Population-wide weight loss during an economic crisis in Cuba in the '90s led to declines in death from diabetes and heart disease, which rebounded once the country got back on its feet, researchers found. During the crisis, which occurred between 1991 and 1995, shortages in food and gas meant people ate less and walked or biked more, Manuel Franco, MD, of the University of Alcala in Madrid, and colleagues noted online in BMJ.
Cubans lost 9 to 11 pounds (4 to 5 kg) on average during that period, and diabetes mortality stabilized; it then fell 50% during a slow recovery period between 1996 and 2002, but rose again by 49% from 2002 onward, they reported. Heart disease mortality dropped by 34% during the recovery period, but the rate of decline slowed after 2002, the researchers found.
Cuba maintained a public health surveillance through its economic crisis, according to Walter Willett, MD, DrPH, of the Harvard School of Public Health, who wrote an accompanying editorial.
The economy has since recovered, largely after the year 2000, and now the prevalence of obesity in that nation has exceeded pre-crisis levels, the researchers said.
About 5 years into the crisis -- around 1996 -- the researchers found an "abrupt downward trend" in mortality from diabetes, coronary heart disease, stroke, and all causes.
"This period lasted an additional six years, during which energy intake status gradually recovered and physical activity levels were progressively reduced," they wrote. "In 2002, mortality rates returned to the pre-crisis pattern."
Primary source: BMJ
Franco M, et al "Population-wide weight loss and regain in relation to diabetes burden and cardiovascular mortality in Cuba 1980-2010" BMJ 2013; DOI: 10.1136/bmj.f1515.
Additional source: BMJ
Willett WC "Weight changes and health in Cuba: learning from hardship" BMJ 2013; DOI: 10.1136/bmj.f1777.