Published Online
on December 8, 2005

A more recent version of this article appeared on January 1, 2006

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Submitted on August 4, 2005
Revised on October 19, 2005
Accepted on October 31, 2005

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.

^* To whom correspondence should be addressed. 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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