Association between Dietary Manganese Intake and Mortality from Cardiovascular Disease in Japanese Population: The Japan Collaborative Cohort Study

Aim: Manganese (Mn) is an essential element in the human body, and it has a significant impact on cardiovascular risk factors such as diabetes, blood pressure, and cholesterol levels. However, no research has been conducted on the association between Mn and cardiovascular disease (CVD), to the best of our knowledge. This study thus examined the association between dietary Mn intake and CVD mortality in the general Japanese population. Methods: The CVD mortality among 58,782 participants from the Japan Collaborative Cohort Study (JACC) aged 40???79 years was determined during a median follow-up period of 16.5 years. The Mn intake was estimated using a food frequency questionnaire at the baseline (1989???1990), and multivariate-adjusted hazard ratios (HRs) for mortality were computed according to quintiles of energy-adjusted Mn intake. Results: During the follow-up period, a total of 3408 CVD deaths were recorded. Participants in the highest quintile of Mn intake had a lower risk of mortality from total stroke (HR:95% CI, 0.76: 0.64???0.90), ischemic stroke (HR: 0.77, 0.61???0.97), ischemic heart disease (HR: 0.76, 0.58???0.98), and total CVD (HR: 0.86, 0.76??? 0.96) compared with those in the lowest quintile. The reduced risk of mortality from intraparenchymal hemorrhage with high Mn intake was observed among women (HR: 0.60, 0.37???0.96) but not men (HR: 0.93, 0.59???1.47). The observed associations were more robust in postmenopausal than in premenopausal women. Conclusions: Our study is the first to show the prospective association between dietary Mn intake and reduced risk of mortality from CVD in the Japanese population.