Manuel Franco|Usama Bilal|Pedro Ordúñez|Mikhail Benet|Alain Morejón|B. Caballero|John Kennelly|Richard Cooper
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
Universidad de Alcalá|Johns Hopkins University|Spanish National Centre for Cardiovascular Research|Universidad de Alcalá|Spanish National Centre for Cardiovascular Research|Universidad de Ciencias Médicas de Cienfuegos|World Health Organization Regional Office for the Americas|Universidad de Ciencias Médicas de Cienfuegos|Universidad de Ciencias Médicas de Cienfuegos|Johns Hopkins University|University of Illinois at Chicago|Loyola University Chicago
evaluate associations populationwide loss gain weight diabetes prevalence incidence mortality well cardiovascular cancer mortality trends cuba 30 year intervalrepeated cross sectional surveys ecological comparison secular trendscuba province cienfuegos 1980 2010measurements cienfuegos included representative sample 1657 1351 1667 1492 adults 1991 1995 2001 2010 respectively national surveys included representative sample 14 304 22 851 8031 participants 1995 2001 2010 respectivelychanges smoking daily energy intake physical activity body weight tracked 1980 2010 using national regional surveys data diabetes prevalence incidence obtained national population based registries mortality trends modelled using national vital statisticsrapid declines diabetes heart disease accompanied average populationwide loss 55 kg weight driven economic crisis mid1990s rebound population weight followed 1995 335 prevalence overweight obesity exceeded precrisis levels 2010 529 prevalence populationwide increase weight immediately followed 116 increase diabetes prevalence 140 increase diabetes incidence six years weight rebound phase diabetes mortality increased 49 93 deaths per 10 000 people 2002 139 deaths per 10 000 people 2010 deceleration rate decline mortality coronary heart disease also observedin relation cuban experience 19802010 association population level weight reduction death diabetes cardiovascular disease opposite effect diabetes cardiovascular burden seen populationwide weight gain