Research Summary

Hunger Perception Drives Mood Shifts in Healthy Adults More Than Circulating Glucose Levels

Edited by:
Anthony Calabro, MA

Key Highlights

  • Higher interstitial glucose levels were associated with a more positive composite mood state in healthy adults.
  • Self-reported metabolic state (hunger minus satiety) mediated the association between glucose and mood.
  • The direct association between glucose and mood was not significant after accounting for metabolic state ratings.
  • Greater interoceptive accuracy was associated with fewer within-person mood fluctuations.

A longitudinal observational study published in eBioMedicine evaluated whether circulating glucose levels are associated with mood independently of subjective metabolic state. Across 4 weeks of monitoring, investigators found that although glucose levels were associated with mood, this relationship was statistically mediated by participants’ ratings of hunger and satiety, suggesting that consciously perceived metabolic state underlies the observed mood shifts.

Researchers enrolled 90 healthy adults (46 women, 44 men; mean age, 24.27 [SD, 3.57] years) and continuously monitored interstitial glucose using a factory-calibrated, sensor-based continuous glucose monitoring device.

Over 4 weeks, participants completed ecological momentary assessments up to twice daily (4,299 total assessments; mean, 47.76 [SD, 8.83] assessments per participant), rating happiness, sadness, hunger, and satiety on 0-to-100 visual analog scales.

Mood state was calculated as happy minus sad (range, −100 to 100) and metabolic state as hunger minus satiety (range, −100 to 100). Linear mixed-effects models assessed within- and between-person associations among glucose, metabolic state ratings, and mood and adjusted for body mass index, age, sex, and insulin resistance (HOMA-IR). A multilevel mediation analysis with 10,000 resamples estimated both direct and indirect effects.

Study Findings
Higher glucose levels were associated with a better composite mood state (LME b = 1.14; 95% CI, 0.09-2.17; P = .038). When mood components were analyzed separately, glucose was significantly associated with higher happiness ratings (b = 0.64; 95% CI, 0.12-1.15; P = .020), whereas the association with sadness was not significant (b = −0.52; 95% CI, −1.21 to 0.18; P = .157).

Glucose levels were strongly associated with metabolic state ratings. Higher glucose was associated with less hunger (b = −8.44; 95% CI, −9.40 to −7.46; P < .001) and greater satiety (b = 9.68; 95% CI, 8.35-10.57; P < .001), resulting in a robust association with the composite metabolic state score (b = −17.88; 95% CI, −19.83 to −15.89; P < .001). In turn, a hungrier metabolic state was associated with lower mood (b = −3.07; 95% CI, −4.29 to −1.84; P < .001).

When both glucose and metabolic state ratings were included in the same model, glucose was no longer significantly associated with mood (b = 0.36; 95% CI, −0.89 to 1.56; P = .577), whereas metabolic state remained significant (b = −2.95; 95% CI, −4.30 to −1.63; P < .001). Mediation analysis demonstrated a significant indirect effect of glucose on mood via metabolic state (average causal mediation effect, 0.78; 95% CI, 0.33-1.22; P < .001) and a non-significant direct effect (average direct effect, 0.33; 95% CI, −0.75 to 1.43; P = .544). The proportion mediated was estimated at 0.68 (95% CI, 0.17-3.94; P = .039), consistent with indirect-only mediation. Insulin resistance did not significantly moderate the glucose–metabolic state–mood relationship (3-way interaction b = 0.78; 95% CI, −0.43 to 2.00; P = .215).

In additional analyses, higher interoceptive accuracy, defined as closer correspondence between standardized glucose levels and metabolic state ratings, was associated with reduced mood variability (b = −3.08; 95% CI, −5.19 to −0.98; P = .005) but not with average mood state (b = −0.88; 95% CI, −7.25 to 5.50; P = .785).

Clinical Implications
According to the study authors, the findings indicate that hunger-related mood changes are linked to consciously perceived metabolic states rather than a largely subconscious effect of circulating glucose. They further noted that greater interoceptive accuracy was associated with fewer mood fluctuations, underscoring the potential role of metabolic interoception in everyday mood regulation among metabolically healthy individuals.

Expert Commentary
“Using a deep phenotyping approach in naturalistic settings, we found an association between glucose and mood that was attenuated when metabolic state ratings were considered,” the authors concluded. “This suggests that self-reported metabolic state mediates glucose's effects on mood, refuting the idea of a largely subconscious influence.”

Reference
Kaduk K, Kaeber M, Kühnel A, et al. Glucose levels are associated with mood, but the association is mediated by ratings of metabolic state. EBioMedicine. Published online December 9, 2025. doi:10.1016/j.ebiom.2025.106035