Cigarette smoking is associated with differences in nutritional habits and related to lipoprotein alterations independently of food and alcohol intake.

OBJECTIVE

To assess the effects of smoking on serum lipoprotein levels taking into account current nutritional intakes.

DESIGN

Case-control study comparing smokers and non-smokers.

SETTING

Ambulatory subjects of the Urban Community of Lille examined at home or at the Health Care Center.

SUBJECTS

Men, between 45 and 65 years of age; n = 89 smokers (cases) and n = 91 non-smokers (controls); non-smokers were randomly selected from the voter's registration lists, 7 smokers and 2 non-smokers were excluded for hyperlipidemia.

INTERVENTIONS

Blood sampling, medical examination and three-day food records validated by a registered dietician.

RESULTS

Smokers were younger (P < 0.001) and thinner (P = 0.003), chose more frequently visible fats of animal origin (P = 0.03) and reported significantly larger daily meat servings (P = 0.01) than non-smokers. Smokers had a significantly higher intake of non-alcoholic energy (P < 0.05), lipids of animal origin (P = 0.003), saturated fat (P < 0.01) and monounsaturated fat (P < 0.01) and a lower P/S ratio (P = 0.02) than non-smokers. After adjustment on age and body mass index, smokers had significantly higher levels of mean serum triglycerides (P = 0.03), VLDL-cholesterol (P = 0.0003) and systolic blood pressure (P = 0.02) and lower values of HDL-cholesterol (P = 0.02) than non-smokers. Additional adjustment for alcohol consumption showed significantly lower apo A-I values (P = 0.03) in smokers than non-smokers. Further adjustment for the intake of lipids of animal origin revealed higher apo B values (P = 0.04) in smokers than non-smokers.

CONCLUSIONS

(1) Smoking is associated with serum lipid and lipoprotein alterations independently of nutritional factors, (2) Nutritional habits of smokers are less 'healthy' than those of non-smokers (3) Smokers is a group of particular importance in terms of multifactorial public health intervention.