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Biological and psychological mediators of the relationships between fat mass, fat-free mass and energy intake

International Journal of Obesityvolume 43pages233242 (2019) | Download Citation



While recent studies in humans indicate that fat-free mass (FFM) is closely associated with energy intake (EI) when in energy balance, associations between fat mass (FM) and EI are inconsistent.


The present study used a cross-sectional design to examine the indirect and direct effects of FFM, FM and resting metabolic rate (RMR) on EI in individuals at or close to energy balance.


Data for 242 individuals (114 males; 128 females; BMI = 25.7 ± 4.9 kg/m2) were collated from the non-intervention baseline conditions of five studies employing common measures of body composition (air-displacement plethysmography), RMR (indirect calorimetry) and psychometric measures of eating behaviours (Dutch Eating Behaviour Questionnaire). Daily EI (weighed dietary records) and energy expenditure (flex heart rate) were measured for 6–7 days. Sub-analyses were conducted in 71 individuals who had additional measures of body composition (dual-energy X-ray absorptiometry) and fasting glucose, insulin and leptin.


After adjusting for age, sex and study, linear regression and mediation analyses indicated that the effect of FFM on EI was mediated by RMR (P < 0.05). FM also independently predicted EI, with path analysis indicating a positive indirect association (mediated by RMR; P < 0.05), and a stronger direct negative association (P < 0.05). Leptin, insulin and insulin resistance failed to predict EI, but cognitive restraint was a determinant of EI and partially mediated the association between FM and EI (P < 0.05).


While the association between FFM and EI was mediated by RMR, FM influenced EI via two separate and opposing pathways; an indirect ‘excitatory’ effect (again, mediated by RMR), and a stronger direct ‘inhibitory’ effect. Psychological factors such as cognitive restraint remain robust predictors of EI when considered alongside physiological determinants of EI, and indeed, have the potential to play a mediating role in the overall expression of EI.

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The authors’ responsibilities were as follows: RJS, GWH, AMJ and SW conceived the project; RJS, SW, AMJ and the project team (Leona O’Reilley and Zoe Fuller) conducted the research. CD, GWH, MH and RJS analysed the data and performed the statistical analysis. MH, GF, CG, JB and RJS wrote the initial manuscript, while all authors commented on the manuscript. RJS had primary responsibility for final content. The authors report no personal or financial conflicts of interest. The present study was funded by the Food Standards Agency, UK, and The Scottish Government’s Rural and Environment Science and Analytical Services Division. None of the funding bodies had a role in the design, analysis or writing of this article.

Author information


  1. School of Food Science and Nutrition, Faculty of Mathematics and Physical Sciences, University of Leeds, Leeds, UK

    • Mark Hopkins
  2. School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK

    • Graham Finlayson
    • , Cristiana Duarte
    • , Catherine Gibbons
    • , John E Blundell
    •  & R James Stubbs
  3. Rowett Institute, University of Aberdeen, Aberdeen, UK

    • Alexandra M Johnstone
    •  & Stephen Whybrow
  4. Biomathematics and Statistics Scotland, Aberdeen, UK

    • Graham W Horgan


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The authors declare that they have no conflict of interest.

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Correspondence to Mark Hopkins.

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