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

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 (greater than or equal to 20 cigarettes/day), 882 mg among current moderate smokers (1-19 cigarettes/day) and 945 mg among never smokers (P = 0.0001). There was a difference of almost 50 mg/day in median calcium intake from cheese (P = 0.01), 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 mg/day of calcium from yogurt vs 115mg/day 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 mu g/day) compared with heavy smokers (0.53 mu g/day) and moderate smokers (0.70 mu g/day). The diet of ex-smokers after 5 y or more of smoking cessation tended to resemble that of never smokers for calcium (about 900 mg/day) and vitamin D (about 2.55 mu g/day). Conclusion: Female current smokers have lower dietary intakes of calcium and vitamin D than never smokers.