Hunger on the Three-Factor Eating Questionnaire Is Associated With Increased Ad Libitum Energy Intake in Different...

This study aimed to assess how food-related behavioral traits, examined with the Three-Factor Eating Questionnaire (TFEQ) and the Perceived Stress Scale (PSS), influence ad libitum intake after fasting and during and after cold exposure compared to thermoneutral conditions, beyond what is explained by energy expenditure alone.

Healthy participants (n = 46; 30 males; age 36.9 ± 10.5 years; BMI 32.3 ± 8.7 kg/m²) completed the TFEQ, PSS, and dual-energy x-ray absorptiometry (DXA) scan. The Hunger subscale of the TFEQ was further divided into internal and external hunger based on the methodology of Bond et al. Participants ate ad libitum from a food intake paradigm on five separate occasions, each over 24 h: (1) after a 36-h fast at thermoneutral temperature, (2) during cold exposure (19.0°C) in the chamber, (3) during thermoneutral conditions (23.5°C) in the chamber, (4) after cold exposure, and (5) after thermoneutral exposure.

Total hunger score predicted intake across all five conditions (β = 0.58 MJ/day, p = 0.02). Internal and external subscales also predicted intake in separate models (β = 1.04 MJ/day, p = 0.02; β = 1.46 MJ/day, p = 0.01). Participants ate more during the cold condition than during thermoneutrality (mean = 1.69 MJ/day, or 404 kcal/day, p = 0.009). Higher external hunger scores correlated with greater intake (partial r = 0.38; p = 0.01), but internal hunger scores did not (partial r = 0.22, p = 0.16), after accounting for sex, race, fat mass, and fat-free mass. Restraint, disinhibition, and PSS were not associated with intake.

Increased susceptibility to hunger cues, particularly external cues, was associated with higher food intake during cold stress. These findings suggest that behavioral approaches, such as reducing responsivity to food cues, are important targets for weight loss interventions.

ClinicalTrials.gov: NCT02939404.