Does the association between smoking status and selected healthy foods depend on gender? A population-based study of 54 417 middle-aged Danes

The Possible Role of Food and Diet in the Quality of Life in Patients with COPD-A State-of-the-Art Review

Diet has been described as a modifiable risk factor for the development and progression of chronic diseases, and emerging evidence increasingly points to its preventive and therapeutic role in chronic obstructive pulmonary disease (COPD). While the relationship between the underlying disease and diet is natural in conditions such as metabolic disorders, obesity, diabetes, etc., the direct effect is not so evident in chronic obstructive pulmonary disease. Poor diet quality and the development of nutrient deficiencies in respiratory diseases, including COPD, can be associated with disease-specific factors such as the exacerbation of respiratory symptoms. These symptoms can be improved by dietary interventions, leading to positive changes in the pathogenesis of the disease and the quality of life of patients. Therefore, our aim was to review the latest randomized controlled trials (RCTs) of dietary interventions in chronic respiratory patients and describe their effects on respiratory function, physical activity, systemic inflammatory parameters, and quality of life. We conducted a literature search on dietary interventions for COPD patients in the PubMed, ClinicalTrials.gov, and Cochrane Central Register of Controlled Trials (CENTRAL) databases, focusing on publications from 1 July 2018 to 1 July 2023. We used specific keywords and MESH terms, focusing on RCTs. A total of 26 articles and 1811 COPD patients were included in this review. On the basis of our findings, dietary interventions, in particular components of the Mediterranean diet such as protein, omega-3 polyunsaturated fatty acids, and vegetables, appear to have beneficial effects in patients with chronic respiratory diseases, and their application is beneficial. However, long-term follow-up studies are still needed to examine the effects of dietary interventions in this patient population.

The Effectiveness of Supplementation with Key Vitamins, Minerals, Antioxidants and Specific Nutritional Supplements in COPD-A Review

Currently, an increasing amount of evidence supports the notion that vitamins C, D and E, carotenoids, and omega-3 fatty acids may protect against the progression of chronic respiratory diseases. Although chronic obstructive pulmonary disease (COPD) primarily affects the lung, it is often accompanied by extrapulmonary manifestations such as weight loss and malnutrition, skeletal muscle dysfunction, and an excess of harmful oxidants, which can lead to a decline in quality of life and possible death. Recently, the role of various vitamins, minerals, and antioxidants in mitigating the effects of environmental pollution and smoking has received significant attention. Therefore, this review evaluates the most relevant and up-to-date evidence on this topic. We conducted a literature review between 15 May 2018 and 15 May 2023, using the electronic database PubMed. Our search keywords included COPD, chronic obstructive pulmonary disease, FEV₁, supplementation: vitamin A, vitamin D, vitamin E, vitamin C, vitamin B, omega-3, minerals, antioxidants, specific nutrient supplementations, clinical trials, and randomized controlled trials (RCTs). We focused on studies that measured the serum levels of vitamins, as these are a more objective measure than patient self-reports. Our findings suggest that the role of appropriate dietary supplements needs to be reconsidered for individuals who are predisposed to or at risk of these conditions.

Role of Diet in Chronic Obstructive Pulmonary Disease Prevention and Treatment

Chronic obstructive pulmonary disease is one of the leading causes of morbidity and mortality worldwide and a growing healthcare problem. Identification of modifiable risk factors for prevention and treatment of COPD is urgent, and the scientific community has begun to pay close attention to diet as an integral part of COPD management, from prevention to treatment. This review summarizes the evidence from observational and clinical studies regarding the impact of nutrients and dietary patterns on lung function and COPD development, progression, and outcomes, with highlights on potential mechanisms of action. Several dietary options can be considered in terms of COPD prevention and/or progression. Although definitive data are lacking, the available scientific evidence indicates that some foods and nutrients, especially those nutraceuticals endowed with antioxidant and anti-inflammatory properties and when consumed in combinations in the form of balanced dietary patterns, are associated with better pulmonary function, less lung function decline, and reduced risk of COPD. Knowledge of dietary influences on COPD may provide health professionals with an evidence-based lifestyle approach to better counsel patients toward improved pulmonary health.

Smoking and weight loss among smokers with overweight and obesity in Look AHEAD

Smoking cessation is associated with increases in body weight, but little is known about the relationship between participation in a weight loss intervention and smoking.

OBJECTIVE

To determine whether (a) weight losses at 1 year differ as a function of baseline smoking status (never smoker, current smoker, ex-smoker) and (b) participation in a weight loss intervention affects smoking behavior.

METHOD

This analysis addressed these questions using the publicly available database from Look AHEAD, a randomized trial comparing intensive lifestyle intervention (ILI) and diabetes support and education (DSE; control condition) among individuals with overweight/obesity and Type 2 diabetes, and included 4,387 participants who had self-reported smoking and objective weight measures available at baseline and at 1 year.

RESULTS

Although participants in ILI lost a significantly greater percentage of weight than those in DSE at 1 year (ILI, M = -8.8%, SD = 6.8; DSE, M = -0.7%, SD = 4.7), there were no differences in weight loss outcomes between never smokers (n = 2,297), ex-smokers (n = 2,115), and current smokers (n = 188) within either condition. Participation in ILI was not associated with compensatory smoking or likelihood of quitting smoking or relapsing.

CONCLUSIONS

Smokers in a weight loss intervention had reductions in weight that were comparable to individuals who did not smoke without any evidence of compensatory smoking to manage eating and appetite. Smokers with obesity should be encouraged to pursue weight loss without concerns regarding the impact on smoking behavior. (PsycINFO Database Record

A Randomized Double-Blind Placebo-Controlled Trial of Fruit and Vegetable Concentrates on Intermediate Biomarkers in Head and Neck Cancer

Background. Head and neck cancer (HNC) patients are at an increased risk for developing second primary tumors (SPTs). Diets rich in fruits and vegetables (FVs) may lower HNC risk. FV concentrates may offer a potential alternative to increasing FV intake. Methods. We conducted a randomized, double-blind, placebo-controlled trial to evaluate whether Juice PLUS+ (JP; a commercial product with multiple FV concentrates) has an effect on p27 and Ki-67, biomarkers associated with the risk of SPTs. During 2004-2008, we randomized 134 HNC patients to 12 weeks of JP (n = 72) or placebo (n = 62). Oral cavity mucosal biopsies and whole blood were obtained at baseline and after 12 weeks. All participants were given the opportunity to receive JP for 5 years following the end of the intervention period, and they were followed yearly for the development of SPTs. Results. After 12 weeks, patients on JP had significantly higher serum α-carotene (P = .009), β-carotene (P < .0001), and lutein (P = .003) but did not differ significantly in p27 (P = .23) or Ki-67 (P = .95). JP use following the initial 12-week trial was not significantly associated with SPT prevention. Conclusions. Despite increased serum micronutrient levels, our results do not suggest a clinical benefit of JP in HNC patients. Future studies should focus on longer intervention periods and/or modified supplement formulations with demonstrated chemopreventive properties.

Does the Relationship Between Cigarette Smoking and Other Key Health Behaviors Vary by Geographic Area Among US Young Adults? A Multilevel Analysis

BACKGROUND

Although researchers and practitioners have long been aware of interdependence among health behaviors, they tend to compartmentalize health behaviors in research and practice. This kind of approach often fails to acknowledge the syndemic nature of health behaviors.

PURPOSE

This study investigated differences in the relationship between cigarette smoking and other key health behaviors, such as vigorous physical activity, fruit and vegetable consumption, and binge drinking among young adults (ages 18 to 30 years) across 180 metropolitan and micropolitan statistical areas (MMSAs) in the USA.

METHOD

A total of 19,027 young adults in the 2009 Behavioral Risk Factor Surveillance System (BRFSS) data were analyzed using multilevel logistic regression models.

RESULTS

Both vigorous physical activity and fruit and vegetable consumption were negatively associated with cigarette smoking, whereas binge drinking was positively associated with smoking. There were significant differences in the relation of smoking with vigorous physical activity, fruit and vegetable consumption, and binge drinking across the 180 MMSAs. These differences were associated with the prevalence of cigarette smoking and binge drinking for each MMSA.

CONCLUSION

As indicated by the social learning theory, geographic area-specific prevalence of health behaviors appears to reflect group norms regarding those behaviors which, in turn, affect the clustering of health behaviors in the respective area.

Maternal smoking, weight status and dietary behaviours during pregnancy: findings from first-time mothers in south-west Sydney, Australia

BACKGROUND

Few studies have been conducted examining the relationship between maternal smoking, weight status and dietary behaviours during pregnancy.

AIM

The objective of the study was to examine the relationship between maternal smoking, weight status and dietary behaviours during pregnancy.

METHODS

An analysis of cross-sectional baseline survey data was conducted with 406 first-time mothers participating in the Healthy Beginnings Trial (HBT) conducted in south-west Sydney, Australia. Mothers' reports of their smoking status, dietary behaviours and pre-pregnancy weight and height were collected through face-to-face interviews. The relationships were examined using log-binomial regression modelling.

RESULTS

Maternal smoking status was not associated with weight status. However, smoking was positively associated with soft drink consumption and negatively associated with daily fruit intake. After adjusting for age, marital status and education level, mothers who reported consuming >1 cup of soft drink per day were more likely to smoke than those consuming less soft drink (adjusted risk ratio, ARR 1.48, 95% CI 1.02-2.22, P = 0.05). Mothers who reported having ≥2 serves of fruit daily were significantly less likely to smoke than those having less fruit (ARR 0.54, 95% CI 0.29-0.95, P = 0.04).

CONCLUSIONS

The study found no evidence linking maternal smoking and weight status and did not support the notion that smoking could lead to a lower weight status. However, maternal smoking was associated with fruit and soft drink consumption and needs to be considered while examining dietary behaviours and weight status.

Investigation of population heterogeneity of diet use among middle-aged Australians

The purpose of the study was to determine patterns of diet use among middle-aged Australian men and women and the relationships between these different usage patterns and demographic characteristics, health status and health habits. A cross-sectional mail survey was conducted among a random sample of 2975 people aged 40-71 years in Victoria, Australia. A total of 1031 usable questionnaires were obtained which included information about the use of diets (e.g. low-fat and low-salt) during the past 3 months along with demographic information, health status and health habits. Based on the responses about the use of thirteen diets for both sexes, latent class analysis was employed to identify the optimal number of use of diets and the assignment of participants to particular groups. Three types of diet uses were identified and provisionally named: diet use, selected diet use and non-diet use. This classification was associated with demographics, health status and health habits, and these associations differed between men and women. The findings suggest that nutrition education programmes should be tailored to the different needs of the diet use groups.

Prospective study of dietary fiber and risk of chronic obstructive pulmonary disease among US women and men

Little is known about the relation between dietary fiber intake and the incidence of respiratory diseases, especially chronic obstructive pulmonary disease (COPD). The authors investigated this issue among 111,580 US women and men (Nurses' Health Study and Health Professionals Follow-up Study), with 832 cases of newly diagnosed COPD being reported between 1984 and 2000. The cumulative average intake of total fiber and of fiber from specific sources (cereal, fruit, and vegetables) was calculated from food frequency questionnaires and a food composition database and divided into quintiles. After adjustment for 11 factors (age, sex, smoking, energy intake, body mass index, US region, physician visits, physical activity, diabetes, and intakes of omega-3 and cured meat), total dietary fiber intake was negatively associated with risk of newly diagnosed COPD (for highest vs. lowest intake, relative risk = 0.67, 95% confidence interval: 0.50, 0.90; P(trend) = 0.03). For specific fiber sources (cereal, fruit, and vegetables), only cereal fiber was significantly associated with newly diagnosed COPD independently of other fiber sources (for highest vs. lowest intake, relative risk = 0.77, 95% confidence interval: 0.59, 0.99; P(trend) = 0.04). These data suggest that a diet high in fiber, and possibly specifically cereal fiber, may reduce risk of developing COPD.

Prospective study of cured meats consumption and risk of chronic obstructive pulmonary disease in men

Cured meats are high in nitrites. Nitrites generate reactive nitrogen species that may cause damage to the lung. The objective is to assess the relation between frequent consumption of cured meats and the risk of newly diagnosed chronic obstructive pulmonary disease (COPD). Between 1986 and 1998, the authors identified 111 self-reported cases of newly diagnosed COPD among 42,915 men from the Health Professionals Follow-up Study. The cumulative average intake of cured meats consumption (processed meats, bacon, hot dogs) was calculated from food frequency questionnaires administrated in 1986, 1990, and 1994 and divided according to servings per week (never/almost never, <1 serving/week, 1-3 servings/week, 4-6 servings/week, at least once/day). After adjustment for age, smoking status, pack-years, pack-years squared, energy intake, race/ethnicity, US region, body mass index, and physical activity, the consumption of cured meats was positively associated with the risk of newly diagnosed COPD (for highest vs. lowest intake: relative risk = 2.64, 95% confidence interval: 1.39, 5.00; p(trend) = 0.002). In contrast to these findings, the consumption of cured meats was not associated with the risk of adult-onset asthma. These data suggest that cured meat may worsen the adverse effects of smoking on risk of COPD.

Beta-cryptoxanthin and lung cancer in Shanghai, China--an examination of potential confounding with cigarette smoking using urinary cotinine as a biomarker for true tobacco exposure

Diet may be a modifier of smoking-related cancer risk, with protective effects of intake of fruits and vegetables and associated antioxidants found in many observational studies. We previously reported serum beta-cryptoxanthin levels being inversely associated with smoking-related lung cancer incidence in a cohort of Chinese men. We noted, however, that serum beta-cryptoxanthin is negatively correlated with smoking. Since self-reports of smoking intensity undoubtedly contain errors, this negative correlation indicates a potential bias in assessing the effects of beta-cryptoxanthin, due to confounding with the unmeasured (residual) portion of cigarette exposure. We evaluated cotinine levels in pre-diagnostic spot urine samples to attempt to improve smoking assessment. We noted that urinary cotinine levels correlated significantly with cigarette consumption overall and that cotinine was strongly predictive of lung cancer risk. Urinary cotinine, however, was not as strong a predictor of lung cancer risk in current smokers as were self-reports of cigarette consumption and cotinine remained only a marginally significant predictor of lung cancer risk after adjustment for self-reports. An apparent benefit of beta-cryptoxanthin remained evident when including both urinary cotinine and self-reported cigarette consumption and cotinine in the statistical model. However, we conclude that cotinine measured from a single spot urine seems to have only limited value in augmenting self-reports of cigarette consumption so that, at present, the apparent protective effects of beta-cryptoxanthin, as seen in our own study, should continue to be regarded as unproven. We believe that future epidemiological evaluation of the association between beta-cryptoxanthin (and other antioxidants) and reduced lung cancer risk must utilize improved biomarkers to augment smokers' own self-reports of smoking amount.

Prospective study of dietary patterns and chronic obstructive pulmonary disease among US women

BACKGROUND

Although many foods and nutrients are associated with lung function or symptoms of chronic obstructive pulmonary disease (COPD), the relation between overall diet and newly diagnosed COPD is not known.

OBJECTIVE

We assessed the relation between dietary patterns and newly diagnosed COPD in women.

DESIGN

Data were collected from a large prospective cohort of US women (Nurses' Health Study). Between 1984 and 2000, 754 self-reported confirmed cases of newly diagnosed COPD were identified among 72 043 women. With the use of principal component analysis, 2 dietary patterns were identified: a prudent pattern (fruit, vegetables, fish, whole-grain products) and a Western pattern (refined grains, cured and red meats, desserts, French fries). Patterns were categorized into quintiles, and the risk of COPD was compared between quintiles (lowest as reference) with the use of Cox proportional hazard models.

RESULTS

After adjustments for 14 potential confounders, the prudent pattern was negatively associated with risk of newly diagnosed COPD [relative risk (RR) for highest compared with lowest quintile: 0.75; 95% CI: 0.58, 0.98; P for trend = 0.02] whereas the Western pattern was positively associated with risk of COPD (RR for highest compared with lowest quintile: 1.31; 95% CI: 0.94, 1.82; P for trend = 0.02). In contrast with findings for COPD, dietary patterns were not associated with the risk of adult-onset asthma.

CONCLUSION

In women, a negative association was found between a diet rich in fruit, vegetables, and fish and the risk of COPD, whereas a positive association was found between a diet rich in refined grains, cured and red meats, desserts, and French fries and the risk of COPD.

Smoking, alcohol, and dietary choices: evidence from the Portuguese National Health Survey

BACKGROUND

Unhealthy lifestyle choices tend to cluster, but controversy remains regarding relationships between smoking and dietary habits. The aim of this study was to compare dietary intake and alcohol consumption, according to smoking status, in the Portuguese population.

METHODS

The study sample included all participants in the third Portuguese National Health Survey who were older than 19 years (20,302 women and 17,923 men). Participants were selected from households in the five regions of Portugal (NUTS II classification), using a multi-stage random probability design. Trained interviewers conducted face-to-face interviews in each household and obtained information on social and demographic characteristics, lifestyle and health, smoking, and intakes of selected food and beverages. Age-adjusted and education-adjusted binomial and multinomial logistic regression models were fitted separately for males and females, to estimate the magnitude of the association between smoking and the consumption of various food and beverage groups.

RESULTS

When heavy smokers were compared with non-smokers, the odds ratio (OR) favouring soup consumption was 0.60 (95% Confidence Interval [95%CI]: 0.54-0.68) in males and 0.46 (95% CI: 0.33-0.65) in females. Similar ORs were observed for vegetables (males: OR = 0.56, 95%CI: 0.49-0.64; females: OR = 0.47, 95%CI: 0.32-0.69) and fruit (males: OR = 0.36, 95%CI: 0.31-0.41; females: OR = 0.29, 95%CI: 0.19-0.44). Overall, these food items were consumed at significantly lower levels as cigarette consumption increased. Heavy male smokers, compared to non-smokers, presented lower odds favouring milk consumption (OR = 0.89; 95%CI: 0.67-0.89). When heavy smokers were compared with non-smokers, the ORs favouring wine drinking, among heavy drinkers, were 1.47 (95%CI: 1.27-1.70) in men and 3.97 (95%CI: 2.07-7.61) in women. Similar ORs were observed for beer (males: OR = 3.30; 95%CI: 2.87-3.78; females: OR = 23.1; 95%CI: 12.2-43.6), Port wine (males: OR = 2.21 95%CI: 1.65-2.98; females: OR = 2.85; 95%CI: 0.68-12.1), brandy (males: OR = 3.67 95%CI: 2.98-4.52; females: OR = 13.2; 95%CI: 3.72-46.6) and whisky (males: OR = 3.31; 95%CI: 2.71-4.03; females: OR = 41.4; 95%CI: 18.5-92.5).

CONCLUSION

This study showed that smokers have a higher intake of alcoholic beverages and a lower consumption of food items rich in fibre, antioxidants, or phytochemicals, which are suspected to have beneficial roles in the prevention of multiple chronic diseases.

Weight concerns and smoking in a general population: the Inter99 study

OBJECTIVE

No previous studies have explored weight concerns in relation to smoking habits, or investigated how weight concerns affect smoking cessation in a general population.

METHOD

Inter99 is a population-based lifestyle interventional study, conducted in 1999-2001 in Copenhagen, Denmark, comprising 30-60 year old men and women. All daily smokers (N=2408) were offered help to quit. The baseline investigation (N=6784) was used for analysing associations of smoking status with weight concerns (cross-sectional design). To analyse how weight concerns affected smoking cessation we included the 1387 daily smokers attending 1-year follow-up; 221 of these were verified quitters (longitudinal design).

RESULTS

Daily smoking men and women had a significantly lower body mass index than never smokers (men: 3%, women 5%) but reported to be significantly less concerned of their weight (men: OR=0.64, 95%CI=0.4-0.9), women: 0.78(0.6-1.0)). Ex-smoking normal weight women were significantly more likely to be frequently concerned of their weight than never smoking normal weight women (OR=2.06, 95CI%=1.6-2.7). Fifty-two percent of the women and 32% of the men with a previous quit attempt reported that weight gain was a reason for relapse. Neither weight concerns nor eating patterns were predictive of point abstinence at 1-year follow-up.

CONCLUSION

Smokers are believed to be very concerned of their weight but in this population-based study, daily smokers more frequently ate what they wanted, had a lower BMI and were significantly less concerned of their weight than never smokers. Weight concerns and eating patterns did not predict abstinence at 1-year follow-up. It seems that weight gain and weight concerns are independent factors.

Clustering of risk behaviors with cigarette consumption: A population-based survey

OBJECTIVE

This study assessed clustering of multiple risk behaviors (i.e., low leisure-time physical activity, low fruits/vegetables intake, and high alcohol consumption) with level of cigarette consumption.

METHODS

Data from the 2002 Swiss Health Survey, a population-based cross-sectional telephone survey assessing health and self-reported risk behaviors, were used. 18,005 subjects (8052 men and 9953 women) aged 25 years old or more participated.

RESULTS

Smokers more frequently had low leisure time physical activity, low fruits/vegetables intake, and high alcohol consumption than non- and ex-smokers. Frequency of each risk behavior increased steadily with cigarette consumption. Clustering of risk behaviors increased with cigarette consumption in both men and women. For men, the odds ratios of multiple (> or =2) risk behaviors other than smoking, adjusted for age, nationality, and educational level, were 1.14 (95% confidence interval: 0.97, 1.33) for ex-smokers, 1.24 (0.93, 1.64) for light smokers (1-9 cigarettes/day), 1.72 (1.36, 2.17) for moderate smokers (10-19 cigarettes/day), and 3.07 (2.59, 3.64) for heavy smokers (> or =20 cigarettes/day) versus non-smokers. Similar odds ratios were found for women for corresponding groups, i.e., 1.01 (0.86, 1.19), 1.26 (1.00, 1.58), 1.62 (1.33, 1.98), and 2.75 (2.30, 3.29).

CONCLUSIONS

Counseling and intervention with smokers should take into account the strong clustering of risk behaviors with level of cigarette consumption.

Concept of a nutritious food: toward a nutrient density score

The American diet is said to be increasingly energy-rich but nutrient-poor. To help improve the nutrient-to-energy ratio, the 2005 Dietary Guidelines for Americans recommend that consumers replace some foods in their diets with more nutrient-dense options. Such dietary guidance presupposes the existence of a nutrient density standard. However, a review of the literature shows that the concept of a nutritious food is not based on any consistent standards or criteria. In many cases, healthful foods are defined by the absence of problematic ingredients-fat, sugar, and sodium-rather than by the presence of any beneficial nutrients they might contain. Past attempts to quantify the nutrient density of foods have been based on a variety of calories-to-nutrient scores, nutrients-per-calorie indexes, and nutrient-to-nutrient ratios. The naturally nutrient rich (NNR) score, which is based on mean percentage daily values (DVs) for 14 nutrients in 2000 kcal food, can be used to assign nutrient density values to foods within and across food groups. Use of the NNR score allows consumers to identify and select nutrient-dense foods while permitting some flexibility where the discretionary calories are concerned. This approach has implications for food labeling, nutritional policy making, and consumer education. The Food and Drug Administration has considered approving nutrient claims based on the ratio of a beneficial nutrient to the food's energy content, as opposed to a specified minimum amount of a nutrient per serving size. Given the current dietary trends, the nutrient density approach can be a valuable tool for nutrition education and dietary guidance.

Dietary intake in male and female smokers, ex-smokers, and never smokers: the INTERMAP study

This report examines dietary intakes in smokers, ex-smokers, and never smokers in INTERMAP. The 4680 participants aged 40-59 years-from 17 population samples in four countries (China, Japan, UK, USA)-provided four 24-h recalls to assess nutrient intakes and two 24-h urine collections to assess excretion of urea, sodium (Na), potassium (K), etc. Compared to never smokers, current smokers generally consumed more energy from alcohol and saturated fats (SFA), less energy from vegetable protein and carbohydrates, less dietary fibre, vitamin E, beta carotene, vitamin C, thiamine, riboflavin, folate, vitamin B6, calcium, iron, phosphorus, magnesium (Mg), and K per 1000 kcal, excreted less K and urea (marker of dietary protein), had a lower ratio of polyunsaturated fat (PFA) to SFA intake, higher Keys dietary lipid score, and higher dietary and urinary Na/K. There were few differences between smokers and never smokers for total energy intake, energy from total and animal protein, monounsaturated fats, PFA, omega 3 and omega 6 PFA, dietary cholesterol, total vitamin A, retinol, vitamin D, vitamin B12, and urinary and dietary Na. Compared to ex-smokers, smokers generally consumed less energy from vegetable protein, omega 3 PFA, carbohydrates, less dietary fibre, beta carotene, vitamin E, vitamin C, thiamine, riboflavin, folate, vitamin B6, iron, phosphorus, Mg, had lower PFA/SFA, and excreted less urea and K. In conclusion, INTERMAP results are consistent with other reports indicating that smokers have less healthful diets than nonsmokers. Public health interventions in smokers should focus not only on helping them to quit smoking but also on improving their diets to further reduce cancer and cardiovascular disease risks.

Diet, smoking and cardiovascular risk in people with schizophrenia: descriptive study

BACKGROUND

Physical health of people with schizophrenia is poor and they die early from cardiovascular disease.

AIMS

To describe the lifestyle of people with schizophrenia through diet, smoking habits, weight and exercise, and to report risk of coronary heart disease (CHD).

METHOD

Dietary habits of 102 community-dwelling people with schizophrenia were assessed by the Scottish Health Survey Questionnaire. Also assessed were smoking habits, physical activity, biochemical indices of nutrition and future risk of CHD.

RESULTS

Fewer males, compared with the general population, reached acceptable levels for consumption of fruit, vegetables, milk, potatoes and pulses. Fewer females reached the levels for consumption of milk and potatoes. Mean number of fruit and vegetable portions consumed per week was 16 (s.d.=14); 71 (70%) were smokers; 25 (86%) females and 50 (70%) males were over weight or obese; 59 (59%) considered themselves physically active; 46 (53%) had a raised cholesterol: high-density lipoprotein ratio, and 64 (74%) a low alpha-tocopherol: cholesterol ratio. Mean 10-year risk of CHD in males was 10.5% (s.d.=8) and in females 7% (s.d.=6).

CONCLUSIONS

The lifestyle of people with schizophrenia must give cause for concern in relation to CHD. Care from concern in relation to secondary care services must address physical as well as mental health.