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Higher Dietary Calcium Intakes Are Associated With Reduced Risks of Fractures, Cardiovascular Events, and Mortality: A Prospective Cohort Study of Older Men and Women
Author(s) -
Khan Belal,
Nowson Caryl A,
Daly Robin M,
English Dallas R,
Hodge Allison M,
Giles Graham G,
Ebeling Peter R
Publication year - 2015
Publication title -
journal of bone and mineral research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.882
H-Index - 241
eISSN - 1523-4681
pISSN - 0884-0431
DOI - 10.1002/jbmr.2515
Subject(s) - medicine , quartile , hazard ratio , prospective cohort study , cohort , cohort study , odds ratio , confidence interval , stroke (engine) , population , osteoporosis , surgery , environmental health , engineering , mechanical engineering
The aim of this population‐based, prospective cohort study was to investigate long‐term associations between dietary calcium intake and fractures, non‐fatal cardiovascular disease (CVD), and death from all causes. Participants were from the Melbourne Collaborative Cohort Study, which was established in 1990 to 1994. A total of 41,514 men and women (∼99% aged 40 to 69 years at baseline) were followed up for a mean (SD) of 12 (1.5) years. Primary outcome measures were time to death from all causes ( n = 2855), CVD‐related deaths ( n = 557), cerebrovascular disease‐related deaths ( n = 139), incident non‐fatal CVD ( n = 1827), incident stroke events ( n = 537), and incident fractures ( n = 788). A total of 12,097 participants (aged ≥50 years) were eligible for fracture analysis and 34,468 for non‐fatal CVD and mortality analyses. Mortality was ascertained by record linkage to registries. Fractures and CVD were ascertained from interview ∼13 years after baseline. Quartiles of baseline energy‐adjusted calcium intake from food were estimated using a food‐frequency questionnaire. Hazard ratios (HR) and odds ratios (OR) were calculated for quartiles of dietary calcium intake. Highest and lowest quartiles of energy‐adjusted dietary calcium intakes represented unadjusted means (SD) of 1348 (316) mg/d and 473 (91) mg/d, respectively. Overall, there were 788 (10.3%) incident fractures, 1827 (9.0%) incident CVD, and 2855 people (8.6%) died. Comparing the highest with the lowest quartile of calcium intake, for all‐cause mortality, the HR was 0.86 (95% confidence interval [CI] 0.76–0.98, p trend = 0.01); for non‐fatal CVD and stroke, the OR was 0.84 (95% CI 0.70–0.99, p trend = 0.04) and 0.69 (95% CI 0.51–0.93, p trend = 0.02), respectively; and the OR for fracture was 0.70 (95% CI 0.54–0.92, p trend = 0.004). In summary, for older men and women, calcium intakes of up to 1348 (316) mg/d from food were associated with decreased risks for fracture, non‐fatal CVD, stroke, and all‐cause mortality. © 2015 American Society for Bone and Mineral Research.