Berglund Fanny, Törmä Johanna, Wennberg Maria, Wennberg Patrik, Oskarsson Viktor
Department of Health and Medical Services, Region Norrbotten, Luleå, Sweden.
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Food Nutr Res. 2023 Aug 21;67. doi: 10.29219/fnr.v67.9537. eCollection 2023.
The dietary habits among snus users are largely unknown and have not been accounted for in observational studies on the health effects of snus use.
To examine whether snus users eat unhealthier than never tobacco users.
A total of 3,397 male participants, examined between 1994 and 2014 in the Northern Sweden Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) study, were included. Snus use and dietary habits were self-reported using questionnaires, from which intakes of different food groups, macronutrients, and a healthy diet score (HDS) were calculated (the latter as a proxy for overall diet quality). The association between snus use and dietary habits was examined by quantile regression models.
In the multivariable-adjusted model, current snus users had a lower HDS (median difference: -0.86 [95% confidence interval: -1.32, -0.40]) than never tobacco users. Snus users also consumed fewer weekly servings of fruits and berries (median difference: -1.03 [-1.65, -0.40]), and their estimated percentage of energy intake consisted of less carbohydrates (median difference: -1.43 [-2.12, -0.74]) and of more total fat (median difference: 0.99 [0.30, 1.67]), saturated fat (median difference: 0.67 [0.29, 1.05]), monounsaturated fat (median difference: 0.44 [0.20, 0.68]), trans fat (median difference: 0.03 [0.01, 0.06]), and alcohol (median difference: 0.21 [0.02, 0.40]).
We observed that snus users had an unhealthier diet than never tobacco users. Future studies on the association between snus use and health outcomes should, therefore, consider diet as a potential confounder.
鼻烟使用者的饮食习惯大多不为人知，在关于使用鼻烟对健康影响的观察性研究中也未被考虑在内。
研究鼻烟使用者的饮食是否比从不吸烟的人更不健康。
纳入了1994年至2014年期间在瑞典北部心血管疾病趋势和决定因素监测（MONICA）研究中接受检查的3397名男性参与者。使用问卷自我报告鼻烟使用情况和饮食习惯，据此计算不同食物组、宏量营养素的摄入量以及健康饮食评分（HDS）（后者作为总体饮食质量的指标）。通过分位数回归模型研究鼻烟使用与饮食习惯之间的关联。
在多变量调整模型中，当前鼻烟使用者的HDS低于从不吸烟的人（中位数差异：-0.86 [95%置信区间：-1.32，-0.40]）。鼻烟使用者每周食用的水果和浆果份数也较少（中位数差异：-1.03 [-1.65，-0.40]），其能量摄入估计百分比中碳水化合物含量较低（中位数差异：-1.43 [-2.12，-0.74]），总脂肪、饱和脂肪、单不饱和脂肪、反式脂肪和酒精含量较高（中位数差异分别为：0.99 [0.30，1.67]、0.67 [0.29，1.05]、0.44 [0.20，0.68]、0.03 [0.01，0.06]、0.21 [0.02，0.40]）。
我们观察到鼻烟使用者的饮食比从不吸烟的人更不健康。因此，未来关于鼻烟使用与健康结果之间关联的研究应将饮食视为潜在的混杂因素。
