Dietary intake of minerals and risk of esophageal squamous cell carcinoma: results from the Golestan Cohort Study

Am J Clin Nutr. 2015 Jul;102(1):102-8. doi: 10.3945/ajcn.115.107847. Epub 2015 May 27.


Background: Dietary factors have been hypothesized to affect the risk of esophageal cancer via different mechanisms, but the intake of minerals is understudied and the evidence is conflicting.

Objective: The objective was to evaluate the associations of dietary intake of minerals with risk of esophageal squamous cell carcinoma (ESCC).

Design: We used data from the Golestan Cohort Study, which was launched in a high-risk region for esophageal cancer in Iran. Participants were enrolled in 2004-2008 and were followed to 2014. Intakes of minerals were assessed with a validated food-frequency questionnaire. A Cox proportional hazards model was used to estimate HRs and 95% CIs of ESCC for dietary intakes of selected minerals.

Results: We identified 201 ESCC cases among 47,405 subjects. Calcium intake was significantly inversely associated with the risk of ESCC (HR per 100-mg/d increase: 0.88; 95% CI: 0.81, 0.96; P = 0.005; quartile 4 vs. quartile 1 HR: 0.49; 95% CI: 0.29, 0.82; P-trend = 0.013). Zinc intake was also inversely associated with ESCC, but the quartile association did not reach significance (HR per 1-mg/d increase: 0.87; 95% CI: 0.77, 0.98; P = 0.027; quartile 4 vs. quartile 1 HR: 0.56; 95% CI: 0.28, 1.12; P-trend = 0.097). The relations between dietary intakes of selenium, magnesium, and copper and risk of ESCC were nonlinear (P-nonlinear trend = 0.001, 0.016, and 0.029, respectively). There was no relation between dietary intake of manganese and the risk of ESCC.

Conclusion: The results suggest that higher intakes of calcium and zinc are associated with a lower risk of ESCC in a high-risk region of Iran.

Keywords: calcium; copper; esophageal cancer; magnesium; manganese; minerals; selenium; zinc.

Publication types

  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / epidemiology*
  • Copper / administration & dosage
  • Esophageal Neoplasms / epidemiology*
  • Esophageal Squamous Cell Carcinoma
  • Female
  • Follow-Up Studies
  • Humans
  • Iran / epidemiology
  • Magnesium / administration & dosage
  • Male
  • Middle Aged
  • Nonlinear Dynamics
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Selenium / administration & dosage
  • Surveys and Questionnaires
  • Trace Elements / administration & dosage*


  • Trace Elements
  • Copper
  • Selenium
  • Magnesium