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Am J Clin Nutr. 2017 Oct;106(4):996-1004. doi: 10.3945/ajcn.117.157396. Epub 2017 Aug 16.

Mediation and modification of genetic susceptibility to obesity by eating behaviors.

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Early Origin of Child Health and Development (ORCHAD) Team 6, Center of Research in Epidemiology and UMR 1153 Statistics Sorbonne Paris Cité (CRESS), National Institute of Health and Medical Research (INSERM), Paris, France.
Paris Descartes University, Paris, France.
MRC Epidemiology Unit, Institute of Metabolic Science, and
MRC Epidemiology Unit, Institute of Metabolic Science, and.
Institute of Cardiometabolism and Nutrition (ICAN), Paris, France.
NutriOmics Team 6, UMRS 1166, National Institute of Health and Medical Research (INSERM), Paris, France; and.
Pierre and Marie Curie University, Sorbonne Universities, Paris, France.
Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.


Background: Many genetic variants show highly robust associations with body mass index (BMI). However, the mechanisms through which genetic susceptibility to obesity operates are not well understood. Potentially modifiable mechanisms, including eating behaviors, are of particular interest to public health.Objective: Here we explore whether eating behaviors mediate or modify genetic susceptibility to obesity.Design: Genetic risk scores for BMI (BMI-GRSs) were calculated for 3515 and 2154 adults in the Fenland and EDEN (Etude des déterminants pré et postnatals de la santé et du développement de l'enfant) population-based cohort studies, respectively. The eating behaviors-emotional eating, uncontrolled eating, and cognitive restraint-were measured through the use of a validated questionnaire. The mediating effect of each eating behavior on the association between the BMI-GRS and measured BMI was assessed by using the Sobel test. In addition, we tested for interactions between each eating behavior and the BMI-GRS on BMI.Results: The association between the BMI-GRS and BMI was mediated by both emotional eating (EDEN: P-Sobel = 0.01; Fenland: P-Sobel = 0.02) and uncontrolled eating (EDEN: P-Sobel = 0.04; Fenland: P-Sobel = 0.0006) in both sexes combined. Cognitive restraint did not mediate this association (P-Sobel > 0.10), except among EDEN women (P-Sobel = 0.0009). Cognitive restraint modified the relation between the BMI-GRS and BMI among men (EDEN: P-interaction = 0.0001; Fenland: P-interaction = 0.04) and Fenland women (P-interaction = 0.0004). By tertiles of cognitive restraint, the association between the BMI-GRS and BMI was strongest in the lowest tertile of cognitive restraint, and weakest in the highest tertile.Conclusions: Genetic susceptibility to obesity was partially mediated by the "appetitive" eating behavior traits (uncontrolled and emotional eating) and, in 3 of the 4 population groups studied, was modified by cognitive restraint. High levels of cognitive control over eating appear to attenuate the genetic susceptibility to obesity. Future research into interventions designed to support restraint may help to protect genetically susceptible individuals from weight gain.


BMI; body mass index; dieting; eating behavior; genetic risk score; genetics; obesity

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