VOLUME 8 NUMBER 3 • SEPTEMBER 2011
123
SA JOURNAL OF DIABETES & VASCULAR DISEASE
PREVENTION IN PRACTICE
Table 2. Effective dietary strategies for weight management
during or after smoking cessation
Eat regular meals, including breakfast. Skipping meals is not effective in
•
helping lose weight
Take smaller portions, especially of high-fat /high-sugar foods. Using a
•
smaller plate can help
Avoid unduly restrictive or nutritionally imbalanced diets as they are
•
generally ineffective in the long term and can be harmful
A maximum weekly rate of loss of 0.5–1 kg is a realistic target
•
Very low-calorie diets may be helpful for short-term use in obese patients
•
under clinical supervision
Eat a low-fat diet consistent with general healthy eating advice, with plenty
•
of fruit and vegetables and wholegrain, starchy foods
A range of flexible approaches to reducing energy intake may help.
•
Consider using meal replacements or commercial slimming groups that
meet good practice standards.
Restrict alcohol intake. Not only is it high in calories it can be a trigger to
•
smoking or overeating. Drink plenty of low-calorie fluids
Filozof C, Pinilla MCF, Fernandez Cruz A. Smoking cessation and weight gain.
•
Obesity
Reviews
2004;
5
: 95-103
National Institute for Health and Clinical Excellence, 2006. Brief interventions and
•
referral for smoking cessation in primary care and other settings.
.
nice.org.uk/PH1/Guidance/pdf/English
National Institute for Health and Clinical Excellence, 2006. Obesity. Guidance on the
•
prevention, identification, assessment and management of overweight and obesity in
adults and children
Parsons AC, Shraim M, Inglis J
•
et al
. Interventions for preventing weight gain after
smoking cessation.
Cochrane Database of Systematic Reviews
1 CD006219, 2009
Useful resources
Pharmacological help with smoking cessation
/
•
MythsaboutNRTFactSheet.pdf
•
•
Weight management and healthy eating
•
more information
tions are now incorporated into the NICE guidelines on successful weight
management.
Even if an individual does not intend to lose weight, advice on a healthy
diet can have other health benefits, particularly as research shows that
many smokers have less healthy diets than non-smokers.
Snacking can be a particular risk for the ex-smoker. Keeping a healthy
range of snacks handy can be useful when the temptation to nibble
kicks in (see Table 3). Restricting access to high-fat, high-sugar foods
and high-calorie snacks in the house may be helpful. Sugar-free gum or
mints can be useful. Nuts are high in calories but eating a few unshelled
peanuts or pistachios with a drink – instead of smoking a cigarette – will
keep a person’s hands busy, and the process of removing the shell slows
down how much is eaten.
INCREASING PHYSICAL ACTIVITY
Increasing physical activity has been shown to be useful in controlling
weight in non-smokers. Exercise may provide an ex-smoker with an al-
ternative activity and interest that may help them cope with nicotine with-
drawal. It may also help offset the decrease in metabolic rate associated
with smoking cessation.
There is little evidence that interventions to increase physical activ-
ity are associated with reduced weight gain during the period of giving
up smoking. However, measures to increase physical activity as part of
smoking cessation programmes may help to limit weight gain over the
long term. Advice should take into account a person’s current level of
fitness as many smokers are less active than non-smokers.
SUMMING UP
Efforts to limit weight gain can play an important role in helping people
to quit smoking and to remain ex-smokers. Interventions designed to im-
prove dietary intake and behaviours, efforts to increase physical activity
and the use of pharmacological treatments can all help in immediate and
long-term weight management in smokers who are trying to quit. They
may be particularly important in people for whom weight gain has been
an issue in previous attempts to stop smoking.
Health professionals working in health promotion are well placed to help
patients understand the reasons for weight gain after smoking cessation
and to help them see the risk of weight gain compared to continuing to
smoke. They can help people find ways to limit weight gain and help with
weight loss when they stop smoking as part of optimising their health.
Table 3. Ideas for healthy snacks
Raw vegetable batons, such as carrot or
•
celery sticks, cherry tomatoes, mange tout,
baby corn, cucumber slices, red pepper,
broccoli or cauliflower florets. Try serving
with a low-fat dip such as salsa or tzatziki
Fresh fruit – whole or chopped, frozen
•
grapes
Plain popcorn or pretzels
•
A small handful of unshelled nuts, seeds,
•
olives or dried fruit
Yoghurt (low-fat plain or low-sugar versions)
•
Bread sticks, oatcakes, rice cakes or
•
crispbreads
A sachet of low-calorie hot chocolate drinks
•
or low-calorie soup
Sugar-free jelly
•
