Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Pediatrics

Examining the roles of body composition, energy expenditure and substrate metabolism in the control of daily energy intake in adolescents with obesity

International Journal of Obesity volume 49, pages 1076–1083 (2025)Cite this article

Subjects

Abstract

Background

The implication of body composition and energy metabolism in the control of human energy intake (EI) has been well described in adults, remaining however unexplored in adolescents with obesity. The aim of this study was to question the role of body composition, energy expenditure (EE) and substrate metabolism in the control of EI of adolescents with obesity.

Methods

Ad libitum 24-h EI, body composition (Dual X-ray absorptiometry), Resting Metabolic Rate (RMR, indirect calorimeter) where measured and Total EE obtained during a 36-h stay in metabolic chambers in 26 adolescents (14.1 ± 1.5 years; 14 girls) with severe obesity.

Results

The mean body weight and Body Mass index were 92.2 ± 17.2 kg and 33.98 ± 4.14 kg.m-2 respectively. 24-h EI was positively correlated with body weight (rho = 0.597, p = 0.014), Fat Free Mass (FFM) kg (rho = 0.576, p = 0.019), 24-h Total EE (TEE (rho =0.675, p < 0.001)), RMR (rho =0.632, p = 0.005), 24-h Carbohydrate (CHO) oxidation rates (rho = 0.716, p < 0.001), and urinary nitrogen excretion (rho =0.28, p < 0.001). According to the path analysis FFM (kg) but not Fat Mass (FM) (kg) was positively correlated with RMR, with direct effects of 0.87 (p < 0.001) and 0.027 (p = 0.74) respectively. The effect of FFM on 24-h EI was mediated by RMR (96% of the effect), while the effect of FM on 24-h EI was also mediated by RMR (67% of the effect).

Conclusions

The present study provides the first evidence regarding the role of RMR as a main tonic signal of appetite control mediating the effect of body composition and mainly FFM (over FM) on daily EI in adolescents with obesity. It also suggests for the first-time relationships between 24-h CHO and protein oxidation and daily EI in this population.

Access through your institution
Buy or subscribe

This is a preview of subscription content, access via your institution

Access options

Access through your institution

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1
Fig. 2: 24-h Energy Expenditure, substrate use and Energy Intake.
Fig. 3: Heat Map illustrating the correlations between energy intake (total and macronutrients) and the adolescents’ anthropometric, body composition and energy metabolism parameters.
Fig. 4: Path diagram for the mediation model with the standardized parameter coefficients for the direct effects (solid lines) of fat mass and fat-free mass on resting metabolic rate and resting metabolic rate on energy intake, the indirect effect (dashed lines) of fat mass and fat-free mass on energy intake mediated by resting metabolic rate.
Fig. 5: Path diagram for the mediation models with the standardized parameter coefficients for the direct effects (solid lines) of Total Energy Expenditure (TEE) on Energy Intake (EI) and the respective mediation effects of Fat oxidation, Carbohydrate oxidation and Nitrogen Excretion on the effect of TEE on EI.

Similar content being viewed by others

Data availability

Data might be available upon request.

References

  1. Badman MK, Flier JS. The gut and energy balance: visceral allies in the obesity wars. Science. 2005;307:1909–14.

    Article  CAS  PubMed  Google Scholar 

  2. Friedman JM. Leptin and the endocrine control of energy balance. Nat Metab. 2019;1:754–64.

    Article  CAS  PubMed  Google Scholar 

  3. Morton GJ, Cummings DE, Baskin DG, Barsh GS, Schwartz MW. Central nervous system control of food intake and body weight. Nature. 2006;443:289–95.

    Article  CAS  PubMed  Google Scholar 

  4. Woods SC, Ramsay DS. Food intake, metabolism and homeostasis. Physiol Behav. 2011;104:4–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Blundell JE, Caudwell P, Gibbons C, Hopkins M, Naslund E, King N, et al. Role of resting metabolic rate and energy expenditure in hunger and appetite control: a new formulation. Dis Model Mech. 2012;5:608–13.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Blundell JE, Gibbons C, Beaulieu K, Casanova N, Duarte C, Finlayson G, et al. The drive to eat in homo sapiens: Energy expenditure drives energy intake. Physiol Behav. 2020;219:112846.

    Article  CAS  PubMed  Google Scholar 

  7. Hopkins M, Gibbons C, Blundell J. Fat-free mass and resting metabolic rate are determinants of energy intake: implications for a theory of appetite control. Philos Trans R Soc Lond B Biol Sci. 2023;378:20220213.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Hopkins M, Blundell JE. Energy balance, body composition, sedentariness and appetite regulation: pathways to obesity. Clin Sci Lond Engl 1979. 2016;130:1615–28.

    CAS  Google Scholar 

  9. Blundell JE, Caudwell P, Gibbons C, Hopkins M, Näslund E, King NA, et al. Body composition and appetite: fat-free mass (but not fat mass or BMI) is positively associated with self-determined meal size and daily energy intake in humans. Br J Nutr. 2012;107:445–9.

    Article  CAS  PubMed  Google Scholar 

  10. Caudwell P, Finlayson G, Gibbons C, Hopkins M, King N, Näslund E, et al. Resting metabolic rate is associated with hunger, self-determined meal size, and daily energy intake and may represent a marker for appetite. Am J Clin Nutr. 2013;97:7–14.

    Article  CAS  PubMed  Google Scholar 

  11. Grannell A, Al-Najim W, Mangan A, Kapoor N, Martin WP, Murphy JC, et al. Fat free mass is positively associated with hunger and energy intake at extremes of obesity. Appetite. 2019;143:104444.

    Article  PubMed  Google Scholar 

  12. McNeil J, Lamothe G, Cameron JD, Riou MÈ, Cadieux S, Lafrenière J, et al. Investigating predictors of eating: is resting metabolic rate really the strongest proxy of energy intake? Am J Clin Nutr. 2017;106:1206–12.

    Article  CAS  PubMed  Google Scholar 

  13. Weise CM, Hohenadel MG, Krakoff J, Votruba SB. Body composition and energy expenditure predict ad-libitum food and macronutrient intake in humans. Int J Obes 2005. 2014;38:243–51.

    CAS  Google Scholar 

  14. Hopkins M, Finlayson G, Duarte C, Whybrow S, Ritz P, Horgan GW, et al. Modelling the associations between fat-free mass, resting metabolic rate and energy intake in the context of total energy balance. Int J Obes 2005. 2016;40:312–8.

    CAS  Google Scholar 

  15. Hopkins M, Finlayson G, Duarte C, Gibbons C, Johnstone AM, Whybrow S, et al. Biological and psychological mediators of the relationships between fat mass, fat-free mass and energy intake. Int J Obes 2005. 2019;43:233–42.

    CAS  Google Scholar 

  16. Piaggi P, Thearle MS, Krakoff J, Votruba SB. Higher daily energy expenditure and respiratory quotient, rather than fat-free mass, independently determine greater ad libitum overeating. J Clin Endocrinol Metab. 2015;100:3011.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Wells JC, Davies PS, Hopkins M, Blundell JE. The « drive to eat » hypothesis: energy expenditure and fat-free mass but not adiposity are associated with milk intake and energy intake in 12 week infants. Am J Clin Nutr. 2021;114:505–14.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Hopkins M, Casanova N, Finlayson G, Stubbs RJ, Blundell JE. Fat-free mass and total daily energy expenditure estimated using doubly labeled water predict energy intake in a large sample of community-dwelling older adults. J Nutr. 2022;152:971–80.

    Article  PubMed  Google Scholar 

  19. Cameron JD, Sigal RJ, Kenny GP, Alberga AS, Prud’homme D, Phillips P, et al. Body composition and energy intake - skeletal muscle mass is the strongest predictor of food intake in obese adolescents: The HEARTY trial. Appl Physiol Nutr Metab Physiol Appl Nutr Metab Juin. 2016;41:611–7.

    Article  CAS  Google Scholar 

  20. Pannacciulli N, Salbe AD, Ortega E, Venti CA, Bogardus C, Krakoff J. The 24-h carbohydrate oxidation rate in a human respiratory chamber predicts ad libitum food intake. Am J Clin Nutr. 2007;86:625–32.

    Article  CAS  PubMed  Google Scholar 

  21. Dulloo AG, Jacquet J, Girardier L. Autoregulation of body composition during weight recovery in human: the Minnesota Experiment revisited. Int J Obes Relat Metab Disord. 1996;20:393–405.

    CAS  PubMed  Google Scholar 

  22. Isacco L, Lazzer S, Pereira B, Fearnbach N, Montaurier C, Vermorel M, et al. Association of protein-energy partitioning with body weight and body composition changes in adolescents with severe obesity. Int J Obes 2005. 2022;46:2021–8.

    CAS  Google Scholar 

  23. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320:1240–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Lazzer S, Boirie Y, Poissonnier C, Petit I, Duché P, Taillardat M, et al. Longitudinal changes in activity patterns, physical capacities, energy expenditure, and body composition in severely obese adolescents during a multidisciplinary weight-reduction program. Int J Obes. 2005;29:37–46.

    Article  CAS  Google Scholar 

  25. Lazzer S, Boirie Y, Montaurier C, Vernet J, Meyer M, Vermorel M. A weight reduction program preserves fat-free mass but not metabolic rate in obese adolescents. Obes Res. 2004;12:233–40.

    Article  PubMed  Google Scholar 

  26. Lazzer S, Vermorel M, Montaurier C, Meyer M, Boirie Y. Changes in adipocyte hormones and lipid oxidation associated with weight loss and regain in severely obese adolescents. Int J Obes 2005. 2005;29:1184–91.

    CAS  Google Scholar 

  27. Montaurier C, Richard R, Boirie Y. Two functional calorimetric chambers in france complete the Room Indirect Calorimetry Operating and Reporting Standards (RICORS) 1.0 Guide List. Obes Silver Spring Md. 2021;29:631.

    Article  Google Scholar 

  28. Brouwer E. Report of the sub-committee on constants and factors. In: KL B (ed). New-York: Academic Press; 1965. p. 441–3.

  29. Ferrannini E. The theoretical bases of indirect calorimetry: a review. Metabolism. 1988;37:287–301.

    Article  CAS  PubMed  Google Scholar 

  30. Favier J, Ripert J, Toque C, Feinberg M. Répertoire général des aliments. In: Table des composition. TEC&DOC Lavoisier. Paris: Lavoisier; 1996.

  31. Robins JM, Greenland S. Identifiability and exchangeability for direct and indirect effects. Epidemiol Camb Mass. 1992;3:143–55.

    Article  CAS  Google Scholar 

  32. Cuenca-García M, Ortega FB, Ruiz JR, Labayen I, Moreno LA, Patterson E, et al. More physically active and leaner adolescents have higher energy intake. J Pediatr Janv. 2014;164:159–66.e2.

    Article  Google Scholar 

  33. Fulton JE, Dai S, Steffen LM, Grunbaum JA, Shah SM, Labarthe DR. Physical activity, energy intake, sedentary behavior, and adiposity in youth. Am J Prev Med. 2009;37:S40–49.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Blundell JE, Finlayson G, Gibbons C, Caudwell P, Hopkins M. The biology of appetite control: Do resting metabolic rate and fat-free mass drive energy intake? Physiol Behav. 2015;152:473–8.

    Article  CAS  PubMed  Google Scholar 

  35. Flatt JP. Dietary fat, carbohydrate balance, and weight maintenance: effects of exercise. Am J Clin Nutr. 1987;45:296–306.

    Article  CAS  PubMed  Google Scholar 

  36. Flatt JP. The difference in the storage capacities for carbohydrate and for fat, and its implications in the regulation of body weight. Ann N Y Acad Sci. 1987;499:104–23.

    Article  CAS  PubMed  Google Scholar 

  37. Flatt JP. Glycogen levels and obesity. Int J Obes Relat Metab Disord. 1996;20:S1–11.

    CAS  PubMed  Google Scholar 

  38. Westerterp-Plantenga MS, Lemmens SG, Westerterp KR. Dietary protein - its role in satiety, energetics, weight loss and health. Br J Nutr. 2012;108:S105–112.

    Article  CAS  PubMed  Google Scholar 

  39. Mellinkoff SM, Frankland M, Boyle D, Greipel M. Relationship between serum amino acid concentration and fluctuations in appetite. J Appl Physiol. 1956;8:535–8.

    Article  CAS  PubMed  Google Scholar 

  40. Millward DJ. A protein-stat mechanism for regulation of growth and maintenance of the lean body mass. Nutr Res Rev. 1995;8:93–120.

    Article  CAS  PubMed  Google Scholar 

  41. Millward DJ. Metabolic demands for amino acids and the human dietary requirement: Millward and rRvers (1988) revisited. J Nutr. 1998;128:2563S–2576S.

    Article  CAS  PubMed  Google Scholar 

  42. Stubbs RJ. Peripheral signals affecting food intake. Nutr Burbank Los Angel Cty Calif. 1999;15:614–25.

    CAS  Google Scholar 

  43. Norris SA, Frongillo EA, Black MM, Dong Y, Fall C, Lampl M, et al. Nutrition in adolescent growth and development. Lancet Lond Engl 2022;399:172–84.

    Article  Google Scholar 

  44. Boirie Y, Beaufrère B, Ritz P. Energetic cost of protein turnover in healthy elderly humans. Int J Obes Relat Metab Disord. 2001;25:601–5.

    Article  CAS  PubMed  Google Scholar 

  45. Simpson SJ, Raubenheimer D. The power of protein. Am J Clin Nutr. 2020;112:6–7.

    Article  PubMed  Google Scholar 

  46. Thivel D, Isacco L, Montaurier C, Boirie Y, Duché P, Morio B. The 24-h energy intake of obese adolescents is spontaneously reduced after intensive exercise: a randomized controlled trial in calorimetric chambers. PLoS ONE. 2012;7:e29840.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The authors want to thank all the participants and the Romagnat Inpatient Pediatric Obesity Clinics.

Author information

Authors and Affiliations

  1. Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, 63000, Clermont-Ferrand, France

    D. Thivel, H. Moore & L. Isacco

  2. International Research Chair Health in Motion, Clermont Auvergne University Foundation, 63000, Clermont-Ferrand, France

    D. Thivel & L. Isacco

  3. School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, LS2 9JT, UK

    M. Hopkins

  4. Department of Medicine, School of Sport Sciences, University of Udine, 33058, Udine, Italy

    S. Lazzer

  5. Clermont Auvergne University, INRAE, Unité de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France

    C. Montaurier

  6. Biostatistics Unit, DRCI, CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France

    B. Pereira

  7. Appetite and Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK

    JE Blundell

  8. Department of Human Nutrition, CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France

    Y. Boirie

Authors
  1. D. Thivel
    View author publications

    Search author on:PubMed Google Scholar

  2. M. Hopkins
    View author publications

    Search author on:PubMed Google Scholar

  3. S. Lazzer
    View author publications

    Search author on:PubMed Google Scholar

  4. C. Montaurier
    View author publications

    Search author on:PubMed Google Scholar

  5. H. Moore
    View author publications

    Search author on:PubMed Google Scholar

  6. B. Pereira
    View author publications

    Search author on:PubMed Google Scholar

  7. JE Blundell
    View author publications

    Search author on:PubMed Google Scholar

  8. L. Isacco
    View author publications

    Search author on:PubMed Google Scholar

  9. Y. Boirie
    View author publications

    Search author on:PubMed Google Scholar

Contributions

YB, SL, CM designed research and conducted research; DT, LI, BP, YD, HM analyzed data; and TD, LI, MH, JB, YB, SL, HM wrote the paper. TD, LI had primary responsibility for final content. All authors read and approved the final manuscript.

Corresponding author

Correspondence to D. Thivel.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Thivel, D., Hopkins, M., Lazzer, S. et al. Examining the roles of body composition, energy expenditure and substrate metabolism in the control of daily energy intake in adolescents with obesity. Int J Obes 49, 1076–1083 (2025). https://doi.org/10.1038/s41366-025-01740-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue date:

  • DOI: https://doi.org/10.1038/s41366-025-01740-6

Search

Advanced search

Quick links