Abstract
BackgroundMost epidemiological studies of calcium intake and mortality risk have been conducted in populations with moderate to high calcium intake, and limited studies have focused on populations with low habitual calcium intake (i.e., mean dietary calcium intake <700 mg/d).ObjectiveThis study investigated the association between dietary calcium intake and death from all causes and cardiovascular disease in Chinese population with low habitual calcium intake.DesignData from 3,139 Chinese men and women in a population-based prospective cohort study, aged >=65 years and free of heart diseases or stroke at baseline, were analyzed. Primary outcome measures, identified from the death registry, were death from all causes and cardiovascular disease. Dietary calcium intake assessed using a validated food frequency questionnaire was categorized into sex-specific quartiles. Data on use of supplemental calcium (yes or no) including individual calcium supplements and other calcium containing supplement were collected. Cox regression models adjusted for demographic and lifestyle variables were used to estimate hazard ratios (HRs) and 95% confidence intervals (CI). ResultsDuring a median of 9.1 years of follow-up, 529 all-cause deaths (344 men, 185 women) and 114 (74 men, 40 women) deaths from cardiovascular disease were identified. An inverse trend between dietary calcium intake and mortality was observed. Compared with the lowest quartile (<458 mg/d for men, <417 mg/d for women), the highest quartile of dietary calcium intake (>762 mg/d for men, >688 mg/d for women) had a significantly reduced risk of all-cause mortality (multivariate HR=0.63, 95% CI=0.49-0.81, P trend<0.001) but an insignificant decreased risk of cardiovascular mortality (multivariate HR=0.70, 95% CI=0.41-1.21, P trend=0.228). Similar inverse association was observed when the analyses were stratified on calcium supplemental use.ConclusionsHigher intake of dietary calcium was associated with reduced risk of all-cause mortality and possibly cardiovascular mortality in Chinese older people with low habitual calcium intake.
Highlights
Increasing calcium intake has been encouraged because of its beneficial effect on bone health
In the National Institutes of Health-American Association of Retired Persons (AARP) Diet and Health Study, supplemental calcium intake of more than 1,000 mg/day or total calcium intake of 1,500 mg/day and higher was associated with elevated total cardiovascular disease (CVD) mortality in men but not in women, whereas dietary calcium intake was not related to total CVD death in either sex [3]
High calcium intake may have a protective effect on mortality in populations, such as Chinese with comparatively low habitual calcium intake [5,6]
Summary
Increasing calcium intake has been encouraged because of its beneficial effect on bone health. The majority of the epidemiological studies examining the association between calcium intake and cardiovascular health have been conducted in White population with moderate to high calcium intake. Among these studies, only a few of them have examined calcium intake in relation to cardiovascular mortality as the study outcome [2]. Objective: This study investigated the association between dietary calcium intake and death from all causes and cardiovascular disease in Chinese population with low habitual calcium intake. Conclusions: Higher intake of dietary calcium was associated with reduced risk of all-cause mortality and possibly cardiovascular mortality in Chinese older people with low habitual calcium intake
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