Street Food Consumption and Overweight and Obesity Among Adults in Tbilisi, Georgia: A Cross-Sectional Survey, 2024

Abstract

Background: Street food (SF) is widely consumed in Tbilisi and often energy-dense. However, its role in the development of overweight and obesity among urban adults remains unclear. Objectives: We aimed to describe street-food consumption patterns among adults and assess whether higher consumption frequency is associated with elevated body mass index (BMI). Methods: A cross-sectional survey was conducted in 2024 among SF consumers at randomly selected vendor sites across Tbilisi (n=860). Overweight or obesity (BMI ≥25 kg/m²) was calculated from self-reported height and weight. Key exposures included street-food consumption frequency (≥2 vs. <2 times/week), food diversity (≥3 vs. ≤2 categories/month), and sugar-sweetened beverage (SSB) intake (Never, Rare, Occasional, Regular). Perceived health risks of street-food consumption were assessed using a five-item scale (range=5-25). Additional covariates included age, sex, socioeconomic status (SES), physical activity, and sedentary time. Associations were examined using chi-square tests, t-tests, and binary logistic regression. Results: The mean age of participants was 38.8 (SD = 12.8) years, and 60.6% were male. Overall, 36.6% of participants had a BMI of 25 kg/m² or greater. High- frequency SF consumers (≥2 times/week) had 3.65 times higher odds of being overweight/obese than those consuming less often (OR=3.65, 95% CI: 2.44-5.45, p<0.05). SSB intake showed an inverse association versus non-consumers (e.g., Regular ≥4/wk.: OR = 0.58; 95% CI, 0.38-0.88; p=0.01). Male sex was associated with an increased risk (OR=1.99; 95% CI, 1.45-2.72); however, age, SF diversity, perceived risk, and physical activity were not. Conclusions: Frequent consumption of street food and sugar-sweetened beverages is a modifiable risk factor for overweight and obesity in Tbilisi. Interventions that reduce consumption frequency and promote healthier beverage options could meaningfully support obesity prevention in urban Georgia.