Data Sheet 1_Energy intake and dietary fiber as principal determinants of obesity in Eastern Europe, 2010–2022: an ecological panel study.docx

BackgroundObesity is a major global health challenge, with Eastern Europe standing out for rapid nutrition transitions and persistent social and economic inequalities. Despite its high prevalence, longitudinal ecological evidence on the structural determinants of obesity in this region remains limited.
ObjectiveTo examine population-level associations between dietary energy availability, dietary fiber intake, macronutrient composition, and insufficient physical activity with obesity and overweight prevalence in Eastern Europe during 2010–2022.
MethodsData from FAOSTAT and the World Health Organization were assembled into a balanced panel of 130 country–year observations. Analyses combined descriptive statistics and Pearson correlations with two-way fixed-effects regressions (country and year), using robust standard errors and one-year lagged predictors to test for robustness.
ResultsHigher energy availability was positively associated with both obesity and overweight, while dietary fiber consistently showed a protective effect. Marginal estimates indicated that an additional 100 kcal/day predicted an increase of nearly one percentage point in obesity, whereas +5 g/day of fiber corresponded to an approximate two-percentage-point reduction. Neither macronutrient shares nor insufficient physical activity showed significant associations.
ConclusionDietary energy and fiber emerge as the primary structural correlates of obesity in Eastern Europe. These findings underscore the need for region-specific, data-driven nutrition and public health policies to address obesogenic environments and reduce socio-economic disparities in diet quality.

研究背景：肥胖（obesity）是一项全球性重大公共卫生挑战，其中东欧地区以营养转型快速、社会与经济不平等持续存在为显著特征。尽管该地区肥胖患病率居高不下，但针对该区域肥胖的结构决定因素的纵向生态学研究证据仍然十分有限。
研究目的：探讨2010-2022年东欧地区膳食能量供给（dietary energy availability）、膳食纤维（dietary fiber）摄入量、宏量营养素（macronutrient）组成以及身体活动不足（insufficient physical activity）与肥胖（obesity）及超重（overweight）患病率的人群层面关联。
研究方法：本研究整合了联合国粮食及农业组织统计数据库（FAOSTAT）与世界卫生组织（World Health Organization）的数据，构建了包含130个国家-年度观测值的平衡面板数据集。分析方法结合描述性统计、皮尔逊相关分析与双向固定效应回归（two-way fixed-effects regressions，控制国家与年份固定效应），并采用稳健标准误（robust standard errors）与一年期滞后预测变量开展稳健性检验。
研究结果：膳食能量供给水平升高与肥胖及超重患病率均呈正相关，而膳食纤维则始终表现出保护作用。边际效应估计结果显示，每日能量供给每增加100千卡，肥胖患病率将升高近1个百分点；而每日膳食纤维摄入每增加5克，肥胖患病率则约降低2个百分点。宏量营养素占比与身体活动不足均未表现出显著关联。
研究结论：膳食能量与膳食纤维是东欧地区肥胖的主要结构相关因素。本研究结果强调，需制定针对区域特点、以数据为导向的营养与公共卫生政策，以改善致肥胖环境（obesogenic environments），并缓解饮食质量方面的社会经济差异。