Abstract

Introduction: Several studies have linked cardiovascular disease (CVD) to dietary intake of a few minerals, although the link is still unclear, and the findings may not apply to various populations. In a prospective study in a Middle Eastern population, we aimed to assess the relationship between dietary intakes of calcium, selenium, zinc, iron, magnesium, and copper and the risk of CVD mortality. Methods: We used data from the Golestan Cohort Study, which has followed 50,045 participants aged 40-75 years since 2004. We excluded subjects reporting extreme intakes of total energy and a positive history of cancer, CVD, or diabetes at baseline. Mineral intake was estimated from the baseline food frequency questionnaire. Supplement use was not common in this population. Mineral intakes were adjusted by the nutrient density method. We used Cox proportional hazards models to estimate hazards ratio (HR) and 95% confidence intervals (CI) for cardiovascular mortality using the lowest quintile of intake as a reference group for each mineral with adjustment for potential confounders. Results: We analyzed 41,863 subjects that had a mean age of 51.5+8.7 years at baseline . During 579,339 person-years of follow-up (median: 14.1 Years), 3,065 (7.22%) participants died due to CVD. Calcium was the only mineral with a mean intake below the US Recommended Dietary Allowance. We observed significant associations between calcium intake (HR Q5 vs Q1 =0.82, 95% CI=0.73-0.93), selenium intake (HR Q5 vs Q1 =1.14, 95% CI=1.01-1.29), and CVD mortality (P-values <0.05). We observed no statistically significant associations with zinc (HR Q5 vs Q1 =1.10, 95% CI=0.98-1.24), iron (HR Q5 vs Q1 =1.08, 95% CI=0.96-1.22), magnesium (HR Q5 vs Q1 =1.01, 95% CI=0.90-1.14), or copper (HR Q5 vs Q1 =1.11, 95% CI=0.99-1.26) intake and CVD mortality. When modeled as continuous linear variables, iron and copper intake were associated greater risk of CVD mortality (P-values<0.05). Conclusion: Dietary calcium intake was associated with decreased, whereas selenium and possibly copper intake were associated with increased risk of CVD mortality in this Middle Eastern population.

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