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Comment & Response
October 28, 2013

Dietary and Supplemental Calcium Intake and Mortality—Reply

Author Affiliations
  • 1Division of Cancer Epidemiology and Genetics, Nutritional Epidemiology Branch, National Cancer Institute, Rockville, Maryland
JAMA Intern Med. 2013;173(19):1841-1842. doi:10.1001/jamainternmed.2013.9232

In Reply In their study of a Hong Kong Chinese population, whose calcium intake is substantially lower than the Western population, Chan et al reported there was a protective effect of dietary calcium intake on total mortality and cardiovascular mortality. The lower cutoff of their highest intake category (>762 mg/d for men and >668 mg/d for women) are around the median intake values (739 mg/d for men and 648 mg/d for women) found in our US cohort. As shown in Figure 2 of our article,1 we observed a nonlinear association between total calcium intake and total cardiovascular disease mortality in men: risk decreased at a calcium intake up to approximately 1200 mg/d, but started to increase at an intake of 1500 mg/d and higher. Therefore, a study with population that has relatively low calcium intake and narrow range of intake is likely to observe an inverse association between calcium intake and mortality, especially cardiovascular disease mortality.