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The mixed-meal tolerance test as an appetite assay: methodological and practical considerations
James A King1,2, Alice E Thackray3,4, Catherine Gibbons5
1National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK. j.a.king@lboro.ac.uk.
International Journal of Obesity (2005)
|July 31, 2025
Summary
Standardizing the mixed-meal tolerance test (MM-TT) is crucial for reliable appetite research. This review identifies key methods to improve MM-TT protocols, enhancing comparability and consistency in studies on appetite regulation and obesity.
Area of Science:
- Nutrition Science
- Endocrinology
- Human Physiology
Background:
- Appetite control is vital for energy balance and obesity management.
- The mixed-meal tolerance test (MM-TT) is a key assay for dynamic appetite assessment.
- Current MM-TT protocols lack standardization, hindering research comparability.
Purpose of the Study:
- To identify and discuss critical methodological considerations for the MM-TT.
- To promote standardization and comparability across MM-TT studies.
- To provide a checklist for researchers designing MM-TT protocols.
Main Methods:
- Narrative review of existing MM-TT methodologies.
- Evaluation of participant familiarization and standardization practices.
- Assessment of test meal characteristics, appetite perception, blood sampling, hormone measurement, and data analysis.
Main Results:
- Significant variability exists in MM-TT protocols.
- A checklist of methodological considerations was developed.
- The review highlights the need for standardized MM-TT procedures.
Conclusions:
- Standardization of MM-TT protocols is essential for consistent and comparable appetite regulation research.
- Further research is needed to strengthen evidence for recommendations on familiarization and standardization.
- Additional investigation into less common MM-TT outcomes is warranted.
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