Takeaway
- Moderate dietary calcium intake may be beneficial against cardiovascular (CV) and all-cause mortality and incident stroke compared with low and high intakes.
- Calcium supplementation may be associated with decreased all-cause and CV mortality in women.
Why this matters
- Findings suggest that people with risk factors for stroke should be encouraged to meet the UK dietary calcium recommendations of ≥700 mg/day, but not exceed a higher limit of 1255 mg/day.
- Additionally, a moderate intake of dietary calcium (771-926 mg/day) may be a protective factor against mortality.
Study design
- Data from European Prospective Investigation into Cancer, Norfolk (EPIC-Norfolk) prospective population-based study were used to evaluate the association between calcium intake and mortality and CV disease (17,968 participants aged 40-79 years; median follow-up period, 20.36 years).
- Meta‑analysis of 27 prospective cohort studies including EPIC‑Norfolk study was performed, stratifying by average calcium intake using a 700 mg/day threshold.
- Funding: EPIC-Norfolk received funding from the Medical Research Council and Cancer Research UK.
Key results
- Compared with the first quintile of calcium intake (<770 mg/day), second (771-926 mg/day) and fourth quintiles (1074-1254 mg/day) were associated with decreased all-cause (adjusted HR [aHR], 0.91; 95% CI, 0.83-0.99 and 0.85; 95% CI, 0.77-0.93, respectively) and CV mortality (aHR, 0.79; 95% CI, 0.67-0.93 and 0.80; 95% CI, 0.67-0.95, respectively).
- No significant association was seen between the third (1074-1254 mg/day) and fifth (≥1255 mg/day) quintiles of calcium intake and all-cause and CV mortality.
- Compared with the first quintile of calcium intake, the second (aHR, 0.84; 95% CI, 0.72-0.97), third (aHR, 0.83; 95% CI, 0.71-0.97) and fourth (aHR, 0.78; 95% CI, 0.66-0.92), but not fifth (aHR, 0.95; 95% CI, 0.78-1.15), quintiles were associated with a lower rate of incident stroke.
- Meta-analysis revealed that higher calcium intake was associated with lower all-cause mortality in studies with low average calcium intake (<700 mg/day) (risk ratio [RR], 0.89; 95% CI, 0.80-0.99) and those with high average calcium intake (≥700 mg/day) (RR, 0.93; 95% CI, 0.89-0.98).
- Calcium supplementation was associated with lower all-cause (RR, 0.89; 95% CI, 0.87-0.91) and CV mortality (RR, 0.85; 95% CI, 0.77-0.94) in women, but not in men.
Limitations
- Risk for residual confounding.
This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.