Cognitive dietary restraint, disinhibition, and hunger are associated with 24-h energy expenditure

Background Higher energy expenditure (EE) is associated with greater food intake, possibly because the human body senses EE and modifies eating behaviors to regulate food intake and ultimately achieve energy balance. As eating behaviors are also influenced by social and cultural factors, any association between EE and eating behavior may differ between ethnicities and sexes. Objective To assess relationships between EE and eating behavior constructs of the Three-Factor Eating Questionnaire (TFEQ). Subjects/Methods In all, 307 healthy adults (201 M/106 F, 160 Native Americans) completed the TFEQ and had measures of 24-h EE in a whole-room calorimeter during energy balance. Body composition was assessed by DXA. Results On average, adjusted 24-h EE was lower (beta = -229 kcal/day, CI: -309 to -148, p < 0.001) but cognitive restraint (Delta = + 1.5; CI: 0.5 to 2.5, p = 0.003) and disinhibition (Delta = + 2.1, CI: 1.3 to 2.8, p < 0.001) scores were higher in women compared with men. In Native Americans, adjusted 24-h EE (beta = + 94 kcal/day, CI: 48 to 139, p < 0.001) and disinhibition scores (Delta = + 1.0, CI: 0.1 to 2.0, p = 0.003) were higher compared with other ethnicities. Higher 24-h EE associated with lower cognitive restraint in women (rho = -0.20, p = 0.04), but not men (p = 0.71; interaction term p = 0.01) with no ethnic differences. Greater 24-h EE associated with higher disinhibition (rho = 0.20, p = 0.001) and hunger cues (rho = 0.16, p = 0.004) with no gender differences. These associations were primarily present in non-Native Americans (rho = 0.23, p = 0.006 and rho = 0.25, p = 0.003) but not observed in Native Americans (both p > 0.40). Conclusions Higher EE is associated with psychological constructs of eating behaviors that favors overeating including lower cognitive restraint, higher dietary disinhibition, and greater susceptibility to hungers cues, supporting the existence of energy-sensing mechanisms influencing human eating behavior. These associations were observed in ethnicities other than Native Americans, possibly explaining the contradictory relationships reported between EE and weight change in different ethnic groups. We propose that increased EE may alter eating behaviors, potentially leading to uncontrolled overeating and weight gain.