Is austerity good for your health?

 

While an economic crisis results in untold misery for countries and their people, a new study of health in Cuba has suggested there could be a silver lining during lean times.
 There could be a tiny silver lining during lean times
Havana, Cuba: the study was based on the economic crisis in the country during the 1990s.

Researchers appear to have implied that people can lose weight during a recession due to a reduction in eating and increasing physical activity.

Their dramatic findings, published online in the British Medical Journal, were based on a study in Cuba, where the population suffered food and fuel shortages following the economic crisis of the early 1990s triggered by the collapse of the Soviet Union.

This resulted in an average of 4 to 5kg (8 to 11 lbs) being shed by the people and subsequent rapid declines in deaths from diabetes and coronary heart disease.

The scientists from the University of Alcalá, in Madrid, also discovered that when Cubans put the weight back on, cases of diabetes surged again.

The researchers concluded that the Cuban crisis could have lessons Britain.

They suggested that an average weight loss of just eleven pounds across the UK could cut deaths from heart disease by a third while the mortality rate of type 2 diabetes, the form of the condition related to obesity, could also be halved.

Whole population trends in food consumption and transport policies linked to physical activity could reduce the burden of two major illnesses, said the researchers.

“During the deepest period of the economic crisis in Cuba, from 1991 to 1995, food was scarce and access to gas was greatly reduced, virtually eliminating motorised transport and causing the industrial and agricultural sectors to shift to manual intensive labour,” said Prof Manuel Franco, who led the international team of researchers from Spain, Cuba and the United States.

"We found a population-wide loss of 4-5 kg in weight in a relatively healthy population was accompanied by diabetes mortality falling by half and mortality from coronary heart disease falling by a third.

“So far, no country or regional population has successfully reduced the distribution of body mass index or reduced the prevalence of obesity through public health campaigns or targeted treatment programmes.”

They examined the association between population-wide body changes and diabetes incidence, prevalence and death rates from type 2 diabetes and cardiovascular disease, cancer and all causes in Cuba between 1980 and 2010.

The country has a long tradition of public health and cardiovascular research which provided the necessary data from national health surveys, cardiovascular studies, primary care chronic disease registries and vital statistics over three decades.

Four population-based cross-sectional surveys were used and data were available on height, weight, energy intake, smoking and physical activity. All participants were aged between 15 and 74.

Population-wide changes in energy intake and physical activity were accompanied by large changes in body weight.

Smoking prevalence slowly decreased during the 1980s and 1990s and declined more rapidly in the 2000s.

Diabetes prevalence surged from 1997 onwards as the population began to gain weight. New cases decreased during the weight loss period but then increased until it peaked in the weight regain years.

In 1996, five years after the start of the weight loss period, there was an abrupt downward trend in death from diabetes.

This lasted six years during which energy intake gradually recovered and physical activity levels were reduced. In 2002, death rates returned to pre-crisis trends and a dramatic increase in diabetes death was observed.

Regarding heart disease and stroke death trends there was a slow decline from 1980 to 1996 followed by a dramatic decline after the weight loss phase. These descending trends have halted during the weight regain phase.

Prof Walter Willett, of the Harvard School of Public Health, Boston, who analysed the research for the journal, said it adds "powerful evidence a reduction in overweight and obesity would have major population-wide benefits".

He also said the authors are appropriately cautious in their conclusions and avoid "attributing all the changes in disease rates to changes in weight".

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