Impact of energy intake, physical activity, and population-wide weight loss on cardiovascular disease and diabetes mortality in Cuba, 1980-2005
Impact of energy intake, physical activity, and population-wide weight loss on cardiovascular disease and diabetes mortality in Cuba, 1980-2005
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DOI：
10.1093/aje/kwm226
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发表时间：
2007-12-15
影响因子：
5
通讯作者：
Cooper, Richard S.
中科院分区：
文献类型：
--
作者：
Franco, Manuel;Ordunez, Pedro;Cooper, Richard S.
古巴1989-2000年的经济危机导致能量摄入减少，身体活动增加，全民体重持续下降。作者评估了这些因素与死亡率趋势的可能关联。从国家和地方调查中系统地检索了人均每日能量摄入量、身体活动、体重减轻和吸烟的数据。1980-2005年的国家生命统计数据被用来评估糖尿病、冠心病、中风、癌症和所有原因的死亡率趋势。危机使人均每日能量摄入量从2 899卡路里减少到1 863卡路里。在危机期间，身体活跃的成年人比例从30%增加到67%，观察到体重指数分布发生了1.5个单位的变化，沿着体重指数类别分布的变化。肥胖患病率从14%下降到7%，超重患病率上升1%，正常体重患病率上升4%。1997-2002年期间，死于糖尿病（51%）、冠心病（35%）、中风（20%）和所有原因（18%）的人数有所下降。还观察到老年人神经病爆发和全因死亡率略有增加。这些结果表明，在不影响营养充足的情况下，旨在减少能量储存的全民措施可能会导致糖尿病和心血管疾病患病率和死亡率下降。
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.