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

It is widely quoted that Hippocrates had long stated that "If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health". The natural experiment in Cuba once again adds to the growing evidence.

However, the independent contributions of food restriction and increasing physical activity needs to be clarified. Almost 80% Indians adults have a BMI less than 20 and yet diabetes has descended down on India like a modern plague. One major change that has happened in India is that auto-two wheelers like motor cycle, scooter and mopeds have replaced the physical activity of Indians across all ages (from school children to retired persons)in urban and rural settings.

Physical activity does several things in addition to burning calories. Exercise speeds up the circulation and enhance the elimination of exogenous and endogenous toxins and release a host of chemicals. This is supported by the fact that, two well controlled experiments in monkeys could not produce concordant results.1,2 These suggest that there is fair amount of confounding between calorie intake and physical activity.

References
1.Mattison JA, Roth GS, Beasley TM, et al. Impact of caloric restriction on health and survival in rhesus monkeys from the NIA study. Nature 2012;489:318–321

2.Colman RJ, Anderson RM, Johnson SC, et al. Caloric Restriction Delays Disease Onset and Mortality in Rhesus Monkeys. Science 2009;325:201-204.