The relationship between basal metabolism and thermal sensitivity has always sparked interest in physiological sciences, although few studies have directly addressed the association between resting energy expenditure (REE) and perceived thermal sensitivity. The research conducted by Mun et al. (2024) fills this gap by investigating, in a large, healthy population sample, how different subjective perceptions of cold and heat correlate with REE, considering variables such as age, lean mass, and body fat.
The study evaluated 1,567 Korean adults using indirect calorimetry and structured questionnaires to characterize perceived thermal sensitivity across four dimensions: cold intolerance, heat intolerance, cold sensation, and heat sensation. The findings reveal a sexually dimorphic pattern of association between REE and these thermal perceptions. In men, higher levels of cold intolerance were significantly associated with lower REE values, while greater intolerance and heat sensation correlated with higher REE values. In women, only the presence of cold sensation was inversely associated with REE, even after multivariate adjustments (Mun et al., 2024).
This distinction between the sexes suggests that distinct physiological mechanisms mediate thermal perception and resting metabolism. Men tend to use strategies such as muscle tremors (shiver thermogenesis) and sweating to compensate for thermal imbalances, responses directly dependent on metabolic rate. In contrast, women appear to preferentially resort to peripheral vasoconstriction as a heat conservation strategy, which may explain the exclusive association between cold sensation and REE in this group. This insulative strategy, less dependent on basal metabolism, would explain the lack of a significant association with the other thermal dimensions in women after controlling for body fat mass.
Another notable aspect of the study is the methodological robustness in categorizing perceived thermal sensitivity. The distinction between “intolerance” (a tendency to be bothered by extreme temperatures) and “sensation” (a physiological experience of cold or heat unrelated to the environment) allows for refined physiological and clinical interpretations of the data. Multivariate statistical analysis, controlling for relevant confounding factors, lends greater validity to the detected associations.
From a clinical and physiological perspective, the results suggest the possibility of using REE as a metabolic marker associated with different thermal sensitivity profiles. This association may be relevant in the context of diseases such as Flammer syndrome, metabolic disorders, and thermoregulatory disorders linked to endocrine imbalances or autonomic dysfunctions. Thermal perception, often overlooked in conventional clinical models, can offer additional pathophysiological information when integrated with an individual’s metabolic profile.
However, a caveat is in order regarding the cross-sectional design of the study, which prevents causal inferences. Additionally, the use of face masks during calorimetry may have overestimated REE compared to canopy-based methods, and variables such as menstrual cycle or subclinical thyroid function, absent from the analyses, could influence the results, especially among women.
Nevertheless, the study represents a significant advance in understanding the interactions between basal metabolism and thermal perception, highlighting the importance of considering individual sensory physiology in metabolic modeling. As a personal reflection, when reviewing this article, I was struck by how subjective aspects often overlooked in clinical practice, such as patient-reported thermal discomfort, can reflect measurable physiological adaptations and even predict health conditions.
Reference:
MUN, Sujeong et al. Resting energy expenditure differs among individuals with different levels of perceived thermal sensitivity: A cross-sectional study. Medicine, vol. 103, no. 21, p. e38293, 2024. Available at: https://doi.org/10.1097/MD.0000000000038293. Accessed on: 20 June. 2025.
