Environmental tobacco smoke exposure and serum carotenoids in children. What is the role of diet?

Abstract

Environmental tobacco smoke (ETS) has been associated with lower serum carotenoid concentrations in children; however, differences in diet quality by ETS exposure have not been thoroughly examined. The association between ETS exposure and serum carotenoids was evaluated along with possible differences in diet quality. Using the 2003–2006 National Health and Nutrition Examination Survey (NHANES) 4,206 6–18 year‐olds with ETS exposure (serum cotinine = 0.05–10 ng/L) and without (serum cotinine <0.05 ng/L) were evaluated to determine an association among ETS exposure, serum carotenoids (α‐carotene, β‐carotene, β‐cryptoxanthin, lutein/zeanthin), and diet quality using data from 24‐hour dietary recalls and usual intake methods provided by the National Cancer Institute. After controlling for age, ETS‐exposed had lower serum α‐carotene (b=−0.06 (p<0.01), β‐carotene (b=−0.08, p<0.01), and β‐cryptoxanthin (b=−0.07, p<0.05). Although control for dietary carotenoids did not impact these coefficients, ETS‐exposed were more likely to have lower median usual fiber (11.9 g vs. 13.3 g, p=0.03), calcium (892 mg vs. 1030 mg, p=0.01), and whole grain intake than ETS‐non‐exposed after controlling for age and income. Dietary carotenoids may not fully represent differences in dietary quality by ETS exposure among nonsmoking children and dietary quality may be poorer among children regularly exposed to ETS.