Obesity in the Russian Federation: epidemiology, socio-demographic and nutritional factors for development

Introduction. The increasing prevalence of obesity is a serious health problem, since obesity significantly increases the risk of diseases such as diabetes type 2, fatty liver disease, hypertension, myocardial infarction, stroke, dementia, osteoarthritis, obstructive sleep apnea, and some types of cancer, and in general, leads to a significant reduction in life expectancy. The aim of this study is to analyze the prevalence of obesity in the adult population of the Russian Federation depending on socio-demographic factors and dietary patterns for the years of observation from 1994 to 2023. Materials and methods. The current prevalence of overweight and obesity in the adult population aged 19+ during 2023 was assessed on the base of the body mass index (BMI) by anthropometric parameters of body weight and height obtained by the Federal State Statistics Service (Rosstat) during the “Sample Survey of Population Diets” over 2023 based on a random sample of forty five thousand households in all constituent entities of the Russian Federation (72,129 adult members of households, 41% of men and 59% of women). To analyze trends in the prevalence of obesity, the results of observations for 1994–2012 under the RLMS project and the data obtained by Rosstat as part of the population diet survey in 2013–2023 were summarized. The prevalence of overweight and obesity according to WHO criteria was analyzed depending on socio-demographic variables: gender, age, place of residence, level of education, average per capita monthly household income. Results. Overweight (without obesity, BMI 25.0–29.9) was found in 52.5% of men and 38.9% of women. At the same time, the prevalence of obesity (BMI≥30.0) is more common in women than in men, respectively, 24.2% and 17.3%. The total frequency of overweight, including obesity, in men is higher than in women, respectively, 69.8% and 63.1%. Among rural residents, the prevalence of obesity is significantly higher than among urban residents. The prevalence of obesity in both urban and rural settlements decreases with an increase in the number of residents. The frequency of obesity in men increases linearly with age from 19 to 65 years, and in the age group over 65 years, it begins to decrease linearly until the age of 90 years. The incidence of overweight, including obesity, increases sharply in men aged of 19 to 35 years, then maintaining a linear increase until the age of 55 years. In women, the incidence of obesity increases slowly from 19 to 50 years, then there is a rapid increase until the age of 65, then, as in men, there is a decrease. In young men, the incidence of overweight, including obesity, at the age of 19–30 years is higher than in women of the same age. The highest prevalence of obesity was found in the Ural and Siberian Federal Districts, in men, respectively, 22.3% 20.7%, in women, respectively, 27.9%, and 28.5%. The minimum incidence of obesity in men and women was found in the North Caucasus Federal District. The incidence of obesity among people of both sexes in the wealthiest groups of the population is lower than in the less wealthy (1st and 2nd quintiles of average monthly income). The proportion of obese men is significantly lower only in the group with higher education, while in women the incidence of obesity decreases linearly in a series from basic general to higher education. Discussion. An analysis of the relationship between the prevalence of overweight and obesity and the specific structure of macronutrient energy consumption in the diet of the adult population of Russia over the observation years 1994–2023 showed the level of total daily energy consumption, absolute values of macronutrients and % of macronutrient energy to be significantly higher in obese individuals. A direct dependence of the increase in the incidence of overweight and obesity on energy consumption due to fat and an inverse dependence on carbohydrate energy consumption is clearly visible in the course of observations. Limitations. The limitations of the study are determined by the registration in 2013 of anthropometric indices of the adult population from the respondents’ words without objective measurements of height and body weight, which should be taken into account when interpreting the data obtained. Conclusion. The results of the analysis of the association of dietary energy structure parameters and the prevalence of obesity should be taken into account when developing a strategy for priority measures to prevent and reduce the prevalence of obesity, both at the population and individual levels