Table 1 Summary of prospective studies that examined the association between calcium intake and risk of mortality
Study | Country | Number of participants | Age (years) | Endpoints (Number of cases) | Follow-up period and person timea | Calcium intake (mg/day) | Covariates in fully adjusted model | Quality score |
|---|---|---|---|---|---|---|---|---|
Chan et al. 2013, a cohort of older community-dwelling people [20] | China | 3,139 men and women | -65 | CVD mortality (114), all-cause mortality (529) | 9.1 years; 27,289 person years | Dietary calcium: M: <458, 458 to 584, 584 to 762, >762; W: <417, 417 to 529, 529 to 688, >688; Calcium supplement users versus nonusers | Age, smoking, sex, BMI, PASE, alcohol, education, history of diabetes and hypertension, energy intake, percentage of energy from total fat, percentage of energy from saturated fat, and calcium supplemental use | 7 |
Dai et al. 2013, SWHS [21] | China | 73,232 women | 40 to 70 | CVD mortality (1,147), all-cause mortality (3,806) | 11 years; 806,549 person years | Dietary calcium: <408, 408 to 600, ≥600 | Age, smoking, sex, BMI, physical activity, alcohol, education, marriage status, tea drinking, use of ginseng, use of calcium supplement, use of multivitamin, intakes of total energy, SFA, phosphorus, fiber, retinol, vitamin E, folic acid, sodium, potassium and zinc | 7 |
Dai et al. 2013, SMHS [21] | China | 61,414 men | 40 to 74 | CVD mortality (800), all-cause mortality (2,418) | 5.5 years; 336,984 person years | Dietary calcium: <408, 408 to 600, ≥600 | Same as above | 7 |
Langsetmo et al. 2013, CaMos [28] | Canada | 9,033 men and women | ≥25 | All-cause mortality (1,160) | 10 years; 77,558 person years | Dietary calcium: per 500 | Age, study center, education, BMI, health status, smoking, alcohol, physical activity, sun exposure, self-reported comorbidity (in men and women: hypertension, heart disease, stroke, type 2 diabetes, COPD, and kidney stones; in women only: osteoporosis, thyroid disease, IBD, breast cancer, and uterine cancer; in men only: prostate cancer), and medication (aspirin use or other NSAIDs) | 7 |
Michaëlsson et al. 2013, Swedish mammography cohort [22] | Sweden | 61,433 women | 39 to 74 | CVD mortality (3,862), all-cause mortality (11,944) | 19’years; 1,094,880 person years | Dietary calcium: <600, 600 to 999, 1,000 to 1,399, ≥1,400; any calcium users versus nonusers | Age, smoking, BMI, physical activity, total energy and vitamin D intake, a healthy dietary pattern, height, living alone, education, use of calcium-containing supplements, and Charlson’s comorbidity index | 8 |
Xiao et al. 2013, NIH-AARP study [23] | USA | 388,229 men and women | 50 to 71 | CVD mortality (11,778) | 12 years; 3,549,364 person years | Dietary calcium: M: 478, 616, 739, 898, 1,247 (medians); W: 408, 532, 648, 798, 1,101 (medians); Calcium supplement: 0, <400, 400 to 1,000, ≥1,000 | Age, BMI, smoking, race, physical activity, alcohol, education, marital status, health status, supplemental calcium intake, fruit and vegetable intake, red meat intake, whole grain intake, total fat intake, and total caloric intake, and use of menopausal hormone therapy (for women) | 8 |
Van Hemelrijck et al. 2013, NHANES III [24] | USA | 18,714 men and women | ≥17 | CVD mortality (1,870) | 18 years; 243,227 person years | Dietary calcium: <500, 500 to 1,000, 1,000 to 1,300, >1,300 | Age, smoking, BMI, sex, race/ethnicity, physical activity, alcohol, poverty to income ratio, comorbidity index, serum vitamin D, vigorous and total energy intake | 7 |
Li et al. 2012, Heidelberg Cohort [25] | German | 23,980 men and women | 35 to 64 | CVD mortality (267) | 11 years; 263,780 person years* | Dietary calcium: 513, 675, 820, 1,130 (medians); Calcium only users versus nonusers of supplements | Age, sex, smoking, BMI, physical activity, alcohol, education, history of diabetes, use of calcium supplements, and intakes of total energy, vitamin D, SFAs and total protein | 7 |
Mursu et al. 2011, IWHS [27] | USA | 38,772 women | 5 to 69 | CVD mortality (3,319) | 11 years; 228,085 person years | Calcium supplement use (yes/no) | Age, education, place of residence, diabetes mellitus, high blood pressure, BMI, waist to hip ratio, hormone replacement therapy, physical activity, smoking, and intake of energy, alcohol, saturated fatty acids, whole grain products, and fruits, and vegetables | 7 |
Kaluza et al. 2010, COSM [5] | Sweden | 23,366 men | 4 to 79 | CVD mortality (819), all-cause mortality (2,358) | 10 years; 224,206 person years | Dietary calcium: <1230, 1230 to 1598, ≥1599 | Age, smoking, physical activity, alcohol, marital status, education, health status, waist-to-hip ratio, energy-adjusted dietary fiber, SFA, vitamin D, and phosphorus intake | 7 |
Umesawa et al. 2006, JACC [18] | Japan | 21,068 men and 32,319 women | 4 to 79 | CVD mortality (800) | 9.6 years; 515,029 person years | Dietary calcium: M: 250, 363, 449, 536, 665 (medians); W: 266, 379, 462, 545, 667 (medians) | Age, smoking, BMI, alcohol, hypertension, diabetes, and intakes of total energy | 6 |
Van der Vijver et al. 1992, Civil Servants [26] | Netherlands | 1,340 men and 1,265 women | 4 to 65 | CVD mortality (NA), all-cause mortality (NA) | 28 years; 72,940 person years* | Dietary calcium: M: ≥585, 585 to 1245, >1245; W: ≥445, 445 to 850, >850 | Age, energy intake, systolic blood pressure | 5 |