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Dietary total, animal, vegetable calcium and type 2 diabetes incidence among Korean adults: The Korean Multi-Rural Communities Cohort (MRCohort)

  • J.M. Oh
    Affiliations
    Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, South Korea

    Institute for Health and Society, Hanyang University, Seoul, South Korea
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  • H.W. Woo
    Affiliations
    Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, South Korea

    Institute for Health and Society, Hanyang University, Seoul, South Korea
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  • M.K. Kim
    Correspondence
    Corresponding author. Mi Kyung Kim, Department of Preventive Medicine, College of Medicine, Hanyang University, 222, Wangsimni-ro, Seongdong-gu, Seoul, 04763, South Korea. Fax: +82 2 2293 0660.
    Affiliations
    Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, South Korea

    Institute for Health and Society, Hanyang University, Seoul, South Korea
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  • Y.-H. Lee
    Affiliations
    Department of Preventive Medicine, Institute of Wonkwang Medical Science, Wonkwang University College of Medicine, Iksan, South Korea
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  • D.H. Shin
    Affiliations
    Department of Occupational and Environmental Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea
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  • M.-H. Shin
    Affiliations
    Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, South Korea
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  • B.Y. Choi
    Affiliations
    Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, South Korea

    Institute for Health and Society, Hanyang University, Seoul, South Korea
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Published:October 13, 2017DOI:https://doi.org/10.1016/j.numecd.2017.10.005

      Highlights

      • Dietary total and vegetable calcium without supplements may be associated with type 2 diabetes incidence.
      • Moderate dietary calcium may be potentially dose-responsive to the risk of type 2 diabetes incidence among women.
      • The association is noteworthy, because many populations have different calcium sources, such as plants, instead of milk.

      Abstract

      Background and aims

      Although a possible mechanism for developing type 2 diabetes in relation to calcium intake has been suggested, there is currently little epidemiological evidence on the association between dietary calcium and type 2 diabetes (T2D). This study aimed to evaluate the prospective association between dietary calcium and T2D incidence among adults 40 years of age or over, from the Multi-rural Communities Cohort (MRCohort), South Korea.

      Methods and Results

      In total, 8313 participants (3033 men and 5280 women) who did not have diabetes at baseline were recruited between 2005 and 2013. The incidence rate ratio (IRR) was estimated using a modified Poisson regression model with a robust error estimator. During follow-up (31,570 person-years), 322 T2D cases were newly diagnosed. Dietary calcium (total and vegetable calcium) were inversely associated with the risk of T2D incidence among women (IRR = 0.61, 95% CI = 0.43–0.86, P for trend = 0.007 in third tertile of baseline total calcium intake comparing to the first tertile; IRR = 0.57, 95% CI = 0.39–0.84, P for trend = 0.006 for baseline vegetable calcium intake), not for men. The tendency of those inverse associations remained in both the normal fasting blood glucose group and the impaired fasting blood glucose group and were independent of obesity, smoking, and magnesium intake.

      Conclusions

      Total and vegetable calcium may be inversely associated with T2D incidence among women, regardless of impaired fasting blood glucose group or normal group. The associations may be potentially dose-responsive. Moderate dietary calcium may be related to lower risk of T2D incidence comparing to low intake group among women.

      Keywords

      Abbreviations:

      BMI (Body mass index), CIs (Confidence intervals), FBG (Fasting blood glucose), FFQ (Food frequency questionnaire), GLM (General linear model), HDL (High-density lipoprotein), IFG (Impaired fasting glucose), IRR (Incidence rate ratio), KoGES (Korean Genome and Epidemiology Study), LDL (Low-density lipoprotein), MRCohort (Multi-Rural Communities Cohort), NFG (Normal fasting glucose), T1 (The first tertile), T2 (The second tertile), T3 (The third tertile), T2D (Type 2 diabetes), WC (Waist circumference)
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