# Dietary calcium is inversely associated with hepatitis B virus infection: an analysis of US National Health and Nutrition Examination Survey (NHANES) 2007–2020

## TL;DR

Higher dietary calcium intake is linked to a lower risk of hepatitis B virus infection in the US population, according to a large health survey.

## Contribution

This study reveals a novel inverse relationship between dietary calcium and HBV infection in a nationally representative sample.

## Key findings

- HBV infection had a linear negative correlation with dietary calcium (OR 0.37; 95%CI 0.19, 0.76).
- Each additional 10 mg of dietary calcium reduced HBV infection risk by 63%.
- The relationship between calcium and HBV varied by sex, race/ethnicity, and BMI.

## Abstract

There have been studies on the relationship between hepatitis B virus (HBV) infection and diet. We hypothesized HBV infection is related to dietary calcium intake, but the evidence is limited. This study aimed to examine whether dietary calcium intake is independently related to HBV infection in the United States population.

A total of 20,488 participants aged over 20 years from the National Health and Nutrition Examination Survey (NHANES), conducted from 2007 to 2020, were included in this study. Pearson correlation was used to test the association between dietary calcium and serum calcium. The relationships of HBV infection with dietary calcium and serum calcium were assessed by logistic regression models.

There was a weak correlation between dietary calcium and serum calcium (r = 0.048). Logistic regression models indicated that HBV infection had a linear negative correlation with dietary calcium (OR 0.37; 95%CI 0.19, 0.76). For each additional 10 mg dietary calcium, the possibility of HBV infection was reduced by 63%. Hepatitis B positive participants had lower serum calcium content than negative participants. Stratified analysis shown the linear relationship between calcium and HBV infection varied among sex, race/ethnicity, and body mass index.

Our findings demonstrated HBV infection was linearly and inversely correlated with dietary calcium. The current study is expected to offer a fresh perspective on reducing HBV infection.

The online version contains supplementary material available at 10.1186/s41043-024-00532-4.