Calcium Intake Is Negatively Associated with the Risk of CVD

by | Jun 4, 2024 | 2024, Calcium, Cardiovascular Health, Minerals, Recent Articles, Stroke, Women's Health

Written by Chrystal Moulton, Science Writer. In women more than 10 years post-menopause, researchers saw a significant negative association between calcium intake and the risk of cardiovascular diseases even after adjusting for both models of baseline characteristics.

calciumCalcium is essential for signal transmission, muscular contraction, bone density, and vascular tone; therefore, calcium is an essential nutrient for the human body1. Previous trials have already shown how crucial calcium is especially in post-menopausal women2,3. However, other studies have conflicting evidence demonstrating high intake of calcium could be associated with the risk of cardiovascular diseases while others showed no risk4-6. In the current trial, researchers investigated whether daily calcium intake was associated with cardiovascular risk in postmenopausal women7.

Researchers used data from the Korean National Health and Nutrition Examination Survey for this study. The study was designed as a large prospective cohort study. Data was analyzed between the years 2005 to 2021. The survey included 24-hour dietary recall and a food frequency questionnaire, nutritional and health examination, as well as a health interview. Women were excluded if: menopause was brought on by medical procedures; if they had menopause before 45 or after the age 70 years old; and if they had missing calcium intake data, thyroid dysfunction, end stage renal disease, or any other diseases that could alter calcium metabolism. Participants in the survey provided their medical history including any history of chest pain, myocardial infarction, and stroke. Researchers also recorded whether participants in the survey, if they were male, consumed more than 7 servings of alcohol twice weekly or, if they were female, consumed more than five servings of alcohol twice weekly. This is defined as high alcohol intake based on the Korean Ministry of Health and Welfare standards. Calcium intake was calculated based on foods consumed individually per day [based on the 24hr dietary recall]. With this information, researchers conducted a logistical regression analysis comparing the risk of cardiovascular disease based on different calcium intake levels: calcium > 400 mg/d, 400 < calcium < 800 mg/d, calcium > 800 mg/d. The odds ratios and the logistical regression model were assessed against two different models of baseline characteristics. Model 1 adjusted for age and model 2 adjusted for age, income, education, insulin usage, hypertension, this lipidemia, smoking, oral contraceptive use, hormonal therapy usage, menopausal age, urban area, BMI, Diabetes, high alcohol intake, and exercise. The risk of myocardial infarction, stroke, cardiovascular disease, and angina (chest pain) were assessed individually based on the three groups of dietary calcium intake. Also, an additional subgroup analysis was done according to postmenopausal duration (<10 years versus >10 years).

Total women that met the study criteria was 12,348. Of these women only 338 consumed more calcium per day than the 1200 mg/d recommended by the North American Menopause Society. No significant differences were observed in the ages at menopause between the three groups [calcium > 400 mg/d, 400 <calcium < 800 mg/d, calcium > 800 mg/d]. Researchers found that calcium intake was positively correlated with urban residence, income level, and educational level. Also, higher daily calcium intake was associated with physical exercise and lower alcohol consumption. According to logistical regression analysis, calcium intake between 400 and 800 mg/d was negatively associated with cardiovascular disease in the unadjusted model [OR= 0.75, P= 0.0071]. However, after adjusting for baseline characteristics in Model 1 and model 2, researchers found no significant association between CVD risk and calcium intake at any level. In a sub analysis, researchers compared years of menopause and calcium intake to the risk of cardiovascular disease. In this analysis, researchers found no significant association between calcium intake and the risk of cardiovascular disease among women in menopause less than 10 years. However, in women who have been in menopause more than 10 years, researchers saw a significant negative association between calcium intake and the risk of cardiovascular diseases even after adjusting for both models of baseline characteristics. See table one for details.

Table 1. Risk of CVD in women >10yrs post-menopause based on calcium intake after Model 2 Adjustment.

Calcium Intake All Stroke Angina Myocardial Infarction
Ca < 400mg 1 1 1 1
400mg< Ca <800mg OR= 0.67, p= 0.0714 OR= 0.59, p= 0.0817 OR= 0.80, p= 0.6911 OR= 0.61, p= 0.1564
>800mg OR= 0.27, p= 0.0029 OR= 0.06, p= 0.0050 OR= 0.28, p= 0.2444 OR= 0.27, p= 0.0029

 

Results from this analysis showed a significantly reduced risk of cardiovascular events including stroke and myocardial infarction when calcium intake exceeded 800 mg among women who have been postmenopausal for more than 10 years. Further studies will be needed to verify these results.

Source: Lee, Jae Kyung, Thi Minh Chau Tran, Euna Choi, Jinkyung Baek, Hae-Rim Kim, Heeyon Kim, Bo Hyon Yun, and Seok Kyo Seo. “Association between Daily Dietary Calcium Intake and the Risk of Cardiovascular Disease (CVD) in Postmenopausal Korean Women.” Nutrients 16, no. 7 (2024): 1043.

© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/
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Posted June 4, 2024.

Chrystal Moulton BA, PMP, is a 2008 graduate of the University of Illinois at Chicago. She graduated with a bachelor’s in psychology with a focus on premedical studies and is a licensed project manager. She currently resides in Indianapolis, IN.

References:

  1. Michos ED, Cainzos-Achirica M, Heravi AS, Appel LJ. Vitamin D, Calcium Supplements, and Implications for Cardiovascular Health: JACC Focus Seminar. J Am Coll Cardiol. Feb 2 2021;77(4):437-449. doi:10.1016/j.jacc.2020.09.617
  2. Cano A, Chedraui P, Goulis DG, et al. Calcium in the prevention of postmenopausal osteoporosis: EMAS clinical guide. Maturitas. Jan 2018;107:7-12. doi:10.1016/j.maturitas.2017.10.004
  3. Kim MK, Chon SJ, Noe EB, et al. Associations of dietary calcium intake with metabolic syndrome and bone mineral density among the Korean population: KNHANES 2008-2011. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. Jan 2017;28(1):299-308. doi:10.1007/s00198-016-3717-1
  4. Naghshi S, Naemi M, Sadeghi O, Darooghegi Mofrad M, Moezrad M, Azadbakht L. Total, dietary, and supplemental calcium intake and risk of all-cause cardiovascular, and cancer mortality: a systematic review and dose-response meta-analysis of prospective cohort studies. Crit Rev Food Sci Nutr. 2022;62(21):5733-5743. doi:10.1080/10408398.2021.1890690
  5. Yang C, Shi X, Xia H, et al. The Evidence and Controversy Between Dietary Calcium Intake and Calcium Supplementation and the Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis of Cohort Studies and Randomized Controlled Trials. J Am Coll Nutr. May-Jun 2020;39(4):352-370. doi:10.1080/07315724.2019.1649219
  6. Chae MJ, Jang JY, Park K. Association between dietary calcium intake and the risk of cardiovascular disease among Korean adults. Eur J Clin Nutr. May 2020;74(5):834-841. doi:10.1038/s41430-019-0525-7
  7. Lee JK, Tran TMC, Choi E, et al. Association between Daily Dietary Calcium Intake and the Risk of Cardiovascular Disease (CVD) in Postmenopausal Korean Women. Nutrients. Apr 3 2024;16(7)doi:10.3390/nu16071043