Dyer A R, Elliott P, Stamler J, Chan Q, Ueshima H, Zhou B F
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611-4402, USA.
J Hum Hypertens. 2003 Sep;17(9):641-54. doi: 10.1038/sj.jhh.1001607.
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.
本报告研究了国际多中心动脉粥样硬化研究(INTERMAP)中吸烟者、既往吸烟者和从不吸烟者的饮食摄入量。来自四个国家(中国、日本、英国、美国)17个群体样本的4680名40 - 59岁参与者提供了四次24小时饮食回忆以评估营养素摄入量,并提供了两次24小时尿液收集样本以评估尿素、钠(Na)、钾(K)等的排泄情况。与从不吸烟者相比,当前吸烟者通常从酒精和饱和脂肪(SFA)中摄入更多能量,从植物蛋白和碳水化合物中摄入的能量较少,膳食纤维、维生素E、β - 胡萝卜素、维生素C、硫胺素、核黄素、叶酸、维生素B6、钙、铁、磷、镁(Mg)和钾的摄入量每1000千卡较少,钾和尿素(膳食蛋白质的标志物)排泄较少,多不饱和脂肪(PFA)与SFA的摄入比例较低,凯斯饮食脂质评分较高,膳食和尿钠/钾比值较高。吸烟者和从不吸烟者在总能量摄入、来自总蛋白和动物蛋白的能量、单不饱和脂肪、PFA、ω - 3和ω - 6 PFA、膳食胆固醇、总维生素A、视黄醇、维生素D、维生素B12以及尿钠和膳食钠方面几乎没有差异。与既往吸烟者相比,吸烟者通常从植物蛋白、ω - 3 PFA、碳水化合物中摄入的能量较少,膳食纤维、β - 胡萝卜素、维生素E、维生素C、硫胺素、核黄素、叶酸、维生素B6、铁、磷、Mg较少,PFA/SFA较低,尿素和钾排泄较少。总之,INTERMAP的结果与其他报告一致,表明吸烟者的饮食不如非吸烟者健康。对吸烟者的公共卫生干预不仅应侧重于帮助他们戒烟,还应侧重于改善他们的饮食,以进一步降低癌症和心血管疾病风险。