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      Association between obesity and calcium:phosphorus ratio in the habitual diets of adults in a city of Northeastern Brazil: an epidemiological study

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          Abstract

          Background

          Low calcium:phosphorus ratios (Ca:P ratio) in habitual diet have been observed worldwide, and it has been shown to be harmful to the bone health of the population. However, no study associating this ratio with obesity was found. Thus, considering that the intake of calcium and phosphorus will generate a ratio between them, which may be associated with obesity, this research seeks at evaluating the relation between obesity and the Ca:P ratio in the habitual diet of adults.

          Methods

          Cross-sectional population-based epidemiological study with stratified and systematic sampling. The sample was composed of 506 adults, aged between 18 and 60 years, of both genders. Information on socioeconomic and demographic conditions was obtained through questionnaires completed during home visits, where anthropometric and dietary evaluations were also conducted.

          Results

          In the habitual diet consumed by the study subjects, a Ca:P ratio above the median of 0.57 reduced the risk of central obesity based on waist-to-height ratio (WHtR) (OR: 0.61; 95% CI: 0.41 – 0.92). Habitual dietary intake of calcium (OR: 0.65; 95% CI: 0.43 – 0.97) and dairy products (OR: 0.56; 95% CI: 0.37 – 0.84) above the median value (485.4 mg and 0.9 servings, respectively) was found to be a protective factor related to central obesity based on WHtR.

          Conclusions

          Values above the median for the Ca:P ratio found in the habitual diet were negatively associated with central obesity based on WHtR. In addition, calcium and dairy consumption were negatively associated with central obesity based on WHtR. Therefore, higher Ca:P ratios contributed to a lower prevalence of central obesity.

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          Abdominal obesity and the risk of all-cause, cardiovascular, and cancer mortality: sixteen years of follow-up in US women.

          Cuilin Zhang, Kathryn Rexrode, Rob van Dam … (2008)
          Accumulating evidence indicates that abdominal adiposity is positively related to cardiovascular disease (CVD) risk and some other diseases independently of overall adiposity. However, the association of premature death resulting from these diseases with abdominal adiposity has not been widely studied, and findings are inconsistent. In a prospective cohort study of 44,636 women in the Nurses' Health Study, associations of abdominal adiposity with all-cause and cause-specific mortality were examined. During 16 years of follow-up, 3507 deaths were identified, including 751 cardiovascular deaths and 1748 cancer deaths. After adjustment for body mass index and potential confounders, the relative risks across the lowest to the highest waist circumference quintiles were 1.00, 1.11, 1.17, 1.31, and 1.79 (95% confidence interval [CI], 1.47 to 1.98) for all-cause mortality; 1.00, 1.04, 1.04, 1.28, and 1.99 (95% CI, 1.44 to 2.73) for CVD mortality; and 1.00, 1.18, 1.20, 1.34, and 1.63 (95% CI, 1.32 to 2.01) for cancer mortality (all P or = 88 cm was 3.02 (95% CI, 1.31 to 6.99) and for waist-to-hip ratio > 0.88 was 3.45 (95% CI, 2.02 to 6.92). After adjustment for waist circumference, hip circumference was significantly and inversely associated with CVD mortality. Anthropometric measures of abdominal adiposity were strongly and positively associated with all-cause, CVD, and cancer mortality independently of body mass index. Elevated waist circumference was associated with significantly increased CVD mortality even among normal-weight women.
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            Relation between serum phosphate level and cardiovascular event rate in people with coronary disease.

            Marcello Tonelli, Frank Sacks, Marc Pfeffer … (2005)
            Higher levels of serum phosphate are associated with adverse cardiovascular outcomes, especially in the setting of overt hyperphosphatemia. Given the biological importance of phosphorus, it is plausible that higher levels of serum phosphate within the normal range may also be associated with adverse outcomes. We performed a post hoc analysis of data from the Cholesterol And Recurrent Events (CARE) study. Baseline serum phosphate levels were measured in 4127 fasting participants who were randomized to receive pravastatin 40 mg daily or placebo and followed up for a median of 59.7 months. We used Cox proportional-hazards models to examine the association between serum phosphate and adverse clinical outcomes after adjustment for potential confounders. During nearly 60 months of follow-up, 375 participants died. A significant association was noted between baseline serum phosphate level and the age-, race-, and sex-adjusted risk of all-cause death (hazard ratio per 1 mg/dL, 1.27; 95% confidence interval, 1.02 to 1.58). After categorization based on baseline phosphate level ( or =4 mg/dL) and further adjustment, a graded independent relation between phosphate and death was observed (P for trend=0.03). For instance, participants with serum phosphate > or =3.5 mg/dL had an adjusted hazard ratio for death of 1.27 (95% confidence interval, 1.02 to 1.59) compared with those with serum phosphate of <3.5 mg/dL. Higher levels of serum phosphate were also associated with increased risk of new heart failure, myocardial infarction, and the composite of coronary death or nonfatal myocardial infarction, but not the risk of stroke. We found a graded independent relation between higher levels of serum phosphate and the risk of death and cardiovascular events in people with prior myocardial infarction, most of whom had serum phosphate levels within the normal range. Given the ready availability and low cost of serum phosphate assays, this finding may prove clinically useful.
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              Dairy consumption is inversely associated with the prevalence of the metabolic syndrome in Tehranian adults.

              Leila Azadbakht, Ahmad Esmaillzadeh, Fereidoun Azizi … (2005)
              Although previous studies showed some benefits from dairy consumption with respect to obesity and insulin resistance syndrome, epidemiologic data on the association between dairy intakes and metabolic syndrome are sparse. The objective was to evaluate the relation between dairy consumption and metabolic syndrome in Tehranian adults. Dairy consumption and features of metabolic syndrome were assessed in a population-based cross-sectional study of 827 subjects (357 men and 470 women) aged 18-74 y. Metabolic syndrome was defined according to guidelines of the Adult Treatment Panel III. Multivariate logistic regression adjusted for lifestyle and nutritional confounders was used in 4 models. Mean (+/-SD) consumption of milk, yogurt, and cheese was 0.7 +/- 0.2, 1.06 +/- 0.6, and 0.9 +/- 0.3 servings/d, respectively. Subjects in the highest quartile of dairy consumption had lower odds of having enlarged waist circumference [odds ratio (OR) by quartile: 1, 0.89, 0.74, 0.63; P for trend < 0.001], hypertension (OR by quartile: 1, 0.88, 0.79, 0.71; P for trend < 0.02), and metabolic syndrome (OR by quartile: 1, 0.83, 0.74, 0.69; P for trend < 0.02). The values of ORs became weaker after further adjustment for calcium intake. Dairy consumption is inversely associated with the risk of having metabolic syndrome. It seems that this relation is somewhat attributed to calcium.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Nutr J
                Journal ID (iso-abbrev): Nutr J
                Title: Nutrition Journal
                Publisher: BioMed Central
                ISSN (Electronic): 1475-2891
                Publication date Collection: 2013
                Publication date (Electronic): 27 June 2013
                Volume: 12
                Page: 90
                Affiliations
                [1 ]Center for Health Sciences, Federal University of Paraiba, Castelo Branco, Joao Pessoa, PB 58059-900, Brazil
                [2 ]Department of Nutrition, Center for Health Sciences, Federal University of Paraiba, Castelo Branco, Joao Pessoa, PB 58059-900, Brazil
                [3 ]Department of Nutrition, Center for Health Sciences, Center for Biological and Health Sciences, Federal University of Viçosa, Viçosa, MG 36570-000, Brazil
                [4 ]Faculty of Medical Sciences, Paraíba, Undergraduate Program in Nutrition, Centro, João Pessoa, PB 58010-740, Brazil
                Article
                Publisher ID: 1475-2891-12-90
                DOI: 10.1186/1475-2891-12-90
                PMC ID: 3702524
                PubMed ID: 23805865
                SO-VID: 93242180-fe31-4204-b6aa-31cd5509253c
                Copyright © Copyright ©2013 Pereira et al.; licensee BioMed Central Ltd.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 2 June 2012
                Date accepted : 17 June 2013
                Categories
                Subject: Research

                ScienceOpen disciplines: Nutrition & Dietetics
                Keywords: calcium: phosphorus ratio,obesity,adult
                Data availability:
                ScienceOpen disciplines: Nutrition & Dietetics
                Keywords: calcium: phosphorus ratio, obesity, adult

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