Energy intake, energy required and mortality in an older population

Objectives: The present study evaluated the association between energy intake, energy required and mortality in older adults. Design: A cohort study with a mean of 1067 (sd 474) years of follow-up. Participants completed a 24 h dietary recall. Energy required per day was computed by BMR. Deaths through 2006 were identified from the National Death Index. A Cox regression was used to estimate the hazard ratios (HR) of quantiles of energy intake and energy required on all-cause and CVD mortality, adjusting for demographics, socio-economic status and co-morbidity. Setting: The National Health and Nutrition Examination Survey (NHANES) III, 1988-1994. Subjects: A total of 4846 participants aged 60 years or above were analysed. Results: Within the follow-up period, there were a total of 2954 deaths (610 %), 519 % were caused by CVD. Relative to those in quartile 1 of energy intake, only quartile 4 was associated with all-cause mortality and CVD mortality with HR of 086 (95 % CI 077, 096, P=0006) and 076 (95 % CI 065, 089, P=0001), respectively. On the other hand, relative to those in quartile 1 of energy required, all quartiles of participants had a lower risk of all-cause mortality and CVD mortality. The interaction effects between energy intake and energy required with all-cause and CVD mortality were insignificant (P=070 and 061, respectively). Conclusions: Independent of energy required, higher energy intake was associated with lower HR of both all-cause and CVD mortality in older adults.