Relationship between diet and smoking--is the diet of smokers different?

STUDY OBJECTIVE--The aim was to compare nutrient intakes of smokers, past smokers, and non-smokers. DESIGN--The study was cross sectional and compared nutrient intake by smoking status using data obtained from a concurrent study of diet. SETTING--The study took place in three towns in England: Ipswich, Wakefield, and Stoke on Trent. PARTICIPANTS--Food records were obtained from 1115 men and 1225 women aged 35 to 54 years, representing response rates of 84-86% in the three towns. MEASUREMENTS AND MAIN RESULTS--Diet was assessed using a 24h food record in household measures. For both men and women vitamin C, total fibre, beta carotene, and vitamin E intakes were lowest in the current smokers and highest in the non-smokers with past smokers having intermediate values. Polyunsaturated/saturated fat ratio was lowest in the current smokers. Men who smoked had higher energy intakes than those who did not. The lower fat intakes of beta carotene, vitamin C, fibre, and polyunsaturated fat in the smokers was due to fewer smokers eating a whole range of foods including fruit, wholemeal bread, cereals, and polyunsaturated margarine. Current smokers had a lower body mass index than non-smokers or past smokers despite their higher energy intakes. CONCLUSIONS--Smokers have different nutrient and food intakes compared with past smokers or non-smokers.     

Parental smoking and the nutrient intake and food choice of British teenagers aged 16-17 years.

STUDY OBJECTIVE: To examine the association between parental smoking habits and the nutrient intake and food choice of teenagers aged 16-17 years, allowing for differences in teenage smoking and the social class and regional distribution of the participants. DESIGN: Data were collected from the 1970 longitudinal birth cohort, cross-sectionally at 16-17 years. The smoking habits of teenagers were evaluated from a questionnaire completed by the subjects themselves, and the smoking habits of parents by interview. The nutrient and food intakes of teenagers were quantitatively assessed using a four day unweighed dietary diary. SETTING: The participants were distributed throughout Britain. PARTICIPANTS: A subsample of 1222 males and 1735 females was isolated from respondents to the 1970 birth cohort 16-17 year data collection sweep undertaken in 1986-87. MAIN RESULTS: Parental smoking habits were associated with different dietary patterns among teenagers regardless of whether the teenagers themselves smoked. Dietary differences noted were similar to those observed previously among smokers, with lower intakes of fibre, vitamin C, vitamin E, folates, and magnesium in particular reported among both males and females in households where parents were smokers. These lower intakes were associated with lower intakes of fruit juices, wholemeal bread, and some vegetables. CONCLUSION: Teenagers who lived with parents who smoked had different nutrient and food intakes to those with non-smoking parents, and teenagers exposed to parental smoking appeared to have similar dietary patterns to teenagers who themselves smoked.     

Quality of food eaten in English primary schools: school dinners vs packed lunches

OBJECTIVE: To compare the food and nutrient intakes of primary school children eating school dinners and packed lunches. SUBJECTS: Six-hundred and twenty-one 7-year-old children participating in the Avon Longitudinal Study of Parents and Children in South West England. METHODS: Diet was assessed by 3-day unweighed food record. RESULTS: The composition of both types of school meals compared unfavourably with dietary guidelines. Intakes of energy, non-starch polysaccharides (NSP), calcium, iron, folate, retinol equivalents, zinc, copper, magnesium, iodine and riboflavin were too low, and intakes of total and saturated fat were too high. However, children who ate school dinners had higher lunchtime intakes of protein, starch, NSP and most vitamins and minerals and lower intakes of sugar (14.2 and 20.9% of energy in school dinners and packed lunches, respectively, P<0.001) and saturated fat (12.0 and 16.2%, P<0.001). Only around half of the recommended amount of fruit and vegetables was eaten by children having either type of school meal. There were also differences in the whole day's nutrient intake according to school meal type. Children eating packed lunches had lower daily intakes of potassium and zinc, and higher intakes of sugar and saturated fat. Differences in nutrient intake were independent of maternal education. CONCLUSIONS: The food and nutrient content of both school dinners and packed lunches needed improvement. However, the standard of food brought from home by children was, if anything, worse than that served at school. Recent moves to improve school dinners will need to be complemented by education about what constitutes a healthy packed lunch.     

Breastfeeding duration and perinatal cigarette smoking in a population-based cohort

OBJECTIVES: We examined the association between breastfeeding duration and maternal smoking before, during, and after pregnancy. METHODS: Data from the 2000-2001 Oregon Pregnancy Risk Assessment Monitoring System were used. Early weaning was defined as not breastfeeding at 10 weeks postpartum. RESULTS: At 10 weeks after pregnancy, 25.7% of mothers who initiated breastfeeding no longer breastfed. After controlling for confounders, quitters (mothers who quit smoking during pregnancy and maintained quit status after pregnancy) and postpartum relapsers (mothers who quit smoking during pregnancy and resumed smoking after delivery) did not have significantly higher risk for early weaning than nonsmokers. However, persistent smokers (mothers who smoked before, during, and after pregnancy) were 2.18 times more likely not to breastfeed at 10 weeks (95% confidence interval=1.52, 2.97). Women who smoked 10 or more cigarettes per day postpartum (i.e., heavy postpartum relapsers and heavy persistent smokers) were 2.3-2.4 times more likely to wean their infants before 10 weeks than were nonsmokers. CONCLUSIONS: Maternal smoking is associated with early weaning. Stopping smoking during pregnancy and decreasing the number of cigarettes smoked postpartum may increase breastfeeding duration.     

Dietary patterns in infancy: the importance of maternal and family influences on feeding practice

It is not known what constitutes an optimal diet in infancy. There are relatively few studies of weaning practice in the UK, and there is a need for prospective data on the effects of infant diet and nutrition on health in later life. We describe the dietary patterns, defined using principal components analysis of FFQ data, of 1434 infants aged 6 and 12 months, born between 1999 and 2003. The two most important dietary patterns identified at 6 and 12 months were very similar. The first pattern was characterised by high consumption of fruit, vegetables and home-prepared foods ('infant guidelines' pattern). The second pattern was characterised by high consumption of bread, savoury snacks, biscuits and chips ('adult foods' pattern). Dietary pattern scores were correlated at 6 and 12 months (r 0.46 'infant guidelines'; r 0.45 'adult foods'). These patterns, which reflect wide variations in weaning practice, are associated with maternal and family characteristics. A key influence on the infant diet is the quality of the maternal diet. Women who comply with dietary recommendations, and who have high intakes of fruit and vegetables, wholemeal bread and rice and pasta, are more likely to have infants who have comparable diets--with high 'infant guidelines' pattern scores. Conversely, women whose own diets are characterised by high intakes of chips, white bread, crisps and sweets are more likely to have infants who have high 'adult foods' pattern scores. The effects of these patterns on growth and development, and on long-term outcomes need to be investigated.     

Fruit and vegetable consumption is lower and saturated fat intake is higher among Canadians reporting smoking.

Understanding differences in dietary patterns by smoking status is important for nutritionists and health educators involved in helping individuals to make healthy dietary and lifestyle choices. Although smokers have a poor quality diet compared with nonsmokers, no study has examined nutritional adequacy and variability in the nutrient intake of smokers. The aim of this study was to compare dietary habits of smokers with nonsmokers in terms of nutrient intake, food groups contributing to nutrient intake, nutritional adequacy and day-to-day variation in nutrient intake. Noninstitutionalized adults aged 18--65 y (n = 1543) who participated in the Food Habits of Canadians Survey (1997--1998) were studied. Subjects, selected from across Canada using a multistage, random-sampling strategy, completed an in-home 24-h dietary recall. Repeat interviews were conducted in a subsample to estimate variability in nutrient intake. Smokers had higher intakes of total and saturated fat, and lower intakes of folate, vitamin C and fiber than nonsmokers. There were no significant differences in calcium, zinc and vitamin A intakes or day-to-day variation in nutrient intake by smoking status. Smokers consumed significantly fewer fruits and vegetables than nonsmokers, leading to lower intakes of folate and vitamin C. In conclusion, smokers have a less healthy diet than nonsmokers, placing them at higher risk for chronic disease as a result of both dietary and smoking habits. Diet may act as a confounder in smoking-disease relationships.     

Ascorbate is depleted by smoking and repleted by moderate supplementation: a study in male smokers and nonsmokers with matched dietary antioxidant intakes

BACKGROUND: Lack of reliable dietary data has hampered the ability to effectively distinguish between effects of smoking and diet on plasma antioxidant status. As confirmed by analyses of comprehensive food-frequency questionnaires, the total dietary intakes of fruit and vegetables and of dietary antioxidants were not significantly different between the study groups in the present study, thereby enabling isolation of the effect of smoking. OBJECTIVE: Our objective was to investigate the effect of smoking on plasma antioxidant status by measuring ascorbic acid, alpha-tocopherol, gamma-tocopherol, beta-carotene, and lycopene, and subsequently, to test the effect of a 3-mo dietary supplementation with a moderate-dose vitamin cocktail. DESIGN: In a double-blind, placebo-controlled design, the effect of a vitamin cocktail containing 272 mg vitamin C, 31 mg all-rac-alpha-tocopheryl acetate, and 400 microg folic acid on plasma antioxidants was determined in a population of smokers (n = 37) and nonsmokers (n = 38). The population was selected for a low intake of fruit and vegetables and recruited from the San Francisco Bay area. RESULTS: Only ascorbic acid was significantly depleted by smoking per se (P < 0.01). After the 3-mo supplementation period, ascorbic acid was efficiently repleted in smokers (P < 0.001). Plasma alpha-tocopherol and the ratio of alpha- to gamma-tocopherol increased significantly in both supplemented groups (P < 0.05). CONCLUSIONS: Our data suggest that previous reports of lower concentrations of plasma vitamin E and carotenoids in smokers than in nonsmokers may primarily have been caused by differences in dietary habits between study groups. Plasma ascorbic acid was depleted by smoking and repleted by moderate supplementation.     

Nutrient intakes during pregnancy: observations on the influence of smoking and social class

The influence of smoking and social class on dietary intake in pregnancy was investigated in a random sample of smokers (greater than or equal to 15 cigarettes/d) and nonsmokers. A total of 206 subjects (94 smokers and 112 nonsmokers) completed a 7-d weighed dietary intake at 28 wk gestation and 178 completed a second assessment at 36 wk. Nonsmokers had higher intakes of almost all nutrients than did smokers and the nutrient density of their diet was greater. Energy intake was nonsignificantly higher in nonsmokers. Women in higher social classes had the highest nutrient intakes. Smokers were shorter than nonsmokers and tended to be of lower social class. After maternal height and social class were controlled for, smoking had a significant effect on intake of many micronutrients. Dietary intake was reduced in late pregnancy, particularly in smokers. These data suggest that smokers in all social classes have a poorer quality of diet.     

Influence of maternal education on food consumption and energy and nutrient intake in a group of pre-school children from Madrid

A study was conducted on the influence of maternal education level on food consumption, energy and nutrient intake, and dietary adequacy in 110 pre-school children from Madrid, Spain. With increasing maternal education, children consumed more sugar(p < 0.05), fruit (p < 0.05), and fish (p < 0.05). Snacking was more frequent with decreasing maternal education (p < 0.05). Though statistical significance was not reached, the consumption of pre-cooked foods was greater among children of mothers educated to a higher level, a phenomenon probably related to the work situation of these women. With respect to dietary composition, no significant differences were found between groups for macronutrient, fiber and energy intakes, except for energy supplied by polyunsaturated fatty acids (PUFA), which was greater in the children of less educated women (p < 0.01). This is probably due to their greater consumption of sunflower seed oil. The diets of children belonging to well-educated mothers came closer to meeting the recommended intakes for folate, vitamin C, and iodine. It would seem that maternal educational level influences the food habits of children. Mothers with less education may require special advice in this area.     

Cigarette smoking during pregnancy in rural Nepal. Risk factors and effects of beta-carotene and vitamin A supplementation

OBJECTIVE: We examined risk factors of smoking and the association between smoking and pregnancy-related and 6-month infant mortality in rural Nepal, where 30% women reported smoking during pregnancy. DESIGN: Cross-sectional analysis of risk factors associated with smoking status and health consequences of smoking, using prospective data collected as part of a randomized community trial to examine the effect of maternal vitamin A or beta-carotene supplementation on maternal mortality. SETTING: Rural, southeastern plains of Nepal. SUBJECTS AND METHODS: A total of 17 767 women contributed at least one pregnancy during 3.5 y of the study. Data on cigarette or bidi (rolled tobacco) smoking were collected using a 7-day recall, twice during pregnancy. Associations between smoking status and maternal diet, morbidity profile, household socioeconomic status and serum concentration of retinol, carotenoids and tocopherols were examined. Further, relative risk (RR) and 95% confidence intervals (CI) were calculated to estimate supplement effects on pregnancy-related mortality, stratified by smoking status during pregnancy. RESULTS: Smokers were more likely to be older, illiterate and poor compared to nonsmokers. Fruit and vegetable consumption among smokers and nonsmokers did not vary. However, smokers were more likely to consume meat/fish/eggs and less likely to consume milk than nonsmokers. They were also more likely to report symptoms of vaginal bleeding, edema, severe headache and convulsions during pregnancy relative to nonsmokers. Mortality per 100,000 pregnancies appeared to be higher among smokers than nonsmokers in the placebo group (915 vs 584, RR=1.57, 95% CI: 0.80-3.08). beta-Carotene supplementation reduced pregnancy-related mortality both among smokers (RR=0.31 95% CI: 0.11-0.89) and nonsmokers (RR=0.41, 95% CI: 0.19-0.89). Similar results obtained with vitamin A supplementation were not statistically significant. Infant mortality up to 6 months was approximately 30% higher among smokers compared to nonsmokers in the placebo group both before and after adjusting for confounding factors. Neither supplement given to women reduced infant mortality. CONCLUSIONS: Cigarette smoking during pregnancy is associated with an increased risk of maternal and infant mortality in rural Nepal. beta-Carotene and to some extent vitamin A may reduce the risk of pregnancy-related mortality, but not infant mortality, among both smokers and nonsmokers.     

Dietary intake of Australian smokers and nonsmokers

Abstract: The 1983 National Dietary Survey of Adults and the 1983 Risk Factor Prevalence Survey No. 2, conducted on the same subjects, provided an opportunity to examine the nutrient intakes of smokers (1024 men and 785 women) and nonsmokers (1974 men and 2421 women). The nutrients analysed were energy (kJ); fat (g/day and contribution to energy); starch (contribution to energy); dietary fibre (g/day and g/1000 kJ); alcohol (g/1000 kJ); polyunsaturated/saturated fats ratio; cholesterol, niacin, vitamin C, calcium, iron, zinc and magnesium (mg/1000 kJ); and vitamin A, thiamin and riboflavin ((μg/1000 kJ). For both men and women, nonsmokers have a significantly higher intake of starch, dietary fibre (g/day and g/1000 kJ), thiamin, vitamin C, calcium and magnesium than smokers, who have a significantly higher intake of alcohol. Male smokers also have a higher intake of energy and cholesterol, but a lower intake of riboflavin, than nonsmokers. These differences in nutrient intakes suggest that non–smokers consume a more nutritious diet than smokers, in regard to having a higher intake of fruit and vegetables, wholegrain cereals and milk and milk products. There is a highly statistically significant association between smoking status and hazardous intake of alcohol. Both men and women who smoke have a significantly lower body mass index (BMI), than nonsmokers or ex–smokers.     

Parental pressure, dietary patterns, and weight status among girls who are "picky eaters"

OBJECTIVE: To determine whether mothers' fruit and vegetable intake and mothers' use of pressure in the feeding domain when their daughters were 7 years old predicted picky eating and dietary intake when their daughters were 9 years old, and to examine diet and weight status in picky and nonpicky eaters. DESIGN/SUBJECTS: Participants were 173 9-year-old non-Hispanic white girls and their mothers. A longitudinal analysis was used to assess maternal influences on picky eating and diet. A cross-sectional analysis was used to examine diet and weight status between picky and nonpicky eaters. Measures included maternal feeding practices, daughters' pickiness, mothers' fruit and vegetable intake, daughters' food intake, and weight status. STATISTICAL ANALYSES: t tests examined differences between picky and nonpicky eaters. Structural equation modeling examined relationships among mothers' fruit and vegetable intake; child feeding practices; daughters' pickiness; and fruit, vegetable, micronutrient, and fiber intakes. RESULTS: Mothers consuming more fruits and vegetables were less likely to pressure their daughters to eat and had daughters who were less picky and consumed more fruits and vegetables. Picky eaters consumed fewer fruits and vegetables, but also fewer fats and sweets. All girls consumed low amounts of vitamin E, calcium, and magnesium, but more picky girls were at risk for not meeting recommendations for vitamins E and C and also consumed significantly less fiber. In addition, picky eaters were less likely to be overweight. CONCLUSIONS: Mothers influenced daughters' fruit and vegetable intake via their own patterns of fruit and vegetable intake and by influencing their daughters' tendencies to be picky eaters. Both picky and nonpicky eaters had aspects of their diets that did not meet recommendations. Taken together, these findings suggest that parents should focus less on "picky eating" behavior and more on modeling fruit and vegetable consumption for their children.     

Smoking status and stages of change for dietary behaviors among WIC women

Objective: To examine whether dietary attitudes and demographics differ based on smoking status among low-income women participating in a dietary intervention. Methods: Smoking status, stages of change for eating a healthier diet, and dietary intake were examined among 2066 women participating in the Maryland Women, Infants, and Children (WIC) Food for Life Program. Results: Relative to nonsmokers, current smokers reported significantly higher overall calories; higher percentages of calories from fat, sweets, and alcohol; and lower percentage of calories from protein. Never smokers who received the dietary intervention evidenced the greatest dietary changes over time. Conclusions: Future interventions should consider targeting smoking and diet simultaneously or employ different strategies for smokers and nonsmokers.     

Breastfeeding mothers consume more vegetables and a greater variety of fruits and vegetables than non‐breastfeeding peers: The influence of socioeconomic position

Aim: This study compared the diets of breastfeeding and non‐breastfeeding mothers from socioeconomically diverse regions of Melbourne to determine whether breastfeeding is a marker for healthier maternal dietary intakes. Methods: This cross‐sectional study obtained information via self‐reported questionnaire from 529 first‐time Melbourne mothers. Breastfeeding status was determined when the children were 3.9 months. Diet information was obtained using a validated Food Frequency Questionnaire. Maternal diet was assessed by seven indicators: average daily intake of fruit, vegetables, non‐core drinks, non‐core sweet snacks, non‐core savoury snacks, variety of fruit and variety of vegetables eaten in the preceding 12 months. Associations between breastfeeding status and each dietary variable were assessed using linear regression analyses. Socioeconomic position, maternal body mass index and the cluster‐based sampling design were controlled for. Results: Of the 529 subjects, 70% were breastfeeding their child. Compared with non‐breastfeeding mothers, breastfeeding mothers were found to consume more serves of vegetables (P= 0.001), a greater variety of fruit and vegetables (P= 0.001 and P≤ 0.001 respectively), and sweet snacks were consumed more frequently (P= 0.006). Differences were observed between low and high socioeconomic position mothers for fruit serves (P= 0.003), vegetable serves (P= 0.010) and fruit variety (P= 0.006). These associations persisted after controlling for socioeconomic position and maternal body mass index. Conclusions: The association between infant feeding (breastfeeding) and some aspects of maternal diet provides further evidence suggesting a link between maternal and child diets from a younger age than previously examined.     

Antioxidant intakes and smoking status: data from the continuing survey of food intakes by individuals 1994-1996

BACKGROUND: Cigarette smoking is a major risk factor for several chronic oxidative diseases that can be ameliorated by antioxidants. OBJECTIVES: This study identified the typical dietary intakes and the major food group contributors of the antioxidants beta-carotene, vitamin C, and vitamin E by smoking status. DESIGN: The 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII) provided the current sample (n = 6749), who were categorized as non- (n = 3231), former (n = 1684), and current (n = 1834) smokers. In the CSFII, individuals' food intakes were estimated with two 24-h dietary recalls. Data were analyzed by using a chi-square test with a simultaneous Fisher's z test, analysis of variance with Scheffe's test, multivariate analysis of covariance, and analysis of covariance with Bonferroni adjustment for multiple comparisons. RESULTS: The sample consisted of 3707 men and 3042 women. Current smokers tended to be younger with less education and lower incomes than nonsmokers and former smokers. The average body mass index (in kg/m(2)) of current smokers was 25.8, the lowest of the 3 groups. Current smokers had the lowest dietary antioxidant intake. Fatty foods such as luncheon meats, condiments and salad dressings, and ground beef contributed more to the antioxidant intakes of current smokers than to those of the other 2 groups, whereas fruit and vegetables contributed less. Current smokers consumed the fewest numbers of servings of all nutrient-bearing groups in the food guide pyramid, except the meat group. CONCLUSION: Future interventions should target the clustering of cigarette smoking and other unhealthy lifestyle habits, eg, an imprudent diet.     

Smoking and exposure to environmental tobacco smoke decrease some plasma antioxidants and increase gamma-tocopherol in vivo after adjustment for dietary antioxidant intakes

BACKGROUND: Free radicals in cigarette smoke may cause oxidative damage to macromolecules, contributing to cardiovascular diseases and cancer. Decreased plasma antioxidant concentrations may indicate cigarette smoke-related oxidative stress. OBJECTIVE: We compared the effects on plasma antioxidant concentrations in cotinine-confirmed active and passive smokers with those in nonsmokers, independent of differences in dietary intakes and other covariates. DESIGN: Plasma samples from 83 smokers, 40 passive smokers, and 36 nonsmokers were analyzed for total ascorbic acid, alpha- and gamma-tocopherols, 5 carotenoids, retinol, and cotinine. Groups were compared by using analysis of variance with adjustment for sex, age, race, body mass index, alcohol intake, triacylglycerol concentration, fruit and vegetable intakes, and dietary antioxidants. RESULTS: After adjustment for dietary antioxidant intakes and other covariates, smokers and passive smokers had significantly lower plasma beta-carotene concentrations than did nonsmokers (0.15, 0.17, and 0.24 micro mol/L, respectively) and significantly higher gamma-tocopherol concentrations (7.8, 7.8, and 6.5 micro mol/L, respectively). Smokers had significantly lower plasma ascorbic acid and beta-cryptoxanthin concentrations than did nonsmokers and passive smokers (ascorbic acid: 43.6, 54.5, and 54.6 micro mol/L, respectively; beta-cryptoxanthin: 0.12, 0.16, and 0.16 micro mol/L, respectively) and significantly lower concentrations of lutein and zeaxanthin than did nonsmokers (0.33 compared with 0.41 micro mol/L). The P values for all the differences described above were < 0.05. No significant differences in plasma concentrations of alpha-tocopherol, alpha-carotene, total carotenoids, lycopene, or retinol were observed. CONCLUSIONS: These results indicate that cigarette smokers and nonsmokers exposed to cigarette smoke have a significantly lower plasma antioxidant status than do unexposed nonsmokers, independent of differences in dietary antioxidant intakes. Further research is required to explain why plasma gamma-tocopherol concentrations were significantly higher in smokers and passive smokers than in nonsmokers.     

Who eats what? A comparison of dietary patterns among men and women in different occupational groups

Abstract: Dietary data were obtained during a community-based study of risk factors for heart disease in 1983. Results were compared for men and women in broadly defined socioeconomic groups based on occupation and education. People in higher status occupation groups and with more education, and women more than men, had food consumption patterns more consistent with current health promotion messages. For example, they reported eating more wholemeal or brown bread and more fresh fruit and vegetables, drinking more skim or low-fat milk, eating fewer eggs and having less sugar in hot drinks or on cereals. There was some evidence, however, of an interplay of influences of cost and health awareness. For example, retired men were less likely than employed men to eat butter, cream, fresh fruit and vegetables, while men in the upper socioeconomic groups reported relatively higher consumption of butter and cream. The results emphasise the need for a range of strategies aimed at specific subgroups in order to improve national dietary patterns in Australia.     

Achieving eatwell plate recommendations: is this a route to improving both sustainability and healthy eating?

By using data from the National Diet and Nutrition Survey (NDNS) rolling programme, the objective was to determine the extent to which consumers meet the nutrition guidelines implicit in the eatwell plate; to profile those eating healthily and gain insight on how they achieved the recommendations and whether in doing so, their eating pattern was also potentially more sustainable. Only 4% of adults simultaneously met five targets related to fat, saturated fatty acids (SFA), 5 A DAY fruit and vegetables, fibre (non‐starch polysaccharide; NSP) and protein intake and, with the exception of target protein intake, the majority of people (51%) achieved none of the guidelines. The addition of the oil‐rich fish recommendation reduces those meeting all six targets to 1%. Just 12% of the population (n = 94) met the three targets for fat, SFA and fruit and vegetable intake. These were designated achievers, who tended to be older by 5 years and to have a degree (P < 0.05), while non‐achievers were more likely to smoke (P < 0.05). Energy intakes were slightly lower in achievers (non‐significant), who had significantly lower fat and SFA intakes and higher intakes of protein. Intakes of NSP were significantly higher among achievers, who on average met the dietary reference value for NSP. The main NDNS food groups with a significantly higher intake in achievers were skimmed milks, chicken and turkey dishes, white fish (not fried) and shellfish and wholemeal breads, while non‐achievers consumed more coated chicken, meat pies and pastries, cheese, whole milks and white bread. It appears that the achievers have reduced the fat content of their diet by focussing on lower fat/higher fibre alternatives within the same category of foods rather than introducing more plant foods such as legumes, nuts and seeds. There is growing interest in the future sustainability of current dietary patterns in light of expected climate change and an expanding global population. Although only one facet of a very complex picture, plant foods are typically associated with fewer greenhouse gas (GHG) emissions than those of animal origin. On this limited basis, achievers were not necessarily eating more sustainably. It is suggested, by reference to literature values (primarily for potential GHG emissions of food production), that with some rebalancing and through the inclusion in current UK dietary patterns of more plant foods, particularly more plant proteins and starchy foods, the existing eatwell plate could not only provide the basis of a cost‐effective healthy diet, but also a potentially more sustainable one too. However, in order to meet these joint objectives, improved consumer understanding and practical advice on how to use the eatwell plate in this way is clearly required.     

Differences in dietary patterns of nonsmoking adults married to smokers vs. nonsmokers

PURPOSE: To compare dietary intakes of nonsmoking adults married to smokers or nonsmokers. DESIGN: Respondents to the U.S. Department of Agriculture's Continuing Survey of Food Intakes by Individuals (CSFII), 1994 to 1996 (response rate = 76.1% for 2 days of dietary intake). Nonsmoking adults aged 18 and older were grouped according to the smoking status of their spouse. SETTING: In-home interviews in all 50 states and Washington, D.C. SUBJECTS: The selected sample included 757 men and 754 women who were married to nonsmokers, and 197 men and 262 women who were married to smokers. MEASURES: Selected demographic variables, food group servings, food energy, and densities of selected nutrients were compared using chi 2 and analysis of covariance. RESULTS: Men and women married to smokers had greater (p < or = .025) energy-adjusted intakes of total and saturated fat but significantly lower (p < or = .05) energy-adjusted intakes of fiber and vitamin A. Men married to smokers consumed significantly more (p < .025) energy-adjusted cholesterol and ethanol but significantly less calcium (p = .026); women married to smokers consumed significantly less (p = .014) energy-adjusted folate. Men married to smokers consumed significantly more (p < or = .05) alcoholic beverages, coffee, and soft drinks; women married to smokers consumed significantly less water (p = .014) but more cheese and table sweeteners (p < or = .05). CONCLUSIONS: Nonsmoking men and women who were married to smokers had compromised dietary intakes. Nonsmoking men whose wives smoked, in particular, had unhealthy diets due to elevated intakes of fat and cholesterol and low intakes of vitamin A, calcium, and fiber. Health professionals should continue to provide tobacco cessation instruction and dietary guidance, but also be aware of at-risk patients' immediate family members who likely share an increased risk of disease because of poor diet quality and exposure to environmental tobacco smoke.     

Smoking status: effects on the dietary intake, physical activity, and body fat of adult men

This investigation evaluated the relationship between smoking status and body fatness, dietary intake, and physical activity in adults. Subjects were 210 males who were either regular cigarette smokers (n = 35) or nonsmokers (n = 175). Estimated body fat and waist-to-hip (girth) measurements were carefully obtained. Additionally, a sensitive assessment of long-term dietary intake and a multifactorial approach to the assessment of physical activity were made. Results indicated that smokers had lower estimated body fat as calculated by multiple skinfold thickness assessments. In contrast, smokers reported the same total energy intakes as nonsmokers and their levels of physical activity were significantly lower than those of nonsmokers. The differences in intake and expenditure in smokers and the role of metabolism as a possible determinant of the body fat differences in smokers vs nonsmokers are discussed.