Распространение ожирения в различных социально-демографических группах населения России

Abstract

The growing prevalence of overweight and obesity has been recognized by WHO as a global obesity pandemic worldwide. The spread of overweight and obesity is also an urgent problem for Russia. The aim of this study was to analyze the nutritional status of the Russian adult population and the prevalence of overweight and obesity depending on a number of socio-demographic factors and family income. Material and methods. The assessment of the nutritional status of adults was carried out on the basis of anthropometric parameters obtained by the Federal State Statistics Service in the course of the "Sample observation of the population's diet" in 2018 based on a random sample of 45 thousand households in all constituent entities of the Russian Federation. 76.960 people aged 19 and over were examined, including 41% of men and 59% of women. The nutritional status of adults was assessed based on the calculation of the body mass index (BMI). According to the WHO classification, BMI values in the range of 18.5-24.9 kg/m2 were taken as normal, BMI 25.0-29.9 kg/m2 was taken as overweight, and BMI≥30.0 kg/m2 indicated obesity. The prevalence of obesity was analyzed depending on socio-demographic variables: gender, age, place of residence (city, village, type of settlement in terms of population, federal district), marital status, educational level, and per capita income. Results. The body weight and height of respondents with a BMI of 18.5-24.9 kg/m2 can be considered as the average normal body weight and height of the adult population in Russia, which amounted to 70.6 kg and 175.4 cm for men, and 60.2 kg and 164 cm for women, respectively. The average body weight of all urban men is 1.3 kg more than that of rural men, while the average body weight of urban women is 2.2 kg less than that of rural women. The growth of urban men and women, respectively, is 2.1 cm and 1.1 cm higher than rural ones. The average BMI values of urban and rural men do not differ, while the BMI of rural women is 1.2 kg/m2 higher than that of urban ones reflecting higher values of the average body weight. The average BMI values of adult men and women are in the zone of values characteristic of overweight (BMI≥25.0 kg/m2). In general, in 2018, only 34.4% of the adult population (33.2% of men and 35.4% of women) had BMI indices corresponding to normal values. Overweight, including obesity (BMI≥25.0 kg/m2), were detected in 66.1%, men and 63.0% of women, and obesity (BMI≥30.0 kg/m2) in 18.8% of men and 27.4% women. The incidence of obesity among adults of both sexes is significantly higher among rural residents, while the incidence of overweight (BMI 25.0-29.9 kg/m2) does not differ. The prevalence of obesity in urban and rural areas decreases with the increase in their population. The frequency of overweight increases with growth in households' average per capita income with high reliability of differences between the 1st and the 5th quintiles of income (p<0.01). At the same time, the incidence of obesity increases from the 1st to the 3rd quintiles, decreasing in the 4th and the 5th quintiles. For men, the dependence of the average BMI values on household income is almost square with high reliability (p<0.001), while for women, a decrease in BMI was revealed only in the 5th quintile of income. Thus, the incidence of obesity among women in the richest population groups is lower than in the less affluent. The incidence of obesity in men increases linearly with age from 19 to 65, and decreases in the age group over 70 years. In women, the frequency of obesity from 19 to 40 years old increases slowly, then there is a rapid increase up to 65 years, and then, like in men, there is a decrease. In young men, the frequency of overweight, including obesity (BMI≥25.0 kg/m2), is 32.3% at the age of 19-25, and 49.3% at the age of 25-30, which, respectively, by 13.1 and 20.0% higher than among women of the same age. Moreover, the frequency of obesity in these age groups of men and women is the same. The highest incidence of BMI≥25.0 kg/m2 in men is observed over 40 (70-76%); in women over 50 (75-83%). The prevalence of obesity (BMI≥30.0 kg/m2) before the age of 50 is approximately the same in men and women, while over the age of 50, the frequency of obesity in women is 12-16% higher than in men. Over the age of 65, there is a decrease of obesity in both sexes, but the incidence remains significantly higher among women than men of a similar age. The prevalence of obesity among urban and rural men in all age groups from 19 to 70 years does not differ significantly. Among rural women the frequency of obesity is significantly higher compared to urban women. Education level affects the prevalence of obesity only in women: the incidence of obesity among women with higher education is considerably lower than among women with less education. Conclusion. Significant differences in the state of nutrition and the prevalence of obesity were revealed depending on the place of residence in urban and rural settlements, the type of settlements in terms of population and the Federal Districts. Noteworthy, there was a significant 10.2% increase in the prevalence of overweight in men in 2018 compared to 2012, while the increase in women was 6.2%. In general, the frequency of overweight increased by 7.8%, amounting to 40.3%. The prevalence of obesity increased in men by 0.9%, while in women decreased by 3.3%. As a result, throughout the adult population, the prevalence of obesity decreased by 1.4%. Based on the available two studies, it is not possible to assert with confidence about the trend of decreasing the prevalence of obesity from 2012 to 2018.