Causal effects of dietary calcium, zinc and iron intakes on coronary artery disease in men: G-estimation and inverse probability of treatment weighting (IPTW) analyses

Basnet, Til Bahadur; Srijana, G C; Basnet, Rajesh; Neupane, Bidusha; Thapa, Goma

doi:10.1016/j.clnesp.2020.12.030

Cited by 6 publications

(2 citation statements)

References 27 publications

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“…Among healthy Japanese men and women aged 40–79 years, higher zinc intake was negatively associated with coronary heart disease mortality in men (HR = 0.68, 95% CI: 0.58–1.03; p trend = 0.05) but not in women (HR = 1.13, 95% CI: 0.71–1.49; p trend = 0.61) [ 21 ]. An assessment of dietary intake in 466 male participants at the Shahid Gangalal National Heart Centre found a significant inverse association between dietary zinc intake equal to or exceeding the recommended daily intake and coronary artery disease (OR in G-estimation method: 0.91; 95% CI: 0.87, 0.96; OR in IPTW: 0.73; 95% CI: 0.66, 0.82) [ 22 ]. In a study of postmenopausal women aged 55–69 years ( n = 34,492), dietary zinc intake was not associated with the risk of CVD mortality; however, the corresponding RRs for dietary zinc were 1.0, 0.61, 0.59, 0.57, and 0.37 among drinkers with 10 g/day of alcohol consumption ( p for trend 0.07).…”

Section: Discussionmentioning

confidence: 99%

Associations of Dietary Zinc–Vitamin B6 Ratio with All-Cause Mortality and Cardiovascular Disease Mortality Based on National Health and Nutrition Examination Survey 1999–2016

Zhang

et al. 2023

Nutrients

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Previous studies have suggested a possible association among dietary zinc and vitamin B6 intake and CVD mortality and all-cause mortality. However, evidence on the association of dietary zinc and vitamin B6 intake and their interactions with CVD mortality and all-cause mortality remains unclear. This prospective study utilized data from the US National Health and Nutrition Examination Survey (NHANES) from 1999 to 2016. After a median follow-up of 10.4 years, 4757 deaths were recorded among 36,081 participants. Higher dietary zinc intake levels (≥9.87 mg/day) were associated with lower CVD mortality (hazard ratio (HR) = 0.85, 95% confidence interval (CI): 0.83–0.87). Vitamin B6 intake levels (≥1.73 mg/day) were associated with lower CVD mortality (HR = 0.91, 95% CI: 0.86–0.96) and all-cause mortality (HR = 0.91, 95% CI: 0.90–0.93). Higher dietary zinc intake and higher vitamin B6 intake were associated with a lower risk of CVD mortality, with an interaction between dietary zinc intake levels and vitamin B intake levels (LZLV group (HR, CI): 1.21,1.12–1.29; LZHV group (HR, CI): 1.42, 1.34–1.50; LZHV group (HR, CI): 1.28, 1.14–1.45; HZHV group (HR, CI): ref). There was also a J-type association (p for nonlinear < 0.001) between the dietary zinc–vitamin B6 ratio and CVD mortality, with a high dietary zinc–vitamin B6 ratio increasing the risk of CVD mortality (HR = 1.27, 95% CI: 1.19–1.35), whereas a moderate dietary zinc–vitamin B6 ratio appeared to be beneficial for CVD mortality. These results suggest that increasing the appropriate proportion of dietary zinc and vitamin B6 intake is associated with a lower risk of CVD mortality. Furthermore, precise and representative studies are needed to verify our findings.

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Section: Discussionmentioning

confidence: 99%

Associations of Dietary Zinc–Vitamin B6 Ratio with All-Cause Mortality and Cardiovascular Disease Mortality Based on National Health and Nutrition Examination Survey 1999–2016

Zhang

et al. 2023

Nutrients

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“…Most of the previous studies have indicated that Zn plays a protective role in CVD. Dietary Zn has been found to be a protective nutrient against coronary artery disease in both Indians and Australians (17)(18)(19). According to the NHANES, after adjusting for covariates including demographics, comorbidities, renal function, and serum phosphorus levels, an increase in dietary Zn intake was independently associated with a lower probability of severe abdominal aortic calcification (AAC) (an increase of 1 mg daily dietary zinc intake was associated with an 8% lower probability of severe AAC) (20).…”

Section: Discussionmentioning

confidence: 99%

L-shaped association between dietary zinc intake and the risk of developing cardiovascular disease in Chinese adults: A cohort study

Zhang

Wang

et al. 2023

Front. Nutr.

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BackgroundAlthough the association of zinc (Zn) with cardiovascular disease (CVD) has been studied, no consensus has been reached on this relationship, particularly dietary Zn intake. The purpose of this study was to assess the effect of dietary Zn intake on the risk of CVD and to analyze whether this effect varied according to zinc consumption using representative data from China.Methods11,470 adults from the China Health and Nutrition Survey (CHNS) were eventually enrolled. The dietary information was collected by the 3 day 24-h dietary recalls combined with dietary weighting method. CVD was defined as participants with self-reported physician-diagnosed apoplexy and/or myocardial infarction during the follow-up. Cox regression was used to calculate the hazard ratios (HRs) of CVD with 95% confidence intervals. Restricted cubic spline function plus Cox regression was used to visualize the influence trend of dietary Zn intake on new-onset CVD and to test whether this trend is linear. 2-segment Cox regression was established to address the nonlinear trend.Results431 participants developed CVD, including 262 strokes and 197 myocardial infarctions. Compared with the lowest quintile (Q1), the adjusted hazard ratios and 95% confidence interval (CI) of CVD in Q2 to Q5 of dietary Zn intake were 0.72 (0.54, 0.97), 0.59 (0.42, 0.81), 0.50 (0.34, 0.72) and 0.44 (0.27, 0.71), respectively. The influence trend of dietary Zn intake on new-onset CVD was nonlinear and L-shaped. When dietary Zn intake <13.66 mg/day, increased dietary Zn intake was significantly associated with decreased risk of developing CVD (HR = 0.87, 95% CI: 0.82–0.92, p-value <0.0001).ConclusionAn L-shaped trend was observed between dietary Zn intake and the risk of developing CVD, indicating that dietary Zn intake should be improved moderately, but not excessively, for the benefit of cardiovascular disease.

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A non-traditional dietary pattern increases risk of coronary artery disease in the Nepalese population

Basnet

et al. 2022

Nutrition

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Causal effects of dietary calcium, zinc and iron intakes on coronary artery disease in men: G-estimation and inverse probability of treatment weighting (IPTW) analyses

Cited by 6 publications

References 27 publications

Associations of Dietary Zinc–Vitamin B6 Ratio with All-Cause Mortality and Cardiovascular Disease Mortality Based on National Health and Nutrition Examination Survey 1999–2016

Associations of Dietary Zinc–Vitamin B6 Ratio with All-Cause Mortality and Cardiovascular Disease Mortality Based on National Health and Nutrition Examination Survey 1999–2016

L-shaped association between dietary zinc intake and the risk of developing cardiovascular disease in Chinese adults: A cohort study

A non-traditional dietary pattern increases risk of coronary artery disease in the Nepalese population

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