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Association of dietary zinc intake with coronary artery calcium progression: the Multi-Ethnic Study of Atherosclerosis (MESA)

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Abstract

Purpose

Zinc is considered protective against atherosclerosis; however, the association between dietary zinc intake and cardiovascular disease remains debated. We investigated whether dietary zinc intake was associated with coronary artery calcium (CAC) progression in the Multi-Ethnic Study of Atherosclerosis (MESA).

Methods

This analysis included 5186 participants aged 61.9 ± 10.2 years (48.8% men; 41.3% white, 25.0% black, 21.6% Hispanic, and 12.1% Chinese American) from the MESA. Dietary zinc intake was assessed by a self-administered, 120-item food frequency questionnaire at baseline (2000–2002). Baseline and follow-up CAC were measured by computed tomography. CAC progression was defined as CAC > 0 at follow-up for participants with CAC = 0 at baseline; and an annualized change of 10 or percent change of ≥ 10% for those with 0 < CAC < 100 or CAC ≥ 100 at baseline, respectively.

Results

Dietary zinc intake was 8.4 ± 4.5 mg/day and 2537 (48.9%) of the included participants had CAC at baseline. Over a median follow-up of 3.4 years (25th–75th percentiles = 2.0–9.1 years), 2704 (52.1%) participants had CAC progression. In the fully adjusted model, higher dietary zinc was associated with a lower risk of CAC progression in both men (hazard ratio [HR] 0.697, 95% confidence interval [CI] 0.553–0.878; p = 0.002) and women (HR 0.675; 95% CI 0.496–0.919; p = 0.012, both comparing extreme groups). Furthermore, such an inverse association was attributable to dietary zinc intake from non-red meat (p < 0.05), rather than red meat sources (p > 0.05).

Conclusions

In this multiethnic population free of clinically apparent cardiovascular disease, higher dietary zinc intake from non-red meat sources was independently associated with a lower risk of CAC progression.

Clinical trial registration number

The MESA trial was registered at clinicaltrials.gov as NCT00005487.

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Data availability

Data described in the manuscript, code book, and analytic code will be made available upon request pending application and approval. But we will make the data used in the manuscript, code book, and analytic code available to editors upon request either before or after publication for checking.

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Acknowledgements

The authors thanked the staff and participants of the MESA for their important contributions. A full list of participating MESA investigators and institutions can be found at http://www.mesa-nhlbi.org. This work was supported by Grants from National Natural Science Foundation of China (NSFC) [81870315, 81900379, 81970683, 81700258]. The MESA study was also supported by contracts N01-HC-95159 through N01-HC-95167 from the National Heart, Lung, and Blood Institute.

Funding

This work was supported by Grants from National Natural Science Foundation of China (NSFC) [81870315, 81900379, 81970683, 81700258].

Author information

Author notes

  1. Jing-Wei Gao, Shao-Ling Zhang and Qing-Yun Hao contributed equally to this work.

Authors and Affiliations

  1. Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-sen University, Guangzhou, 510120, China

    Jing-Wei Gao, Qing-Yun Hao, Fei-Fei Huang, Hai-Feng Zhang, Jing-Feng Wang & Pin-Ming Liu

  2. Department of Endocrinology, Sun Yat-Sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China

    Shao-Ling Zhang & Li Yan

  3. Medical Research Center, Sun Yat-Sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China

    Zhao-Yu Liu

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  1. Jing-Wei Gao
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Contributions

Study design: JWG, SLZ and PML. Supervision: JFW and LY. Data acquisition: JWG, QYH an PML. Data analyses/interpretation: JWG, QYH, ZYL, FFH, and HFZ. Manuscript writing and editing: JWG and PML. The final manuscript was approved by all the authors.

Corresponding authors

Correspondence to Jing-Feng Wang or Pin-Ming Liu.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Gao, JW., Zhang, SL., Hao, QY. et al. Association of dietary zinc intake with coronary artery calcium progression: the Multi-Ethnic Study of Atherosclerosis (MESA). Eur J Nutr 60, 2759–2767 (2021). https://doi.org/10.1007/s00394-020-02452-5

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  • DOI: https://doi.org/10.1007/s00394-020-02452-5

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