"This is 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," said Manuel Franco, MD, a PhD candidate in the Bloomberg School of Public Health's Department of Epidemiology. "Population-wide approaches designed to reduce caloric intake and increase physical activity, without affecting nutritional sufficiency, might be best suited for the prevention of cardiovascular disease and diabetes."

The study authors gathered data on energy intake, body weight and physical activity. There was a drop in the daily per capita food availability from the late 1980s to 1995, resulting in a daily energy intake decline from 2,899 kcal in 1988 to 1,863 kcal in 1993. In 1987, 30 percent of Havana residents were physically active. From 1991 to 1995, 70 percent of Cubans were physically active as a result of widespread use of bicycles and walking as means of transportation. Obesity prevalence in Cienfuegos, Cuba, decreased from 14.3 percent in 1991 to 7.2 percent in 1995.

During the end of the Cuban economic downturn and the years following it, there were substantial declines in cardiovascular disease, type 2 diabetes and all-cause mortality. The researchers report a plateau in the number of deaths from diabetes during the food shortage of 1988 till 1996, when physical activity increased and obesity decreased.

MEDICA.de; Source: Johns Hopkins Bloomberg School of Public Health