Association between Smoking Status and Food and Nutrient Consumption in Japanese: a Large-Scale Cross-Sectional Study

Background: In Japan, in comparison with the rest of the world the death rate of lung cancer is low although the smoking rate is relatively high. This is the so-called "Japanese smoking paradox". A healthy diet is proposed to attenuate the risk without quitting smoking. We here examined the relationships between smoking status (SS) and the consumption of food and nutrient in Japan. Materials and Methods: Totals of 5,587 men and 2,718 women were divided into three (non-smokers, smokers and heavy smokers) and two (non-smokers and smokers) groups, respectively, according to pack-year, which represents the amount of smoking over a long period. Food and nutrient consumption was estimated with a validated food frequency questionnaire. Using general linear models, food and nutrient consumption was estimated for each group in men and women, separately. Results: In men, SS was positively related to consumption of rice, 3 alcoholic beverages, carbohydrate, alcohol and other 8 foods/nutrients (p< 0.05 for all) and negatively to those of protein animal, fat, fatty acids, dietary fiber, isoflavones and 36 other foods/nutrients (p<0.05 for all). In women, SS was positively associated with intake of 13 foods/nutrients, while being negatively associated with those of rice, energy, dietary fiber, and 14 other foods/nutrients (p<0.05 for all). Conclusions: Our results support lower intake of vegetables and fruits rich in antioxidants, which are thought as preventive factors for many diseases, in smokers.