Low Relative Lean Mass is Associated with Increased Likelihood of Abdominal Aortic Calcification in Community-Dwelling Older Australians.

Age-related loss of skeletal muscle is associated with increased risk of functional limitation and cardiovascular (CV) mortality. In the elderly abdominal aortic calcification (AAC) can increase CV risk by altering aortic properties which may raise blood pressure and increase cardiac workload. This study investigated the association between low muscle mass and AAC in community-dwelling older Australians. Data for this cross-sectional analysis were drawn from a 2010 sub-study of the Melbourne Collaborative Cohort Study in the setting of community-dwelling older adults. Three hundred and twenty-seven participants [mean age = 71 ± 6 years; mean BMI = 28 ± 5 kg/m(2); females n = 199 (62 %)] had body composition determined by dual-energy x-ray absorptiometry (DXA) and AAC determined by radiography. Participants were stratified into tertiles of sex-specific BMI-normalised appendicular lean mass (ALM). Those in the lowest tertile were considered to have low relative muscle mass. Aortic calcification score (ACS) was determined visually as the extent of calcification on the aortic walls between L1 and L4 vertebrae (range: 0-24). Severe AAC was defined as ACS ≥ 6. Prevalence of any AAC was highest in participants with low relative muscle mass (74 %) compared to the middle (65 %) and upper (53 %) tertiles (p trend = 0.006). The lower ALM/BMI tertile had increased odds (Odds ratio = 2.3; 95 % confidence interval: 1.1-4.6; p = 0.021) of having any AAC; and having more severe AAC (2.2; 1.2-4.0; p = 0.009) independent of CV risk factors, serum calcium and physical activity. AAC is more prevalent and severe in community-dwelling older adults with low relative muscle mass. Maintaining muscle mass could form part of a broader primary prevention strategy in reducing AAC.

Dietary α-Linolenic Acid and Total ω-3 Fatty Acids Are Inversely Associated with Abdominal Aortic Calcification in Older Women, but Not in Older Men.

BACKGROUND: Associations of α-linolenic acid (ALA), eicosapentaenoic acid (EPA) plus decosahexaenoic acid (DHA), and total omega-3 (n-3) fatty acid (FA) intakes with abdominal aortic calcification (AAC) are not well understood. OBJECTIVE: This study explored the associations between baseline and long-term changes in ω-3 FA consumption and AAC severity among community-dwelling older men and women. METHODS: The present study used a subset of the Melbourne Collaborative Cohort Study in which participants were interviewed in 1990-1994 and again in 2010-2011. Dietary intake was evaluated at both baseline and follow-up with use of food-frequency questionnaires. AAC severity was assessed by both lateral thoraco-lumbar radiography and dual-energy X-ray absorptiometry (DXA) at follow-up. RESULTS: A total of 312 participants aged 45-64 y old at baseline were followed for a duration of (mean ± SD) 18 ± 1 y. Baseline energy-adjusted ALA intake tended to be inversely associated with AAC severity by radiography [OR (95% CI) for tertile 3 vs. tertile 1: 0.49 (0.23, 1.02), P-trend: 0.06] and was inversely associated with AAC severity by DXA [OR (95% CI) for tertile 3 vs. tertile 1: 0.37 (0.16, 0.83)] in women, after adjustment for confounders. Women in the third tertile of total ω-3 FA intake had significantly lower AAC severity by radiography [OR (95% CI): 0.33 (0.16, 0.71)] and DXA [OR (95% CI): 0.27 (0.12, 0.62)] than those in the first tertile. Changes in tertile of ω-3 FA intake over 18 y were not found to be associated with AAC severity in either men or women. CONCLUSION: The results of our study suggest that dietary ALA and total ω-3 FA intakes are both important predictors of the development of AAC in older women, but not in older men.

High calcium intake in men not women is associated with all-cause mortality risk: Melbourne Collaborative Cohort Study.

The risk of mortality associated with high dietary calcium is uncertain. Unlike a highly publicised study in Swedish women, high dietary calcium intake in men-not women-was associated with increased all-cause mortality. PURPOSE: The association of dietary calcium with mortality is controversial. A study of women from the Swedish Mammography Cohort (SMC) suggested higher calcium was associated with higher mortality risk, whilst a study of Australian adults from the Melbourne Collaborative Cohort Study (MCCS) suggested higher intakes were associated with lower mortality risk. Thus, we aimed to perform a sex-specific re-analysis of the MCCS to evaluate the association of dietary calcium with mortality outcomes and directly compare hazard estimates (95% confidence intervals) in women with those from the SMC. METHODS: A prospective cohort study of community-dwelling Australian adults was conducted, in which 34,627 individuals (women 20,834 (60.2%); mean ± SD, age = 54 ± 8 years) were included at baseline after excluding those with prevalent cardiovascular (CV) disease, cancer or incomplete data. Energy-adjusted dietary calcium was categorised into the following levels of consumption (mg/day): < 600, 600-999, 1000-1399 and ≥ 1400. Mortality from all-causes, any cardiovascular disease and myocardial infarction was determined. Mortality hazards relative to intakes were estimated to be of 600-999 mg/day. RESULTS: In women, hazard estimates for calcium intake of ≥ 1400 mg/day did not reach significance for all-cause (HR = 0.85; 0.66, 1.10) or CV (HR = 1.10; 0.69, 1.81) mortality in adjusted models. In men, intakes of ≥ 1400 mg/day were associated with a 42% increased all-cause mortality risk (HR = 1.42; 1.02, 1.99). There was a trend toward increased CV mortality (HR = 1.83; 0.94, 3.55). CONCLUSION: Contrary to findings from a similar study conducted in Swedish women, Australian women, after adjustment for cofounders showed no increase in mortality risk with high calcium intakes possibly reflecting differences in calcium handling dynamics, diet or lifestyle factors between the two countries. We identified an increased risk for men.

Adiposity assessed by anthropometric measures has a similar or greater predictive ability than dual-energy X-ray absorptiometry measures for abdominal aortic calcification in community-dwelling older adults.

To determine whether adiposity assessed by dual-energy X-ray absorptiometry (DXA) compared to simple anthropometric assessments, are more predictive of abdominal aortic calcification (AAC), a risk factor for atherosclerosis. A cross-sectional study of 312 participants (60.3 % female) aged 70.6 ± 5.6 years was conducted in 2010-2011. AAC was assessed by radiography. Adiposity was estimated for whole body, trunk, android, gynoid and visceral regions using DXA in addition to body mass index (BMI), waist circumference (WC) and waist to hip ratio (WHR). WHR [tertile 1 as reference, OR (95 % CI) for tertile 3: 3.62 (1.35-9.72)] and android to gynoid fat ratio [tertile 3: 2.87 (1.03-8.01)] were independent predictors of AAC severity among men. Positive associations with AAC severity were observed for WC [tertile 1 as reference, OR for tertile 3: 2.46 (1.12-5.41)], % trunk fat mass [tertile 2: 3.26 (1.52-7.03)], % android fat mass [tertile 2: 2.42 (1.13-5.18), tertile 3: 2.20 (1.02-4.73)] and visceral fat area [tertile 2: 2.28 (1.06-4.87), tertile 3: 2.32 (1.01-5.34)] among women. Indices of total body composition, BMI and % body fat mass were not associated with AAC severity in either men or women. Simple anthropometric measures, WHR and WC were the best predictors of AAC severity in men and women respectively, although higher android to gynoid fat ratio and central fat, assessed by DXA, were also predictive of higher risks of AAC severity in men and women respectively. Our findings add to existing evidence that relatively inexpensive and easily obtained anthropometric measures can be clinically useful indicators of atherosclerosis risk.

Higher Dietary Calcium Intakes Are Associated With Reduced Risks of Fractures, Cardiovascular Events, and Mortality: A Prospective Cohort Study of Older Men and Women.

The aim of this population-based, prospective cohort study was to investigate long-term associations between dietary calcium intake and fractures, non-fatal cardiovascular disease (CVD), and death from all causes. Participants were from the Melbourne Collaborative Cohort Study, which was established in 1990 to 1994. A total of 41,514 men and women (∼99% aged 40 to 69 years at baseline) were followed up for a mean (SD) of 12 (1.5) years. Primary outcome measures were time to death from all causes (n = 2855), CVD-related deaths (n = 557), cerebrovascular disease-related deaths (n = 139), incident non-fatal CVD (n = 1827), incident stroke events (n = 537), and incident fractures (n = 788). A total of 12,097 participants (aged ≥50 years) were eligible for fracture analysis and 34,468 for non-fatal CVD and mortality analyses. Mortality was ascertained by record linkage to registries. Fractures and CVD were ascertained from interview ∼13 years after baseline. Quartiles of baseline energy-adjusted calcium intake from food were estimated using a food-frequency questionnaire. Hazard ratios (HR) and odds ratios (OR) were calculated for quartiles of dietary calcium intake. Highest and lowest quartiles of energy-adjusted dietary calcium intakes represented unadjusted means (SD) of 1348 (316) mg/d and 473 (91) mg/d, respectively. Overall, there were 788 (10.3%) incident fractures, 1827 (9.0%) incident CVD, and 2855 people (8.6%) died. Comparing the highest with the lowest quartile of calcium intake, for all-cause mortality, the HR was 0.86 (95% confidence interval [CI] 0.76-0.98, p(trend) = 0.01); for non-fatal CVD and stroke, the OR was 0.84 (95% CI 0.70-0.99, p(trend) = 0.04) and 0.69 (95% CI 0.51-0.93, p(trend) = 0.02), respectively; and the OR for fracture was 0.70 (95% CI 0.54-0.92, p(trend) = 0.004). In summary, for older men and women, calcium intakes of up to 1348 (316) mg/d from food were associated with decreased risks for fracture, non-fatal CVD, stroke, and all-cause mortality.