The contribution of beverages to intakes of energy and MyPlate components by current, former, and never smokers in the United States

Authors: ZIZZA, CLAIRE - Auburn University; Sebastian, Rhonda; Enns, Cecilia; ISIK, ZEYNEP - Auburn University; Goldman, Joseph; Moshfegh, Alanna

Submitted to: Journal of the Academy of Nutrition and Dietetics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 7/4/2015
Publication Date: 12/1/2015
Citation: Zizza, C.A., Sebastian, R.S., Enns, C.W., Isik, Z., Goldman, J.D., Moshfegh, A.J. 2015. The contribution of beverages to intakes of energy and MyPlate components by current, former, and never smokers in the United States. Journal of the Academy of Nutrition and Dietetics. 115:(12):1939-1949.

Interpretive Summary: Smoking increases the risk of illness and death. People who smoke often exhibit other behaviors that can further increase their risk for disease, including poor dietary behaviors. Identifying differences in dietary patterns of current, former, and never smokers (i.e., differences by smoking status) can be useful in designing strategies to improve the diet and health of current smokers. Some research has noted that current smokers consume more alcoholic drinks and coffee than nonsmokers, but no comprehensive assessment of beverage intake patterns and/or the contribution of beverages to overall dietary intake by smoking status has ever been conducted. To address this gap, we analyzed dietary data from 9,495 adults who participated in What We Eat in America, the dietary survey component of the National Health and Nutrition Examination Survey (NHANES). The objective of this study was to compare beverage intakes and contributions of energy and MyPlate components from food alone, beverages alone, and food and beverages together in the diets of current, former, and never smokers. We found that current smokers drank more beverages overall than never and former smokers. Relative to never smokers, current smokers drank more total coffee (mainly coffee with caloric additions), sugar-sweetened beverages (mainly soft drinks), and total alcoholic beverages (mainly beer). Total energy intake did not differ by smoking status, but smokers consumed more of their energy from beverages. The total daily intake of empty calories was more than 20% higher for current than never smokers, and this difference was accounted for by current smokers’ higher intake of nutrient-poor, calorically-dense beverages. All groups of adults, regardless of smoking status, could benefit from increasing intakes of fruit and vegetable juices and milk, lowering intakes of sugar-sweetened beverages and alcoholic beverages, and reducing or omitting caloric additions to coffee and tea. It may be especially beneficial for current smokers to decrease their alcohol intakes and include more 100% fruit juices in their diets. This information will be of benefit to diet and health practitioners and program planners seeking to improve the health of all adults and especially that of current smokers.

Technical Abstract: Though beverage intake patterns have been shown to differ by smoking status, it is unknown whether the contributions of beverages to intakes of energy and MyPlate components also differ. The objective of this study was to compare beverage intakes and contributions of energy and MyPlate components by source (food alone, beverages alone, and food and beverages together) in diets of current, former, and never smokers. Dietary data from 4,823 men and 4,672 women who participated in What We Eat in America, NHANES 2005-2008 were analyzed. Regression analyses identified differences in intake (within gender) between smoking status groups. Current smokers consumed more total beverages, coffee, and sugar-sweetened beverages than never and former smokers (p<0.001). Male current smokers drank more alcoholic beverages than never and former smokers, whereas female current and former smokers both consumed more alcoholic beverages than never smokers. Current smokers obtained more energy from beverages than their nonsmoking counterparts, though total energy intake did not differ. Intakes of added sugars, alcohol, and empty calories were higher for current than never smokers, and differences were accounted for by current smokers’ beverage choices. This study adds to the body of research on smoking and dietary behavior by showing that not only do smokers consume a higher volume of beverages, but they also have a higher intake of energy provided by beverages, mainly empty calories from added sugars and alcohol. Recognizing the common co-occurrence of smoking and specific beverage choices may help target health promotion and disease prevention efforts.