Influence of Body Composition on the Accuracy of Reported Energy Intake in Children

Objective: Mis‐reporting dietary intake is a substantial barrier to understanding the role of dietary behavior in disease. Work with adults indicates that heavier individuals under‐report dietary intake and that under‐reporting may be macronutrient‐specific. Whether weight status and macronutrient intake influence the accuracy of dietary reports among children, however, is less clear. This research evaluated children's dietary reporting accuracy as a function of their relative weight, body composition, and macronutrient intake. Research Methods and Procedures: Participants included 146 4‐ to 11‐year‐old children. Reported energy intake was determined by interviewing children in the presence of parents, using three multiple pass, 24‐hour recalls. Children were classified as having had an under‐reported, accurately reported, or over‐reported dietary intake relative to total energy expenditure, as measured by doubly labeled water. Reporting accuracy was examined as a function of children's body weight, body composition (using dual energy x‐ray absorptiometry), and macronutrient intake. Results: Average reported intake was, on average, 14% greater than children's estimated expenditure (p < 0.01). Reporting accuracy varied as a function of children's relative weight and body composition; under‐reporting tended to occur among heavier children, having the highest body fat content (p < 0.0001) and relative weight (p < 0.0001). Discussion: These findings suggest that weight status influences the accuracy of dietary reports made by children and their parents. More research is needed to address possible psychological and social factors that introduce bias in reporting children's dietary data.     

Energy Intake Patterns in Obese Women with Binge Eating Disorder

Objective: For binge eating disorder (BED) to be accepted as a distinct diagnostic category in the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition, it must be demonstrated that the criteria identify a diagnostic entity that is distinct from bulimia nervosa and obesity. This study examined the difference in total energy intake per day, patterns of energy intake throughout the day, and nutrient content of foods consumed in obese individuals who met the criteria for BED (on binge and non‐binge days) and those who did not. Research Methods and Procedures: Twenty women, 12 who met Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition, criteria for BED and 8 matched obese controls, participated in the study. All participants underwent six random 24‐hour dietary recall telephone interviews conducted by experienced interviewers using the Nutrition Data Software System. Results: The BED group ingested significantly more kilocalories on days when they had binge eating episodes than the obese control group on average. The BED group ate significantly more in the evening on binge days than their control group counterparts. There is some indication in the data that those with BED may be restricting caloric intake. Finally, data indicated that the BED group ate significantly more protein, carbohydrate, and fat on binge days than on non‐binge days. However, the proportion of kilocalories from each nutrient shifted on BED binge days compared with non‐binge days to favor consumption of fat over carbohydrates. Discussion: More research needs to be done to determine if these findings are reproducible. Then, the neurobiological underpinnings of these differences in nutrient intake patterns and nutrient selection can be studied to help to determine the biological basis of the disorder.     

Association between Serum Leptin Levels and 24‐Hour Blood Pressure in Obese Women

Objective: To assess the relationship between serum leptin and 24‐hour blood pressure (BP) in obese women, according to body fat distribution. Research Methods and Procedures: A cross‐sectional study was carried out in a population of 70 nondiabetic, normotensive, obese women (40 with android and 30 with gynoid type of obesity) and 20 nonobese healthy women as a control group. All subjects underwent 24‐hour ambulatory BP monitoring. Blood samples were collected for serum leptin and plasma insulin measurements. Total cholesterol and high‐density lipoprotein cholesterol were also measured. Results: Serum leptin levels were significantly higher in obese subjects than in controls, and they were more elevated in android obese women than in gynoid ones. Leptin levels were positively related to body mass index (BMI), insulin, and waist and hip circumferences in the android group. Among gynoid subjects, leptin levels showed positive associations with BMI and insulin. In women with android obesity, strong positive correlations (p < 0.001) were found between leptin levels and 24‐hour systolic BP (SBP), daytime SBP, nighttime SBP, 24‐hour diastolic BP (DBP), and daytime DBP. Multiple regression analyses, including age, insulin and leptin concentrations, BMI, and waist and hip circumferences on 24‐hour and daytime SBP and DBP, showed that only leptin levels contributed to the variability of BP. Conclusions: Our study shows that serum leptin levels are directly related to 24‐hour BP levels in normotensive women with android fat distribution, independently of BMI.     

Impact of Dieting Status and Dietary Restraint on Postexercise Energy Intake in Overweight Women

Objective: To investigate the unknown relationship between dieting status and dietary restraint on postexercise energy intake (PE-EI) in overweight sedentary women after a bout of moderate-intensity exercise. Specifically, this was investigated in women who were categorized as dieting with high restraint, nondieting with high restraint, or nondieting with low restraint. Research Methods and Procedures: This study consisted of two experimental conditions, exercise (E) and nonexercise (NE) in a counterbalanced-crossover design on 2 different days. On the E day, the subjects participated in moderate-intensity exercise, walking on a treadmill for 60 minutes at 60% to 70% of their maximum heart rate. PE-EI at lunch and 12 hours after was compared on the E and an NE day. Dietary restraint was determined using the Three-Factor Eating Questionnaire. Results: Participants (n = 36) were 26 ± 7 years of age, sedentary, and had a mean body mass index of 27 ± 3 kg/m². There was a significant interaction (F_(2,33) = 3.32, p = 0.049) of dieting/restraint status and condition (E vs. NE day) on 12-hour EI. The mean difference in 12-hour EI between the E and the NE day was significantly higher (p < 0.01) for the dieting with high restraint than for the nondieting with high restraint. Discussion: The results of this study demonstrate that dieting status, high dietary restraint, and higher levels of disinhibition may influence PE-EI in overweight women after a bout of moderate-intensity physical activity.     

Weekend Eating in the United States Is Linked with Greater Energy,Fat, and Alcohol Intake

Objectives: To determine if macronutrient consumption for the U.S. population is greater on weekend days than weekdays. Research Methods and Procedures: The nationally representative 1994 to 1996 Continuing Survey of Food Intakes by Individuals was used for this analysis. Dietary intake was assessed using two independent days of dietary recall data. Ordinary least squares multivariate analysis was used to analyze dietary outcome variables to explore the effect of weekend day vs. weekday intake. Results: This study's results indicate that statistically significant dietary intake differences occur for different days of the week but not for all age groups—nor for all nutrients. The average American, 2 years and older, consumes 82 kcal more per day on each weekend day (Friday through Sunday) than they do on weekdays (Monday through Thursday). These overall increases in dietary intake are significant for the overall sample and are largest for the 19‐ to 50‐year‐old age group; among this age group, the weekend day increase (vs. weekday) is 115 kcal/d. The increased proportions of energy from fat and alcohol consumed on weekends are greater for this adult age group by 0.7% and 1.4%, respectively, whereas the proportion of energy from carbohydrate decreases 1.6%. Discussion: The effects of weekend days on nutrient intake are substantial and should be considered in future clinical and population‐based interventions and in dietary monitoring and research in the U.S.     

Binge Size Increases with Body Mass Index in Women with Binge-Eating Disorder

Objective: To determine whether meal size is related to body mass index (BMI) in obese subjects with binge-eating disorder (BED). Research Methods and Procedures: Five groups of subjects each consumed two laboratory-test meals on nonconsecutive days. Forty-two women, categorized by BMI and BED diagnosis, were instructed to “binge” during one meal and to eat “normally” during another. Eighteen women had BMI values >38 kg/m² (more-obese) and 17 had BMI values between 28 to 32 kg/m² (less-obese). Twelve of the more-obese and nine of the less-obese individuals met Diagnostic and Statistical Manual (DSM)-IV criteria for BED. Seven normal-weight women also participated as controls. Results: Subjects with BED ate significantly more in both meals than subjects without BED. Binge meals were significantly larger than normal meals only among subjects with BED. The more-obese subjects with BED ate significantly more than the less-obese subjects with BED, but only when they were asked to binge. Intake of the binge meal was significantly, positively correlated with BMI among subjects with BED. Subjects with BED reported significantly higher satiety ratings after the binge than after the normal meal, but subjects without BED reported similar ratings after both meals. Regardless of instructions and diagnosis, obese subjects consumed a significantly higher percentage of energy from fat (38.5%) than did normal-weight subjects (30.8%). Discussion: During binge meals, the energy intake of subjects with BED is greater than that of individuals of similar body weight without BED and is positively correlated with BMI.     

Resemblance for Body Mass Index in Families of Obese African American and European American Women

Objective: We determined the levels of resemblance in body mass index (BMI) in large samples of families selected through obese African American and European American women. Research Methods and Procedures: We examined correlations among relatives in 1185 European American and African American families ascertained through age-matched obese women (BMI ≥ 30 kg/m²). A subset of 801 families were ascertained through extremely obese women (BMI ≥ 40 kg/m²). Results: Parent-offspring and sibling correlations ranged from 0.19 to 0.15, suggesting a moderate level of heritability in both groups. Mean BMI values for female relatives were lower for European Americans than for African Americans even though probands were matched, perhaps because the European American relatives regress to a lower population mean. We found significantly higher family correlations for height in European Americans, suggesting greater environmental variability among African Americans for factors affecting growth and physical development. Discussion: Our results suggest a similar level of heritability of BMI in families of obese African American and European American women. Other genetic studies will be needed to determine the extent to which the same or different genes and environmental conditions contribute to an overall similar heritability in the two racial groups.     

Assessment of Global Coronary Heart Disease Risk in Overweight and Obese African‐American Women

Objective : To examine, with the use of national guidelines, coronary heart disease (CHD) risk with increasing BMI for primary prevention in urban African‐American women. Research Methods and Procedures : Participants were recruited for CHD risk factor screening from 20 churches as part of a larger study of nutrition and fitness (Project Joy). All participants had a demographic, smoking and medical history assessment, and the following measurements were taken: weight, height, waist circumference, blood pressure, lipid levels, and glucose. Three methods of defining risk, the Framingham Point Scoring System, a count of risk factors, and the presence of the multiple metabolic syndrome, based on the National Cholesterol Education Program Adult Treatment Panel III Report and BMI classes established by the Clinical Guidelines, were used. Results : A total of 396 women were eligible. Participants were 40 to 80 years of age and had marked excess prevalence of overweight and obesity (84%); 55% were obese. There was a linear increase in risk factors as BMI increased. Lipids did not differ significantly among BMI classifications. Seventeen percent of women had multiple metabolic syndrome. Eight percent and 16% of women in the normal and overweight BMI classes, respectively, had two or more modifiable risk factors. There was no difference in number of modifiable risk factors among the obese classes. The Framingham Point Scoring System assigned a <10% risk of a hard CHD event in 10 years to 97% of the women. Discussion : National risk assessment guidelines for primary prevention of CHD may not be adequate for overweight and obese urban African‐American women and require further study.     

Body Mass Index and Physical Function in Older Women

Objective: We modified existing standardized measurement tools in the Physical Performance Test and tasks from the Frailty and Injuries: Cooperative Studies of Intervention Technique Study to evaluate physical function in older women. Our objectives were (1) to characterize physical function themes based on combinations of tasks (deriving factors or components) and (2) to quantify the correlation between derived factors and body mass index (BMI). Research Methods and Procedures: Nutrition risk screens from enrollees in a Medicare‐managed risk program served as the sampling frame. To obtain adequate representation for a range of BMI, a random sample was obtained of 90 women from the following BMI strata: BMI, 22 to <27 kg/m²; BMI, 27 to <30 kg/m²; and BMI, ≥30 kg/m². Subjects were asked to perform a series of 18 functional tasks during a home visit. Results: The mean age was similar in the three BMI groups with an overall mean age of 71 ± 4.9 years (SD). Factors characterized by lower‐body function, upper‐body function, coordination, and strength were responsible for 30%, 11%, 9%, and 9% of the variance in task scores, respectively. BMI, controlling for age, explained 5%, 14%, 3%, and 0% of the variation in these factors, respectively. Higher BMI is associated significantly with poorer upper‐ and lower‐body function but is not associated significantly to strength or coordination. Discussion: Higher BMI seems to differentially impede specific aspects of physical function, especially upper‐body function, and to a lesser extent, lower‐body function. BMI does not seem to be associated with levels of coordination or strength. Better understanding of how BMI impacts physical function will aid in the design of interventions to promote independent living in elderly, obese women.     

Dietary Intake in Relation to Restrained Eating,Disinhibition, and Hunger in Obese and Nonobese Swedish Women

The aims of this study were to: describe dietary intakes of obese and nonobese middle-aged women using a validated food frequency questionnaire; to assess dietary restraint, disinhibition, and hunger by the three factor eating questionnaire (TFEQ) in obese and nonobese samples and determine which of the factors are independently associated with obesity; and to examine correlations between selected nutritional variables and the TFEQ factors. Subjects studied included 179 obese Swedish women (BMI>32) and 147 nonobese population-based controls (BMI<28). Age-adjusted mean energy intake was significantly higher in obese women (2730 ± 78 vs. 2025 ± 85 kcal, p<0.0001). In absolute and relative terms, fat intake was higher and alcohol intake was lower in the obese subjects. Disinhibition was the strongest TFEQ factor independently differentiating the obese and nonobese states, i.e., after adjustment for restraint and hunger. Within the obese sample, strong associations were seen between energy intake and disinhibition (p=0.0005) and hunger (p=0.0004). The association between energy intake and restrained eating was negative and weaker (p=0.04). No such associations were seen in nonobese women. Thus, using a dietary instrument that is valid and unbiased with respect to obesity, strong psychological correlates, possibly causal, of variability in energy intake were detected in middle-aged women with obesity. Disinhibition is associated with both obesity and high-energy intakes and is therefore an important factor to consider in the treatment of women with obesity.     

Use of Tape‐Recorded Food Records in Assessing Children's Dietary Intake

Background: Dietary assessment among children is particularly problematic when techniques are dependent on memory skills or advanced cognitive development. Objective: The current study explored the use of self‐report by tape recorders to document children's dietary intake immediately upon consumption, and compared this method with the traditional, interviewer‐guided recall technique. In addition, the influence of body fatness and sociodemographic characteristics on the accuracy of recall and tape‐recorded food records was determined. Research Methods and Procedures: The sample included 30 black and white children aged 6.5 to 11.6 years (x¯ = 9.5). Energy intake (EI), measured by six 24‐hour food records (three for each method), was compared with total energy expenditure calculated by the doubly labeled water technique. Paired t tests, correlation analyses, and multiple re‐gression analyses were performed. Results: The analyses revealed poor validity of the tape recorder method (x¯ misreporting score = ?1.13 ± 2.62 MJ/day, r for total energy expenditure and EI = ?0.06, p = 0.74). Estimates of EI differed significantly between the tape recorder and recall methods (p < 0.01). The traditional recall method was confirmed as a valid estimate of energy intake (x¯ misreporting score = 0.04 ± 2.38 MJ/day), although demonstrating a modest correlation with TEE (r = 0.32, p = 0.08). Although no significant predictors of misreporting using the recall method were identified in the multivariate analyses, older children and children with higher adiposity were more likely to misreport using the tape recorder method. Discussion: The results suggest that the use of the tape recorder for estimating EI does not result in accurate assessments among children, although this techniquemay be useful for specific subgroups (i.e., younger and leaner children).     

Maternal Prepregnancy Body Mass Index and Gestational Weight Gain on Offspring Overweight in Early Infancy

Objective

The aim of the present study was to evaluate the association of maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG) with anthropometry in the offspring from birth to 12 months old in Tianjin, China.

Methods

Between 2009 and 2011, health care records of 38,539 pregnant women had been collected, and their children had been measured body weight and length at birth, 3, 6, 9 and 12 months of age. The independent and joint associations of pre-pregnancy BMI and GWG based on the Institute of Medicine (IOM) guidelines with anthropometry in the offspring were examined using General Linear Model and Logistic Regression.

Results

Prepregnancy BMI and maternal GWG were positively associated with Z-scores for birth weight-for-gestational age, birth length-for-gestational age, and birth weight-for-length. Infants born to mothers with excessive GWG had the greatest changes in Z-scores for weight-for-age from birth to Month 3, and from Month 6 to Month 12, and the greatest changes in Z-scores for length-for-age from birth to months 3 and 12 compared with infants born to mothers with adequate GWG. Excessive GWG was associated with an increased risk of offspring overweight or obesity at 12 months old in all BMI categories except underweight.

Conclusions

Maternal prepregnancy overweight/obesity and excessive GWG were associated with greater weight gain and length gain of offspring in early infancy. Excessive GWG was associated with increased infancy overweight and obesity risk.     

Effects of a Fat Substitute,Sucrose Polyester,on Food Intake,Body Composition,and Serum Factors in Lean and Obese Zucker Rats

Sucrose polyester, a fat substitute, has shown promise in reducing blood cholesterol and body weight of obese individuals. Effects of this compound in the Zucker rat, a genetic model of obesity, are unknown. Thus, we examined food intake, body weight, body composition, and several metabolic parameters in sera of lean and obese female Zucker rats. Eight-week-old lean and obese animals were given a choice between a control diet (15% corn oil) and fat substitute diet (5% corn oil and 10% sucrose polyester) for 2 days. Next, one-half of the lean and obese groups received control diet; the remaining lean and obese rats received fat substitute diet for 18 days. Cumulative food intake was depressed in fat substitute groups relative to control-fed animals; however, this effect was more predominant in obese animals. Obese rats consuming fat substitute diet (O-FS) gained less weight as compared to obese control-fed animals (O-C). Lean rats given fat substitute (L-FS) did not have significantly different body weights as compared to the L-C group. Fat substitute groups, combined, had lower body fat and higher body water as compared to controls. The O-FS group had lower serum glucose and insulin and higher fatty acid levels compared to the O-C group. There were no differences in serum cholesterol, HDL, or triglyceride levels due to fat substitute diet. These data suggest that the obese Zucker rat is unable to defend its body weight when dietary fat is replaced with sucrose polyester.     

Effect of Body Mass Index on Global DNA Methylation in Healthy Korean Women

Obesity is known to be strongly associated with cardiovascular disease and cancer, the leading causes of mortality worldwide, and develops owing to interactions between genes and the environment. DNA methylation can act as a downstream effector of environmental signals, and analysis of this process therefore holds substantial promise for identifying mechanisms through which genetic and environmental factors jointly contribute to disease risk. Global DNA methylation of peripheral blood cells has recently been proposed as a potential biomarker for disease risk. Repetitive element DNA methylation has been shown to be associated with prominent obesity-related chronic diseases, but little is known about its relationship with weight status. In this study, we quantified the methylation of Alu elements in the peripheral blood DNA of 244 healthy women with a range of body mass indexes (BMIs) using pyrosequencing technology. Among the study participants, certain clinical laboratory parameters, including hemoglobin, serum glutamic oxaloacetic transaminase, serum glutamic-pyruvic transaminase, total cholesterol, and triglyceride levels were found to be strongly associated with BMI. Moreover, a U-shaped association between BMI and Alu methylation was observed, with the lowest methylation levels occurring at BMIs of between 23 and 30 kg/m². However, there was no significant association between Alu methylation and age, smoking status, or alcohol consumption. Overall, we identified a differential influence of BMI on global DNA methylation in healthy Korean women, indicating that BMI-related changes in Alu methylation might play a complex role in the etiology and pathogenesis of obesity. Further studies are required to elucidate the mechanisms underlying this relationship.     

Impact of Weight Reduction on Early Carotid Atherosclerosis in Obese Premenopausal Women

Objective: To investigate the extent of carotid atherosclerosis and the effect of weight loss on carotid intima‐media thickness (IMT) in obese premenopausal women. Research Methods and Procedures: In 43 obese premenopausal women who participated in a 3‐month weight reduction program with a hypocaloric diet, IMT was measured by B‐mode high‐resolution ultrasound at entry and after 5 months of follow‐up. Blood samples were analyzed at entry, after intervention, and after 5 months of follow‐up. Nineteen lean women served as control subjects. Results: At entry, common carotid IMT (0.72 vs. 0.59 mm), carotid bulb IMT (0.90 vs. 0.71 mm), and overall mean IMT (0.81 vs. 0.65 mm) were greater in obese women than in lean women (all p < 0.01). After dietary intervention decreases in blood pressure, low density lipoprotein to high density lipoprotein cholesterol ratio, triglycerides, fibrinogen, plasminogen activator inhibitor‐1, and an increase in tissue‐type plasminogen activator activity levels were observed. These effects persisted after follow‐up in 14 women who maintained reduced weight. Reduction in carotid bulb IMT (to 0.81 mm, p < 0.01) and overall mean IMT (to 0.79 mm, p < 0.05) was observed in this subgroup. No significant change of carotid IMT was detected in eight women who regained weight. Changes in IMT were associated independently and significantly with changes in body mass index, low density lipoprotein to high density lipoprotein cholesterol ratio, and plasminogen activator inhibitor‐1 antigen. Discussion: Obese premenopausal women had greater IMT than did age‐matched lean controls. It seems that this early atherosclerotic changes may be reversed by normalization of body weight.     

Body Mass Index Cutoffs for Underweight,Overweight, and Obesity in South Korean Schoolgirls

Objectives: To establish BMI percentiles and cutoffs for underweight, overweight, and obesity in South Korean schoolgirls. Research Methods and Procedures: A total of 1229 South Korean schoolgirls aged 8 to 18 years were randomly selected to complete a self‐administered questionnaire. BMI charts and cutoffs were constructed after analyzing data from 1107 subjects. Percentile curves were established by the modified LMS method. Results: The percentiles for underweight, overweight, and obesity corresponding to BMI of 18.5, 23.0, and 25.0 kg/m² at age 18 were the 13.0th percentile, the 77.8th percentile, and the 91.2nd percentile, respectively. The corresponding prevalences of underweight, overweight, and obesity were 12.1, 12.5, and 9.8%, respectively. Discussion: We established for the first time, to our knowledge, new BMI cutoffs for ages 8 to 18 that corresponded to BMIs of 18.5, 23.0, and 25.0 kg/m² for Asian adults designated by the International Obesity Task Force. These newly established BMI cutoffs might help to estimate the prevalence of overweight and obesity in Asian children.     

Assessing the Validity of Body Mass Index Standards in Early Postmenopausal Women

Objective: To examine the relationship between percentage of total body fat (%Fat) and body mass index (BMI) in early postmenopausal women and to evaluate the validity of the BMI standards for obesity established by the NIH. Research Methods and Procedures: Three hundred seventeen healthy, sedentary, postmenopausal women (ages, 40 to 66 years; BMI, 18 to 35 kg/m²; 3 to 10 years postmenopausal) participated in the study. Height, weight, BMI, and %Fat, as assessed by DXA, were measured. Receiver operating characteristic analysis was performed to evaluate the ability of BMI to discriminate obesity from non‐obesity using 38%Fat as the criterion value. Results: A moderately high relationship was observed between BMI and %Fat (r = 0.81; y = 1.41x + 2.65) with a SE of estimate of 3.9%. Eighty‐one percent of other studies examined fell within 1 SE of estimate as derived from our study. Receiver operating characteristic analysis showed that BMI is a good diagnostic test for obesity. The cutoff for BMI corresponding to the criterion value of 38%Fat that maximized the sum of the sensitivity and specificity was 24.9 kg/m². The true‐positive (sensitivity) and false‐positive (1 ? specificity) rates were 84.4% and 14.6%, respectively. The area under the curve estimate for BMI was 0.914. Discussion: There is a strong association between %Fat and BMI in postmenopausal women. Current NIH BMI‐based classifications for obesity may be misleading based on currently proposed %Fat standards. BMI >25 kg/m² rather than BMI >30 kg/m² may be superior for diagnosing obesity in postmenopausal women.     

The Association of Body Weight,Dietary Intake,and Energy Expenditure with Dietary Restraint and Disinhibition

LAWSON, OLGA J, DONALD A WILLIAMSON, CATHERINE M CHAMPAGNE, JAMES P DELANY, ELLEN R BROOKS, PAULA M HOWAT, PATRICIA J WOZNIAK, GEORGE A BRAY AND DONNA H RYAN. The association of body weight, dietary intake, and energy expenditure with dietary restraint and disinhibition. Obes Res. 1995;3:153–161. The hypotheses that dieting and/or overeating are associated with adiposity, eating disturbances, and lowered energy expenditure were tested in this study. A sample of 44 premenopausal women scoring high and low on measures of dietary restraint and disinhibition of dietary control, as measured by the Three Factor Eating Questionnaire, was studied. A 2 × 2 factorial design was employed (High/Low Restraint x High/Low Disinhibition). Dependent variables were: body composition, dietary intake, activity, resting metabolic rate, and thermic effect of food. Unrestrained overeaters (Low Restraint/High Disinhibition group) were very obese. High Dietary Restraint was associated with intent to diet and controlled eating. High scores on the Disinhibition Scale were associated with episodic overeating. Groups did not differ in resting metabolic rate (controlled for fat-free mass). Lower thermic effect of food was found to be associated with the obesity found in High Disinhibition subjects. Thus, Dietary Restraint was not associated with significant adverse effects upon physical or psychological health. High Disinhibition, however, was associated with adiposity and significant disturbances of eating.