Differences in dietary intake with smoking, alcohol, and education.

Differences in the frequency of consumption of 30 selected foods and in the estimated intake of total calories and selected nutrients in relation to alcohol drinking, tobacco smoking, and education were described using information obtained from 1,774 controls of a case-control study of digestive tract cancers conducted in northern Italy. Heavy alcohol consumption, tobacco smoking, and lower level of education were associated with a diet poorer in several aspects, including lower consumption of fresh fruit and green vegetables and higher intake of specific indicator foods, such as sausages and canned meat. For instance, the mean number of portions of fresh fruit per week was 10.5 among male nondrinkers vs. 9.0 among heavy drinkers, 10.4 among male nonsmokers vs. 8.1 among heavy smokers, and 8.8 in less educated individuals vs. 10.7 among those more educated. Consequently, intake of beta-carotene, ascorbic acid, and calcium tended to be inversely related to alcohol and tobacco and directly related to education. Most associations were stronger in males, for whom alcohol consumption was also more common in less educated individuals. Calorie intake was directly related to alcohol consumption, largely reflecting calories provided by alcohol itself. However, alcohol drinking was also directly related to fat consumption. In both sexes, there was a strong positive correlation between cigarette smoking and coffee drinking. These results provide quantitative documentation that alcohol drinking, tobacco smoking, and education, three of the major determinants of cancer risks, were also correlates of dietary patterns and, hence, may exert an important confounding or modifying effect on the diet and cancer relationship.     

Tobacco and alcohol consumption: impact on other cardiovascular and cancer risk factors in a southern European Mediterranean population

Tobacco and alcohol consumption are strongly related to other cardiovascular and cancer risk factors. The aim of the present study was to analyse the association of nutrient intake, blood lipid variables and leisure-time physical activity with tobacco and alcohol consumption status. Participants were recruited in a cross-sectional population-based survey, including cardiovascular risk factor measurements and evaluation of physical activity and diet intake in a Mediterranean population (n 1748). Multiple linear regression analysis, adjusted for several confounders, showed a direct association of saturated fatty acids (g and % total energy intake), dietary cholesterol intakes and serum triacylglycerol with smoking. An inverse association was observed for smoking and unsaturated fatty acids (% energy intake), vitamin C, alpha-tocopherol and beta-carotene intakes, leisure-time physical activity and HDL-cholesterol. These associations were not observed for alcohol drinking. After adjusting for the confounders earlier mentioned, low dietary intakes of vitamin C and dietary fibre were more likely in heavy-smokers as compared with non-smokers (odds ratio 1.74 (95 % CI 1.07, 2.73) and 1.94 (95 % CI 1.29, 2.92) of low vitamin C (<60 mg/d) and dietary fibre intakes (<10 g/d) respectively). Alcohol consumption was directly associated with HDL-cholesterol and triacylglycerol, and attenuated the effects of smoking on HDL-cholesterol. These results suggest that the dietary intake of fibre and several antioxidant components of the Mediterranean diet is reduced in smokers, who also show an adverse lipid profile. However, the worst triacylglycerol levels are associated with the combination of heavy smoking and heavy alcohol drinking. Moderate alcohol consumption was not associated with an unhealthy diet pattern or adverse lipid profile. The health benefits of the Mediterranean diet appear to be strongly counteracted by smoking.     

中国人群生活及膳食行为与鼻咽癌关系的Meta分析

目的为探讨个人膳食及行为和鼻咽癌发病的关系,为今后鼻咽癌的防治提供线索和依据。方法采用Meta分析分析国内外24篇关于中国人群中鼻咽癌发病与生活及膳食行为的研究文献。结果主动吸烟、适量饮酒、饮茶、喝牛奶、食腌制蔬菜、食腌制肉类、食新鲜蔬菜、食新鲜水果的合并OR值(95%CI)分别为:1.85(1.45~2.35)、0.79(0.71~0.88)、0.77(0.51~1.14)、0.74(0.65~0.85)、1.88(1.60~2.21)、2.31(1.70~2.68)、0.39(0.30~0.51)和0.53(0.46~0.61)。结论主动吸烟、食腌制蔬菜、食腌制肉类是我国人群鼻咽癌发病的危险因素。而适量饮酒、喝牛奶、食新鲜蔬菜、食新鲜水果是其保护因素。饮茶和鼻咽癌的发病无关联性。     

Relationship of alcohol consumption to diet: a population-based study in Hawaii

The relationship of alcohol use to diet was examined in 2272 male and 2337 female adults aged 45 y and older who provided a quantitative diet history during 1977-1979. Mean values for each dietary variable, adjusted for smoking, ethnicity, income, and education, were compared in each sex between abstainers and drinkers and by tertile of ethanol intake. Linear relationships with extent of drinking were also sought. Drinkers were found to be less obese than abstainers. Consumption of carbohydrate, vitamins, calcium, fruits, fruit juices, and raw vegetables was greater among abstainers whereas consumption of fat (particularly polyunsaturated fatty acids), cholesterol, zinc, meat, pickled vegetables, and dried fish was greater among drinkers. Because validations of dietary questionnaires have shown that alcohol consumption is more accurately recalled than food intake, the possibility of a residual confounding effect for these dietary variables should be considered in epidemiologic studies of alcohol and health.     

Cumulative Coffee Consumption and Reduced Risk of Oral and Oropharyngeal Cancer

We examined the association between coffee consumption and oral cancer in a hospital-based case-control study comprising 143 patients with oral and oropharyngeal squamous cell carcinoma attended at 3 major hospitals in São Paulo, Brazil, and 240 controls without cancer, recruited from outpatient units of the same hospitals and matched with cases by sex and age. Associations were assessed by multivariate logistic regression conditioned on sociodemographic and behavioral characteristics. Tobacco smoking, alcohol drinking, and higher intake of bacon and deep-fried foods were directly related to disease; the inverse was observed to family income and salad intake. Coffee consumption and tobacco smoking were partially correlated (Spearman correlation coefficient 0.14 among cases, 0.31 among controls). When adjusted for all covariates, a cumulative coffee consumption higher than 18.0 daily liters × year during lifetime was indicated to be protective against disease (adjusted odds ratio 0.39, 95% confidence interval 0.16–0.94, P = 0.037). This observation may have pharmacological implications for clinical medication of these cancers and is relevant to programs aimed at reducing the burden of disease.     

Descriptors of alcohol consumption among noninstitutionalized nonalcoholic elderly

This paper describes relationships between reported alcohol consumption and selected sociodemographic and health variables. Two hundred and four men and 367 women aged 60-95 years were examined as part of a nutritional status survey of elderly. Fifty-three percent of men and 44% of women reported drinking at least 2 g of alcohol per week. Men were more likely to drink than women, and the level of alcohol consumption decreased with age. Drinking was positively associated with education (p less than 0.01) and negatively associated with recent medical care (p less than 0.01), history of MI (p less than 0.05), and denture use (p less than 0.05). Among drinkers, reported alcohol intake was higher for subjects less than age 70 (p less than 0.01), males (p less than 0.01), the college educated (p less than 0.01), and smokers (p less than 0.05). Level of alcohol intake was lower for those who had received medical care in the year preceding study participation (p less than 0.05). Identical results were observed for alcohol intake expressed as percent of total calories. Intake ranged from 3.8% of total calories among subjects 80+ years old to 6.2% of total calories among 60-69-year-olds.     

Predictors of alcohol intake and heavy drinking in early adulthood: a 5-year follow-up of 15-19-year-old Finnish adolescents

Relative contributions of earlier drinking and smoking vs mental health risk factors in predicting alcohol intake and heavy drinking in young adulthood were assessed. Higher average alcohol intake and heavy drinking (13 or more drinks on one occasion) in 1995 were significantly related to male gender and earlier high scores in 1990 of relief smoking, relief drinking, and their interaction. Parental alcohol problems, social group, perceived degree of social support, trait anxiety, number of negative life events, self-esteem, grade-point average, somatic symptoms score, or immature, neurotic, or mature defence style measured in 1990 did not predict alcohol intake or heavy drinking 5 years later. The findings suggest that alcohol intake and heavy drinking in young adulthood can be predicted by earlier self-reports on relief smoking and alcohol intake in adolescence.     

Descriptors of alcohol consumption among noninstitutionalized nonalcoholic elderly.

This paper describes relationships between reported alcohol consumption and selected sociodemographic and health variables. Two hundred and four men and 367 women aged 60-95 years were examined as part of a nutritional status survey of elderly. Fifty-three percent of men and 44% of women reported drinking at least 2 g of alcohol per week. Men were more likely to drink than women, and the level of alcohol consumption decreased with age. Drinking was positively associated with education (p less than 0.01) and negatively associated with recent medical care (p less than 0.01), history of MI (p less than 0.05), and denture use (p less than 0.05). Among drinkers, reported alcohol intake was higher for subjects less than age 70 (p less than 0.01), males (p less than 0.01), the college educated (p less than 0.01), and smokers (p less than 0.05). Level of alcohol intake was lower for those who had received medical care in the year preceding study participation (p less than 0.05). Identical results were observed for alcohol intake expressed as percent of total calories. Intake ranged from 3.8% of total calories among subjects 80+ years old to 6.2% of total calories among 60-69-year-olds.     

Quitting smoking in Northern Italy: A cross-sectional analysis of 2621 subjects

To describe the relationship between sociodemographic factors, life-style habits, selected dietary indicators, smoking-related variables, and quitting smoking we analyzed data derived from the comparison group of a case-control study of colorectal and breast cancers based on a network of teaching and general hospitals in Northern Italy. A total of 2621 subjects (1215 women and 1406 men) who were ever cigarette smokers were included for analysis. Age-adjusted rates of stopping smoking (quit rates) and multivariate odds ratios (OR) of quitting smoking were computed. The overall age-adjusted quit rate was 38.6% for males and 24.9% for females, corresponding to an OR of quitting of 0.6 (95% CI: 0.5–0.7) for females vs males. The quitting rate increased with increasing age. After allowing for age, smoking cessation was more frequently reported by more educated or higher social class individuals. No relationship was present between quitting smoking and alcohol consumption, but quitting smoking was inversely related to coffee consumption. The probability of quitting smoking increased directly with number of cigarettes among males but not among females, who showed a J-shaped pattern. Older, heavy smokers were more likely to give up smoking. A general pattern of increasing rates of quitting smoking with higher consumption of vegetables and fruit, and hence -carotene, was present. This study confirms a positive association between quitting smoking and increasing age, higher education, low coffee consumption, heaviness of smoking and high consumption of vegetables and fruit.     

A prospective study linked both alcohol and tobacco to Dupuytren's disease

OBJECTIVE: To address the role of alcohol intake and tobacco smoking and the combination of the two on subsequent risk of Dupuytren's disease. STUDY DESIGN AND SETTING: Cohort study of 7,254 subjects enrolled in the Copenhagen City Heart Study (1981-1983). Both self-reported information on lifestyle and objective measures at the baseline examination were linked to presence of Dupuytren's disease at a subsequent examination (1991-1994) using multivariate logistic regression analysis. RESULTS: A total of 772 subjects had signs of Dupuytren's disease at follow-up. After adjustment for age, sex, educational level, diabetes, and either alcohol or tobacco consumption, respectively, odds ratios for having the disease increased in a dose-dependent manner with increasing levels of alcohol or tobacco intake; however, there was no statistical interaction between heavy smoking and heavy drinking. CONCLUSION: Alcohol intake and tobacco smoking are independently associated with increased risk of Dupuytren's disease, and the combination of the two conveys a very large risk.     

Alcohol drinking and tobacco smoking in gastric cancer. A case-control study

This study compares 210 cases of cancer of the stomach (138 males and 72 females) with 630 controls (414 males and 216 females) afflicted with a wide variety of diseases. All patients (cases and controls) were admitted for treatment at the University Hospital of Montevideo, Uruguay in the time period July 1985-December 1988. They were submitted to the same detailed questionnaire by 3 social workers unaware of the objectives of the study. The analysis was performed at the Louisiana State University of New Orleans, using multiple logistic regression. The variables analyzed were cigarette smoking, alcohol ingestion, salted meat intake, total vegetable consumption, total fruit consumption and "mate" ingestion. Strong positive associations were found in both sexes for low fruit and vegetable consumption, high intake of salted meat and "mate" ingestion. Only males showed significantly elevated OR's for tobacco smoking and alcohol drinking. Of the main tobacco variables, time-dependent one's (age at start, duration) displayed significant gradients of increasing risks. Thus, a prolonged exposure seems more important than the amount smoked per day for the risk of developing gastric carcinoma. Both wine and hard liquor carried increased OR's, but heavy drinkers of wine displayed a six-fold increase in risk, replicating previous reports from France.     

The relationships among socioeconomic status, fruit and vegetable intake, and alcohol consumption

Abstract Purpose . We examined the relationships among fruit and vegetable intake, alcohol consumption, and socioeconomic status (SES). We hypothesized that fruit and vegetable consumption would be inversely associated with alcohol consumption and the relationship would differ by SES. Design . A cross-sectional analysis. Setting . Large, urban Midwestern county. Subjects . A unique, racially/ethnically diverse sample of 9959 adults (response rate: 66.3%). Measures . Fruit and vegetable intake was measured using two items that assessed servings per day. Alcohol consumption was measured in terms of volume of alcohol consumed and binge drinking. Individual measures of SES included education and household income. Analysis . Weighted multivariate linear and Poisson regression were used to estimate effects. Results . The relationship between fruit and vegetable intake and alcohol consumption varied by SES. Those with lower household incomes who consumed five or more servings of fruits and vegetables per day were less likely to engage in binge drinking relative to those consuming zero to one servings of fruits and vegetables per day (risk ratio = .66; 95% confidence interval: .46, .95). No association was observed for higher-household-income individuals. Conclusion . We observed an inverse relationship between fruit and vegetable consumption and alcohol intake in those with lower household incomes but not in those with higher household incomes. Results suggest that the relationship between diet and alcohol consumption may be more relevant in populations with more restricted economic choices. Results are, however, based on cross-sectional data.     

Cumulative coffee consumption and reduced risk of oral and oropharyngeal cancer

We examined the association between coffee consumption and oral cancer in a hospital-based case-control study comprising 143 patients with oral and oropharyngeal squamous cell carcinoma attended at 3 major hospitals in Sao Paulo, Brazil, and 240 controls without cancer, recruited from outpatient units of the same hospitals and matched with cases by sex and age. Associations were assessed by multivariate logistic regression conditioned on sociodemographic and behavioral characteristics. Tobacco smoking, alcohol drinking, and higher intake of bacon and deep-fried foods were directly related to disease; the inverse was observed to family income and salad intake. Coffee consumption and tobacco smoking were partially correlated (Spearman correlation coefficient 0.14 among cases, 0.31 among controls). When adjusted for all covariates, a cumulative coffee consumption higher than 18.0 daily liters × year during lifetime was indicated to be protective against disease (adjusted odds ratio 0.39, 95% confidence interval 0.16-0.94, P = 0.037). This observation may have pharmacological implications for clinical medication of these cancers and is relevant to programs aimed at reducing the burden of disease.     

Prevalence of risk health behavior among members of private health insurance plans: results from the 2008 national telephone survey Vigitel, Brazil

This article aims at estimating the prevalence of adults engaging in protective and risk health behaviors among members of private health insurance plans. It was used a random sample of individuals over the age of 18 living in the Brazilian state capitals collected on 28,640 telephone interviews in 2008. The results showed that among males there was a high prevalence of the following risk factors: tobacco, overweight, low fruit and vegetable consumption, high meat with fat consumption and alcohol drinking. Among females we found a high prevalence of high blood pressure, diabetes, dyslipidemia and osteoporosis. Men were generally more physically active and women consumed more fruit and vegetables. As more educated males were lower was the prevalence of tobacco, high blood pressure, but also a higher prevalence of overweight, consumption of meat with fat, dyslipidemia and lower number of yearly check-ups done. For females, tobacco smoking, overweight, obesity, decreasing with schooling, and consumption of fruit and vegetables, physical activity, mammography and PAP test, increased with schooling. The health insurance user population constitutes about 26% of Brazilian people and the current study aims to accumulate evidence for health promotion actions by this public.     

Factors associated with the improvement of lifestyle among a middle and advanced aged male population]

Factors associated with improvement of lifestyle (diet, smoking, drinking, exercise and health check-up) were studied among 3,503 males aged 40 or more, based on data obtained by two questionnaire surveys which were conducted at about a five year interval in a mountainous area of Aichi Prefecture. Age was positively associated with the improvement of every habit except for health check-up. Developing diseases was associated with the improvement of every habit except for exercise, with strong associations existing between liver diseases and improvement in drinking habits and between diabetes and improved nutritional balance. Improved dietary habits was inversely associated with frequent use of instant foods and irregular eating habits. Moderation in eating was associated with a balanced diet, frequent intake of yellow/green vegetables, fats & oils, and non-smoking at the time of the initial survey. Cessation of smoking was positively associated with fruit intake and inversely associated with irregular meal times, number of cigarettes per day and alcohol intake at baseline. An increase in frequency of exercise was positively associated with consumptions of fruits and dairy products and inversely associated with frequent use of instant foods at time of the initial survey, while an increase in frequency of health check-up was observed among men who had a balanced diet. The improvement of each habit was associated with the improvement of one or more other habits. These results suggest that likelihood for improving lifestyle is higher among men who have a health consciousness and that improvements in these habits are independent.     

Dietary and physical activity correlates of long-term weight loss

Covariations in body mass index (BMI), physical activity, macronutrient intake, and the frequency of consumption of specific foods were examined among 82 men and 75 women participating in a behavioral weight loss program over a period of 18 months. Results of repeated measures analyses of covariance showed that BMI change was inversely related to change in physical activity and change in frequency of vegetable consumption. BMI change was positively related to change in calorie intake from fat and change in frequency of consumption of beef, hot dogs, and sweets. Change in fat calories predicted BMI change better than change in total calories. In addition, change in the frequency of consumption of specific foods accounted for a larger percentage of the variance in BMI change than did change in macronutrients (10.4% vs. 5.2%). No differences were found between predictors of weight loss vs. weight maintenance.     

Diet diversity and the risk of oral and pharyngeal cancer

BACKGROUND: Diet diversity has been recommended to achieve a healthy diet and prevent cancer. AIM OF THE STUDY: The relation between diet diversity (i.e., variety in food intake computed as the total number of foods consumed at least once per week) and the risk of oral and pharyngeal cancer was investigated using data from a multicentric case-control study carried out between 1991 and 2005 in Italy. METHODS: Cases were 805 patients with histologically confirmed incident cancers of the oral cavity and pharynx, and controls were 2,081 patients admitted for acute, non-neoplastic diseases, unrelated to tobacco or alcohol consumption. RESULTS: A significant inverse association was observed with total diet diversity. The multivariate odds ratio (OR), adjusted for education, tobacco and alcohol, was 0.78 (95% confidence interval, CI 0.61-0.98) for subjects in the highest tertile of diversity. Inverse relations were found also for diversity within vegetables (OR = 0.62; 95% CI 0.49-0.78) and fruits (OR = 0.67; 95% CI 0.53-0.86). CONCLUSIONS: This study suggests that a more diversified, and particularly a diet varied in vegetables and fruit, is a favourable indicator of oral and pharyngeal cancer risk, independently from the major recognised risk factors, i.e. alcohol and tobacco consumption.     

吸烟饮酒作为低发区鼻咽癌致病因素的分析

目的研究我国鼻咽癌低发地区吸烟、饮酒与鼻咽癌致病的关系。方法使用标准化的调查表收集2005年1月～2008年10月湖北省内的245例鼻咽癌及245名与之性别、年龄（±5岁）配对的健康人群的相关信息,并比较他们的吸烟及饮酒习惯。结果本研究发现吸烟可增加鼻咽癌的致病危险性（OR调整=2.22;95%CI：1.42～3.49）。吸烟累积量与鼻咽癌致病危险性有剂量效应关系。吸烟累积量（每天吸烟的支数×烟龄）为300～600支的人患病的危险性是300支以下的人的7.19倍（OR调整=7.19;95%CI：3.02～17.11）,而当吸烟累积量达600支以上,患病危险性则提高到11.89倍（OR调整=11.89;95%CI：4.14～34.13）。重度饮酒能够导致鼻咽癌致病危险性提高,且结果有统计学意义。结论吸烟是鼻咽癌致病的危险因素,吸烟的累积量与鼻咽癌致病风险有剂量效应关系;重度饮酒可导致鼻咽癌发病危险性提高。     

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

OBJECTIVE: Smoking serves different functions for men and women. Thus, we wanted to investigate the association between smoking behaviour and intakes of selected healthy foods in men and women with special focus on differences and similarities between the two genders. DESIGN: In 1993-1997, a random sample of 80 996 men and 79 729 women aged 50-64 y was invited to participate in the study 'Diet, Cancer and Health'. In all, 27 179 men and 29 876 women attended a health examination and completed a 192-item food-frequency questionnaire (FFQ). The association between smoking status and low, median and high intakes of selected foods was examined among 25 821 men and 28 596 women. SETTING: The greater Copenhagen and Aarhus area, Denmark. RESULTS: For both men and women, smoking status group was associated with diet, such that increasing level of smoking status ranging from never smokers over ex-smokers to currently heavy smokers was associated with a lower intake of the healthy foods: fresh fruit, cooked vegetables, raw vegetables/salad, and olive oil. For wine, increasing level of smoking status category was associated with a higher fraction of abstainers and heavy drinkers. The difference between the extreme smoking status categories was larger than the difference between men and women within smoking status categories such that never smoking men in general had a higher intake of healthy foods than heavy smoking women. Correction for age, educational level, and body mass index (BMI) did not affect the results. CONCLUSION: In this middle-aged population, intake of healthy foods were associated with smoking behaviour with a dose-response type of relationship. The overall pattern was similar for men and women.     

Association between smoking and alcohol use in the general population: stable and unstable odds ratios across two years in two different countries

AIMS: The main objective of this article was to compare alcohol and tobacco consumption in the US and the Basque Country (the North of Spain) with particular attention to the association between alcohol and tobacco use. The consistency of findings was considered by analyzing data from two different years. These comparisons may provide a rational basis for exploring the associations between alcohol and cigarette use that are influenced by changes in use prevalences. METHODS: Two epidemiological samples from the US, obtained in 1992 and 1996, and two from the Basque Country, obtained in the same years, were used. Sampling methodologies were similar. Questionnaires were self-administrated with the help of interviewers, and were used to define ever smokers, ex-smokers, current smokers, heavy smokers, ever drinkers, ex-drinkers, current drinkers and weekly drinkers. The associations between smoking and alcohol drinking were explored through logistic regressions. RESULTS: The associations between current smoking and current drinking in the general population, and between ever smoking and weekly drinking among current drinkers appear very stable. In 1992 and 1996, US subjects who decided to try alcohol tended to try smoking and vice versa. In US Caucasians (particularly in 1996), heavy smoking was strongly associated with ever drinking among current smokers. In the Basque Country in 1992, there was a significant association between smoking cessation and drinking cessation among ever drinkers who also were ever smokers. CONCLUSIONS: Our analyses suggest that some associations between alcohol drinking and smoking behaviours are likely to be detected in Western countries where alcohol and nicotine are legal and easily available. On the other hand, other associations may be detected only in certain social contexts. These social contexts make the associations in subpopulations who are vulnerable to addiction, influence the results in the general population. In social contexts that exert considerable social pressure to quit smoking, such as in US Caucasians (particularly in 1996), heavy smoking was strongly associated with ever drinking among current smokers. When a social environment strongly discourages smoking and alcohol initiation (as in the US in 1992 and 1996), subjects who decide to try alcohol tend to try smoking and vice versa. The lack of social stigmatization of smoking and drinking in the Basque Country in 1992 may help to explain the significant association between smoking cessation and drinking cessation among ever drinkers who also were ever smokers.