Environmental Medicine and Toxicology

Environmental Medicine and Toxicology

The association of mineral element concentrations and dietary habits with the risk of cardiovascular diseases: A random forest analysis

Document Type : Original Article

Authors
Nahid Salehi 1
Zohreh Manoochehri 2
Samaneh Nakhaee 3
Hosna Janjani 4
Amir Ahmadi 5
Borhan Mansouri 2
1 Cardiovascular Research Center, Health Policy and Promotion Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
2 Substance Abuse Prevention Research Center, Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
3 Medical Toxicology and Drug Abuse Research Center, Birjand University of Medical Sciences, Birjand, Iran
4 Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
5 Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
10.22034/emt.2026.598803.1000
Abstract
Background and Objectives: Cardiovascular diseases (CVDs) are a major cause of death worldwide, with environmental and dietary factors significantly contributing to the development of these diseases. This study aims to examine how mineral element concentrations and dietary habits together affect CVDs risk.
Methods: We conducted a cross-sectional study of 224 participants, including 102 patients with CVDs and 122 healthy controls aged 35 to 65 years from western Iran. Serum concentrations of 11 mineral elements (aluminum (Al), boron (B), calcium (Ca), cobalt (Co), potassium (K), lithium (Li), magnesium (Mg), manganese (Mn), molybdenum (Mo), phosphorus (P), and vanadium (V)) were measured using ICP-MS. Dietary habits were assessed using validated questionnaires, and Random Forest (RF) analysis and logistic regression were employed for statistical analysis.
Results: The RF model demonstrated high predictive performance, with V, Li, Al, Mn, and Co emerging as the most influential mineral elements. In multivariable logistic regression analysis, higher serum V concentrations were significantly associated with CVDs (Odds ratio (OR) = 8.80, 95% CI: 5.069–15.252), whereas the association between Li and CVDs was not statistically significant based on the reported confidence interval (OR = 3.32, 95% CI: 0.431–25.467). Older age was also associated with higher odds of CVDs (OR = 1.20 per year). Among dietary factors, daily consumption of grilled foods (OR=6.435) and use of solid oil (OR=1.963) were associated with elevated risk.
Conclusion: Serum V concentrations and selected dietary practices, particularly frequent consumption of grilled foods and use of solid oils, were associated with CVDs.

Graphical Abstract

The association of mineral element concentrations and dietary habits with the risk of cardiovascular diseases: A random forest analysis

Highlights

  • Serum vanadium (OR = 8.80) and lithium (OR = 3.32) significantly elevate CVD risk.
  • Random forest model shows 97% sensitivity and 100% specificity for CVD prediction.
  • Daily grilled food consumption increases CVD odds 6.4 times versus monthly intake.
  • Using solid oil for cooking doubles CVD risk compared to liquid oil (OR = 1.96).

Keywords
Cardiovascular diseases
Mineral elements
Vanadium
Dietary habits
Random Forest
Logistic regression
Subjects
[1] Kavak S. Biomechanics and Oxidative Stress: An Integrative Review of the Redox–Mechanobiological Axis and the Role of Trace Elements in Disease. Biol Trace Elem Res. 2026; 204: 6961–6970. http://doi.org/10.1007/s12011-026-05163-w
[2] Lamas GA, Navas-Acien A, Mark DB, Lee KL. Heavy metals, cardiovascular disease, and the unexpected benefits of chelation therapy. J Am Coll Cardiol. 2016; 67(20): 2411–2418. http://doi.org/10.1016/j.jacc.2016.02.066
[3] Wang K, Mao Y, Liu Z, Li Y, Li Z, Sun Y, et al. Association of Blood Heavy Metal Exposure with Atherosclerotic Cardiovascular Disease (ASCVD) Among White Adults: Evidence from NHANES 1999–2018. Biol Trace Elem Res. 2023;201(9):4321–33. http://doi.org/10.1007/s12011-022-03537-4
[4] Ertik O, Tunali S, Acar ET, Bal-Demirci T, Ülküseven B, Yanardag R. Antioxidant Activity and Protective Effects of an Oxovanadium (IV) Complex on Heart and Aorta Injury of STZ-Diabetic Rats. Biol Trace Elem Res. 2024;202(5):2085-2099. http://doi.org/10.1007/s12011-023-03802-0
[5] Wang Y, Ouyang L, Ma X, Chen X, He Y. Hemodynamics and arrhythmia disorder caused by lithium poisoning: A case report. Journal of Central South University Medical Sciences. 2024;49(2):311-316. http://doi.org/10.1007/s12011-023-03802-0
[6] Dudev T, Cheshmedzhieva D, Doudeva L. Competition between abiogenic Al3+ and native Mg2+, Fe2+ and Zn2+ ions in protein binding sites: implications for aluminum toxicity. J Mol Model. 2018;24(3):55. http://doi.org/10.1007/s00894-018-3592-0
[7] Tan Q, Ma J, Zhou M, Wang D, Wang B, Nie X, et al. Heavy metals exposure, lipid peroxidation and heart rate variability alteration: Association and mediation analyses in urban adults. Ecotoxicol Environ Saf. 2020; 205: 111149. http://doi.org/10.1016/j.ecoenv.2020.111149
[8] Van Horn L, McCoin M, Kris-Etherton PM, Burke F, Carson JAS, Champagne CM, et al. The evidence for dietary prevention and treatment of cardiovascular disease. J Am Diet Assoc. 2008;108(2):287–331. http://doi.org/10.1016/j.jada.2007.10.050
[9] Salter AM. Dietary fatty acids and cardiovascular disease. Animal. 2013;7:163–71.
[10] Williams CM, Lovegrove JA, Griffin BA. Dietary patterns and cardiovascular disease. Proc Nutr Soc. 2013;72(4):407–11.
[11] Alissa EM, Ferns GA. Dietary fruits and vegetables and cardiovascular diseases risk. Crit Rev Food Sci Nutr. 2017;57(9):1950–62. http://doi.org/10.1080/10408398.2015.1040487
[12] Brandhorst S, Longo VD. Dietary restrictions and nutrition in the prevention and treatment of cardiovascular disease. Circ Res. 2019;124(6):952–65. http://doi.org/10.1161/CIRCRESAHA.118.313352
[13] Moradinazar M, Pasdar Y, Najafi F, Shahsavari S, Shakiba E, Hamzeh B, et al. Association between dyslipidemia and blood lipids concentration with smoking habits in the Kurdish population of Iran. BMC Public Health. 2020; 20: 1-10. http://doi.org/10.1186/s12889-020-08809-z
[14] Pasdar Y, Najafi F, Moradinazar M, Shakiba E, Karim H, Hamzeh B, et al. Cohort profile: Ravansar Non-Communicable Disease cohort study: the first cohort study in a Kurdish population. Int J Epidemiol. 2019; 48(3):682-3f. http://doi.org/10.1093/ije/dyy296
[15] Breiman L. Random forests. Machine learning. 2001;45:5-32.
[16] Su X, Xu Y, Tan Z, Wang X, Yang P, Su Y, et al. Prediction for cardiovascular diseases based on laboratory data: An analysis of random forest model. J Clin Lab Anal. 2020;34(9):e23421. http://doi.org/10.1002/jcla.23421
[17] https://cran.r-project.org/web/packages/randomForest/index.html.
[18] Kuhn M, Wing J, Weston S, Williams A, Keefer C, Engelhardt A, et al. Package ‘caret’. The R Journal. 2020;223(7).
[19] Zhang Z, Chau PY, Lai HK, Wong CM. A review of effects of particulate matter-associated nickel and vanadium species on cardiovascular and respiratory systems. Int J Environ Health Res. 2009 Jun;19(3):175-85. http://doi.org/10.1080/09603120802460392
[20] Wang YB, Yu YQ, Yang JY, Liu YY. Bioaccessibility of vanadium in respiratory inhalation and skin contact routes by in vitro biomimetic simulations and environmental risk assessment. Environ Geochem Health. 2026 Jul 14;48(10):453. http://doi.org/10.1007/s10653-026-03351-0
[21] Banik BK, Bajpai S, Kamboj M, Pandey G. Trace Metals Selenium, Chromium and Vanadium: Chemistry, Biology and Human Health. Chapter 8, Role of Vanadium Compounds on Human Health. CRC Press, Taylor & Francis Group, 2025, 272 pages. 18:169.
[22] Ścibior A, Kurus J. Vanadium and oxidative stress markers-in vivo model: a review. Current Med Chem. 2019; 26(29): 5456-500. http://doi.org/10.2174/0929867326666190108112255
[23] Wang Y, Hassan HM, Nisar A, Zahara SS, Akbar A, Al-Emam A. Cardioprotective potential of tectochrysin against vanadium induced heart damage via regulating NLRP3, JAK1/STAT3 and NF-κB pathway. J Trace Elem Med Biol. 2025 1;87:127588. http://doi.org/10.1016/j.jtemb.2025.127588
[24] Dolan CC, Whitcomb LA, Del Carpio E, Rose L, Chicco AJ, Crans DC. How vanadium and manganese compounds impact cardiac mitochondrial function. Frontiers Chem Biol. 2025 17;4:1602602. http://doi.org/10.3389/fchbi.2025.1602602
[25] Li H, Zhou DL, Zhang Q, He KP, Feng CY, Lan YJ. Cardiovascular System Symptoms and Blood Pressure in Workers Exposed to Vanadium. J Environ Occup Med. 2013. 30(2): 140-142.
[26] Ostro B, Feng WY, Broadwin R, Green S, Lipsett M. The effects of components of fine particulate air pollution on mortality in california: results from CALFINE. Environ Health Perspect. 2007;115(1):13-9. http://doi.org/10.1289/ehp.9281
[27] Tian L, Qiu H, Lin H, Hossain SR, Wu Y, Wong TW, Yu IT. Elevated PM2. 5 nickel and vanadium increase cardiovascular mortality in Hong Kong. Epidemiol. 2011; 22(1): S159-60. http://doi.org/10.1097/01.ede.0000392163.11869.e9
[28] Sikka RR. Vanadium in Fine Particulate Matter and its Association with Blood Pressure in the Multi-Ethnic Study of Atherosclerosis Cohort (Doctoral dissertation). University of Washington Libraries, 2014, 26 pages.
Environmental Medicine and Toxicology
Volume 1, Issue 1
Summer 2026
Pages 13-21

  • Receive Date 23 August 2026
  • Revise Date 12 September 2026
  • Accept Date 15 September 2026
  • First Publish Date 15 September 2026
  • Publish Date 17 September 2026