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00925njm 22002777a 4500 dc Lassale, Camille author Hernaez, Alvaro author Toledo, Estefanía author Castaner, Olga author Sorli, Jose V author Salas-Salvado, Jordi author Estruch, Ramon author Ros, Emilio author Alonso-Gomez, Angel M author Lapetra, Jose author Cueto, Raquel author Fiol Sala, Miquel author Serra-Majem, Lluis author Pinto, Xavier author Gea, Alfredo author Corella, Dolores author Babio, Nancy author Fito, Montserrat author Schroder, Helmut author 2021-05 Clinical data on the direct health effects of energy deficit or surplus beyond its impact on body weight are scarce. We aimed to assess the association with all-cause, cardiovascular and cancer mortality of (1) sustained energy deficit or surplus, calculated according to each individual's en-ergy intake (EI) and theoretical energy expenditure (TEE), and (2) mid-term change in total EI in a prospective study. In 7119 participants in the PREDIMED Study (PREvencion con DIeta MEDi-terranea) with a mean age of 67 years, energy intake was derived from a 137-item food frequency questionnaire. TEE was calculated as a function of age, sex, height, body weight and physical ac-tivity. The main exposure was the proportion of energy requirement covered by energy intake, cumulative throughout the follow-up. The secondary exposure was the change in energy intake from baseline. Cox proportional hazard models were used to estimate hazard ratios and 95% con-fidence intervals for all-cause, cardiovascular and cancer mortality. Over a median follow-up of 4.8 years, there were 239 deaths (excluding the first 2 years). An energy intake exceeding energy needs was associated with an increase in mortality risk (continuous HR10% over energy needs = 1.10; 95% CI 1.02, 1.18), driven by cardiovascular death (HR = 1.26; 95% CI 1.11, 1.43). However, consum-ing energy below estimated needs was not associated with a lower risk. Increments over time in energy intake were associated with greater all-cause mortality (HR10% increase = 1.09; 95% CI 1.02, 1.17). However, there was no evidence that a substantial negative change in energy intake would reduce mortality risk. To conclude, in an older Mediterranean cohort, energy surplus or increase over a 5-year period was associated with greater risk of mortality, particularly cardiovascular mortality. Energy deficit, or reduction in energy intake over time were not associated with mortal-ity risk. Lassale C, Hernaez A, Toledo E, Castaner O, Sorli JV, Salas-Salvado J, et al. Energy Balance and Risk of Mortality in Spanish Older Adults. Nutrients. 2021 May;13(5):1545. https://hdl.handle.net/20.500.13003/19572 https://hdl.handle.net/20.500.12105/23261 34064328 10.3390/nu13051545 2072-6643 Nutrients 2-s2.0-85105181586 662344000001 L2007083975 Energy balance Mortality Epidemiology Energy Balance and Risk of Mortality in Spanish Older Adults