The Thermic Effect of Food: A Review

Abstract

Two-thirds of U.S. adults are overweight. There is an urgent need for effective methods for weight management. A potentially modifiable component of energy expenditure is the thermic effect of food (TEF), the increase in the metabolic rate that occurs after a meal. Evidence suggests that TEF is increased by larger meal sizes (as opposed to frequent small meals), intake of carbohydrate and protein (as opposed to dietary fat), and low-fat plant-based diets. Age and physical activity may also play roles in TEF. The effects of habitual diet, meal timing, and other factors remain to be clarified. Further research into the factors that affect TEF may lead to better treatment methods for improved weight management.

• Key teaching points
• Measurement of the thermic effect of food.
• Physiological determinants of the thermic effect of food.
• The effects of meal variations on postprandial thermogenesis.
• Effect of age and physical activity on the thermic effect of food.

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The Thermic Effect of Food: A Review
Manuel Calcagno, Hana Kahleova, Jihad Alwarith, Nora N. Burgess, Rosendo
A. Flores, Melissa L. Busta & Neal D. Barnard
To cite this article: Manuel Calcagno, Hana Kahleova, Jihad Alwarith, Nora N. Burgess, Rosendo
A. Flores, Melissa L. Busta & Neal D. Barnard (2019): The Thermic Effect of Food: A Review,
Journal of the American College of Nutrition, DOI: 10.1080/07315724.2018.1552544
To link to this article: https://doi.org/10.1080/07315724.2018.1552544
Published online: 25 Apr 2019.
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The Thermic Effect of Food: A Review
Manuel Calcagno
a
, Hana Kahleova
a
, Jihad Alwarith
a
, Nora N. Burgess
a
, Rosendo A. Flores
a
, Melissa L. Busta
a
,
and Neal D. Barnard
a,b
a
Clinical Research, Physicians Committee for Responsible Medicine, Washington, DC, USA;
b
Adjunct Faculty, George Washington University
School of Medicine and Health Sciences, Washington, DC, USA
ABSTRACT
Two-thirds of U.S. adults are overweight. There is an urgent need for effective methods for weight
management. A potentially modifiable component of energy expenditure is the thermic effect of
food (TEF), the increase in the metabolic rate that occurs after a meal. Evidence suggests that TEF
is increased by larger meal sizes (as opposed to frequent small meals), intake of carbohydrate and
protein (as opposed to dietary fat), and low-fat plant-based diets. Age and physical activity may
also play roles in TEF. The effects of habitual diet, meal timing, and other factors remain to be
clarified. Further research into the factors that affect TEF may lead to better treatment methods
for improved weight management.
KEY TEACHING POINTS
Measurement of the thermic effect of food.
Physiological determinants of the thermic effect of food.
The effects of meal variations on postprandial thermogenesis.
Effect of age and physical activity on the thermic effect of food.
ARTICLE HISTORY
Received 28 August 2018
Accepted 22 November 2018
KEYWORDS
Thermic effect of food;
energy expenditure;
thermogenesis; meta-
bolic rate
Introduction
Two-thirds of U.S. adults are overweight, and weight prob-
lems are increasingly common in much of the rest of the
world (1). There is an urgent need for effective methods for
prevention and treatment. Because obesity develops over
time as energy intake exceeds output (2), factors that influ-
ence energy expenditure, even modestly, may be clinically
important over time.
Total energy expenditure has several components. Basal
metabolism is energy expended at rest and accounts for
approximately 60% of total daily energy expenditure. The
thermic effect of food (TEF), also called specific dynamic
action or dietary induced thermogenesis, is the increase in
metabolism after a meal and accounts for approximately
10% of total energy expenditure. It represents the energy
expenditure of processing and storing food, as well as the
metabolic effects of the influx of nutrients. Intentional (e.g.,
sports-related) exercise accounts for between 0% and 10% of
total energy expenditure (3). Non-exercise activity thermo-
genesis (e.g., daily living activities, fidgeting, maintenance of
posture) accounts for the remaining roughly 20% of total
energy expenditure (4).
Evidence suggests that it may be possible to alter TEF as
a weight-loss tool in both research and clinical settings. This
article describes the factors that influence TEF and outlines
potential areas for further research.
Measurement of the thermic effect of food
Body metabolism is measured by several methods with vary-
ing degrees of accuracy and cost-effectiveness (Table 1)(5).
In the doubly labeled water method, nonradioactive hydro-
gen and oxygen isotopes are measured in body fluids (e.g.,
urine), allowing for extended measurements under free-liv-
ing conditions (3). Direct calorimetry measures the loss of
body heat using an isothermal system, a heat sink (adia-
batic) system, or a convection system. It is accurate, but
expensive to build and maintain (3). Indirect calorimetry,
the most widely used method, measures oxygen consump-
tion and carbon dioxide production (6,7). Other methods
are used less frequently due to expense or impracticality.
TEF is typically reported as the area between the energy
expenditure and basal metabolic curves (3).
Physiological determinants of the thermic effect
of food
In order for food to contribute to energy expenditure, it
must be digested and absorbed and its components (e.g.,
glucose) must enter cells to be metabolized. When cells are
insulin resistant, glucose is less able to enter muscle and
liver cells. Insulin sensitivity and, to a lesser extent, abdom-
inal adiposity appear to be the principal factors regulating
TEF (8).
CONTACT Hana Kahleova, MD, PhD hkahleova@pcrm.org Director of Clinical Research, Physicians Committee for Responsible Medicine, 5100 Wisconsin
Ave. NW, Suite 200, Washington, DC 20016, USA.
ß2018 American College of Nutrition
JOURNAL OF THE AMERICAN COLLEGE OF NUTRITION
https://doi.org/10.1080/07315724.2018.1552544

A 1984 study (n¼15) monitored the rate of glucose stor-
age in lean and obese individuals at a constant rate of glu-
cose uptake (0.624 g/min). The obese group displayed
delayed glucose metabolism compared with the lean group
(2–5 mg/kg-min and 7 mg/kg-min, respectively). At 3 mg/kg-
min, glucose oxidation is saturated, and glucose storage con-
tinues to rise. Thus, approximately 4 mg/kg-min is allocated
to glucose storage in lean subjects; in obese individuals only
a small amount of glucose is stored as glycogen through the
energy-requiring process, conserving the remaining
energy (9).
A 1992 study compared 24 moderately obese women who
first underwent a weight-reduction program until they
reached normal body weight versus 24 never-obese women,
matched for body weight, fat mass, and age. TEF was 1.6%
lower in the formerly obese group (8.2%) when compared to
never-obese participants (9.8%) (p¼0.043), but the lower
TEF in the formerly obese group remained relatively
unchanged even after weight loss (8.7%) (p¼0.341).
Researchers concluded that a reduction in TEF is a contri-
buting factor to obesity rather than a consequence of obes-
ity (10).
The effects of variations in body composition on TEF
have not been fully characterized, but multiple factors that
are found in overweight individuals (e.g., less physical activ-
ity, insulin resistance, and differences in meal composition)
are likely to reduce TEF in this group, compared with lean
individuals.
A 1992 study (n¼32) documented the independent
effects of obesity and insulin resistance on postprandial
thermogenesis. After a euglycemic hyperinsulinemic clamp
was administered, insulin-resistant individuals (both lean
and obese) displayed reduced glucose storage compared with
their insulin-sensitive counterparts. A positive correlation
(r¼0.5) between thermogenesis and the rate of glucose
storage was observed (p<0.01) (11).
In summary, insulin sensitivity seems to play a role in
metabolism, particularly affecting TEF. Individuals with
excessive body weight tend to have a higher risk of develop-
ing insulin resistance, thus increasing their chances of
having decreased TEF. It is not yet clear how much it actu-
ally affects TEF, and more research is needed in this area.
Factors influencing the thermic effect of food
Age, physical activity, and meal size, composition, frequency,
and timing all influence the thermic effect of food and are
described next.
a. Age: TEF may decrease with age. A 2014 Mayo Clinic
study comparing 123 older (60–88 years) adults to 86
younger (18–35 years) adults found that, expressed as
a percentage of meal size, TEF was lower in older adults
(6.4% versus 7.3%, p¼0.02). The difference remained after
adjustment for fat-free mass, fat mass, and subcutaneous
fat (12). Two smaller studies made similar observations
(13,14). The result of reduced TEF, along with decreased
physical activity, may be an increased fat storage with age.
However, the observed fall in TEF may not reflect the aging
process per se; it may reflect other changes in metabolism
occurring over time (e.g., those resulting from meal compos-
ition, described in the preceding).
b. Physical activity: A study (n¼36) comparing active
and sedentary men in both younger and older age groups
found TEF to be 45% higher in the active, young
group (323.42 kJ) and 31% higher in the active, older
group (292.04 kJ), compared with their respective sedentary
groups (222.17 kJ and 215.47 kJ, respectively) (p<0.01).
Table 1. Methods Used to Measure the Thermic Effect of Food (TEF).
Method Complexity Cost Measurement time (hours) Accuracy Reliability
Indirect calorimetry
1. Confinement system High Moderate/high 1–48 80% 100%
2. Closed circuit system
Respiratory chamber High Moderate/high 1–100 90% 75%
Spirometry Moderate Moderate 0.3–250% 25%
3. Total collection system
Flexible Moderate Moderate 0.3–260% 25%
Rigid Moderate Moderate 0.5–2 40% 25%
4. Open circuit system
Ventilated hood/canopy Moderate Low/moderate 0.2–6 80% 75%
Ventilated chamber Moderate/high Low/moderate 1–48 80% 75%
Expiratory collecting system Low Moderate 0.3–48 50% 25%
5. Isotope dilution Low High 48–240 70% 75%
Direct calorimetry
1. Isothermal system Moderate/high Moderate/high 0.3–1.5 100% 100%
2. Heat-sink/Adiabetic system
Chamber High Moderate/high 2–48 90% 100%
Suite Moderate/high Moderate/high 2–48 70% 50%
3. Convection system High Moderate/high 2–48 80% 75%
Noncalorimetric methods
1. Physiologic measurements
Heart rate Low Moderate 1–72 10% 10%
Electromyography Moderate Moderate 1–24 10% 10%
Pulmonary ventilation Moderate/high Moderate 1–24 10% 10%
2. Physiologic observations Not applicable Low N/A 10% 10%

Multiple readings.

Highly variable.
2 M. CALCAGNO ET AL.

The researchers concluded that, regardless of age or body
composition, physical activity increases TEF (15).
c. Energy content of meals: A 1990 study (n¼16)
reported that a higher energy intake, regardless of meal
composition, results in increased TEF (p<0.001) (16). One
study compared three different meals of 2092 kJ, 4184 kJ,
and 6276 kJ. The corresponding TEF values were <10%,
21%, and 33.5% from baseline, respectively (17). A meta-
analysis of 27 studies showed a significant increase in TEF
of 1.1–1.2 kJ/h for every 100 kJ of energy intake (p<0.001)
(18). A similar study (n¼10) compared a low-energy, high-
fat meal (818 kJ) with a high-energy, low-fat meal (2,929 kJ),
finding higher TEF values with the high-energy meal (19).
d. Meal composition: Three studies have compared the
effects of high-carbohydrate versus high-fat meals. Two of
these (n¼12, n¼24), providing similar caloric content
meals, found TEF to be 96% (26.8 kJ/h) (20) and 16% (8 kJ/
h) (21) higher on the high-carbohydrate meal, compared
with the high/moderate fat group, respectively, but did not
provide data on statistical significance. A 2005 study of lean
young men (n¼14) also found TEF to be 32% higher on
the high-carbohydrate meal (43.1 kJ/h), compared with a
high-fat meal (32.6 kJ/h) with isoenergetic content (3,255 kJ)
(p<0.05) (22).
In contrast, a crossover study (n¼19) compared isoener-
getic high-protein, high-fat, and high-carbohydrate meals,
finding no difference between the high-carbohydrate
(39.2 kJ/h) and high-fat (39.2 kJ/h) meals, while TEF was
17% higher on the high-protein group (45.9 kJ/h)
(p<0.01) (23).
The type of dietary fat may make a difference. A 2013
study (n¼7) provided isoenergetic meals with similar
macronutrient composition with either medium-chain (20 g)
or long-chain (18.4 g) triglyceride and found TEF to be 34%
higher (7.5 kJ/h) in the medium-chain triglyceride meal
group (p<0.005) (24). Another study (n¼8) similarly
found TEF to be 132% higher with meals containing
medium-chain triglyceride alone (11.1 kJ/h higher) (p<0.01)
and 110% higher with both medium-chain and long-chain
triglyceride (9.3 kJ/h) (p<0.01) as opposed to long-chain tri-
glyceride alone (25).
Additionally, a study (n¼29) comparing meals contain-
ing polyunsaturated, monounsaturated, and saturated fat
reported thermogenesis of 37.2 kJ/h, 36.8 kJ/h, and 30.0 kJ/h,
respectively (p<0.05) (26). In contrast, a previous small
(n¼14) study comparing MUFA from extra virgin olive oil
versus saturated fat from cream found no significant differ-
ence in thermogenesis between groups (27).
Vegetables, fruits, whole grains, and legumes have higher
fiber content, compared with refined grains or animal-
derived products, and may require more energy to digest. A
2005 randomized, controlled study (n¼64) compared a
low-fat vegan diet to a control diet (National Cholesterol
Education Program guidelines) in overweight, postmeno-
pausal women. Researchers measured TEF after consump-
tion of a 720-calorie test meal, then asked participants
randomized to the vegan diet to follow the diet for 14 weeks.
Repeat TEF testing showed a 16% increase in TEF within
the vegan group (p<0.05) In a regression model, thermic
effect of food emerged as a significant predictor of weight
change (p<0.05) (28).
e. Processed versus unprocessed foods: Milling of grains
leads to a loss of dietary fiber (from bran) as well as a loss
of protein (from the germ). A crossover study (n¼17) com-
paring isocaloric meals consisting of sandwiches made with
either refined or unrefined grains showed a greater thermic
effect (46.8% higher) from the unrefined grain product
(p<0.001) (29), presumably related to changes in fiber and
macronutrient content.
f. Palatability: A 1985 study (n¼8) suggested that palat-
ability could possibly increase sympathetic activity, thus
increasing TEF (30). However, several subsequent studies
found no differences in TEF when comparing palatable to
unpalatable meals (p>0.05) (31–33).
g. Meal frequency, regularity, and timing: Four studies
compared the effects on TEF of a single large meal versus
frequent, small meals with the same total energy density.
Two trials found TEF to be higher on the single, large meal,
as opposed to several frequent, small meals, during 3- to 5-
hour measurements (10.6 kJ/h, or 32%, higher after one large
vs. four smaller meals, and 13.3 kJ/h, or 38%, higher after
one large vs. six smaller meals, respectively, p<0.05 on
both) (34,35). One study did not detect any difference
between one large meal and two smaller meals, potentially
due to a relatively small difference between the interventions
(36). Another study showed a 30.3% higher TEF on a single,
large meal, compared with three smaller meals.
Unfortunately, the researchers have measured TEF for only
a short period of time, which may have resulted in insuffi-
cient power to detect significant differences in response to
changes in meal frequency (37). A 2016 meta-analysis that
standardized the units concluded that TEF was significantly
higher with a single large meal, compared with smaller fre-
quent meals (p¼0.02) (18).
A 2003 randomized crossover study (n¼9) compared a
regular meal plan (6 meals/day) to an irregular meal plan
(3–9 meals/day), with the number of meals being the same
throughout the week, resulting in a significant decrease in
TEF during the irregular meal plan (p¼0.003) (38).
The effect of meal timing was examined in a 1993 study
(n¼9) that found TEF to be higher in the morning as com-
pared to the afternoon (p¼0.02) and night (p¼0.002), and
higher in the afternoon compared to the night (p¼0.06)
(39). Later studies tested the effects of skipping meals. In a
crossover design with 17 participants, comparing a conven-
tional 3/day meal pattern to skipping breakfast or dinner,
TEF was higher when a meal had been skipped (þ41 kcal/
day with breakfast skipping and þ91 kcal/day for dinner
skipping) (p<0.01), while fat oxidation was only increased
when breakfast was skipped (p<0.001). It is also conceiv-
able that prolonged fasting could lead to a state of stress,
increasing adrenergic activity, lipolysis, and energy expend-
iture in those who skip a meal (40). However, a small 2014
study (n¼9) found no relationship between skipping break-
fast and TEF (41).
JOURNAL OF THE AMERICAN COLLEGE OF NUTRITION 3

h. Meal duration: Two studies (n¼21, n¼9) investi-
gated the effect of meal duration on TEF, but only one
reached statistical significance. One study (n¼21) recorded
meal duration and number of chews in men, showing that
slow eating was associated with a considerable increase in
TEF at 90 minutes (p<0.05), possibly due to postprandial
splanchnic circulation after the meal (42). The other study
(n¼9) showed that slow eating tended to increase TEF in
females by 32% (10.3 kJ/kg/h) at 180 minutes compared to
fast eating (p>0.05) (43).
In summary, TEF tends to decrease with age. In contrast,
physical activity, higher energy meals, high-carbohydrate
and high-protein meals as opposed to high-fat meals, and
single large meals tend to increase TEF. In addition, high
consumption of fruits, vegetables, and high-fiber-content
meals also seem to have a positive effect on TEF. Meal tim-
ing and meal duration might play a role but to what extent
is not yet clear, while palatability does not seem to have an
effect on TEF. More research with larger sample size would
be beneficial.
Conclusion
TEF is a significant part of energy expenditure and can be
to a certain degree increased by factors that are under indi-
vidual control, such as by eating larger meals and meals
high in carbohydrates and protein, and by increased physical
activity. Although the effects of such manipulations are
small, they may play an important role over the long term,
suggesting that they may have value as part of the manage-
ment of obesity and obesity-related conditions, such as type
2 diabetes (44).
The body of literature on TEF is limited. Many studies
are small in size, and methodology varies considerably
between studies. Nonetheless, to the extent that postprandial
energy expenditure can be increased, weight-control efforts
may be facilitated. More research studies with larger sample
sizes and appropriate controls are needed.
Funding
This work was funded by the Physicians Committee for
Responsible Medicine.
ORCID
Manuel Calcagno http://orcid.org/0000-0002-2419-6402
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