title: The association between total energy intake and early mortality: data from the Malmö Diet and Cancer Study.
abstract: OBJECTIVE
  In animal studies, low energy intake (EI) has been associated with a longer lifespan. We examine whether EI is an independent risk factor for prospective all-cause mortality, cardiovascular and cancer mortality in humans.
  
  
  METHODS
  Population-based, prospective cohort study.
  
  
  METHODS
  The Malmö Diet and Cancer Study is a population-based prospective cohort study. A total of 28 098 individuals, mean age 58.2 years, completed questionnaires on diet and life-style and attended a physical examination during 1991-96.
  
  
  METHODS
  Information on mortality was acquired from national registries during a mean follow-up time of 6.6 years. Subjects were categorized by quartiles of total EI. The first quartile was used as a reference point in estimating multivariate relative risks (RR; 95% CI, Cox's regression model). Adjustments were made for confounding by age and various life-style factors.
  
  
  RESULTS
  The lowest total mortality was observed for women in the third quartile (RR: 0.74; CI: 0.57-0.96) and for men in the second and third quartiles (RR: 0.85; CI: 0.69-1.04 and RR: 0.85; CI: 0.69-1.04 respectively). Similar U-shaped patterns were observed for cardiovascular mortality amongst women and cancer mortality amongst men. A statistically significant trend (P = 0.029) towards lower cardiovascular mortality from the first to the fourth quartile was observed for men.
  
  
  CONCLUSIONS
  Low caloric consumers did, on average, not have lower mortality than average or high caloric consumers. Generally, individuals approximately meeting national recommendations for total EI had the lowest mortality. For men, high caloric intake was associated with lower cardiovascular mortality.
authors.affiliation: Department of Medicine, Lund University, University Hospital (UMAS), S-205 02 Malmö, Sweden. margret.leosdottir@medforsk.mas.lu.se
authors.forename: M
authors.initials: M
authors.lastname: Leosdottir
authors.forename: P
authors.initials: P
authors.lastname: Nilsson
authors.forename: J-A
authors.initials: JA
authors.lastname: Nilsson
authors.forename: H
authors.initials: H
authors.lastname: Månsson
authors.forename: G
authors.initials: G
authors.lastname: Berglund
mesh_terms: D017677:Age Distribution; D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013548:Sweden / Q000453:epidemiology
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins