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Reproducibility, power and validity of visual analogue scales in assessment of appetite sensations in single test meal studies


OBJECTIVE: To examine reproducibility and validity of visual analogue scales (VAS) for measurement of appetite sensations, with and without a diet standardization prior to the test days.

DESIGN: On two different test days the subjects recorded their appetite sensations before breakfast and every 30 min during the 4.5 h postprandial period under exactly the same conditions.

SUBJECTS: 55 healthy men (age 25.6±0.6 y, BMI 22.6±0.3 kg/m2).

MEASUREMENTS: VAS were used to record hunger, satiety, fullness, prospective food consumption, desire to eat something fatty, salty, sweet or savoury, and palatability of the meals. Subsequently an ad libitum lunch was served and energy intake was recorded. Reproducibility was assessed by the coefficient of repeatability (CR) of fasting, mean 4.5 h and peak/nadir values.

RESULTS: CRs (range 20–61 mm) were larger for fasting and peak/nadir values compared with mean 4.5 h values. No parameter seemed to be improved by diet standardization. Using a paired design and a study power of 0.8, a difference of 10 mm on fasting and 5 mm on mean 4.5 h ratings can be detected with 18 subjects. When using desires to eat specific types of food or an unpaired design, more subjects are needed due to considerable variation. The best correlations of validity were found between 4.5 h mean VAS of the appetite parameters and subsequent energy intake (r=±0.50−0.53, P<0.001).

CONCLUSION: VAS scores are reliable for appetite research and do not seem to be influenced by prior diet standardization. However, consideration should be given to the specific parameters being measured, their sensitivity and study power.

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  1. Blundell JE, Stubbs JR . Diet composition and the control of food intake in humans. In: Bray GA, Bouchard C, James WPT (eds). Handbook of obesity. Marcel Dekker: New York, 1997, pp 243–272.

  2. Joyce CRB, Zutshi DW, Hrubes V, Mason RM . Comparison of fixed interval and visual analogue scales for rating chronic pain Eur J Clin Pharmac 1975 8: 415–420.

    CAS  Article  Google Scholar 

  3. Revill SI, Robinson JO, Rosen M, Hogg IJ . The reliability of a linear analogue evaluating pain Anaesthesia 1976 31: 1191–1198.

    CAS  Article  Google Scholar 

  4. Price DD, McGrath PA, Rafii A, Buckingham B . The validation of visual analogue scales as ratio scale measures for chronic and experimental pain Pain 1983 17: 45–56.

    CAS  Article  Google Scholar 

  5. Yarnitsky D, Sprecher E, Zaslansky R, Hemli JA . Multiple session experimental pain measurement Pain 1996 67: 327–333.

    CAS  Article  Google Scholar 

  6. Robinson RG, McHugh PR, Folstein MF . Measurement of appetite disturbances in psychiatric disorders J Psychiat Res 1975 12: 59–68.

    CAS  Article  Google Scholar 

  7. Silverstone T, Fincham . Experimental techniques for the measurement of hunger and food intake in man for use in the evaluation of anorectic drugs. In: Garattini S, Samanin R (ed). Central mechanisms of anorectic drugs. Raven Press: New York, 1978, pp 375–382.

    Google Scholar 

  8. Lappalainen R, Mennen L, van Weert L, Mykkänen H . Drinking water with a meal: A simple method of coping with feelings of hunger, satiety and desire to eat Eur J Clin Nutr 1993 47: 815–819.

    CAS  PubMed  Google Scholar 

  9. Porrini M, Crovetti R, Testolin G, Silva S . Evaluation of satiety sensations and food intake after different preloads Appetite 1995 25: 17–30.

    CAS  Article  Google Scholar 

  10. Barkeling B, Rössner S, Sjöberg A . Methodological studies on single meal food intake characteristics in normal weight and obese men and women Int J Obes 1995 19: 284–290.

    CAS  Google Scholar 

  11. Bland JM, Altmann DG . Statistical methods for assessing agreement between two methods of clinical measurement Lancet 1986 i: 307–310.

    Article  Google Scholar 

  12. Stratton RJ, Stubbs RJ, Hughes D, King N, Blundell JE, Elia M . Comparison of the traditional paper visual analogue scale questionnaire with an Apple Newton electronic appetite rating system (EARS) in free living subjects feeding ad libitum Eur J Clin Nutr 1998 52: 737–741.

    CAS  Article  Google Scholar 

  13. Raben A, Tagliabue A, Astrup A . The reproducibility of subjective appetite scores Br J Nutr 1995 73: 517–530.

    CAS  Article  Google Scholar 

  14. Silverstone JT . The measurement of hunger in relation to food intake Proceedings of the VII International Congress on Nutrition. Hamburg 1966 51–53.

    Google Scholar 

  15. Hill AJ, Leathwood PD, Blundell JE . Some evidence for short-term caloric compensation in normal weight human subjects: The effects of high- and low-energy meals on hunger, food preference and food intake Hum Nutr 1987 41A: 244–257.

    Google Scholar 

  16. Hulshof T, de Graff C, Weststrate JA . The effects of preloads varying in physical state and fat content on satiety and energy intake Appetite 1993 21: 273–286.

    CAS  Article  Google Scholar 

  17. De Graff C . The validity of appetite ratings Appetite 1993 21: 156–160.

    Article  Google Scholar 

  18. Food and Agriculture Organization/World Health Organization/United Nations University . Energy and protein requirements. Report of a joint FAO/WHO/UNV Expert Con-sultation. Technical Report Series 74. World Health Organization, 1985.

  19. Altman DG . Practical Statistics for Medical Research. Chapman & Hall: London, 1991, pp 455–460.

  20. Costill DL . Carbohydrates for exercise: Dietary demands for optimal performance Int J Sports Med 1988 9: 1–18.

    CAS  Article  Google Scholar 

  21. Bisdee JT, James WP, Shaw MA . Changes in energy expenditure during the menstrual cycle Br J Nutr 1989 61: 187–199.

    CAS  Article  Google Scholar 

  22. Lissner L, Stephens J, Levitsky DA, Rasmussen KM, Strupp BJ . Variation in energy intake during the menstrual cycle: Implications for food-intake research Am J Clin Nutr 1988 48: 956–962.

    CAS  Article  Google Scholar 

  23. Wald A, Van Thiel DH, Hoechstetter L, Gavaler JS, Egler KM, Verm R, Scott L, Lester R . Gastrointestinal transit: The effect of the menstrual cycle Gastroneterology 1981 80: 1497–1500.

    CAS  Google Scholar 

  24. Notivol R, Carrio I, Cano L, Estorch M, Vilardell F . Gastric emptying and serum insulin levels after intake of glucose–polymer solutions Eur J Appl Physiol 1984 58: 661–665.

    Google Scholar 

  25. Datz FL, Christian PE, Moore J . Gender-related differences in gastric emptying J Nucl Med 1987 28: 1204–1207.

    CAS  PubMed  Google Scholar 

  26. Hill AJ, Magson LD, Blundell JE . Hunger and palatability: Tracking ratings of subjective experiences before, during and after the consumption of preferred and less preferred food Appetite 1984 5: 361–371.

    CAS  Article  Google Scholar 

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We are grateful to Charlotte Kostecki, Karina Graff Larsen and Berit Kristiansen for expert assistance in the preparation and serving of more than 200 meals. The study was supported by The Danish Research and Development programme for Food Technology (1995–1998) and The Danish Medical Research Council.

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Correspondence to A Flint.


Appendix 1

Table 6

Table 6 Questions on appetite and desire for specific food types

Appendix 2

Table 7

Table 7 Questions on palatability of test meals

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Flint, A., Raben, A., Blundell, J. et al. Reproducibility, power and validity of visual analogue scales in assessment of appetite sensations in single test meal studies. Int J Obes 24, 38–48 (2000).

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  • visual analogue scales
  • hunger
  • satiety
  • diet standardization

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