[Analysis of the association of diet energy from macronutrients and prevalence of overweight and obesity among the Russian population]

The fundamental cause for the development of overweight and obesity in adults is a positive balance of energy. However, many environmental factors can contribute to or restrain the development of obesity. These, of course, include the composition of the diet and the structure of its energy value. The aim of the study was to explore the relationship between the prevalence of overweight and obesity with the macronutrients' energy intake of Russian adult population. Material and methods. Assessment of dietary intake and anthropometric parameters (height, weight) of the adult population were obtained in a cross-sectional survey of households in Russia (Russian longitudinal monitoring surveys, RLMS project). For analysis, we selected data from a survey of adults of both sexes (24 767 men and 30 040 women) aged 19-60 years, obtained in 7 rounds of the project during the period 2000-2012. Association of dependent variables of macronutrients' energy as a percentage (%E) (fat, protein, total carbohydrates, natural mono- and disaccharides, added sugar), and independent (factor) variables namely gender and 4 categories of body mass index (BMI), characterizing nutritional status, was investigated using the ANOVA. The total daily energy intake and age were used as covariates in the model. Results and discussion. The intake of total daily energy, the absolute values of macronutrients' intake and %E of macronutrients are significantly higher in obesity (with the exception of the consumption of various fractions of carbohydrates) compared to normal BMI values. A direct association of the %E protein and the BMI category has been established. This relationship is more pronounced in men, but statistically significant in women as well (p<0.001 when comparing all BMI groups). A linear increase in the proportion of %E of fat with an increase in the BMI category in the direction from malnutrition to obesity was found in men (p<0.001 when comparing all BMI groups). In women, statistically significant differences in %E of fat intake in BMI groups were observed only between obesity and normal. In men, the consumption of %E due to total carbohydrates is lower in groups with overweight and obesity compared with normal and malnutrition. The exception is only for %E of natural mono- and disaccharides, the consumption of which in men increases in the range from malnutrition to obesity. In women with overweight and obesity, consumption of %E due to polysaccharides and natural sugar doesn't differ from consumption in persons with normal BMI. Consumption of %E due to added sugar and the frequency of consumption of more than 10%E due to sugar are reduced in people of both sexes in the direction normal, overweight, and obesity. The opposite effect of BMI on the consumption of %E of fat and carbohydrates is clearly manifested in an increase in the ratio of %E fat/%E carbohydrates in people with overweight and obesity. Analysis of variance was confirmed when assessing the frequency of distribution of respondents with overweight and obesity in quartiles of macronutrients' %E differentiated by gender. The frequency of overweight and obesity is significantly higher in the groups of highest quartiles of %E of protein, total fat, saturated fatty acids and lowest quartiles of %E of total carbohydrates and their individual fractions, including added sugar. Conclusion. The data obtained indicate a more significant role of the energy of the diet fat component in the prevalence of overweight and obesity, while the energy of carbohydrates, including added sugar, has no direct association with the prevalence of these conditions. The results obtained should be taken into account when developing measures to prevent and reduce the prevalence of obesity, both at the population and individual levels.

Keywords: adults; dietary intake; energy structure of diet; macronutrients; obesity; overweight.