Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-15T17:14:04.061Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  09 March 2007

Helmut Schröder ,
Jaume Marrugat ,
Roberto Elosua  and
Maribel I. Covas
Helmut Schröder
Affiliation:
Lipids and Cardiovascular Epidemiology Unit, Institut Municipal d'Investigació Mèdica, IMIM, 08003, Barcelona, Spain Department of Nutrition, Sports Medicine Barcelona, Barcelona, Spain
Jaume Marrugat*
Affiliation:
Lipids and Cardiovascular Epidemiology Unit, Institut Municipal d'Investigació Mèdica, IMIM, 08003, Barcelona, Spain
Roberto Elosua
Affiliation:
Lipids and Cardiovascular Epidemiology Unit, Institut Municipal d'Investigació Mèdica, IMIM, 08003, Barcelona, Spain
Maribel I. Covas
Affiliation:
Lipids and Cardiovascular Epidemiology Unit, Institut Municipal d'Investigació Mèdica, IMIM, 08003, Barcelona, Spain
*
*Corresponding author:Professor Jaume Marrugat, fax +34 93 2213237, email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

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, α-tocopherol and β-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.

Keywords

CancerCardiovascular risk factorsDiet
Type
Research Article
Information
British Journal of Nutrition , Volume 88 , Issue 3 , September 2002 , pp. 273 - 281
Copyright
Copyright © The Nutrition Society 2002

References

Ballesteros Pomar, MD, Rubio Herrera, MA, Gutiérrez Fuentes, JA, Gómez Gerique, JA, Gómez da la Cámera, A, Pascual, O, Gárate, I, Montero, R & Campiñia SThe DRECE Study Group (2000) Dietary habits and cardiovascular risk in the Spanish population: The DRECE study (II) micronutrient intake. Annals of Nutrition and Metabolism 44, 177–182.CrossRefGoogle ScholarPubMed
Byers, T & Guerrero, N (1995) Epidemiologic evidence for vitamin C and vitamin E in cancer prevention. American Journal of Clinical Nutrition 62, 1385S–1392S.CrossRefGoogle ScholarPubMed
Castelli, WP, Doyle, JT, Gordon, T, Hames, CG, Hjortland, MC, Hulley, SB, Kagan, A & Zukel, WJ (1997) Alcohol and blood lipids. The cooperative lipoprotein phenotyping study. Lancet 2, 153–155.Google Scholar
Cosin-Aguilar, J, Andres-Conejos, F, Hernandiz-Martinez, A, Solaz-Minguez, J, Marrugat, J & Bayes-De-Luna, A (1995) Effect of smoking on sudden and premature death. Journal of Cardiovascular Risk 2, 345–351.Google Scholar
Craig, WY (1993) The effect of compounds associated with cigarette smoking on the secretion of lipoprotein lipid by HepG2 cells. Biochimica et Biophysica Acta 1165, 249–258.CrossRefGoogle ScholarPubMed
Dallongeville, J, Marecaux, N, Fruchart, JC & Amouyel, P (1998) Cigarette smoking is associated with unhealthy patterns of nutrient intake: a meta-analysis. Journal of Nutrition 128, 1450–1457.CrossRefGoogle ScholarPubMed
D'Avanzo, B, La Vecchia, C, Braga, C, Franceschi, S, Negri, E & Parpinel, M (1997) Nutrient intake according to education, smoking, and alcohol in Italian women. Nutrition and Cancer 28, 46–51.CrossRefGoogle ScholarPubMed
Doll, R, Peto, R, Wheatley, K, Gray, R & Sutherland, I (1994) Mortality in relation to smoking: 40 years observations on male British doctors. British Medical Journal 309, 901–911.Google Scholar
Duthie, SJ, Ross, M & Collins, AR (1995) The influence of smoking and diet on the hypoxanthine phosphoribosyltransferase (hprt) mutant frequency in circulating T lymphocytes from a normal human population. Mutation Research 331, 55–64.Google Scholar
Elosua, R, Garcia, M, Aguilar, A, Molina, L, Covas, MI & Marrugat, J (2000) Validation of the Minnesota leisure time physical activity questionnaire in Spanish woman. Medicine and Science in Sports and Exercise 32, 1431–1437.CrossRefGoogle Scholar
Elosua, R, Marrugat, J, Molina, L, Pons, S & Pujol, E (1994) Validation of the Minnesota leisure time physical activity questionnaire in Spanish men. The MARATHOM investigators. American Journal of Epidemiology 139, 1197–1209.CrossRefGoogle ScholarPubMed
Freeman, DJ, Griffin, BA, Murray, E, Lindsay, GM, Gaffney, D, Packard, CJ & Shepherd, J (1993) Smoking and plasma lipoproteins in man: effects on low density lipoprotein cholesterol levels and high density lipoprotein subfraction distribution. European Journal of Clinical Investigation 23, 630–640.CrossRefGoogle ScholarPubMed
Gaziano, JM & Buring, JE (1998) Alcohol intake, lipids and risks of myocardial infarction. Novartis Foundation Symposium 216, 86–95.Google Scholar
Gensini, GF, Comeglio, M & Colella, A (1998) Classical risk factors and emerging elements in the risk profile for coronary artery disease. European Heart Journal 19, Suppl. A, A53–A61.Google ScholarPubMed
Gióvannucci, E & Martinez, ME (1996) Tobacco, colorectal cancer, and adenomas: a review of the evidence. Journal of the National Cancer Institute 88, 1717–1730.Google Scholar
Goldbourt, U, Holtzman, E & Neufeld, HN (1985) Total and high density lipoprotein cholesterol in the serum and risk of mortality: evidence of a threshold effect. British Medical Journal 290, 1239–1243.Google Scholar
Hulley, SB & Gordon, S (1981) Alcohol and high-density lipoprotein cholosterol: causal inference from diverse study designs. Circulation 64, 57–63.Google Scholar
Jacobs, DR, Mebane, IL, Bangdiwala, SI, Criqui, MH & Tyroler, HA (1990) High density lipoprotein cholesterol as a predictor of cardiovascular disease mortality in men and women: the follow-up study of the Lipid Research Clinics Prevalence Study. American Journal of Epidemiology 131, 32–47.CrossRefGoogle ScholarPubMed
Jacobs, DR & Gottenborg, S (1981) Smoking and weight: The Minnesota Lipid Research Clinic. American Journal of Public Health 71, 391–396.Google Scholar
Kabat, GC (1996) Aspects of the epidemiology of lung cancer in smokers and nonsmokers in the United States. Lung Cancer 15, 1–20.Google Scholar
Klör, HU, Hauenschild, A, Holbach, I, Schnell-Kretschmer, H & Stroh, S (1997) Nutrition and cardiovascular disease. European Journal of Medical Research 2, 243–257.Google ScholarPubMed
Lloveras, G, Ribas, BL, Ramon, JM, Serra Majem, L & Roman Vinas, B (2001) Food consumption and nutrient intake in relation to smoking. Medicina Clinica 116, 129–132.Google Scholar
McPhillips, JB, Eaton, CB, Gans, KM, Derby, CA, Lasater, TM, McKenny, JL & Carleton, RA (1994) Dietary differences in smokers and nonsmokers from two southeastern New England communities. Journal of the American Dietetic Association 94, 287–292.CrossRefGoogle ScholarPubMed
Margetts, BM & Jackson, AA (1993) Interactions between people's diet and their smoking habits: the dietary and nutritional survey of British adults. British Medical Journal 307, 1381–1384.Google Scholar
Masiá, R, Pena, A, Marrugat, J, Sala, J, Vila, J, Pavesi, M, Covas, M, Aubó, C & Elosua, R (1998) High prevalence of cardiovascular risk factors in Gerona, Spain, a province with low myocardial infarction disease. Journal of Epidemiology and Community Health 52, 707–715.Google Scholar
Menotti, A, Kromhout, D, Blackburn, H, Fidanza, F, Buzina, R & Nissinen, A (1999) Food intake patterns and 25-year mortality from coronary heart disease: cross-cultural correlations in the Seven Countries Study. The Seven Countries Study Research Group. European Journal of Epidemiology 15, 507–515.CrossRefGoogle Scholar
Midgette, AS, Baron, JA & Rohan, TE (1993) Do cigarette smokers have diets that increase their risks of coronary heart disease and cancer? American Journal of Epidemiology 137, 521–529.CrossRefGoogle ScholarPubMed
Morrow, JD, Frei, B, Longmire, AW, Gaziano, JM, Lynch, SM, Shyr, Y, Strauss, WE, Oates, JA & Roberts, LJ 2nd (1995) Increase in circulating products of lipid peroxidation (F2-isoprostanes) in smokers. Smoking as a cause of oxidative damage. New England Journal of Medicine 332, 1198–1203.CrossRefGoogle ScholarPubMed
Palaniappan, U, Starkey, J, O'Loughlin, J & Gray-Donald, K (2001) Fruit and vegetable consumption is lower and saturated fat intake is higher among Canadians reporting smoking. Journal of Nutrition 131, 1952–1958.Google Scholar
Paunio, M, Virtamo, J, Gref, CG & Heinonen, OP (1996) Serum high density lipoprotein cholesterol, alcohol, and coronary mortality in male smokers. British Medical Journal 312, 1200–1203.Google Scholar
Primatesta, P, Falaschetti, E, Gupta, S, Marmot, MG & Poulter, NR (2001) Association between smoking and blood pressure: evidence from the health survey for England. Hypertension 37, 187–193.Google Scholar
Rehm, J & Bondy, S (1998) Alcohol and all-cause mortality: an overview. Novartis Foundation Symposium 216, 223–232.Google ScholarPubMed
Rimm, EB, Williams, P, Fosher, K, Criqui, M & Stampfer, MJ (1999) Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors. British Medical Journal 319, 1523–1528.CrossRefGoogle ScholarPubMed
Ringborg, U (1998) Alcohol and risk of cancer. Alcoholism Clinical and Experimental Research 22, 323S–328S.CrossRefGoogle ScholarPubMed
Rumpler, WV, Clevidence, BA, Muesing, RA & Rhodes, DG (1999) Changes in women's plasma lipid and lipoprotein concentrations due to moderate consumption of alcohol are affected by dietary fat level. Journal of Nutrition 129, 1713–1717.Google Scholar
Schröder, H, Covas, MI, Marrugat, J, Pena, A, Alcántara, M & Masiá, R (2001) Use of a three-day estimated food record, a 72-hour recall, and a food frequency questionnaire for dietary assessment in a Mediterranean Spanish population. Clinical Nutrition 20, 429–430.Google Scholar
Thune, I, Njolstad, I, Lochen, ML & Forde, OH (1998) Physical activity improves the metabolic risk profiles in men and women: the Tromso Study. Archives of Internal Medicine 158, 1633–1640.Google Scholar
Todd, S, Woodward, M, Tunstall-Pedoe, H & Bolton-Smith, C (1999) Dietary antioxidant vitamins and fibre in the etiology of cardiovascular disease and all-causes mortality: results from the Scottish Heart Health study. American Journal of Epidemiology 150, 1073–1080.CrossRefGoogle ScholarPubMed
Trichopoulou, A, Lagiou, P, Kuper, H & Trichopoulos, D (2000) Cancer and the Mediterranean dietary tradition. Cancer Epidemiology, Biomarkers and Prevention 9, 869–873.Google Scholar
Trichopoulou, A & Lagiou, P (1997) Healthy traditional Mediterranean diet: an expression of culture, history and lifestyle. Nutrition Reviews 55, 383–389.CrossRefGoogle ScholarPubMed
Verschuren, WM, Jacobs, DR, Bloemberg, BP, Kromhout, D, Menotti, A, Aravanis, C, Blackburn, H, Buzina, R, Dontas, AS, Fidanza, F, Karvonen, MJ, Nedeljkovic, S, Nissinen, A & Toshima, H (1995) Serum total cholesterol and long-term coronary heart disease mortality in different cultures. Twenty-five-year follow-up of the seven countries study. Journal of the American Medical Association 274, 131–136.CrossRefGoogle ScholarPubMed
Walmsley, CM, Bates, CJ, Prentice, A & Cole, TJ (1998) Relationship between alcohol and nutrient intakes and blood status indices of older people living in the UK: further analysis of data from the National.Diet and Nutrition Survey of people aged 65 years and over, 1994/5. Public Health Nutrition 1, 157–167.CrossRefGoogle ScholarPubMed
Yano, K, Rhoads, GG & Kagan, A (1977) Coffee, alcohol and risk of coronary heart disease among Japanese men living in Hawaii. New England Journal of Medicine 297, 405–409.CrossRefGoogle ScholarPubMed
Yong, LC, Brown, CC, Schatzkin, A, Dresser, CM, Slesinski, MJ, Cox, CS & Taylor, PR (1997) Intake of vitamins E, C, and A and risk of lung cancer. The NHANES I epidemiologic follow up study. First National Health and Nutrition Examination Survey. American Journal of Epidemiology 146, 231–243.Google Scholar
Zeegers, MP, Tan, FE, Dorant, E & van Den Brandt, PA (2000) The impact of characteristics of cigarette smoking on urinary tract cancer risk: a meta-analysis of epidemiologic studies. Cancer 89, 630–639.Google Scholar