European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Eur J Public Health. 2013 Apr;23(2):291-8. doi: 10.1093/eurpub/cks054. Epub 2012 May 29.
Limited evidence exists on obesity in the former Soviet Union (fSU), particularly its micro- and meso-level determinants. The objectives of this study were to determine age- and gender-adjusted prevalence of self-reported overweight and obesity in nine fSU countries; explore the relationship between individual and household (micro-level) factors and obesity; and explore the relationship between features of nutritional and physical environments (meso-level) and obesity.
Data were collected from 18,000 adults using household surveys and from 333 communities using community profiles in Azerbaijan, Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine in 2010. Individual- and community-level determinants of self-reported obesity (body mass index ≥ 30 kg/m(2)) were analysed using multi-level random intercept logistic regression models.
A total of 13% of the males and 18% of the females were categorized as obese. Factors associated with obesity in males were older age, increasing educational achievement, declining self-reported health, alcohol consumption and automobile ownership. Males who were current smokers, not married and perceived physical activity to be important were less likely to be obese. For females, obesity was associated with older age, completion of secondary-level education, declining self-reported health and average household financial situation. Unmarried women were less likely to be obese. Multi-level analysis indicated that individuals living in communities with higher presence of garbage were more likely to be obese.
This is the first study to examine both micro- and meso-level influences on obesity in fSU using multi-level analysis. Findings indicate a similar obesity risk profile to countries in Western Europe and North America.
前苏联（fSU）的肥胖问题相关证据有限，尤其是其微观和中观层面的决定因素。本研究的目的是确定 fSU 九个国家中自我报告超重和肥胖的年龄和性别调整患病率；探讨个体和家庭（微观层面）因素与肥胖的关系；以及探索营养和物理环境（中观层面）特征与肥胖的关系。
2010 年，在阿塞拜疆、亚美尼亚、白俄罗斯、格鲁吉亚、哈萨克斯坦、吉尔吉斯斯坦、摩尔多瓦、俄罗斯和乌克兰，使用家庭调查收集了 18000 名成年人的数据，并使用社区概况收集了 333 个社区的数据。使用多水平随机截距逻辑回归模型分析了自我报告肥胖（体重指数≥30kg/m2）的个体和社区水平决定因素。
男性中共有 13%和女性中共有 18%被归类为肥胖。与男性肥胖相关的因素包括年龄较大、受教育程度提高、自我报告健康状况下降、饮酒和拥有汽车。当前吸烟、未婚和认为体育锻炼重要的男性肥胖的可能性较低。对于女性，肥胖与年龄较大、完成中等教育水平、自我报告健康状况下降和平均家庭经济状况有关。未婚女性肥胖的可能性较低。多水平分析表明，居住在垃圾存在率较高的社区的个体更有可能肥胖。
这是首次使用多水平分析方法研究 fSU 微观和中观层面肥胖影响的研究。研究结果表明，fSU 的肥胖风险概况与西欧和北美国家相似。
