The association between total energy intake and early mortality: data from the Malmo ̈ Diet and Cancer Study

Objectives. 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. Design. Population-based, prospective cohort study. Setting and subjects. The Malmo ̈ 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. Main outcome measures. 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 quartile