title: Higher Dietary Calcium Intakes Are Associated With Reduced Risks of Fractures, Cardiovascular Events, and Mortality: A Prospective Cohort Study of Older Men and Women.
abstract: 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.
authors.affiliation: NorthWest Academic Centre, The University of Melbourne, Western Health, St. Albans, Australia.
authors.forename: Belal
authors.initials: B
authors.lastname: Khan
authors.affiliation: School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia.
authors.forename: Caryl A
authors.initials: CA
authors.lastname: Nowson
authors.affiliation: NorthWest Academic Centre, The University of Melbourne, Western Health, St. Albans, Australia.|School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia.
authors.forename: Robin M
authors.initials: RM
authors.lastname: Daly
authors.affiliation: Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.|Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia.
authors.forename: Dallas R
authors.initials: DR
authors.lastname: English
authors.affiliation: Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia.
authors.forename: Allison M
authors.initials: AM
authors.lastname: Hodge
authors.affiliation: Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.|Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia.
authors.forename: Graham G
authors.initials: GG
authors.lastname: Giles
authors.affiliation: NorthWest Academic Centre, The University of Melbourne, Western Health, St. Albans, Australia.|Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Australia.
authors.forename: Peter R
authors.initials: PR
authors.lastname: Ebeling
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D002136:Calcium, Dietary / Q000008:administration & dosage*; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000517:prevention & control*; D005260:Female; D050723:Fractures, Bone / Q000401:mortality* / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors
chemical_list: D002136:Calcium, Dietary
keywords: CARDIOVASCULAR DISEASES; DIETARY CALCIUM; EPIDEMIOLOGICAL STUDY; FRACTURE PREVENTION; MORTALITY; STROKE