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Introduction <p>The association between calcium (Ca) intake and incidence of type 2 diabetes mellitus (T2DM) remains still inconclusive. We investigated the association of total and food source-specific Ca intake and the incidence of T2DM in Iranian adults.</p> Methods <p>This cohort study was conducted on adult Iranian men and women (<i>n</i> = 2,458 subjects, mean age 39.3 ± 13.4 years, 1130 men (46%) and 1328 women (54%)), free of T2DM, who were assessed for Ca intake at baseline (2006–2008) and were followed up to 2018–2022. To evaluate potential non-linear associations between dietary calcium intake and T2DM risk, we employed univariate unrestricted regression spline analysis. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of developing T2DM across quartiles and per each 100&#xa0;mg/d of total and food-specific Ca intake.</p> Results <p>During the study follow-up, 353 subjects with T2DM were diagnosed. Mean daily Ca intake was 1,313 ± 526&#xa0;mg/day, mainly from dairy and plant-based foods (51.62 and 40.08%, respectively), and the remaining from the processed and ultra-processed foods (UPFs) and animal sources (2.23 and 6.07%, respectively). Dairy sources contributed a Ca intake of 704 ± 393&#xa0;mg/day. Higher intake of dietary Ca from plant-based foods (&gt; 640 vs. &lt;322&#xa0;mg/day) was associated with a decreased risk of T2DM by 40% (HR = 0.60, 95% CI = 0.41–0.87). Conversely, higher Ca intake from processed and UPFs (&gt; 100 vs. &lt;28.6&#xa0;mg/day) increased T2DM risk (HR = 1.53, 95%CI = 1.10–2.13). Furthermore, each 100&#xa0;mg/day increase in dietary Ca from processed and UPFs raised the risk of T2DM (HR = 1.26, 95% CI = 1.04–1.52). Intake of Ca from dairy was not associated with the incidence of T2DM (HR = 0.98, 95% CI = 0.95–1.01). </p> Conclusion <p> A higher intake of dietary Ca from plant-based foods shows an inverse association with risk of T2DM. Conversely, increased consumption of Ca from processed and UPFs seems to be a risk factor for developing T2DM. These findings suggest that the source of dietary Ca may play a significant role in T2DM risk, highlighting the importance of food choices in managing health outcomes.</p>

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Investigation of the association between total dietary calcium intake and its various sources with type 2 diabetes: Tehran lipid and glucose study

  • 期刊论文

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  • 发表日期：

    2025年10月14日

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  • Niloufar Rasaei,
  • Zahra Bahadoran,
  • Parvin Mirmiran,
  • Fereidoun Azizi

摘要

Introduction

The association between calcium (Ca) intake and incidence of type 2 diabetes mellitus (T2DM) remains still inconclusive. We investigated the association of total and food source-specific Ca intake and the incidence of T2DM in Iranian adults.

Methods

This cohort study was conducted on adult Iranian men and women (n = 2,458 subjects, mean age 39.3 ± 13.4 years, 1130 men (46%) and 1328 women (54%)), free of T2DM, who were assessed for Ca intake at baseline (2006–2008) and were followed up to 2018–2022. To evaluate potential non-linear associations between dietary calcium intake and T2DM risk, we employed univariate unrestricted regression spline analysis. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of developing T2DM across quartiles and per each 100 mg/d of total and food-specific Ca intake.

Results

During the study follow-up, 353 subjects with T2DM were diagnosed. Mean daily Ca intake was 1,313 ± 526 mg/day, mainly from dairy and plant-based foods (51.62 and 40.08%, respectively), and the remaining from the processed and ultra-processed foods (UPFs) and animal sources (2.23 and 6.07%, respectively). Dairy sources contributed a Ca intake of 704 ± 393 mg/day. Higher intake of dietary Ca from plant-based foods (> 640 vs. <322 mg/day) was associated with a decreased risk of T2DM by 40% (HR = 0.60, 95% CI = 0.41–0.87). Conversely, higher Ca intake from processed and UPFs (> 100 vs. <28.6 mg/day) increased T2DM risk (HR = 1.53, 95%CI = 1.10–2.13). Furthermore, each 100 mg/day increase in dietary Ca from processed and UPFs raised the risk of T2DM (HR = 1.26, 95% CI = 1.04–1.52). Intake of Ca from dairy was not associated with the incidence of T2DM (HR = 0.98, 95% CI = 0.95–1.01).

Conclusion

A higher intake of dietary Ca from plant-based foods shows an inverse association with risk of T2DM. Conversely, increased consumption of Ca from processed and UPFs seems to be a risk factor for developing T2DM. These findings suggest that the source of dietary Ca may play a significant role in T2DM risk, highlighting the importance of food choices in managing health outcomes.