[EQ] Impact of Energy Intake, Physical Activity, and Population-wide Weight Loss on Cardiovascular Disease and Diabetes Mortality in Cuba

 Impact of Energy Intake, Physical Activity, and Population-wide Weight Loss on  
 Cardiovascular Disease and Diabetes Mortality in Cuba, 1980–2005

  Manuel Franco¹, Pedro Orduñez², Benjamín Caballero³, José A. Tapia Granados⁴, Mariana Lazo¹,  
 José Luís Bernal², Eliseo Guallar^1,5 and Richard S. Cooper⁶

¹ Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology, and Clinical Research, Bloomberg School 
  of Public Health, Johns Hopkins University, Baltimore, MD
² Hospital Universitario "Dr. Gustavo Aldereguia Lima," Cienfuegos, Cuba
³ Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
⁴ Institute of Labor and Industrial Relations and School of Social Work, University of Michigan, Ann Arbor, MI
⁵ Department of Epidemiology, Centro Nacional de Investigacion Cardiovascular, Madrid, Spain
⁶ Department of Preventive Medicine and Epidemiology, Stritch School of Medicine, Loyola University, Maywood, IL  

American Journal of Epidemiology  -   Advance Access published online on September 19, 2007 

Website: http://aje.oxfordjournals.org/cgi/content/full/kwm226v1

 "..... Cuba's economic crisis of 1989–2000 resulted in reduced energy intake, increased physical activity, and sustained  
 population-wide weight loss. The authors evaluated the possible association of these factors with mortality trends.  
 Data on per capita daily energy intake, physical activity, weight loss, and smoking were systematically retrieved from  
 national and local surveys. National vital statistics from 1980–2005 were used to assess trends in mortality from diabetes,  
 coronary heart disease, stroke, cancer, and all causes.

The crisis reduced per capita daily energy intake from 2,899 calories to 1,863 calories. During the crisis period, the  
 proportion of physically active adults increased from 30% to 67%, and a 1.5-unit shift in the body mass index distribution  
 was observed, along with a change in the distribution of body mass index categories.

The prevalence of obesity declined from 14% to 7%, the prevalence of overweight increased 1%, and the prevalence of  
 normal weight increased 4%. During 1997–2002, there were declines in deaths attributed to diabetes (51%), coronary  
 heart disease (35%), stroke (20%), and all causes (18%). An outbreak of neuropathy and a modest increase in the  
 all-cause death rate among the elderly were also observed. These results suggest that population-wide measures  
 designed to reduce energy stores, without affecting nutritional sufficiency, may lead to declines in diabetes and  
 cardiovascular disease prevalence and mortality.  ^..." 

 

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