The goal of our study was to examine the effect of regional characteristics of living environment on individual a priori and a posteriori dietary patterns of the Russian population. For the analysis, we used cross-sectional data from the Epidemiology of Cardiovascular Diseases in the Regions of the Russian Federation study of 2013-2014. The sample included 18,054 men and women 25-64 years of age from 12 regions. Based on the frequency of consumption of basic foods, four a posteriori empirical dietary patterns (EDPs), along with an a priori cardioprotective dietary pattern (CPDP) were identified. To describe the regional living environment, 5 regional indices were used. The adherence to the meat-based EDP was directly associated with deterioration of social living conditions and the more northerly location of the region of residence. The probability of CPDP increased with deterioration of social living conditions, an aggravation of demographic crisis, higher industrial development of the region, as well as with a decline in the economic development of the region, income and economic inequality of the population. We detected some gender-dependent differences in associations. The revealed patterns reflect the national dietary preferences of Russians, and regional indices characterize the effect of living environment.