2 diabetes first diagnosed between 1996 and 2006, drawn from 197 family practices in the United Kingdom General Practice Research Database. ⋯ After adjustment for age, sex, and diabetes duration, there was a consistent decrease in relative mortality during the period of study. Relative mortality for subjects diagnosed in 1996 was 13% (95% CI: 2, 25) higher than that in 2001; for subjects diagnosed in 2006, relative mortality was 26% (95% CI: 8, 40) lower than that in 2001. Relative mortality of type 2 diabetes appears to be decreasing in men and women in the United Kingdom.