Obesity trends and body mass index changes after starting antiretroviral treatment : the Swiss HIV Cohort Study

BACKGROUND: The factors that contribute to increasing obesity rates in human immunodeficiency virus (HIV)-positive persons and to body mass index (BMI) increase that typically occurs after starting antiretroviral therapy (ART) are incompletely characterized. METHODS: We describe BMI trends in the entire Swiss HIV Cohort Study (SHCS) population and investigate the effects of demographics, HIV-related factors, and ART on BMI change in participants with data available before and 4 years after first starting ART. RESULTS: In the SHCS, overweight/obesity prevalence increased from 13% in 1990 (n = 1641) to 38% in 2012 (n = 8150). In the participants starting ART (n = 1601), mean BMI increase was 0.92 kg/m(2) per year (95% confidence interval, .83-1.0) during year 0-1 and 0.31 kg/m(2) per year (0.29-0.34) during years 1-4. In multivariable analyses, annualized BMI change during year 0-1 was associated with older age (0.15 [0.06-0.24] kg/m(2)) and CD4 nadir <199 cells/µL compared to nadir >350 (P < .001). Annualized BMI change during years 1-4 was associated with CD4 nadir <100 cells/µL compared to nadir >350 (P = .001) and black compared to white ethnicity (0.28 [0.16-0.37] kg/m(2)). Individual ART combinations differed little in their contribution to BMI change. CONCLUSIONS: Increasing obesity rates in the SHCS over time occurred at the same time as aging of the SHCS population, demographic changes, earlier ART start, and increasingly widespread ART coverage. Body mass index increase after ART start was typically biphasic, the BMI increase in year 0-1 being as large as the increase in years 1-4 combined. The effect of ART regimen on BMI change was limited.

La nova formació professional a les comarques de Girona

A partir del curs 1999-2000 s'inicia a Catalunya l'aplicació generalitzada dels cicles formatius de la nova formació professional implantadaper la Llei d'ordenació general del sistema educatiu (LOGSE), aprovada el ja llunyà 1990. Amb tot, alguns centres de les comarques de Girona ja ho han fet aquest curs mateix i la majoria entraran el curs vinent en el nou sistema

Impact of the gut microbiota on the development of obesity and type 2 diabetes mellitus.

Obesity and its associated disorders are a major public health concern. Although obesity has been mainly related with perturbations of the balance between food intake and energy expenditure, other factors must nevertheless be considered. Recent insight suggests that an altered composition and diversity of gut microbiota could play an important role in the development of metabolic disorders. This review discusses research aimed at understanding the role of gut microbiota in the pathogenesis of obesity and type 2 diabetes mellitus (TDM2). The establishment of gut microbiota is dependent on the type of birth. With effect from this point, gut microbiota remain quite stable, although changes take place between birth and adulthood due to external influences, such as diet, disease and environment. Understand these changes is important to predict diseases and develop therapies. A new theory suggests that gut microbiota contribute to the regulation of energy homeostasis, provoking the development of an impairment in energy homeostasis and causing metabolic diseases, such as insulin resistance or TDM2. The metabolic endotoxemia, modifications in the secretion of incretins and butyrate production might explain the influence of the microbiota in these diseases.

The effectiveness of market intervention policies to improve diet quality and to reduce the prevalence of obesity in Spain

Our project aims at analyzing the relevance of economic factors (mainly income and other socioeconomic characteristics of Spanish households and market prices) on the prevalence of obesity in Spain and to what extent market intervention prices are effective to reduce obesity and improve the quality of the diet, and under what circumstances. In relation to the existing literature worldwide, this project is the first attempt in Spain trying to get an overall picture on the effectiveness of public policies on both food consumption and the quality of diet, on one hand, and on the prevalence of obesity on the other. The project consists of four main parts. The first part represents a critical review of the literature on the economic approach of dealing with the obesity prevalence problems, diet quality and public intervention policies. Although another important body of obesity literature is dealing with physical exercise but in this paper we will limit our attention to those studies related to food consumption respecting the scope of our study and as there are many published literature review dealing with the literature related to the physical exercise and its effect on obesity prevalence. The second part consists of a Parametric and Non-Parametric Analysis of the Role of Economic Factors on Obesity Prevalence in Spain. The third part is trying to overcome the shortcomings of many diet quality indices that have been developed during last decades, such as the Healthy Eating Index, the Diet Quality Index, the Healthy Diet Indicator, and the Mediterranean Diet Score, through the development of a new obesity specific diet quality index. While the last part of our project concentrates on the assessment of the effectiveness of market intervention policies to improve the healthiness of the Spanish Diet Using the new Exact Affine Stone Index (EASI) Demand System.

A neuron-specific deletion of the microRNA-processing enzyme DICER induces severe but transient obesity in mice.

MicroRNAs (miRNAs) are small, non-coding RNA molecules that regulate gene expression post-transcriptionally. MiRNAs are implicated in various biological processes associated with obesity, including adipocyte differentiation and lipid metabolism. We used a neuronal-specific inhibition of miRNA maturation in adult mice to study the consequences of miRNA loss on obesity development. Camk2a-CreERT2 (Cre+) and floxed Dicer (Dicerlox/lox) mice were crossed to generate tamoxifen-inducible conditional Dicer knockouts (cKO). Vehicle- and/or tamoxifen-injected Cre+;Dicerlox/lox and Cre+;Dicer+/+ served as controls. Four cohorts were used to a) measure body composition, b) follow food intake and body weight dynamics, c) evaluate basal metabolism and effects of food deprivation, and d) assess the brain transcriptome consequences of miRNA loss. cKO mice developed severe obesity and gained 18 g extra weight over the 5 weeks following tamoxifen injection, mainly due to increased fat mass. This phenotype was highly reproducible and observed in all 38 cKO mice recorded and in none of the controls, excluding possible effects of tamoxifen or the non-induced transgene. Development of obesity was concomitant with hyperphagia, increased food efficiency, and decreased activity. Surprisingly, after reaching maximum body weight, obese cKO mice spontaneously started losing weight as rapidly as it was gained. Weight loss was accompanied by lowered O2-consumption and respiratory-exchange ratio. Brain transcriptome analyses in obese mice identified several obesity-related pathways (e.g. leptin, somatostatin, and nemo-like kinase signaling), as well as genes involved in feeding and appetite (e.g. Pmch, Neurotensin) and in metabolism (e.g. Bmp4, Bmp7, Ptger1, Cox7a1). A gene cluster with anti-correlated expression in the cerebral cortex of post-obese compared to obese mice was enriched for synaptic plasticity pathways. While other studies have identified a role for miRNAs in obesity, we here present a unique model that allows for the study of processes involved in reversing obesity. Moreover, our study identified the cortex as a brain area important for body weight homeostasis.

Anàlisis i proposta d’accés amb itineraris ciclables entre Girona i els municipis del seu entorn immediat

L’objectiu és proporcionar a la població de l’àrea d’estudi (Girona i municipis propers), eines i vies necessàries per tal que puguin ser eficients energèticament i efectius en la seva mobilitat quotidiana. Es crea un mapa d’aptitud per determinar la connexió idònia entre la ciutat de Girona i els municipis inclosos en l’àrea d’estudi mitjançant una xarxa de vies ciclistes, s’analitza el mapa d’aptitud amb la xarxa actual i futura de vies ciclistes, es proposen nous carrils bici per tal d’unir zones exemptes de vies ciclables i s’analitza l’opció de combinar el transport públic (tren i autobús) amb la bicicleta. Per definir la xarxa s’utilitza el programa SIG, considerant uns determinats paràmetres, en un radi de 15 km des de l’Ajuntament de Girona i es compara amb la xarxa de vies ciclables actuals i les propostes de futur. També s’inclou un pressupost

Prevalence of overweight and obesity in children and adolescents in Seychelles : results of the School Screening Program in 2013

Results related to overweight and obesity in 2013: Participation to the school screening program was satisfactory in 2013, but a bit less than in previous years (4220 children seen out of a total of approximately 6000 eligible ones). Less than maximal participation to the screening program can relate to different factors, e.g.; a trend for obese children to decline participation; lack of time of school nurses to complete the screening program due to competing duties at health centre level. Good organization by the school nurses and adequate facilities for screening are also important factors for a good conduct of the screening program.

Psychological correlates of childhood obesity.

To enhance the prevention and intervention efforts of childhood obesity, there is a strong need for the early detection of psychological factors contributing to its development and maintenance. Rather than a stable condition, childhood obesity represents a dynamic process, in which behavior, cognition and emotional regulation interact mutually with each other. Family structure and context, that is, parental and familial attitudes, activity, nutritional patterns as well as familial stress, have an important role with respect to the onset and maintenance of overweight and obesity. Behavioral and emotional problems are found in many, though not all, obese children, with a higher prevalence in clinical, treatment-seeking samples. The interrelatedness between obesity and psychological problems seems to be twofold, in that clinically meaningful psychological distress might foster weight gain and obesity may lead to psychosocial problems. The most frequently implicated psychosocial factors are externalizing (impulsivity and attention-deficit hyperactivity disorder) and internalizing (depression and anxiety) behavioral problems and uncontrolled eating behavior. These findings strengthen the need to further explore the interrelatedness between psychological problems and childhood obesity.

Normal weight obesity: relationship with lipids, glycaemic status, liver enzymes and inflammation

BACKGROUND AND AIMS: Normal weight obesity (NWO) is defined as an excessive body fat associated with a normal body mass index (BMI) and has been associated with early inflammation, but its relationship with cardiovascular risk factors await investigation. METHODS AND RESULTS: Cross-sectional study including 3213 women and 2912 men aged 35-75 years to assess the clinical characteristics of NWO in Lausanne, Switzerland. Body fat was assessed by bioimpedance. NWO was defined as a BMI<25 kg/m(2) and a % body fat ≥66(th) gender-specific percentiles. The prevalence of NWO was 5.4% in women and less than 3% in men, so the analysis was restricted to women. NWO women had a higher % of body fat than overweight women. After adjusting for age, smoking, educational level, physical activity and alcohol consumption, NWO women had higher blood pressure and lipid levels and a higher prevalence of dyslipidaemia (odds-ratio=1.90 [1.34-2.68]) and fasting hyperglycaemia (odds-ratio=1.63 [1.10-2.42]) than lean women, whereas no differences were found between NWO and overweight women. Conversely, no differences were found between NWO and lean women regarding levels of CRP, adiponectin and liver markers (alanine aminotransferase, aspartate aminotransferase and gamma glutamyl transferase). Using other definitions of NWO led to similar conclusions, albeit some differences were no longer significant. CONCLUSION: NWO is almost nonexistent in men. Women with NWO present with higher cardiovascular risk factors than lean women, while no differences were found for liver or inflammatory markers. Specific screening of NWO might be necessary in order to implement cardiovascular prevention.

La Participació dels estudiants en la universitat. Anàlisi de la situació a la Universitat de Girona

Aquest estudi posa a debat tant els nivells com les formes de participació dels estudiants en el funcionament de la universitat amb la finalitat d’aprofundir en els models i les dinàmiques que afavoreixen la participació dels estudiants. Parteix de l’estudi del cas de la Universitat de Girona i recull, des de diferents punts de vista, quina és la situació actual pel que fa a la participació dels estudiants en aquesta universitat, i es proposen algunes línies d’actuació per promoure-la. A la base d’aquest estudi se situa el convenciment que la participació dels estudiants en el funcionament de la universitat és un objectiu desitjable per part de la comunitat universitària, i que, com a centre de formació que és la universitat, cal que es plantegi la participació com un objectiu d’aprenentatge propi ja que, a més de formar científi cs i professionals en diferents àmbits, la universitat també contribueix (o hauria de contribuir) a la formació de ciutadans. Es tracta d’un treball fi nançat per la convocatòria 20 de la UdG d’ajuts a projectes cooperatius d’R+D en els àmbits humanístic i de les ciències socials i que s’ha desenvolupat en la seva major part durant l’any 2008 i inicis del 2009. Les dades de participació que es presenten sobre la UdG són de l’any 2008

CB1 blockade potentiates down-regulation of lipogenic gene expression in perirenal adipose tissue in high carbohydrate diet-induced obesity.

De novo lipogenesis and hypercaloric diets are thought to contribute to increased fat mass, particularly in abdominal fat depots. CB1 is highly expressed in adipose tissue, and CB1-mediated signalling is associated with stimulation of lipogenesis and diet-induced obesity, though its contribution to increasing fat deposition in adipose tissue is controversial. Lipogenesis is regulated by transcription factors such as liver X receptor (LXR), sterol-response element binding protein (SREBP) and carbohydrate-responsive-element-binding protein (ChREBP). We evaluated the role of CB1 in the gene expression of these factors and their target genes in relation to lipogenesis in the perirenal adipose tissue (PrAT) of rats fed a high-carbohydrate diet (HCHD) or a high-fat diet (HFD). Both obesity models showed an up-regulated gene expression of CB1 and Lxrα in this adipose pad. The Srebf-1 and ChREBP gene expressions were down-regulated in HFD but not in HCHD. The expression of their target genes encoding for lipogenic enzymes showed a decrease in diet-induced obesity and was particularly dramatic in HFD. In HCHD, CB1 blockade by AM251 reduced the Srebf-1 and ChREBP expression and totally abrogated the remnant gene expression of their target lipogenic enzymes. The phosphorylated form of the extracellular signal-regulated kinase (ERK-p), which participates in the CB1-mediated signalling pathway, was markedly present in the PrAT of obese rats. ERK-p was drastically repressed by AM251 indicating that CB1 is actually functional in PrAT of obese animals, though its activation loses the ability to stimulate lipogenesis in PrAT of obese rats. Even so, the remnant expression levels of lipogenic transcription factors found in HCHD-fed rats are still dependent on CB1 activity. Hence, in HCHD-induced obesity, CB1 blockade may help to further potentiate the reduction of lipogenesis in PrAT by means of inducing down-regulation of the ChREBP and Srebf-1 gene expression, and consequently in the expression of lipogenic enzymes.

Meal-induced thermogenesis in obese children with or without familial history of obesity.

Resting metabolic rate (RMR) and the thermic effect of a meal (TEM) were measured in a group of 26 prepubertal children divided into three groups: (1) children with both parents obese (n = 8, group OB2); (2) children with no obese parents and without familial history of obesity (n = 8, OB0); and (3) normal body weight children (n = 10, C). Average RMR was similar in OB2 and OB0 children (4785 +/- 274 kJ/day vs 5091 +/- 543 kJ/day), but higher (P < 0.05) than in controls (4519 +/- 322 kJ/day). Adjusted for fat-free mass (FFM) mean RMRs were comparable in the three groups of children (4891 +/- 451 kJ/day vs 5031 +/- 451 kJ/day vs 4686 +/- 451 kJ/day in OB2, OB0, and C, respectively). The thermic response to the mixed meal was similar in OB2, OB0 and C groups. The TEM calculated as the percentage of RMR was lower (P < 0.05) in obese than in control children: 10.2% +/- 3.1% vs 10.9% +/- 4.3% vs 14.0% +/- 4.3% in OB2, OB0, and C, respectively. The similar RMR as absolute value as well as adjusted for FFM, and the comparable thermic effect of food in the obese children with or without familial history of obesity, failed to support the view that family history of obesity can greatly influence the RMR and the TEM of the obese child with obese parents.

L'Espiral de la història, de Televisió de Girona

L’experiència de crear, en format televisiu, un programa de difusió històrica per part d’una televisió local resulta altament interessant, perquè ofereix continguts d’àmbit més proper a un públic que difícilment té accés a la seva història des del sector audiovisual. Tots els principis continguts en la proposta científica d’utilitzar les imatges com a transmissores de coneixements i de cultura, convergeixen en el projecte de creació, per part de Televisió de Girona, del programa L’espiral de la història, atès que resulta una excel·lent mostra de la conjunció de diverses tipologies documentals posades al servei d’un objectiu: la difusió de la història de la ciutat de Girona a través del llenguatge audiovisual

Proposta de consolidació d'un talús a l'estadi municipal de futbol de Montilivi (Girona)

L’estudi pretén comprovar que el talús adjacent a la grada est de l’Estadimunicipal de Montilivi no és estable i posteriorment proposar una mesura correctora, dimensionar-la i comprovar-la amb un programa d’ordinador específic Els antecedents al problema són els següents: A la ciutat de Girona, concretament al barri de Montilivi existeix un problemàtica que es va reiterant any rere any. Degut a les característiques geomecàniques del seu subsòl, argiles expansives, quan s’augmenta les condicions d’humitat del terreny, es produeix una solifluxió del terreny i desencadena en esllavissades. S’hi ha intentat posar solució però el fet és que només s’ha apedaçat el problema. A l’any 1996 es produeix la primera esllavissada del talús. S’ensorra la grada preferent del camp del Girona. El 7 de maig de 2004. Un nou esfondrament a la grada est de l’estadi que afecta al nou vial d’accés a la Universitat de Girona. Finalment, i després de la gran nevada del 2010, es produeix una nova esllavissada en elrecinte de l’obra d’ampliació de l’estadi de Montilivi

Projecte d'una indústria càrnia elaboradora d'embotits cuits seguint criteris d'eficiència energètica, situada al polígon industrial del Terme Municipal de Riudellots de la Selva, província de Girona

Disseny i posada en marxa d’una indústria càrnia elaboradora d’embotits cuits on es segueixen criteris d’eficiència energètica en tot el procés. La indústria s’ubicarà al polígon industrial Girona, sector Ponent, del terme municipal de Riudellots de la Selva a la comarca de la Selva, en una propietat del promotor, dotada amb bones comunicacions per carretera, ferrocarril i avió, i a més es trova situada a prop de nuclis urbans importants com Girona i Barcelona. Per tant, per la seva localització i les bones infraestructures existents podem assegurar que tindrà un bon accés per la recepció de les matèries primeres i per la distribució dels productes acabats. Es dissenyen les instal•lacions de la indústria per garantir una capacitat productiva de 1.000 tones de producte acabat a l’any. La comercialització dels seus productes es preveu que sigui bàsicament a nivell de la província de Girona, abraçant una quota de mercat del sector carni en aquesta zona d’un 10%, i podent ampliar el seu mercat objectiu en un futur a d’altres províncies o a l’estranger si fos viable. Del volum anual de producció, es decideix que el 45% de la producció vagi destinada a envasos llescats, ja que la venda d’un producte llescat fa que el consumidor final compri l’estrictament necessari, per tant aquest fet assegura que elmercat sigui més estable. El 55% restant es destina a la presentació a l’engròs, per poder servir el producte a carnisseries o al sector restauració