Research Article | OPEN ACCESS
The Association of Calcium Intake and Other Risk Factors with Cardiovascular Disease among Obese Adults in USA
1Yang Chen, 2Sheryl Strasser, 1Katie Callahan, 1David Blackley, 1Yan Cao, 1Liang Wang and 1, 3Shimin Zheng
1Department of Biostatistics and Epidemiology, College of Public Health,
East Tennessee State University, Johnson City, TN 37604, USA
2School of Public Health, Georgia State University, Atlanta, GA, USA
3Department of Finance, Nanjing Audit University, Nanjing, P.R. China
Advance Journal of Food Science and Technology 2014 3:333-343
Received: September 24, 2013 | Accepted: October 26, 2013 | Published: March 10, 2014
Abstract
In this study, we used a cross-sectional study design to examine the relationship between the calcium intake and risk factors for CVD among obese adults by using continuous waves of National Health and Nutrition Examination Survey (NHANES) data 1999-2010. The association between calcium intake and risk factors of CVD (hypertension, total cholesterol, HDL, glycohemoglobin), CRP, albuminuria) is assessed among obese adults in USA. The incidence of Cardiovascular Disease (CVD) is high among obese people. The potential effects of inadequate calcium intake on CVD are receiving increased epidemiologic attention. Understanding the association between risk factors for CVD and calcium intake among obese adults is important for the advancement of CVD, nutrition and obesity research. Data collected from the National Health and Nutrition Examination Survey from 1999-2010 were examined, utilizing a subset of 14,856 obese subjects. Analysis of Variance statistical tests were conducted to determine associations between calcium intake and CVD risk. Simple and multiple linear and logistic regression analyses were conducted to determine the predicted value of calcium intake with CVD. After adjusting for energy intake and other potential risk factors, systolic blood pressure, diastolic blood pressure, C-reactive protein, glycosylated hemoglobin and albuminuria were negatively associated with calcium intake at &alpha = 0.05 level in both linear and logistic regression analyses. In a comparison of calcium intake by quartiles, results reveal that total cholesterol had a weak negative association with calcium intake at &alpha = 0.1 level. The implications of these study results are important as the importance of adequate calcium intake and its potential to decrease CVD among obese adults has incredible preventive value for populations. Additional research that focuses on dietary intake, calcium thresholds and impacts on total cholesterol levels in the body is warranted.
Keywords:
Blood pressure, calcium, cardiovascular, cholesterol, epidemiologic, hypertension, logistic regression, NHANES, obese, quartiles,
References
- Agricultural Research Service, Beltsville Human Nutrition Research Center, Food Surveys Research Group, Beltsville, MD, 2013. USDA Food and Nutrient Database for Dietary Studies 2.0. (Accessed on: March 6, 2013).
Direct Link -
Alberti, K.G., P. Zimmet and J. Shaw, 2005. IDF epidemiology task: Force consensus group. The metabolic syndrome: A new worldwide definition. Lancet, 366: 1059-1062.
CrossRef
-
Analytic Note Regarding, 2007. Analytic Note Regarding 2007-2010 Survey Design Changes and Combining Data Across other Survey Cycles, 2011. (Accessed on: March 6, 2013).
Direct Link
-
Bolland, M.J., P.A. Barber, R.N. Doughty, B. Mason, A. Horne, R. Ames, G.D. Gamble, A. Grey and I.R. Reid, 2008. Vascular events in healthy older women receiving calcium supplementation: Randomised controlled trial. BMJ, 336: 262-6.
CrossRef PMid:18198394 PMCid:PMC2222999
-
Bostick, R., L. Kushi, Y. Wu, K. Meyer, T. Sellers and A. Folsom, 1999. Relation of calcium, vitamin D and dairy food intake to ischemic heart disease mortality among postmenopausal women. Am. J. Epidemiol., 149: 151-161.
CrossRef PMid:9921960
-
Chalupka, S., 2012. Associations of dietary calcium intake and calcium supplementation with myocardial infarction, stroke and overall cardiovascular mortality. Workplace Health Saf., 60(8): 372.
CrossRef PMid:22850138
-
Chobanaian, A.V., G.L. Bakris, H.R. Black and W.C. Cushman, 2003. The seventh report of the joint national committee on prevention, detection, evaluation and intervention of high blood pressure: The JNC 7 Report. JAMA, 289: 2560-72.
CrossRef PMid:12748199
- Committee on Public Health Priorities to Reduce and Control Hypertension in the U.S. Population, Institute of Medicine, 2010. A Population-based Policy and Systems Change Approach to Prevent and Control Hypertension. National Academies Press, Washington, DC.
- Cooney, M.T., A. Dudina, D. De Bacquer, L. Wilhelmsen, S. Sans and A. Menotti, 2009. HDL cholesterol protects against cardiovascular disease in both genders, at all ages and at all levels of risk. Atherosclerosis, 206: 611-6.
CrossRef PMid:19375079
- Effectiveness of Health Communication Campaigns That Include Mass Media and Health-Related Product Distribution, 2013. Community Guide News. The Community Guide. (Accessed on: March 6, 2013).
Direct Link
-
Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults, 2001. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation and treatment of high blood cholesterol in adults (Adult treatment panel III). JAMA, 285: 2486-2497.
CrossRef PMid:11368702
- Finkelstein, E.A., J.G. Trogdon, J.W. Cohen and W. Dietz, 2009. Annual medical spending attributable to obesity: Payer-and service-specific estimates. Health Affair., 28(5): w822-w831.
CrossRef PMid:19635784
- Friões, F., A. Azevedo and A. Castro, 2003. Impact of cardiovascular risk factors in an urban sample of Portuguese adults according to the Framingham risk prediction models. Rev. Port. Cardiol., 22(4): 511-520.
PMid:12879643
-
Frohlich, E.D., C. Grimm, D.R. Labarthe, M.H. Maxwell, D. Perloff and W.H. Weidman, 1988. Recommendations for human blood pressure measurement by sphygmomanometer. Hypertension, 11: 210A-222A.
-
Gerstein, H.C., J.F. Mann, Q. Yi, B. Zinman, S.F. Dinneen and B. Hoogwerf, 2001. Albuminuria and risk of cardiovascular events, death and heart failure in diabetic and nondiabetic individuals. JAMA, 286: 421-6.
CrossRef PMid:11466120
-
Goran, M.I., G.D. Ball and M.L. Cruz, 2003. Obesity and risk of type 2 diabetes and cardiovascular disease in children and adolescents. J. Clin. Endocrinol. Metab., 88(4): 1417-1427.
CrossRef PMid:12679416
-
Hansen, M.L., P.W. Gunn and D.C. Kaelber, 2007. Underdiagnosis of hypertension in children and adolescents. JAMA, 298(8): 874-9.
CrossRef PMid:17712071
- Heart Disease Conditions, 2012. Heart Disease. Centers for Disease Control and Prevention. (Accessed on: March 6, 2013).
Direct Link
- Hillege, H.L., V. Fidler, G.F. Diercks, W.H. van Gilst, D. de Zeeuw and D.J. van Veldhuisen, 2002. Urinary albumin excretion predicts cardiovascular and noncardiovascular mortality in general population. Circulation, 106: 1777-1782.
CrossRef PMid:12356629
- Hypertension Care Strategies: Closing the Quality Gap, 2004. Agency for Healthcare Research and Quality, Rockville, MD. (Accessed on: March 6, 2013).
Direct Link
- Kearney, P.M., M. Whelton and K. Reynolds, 2005. Global burden of hypertension: Analysis of worldwide data. Lancet, 365: 217.
CrossRef
-
Khaw, K.T., N. Wareham, S. Bingham, R. Luben, A. Welch and N. Day, 2004. Association of hemoglobin A1c with cardiovascular disease and mortality in adults: The European prospective investigation into cancer in Norfolk. Ann. Intern. Med., 141: 413-420.
CrossRef PMid:15381514
-
Kochanek, K.D., J.Q. Xu, S.L. Murphy, A.M. Miniño and H.C. Kung, 2011. Deaths: Final data for 2009. National Vital Statistics Reports, 60(3).
PMid:24974587
-
Lawes, C.M., S. Vander Hoorn, M.R. Law, P. Elliott, S. MacMahon and A. Rodgers, 2006. Blood pressure and the global burden of disease 2000. Part II: Estimates of attributable burden. J. Hypertens., 24: 423-430.
CrossRef PMid:16467640
-
Leading Causes of Death, 2013. Centers for Disease Control and Prevention. (Accessed on: March 6, 2013).
Direct Link
-
Liu, S., Y. Song, E.S. Ford, J.E. Manson, J.E. Buring and P.M. Ridker, 2005. Dietary calcium, vitamin d and the prevalence of metabolic syndrome in middle-aged and older U.S. women. Diabetes Care, 28(12): 2926-2932.
CrossRef PMid:16306556
- McCarron, D.A. and R.P. Heaney, 2004. Estimated healthcare savings associated with adequate dairy food intake. Am. J. Hypertens., 17(1): 88-97.
CrossRef PMid:14700520
- Micronutrients/Minerals, 2013. Rthomolecular. org. (Accessed on: March 6, 2013).
Direct Link
-
Misteli, L., 2012. Community-based Nutrition Education Shown to be Successful in Increasing Calcium Intake. (Accessed on: March 6, 2013).
Direct Link
- Moshfegh, A.J., D. Baer, L. Cleveland, D. Rhodes, R. Sebastian, R. Staples, K. Kuczynski, D. Paul, J. Clemens, W. Rumpler and J. Judd, 2003. Validation of reported energy intakes in 24-hour dietary recalls using USDA automated multiple-pass method. FASEB J., 17(4): A281.
- National Center for Health Statistics, 1992. Sample design: Third national health and nutrition examination survey. Vital Health Stat. 1, 113: 2-18.
- National Center for Health Statistics, 2008. The National Health and Nutrition Examination Survey (NHANES) 2001-2006 Data Files. (Accessed on: March 6, 2013).
Direct Link
-
National Health and Nutrition Examination Survey, 1999. Exam Procedures Manual. (Accessed on: March 6, 2013).
Direct Link
- National Health and Nutrition Examination Survey, 2004. Exam Procedures Manual. (Accessed on: March 6, 2013).
Direct Link
-
Nestle, M. and M.C. Nesheim, 2013. To supplement or not to supplement: The U.S. preventive services task force recommendations on calcium and vitamin D. Ann. Intern. Med., 158(9): 701-702.
CrossRef PMid:23440174
- Osborne, C.G., R.B. McTyre and J. Dudek, 1996. Evidence for the relationship of calcium to blood pressure. Nutr. Rev., 54: 365-381.
CrossRef PMid:9155209
- Overweight and Obesity, 2012. Centers for Disease Control and Prevention. (Accessed on: March 6, 2013).
Direct Link
- Pearson, T.A., G.A. Mensah, R.W. Alexander, J.L. Anderson, R.O. Cannon 3rd and M. Criqui, 2003. Markers of inflammation and cardiovascular disease: Application of clinical and public health practice: A statementfor healthcare professionals from the centers for disease control and prevention and the american heart association. Circulation, 107: 499-511.
CrossRef PMid:12551878
- Peterlik, M. and H.S. Cross, 2005. Vitamin D and calcium deficits predispose for multiple chronic diseases. Eur. J. Clin. Invest., 35(5): 290-304.
CrossRef PMid:15860041
- Romero-Corral, A., J. Sierra-Johnson, F. Lopez-Jimenez, R.J. Thomas, P. Singh and M. Michal Hoffmann, 2008. Relationships between leptin and C-reactive protein with cardiovascular disease in the adult general population. Nat. Rev. Cardiol., 5: 418-425.
CrossRef PMid:18431365
- Samelson, E.J., S.L. Booth and C.S. Fox, 2012. Calcium intake is not associated with increased coronary artery calcification: The Framingham Study. Am. J. Clin. Nutr., 11: 7.
CrossRef
- Sigal, E.A., J. Xu, C. Loria, C. Mattil, U. Goldbourt, B.V. Howard and H.E. Resnick, 2007. Dietary Calcium is associated with body mass index and body fat in American Indians at American society for nutrition. J. Nutr., 137(8): 1955-1960.
CrossRef PMid:17634270 PMCid:PMC4182955
-
Soares, P.A., C. Kovacs and P. Moreira, 2012. Is intake of vitamin D and calcium important for cardiovascular health in elderly obese patients? Obes. Surg., 22(3): 437-444.
CrossRef PMid:22246394
- Stamler, J., O. Vaccaro, J.D. Neaton and D. Wentworth, 1993. Diabetes, other risk factors and 12-yr cardiovascular mortality for men screened in the multiple risk factor intervention trial. Diabetes Care, 16: 434-444.
CrossRef PMid:8432214
- Stanton, M., 2006. Research in Action, Issue 19. The High Concentration of U.S. Health Care Expenditures. Agency for Healthcare Research and Quality. (Accessed on: March 6, 2013).
Direct Link
-
The National Health and Nutrition Examination Survey Analytic and Reporting Guidelines, 2006. The National Health and Nutrition Examination Survey (NHANES). (Accessed on: March 6, 2013).
Direct Link
- Wakimoto, P. and G. Block, 2001. Dietary intake, dietary patterns and changes with age: An epidemiological perspective. J. Gerontol. A-Biol., 56A(Special Issue II): 65-80.
- Wang, L., J.E. Manson and H.D. Sesso, 2012. Calcium intake and risk of cardiovascular disease: A review of prospective studies and randomized clinical trials. Am. J. Cardiovasc. Drugs, 12(2): 105-116.
CrossRef PMid:22283597 PMCid:PMC3336363
-
Weaver, C.M., 1998. Calcium in food fortification strategies. Int. Dairy J., 8(5-6): 443-449.
CrossRef
- Witte, K., A.L. Clark and J. Cleland, 2001. Chronic heart failure and micronutrients. J. Am. Coll. Cardiol., 37(7): 1765-1774.
CrossRef
Competing interests
The authors have no competing interests.
Open Access Policy
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Copyright
The authors have no competing interests.
|
|
![](http://www.maxwellsci.com/images/AJFST-maxw.jpg) |
ISSN (Online): 2042-4876
ISSN (Print): 2042-4868 |
![Submit Manuscript](../images/sub.jpg) |
Information |
|
|
|
Sales & Services |
|
|
|