scholarly journals Calcium intake, calcium supplementation and cardiovascular disease and mortality in the British population: EPIC-norfolk prospective cohort study and meta-analysis

Author(s):  
Tiberiu A. Pana ◽  
Mohsen Dehghani ◽  
Hamid Reza Baradaran ◽  
Samuel R. Neal ◽  
Adrian D. Wood ◽  
...  

AbstractThe role of dietary calcium in cardiovascular disease prevention is unclear. We aimed to determine the association between calcium intake and incident cardiovascular disease and mortality. Data were extracted from the European Prospective Investigation of Cancer, Norfolk (EPIC-Norfolk). Multivariable Cox regressions analysed associations between calcium intake (dietary and supplemental) and cardiovascular disease (myocardial infarction, stroke, heart failure, aortic stenosis, peripheral vascular disease) and mortality (cardiovascular and all-cause). The results of this study were pooled with those from published prospective cohort studies in a meta-analsyis, stratifying by average calcium intake using a 700 mg/day threshold. A total of 17,968 participants aged 40–79 years were followed up for a median of 20.36 years (20.32–20.38). Compared to the first quintile of calcium intake (< 770 mg/day), intakes between 771 and 926 mg/day (second quintile) and 1074–1254 mg/day (fourth quintile) were associated with reduced all-cause mortality (HR 0.91 (0.83–0.99) and 0.85 (0.77–0.93), respectively) and cardiovascular mortality [HR 0.95 (0.87–1.04) and 0.93 (0.83-1.04)]. Compared to the first quintile of calcium intake, second, third, fourth, but not fifth quintiles were associated with fewer incident strokes: respective HR 0.84 (0.72–0.97), 0.83 (0.71–0.97), 0.78 (0.66–0.92) and 0.95 (0.78–1.15). The meta-analysis results suggest that high levels of calcium intake were associated with decreased all-cause mortality, but not cardiovascular mortality, regardless of average calcium intake. Calcium supplementation was associated with cardiovascular and all-cause mortality amongst women, but not men. Moderate dietary calcium intake may protect against cardiovascular and all-cause mortality and incident stroke. Calcium supplementation may reduce mortality in women.

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2623
Author(s):  
Chengyao Tang ◽  
Xiaowen Wang ◽  
Li-Qiang Qin ◽  
Jia-Yi Dong

The association of the Mediterranean diet (MD) with mortality among people with a history of cardiovascular disease (CVD) has not been systematically examined. Hereby, our objective was to investigate the association of MD with all-cause and cardiovascular mortality in people with a history of CVD. We searched five electronic databases including Embase, PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials to screen eligible studies published before 31 August 2020. A random-effect model was used to examine the association of a 2-unit increment in MD score with the risk of all-cause and cardiovascular mortality. We conducted sensitivity and subgroup analyses and examined potential publication bias by Egger’s and Begg’s tests. Seven cohort studies (eight datasets) with a total of 37,879 participants who had a history of CVD were eligible for the main analysis. The pooled hazard ratios were 0.85 (95% CIs: 0.78–0.93; n = 8) for all-cause mortality and 0.91 (95% CIs; 0.82–1.01; n = 4) for cardiovascular mortality for each 2-unit increment in a score of adherence to MD. Subgroup analyses for all-cause mortality showed that the association appeared relatively stronger in Mediterranean areas (HR = 0.76 [0.69–0.83]) than non-Mediterranean areas (HR = 0.95 [0.93–0.98]) and in studies with a shorter duration (HR = 0.75 [0.66–0.84] for <7 years vs. HR = 0.94 [0.91–0.98] for ≥7 years). No evidence of publication bias was observed. The present meta-analysis of prospective cohort studies provided evidence that adherence to MD improved survival in people with a history of CVD.


2020 ◽  
Vol 11 (4) ◽  
pp. 790-814 ◽  
Author(s):  
Mei Chung ◽  
Naisi Zhao ◽  
Deena Wang ◽  
Marissa Shams-White ◽  
Micaela Karlsen ◽  
...  

ABSTRACT Tea flavonoids have been suggested to offer potential benefits to cardiovascular health. This review synthesized the evidence on the relation between tea consumption and risks of cardiovascular disease (CVD) and all-cause mortality among generally healthy adults. PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, Food Science and Technology Abstracts, and Ovid CAB Abstract databases were searched to identify English-language publications through 1 November 2019, including randomized trials, prospective cohort studies, and nested case-control (or case-cohort) studies with data on tea consumption and risk of incident cardiovascular events (cardiac or peripheral vascular events), stroke events (including mortality), CVD-specific mortality, or all-cause mortality. Data from 39 prospective cohort publications were synthesized. Linear meta-regression showed that each cup (236.6 mL)  increase in daily tea consumption (estimated 280 mg  and 338 mg  total flavonoids/d for black and green tea, respectively) was associated with an average 4% lower risk of CVD mortality, a 2% lower risk of CVD events, a 4% lower risk of stroke, and a 1.5% lower risk of all-cause mortality. Subgroup meta-analysis results showed that the magnitude of association was larger in elderly individuals for both CVD mortality (n = 4; pooled adjusted RR: 0.89; 95% CI: 0.83, 0.96; P = 0.001), with large heterogeneity (I2 = 72.4%), and all-cause mortality (n = 3; pooled adjusted RR: 0.92; 95% CI: 0.90, 0.94; P &lt; 0.0001; I2 = 0.3%). Generally, studies with higher risk of bias appeared to show larger magnitudes of associations than studies with lower risk of bias. Strength of evidence was rated as low and moderate (depending on study population age group) for CVD-specific mortality outcome and was rated as low for CVD events, stroke, and all-cause mortality outcomes. Daily tea intake as part of a healthy habitual dietary pattern may be associated with lower risks of CVD and all-cause mortality among adults.


2013 ◽  
Vol 2013 ◽  
pp. 1-8
Author(s):  
Gábor Speer ◽  
Pál Szamosujvári ◽  
Péter Dombai ◽  
Katalin Csóré ◽  
Kinga Mikófalvi ◽  
...  

Purpose. Adequate calcium intake is the basis of osteoporosis therapy—when this proves insufficient, even specific antiosteoporotic agents cannot exert their actions properly.Methods. Our representative survey analyzed the dietary intake and supplementation of calcium in 8033 Hungarian female and male (mean age: 68 years) (68.01 (CI95: 67.81–68.21)) patients with osteoporosis.Results. Mean intake from dietary sources was665±7.9 mg (68.01 (CI95: 67.81–68.21)) daily. A significant positive relationship could be detected between total dietary calcium intake and lumbar spine BMD (P=0.045), whereas such correlation could not be demonstrated with femoralT-score. Milk consumption positively correlated with femur (P=0.041), but not with lumbar BMD. The ingestion of one liter of milk daily increased theT-score by 0.133. Average intake from supplementation was558±6.2 mg (68.01 (CI95: 67.81–68.21)) daily. The cumulative dose of calcium—from both dietary intake and supplementation—was significantly associated with lumbar (r=0.024,P=0.049), but not with femur BMD (r=0.021,P=0.107). The currently recommended 1000–1500 mg total daily calcium intake was achieved in 34.5% of patients only. It was lower than recommended in 47.8% of the cases and substantially higher in 17.7% of subjects.Conclusions. We conclude that calcium intake in Hungarian osteoporotic patients is much lower than the current recommendation, while routinely applied calcium supplementation will result in inappropriately high calcium intake in numerous patients.


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