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

David K. Cundiff

In This Article


Tobacco use is strongly associated with higher fat and lower fiber diets, higher HbA1c levels, and higher-risk serum lipid profiles. The metabolic rate of smokers is greater that that of nonsmokers, which accounts for a higher caloric intake without increased weight gain. Higher risks of cardiovascular disease and tobacco-related cancers in smokers may in part be due to the higher fat diets associated with tobacco use. An increased rate of type 2 diabetes in smokers compared with nonsmokers probably also relates to these dietary differences. Assessing the effects of smoking on the complications of type 1 diabetes (eg, retinopathy, nephropathy, neuropathy, coronary artery disease, limb amputations) is complicated by the association of tobacco use with a more atherogenic diet.

Tobacco users should be told of their increased proclivity to have an unhealthy high fat, low fiber diet. They should be counseled to consciously strive to achieve a lower fat and higher fiber diet.


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