Smoking, dietary calcium and vitamin D deficiency in women: a population-based study

Abstract

Objective: To determine differences in dietary calcium and vitamin D intakes between female never, former and current smokers. Design: Population-based survey using a validated food frequency questionnaire. Setting: The Bus Sante  2000, epidemiologic observatory of Geneva, Switzerland. Subjects: 2319 women resident in Geneva, Switzerland between 1993 and 1997. Results: Daily calcium intake was 798 mg among current heavy smokers ( 20 cigarettesaday), 882 mg among current moderate smokers (1 ± 19 cigarettesaday) and 945 mg among never smokers (P 0.0001). There was a difference of almost 50 mgaday in median calcium intake from cheese (P 0.04), which corresponded to about one-third of the total difference in calcium intake between heavy smokers and never smokers. Of the current heavy smokers, 21% did not eat yogurt compared to 10% of never smokers (P 0.001). Among yogurt eaters, heavy smokers consumed 90 mgaday of calcium from yogurt vs 115 mgaday in never smokers (P 0.003). Smokers ate more butter and cream (P 0.02) or milk (P 0.06) than never smokers, but these were minor sources of calcium. Fish was the main cause of higher intake of vitamin D in never smokers (0.81 mgaday) compared with heavy smokers (0.53 mgaday) and moderate smokers (0.70 mgaday). The diet of ex-smokers after 5 y or more of smoking cessation tended to resemble that of never smokers for calcium (about 900 mgaday) and vitamin D (about 2.55 mgaday). Conclusion: Female current smokers have lower dietary intakes of calcium and vitamin D than never smokers. Sponsorship: This study was funded by the Swiss National Fund for Scienti®c Research (grants 32.31.326.91,).

Dietary intake in male and female smokers, ex-smokers, and never smokers: The INTERMAP Study

“…Niacin intake was significantly lower in smokers only for US men. Other studies have reported both higher 1,2,11 and lower 1,2,13,17,35 intakes of vitamin D in smokers compared to nonsmokers. Vitamin B 12 intake has generally not varied by smoking status.…”

Difficulties with vitamin D nutrition research: objective targets of adequacy, and assays for 25-hydroxyvitamin D

“…The recent dietary survey of Morabia et al (2000) failed to specify an intake that they would have considered adequate. Morabia et al simply concluded that heavy smokers were more prone to vitamin D de®ciency because their mean vitamin D intake of 1.92 mgaday was statistically less than the mean intake of 2.39 mgaday for non-smokers.…”

“…Recent issues of this journal have seen two articles highlighting the nutritional need for vitamin D in adults (Schaafsma et al, 2000;Morabia et al, 2000). This editorial is a critical commentary with suggested strategies to make publications relating to vitamin D requirements of practical bene®t to others.…”

Response to Vieth and Carter

“…This is precisely why we focused on differential intakes according to smoking status. The goal of our study (Morabia et al, 2000) has been inaccurately summarized by Vieth and Carter (Vieth & Carter, 2001). We have reported that salmon, 45% fat cheese, margarine and eggs are the most important sources of vitamin D in the Geneva population.…”

“…The comments on our paper (Morabia et al, 2000) in the editorial by Vieth and Carter (Vieth & Carter, 2001) re¯ect an unfortunately common misinterpretation of epidemiologic data.…”