1. V C U
Differences in Food Intake and Exercise by Smoking Status in Middle and High School Students Diane B. Wilson*, EdD, RD, Brian N. Smith, PhD, Ilene S. Speizer, PhD, Melanie K. Bean, BA, Karen S. Mitchell, BS, L. Samy Uguy, PhD, Elizabeth Fries, PhD *Department of Internal Medicine, Department of Psychology, Virginia Commonwealth University, Richmond, VA
Objective
To examine the relationship between smoking and the intake of fruit, vegetables, and milk/dairy products and the frequency of exercise among males and females in middle school and high school.
Introduction
Tobacco use, poor diet, and lack of exercise, are the leading preventable causes of death in the US. Currently, 23% of high school students and many teens do not meet the recommended Healthy People 2010 standards for eating healthy, nutrient dense foods. It is not fully understood how poor diet and smoking together may impact chronic disease risk. This study was designed to examine how smoking is related to diet and exercise among middle school and high school adolescents towards improving lifestyle habits in this population.
Methods
This study was designed to examine the relationship of smoking and the intake of fruit, vegetables, and milk/dairy products, as well as the frequency of exercise, in Middle School (n=8,022) and High School (n=2,613) adolescents. Baseline data, collected as a part of a comprehensive state-wide outcome evaluation of youth tobacco prevention programs, were analyzed using multivariate regression models.
Table 1. Demographic and variable frequencies (%) by school level.
Table 2. Outcome variable
frequencies (%) by school level
Variable
MIDDLE
SCHOOL
N=8,022
HIGH SCHOOL
N=2,613
Gender
Female
51.4
53.0
Male
48.6
47.0
Ethnicity
Black
19.6
20.3
White
74.6
71.7
Other
5.8
8.0
Grade in school
6th
42.4
7th
34.4
8th
23.2
9th
40.4
10th
25.1
11th
19.0
12th
15.5
Smoking Status
Smoker
5.0
20.9
Non-smoker
95.0
79.1
BMI
Underweight (≤18.54)
38.3
13.4
Normal ( )
47.2
63.5
Overweight ( )
10.0
15.2
Obese (≥29.95)
4.5
7.9
Weight Goals
Trying to lose weight
47.7
42.6
Not trying to lose weight
52.3
57.4
Variable
MIDDLE
SCHOOL
N=8,022
HIGH
N=2,613
Fruit Consumption
≥1 serving/day
46.8
43.7
<7 servings/week
53.2
56.3
Vegetable Consumption
50.8
52.6
49.2
47.4
Milk/Dairy Consumption
61.5
63.0
38.5
37.0
Exercise Frequency
≥3 times/week
77.6
71.7
<3 times/week
22.4
28.3
Figure 1. Gender comparisons of food consumption and exercise frequency in Middle School smokers and non-smokers.
Notes: Adjusted analysis; non-smokers are referent category. Covariates include BMI, grade, weight loss goals, and ethnicity. Odds ratios <1.0 indicate that smokers are less likely to have consumed food or exercised; odds ratios ≥1.0 indicate that smokers are more likely to have consumed food or exercised.
Results
Demographic characteristics, smoking frequencies, and covariates of the study sample are shown in Table 1.
In HS male, female, and total HS sample, smokers were significantly less likely to eat ≥1 serving/day of milk/dairy products and to exercise ≥3x/week tan non-smokers.
Smoking and vegetable consumption in HS females and HS total sample were also significant.
In middle school, female smokers were significantly less likely to eat ≥1 serving/day of vegetables.
Both MS female and total MS sample smokers were significantly less likely than non-smokers to exercise ≥3x/week.
Conclusions
Adolescents who smoke were less likely to consume vegetables and milk/dairy products, and to exercise less frequently than non-smokers. We found evidence of these patterns in high school students than in middle school students, and
more often in girls than in boys. Ethnicity, particularly being African American, was significantly associated with decreased odds of eating vegetables, milk products, and exercising.
Figure 2. Gender comparisons of food consumption and exercise frequency in high school smokers and non-smokers.
Notes: Adjusted analysis; non-smokers are referent category. Covariates include BMI, grade, weight loss goals, and ethnicity. Odds ratios <1.0 indicate that smokers are less likely to have consumed food or exercised; odds ratios ≥1.0 indicate that smokers are more likely to have consumed food or exercised.
Acknowledgement: The authors wish to thank Jerlym S. Porter, MS for her assistance in the preparation of the poster.
Implications
This study indicated that smoking prevention/cessation interventions for youth need to combine a strong emphasis on eating healthy foods and exercising.
These results underscore smoking and diet/exercise concerns starting in middle school and particularly in females that warrant greater attention.