title: Impact of energy intake, physical activity, and population-wide weight loss on cardiovascular disease and diabetes mortality in Cuba, 1980-2005.
abstract: 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.
authors: Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. mfranco@jhsph.edu
authors: Manuel
authors: M
authors: Franco
authors: Pedro
authors: P
authors: Orduñez
authors: Benjamín
authors: B
authors: Caballero
authors: José A
authors: JA
authors: Tapia Granados
authors: Mariana
authors: M
authors: Lazo
authors: José Luís
authors: JL
authors: Bernal
authors: Eliseo
authors: E
authors: Guallar
authors: Richard S
authors: RS
authors: Cooper
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000886:Anthropometry; D001827:Body Height; D001835:Body Weight; D002318:Cardiovascular Diseases / Q000401:mortality*; D003462:Cuba / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000401:mortality*; D002149:Energy Intake; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009369:Neoplasms / Q000401:mortality; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D015431:Weight Loss