Diet and Tobacco Use: Analysis of Data From the Diabetic Control and Complications Trial, a Randomized Study

David K. Cundiff

In This Article


After screening the 99 nutritional variables tracked in the DCCT, the ones with significant group differences (eg, smokers vs nonsmokers) are reported here.

The comparison of nutrient intake and tobacco use status at each of the 3 time periods shows that, compared with female nonsmokers, female smokers consumed 78-98 more calories per day (not significant). However, they consistently ingested less simple carbohydrates and fiber but more fats, cholesterol, and alcohol (Table 1a). Compared with females who smoked and quit, those who continued tobacco use had higher percentages of calories as total fat and saturated fat and lower intake of dietary fiber (Table 2a).

While the HbA1c scores of female tobacco users were consistently higher than nontobacco users (Table 1a), this reached statistical significance only at 4 years (Table 1a).

Female tobacco users consistently had significantly lower HDL serum cholesterols, higher LDL/HDL ratios, and higher triglycerides than nontobacco users (Tables 1a and 3a). Tobacco smoking females consumed more fats and had more unfavorable lipid profiles than former smokers (Table 2a). Former tobacco using females differed relatively little from never tobacco users in nutrient intake and lipid profiles (Table 4a).

Men with a history of tobacco using consumed between 14.6 and 16.7 more grams of fat and 0.55-2.62 more grams of alcohol per day than nontobacco users, largely accounting for their 160-224 additional calories per day (Table 1b). These tobacco using males also consistently ingested more cholesterol and sodium but less fiber.

Male former smokers consumed more fats than never smokers (Table 4b) but less than current smokers (Table 2b).

Compared with male nonsmokers, male smokers had consistently higher HbA1c scores, serum cholesterols, LDL/HDL ratios, and triglycerides than nonsmokers while HDL cholesterols were lower (Table 1b). Former tobacco using males had HbA1c levels and lipid profiles that resembled those of nontobacco-users much more than current users (Tables 2b and 4b).

Despite significantly higher caloric intake, smoking males had nonsignificantly lower BMIs.

Pooling females and males, the associations of diet with tobacco use was fairly independent of age. This is illustrated by the age breakdowns of the correlations between tobacco use and percent saturated fat and serum triglyceride levels (Tables 5a and 5b).


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