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Epidemiology

Association between dietary calcium intake and the risk of cardiovascular disease among Korean adults

European Journal of Clinical Nutrition volume 74, pages 834–841 (2020)Cite this article

Subjects

Abstract

Background/Objectives

Although dietary calcium intake is associated with a risk of cardiovascular disease (CVD), it has not been studied extensively in Asian populations. We therefore investigated the association between dietary calcium intake and CVD among Korean adults and the effect of obesity on this association.

Subjects/Methods

In total, 9186 participants were included in the analysis after excluding 844 with prevalent CVD/cancer or implausible energy intake. Nutrient intake, including dietary calcium, was estimated using a validated semi-quantitative food frequency questionnaire. CVD included myocardial infarction, coronary artery disease, and stroke per the World Health Organization criteria. Cox proportional hazards models were used to calculate multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs).

Results

In the fully adjusted model, HRs of CVD across increasing quintiles of dietary calcium intake were 1.0 (reference), 0.85 (95% CI: 0.66–1.10), 0.77 (95% CI: 0.58–1.02), 0.59 (95% CI: 0.42–0.83), and 0.72 (95% CI: 0.48–1.08); a significant linear trend was detected (p for trend = 0.04). However, this association varied according to the obesity status. High dietary calcium intake was associated with a reduced CVD risk among nonobese participants (body mass index [BMI] < 25 kg/m2; p for trend = 0.02), whereas this was not significant among obese participants (BMI ≥ 25 kg/m2; p for trend = 0.88).

Conclusions

The association between dietary calcium intake and incident CVD may be influenced by obesity status. We provide evidence for developing dietary calcium intake guidelines for Koreans, allowing for the effects of obesity.

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Acknowledgements

Data in this study were derived from the Korean Genome and Epidemiology Study, National Research Institute of Health, Centers for Disease Control and Prevention, Ministry of Health and Welfare, Republic of Korea.

Funding

This research was supported by the 2019 Yeungnam University Research Grant and by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (grant number: NRF-2017R1A1A3A04069759).

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Authors and Affiliations

  1. Department of Food and Nutrition, Yeungnam University, Gyeongsan, Gyeongbuk, 38541, Republic of Korea

    M. J. Chae, J. Y. Jang & K. Park

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Contributions

MJC and JYJ conducted the analysis and drafted the paper; KP supervised the analysis, contributed to the discussion, and edited the paper.

Corresponding author

Correspondence to K. Park.

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Chae, M.J., Jang, J.Y. & Park, K. Association between dietary calcium intake and the risk of cardiovascular disease among Korean adults. Eur J Clin Nutr 74, 834–841 (2020). https://doi.org/10.1038/s41430-019-0525-7

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