Dietary calcium and magnesium intake in relation to cancer incidence and mortality in a German prospective cohort (EPIC-Heidelberg)

Abstract

To prospectively evaluate the associations of dietary calcium and magnesium intake with cancer incidence and mortality, data of 24,323 participants of the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Heidelberg), who were aged 35-64 years and cancer-free at recruitment (1994)(1995)(1996)(1997)(1998), were analyzed using multivariate Cox regression models. After an average follow-up time of 11 years, 2,050 incident cancers were diagnosed and 513 cancer deaths occurred. Dietary calcium intake was inversely but not statistically significantly associated with colorectal cancer risk (hazard ratio [HR] for per 100 mg increase in intake: 0.95; 95% confidence interval [CI]: 0.88, 1.02) and lung cancer risk (HR for per 100 mg increase in intake: 0.94; 95% CI: 0.87, 1.02). No statistically significant associations were observed between dietary calcium intake and site-specific or overall cancer incidence or mortality. Dietary magnesium intake was not statistically significantly associated with any of the investigated outcomes. This prospective cohort study provides no strong evidence to support that high dietary calcium and magnesium intake in the intake range observed in a German population may reduce cancer incidence or mortality. To prospectively evaluate the association of dietary calcium and magnesium intake with 2 cancer incidence and mortality and all-cause mortality, the authors analyzed data of 3 24,323 participants of the Heidelberg cohort of the European Prospective Investigation 4 into Cancer and Nutrition (EPIC-Heidelberg), who were aged 35-64 years and cancer-5 free at recruitment stage (1994)(1995)(1996)(1997)(1998), using multivariate Cox regression models. After an 6 average follow-up time of 11 years, 2,050 incident cancers were diagnosed and 513 7 cancer deaths occurred (all-cause deaths = 1,161). Dietary calcium intake was inversely 8 but not statistically significantly associated with colorectal cancer risk (hazard ratio (HR) 9for per 100-mg increase of intake: 0.95; 95% confidence interval (CI): 0.88, 1.02) and 10 lung cancer risk (HR for per 100-mg increase of intake: 0.94; 95% CI: 0.87, 1.02). No 11 statistically significant association was observed between dietary calcium intake and total 12 cancer incidence. Compared with participants in the lowest quartile of dietary calcium 13 intake, participants in the highest quartile had an increased risk of all-cause mortality (HR: 14 1.20; 95% CI: 0.99, 1.45; P trend = 0.09; HR for per 100-mg increase of intake: 1.02; 95% 15 CI: 1.00, 1.05). Dietary magnesium intake was not statistically significantly related to 16 any of the investigated outcomes. This prospective cohort study provides no strong 17 evidence to support the preventive effect of dietary calcium and magnesium intake on 18 cancer incidence and mortality. However, this study suggests a mild adverse effect of 19 dietary calcium intake on all-cause mortality. 20 21

Association between inflammatory potential of diet and mortality among women in the Swedish Mammography Cohort

“…Vitamin E and magnesium have an anti-inflammatory effect score in the DII calculation [23]. No association was observed between magnesium and calcium and cancer-related mortality in the EPIC-Heidelberg study [68]. In a prospective study conducted by Pocobelli et al [69], vitamin E was found to significantly reduce CVD mortality; however, no association was observed with cancer mortality.…”

“…Previous studies also have examined the effect of specific food items on mortality, including high-fat dairy [66,67], and nutrients such as magnesium [68], and vitamin E [69], and the results have been inconsistent. High-fat dairy is rich in saturated fat and total fat which form the pro-inflammatory components in DII calculation.…”

Prediagnostic Intake of Dairy Products and Dietary Calcium and Colorectal Cancer Survival—Results from the EPIC Cohort Study

“…Another limitation of this study is the lack of data on calcium supplements use in the EPIC cohort. This was however assessed in EPIC-Heidelberg, which showed that calcium supplements were used by less than 10% of subjects (42). Furthermore, results of a randomized controlled trial, investigating the risk of cancer death in over 5,000 subjects with previous fractures who were randomized to use calcium supplements, showed no association between calcium supplements use and cancer mortality (43).…”

Magnesium intake and risk of colorectal cancer: a meta-analysis of prospective studies

“…[19][20][21][22][23][24][25][26] The purpose of this study was to examine the relationship between magnesium intake and the risk of CRC by undertaking a metaanalysis of prospective studies. We attempted to plan, conduct and report this meta-analysis in adherence to the guidelines of the 'Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group'.…”