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首页> 外文期刊>BMJ: British medical journal >Weight changes and health in Cuba
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Weight changes and health in Cuba

机译：在古巴体重变化和健康

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Changes in food supplies and reductions in physical activity are fueling increases in overweight and obesity, diabetes, and cardiovascular disease worldwide. We have had few opportunities to see a reversal of this process, which is continuing inexorably almost everywhere. One such opportunity was provided by the well developed public health surveillance systems in Cuba, which were maintained during a period of serious economic hardship in the early 1990s. In a linked study, Franco and colleagues used these systems to look at the effects of reduced energy intake and increased physical activity on body weight and the occurrence of diabetes, cardiovascular disease, cancer, and death. In Cuba, decreased food availability and increased physical activity, supported by the distribution of more than a million bicycles during 1991 to 1995, led to an average 5.5 kg reduction in weight over five years, shifting the whole population distribution of weight downwards. Predictably, a profound and almost immediate reduction in the incidence of diabetes occurred, and a striking decline in cardiovascular mortality began, with a lag of about five years. These findings are consistent with those of the many epidemiologic and clinical studies that have examined the incidence of diabetes, cardiovascular disease, and cancer. The economic crisis was followed by a slow recovery, increased food intake, reduction in activity, and an increase in the prevalence of obesity to three times higher than before the crisis. With weight regain, the trend in incidence of diabetes rapidly reversed, and a decade after the period of weight loss, the decline in cardiovascular disease had greatly slowed. Most troublesome, the continued rapidincrease in obesity and diabetes predicts that the decline in cardiovascular disease, and thus total mortality, will be reversed because the full impact of diabetes on incidence of cardiovascular disease is not seen until several decades after diagnosis. The apparent lack of effect of weight loss on death from cancer seen in the current study is not surprising. Only some cancers are associated with obesity and disease latency can be decades. More detailed analyses by specific types of cancer would be useful.
机译：粮食供应和减少的变化身体活动正在推动增长超重和肥胖、糖尿病和全球心血管疾病。机会看到逆转这个过程,这是继续无情地几乎无处不在。提供这样一个机会发达的公共卫生监测系统古巴、维护期间在1990年代初的严重的经济困境。这些联系的一项研究中,弗兰克和他的同事使用系统看减少能量的影响身体摄入和增加体力活动重量和糖尿病的发生,心血管疾病、癌症和死亡。古巴、粮食供应减少和增加体育活动,支持的分布在1991年超过一百万辆自行车1995年,导致了平均减少5.5公斤重量在5年内,将整体人口分布的体重下降。可以预见的是,深刻,几乎立即降低糖尿病的发病率,和心血管的显著下降死亡率开始,滞后约5年。这些发现与是一致的许多流行病学和临床研究检查糖尿病的发病率,心血管疾病和癌症。危机是紧随其后的是一个缓慢的复苏,增加减少食物摄入量,活动,和一个肥胖的患病率增加到三个倍高于危机前的水平。恢复,糖尿病的发病率趋势迅速逆转,和十年后减肥,心血管的下降疾病已经大大放缓。持续rapidincrease肥胖和糖尿病预测心血管的下降疾病,因此总死亡率逆转,因为糖尿病的全面影响心血管疾病的发病率未见直到几十年之后的诊断。明显缺乏减肥对死亡的影响从癌症中看到当前的研究令人惊讶。肥胖和疾病延迟可以几十年。详细分析了特定类型的癌症将是有用的。

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