Almaz Sharman

Published household statistics describe food quantities and budget allocation but do not directly measure individual dietary intake. This study examined food-group-specific socioeconomic and household-composition contrasts and food-purchase expenditure distributions in Kazakhstan in 2025. An ecological repeated cross-sectional study used official household survey aggregates. Regional maps reproduced published fruit and fish indicators for 2025. Recent regional urban–rural comparisons covered 2022–2025, with the principal interpretation restricted to 11 oblasts not involved in the 2022 regional splits; six oblasts with estimated 2022 values were displayed separately. The national annual series for 2001–2025 was retained as historical context rather than a fully harmonised estimate of dietary change. In 2025, the highest population decile of per capita income used for consumption had a fish indicator 3.9 times that of the lowest decile; corresponding ratios were approximately 3.3 for meat, milk/dairy products and fruit and 1.5 for bread/cereal products. Per capita indicators were lower across all ten food groups in households with five or more members than in one-person households. Food purchases exceeded 50% of consumer expenditure in 64.0% of households and 71.7% of households with five or more children. Recent regional changes differed by food group and urban–rural category. These descriptive findings identify contrasts in household apparent consumption and expenditure allocation. They do not establish individual dietary adequacy, food-insecurity prevalence, household-level associations between separately tabulated indicators, or independent causal effects.

Purpose: Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death worldwide and is the fourth leading cause of death in Kazakhstan. Cigarette smoking is a prevalent risk factor for COPD. While quitting smoking is the preferred way to reduce COPD risk, literature suggests that heated tobacco products (HTP) might be a better option for people who cannot quit smoking. The aim of this paper was to analyze the long-term effects of shifting to HTP use in long- term smokers compared to continued combustible cigarettes (CC) use. Patients and methods: A cohort of 1200 participants (393 HTP and 807 CC) aged 40-59 years with a minimum of 10 pack-year smoking history were recruited and followed for five years. The functional outcomes compared between HTP, CC users and No-Smokers (NS, people who stopping smoking) included: (1) COPD Assessment Test (CAT); (2) post-bronchodilator lung function; (3) 6-minute walking distance (6MWD) test; and (4) metabolic syndrome components. Multivariable linear mixed models (MIXED) were used to compare functional outcomes between visits and to test associations between health outcomes and smoking type (HTP vs. CC vs. NS) over time. Results: Out of 1200 participants 830 (466 CC users, 248 HTP users and 116 No-Smokers) remained in the study by the fifth year of follow up. Linear mixed models showed HTP use was associated with better CAT scores and HDL cholesterol level compared to CC users. Lung function (FVC) decrease was significantly less in HTP users. FEV, 6MWD, waist circumference, fasting blood glucose, triglycerides and diastolic blood pressure significantly changes over time, but without between-group difference in dynamic. Conclusion: This study demonstrated that HTP users experienced it to a significantly lesser decrease in lung function by FVC compared to CC users over time (in time dependent model), while demonstrating better stable levels in other functional outcomes. The results of this study suggest that HTP might be a less deleterious alternative compared to CC in people with long history of CC use and who cannot quit smoking.