Effect of excise tax on sugar-sweetened beverages in Catalonia, Spain, three and a half years after its introduction

Background: The World Health Organisation urges countries to levy specifc excise taxes on SSBs. Currently, more than 50 countries have introduced some type of tax on SSBs. In March 2017, the Autonomous Region of Catalonia approved the introduction of a tiered excise tax on SSBs for public health reasons. To evaluate the efect of the Catalonian excise tax on the price and purchase of sugar-sweetened beverages (SSBs) and their possible substitutes, i.e., non-sugar-sweetened beverages (NSSBs) and bottled water, three and half years after its introduction, and 1 year after the outbreak of the COVID-19 pandemic. Methods: We analysed purchase data on soft drinks, fruit drinks and water, sourced from the Ministry of Agriculture food-consumption panel, in a random sample of 12,500 households across Spain. We applied the synthetic control method to infer the causal impact of the intervention, based on a Bayesian structural time-series model which predicts the counterfactual response that would have occurred in Catalonia, had no intervention taken place. Results: As compared to the predicted (counterfactual) response, per capita purchases of SSBs fell by 0.17 l three and a half years after implementing the SSB tax in Catalonia, a 16.7% decline (95% CI: −23.18, −8.74). The mean SSB price rose by 0.11 €/L, an 11% increase (95% CI: 9.0, 14.1). Although there were no changes in mean NSSB prices, NSSB consumption rose by 0.19 l per capita, a 21.7% increase (95% CI: 18.25, 25.54). There were no variations in the price or consumption of bottled water. The efects were progressively greater over time, with SSB purchases decreasing by 10.4% at 1 year, 12.3% at 2 years, 15.3% at 3 years, and 16.7% at three and a half years of the tax’s introduction. Conclusions: The Catalonian SSB excise tax had a sustained and progressive impact over time, with a fall in consumption of as much as 16.7% three and half years after its introduction. The observed NSSB substitution efect should be borne in mind when considering the application of this type of tax to the rest of Spain.This study was supported by the Spanish Health Research Strategic Action (Acción Estratégica en Salud) of the Carlos III Institute of Health (Project ENPY 120/18). The funders had no role in the design of the study, in collection, analysis, and interpretation of data, or in writing the manuscript.S

Paraspinal muscle gene expression across different aetiologies in individuals undergoing surgery for lumbar spine pathology

PURPOSE The purpose of this study was to understand potential baseline transcriptional expression differences in paraspinal skeletal muscle from patients with different underlying lumbar pathologies by comparing multifidus gene expression profiles across individuals with either disc herniation, facet arthropathy, or degenerative spondylolisthesis. METHODS Multifidus biopsies were obtained from patients (n = 44) undergoing lumbar surgery for either disc herniation, facet arthropathy, or degenerative spondylolisthesis. Diagnostic categories were based on magnetic resonance images, radiology reports, and intraoperative reports. Gene expression for 42 genes was analysed using qPCR. A one-way analysis of variance was performed for each gene to determine differences in expression across diagnostic groups. Corrections for multiple comparisons across genes (Benjamini-Hochberg) and for between-group post hoc comparisons (Sidak) were applied. RESULTS Adipogenic gene (ADIPOQ) expression was higher in the disc herniation group when compared to the facet arthropathy group (p = 0.032). Adipogenic gene (PPARD) expression was higher in the degenerative spondylolisthesis group when compared to the disc herniation group (p = 0.013), although absolute gene expression levels for all groups was low. Fibrogenic gene (COL3A1) had significantly higher expression in the disc herniation group and facet arthropathy group when compared to the degenerative spondylolisthesis group (p < 0.001 and p = 0.038, respectively). When adjusted for multiple comparisons, only COL3A1 remained significant (p = 0.012). CONCLUSION Individuals with disc herniation and facet arthropathy demonstrate higher COL3A1 gene expression compared to those with degenerative spondylolisthesis. Future research is required to further understand the biological relevance of these transcriptional differences

Paraspinal Muscle Health is Related to Fibrogenic, Adipogenic, and Myogenic Gene Expression in Patients with Lumbar Spine Pathology

BACKGROUND Lumbar spine pathology is a common feature of lower back and/or lower extremity pain and is associated with observable degenerative changes in the lumbar paraspinal muscles that are associated with poor clinical prognosis. Despite the commonly observed phenotype of muscle degeneration in this patient population, its underlying molecular mechanisms are not well understood. The aim of this study was to investigate the relationships between groups of genes within the atrophic, myogenic, fibrogenic, adipogenic, and inflammatory pathways and multifidus muscle health in individuals undergoing surgery for lumbar spine pathology. METHODS Multifidus muscle biopsies were obtained from patients (n = 59) undergoing surgery for lumbar spine pathology to analyze 42 genes from relevant adipogenic/metabolic, atrophic, fibrogenic, inflammatory, and myogenic gene pathways using quantitative polymerase chain reaction. Multifidus muscle morphology was examined preoperatively in these patients at the level and side of biopsy using T2-weighted magnetic resonance imaging to determine whole muscle compartment area, lean muscle area, fat cross-sectional areas, and proportion of fat within the muscle compartment. These measures were used to investigate the relationships between gene expression patterns and muscle size and quality. RESULTS Relationships between gene expression and imaging revealed significant associations between decreased expression of adipogenic/metabolic gene (PPARD), increased expression of fibrogenic gene (COL3A1), and lower fat fraction on MRI (r = -0.346, p = 0.018, and r = 0.386, p = 0.047 respectively). Decreased expression of myogenic gene (mTOR) was related to greater lean muscle cross-sectional area (r = 0.388, p = 0.045). CONCLUSION Fibrogenic and adipogenic/metabolic genes were related to pre-operative muscle quality, and myogenic genes were related to pre-operative muscle size. These findings provide insight into molecular pathways associated with muscle health in the presence of lumbar spine pathology, establishing a foundation for future research that addresses how these changes impact outcomes in this patient population

Adherence to mediterranean diet and its associated factors in adolescents from Madrid

[ES] Objetivo: La dieta poco saludable es el principal factor que contribuye a la obesidad infantil. El objetivo de este estudio fue evaluar la adherencia a la dieta mediterránea en una muestra de adolescentes y analizar los factores asociados a la misma. Metodos: Se realizó una encuesta transversal a 573 adolescentes de entre 11 y 14 años en Madrid en 2018. Se recogieron variables mediante un cuestionario. La adherencia a la dieta mediterránea se midió con el índice KIDMED. Las características asociadas a una alta adherencia se analizaron mediante razones de prevalencia (RP) obtenidas con regresión de Poisson de varianza robusta. Resultados: El 64,3% de los participantes presentaron un nivel de adherencia medio a la dieta mediterránea. La alta adherencia fue menos frecuente en adolescentes mujeres (17% [RP=0,63; p=0,02]), cuyas madres no habían superado los estudios primarios (16,3% [RP=0,58; p=0,07]), que dormían menos de 8,5 horas al día (16,8% [RP=0,54; p<0,01]) o que usaban el móvil más de 2,6 horas al día (12,2% [RP=0,56; p=0,02]). Conclusiones: La adherencia a la dieta mediterránea es inferior a la óptima en cuatro de cada cinco adolescentes, y resulta menor en adolescentes mujeres, cuyas madres no superaron los estudios primarios o que dedicaban más tiempo al móvil y menos a dormir. Nuestros resultados apuntan a la importancia de atender a los hábitos de sueño y a reducir el uso de pantallas para mejorar la adherencia a la dieta mediterránea en adolescentes. [EN] Objective: Unhealthy diet is the main contributor to childhood obesity. The aim of this study was to assess adherence to the mediterranean diet in a sample of adolescents and analyse adherence-related factors. Methods: Cross-sectional descriptive study (June-October 2020), in a non-probabilistic sample of 473 patients with Substance Use Disorder, from the 8 Addiction Care Centers (CAD) of the Madrid City Council. Their demographic, habits and health characteristics, IgM and IgG for SARS-CoV-2, previous PCR, presence of symptoms, contact with COVID-19 cases were described, and multivariate analysis was performed using binary logistic regression. Results: A total of 64.3% of participants displayed a medium level and 21.3% a high level of adherence to the mediterranean diet. High adherence was less frequent among teenage girls (17% [PR=0.63; p=0.02]), those whose mothers had not gone beyond primary school (16.3% [PR=0.58; p=0.07]), those who slept less than 8.5 h/day (16.8% [PR=0.54; p<0.01]), and those who used a mobile telephone for more than 2.6 hours per day (12.2% [PR=0.56; p=0.02]). Conclusions: Adherence to the mediterranean diet is less than optimum in four out of five adolescents, and is lower in teenage girls whose mothers had not gone beyond primary school or who devote more time to mobile telephones and less time to sleeping. Our results highlight the importance of paying attention to sleeping habits and reducing the use of screens when seeking to improve mediterranean diet adherence among adolescents.Este trabajo fue apoyado por el Instituto Mixto de Investigación, Escuela Nacional de Sanidad (IMIENS), resolución del 14 de febrero de 2019.S

Quality of food products announced on television before and after the plan to improve their composition, 2017-2020

[ES] Objetivo: Comparar la calidad nutricional de los alimentos y bebidas anunciados por televisión en España antes y después del plan para mejorar su composición. Método: Se grabaron las emisiones por televisión digital terrestre (TDT) en horario infantil de los canales más populares. Se registraron los productos anunciados en los cortes comerciales y su composición nutricional. Se comparó su distribución de frecuencias por categorías alimentarias y su adherencia al perfil nutricional de la Organización Mundial de la Salud en 2017 y 2020. Resultados: En 256 horas de emisión se identificaron 173 productos (78 en 2017 y 95 en 2020). Los más anunciados fueron los chocolates (26,9% en 2017 y 22,1% en 2020). El 76,3% de los productos anunciados eran no saludables (76,9% en 2017 y 75,8% en 2020; p=0,86). Conclusiones: El perfil nutricional de los productos anunciados por televisión, mayoritariamente no saludables, no cambió tras la implantación del plan para mejorar su composición. Es preciso regular la publicidad alimentaria para proteger a los niños. [EN] Objective: To compare the nutritional quality of the foods and beverages advertised on television in Spain, before and after the plan to improve their composition. Method: DTT broadcasts of the more popular channels were recorded in children's hours. Every advertised products in commercial breaks were registered and their nutritional data collected. We compared the distribution of frequencies by food categories and their adherence to the nutritional standards of the World Health Organization in 2017 and 2020. Results: In 256h of broadcasting we identified 173 products (78 in 2017 and 95 in 2020). The most advertised products were chocolates (26.9% in 2017 and 22.1% in 2020). 76.3% of the products advertised were unhealthy (76.9% in 2017 vs. 75.8% in 2020; p=0.86). Conclusions: The nutritional profile of the foods and drinks advertised on television, mostly unhealthy, did not change after the implementation of the plan to improve their composition. A regulation is needed to protect children from food advertising.Este estudio ha recibido financiación del Instituto Mixto de Investigación Escuela Nacional de Sanidad (IMIENS: Resolución de la convocatoria de ayudas para la realización de Proyectos de Investigación Conjuntos, publicada en BICI n.◦ 2 de 16 de octubre de 2017).S

Paraspinal muscles in individuals undergoing surgery for lumbar spine pathology lack a myogenic response to an acute bout of resistance exercise

BACKGROUND: Lumbar spine pathology (LSP) is a common source of low back or leg pain, and paraspinal muscle in these patients demonstrates fatty and fibrotic infiltration, and cellular degeneration that do not reverse with exercise-based rehabilitation. However, it is unclear of this lack of response is due to insufficient exercise stimulus, or an inability to mount a growth response. The purpose of this study was to compare paraspinal muscle gene expression between individuals with LSP who do and do not undergo an acute bout of resistance exercise. METHODS: Paraspinal muscle biopsies were obtained from 64 individuals with LSP undergoing spinal surgery. Eight participants performed an acute bout of machine-based lumbar extension resistance exercise preoperatively. Gene expression for 42 genes associated with adipogenic/metabolic, atrophic, fibrogenic, inflammatory, and myogenic pathways was measured, and differential expression between exercised and non-exercised groups was evaluated for (a) the full cohort, and (b) an age, gender, acuity, and etiology matched sub-cohort. Principal components analyses were used to identify gene expression clustering across clinical phenotypes. RESULTS: The exercised cohort demonstrated upregulation of inflammatory gene IL1B, inhibition of extracellular matrix components (increased MMP3&9, decreased TIMP1&3, COL1A1) and metabolic/adipogenic genes (FABP4, PPARD, WNT10B), and downregulation of myogenic (MYOD, ANKRD2B) and atrophic (FOXO3) genes compared to the non-exercised cohort, with similar patterns in the matched sub-analysis. There were no clinical phenotypes significantly associated with gene expression profiles. CONCLUSION: An acute bout of moderate-high intensity resistance exercise did not result in upregulation of myogenic genes in individuals with LSP. The response was characterized by mixed metabolic and fibrotic gene expression, upregulation of inflammation, and downregulation of myogenesis

Organización y actividades preventivas en el sector del transporte de mercancías por carretera

[ES] Objetivos: Identificar los recursos y actividades preventivas más prevalentes en el sector del transporte de mercancías por carretera y los hechos diferenciales con el resto de la población trabajadora española. Metodología: Estudio descriptivo de los datos de la Encuesta de Salud y Condiciones de Trabajo del sector del transporte y estudio comparativo con el resto de la población trabajadora a través de la V-Encuesta Nacional de Condiciones de Trabajo. Para el análisis estadístico se ha aplicado el ji cuadrado y la t-student. Resultados: El 77% de las empresas de este sector tienen menos de 50 trabajadores. El 41% de los conductores señala que en su empresa no existe Delegado de Prevención y un 25% no dispone de ningún Recurso Preventivo. Destaca el alto desconocimiento existente entre los conductores de los recursos preventivos en su empresa (34,3%). La modalidad preventiva más frecuentemente instaurada en el sector es la asunción de la prevención por parte del empresario (13,6%) a diferencia del resto de sectores donde predomina el SP. Ajeno (43%). Conclusiones: Predominio de la pequeña empresa en el Sector del transporte asociado a un escaso desarrollo del tejido prevenGoals: To identify the most prevalent resources and preventive activities in professional long-haul drivers and their peculiarities related to the other Spanish production branches. Methodology: We develop a descriptive analysis of data from the Survey of Health and Working Conditions in professional truck drivers and we compare these results with the other Spanish production branches through the VNational Survey on Working Conditions. The statistical analysis applied T-Student test and the Ji square. Results: In this branch 77% of companies have less than 50 employees. 41% of drivers referred that it does not exist the «Delegado de Prevención» (workers representative) in their companies and 25% that there is not any Preventive Action. It is specially relevant the unknowledge among drivers about preventive resources in their companies (34.3%). The most frequently introduced preventive modality in the sector is the employer taking prevention by himself (13.6%) whilst other sectors are mainly covered by External Preventive Services (43%). Conclusions: If Transport branch is compared with the general - reference population it shows an image in which undersized companies linked to a weak development of preventive network could be determinant to their lowest preventive activities. Also we find a better self perceived health related to a better access to preventive activities.tivo en comparación con la población de referencia. Ambas características pueden ser determinantes de la menor actividad preventiva, más baja que la observada en la población de referencia. El acceso a actividades preventivas entre los conductores se relaciona con una mejor salud percibida. Goals: To identify the most prevalent resources and preventive activities in professional long-haul drivers and their peculiarities related to the other Spanish production branches. Methodology: We develop a descriptive analysis of data from the Survey of Health and Working Conditions in professional truck drivers and we compare these results with the other Spanish production branches through the VNational Survey on Working Conditions. The statistical analysis applied T-Student test and the Ji square. Results: In this branch 77% of companies have less than 50 employees. 41% of drivers referred that it does not exist the «Delegado de Prevención» (workers representative) in their companies and 25% that there is not any Preventive Action. It is specially relevant the unknowledge among drivers about preventive resources in their companies (34.3%). The most frequently introduced preventive modality in the sector is the employer taking prevention by himself (13.6%) whilst other sectors are mainly covered by External Preventive Services (43%). Conclusions: If Transport branch is compared with the general - reference population it shows an image in which undersized companies linked to a weak development of preventive network could be determinant to their lowest preventive activities. Also we find a better self perceived health related to a better access to preventive activities.[EN] Goals: To identify the most prevalent resources and preventive activities in professional long-haul drivers andtheir peculiarities related to the other Spanish production branches.Methodology: We develop a descriptive analysis ofdata from the Survey of Health and Working Conditions inprofessional truck drivers and we compare these resultswith the other Spanish production branches through the VNational Survey on Working Conditions. The statistical analysis applied T-Student test and the Ji square. Results: In this branch 77% of companies have less than 50 employees. 41% of drivers referred that it does not exist the "Delegado de Prevención" (workers representative) in their companies and 25% that there is not any Preventive Action. It is specially relevant the unknowledge among drivers about preventive resources in their companies (34.3%). The most frequently introduced preventivemodality in the sector is the employer taking prevention by himself (13.6%) whilst other sectors are mainly covered by External Preventive Services (43%). Conclusions: If Transport branch is compared with the general - reference population it shows an image in which undersized companies linked to a weak development of preventive network could be determinant to their lowest preventive activities. Also we find a better self perceived health related to a better access to preventive activitiesS

Efectos extra-auditivos del ruido, salud, calidad de vida y rendimiento en el trabajo; actuación en vigilancia de la salud

Este documento se ha realizado en el marco del proyecto de investigación “Estudio de prevalencia de los efectos extra-auditivos del ruido y su relación en la calidad de vida y rendimientos en la población trabajadora española”. Financiado por el FIS (PI07/90034)Esta publicación tiene como objetivo difundir los resultados del proyecto de investigación “ESTUDIO DE PREVALENCIA DE LOS EFECTOS EXTRA-AUDITIVOS DEL RUIDO Y SU RELACIÓN EN LA CALIDAD DE VIDA Y RENDIMIENTO EN LA POBLACIÓN TRABAJADORA ESPAÑOLA” realizado por un equipo de investigación formado por investigadores de la Escuela Nacional de Medicina del Trabajo del Instituto de Salud Carlos III y de la Universidad de Alcalá de Henares

Beneficial or detrimental activity of regulatory T cells, indoleamine 2,3-dioxygenase, and heme oxygenase-1 in the lungs is influenced by the level of virulence of Mycobacterium tuberculosis strain infection

Tuberculosis (TB) caused by the complex Mycobacterium tuberculosis (Mtb) is the main cause of death by a single bacterial agent. Last year, TB was the second leading infectious killer after SARS-CoV-2. Nevertheless, many biological and immunological aspects of TB are not completely elucidated, such as the complex process of immunoregulation mediated by regulatory T cells (Treg cells) and the enzymes indoleamine 2,3-dioxygenase (IDO) and heme oxygenase 1 (HO-1). In this study, the contribution of these immunoregulatory factors was compared in mice infected with Mtb strains with different levels of virulence. First Balb/c mice were infected by intratracheal route, with a high dose of mild virulence reference strain H37Rv or with a highly virulent clinical isolate (strain 5186). In the lungs of infected mice, the kinetics of Treg cells during the infection were determined by cytofluorometry and the expression of IDO and HO-1 by RT-PCR and immunohistochemistry. Then, the contribution of immune-regulation mediated by Treg cells, IDO and HO-1, was evaluated by treating infected animals with specific cytotoxic monoclonal antibodies for Treg cells depletion anti-CD25 (PC61 clone) or by blocking IDO and HO-1 activity using specific inhibitors (1-methyl-D,L-tryptophan or zinc protoporphyrin-IX, respectively). Mice infected with the mild virulent strain showed a progressive increment of Treg cells, showing this highest number at the beginning of the late phase of the infection (28 days), the same trend was observed in the expression of both enzymes being macrophages the cells that showed the highest immunostaining. Animals infected with the highly virulent strain showed lower survival (34 days) and higher amounts of Treg cells, as well as higher expression of IDO and HO-1 one week before. In comparison with non-treated animals, mice infected with strain H37Rv with depletion of Treg cells or treated with the enzymes blockers during late infection showed a significant decrease of bacilli loads, higher expression of IFN-g and lower IL-4 but with a similar extension of inflammatory lung consolidation determined by automated morphometry. In contrast, the depletion of Treg cells in infected mice with the highly virulent strain 5186 produced diffuse alveolar damage that was similar to severe acute viral pneumonia, lesser survival and increase of bacillary loads, while blocking of both IDO and HO-1 produced high bacillary loads and extensive pneumonia with necrosis. Thus, it seems that Treg cells, IDO and HO-1 activities are detrimental during late pulmonary TB induced by mild virulence Mtb, probably because these factors decrease immune protection mediated by the Th1 response. In contrast, Treg cells, IDO and HO-1 are beneficial when the infection is produced by a highly virulent strain, by regulation of excessive inflammation that produced alveolar damage, pulmonary necrosis, acute respiratory insufficiency, and rapid death