Satiation is a key component of food intake regulation as it brings an eating episode to an end. The effect of sex on satiation measurement has not been characterized.
To assess the effects of biological variables on satiation.
Retrospective cohort study. We included 959 participants (mean age 39 [SD 12] years; 70.7% female, and BMI 33 kg/m2 ) who had measurements of satiation with a nutrient-drink test to assess volume to fullness (VTF) and maximum tolerated volume (MTV), and/or an ad libitum meal test to assess calories consumed to fullness (CTF). We performed univariate and multiple regression analyses to estimate the contribution of sex to VTF, MTV, and CTF, compared to other biological variables, such as age, weight, height, BMI, waist-to-hip circumference (W/H), and lean mass percentage (LM%), that are known to affect these parameters.
Females had higher BMI, W/H, and LM%. VTF, MTV, and CTF were lower in females: 704  vs. 783  mL, p = 0.001; 1226  vs. 1419  mL, p < 0.001; and 871  vs. 1086  kcal, p < 0.001; respectively. Sex was a strong and independent predictor of VTF, MTF and CTF: parameter estimate [PE] = −80.8, p = 0.006; PE = −124.2, p = 0.0007; and PE = −110, p = 0.001; respectively.
Sex has a strong effect on satiation measured by VTF, MTV, and CTF, even after adjusting for other biological factors known to affect these parameters. Females seem to integrate intra-meal inhibition signals to consume fewer calories unrelated to body size or composition.
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Data collected for the study, including individual de-identified participant data, as well as study protocol, and informed consent will be available to interested parties with publication, after signing of a data access agreement. Data may be requested by contacting Dr. Andres Acosta M.D, Ph.D., at Acosta.email@example.com.
Blundell JE, Halford JC. Regulation of nutrient supply: the brain and appetite control. Proc Nutr Soc. 1994;53:407–18.
Cummings DE, Overduin J. Gastrointestinal regulation of food intake. J Clin Invest. 2007;117:13–23.
Acosta A, Camilleri M, Shin A, Vazquez-Roque MI, Iturrino J, Burton D, et al. Quantitative gastrointestinal and psychological traits associated with obesity and response to weight-loss therapy. Gastroenterology. 2015;148:537–46.e4.
Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants. Lancet. 2016;387:1377–96.
Asarian L, Geary N. Sex differences in the physiology of eating. Am J Physiol Regul Integr Comp Physiol. 2013;305:R1215–67.
Brennan IM, Feltrin KL, Nair NS, Hausken T, Little TJ, Gentilcore D, et al. Effects of the phases of the menstrual cycle on gastric emptying, glycemia, plasma GLP-1 and insulin, and energy intake in healthy lean women. Am J Physiol Gastrointest Liver Physiol. 2009;297:G602–10.
Leeners B, Geary N, Tobler PN, Asarian L. Ovarian hormones and obesity. Hum Reprod Update. 2017;23:300–21.
Lovejoy JC, Champagne CM, de Jonge L, Xie H, Smith SR. Increased visceral fat and decreased energy expenditure during the menopausal transition. Int J Obes. 2008;32:949–58.
Lopez LM, Edelman A, Chen M, Otterness C, Trussell J, Helmerhorst FM. Progestin-only contraceptives: effects on weight. Cochrane Database Syst Rev. 2013;7:Cd008815.
Del Parigi A, Chen K, Gautier J-F, Salbe AD, Pratley RE, Ravussin E, et al. Sex differences in the human brain’s response to hunger and satiation. Am J Clin Nutr. 2002;75:1017–22.
Cornier MA, Salzberg AK, Endly DC, Bessesen DH, Tregellas JR. Sex-based differences in the behavioral and neuronal responses to food. Physiol Behav. 2010;99:538–43.
Gregersen NT, Møller BK, Raben A, Kristensen ST, Holm L, Flint A, et al. Determinants of appetite ratings: the role of age, gender, BMI, physical activity, smoking habits, and diet/weight concern. Food Nutr Res. 2011;55.
Raben A, Agerholm-Larsen L, Flint A, Holst JJ, Astrup A. Meals with similar energy densities but rich in protein, fat, carbohydrate, or alcohol have different effects on energy expenditure and substrate metabolism but not on appetite and energy intake. Am J Clin Nutr. 2003;77:91–100.
Bédard A, Hudon A-M, Drapeau V, Corneau L, Dodin S, Lemieux S. Gender differences in the appetite response to a satiating diet. J Obes. 2015;2015:140139-.
Monrroy H, Pribic T, Galan C, Nieto A, Amigo N, Accarino A, et al. Meal enjoyment and tolerance in women and men. Nutrients. 2019;11:119.
Monrroy H, Borghi G, Pribic T, Galan C, Nieto A, Amigo N, et al. Biological response to meal ingestion: gender differences. Nutrients. 2019;11:702.
Benelam B. Satiation, satiety and their effects on eating behaviour. Nutr Bull. 2009;34:126–73.
Forde CG Chapter 7 - Measuring Satiation and Satiety. In: Ares G, Varela P, editors. Methods in Consumer Research, Volume 2: Woodhead Publishing; 2018. p. 151–82.
Chial HJ, Camilleri C, Delgado-Aros S, Burton D, Thomforde G, Ferber I, et al. A nutrient drink test to assess maximum tolerated volume and postprandial symptoms: effects of gender, body mass index and age in health. Neurogastroenterol Motil. 2002;14:249–53.
Tack J, Caenepeel P, Piessevaux H, Cuomo R, Janssens J. Assessment of meal induced gastric accommodation by a satiety drinking test in health and in severe functional dyspepsia. Gut. 2003;52:1271–7.
Halawi H, Camilleri M, Acosta A, Vazquez-Roque M, Oduyebo I, Burton D, Busciglio I, et al. Relationship of gastric emptying or accommodation with satiation, satiety, and postprandial symptoms in health. Am J Physiol Gastrointest Liver Physiol. 2017;313:G442–G447.
Delgado-aros S, Cremonini F, Castillo JE, Chial HJ, Burton DD, Ferber I, et al. Independent influences of body mass and gastric volumes on satiation in humans. Gastroenterology. 2004;126:432–40.
Boeckxstaens GE, Hirsch DP, van den Elzen BD, Heisterkamp SH, Tytgat GN. Impaired drinking capacity in patients with functional dyspepsia: relationship with proximal stomach function. Gastroenterology. 2001;121:1054–63.
Sysko R, Steinglass JE, Schebendach JE, Mayer LES, Walsh BT. Rigor and reproducibility via laboratory studies of eating behavior: A focused update and conceptual review. Int J Eat Disord. 2018;51:608–16.
Vijayvargiya P, Chedid V, Wang XJ, Atieh J, Maselli D, Burton DD, et al. Associations of gastric volumes, ingestive behavior, calorie and volume intake, and fullness in obesity. Am J Physiol-Gastrointest Liver Physiol. 2020;319:G238–G44.
Vazquez Roque MI, Camilleri M, Stephens DA, Jensen MD, Burton DD, Baxter KL, et al. Gastric sensorimotor functions and hormone profile in normal weight, overweight, and obese people. Gastroenterology. 2006;131:1717–24.
Gonzalez‐Izundegui D, Campos A, Calderon G, Ricardo‐Silgado ML, Cifuentes L, Decker PA, et al. Association of gastric emptying with postprandial appetite and satiety sensations in obesity. Obesity. 2021;29:1497–507.
Iida A, Konagaya T, Kaneko H, Funaki Y, Kanazawa T, Tokudome K, et al. Usefulness of a slow nutrient drinking test for evaluating gastric perception and accommodation. Digestion. 2011;84:253–60.
Kindt S, Coulie B, Wajs E, Janssens J, Tack J. Reproducibility and symptomatic predictors of a slow nutrient drinking test in health and in functional dyspepsia. Neurogastroenterol Motil. 2008;20:320–9.
Gregersen NT, Flint A, Bitz C, Blundell JE, Raben A, Astrup A. Reproducibility and power of ad libitum energy intake assessed by repeated single meals. Am J Clin Nutr. 2008;87:1277–81.
Horner K, Byrne N, King N. Reproducibility of subjective appetite ratings and ad libitum test meal energy intake in overweight and obese males. Appetite. 2014;81.
Lara J, Taylor M, Macdonald I. Is ad libitum energy intake in overweight subjects reproducible in laboratory studies using the preload paradigm? European journal of clinical nutrition. 2010;64:1028–31.
Geliebter A. Gastric distension and gastric capacity in relation to food intake in humans. Physiol Behav. 1988;44:665–8.
Kim DY, Camilleri M, Murray JA, Stephens DA, Levine JA, Burton DD. Is there a role for gastric accommodation and satiety in asymptomatic obese people? Obes Res. 2001;9:655–61.
Yunker AG, Alves JM, Luo S, Angelo B, DeFendis A, Pickering TA, et al. Obesity and sex-related associations with differential effects of sucralose vs sucrose on appetite and reward processing: a randomized crossover trial. JAMA Network Open. 2021;4:e2126313-e.
Palmer BF, Clegg DJ. The sexual dimorphism of obesity. Mol Cell Endocrinol. 2015;402:113–9.
Campos A, Port JD, Acosta A. Integrative hedonic and homeostatic food intake regulation by the central nervous system: insights from neuroimaging. Brain Sci. 2022;12:431.
Hallam J, Boswell RG, DeVito EE, Kober H. Gender-related differences in food craving and obesity. Yale J Biol Med. 2016;89:161–73.
Chen Y, Jiang M, Krupka EL. Hunger and the gender gap. Experimental Economics. 2019;22:885–917.
Manippa V, Padulo C, van der Laan LN, Brancucci A. Gender differences in food choice: effects of superior temporal sulcus stimulation. Front Hum Neurosci. 2017;11:597-.
Haase L, Green E, Murphy C. Males and females show differential brain activation to taste when hungry and sated in gustatory and reward areas. Appetite. 2011;57:421–34.
Spinelli S, Monteleone E. Food preferences and obesity. Endocrinol Metab. 2021;36:209–19.
Acosta A, Camilleri M, Abu Dayyeh B, Calderon G, Gonzalez D, McRae A, et al. Selection of Antiobesity Medications Based on Phenotypes Enhances Weight Loss: A Pragmatic Trial in an Obesity Clinic. Obesity (Silver Spring). 2021;29:662–71.
Bhargava A, Arnold AP, Bangasser DA, Denton KM, Gupta A, Hilliard Krause LM, et al. Considering sex as a biological variable in basic and clinical studies: an endocrine society scientific statement. Endocr Rev. 2021;42:219–58.
We thank participants in the studies, the nurses, the staff of the Mayo Clinic Clinical Research Trials Unit (supported by Mayo Clinic Center for Clinical and Translational Science [CCaTS] grant UL1-TR000135), and Michael Ryks and Deborah Rhoten for their excellent technical support.
Dr. Acosta is supported by NIH (NIH K23-DK114460), Mayo Clinic Center for Individualized Medicine – Gerstner Career Development Award. Dr. Camilleri receives funding related to obesity from the National Institutes of Health (NIH RO1-DK67071). Dr. Kapoor is supported by the NIA grant U54 AG044170. The funding source was not involved in the study design, in collection, analysis, and interpretation of the data, in writing the report, or in the decision to submit the paper for publication. The corresponding author had full access to all the data in the study and takes responsibility for the integrity of the data, the accuracy of the data analysis, and the decision to submit for publication.
Dr. Acosta is a stockholder in Gila Therapeutics, Phenomix Sciences; he serves as a consultant for Rhythm Pharmaceuticals, General Mills. Dr. Camilleri is a stockholder in Phenomix Sciences and Enterin and serves as a consultant to Takeda, Allergan, Rhythm, Kallyope, and Arena with compensation to his employer, Mayo Clinic. Dr. Kapoor serves as a consultant for Mithra and Astellas Pharmaceuticals. She is also a consultant for the company Womaness. The rest of the authors have nothing to disclose.
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Hurtado, M.D., Cifuentes, L., Campos, A. et al. Sex as an independent variable in the measurement of satiation: a retrospective cohort study. Int J Obes 46, 2156–2162 (2022). https://doi.org/10.1038/s41366-022-01228-7