Cuba's nationwide CR

[KHashmi317]

With recent lifting of U.S. sanctions of Cuba, and improved overall (more open) communication, let's hope some university or organization can take advantage of this historical data...

 

The full 2006 documentary --The Power of Community - How Cuba Survived Peak Oil -- is online:

 

Esp. starting at: 14:00

 

Also: https://en.wikipedia.org/wiki/Special_Period#Famine

 

Nutrition fell from 3,052 calories per day in 1989 to 2,099 calories per day in 1993. Other reports indicate even lower figures, 1,863 calories per day. Some estimated that the very old and children received only 1,450 calories per day.[13] The recommended minimum is 2,100–2,300 calories.

The Special Period's malnutrition created epidemics, but it had positive effects too. Manuel Franco describes the Special Period as "the first, and probably the only, natural experiment, born of unfortunate circumstances, where large effects on diabetes, cardiovascular disease and all-cause mortality have been related to sustained population-wide weight loss as a result of increased physical activity and reduced caloric intake".[10]

A paper in the American Journal of Epidemiology, says that "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."[11] This was caused by how the population tried to reduce the energy store without reducing the nutritional value of the food.[11]

[AlPater]

I suppose diabetes remains a factor likely greatly influenced by reduced energy intake, but even the medical system probably was affected by the Special Period.  Physical activity, of course is important too and why were there not less cancers when fewer smoked?  Many of the diseases and the mortality probably have great time lags, do they not?

 

Population-wide weight loss and regain in relation to diabetes burden and cardiovascular mortality in Cuba 1980-2010: repeated cross sectional surveys and ecological comparison of secular trends.

Franco M, Bilal U, Orduñez P, Benet M, Morejón A, Caballero B, Kennelly JF, Cooper RS.

BMJ. 2013 Apr 9;346:f1515. doi: 10.1136/bmj.f1515.

PMID: 23571838 Free Article

http://www.bmj.com/content/346/bmj.f1515.long

http://www.bmj.com/content/346/bmj.f1515.full.pdf+html

 

Abstract

 

OBJECTIVE:

 

To evaluate the associations between population-wide loss and gain in weight with diabetes prevalence, incidence, and mortality, as well as cardiovascular and cancer mortality trends, in Cuba over a 30 year interval.

 

DESIGN:

 

Repeated cross sectional surveys and ecological comparison of secular trends.

 

SETTING:

 

Cuba and the province of Cienfuegos, from 1980 to 2010.

 

PARTICIPANTS:

 

Measurements in Cienfuegos included a representative sample of 1657, 1351, 1667, and 1492 adults in 1991, 1995, 2001, and 2010, respectively. National surveys included a representative sample of 14 304, 22 851, and 8031 participants in 1995, 2001, and 2010, respectively.

 

MAIN OUTCOME MEASURES:

 

Changes in smoking, daily energy intake, physical activity, and body weight were tracked from 1980 to 2010 using national and regional surveys. Data for diabetes prevalence and incidence were obtained from national population based registries. Mortality trends were modelled using national vital statistics.

 

RESULTS:

 

Rapid declines in diabetes and heart disease accompanied an average population-wide loss of 5.5 kg in weight, driven by an economic crisis in the mid-1990s. A rebound in population weight followed in 1995 (33.5% prevalence of overweight and obesity) and exceeded pre-crisis levels by 2010 (52.9% prevalence). The population-wide increase in weight was immediately followed by a 116% increase in diabetes prevalence and 140% increase in diabetes incidence. Six years into the weight rebound phase, diabetes mortality increased by 49% (from 9.3 deaths per 10 000 people in 2002 to 13.9 deaths per 10 000 people in 2010). A deceleration in the rate of decline in mortality from coronary heart disease was also observed.

 

CONCLUSIONS:

 

In relation to the Cuban experience in 1980-2010, there is an association at the population level between weight reduction and death from diabetes and cardiovascular disease; the opposite effect on the diabetes and cardiovascular burden was seen on population-wide weight gain.