Association between intakes of minerals (potassium, magnesium, and calcium) and diet quality and risk of cerebral atherosclerosis in ischemic stroke patients

Jihyun Son; Han-Saem Choe; Ji-Yun Hwang; Tae-Jin Song; Yoonkyung Chang; Yong-Jae Kim; Yuri Kim

doi:10.4163/jnh.2015.48.2.167

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Son, Choe, Hwang, Song, Chang, Kim, and Kim: Association between intakes of minerals (potassium, magnesium, and calcium) and diet quality and risk of cerebral atherosclerosis in ischemic stroke patients

Research Article

J Nutr Health 2015;48(2):167-179.

Published online: 19 January 2015

DOI: https://doi.org/10.4163/jnh.2015.48.2.167

Association between intakes of minerals (potassium, magnesium, and calcium) and diet quality and risk of cerebral atherosclerosis in ischemic stroke patients

Jihyun Son¹, Han-Saem Choe², Ji-Yun Hwang³, Tae-Jin Song⁴, Yoonkyung Chang⁴, Yong-Jae Kim⁴, Yuri Kim^1,^2,^†

¹Department of Clinical Nutrition, The Graduate School of Clinical Health Sciences, Ewha Womans University, Seoul 120-750, Korea

²Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 120-750, Korea

³Nutrition Education Major Graduate School of Education, Sangmyung University, Seoul 110-743, Korea

⁴Stroke Center, Department of Neurology, Ewha Womans University, School of Medicine, Seoul 158-710, Korea

^†To whom correspondence should be addressed. tel: 02-3277-4485, e-mail: yuri.kim@ewha.ac.kr

Received 10 March 2015 Revised 8 April 2015 Accepted 15 April 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose:

This study was conducted to evaluate the association between intakes of potassium, magnesium, and calcium and diet quality in ischemic stroke patients.

Methods:

This study analyzed data from 285 subjects recruited from February 2011 to August 2014 in Seoul, Korea. Nutrition intakes were obtained from a semi-quantitative food frequency questionnaire composed of 111 food items. The subjects were divided into 4 groups by quartiles according to intakes of potassium, magnesium, and calcium. Index of Nutritional Quality (INQ), Mean Adequacy Ratio (MAR), and DQI-International (DQI-I) were analyzed for assessment of diet quality.

Results:

We found a positive association of intakes of these three minerals with MAR and DQI-I after adjustment for age, sex, education level, smoking, atrial fibrillation, and total energy intake. However, total moderation of DQI-I score in the Q4 group was significantly lower than that of the Q1 group. The age, sex, education level, and smoking, atrial fibrillation, and total energy intake-adjusted odds ratios of extensive cerebral atherosclerosis were inversely associated with intake of magnesium (Ptrend = 0.0204). However, this association did not exist with intakes of potassium and calcium.

Conclusion:

Potassium, magnesium, and calcium rich and high quality diet could be associated with decreased risk of ischemic stroke, in part, via effect on extensive cerebral atherosclerosis.

Keywords: ischemic stroke, mineral intake, diet quality, cerebral atherosclerosis

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Fig. 1.

Comparison of intake of potassium, magnesium, and calcium with Dietary Reference Intakes for Koreans (KDRIs), 2010.

Table 1.

Components of Diet Quality Index-International (DQI-I)²

Component	Score	Scoring Criteria
Variety	0~20 points
Overall food group variety (meat/poultr fish/eggs; dairy/beans; grain; fruit; vegetable)	ry/ 0~15 points	≥ 1 serving from each food group/d = 15
		Any 1 food group missing/d = 12
		Any 2 food group missing/d = 9
		Any 3 food group missing/d = 6
		≥ 4 food group missing/d = 3
		None from any food group = 0
Within-group variety for protein source(meat, poultry, fish, dairy, beans, eggs)	0~5 points	≥ 3 different sources/d = 5
		2 different sources/d = 3
		From 1 source/d = 1
		None = 0
Adequacy	0~40 points
Vegetable group^1,2)	0~5 points	≥ 7 servings = 5, 0 servings/d = 0
		≥ 100%
		< 100-50%
		< 50%
Fruits group^1,2)	0~5 points	≥ 1 servings = 5, 0 servings/d = 0
		≥ 100%
		< 100-50%
		< 50%
Grain group^1,2)	0~5 points	≥ 6 servings = 5, 0 servings/d = 0
		≥ 100%
		< 100-50%
		< 50%
Fiber^1,2)	0~5 points	≥ 20-30 g/d = 5, 0 g/d = 0
		< 100-50%
		< 100-50%
		< 50%
Protein¹⁾	0~5 points	≥ 10% of energy/d = 5, 0% of energy/d = 0
		≥ 100%
		< 100-50%
		< 50%
Iron^1,3)	0~5 points	≥ 100% of RNI⁵⁾/d = 5, 0% of RNI/d = 0
		≥ 100%
		< 100-50%
		< 50%
Calcium¹⁾	0~5 points	≥ 100% of RNI/d = 5, 0% of RNI/d = 0
		≥ 100%
		< 100-50%
		< 50%
Vitamin C^1,3)	0~5 points	≥ 100% of RNI/d = 5, 0% of RNI/d = 0
		≥ 100%
		< 100-50%
		< 50%
Moderation	0~30 points
Total fat	0~6 points	≤ 20% of total energy/d = 6
		> 20-30% of total energy/d = 3
		> 30% of total energy/d = 0
Saturated fat	0~6 points	≤ 7% of total energy/d = 6
		> 7-10% of total energy/d = 3
		> 10% of total energy/d = 0
Cholesterol	0~6 points	≤ 300 mg/d = 6
		> 300-400 mg/d = 3
		> 400 mg/d = 0
Sodium	0~6 points	≤ 2,400 mg/d = 6
		> 2,400~3,400 mg/d = 3
		> 3,400 mg/d = 0
Empty calorie foods	0~6 points	≤ 3% of total energy/d = 6
		> 3-10% of total energy/d = 3
		> 10% of total energy/d = 0
Overall balance	0~10 points
Macronutrient ratio (carbohydrate : protein : fat)⁴⁾	0~6 points	55-65 : 10-20 : 15-20 = 6
		52-68 : 8-21 : 13-23 = 4
		50-70 : 7-22 : 12-25 = 2
		Otherwise = 0
Fatty acid ratio (PUFA : MUFA⁶⁾ : SFA⁷	0~4 points	P/S⁸⁾ = 1-1.5 and M/S⁹⁾ = 1-1.5 = 4
		Else if P/S = 0.8-1.7 and M/S = 0.8-0.7 = 2
		Otherwise = 0

Values are the percentage of the sample in subcategories. 1) Used as a continuous variable 2) Based on 1,200 kcal diet 3) Scoring system based on the RNI value for Korea 4) Ratio of energy from carbohydrate to protein to fat following DRIs for Korea 5) RNI, Recommended Nutrition Intakes 6) MUFA, mono-unsaturated fatty acids 7) SFA, saturated fatty acids 8) P/S, ratio of PUFA to SFA intake 9) M/S, ratio of MUFA to SFA intake

Table 2.

General characteristics of subjects according to intakes of potassium, magnesium and calcium

	Total	Potassium			Magnesium			Calcium
	Total	Q1	Q4	P	Q1	Q4	P	Q1	Q4	P
		(n = 71)	(n = 71)	value¹⁾	(n = 71)	(n = 71)	value	(n = 71)	(n = 71)	value
Age²⁾	63.6 ± 11.9	66.7 ± 11.9	63.9 ± 11.9	0.1767	66.4 ± 12.0	62.7 ± 11.6	0.0185	64.5 ± 12.2	64.6 ± 11.5	0.6428
Men, n (%)		43 (60.6)	37 (52.1)	0.5981	43 (60.6)	40 (56.3)	0.9590	46 (64.8)	33 (46.5)	0.1214
Education status, n (%)				0.0221			0.0667			0.0531
≤ Primary school		27 (39.1)	16 (23.2)		25 (36.8)	14 (20.6)		21 (30.4)	18 (26.5)
Secondary~High school		31 (44.9)	34 (49.3)		33 (48.5)	33 (48.5)		35 (47.8)	35 (51.5)
≥ University		11 (15.9)	19 (27.5)		10 (14.7)	21 (30.9)		15 (21.7)	15 (22.1)
Smoking, n (%)		18 (26.1)	14 (19.7)	0.5432	18 (26.1)	12 (16.9)	0.3125	23 (33.3)	11 (15.5)	0.1033
Alcohols, n (%)		28 (39.4)	26 (36.6)	0.7612	29 (40.9)	31 (43.7)	0.3526	29 (40.9)	23 (32.4)	0.3694
Regular exercise, n (%)		26 (37.1)	24 (33.8)	0.1485	24 (34.3)	29 (40.9)	0.8081	22 (31.9)	26 (36.6)	0.2222
Coronary heart disease, n (%)		9 (12.7)	11 (15.5)	0.6458	12 (16.9)	10 (14.1)	0.3876	8 (11.3)	12 (16.9)	0.3265
Hypertension, n (%)		30 (42.3)	41 (57.8)	0.1013	35 (49.3)	42 (59.2)	0.5773	31 (43.7)	42 (59.2)	0.1692
Atrial fibrillation, n (%)		40 (62.5)	26 (41.9)	0.0250	40 (62.5)	28 (45.9)	0.2136	40 (62.5)	27 (42.9)	0.1298
Extensive Cerebral atherosclerosis, n (%)		55 (78.6)	52 (74.3)	0.2419	61 (87.1)	51 (75.0)	0.0355	57 (81.4)	54 (77.1)	0.7782
Diabetes, n (%)		19 (26.8)	24 (33.8)	0.7499	22 (31.0)	28 (39.4)	0.0953	17 (23.9)	24 (33.8)	0.6023

Values are presented as n (%) or as Mean ± SD. 1) By chi-square test 2) p from general linear regression for continuous variable

Table 3.

Anthropometric and biochemical markers according to intakes of potassium, magnesium, and calcium

	Total	Potassium			Magnesium			Calcium
	Total	Q1 (n = 71)	Q4 (n = 71)	^P _trend¹⁾	Q1 (n = 71)	Q4 (n = 71)	^Ptrend	Q1 (n = 71)	Q4 (n = 71)	^P trend
Height, cm	162.8 ± 8.7²⁾	162.5 ± 8.9	162.1 ± 8.6	0.4013	162.5 ± 8.6	162.6 ± 8.8	0.6966	163.9 ± 8.3	161.3 ± 9.6	0.4601
Weight, kg	65.8 ± 8.7	63.6 ± 10.8	63.0 ± 11.3	0.7341	64.2 ± 11.0	64.2 ± 12.4	0.9990	70.2 ± 50.5	62.4 ± 11.8	0.8524
BMI³⁾, kg/m²	24.6 ± 8.1	23.9 ± 3.1	23.9 ± 3.0	0.4600	24.2 ± 3.2	24.1 ± 3.2	0.8547	25.6 ± 15.3	23.9 ± 3.3	0.4429
WC⁴⁾, cm	85.3 ± 9.1	85.5 ± 8.3	83.8 ± 8.1	0.2364	85.4 ± 8.4	84.1 ± 8.3	0.9181	85.2 ± 8.6	83.4 ± 7.4	0.5479
SBP⁵⁾, mmHg	149.9 ± 28.2	150.5 ± 8.3	146.7 ± 31.2	0.1369	153.8 ± 25.0	148.4 ± 29.0	0.3283	147.7 ± 25.2	144.4 ± 29.8	0.1071
DBP⁶⁾, mmHg	83.0 ± 13.9	82.5 ± 12.2	81.0 ± 17.2	0.3506	83.4 ± 10.6	81.9 ± 17.5	0.5398	82.3 ± 12.2	80.6 ± 17.3	0.6008
Fasting blood glucose, mg/dl	117.2 ± 53.7	120.3 ± 50.3	111.0 ± 43.0	0.9297	120.4 ± 53.6	109.5 ± 41.8	0.8592	118.0 ± 43.0	113.3 ± 59.5	0.7209
HbA1c,%	6.7 ± 1.5	6.4 ± 1.2	6.8 ± 1.8	0.6831	6.5 ± 1.2	6.8 ± 1.7	0.6538	6.4 ± 1.1	6.8 ± 1.8	0.2247
TG⁷⁾, mg/dl	121.5 ± 71.5	121.6 ± 72.2	115.3 ± 59.0	0.5805	116.4 ± 57.5	112.9 ± 57.5	0.7103	130.5 ± 73.5	116.5 ± 78.7	0.4272
Total cholesterol, mg/dl	174.9 ± 40.7	169.2 ± 37.8	167.8 ± 40.3	0.7549	174.6 ± 29.5	169.0 ± 41.3	0.3532	169.6 ± 38.6	167.8 ± 43.0	0.7187
HDL⁸⁾ cholesterol, mg/dl	43.2 ± 11.8	42.1 ± 11.3	41.9 ± 9.8	0.1995	42.3 ± 11.6	43.3 ± 9.5	0.7927	41.4 ± 10.5	43.0 ± 10.0	0.8164
LDL⁹⁾ cholesterol, mg/dl	110.8 ± 34.8	107.6 ± 31.6	104.5 ± 39.1	0.5566	114.6 ± 25.9	106.2 ± 37.7	0.2069	109.7 ± 30.6	103.6 ± 37.6	0.2460
AI¹⁰⁾	3.3 ± 1.4	3.2 ± 1.2	3.2 ± 1.5	0.2246	3.3 ± 1.1	3.1 ± 1.3	0.3013	3.3 ± 1.2	3.1 ± 1.5	0.6733
CRF¹¹⁾	4.3 ± 1.4	4.2 ± 1.2	4.2 ±1.5	0.2246	4.3 ± 1.1	4.1 ± 1.3	0.3013	4.3 ± 1.2	4.1 ± 1.5	0.6733

1) Adjusted for age, sex, education level, smoking, atrial fibrillation, and total energy intake. 2) Values are Mean ± SD. 3) BMI, Body Mass Index 4) WC, Waist circumferences 5) SBP, Systolic Blood Pressure 6) DBP, Diastolic Blood Pressure 7) TG, Triglyceride 8) HDL, High-Density Lipoprotein 9) LDL, Low-Density Lipoprotein 10) AI, Atherogenic Index 11) CRF, Cardiac Risk Factor

Table 4.

Daily food intakes by food group according to the intakes of potassium, magnesium, and calcium

	Total	Potassium			Magnesium			Calcium
	Total	Q1 (n = 71)	Q4 (n = 71)	P_trend¹⁾	Q1 (n = 71)	Q4 (n = 71)	Ptrend	Q1 (n = 71)	Q4 (n = 71)	Ptrend
Grain and products, g	245.9 ± 124.5 1	185.5 ± 96.5²⁾	⁾ 308.5 ± 156.0	0.0002	203.9 ± 97.2	298.1 ± 152.1	< 0.0001	195.1 ± 98.1	279.8 ± 146.4	0.0003
Potatoes and starch products, g	58.1 ± 78.7	31.3 ± 31.2	115.7 ± 129.8	< 0.0001	29.6 ± 33.8	100.9 ± 119.6	0.0035	44.3 ± 73.4	100.0 ± 114.8	0.4270
Sugar and products, g	18.5 ± 16.8	12.3 ± 11.3	23.2 ± 15.6	0.4471	12.0 ± 12.1	24.3 ± 15.0	0.7809	13.6 ± 13.5	21.7 ± 15.3	0.5703
Legumes and products, g	90.6 ± 87.1	52.0 ± 54.0	138.7 ± 112.4	0.0029	75.0 ± 89.4	115.4 ± 79.6	0.5950	50.7 ± 53.9	147.8 ± 113.5	< 0.0001
Seeds nuts and products, g	2.9 ± 4.0	0.9 ± 1.2	4.9 ± 4.3	0.0004	0.9 ± 1.2	5.5 ± 5.1	< 0.0001	1.1 ± 1.8	5.0 ± 4.8	< 0.0001
Vegetables, g	439.3 ± 275.6	197.6 ± 65.8	759.7 ± 304.3	< 0.0001	241.6 ± 152.8	721.6 ± 330.3	< 0.0001	211.9 ± 79.1	742.2 ± 315.9	< 0.0001
Mushrooms, g	13.2 ± 16.2	5.5 ± 7.0	24.6 ± 21.8	0.0002	5.1 ± 7.2	24.6 ± 22.3	< 0.0001	6.7 ± 9.3	23.7 ± 22.2	0.0002
Fruits, g	153.0 ± 186.4	48.9 ± 46.5	314.4 ± 276.8	0.0002	53.8 ± 63.5	328.9 ± 270.3	< 0.0001	73.2 ± 126.1	264.3 ± 244.7	0.1659
Meat and products, g	113.2 ± 91.2	62.7 ± 40.3	155.9 ± 113.7	0.1345	66.3 ± 41.8	157.5 ± 107.4	0.3045	80.4 ± 77.1	133.0 ± 91.9	0.0034
Eggs and products, g	35.1 ± 33.3	19.1 ± 11.9	51.8 ± 50.8	0.0763	20.0 ± 15.9	53.9 ± 50.9	0.0064	20.0 ± 14.8	54.7 ± 50.7	0.0017
Fish and shellfish, g	62.0 ± 43.8	36.6 ± 20.2	89.5 ± 56.1	0.0020	33.6 ± 20.0	99.3 ± 57.9	< 0.0001	37.2 ± 21.5	90.9 ± 53.5	0.0013
Seaweeds, g	5.6 ± 8.5	2.6 ± 2.8	10.7 ± 14.5	0.0001	3.3 ± 3.5	9.1 ± 10.1	0.0493	2.7 ± 3.0	10.9 ± 14.4	0.0002
Milk and dairy products, g	83.6 ± 110.2	49.5 ± 84.3	124.4 ± 144.7	0.6533	53.8 ± 87.0	126.1 ± 145.3	0.6441	16.4 ± 23.4	163.7 ± 145.8	< 0.0001
Fats and oils, g	13.3 ± 7.3	7.2 ± 5.4	20.3 ± 7.6	< 0.0001	7.6 ± 5.5	21.0 ± 6.9	< 0.0001	8.0 ± 5.7	20.2 ± 7.4	< 0.0001
Spice, g	38.1 ± 23.0	17.8 ± 7.1	64.4 ± 26.7	< 0.0001	19.6 ± 8.9	62.5 ± 27.3	< 0.0001	18.4 ± 6.8	64.7 ± 25.9	< 0.0001

1)P for trend after adjusted for age, sex, education level, smoking, atrial fibrillation, and total energy intake 2)Values are Mean ± SD.

Table 5.

Daily nutrient intake according to intakes of potassium, magnesium and calcium¹⁾

	Total	Potassium			Magnesium			Calcium
	Total	Q1 (n = 71)	Q4 (n = 71)	P_trend²⁾	Q1 (n = 71)	Q4 (n = 71)	P_trend²⁾	Q1 (n = 71)	Q4 (n = 71)	P_trend²⁾
Energy (kcal) 2	2,007.9 ± 810.0³⁾	1,244.0 ± 316.1	2,819.7 ± 822.7	< 0.0001	1,355.5 ± 358.1	2,819.1 ± 806.9	< 0.0001	1,366.6 ± 417.6	2,626.9 ± 821.8	< 0.0001
Carbohydrate (g)	138.4 ± 26.0	142.6 ± 28.7	140.7 ± 23.6	0.4547	146.0 ± 26.8	135.0 ± 22.8	0.0014	141.8 ± 33.6	137.8 ± 19.2	0.1213
Protein (g)	40.8 ± 7.2	37.8 ± 7.6	43.8 ± 7.2	< 0.0001	37.7 ± 7.6	43.4 ± 7.2	< 0.0001	36.9 ± 7.8	45.2 ± 6.8	< 0.0001
Fat (g)	27.4 ± 7.9	23.7 ± 7.5	29.3 ± 7.0	0.0001	22.9 ± 7.4	30.0 ± 6.2	< 0.0001	23.8 ± 9.6	30.4 ± 5.8	< 0.0001
Fiber (g)	13.9 ± 4.5	11.5 ± 3.2	17.5 ± 4.8	< 0.0001	12.0 ± 3.5	16.5 ± 5.1	< 0.0001	11.5 ± 3.9	17.6 ± 4.5	< 0.0001
Calcium (mg)	304.7 ± 119.5	259.0 ± 110.5	366.6 ± 138.9	< 0.0001	272.3 ± 121.3	349.0 ± 130.2	0.0001	212.8 ± 62.0	416.4 ± 123.8	< 0.0001
Phosphorus (mg)	622.6 ± 127.2	562.5 ± 127.5	697.7 ± 133.2	< 0.0001	573.4 ± 128.7	678.8 ± 138.0	< 0.0001	530.9 ± 101.7	732.1 ± 120.2	< 0.0001
Iron (mg)	8.8 ± 2.0	7.7 ± 1.6	10.2 ± 1.9	< 0.0001	7.8 ± 1.6	9.8 ± 2.1	< 0.0001	7.7 ± 1.7	10.3 ± 1.8	< 0.0001
Sodium (mg)	2,711.9 ± 965.4	2,296.6 ± 641.1	3,209.3 ± 1204.8	< 0.0001	2,452.5 ± 983.6	3,006.9 ± 1061.7	7 0.0007	2,212.8 ± 667.3	3,379.5 ± 1143.8	< 0.0001
Potassium (mg)	1,768.8 ± 527.5	1,462.2 ± 392.2	2,223.5 ± 537.8	< 0.0001	1,479.0 ± 405.5	2,126.3 ± 560.4	< 0.0001	1,468.6 ± 486.0	2,232.2 ± 514.7	< 0.0001
Magnesium (mg)	44.4 ± 16.7	36.4 ± 16.9	55.8 ± 17.7	< 0.0001	28.7 ± 9.4	58.5 ± 15.8	< 0.0001	37.8 ± 18.1	54.9 ± 17.3	< 0.0001
Zinc (mg)	6.2 ± 1.0	5.8 ± 1.0	6.6 ± 0.7	< 0.0001	5.9 ± 1.0	6.5 ± 0.9	0.0046	5.7 ± 1.0	6.7 ± 0.8	< 0.0001
Vitamin A (μgRE)	569.9 ± 301.4	405.7 ± 169.5	767.1 ± 380.5	< 0.0001	418.5 ± 186.4	764.2 ± 381.5	< 0.0001	410.3 ± 215.0	796.9 ± 356.9	< 0.0001
vitamin B₁ (mg)	0.7 ± 0.1	0.6 ± 0.1	0.8 ± 0.1	< 0.0001	0.6 ± 0.1	0.7 ± 0.1	< 0.0001	0.6 ± 0.1	0.8 ± 0.1	< 0.0001
vitamin B₂ (mg)	0.7 ± 0.2	0.6 ± 0.2	0.8 ± 0.2	< 0.0001	0.6 ± 0.2	0.8 ± 0.2	< 0.0001	0.6 ± 0.2	0.9 ± 0.2	< 0.0001
vitamin B₆ (mg)	0.9 ± 0.2	0.9 ± 0.2	1.1 ± 0.2	< 0.0001	0.8 ± 0.2	1.1 ± 0.2	< 0.0001	0.9 ± 0.2	1.1 ± 0.2	< 0.0001
vitamin B₁₂ (ug)	5.6 ± 2.4	5.0 ± 2.2	6.3 ± 3.0	0.0007	4.8 ± 2.1	6.3 ± 2.7	< 0.0001	4.6 ± 2.1	6.9 ± 2.9	< 0.0001
Niacin (mg)	9.0 ± 1.8	8.1 ± 1.9	10.0 ± 1.6	<.0001	7.9 ± 1.7	10.0 ± 1.6	<.0001	8.2 ± 2.0	10.0 ± 1.8	<.0001
Vitamin C (mg)	67.6 ± 32.7	51.6 ± 25.2	91.9 ± 35.3	< 0.0001	51.5 ± 24.7	88.9 ± 36.1	< 0.0001	56.3 ± 37.9	91.1 ± 32.0	< 0.0001
Folate (ug)	336.3 ± 112.8	282.0 ± 87.3	408.5 ± 122.1	< 0.0001	296.0 ± 93.0	392.5 ± 125.5	< 0.0001	277.5 ± 102.2	422.4 ± 115.3	< 0.0001
Vitamin E (mg α-TE)	10.0 ± 2.8	8.5 ± 2.4	11.5 ± 3.1	< 0.0001	8.2 ± 2.3	11.7 ± 2.9	< 0.0001	8.5 ± 2.4	12.1 ± 2.7	< 0.0001

1) Intake was adjusted for 1,000 kcal of energy. 2) P for trend after adjusted for age, sex, education level, smoking, and atrial fibrillation 3) Values are Mean ± SD.

Table 6.

The nutritional quality (INQ and MAR) of subjects according to intakes of potassium, magnesium, and calcium

	Total	Potassium			Magnesium			Calcium
	Total	Q1 (n = 71)	Q4 (n = 71)	^P_trend¹⁾	Q1 (n = 71)	Q4 (n = 71)	^Ptrend	Q1 (n = 71)	Q4 (n = 71)	^Ptrend
INQ³⁾
Protein	1.7 ± 0.3²⁾	1.6 ± 0.3	1.8 ± 0.3	< 0.0001	1.6 ± 0.3	1.8 ± 0.3	< 0.0001	1.6 ± 0.3	1.9 ± 0.3	< 0.0001
Phosphorus	1.8 ± 0.3	1.6 ± 0.4	2.0 ± 0.4	< 0.0001	1.7 ± 0.3	2.0 ± 0.4	< 0.0001	1.6 ± 0.3	2.1 ± 0.3	< 0.0001
Calcium	0.9 ± 0.3	0.7 ± 0.3	1.0 ± 0.4	< 0.0001	0.8 ± 0.3	1.0 ± 0.3	< 0.0001	0.6 ± 0.2	1.2 ± 0.3	< 0.0001
Iron	2.0 ± 0.5	1.8 ± 0.4	2.3 ± 0.5	< 0.0001	1.8 ± 0.4	2.3 ± 0.5	< 0.0001	1.8 ± 0.4	2.4 ± 0.5	< 0.0001
Vitamin A	1.8 ± 0.9	1.3 ± 0.5	2.4 ± 1.2	< 0.0001	1.3 ± 0.6	2.3 ± 1.2	< 0.0001	1.3 ± 0.6	2.4 ± 1.1	< 0.0001
Vitamin B₁	1.2 ± 0.2	1.1 ± 0.2	1.3 ± 0.2	< 0.0001	1.1 ± 0.2	1.3 ± 0.2	< 0.0001	1.2 ± 0.3	1.3 ± 0.2	< 0.0001
Vitamin B₂	1.1 ± 0.3	0.9 ± 0.3	1.3 ± 0.3	< 0.0001	0.9 ± 0.3	1.3 ± 0.3	< 0.0001	0.9 ± 0.3	1.3 ± 0.3	< 0.0001
Niacin	1.2 ± 0.2	1.1 ± 0.3	1.3 ± 0.2	< 0.0001	1.1 ± 0.2	1.3 ± 0.2	< 0.0001	1.1 ± 0.3	1.3 ± 0.2	< 0.0001
Vitamin C	1.4 ± 0.6	1.1 ± 0.5	1.8 ± 0.7	< 0.0001	1.0 ± 0.5	1.8 ± 0.7	< 0.0001	1.2 ± 0.7	1.8 ± 0.6	< 0.0001
MAR⁴⁾	0.9 ± 0.1	0.7 ± 0.2	1.0 ± 0.0	< 0.0001	0.8 ± 0.2	1.0 ± 0.0	< 0.0001	0.8 ± 0.2	1.0 ± 0.0	< 0.0001

1) p < for trend after adjusted for age, sex, education level, smoking, atrial fibrillation, and total energy intake 2) Values are Mean ± SD. 3) INQ, Index Nutritional Quality 4) MAR, Mean Adequacy Ratio

Table 7.

Diet Quality Index-International (DQI-I) score of subjects according to the intakes of potassium, magnesium, and calcium

	Total	Potassium			Magnesium			Calcium
	Total	Q1 (n = 71)	Q4 (n = 71)	^P_trend¹⁾	Q1 (n = 71)	Q4 (n = 71)	^Ptrend	Q1 (n = 71)	Q4 (n = 71)	^Ptrend
Variety (20)	14.2 ± 3.5²⁾	10.7 ± 2.2	16.9 ± 2.9	< 0.0001	11.2 ± 2.4	17.3 ± 2.8	< 0.0001	11.0 ± 2.4	17.0 ± 2.7	< 0.0001
Overall food group variety (15)	9.2 ± 3.5	5.7 ± 2.2	11.9 ± 2.9	< 0.0001	6.2 ± 2.4	12.3 ± 2.8	< 0.0001	6.0 ± 2.4	12.0 ± 2.7	< 0.0001
Within-group variety for protein source (5)	5.0 ± 0.0	5.0 ± 0.0	5.0 ± 0.0	-	5.0 ± 0.0	5.0 ± 0.0	-	5.0 ± 0.0	5.0 ± 0.0	-
Adequacy (40)	31.1 ± 5.8	23.5 ± 3.9	36.6 ± 2.2	< 0.0001	24.8 ± 5.2	36.3 ± 2.4	< 0.0001	24.4 ± 5.0	36.2 ± 2.3	< 0.0001
Vegetable group (5)	2.5 ± 1.4	1.4 ± 0.7	3.9 ± 1.1	< 0.0001	1.4 ± 0.8	3.7 ± 1.2	< 0.0001	1.5 ± 0.9	3.8 ± 1.3	< 0.0001
Fruit group (5)	3.5 ± 2.1	2.1 ± 1.7	4.5 ± 1.1	0.0001	2.2 ± 2.5	4.6 ± 1.0	0.0001	2.5 ± 2.5	4.4 ± 1.1	0.0087
Grain group (5)	2.5 ± 1.3	1.8 ± 0.6	3.4 ± 1.6	0.1495	2.0 ± 0.7	3.2 ± 1.5	< 0.0001	2.0 ± 0.8	3.0 ± 1.5	0.0006
Fiber (5)	4.5 ± 0.8	3.4 ± 0.8	5.0 ± 0.0	< 0.0001	3.8 ± 1.0	5.0 ± 0.1	< 0.0001	3.6 ± 0.9	5.0 ± 0.0	< 0.0001
Protein (5)	5.0 ± 0.1	4.9 ± 0.2	5.0 ± 0.0	0.1330	4.9 ± 0.2	5.0 ± 0.0	0.1859	4.9 ± 0.2	5.0 ± 0.0	0.1788
Iron (5)	4.9 ± 0.5	4.7 ± 0.6	5.0 ± 0.0	0.0278	4.7 ± 0.6	5.0 ± 0.0	0.0490	4.7 ± 0.6	5.0 ± 0.0	0.0129
Calcium (5)	3.7 ± 1.2	2.2 ± 0.8	4.9 ± 0.5	< 0.0001	2.6 ± 1.0	4.8 ± 0.5	< 0.0001	2.0 ± 0.5	5.0 ± 0.0	< 0.0001
Vitamin C (5)	4.3 ± 1.0	3.0 ± 1.0	5.0 ± 0.0	< 0.0001	3.2 ± 1.2	5.0 ± 0.1	< 0.0001	3.2 ± 1.2	5.0 ± 0.0	< 0.0001
Moderation (30)	18.3 ± 6.2	22.8 ± 5.4	15.8 ± 5.0	0.0271	23.0 ± 4.4	15.0 ± 4.7	< 0.0001	22.3 ± 6.3	15.6 ± 4.8	0.0070
Total fat (6)	5.3 ± 1.5	5.6 ± 1.0	5.2 ± 1.4	0.2156	5.7 ± 0.8	5.2 ± 1.5	0.0232	5.5 ± 1.3	5.0 ± 1.5	0.2032
Saturated fat (6)	4.9 ± 1.9	5.2 ± 1.8	4.8 ± 1.9	0.5307	5.5 ± 1.5	4.6 ± 2.1	0.0474	5.3 ± 1.6	4.7 ± 1.9	0.0914
Cholesterol (6)	3.6 ± 2.7	5.6 ± 1.1	1.9 ± 2.3	0.0043	5.7 ± 1.2	1.5 ± 2.2	< 0.0001	5.3 ± 1.7	1.7 ± 2.3	0.0002
Sodium (6)	1.0 ± 1.9	3.3 ± 2.1	0.1 ± 0.5	< 0.0001	2.7 ± 2.4	0.0 ± 0.4	< 0.0001	3.0 ± 2.2	0.0 ± 0.4	< 0.0001
Empty calorie foods (6)	3.5 ± 2.5	3.0 ± 2.6	3.9 ± 2.4	0.0006	3.3 ± 2.6	3.7 ± 2.6	0.6264	3.1 ± 2.7	4.2 ± 2.4	0.0006
Overall balance (10)	3.4 ± 2.6	3.8 ± 2.6	3.2 ± 2.4	0.4931	3.7 ± 2.6	3.1 ± 2.4	0.7095	3.9 ± 2.8	3.2 ± 2.3	0.2092
Macronutrient ratio (6)	1.2 ± 1.8	1.5 ± 1.8	1.0 ± 1.7	0.1331	1.5 ± 1.7	0.9 ± 1.7	0.0502	1.5 ± 1.9	0.9 ± 1.7	0.0898
Fatty acid ratio (4)	2.2 ± 1.7	2.3 ± 1.6	2.3 ± 1.7	0.0094	2.3 ± 1.6	2.2 ± 1.7	0.0094	2.4 ± 1.6	2.3 ± 1.6	0.8957
Total DQI-I Score (100)	67.0 ± 9.3	60.9 ± 7.7	72.5 ± 7.4	< 0.0001	62.7 ± 8.6	71.7 ± 7.6	0.0248	61.5 ± 9.8	72.1 ± 7.2	< 0.0001

1) P for trend after adjusted for age, sex, education level, smoking, atrial fibrillation, and total energy intake 2) Values are Mean ± SD

Table 8.

The Pearsons's correlation coefficients between the ntakes of potassium, magnesium, and calcium and diet quality scores (MAR, DQI-I)

	Potassium	Magnesium	Calcium
MAR
Unadjusted	0.55892	0.52203	0.51809
Unadjusted	(p = < .0001)	(p = < .0001)	(p = < .0001)
Adjusted¹⁾	0.28739	0.22073	0.24925
Adjusted¹⁾	(p = < .0001)	(p = 0.0009)	(p = 0.0002)
Total DQI-I Score
Unadjusted	0.47989	0.34449	0.39591
Unadjusted	(p = < .0001)	(p = < .0001)	(p = < .0001)
Adjusted	0.35962	0.13149	0.22530
Adjusted	(p = < .0001)	(p = 0.0431)	(p = 0.0005)

1) Adjusted for age, sex, education level, smoking, atrial fibrilla tion, and total energy intake 2) MAR, Mean Adequacy Ratio 3) DQI-I, Diet Quality Index-International

Table 9.

Odds ratio (with 95% CIs) of extensive cerebral atherosclerosis according to intakes of potassium, magnesium and calcium¹⁾

	Q1	Q2	Q3	Q4	^Ptrend
	Q1	OR (95% CI)	OR (95% CI)	OR (95% CI)	^Ptrend
Potassium
Model 1²⁾	1 (ref.)	1.269 (0.580-2.777)	2.346 (0.972-5.665)	1.079 (0.502-2.320)	0.2669
Model 2³⁾	1 (ref.)	0.989 (0.406~2.410)	2.888 (1.078~7.742)	1.366 (0.568~3.285)	0.6425
Model 3⁴⁾	1 (ref.)	1.638 (0.359~7.469)	2.835 (0.782~10.283)	1.428 (0.491~4.156)	0.3324
Magnesium
Model 1	1 (ref.)	2.259 (0.928~5.498)	1.788 (0.767~4.166)	0.758 (0.360~1.593)	0.0181
Model 2	1 (ref.)	1.691 (0.631~4.531)	1.605 (0.636~4.052)	0.834 (0.361~1.928)	0.1957
Model 3	1 (ref.)	4.396 (0.971~19.895)	2.292 (0.651~8.066)	0.926 (0.330~2.605)	0.0204
Calcium
Model 1	1 (ref.)	1.299 (0.572~2.953)	1.299 (0.572~2.953)	0.924 (0.423~2.017)	0.3961
Model 2	1 (ref.)	1.357 (0.548~3.362)	1.802 (0.708~4.591)	1.500 (0.617~3.646)	0.4846
Model 3	1 (ref.)	2.505 (0.639~9.818)	1.972 (0.613~6.350)	1.991 (0.678~5.848)	0.2000

1) Based on a multiple logistic regression analysis 2) Values are not adjusted. 3) Values are adjusted age, sex, education leve smoking. 4) Values are adjusted age, sex, education level, smoking, atrial fibrillation, and total energy intake.

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