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Stroke. 2006;37:20-26
Published online before print December 8, 2005, doi: 10.1161/01.STR.0000195155.21143.38
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(Stroke. 2006;37:20.)
© 2006 American Heart Association, Inc.


Original Contributions

Dietary Intake of Calcium in Relation to Mortality From Cardiovascular Disease

The JACC Study

Mitsumasa Umesawa, MD; Hiroyasu Iso, MD; Chigusa Date, MD; Akio Yamamoto, MD; Hideaki Toyoshima, MD; Yoshiyuki Watanabe, MD; Shogo Kikuchi, MD; Akio Koizumi, MD; Takaaki Kondo, MD; Yutaka Inaba, MD; Naohito Tanabe, MD; Akiko Tamakoshi, MD JACC Study Group

From the Department of Public Health Medicine (M.U., H.I.), Doctoral Program in Social and Environmental Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Japan; Department of Social and Environmental Medicine (H.I.), Graduate School of Medicine, Osaka University, Japan; Department of Food Sciences and Nutrition (C.D.), Faculty of Human Life and Environment, Nara Women’s University, Kitauoyanishi-machi, Japan; Infectious Disease Research Division (A.Y., T.K.), Hyogo Prefectural Institute of Public Health and Environmental Sciences, Japan; Department of Public Health/Health Information Dynamics (H.T.), Fields of Science, Program of Health and Community Medicine, Nagoya University Graduate School of Medicine, Japan; Department of Epidemiology for Community Health and Medicine (Y.W.), Kyoto Prefectural University of Medicine Graduate School of Medical Science, Japan; Department of Public Health (S.K.), Aichi Medical University, Japan; Department of Health and Environmental Sciences (A.K.), Graduate School of Medicine, Kyoto University, Japan; Department of Epidemiology and Environmental Health (Y.I.), Juntendo University of Medicine, Japan; Department of Community Preventive Medicine (N.T.), Niigata University Graduate School of Medicine and Dental Sciences, Japan; and Department of Preventive Medicine/Biostatistics and Medical Decision Making (A.T.), Field of Social Science, Program in Health and Community Medicine, Nagoya University Graduate School of Medicine, Japan.

Correspondence to Hiroyasu Iso, MD, Professor, Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Osaka-fu 565-0871, Japan. E-mail fvgh5640{at}mb.infoweb.ne.jp

Background and Purpose— No prospective studies have examined the association between calcium intake and the risk of cardiovascular disease in Japanese populations with a low mean calcium intake.

Methods— Between 1988 and 1990, 110 792 Japanese subjects (46 465 men and 64 327 women) 40 to 79 years of age without a history of stroke, coronary heart disease, or cancer, completed a lifestyle questionnaire including food intake frequency under the Japan Collaborative Cohort (JACC) Study for Evaluation of Cancer Risk Sponsored by Monbusho. By the end of 1999, after 515 029 person years of follow-up, 566 deaths from stroke (101 subarachnoid hemorrhages, 140 intraparenchymal hemorrhages, and 273 ischemic strokes) and 234 deaths from coronary heart disease had been documented.

Results— The intake of total calcium tended to be inversely associated with mortality from total stroke but not from coronary heart disease or total cardiovascular disease for men and women. The inverse association with dairy calcium intake was apparent for total stroke, both hemorrhagic and ischemic. The multivariate relative risk for men with highest versus lowest quintiles of dairy calcium intake was 0.53 (95% CI, 0.34 to 0.81) for total stroke, 0.46 (0.23 to 0.91) for hemorrhagic stroke, and 0.53 (0.29 to 0.99) for ischemic stroke; corresponding relative risks for women were 0.57 (0.38 to 0.86), 0.51 (0.28 to 0.94), and 0.50 (0.27 to 0.95).

Conclusions— Dietary calcium intake from dairy products was associated with reduced mortality from stroke for Japanese men and women.


Key Words: calcium • follow-up studies • mortality • stroke




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