Dietary adequacy and dietary quality of Inuit in the Canadian Arctic who smoke and the potential implications for chronic disease.

OBJECTIVE To compare dietary intake and quality among adult Inuit by smoking status. DESIGN A cross-sectional study using data from a validated quantitative FFQ. SETTING Three isolated communities in Nunavut, Canada. SUBJECTS Adult Inuit (n 208), aged between 19 and 79 years, from randomly selected households. RESULTS Average energy intake did not differ between male smokers (n 22) and non-smokers (n 14; 16 235 kJ and 13 503 kJ; P = 0·18), but was higher among female smokers (n 126) compared with non-smokers (n 46; 12 704 kJ and 8552 kJ; P < 0·0001). Average daily nutrient intakes were similar among men and higher among female smokers compared with non-smokers for all nutrients (P ≤ 0·05) except n-3 fatty acids, vitamin A, vitamin D and Se. Female smokers had lower intake densities of thiamin, niacin, vitamin B6, folate, Mg, Na (P ≤ 0·05), protein, n-3 fatty acids, cholesterol, Fe (P ≤ 0·01), vitamin B12 and Se (P ≤ 0·001). Between 20 % and 50 % of male and female smokers were below the Dietary Reference Intake (DRI) for Ca, folate, Mg and vitamins A and K, and more than 50 % were below the DRI for fibre and vitamin E. The proportion of smokers below the DRI was lower for all nutrients, except fibre and folate among men. Among smokers, non-nutrient-dense foods and traditional foods contributed less to energy (-2·1 % and -2·0 %, respectively). CONCLUSIONS Adult smokers consumed fewer nutrient-dense, traditional foods, but had increased energy intake, which likely contributed to fewer dietary inadequacies compared with non-smokers. Promoting traditional food consumption supplemented with market-bought fruits and vegetables is important to improve dietary quality, especially among smokers.