HAVANA – Cubans are no strangers to the battle of the bulge.
Waistlines have expanded since the economic crisis of the early 1990s eased on the communist-run island -- so much so that 30 percent of adults are now overweight, a newly released government study reveals.
Some people outside Cuba hold on to a stereotype of malnourished Cubans waiting in lines for a few potatoes, but there's ample evidence to the contrary in Havana, where bulging waistlines are stuffed into snug skirts or peek through too-tight guayabera shirts.
"People eat lots of things like pizza and bread that fill you up, but put on a lot of weight," said Lucia, a plump housewife who didn't want her last name used, saying she was embarrassed about her weight and uncomfortable talking publicly about something as political as food.
"If you want to go on a diet it's hard because vegetables and fruits cost a lot," she said.
In Cuba, as elsewhere, "obesity and excess weight represent a serious public health problem," causing conditions such as diabetes, hypertension and heart troubles, said the study by Cuba's Nutrition and Food Safety Institute.
Released by state media this month, the 2004 study focused on urban areas, where three-quarters of Cubans live. The study said 30 percent of Cuba's men and 31 percent of its women are overweight, and that about a fourth of the island's 11.2 million people have a tendency toward obesity. Those most likely to be overweight are in their 50s, it added.
An estimated two-thirds of American adults are overweight or obese, according to U.S. federal statistics. Using a ratio taking into account height and weight, the U.S. Centers for Disease Control and Prevention says that generally anyone with a body mass index greater than 25 is overweight. Greater than 30 is obese.
It was unclear if the same index was used for the Cuban study. However, Cuban nutrition researchers told the communist youth newspaper Juventud Rebelde that BMI is the most effective way to determine if someone is overweight or obese.
Cuba has a food ration system that supplements diets with a subsidized basket of rice, beans, potatoes, bread, eggs, a little meat, fish and chicken and other goods. The government estimates it provides a third of the 3,300 calories each Cuban consumes daily.
Cubans also get subsidized meals at work and school, and buy food at farmers markets and overpriced supermarkets or through black market purchases and trades.
Residents say getting food remains challenging, but it's easier now than in the early 1990s when the Soviet Union collapsed and generous subsidies ended. Officially, Cuba's gross domestic product fell by about 35 percent between 1989 and 1990, sparking widespread food shortages.
In 1994, the government opened markets where private farmers could sell crops at unrestricted prices -- previously a crime. The state also runs farmers markets with less variety, but lower prices. Together, the markets are the only source of fresh fruits and vegetables for most urban Cubans.
Prices are low by U.S. standards: five pounds of tomatoes and a big pineapple each cost less than an American nickel.
But even with free housing and health services and subsidized services, Cubans complain that salaries averaging about 350 pesos a month ($16.60) don't buy more than a few items, such as onions and garlic and maybe a few tropical fruits.
"It is true that maintaining a balanced diet in today's Cuba, with the economic conditions the country faces, is difficult," endocrinologist Malicela Barcelo told Juventud Rebelde. "We have vegetables and fruits all year, but they are very expensive."
Even if Cubans had the money, there is no guarantee they would spend more on produce. Government-run vegetarian restaurants are often nearly empty. At home, salads are usually just some chopped cabbage, a few tomato slices and a wedge of avocado dressed with oil and vinegar.
The Cuban diet is heavy in starch, especially rice and potatoes. Fried foods are popular, and pork is generally preferred over fish.
And like Americans, many Cubans are sedentary, although they tend to walk more because most don't have cars.
Barcelo and other experts said changing eating habits would help.
"It is common for Cubans to skip breakfast and eat the majority of their food when they get home from work," said Armando Rodriguez Suarez, a researcher for the nutrition institute. "Then all that turns into fat because they sit in front of the television to watch the baseball game or the telenovela."