Self-report ratings of appetite, particularly visual analogue scales (VAS) are commonly used to measure subjective appetite and to assess modifications thereof following an intervention (1,2) . Subjective rated appetite is a widely employed proxy measure for Actual Energy Intake (AEI) (3) , measurement of which requires greater time and resources. The validity of self-report measures of appetite as surrogate measures of AEI have not been systematically reviewed elsewhere.To identify the corpus of papers assessing both self -reported appetite and AEI in the same trial and to establish whether self-report scales reliably predict AEI.A literature search was undertaken spanning 1999 to 2015 identifying studies recording both VAS ratings and AEI, generally in response to a nutrient or food intervention. Outcomes were pre-defined as there being agreement between self-reported appetite and AEI (link) or no agreement between self-reported appetite scores and AEI (no link). The presence of statistical (direct) comparison between the two methods was also recorded, the type of intervention, subject or patient were also noted. Each paper was scored independently by two authors.462 papers were included in this review. Appetite scores failed to correspond with AEI in 51·3 % of total studies. Only 6 % of studies evaluated directly compared the two measures statistically. A Chi Squared test revealed a significant departure (P < 0·001) from observed and expected frequencies for direct assessment of a link when studies were separated by 'intervention type'. This effect appears to be, in part, due to the use of pharmaceutical interventions and particularly where satiety regulating hormones were manipulated.The very substantive corpus identified in this review allows us to conclude that self-reported appetite ratings of appetite do not reliably predict AEI. Caution should be exercised when deriving conclusions based from self -report appetite data alone in relation to prospective energy intake.
Three years ago Sophie Till started working with pianist Edna Golandsky, the leading exponent of the Taubman Piano Technique, an internationally acclaimed approach that is well known to pianists, on the one hand, for allowing pianists to attain a phenomenal level of virtuosity and on the other, for solving very serious piano-related injuries. Till, a violinist, quickly realized that here was a unique technical approach that could not only identify and itemize the minute movements that underlie a virtuoso technique but could show how these movements interact and go into music making at the highest level. Furthermore, through the work of the Golandsky Institute, she saw a pedagogical approach that had been developed to a remarkable depth and level of clarity. It was an approach that had the power to communicate in a way she had never seen before, despite her own first class violin training from the earliest age. While the geography and “look” on the violin are different from the piano, the laws governing coordinate motion specifically in playing the instrument are the same for pianists and violinists. As a result of Till’s work translating the technique for violin, a new pedagogical approach for violinists of all ages is emerging; the Taubman/Golandsky Approach to the Violin. In reflecting on these new developments, Edna Golandsky wrote, “I have been working with the Taubman Approach for more than 30 years and have worked regularly with other instrumentalists. However, Sophie Till was the first violinist who asked me to teach her with the same depth that I do with pianists. With her conceptual and intellectual agility as well as complete dedication to helping others, she has been the perfect partner to translate this body of knowledge for violinists. Through this collaboration, Sophie is helping develop a new ‘language’ for violinist that will prevent future problems, solve present ones and start beginners on the right road to becoming the best they can be. The implications of this new work for violinists are enormous.”
Subjective ratings of appetite, derived from visual analogue scales, are widely used stock-in-trade in appetitive research. These instruments follow a general format and may include a series of decoy questions, closely related questions (such as on motivation to eat and fullness), and scale reversals (1) . They are applied in studies that are designed to assess whether interventions have the potential to modify appetite, with the implicit or explicit inference that this will in turn modify energy intake (EI). Our group noted in previous studies that appetitive scores did not relate strongly to actual scores of subsequent EI. An informal survey of the literature suggested this disconnect was common in other papers, but also unremarked (2,3) . We therefore aim to undertake a systematic review of literature (SLR) reporting both rated appetite and EI to establish whether subjective ratings of appetite are reliable predictors of energy intake.In line with guidance on SLR, the searches have been undertaken by two independent workers using the agreed sets of terms and using three independent databases (Scopus, Medline, Web of Knowledge). Endnote is then used to de-duplicate lists from databases. The identified papers are manually screened for relevance: reviews, non-human and other non-relevant papers are excluded, yielding a set for analysis. The final list of papers will then be assessed by two researchers independently and scored with a binary outcome as to whether a link does or does not exist. At point of reporting, a screen from 2003-2014 de duplication and triage has yielded 582 papers for analysis. 442 have so far been included in the analysis. Only a small subset of papers n = 9, report a direct comparison of rated appetite and actual intake, so the majority of outcomes are inferential. Of 295 papers found to be relevant, 81% showed no relationship between rated appetite and energy intake. Of those with a direct comparison 56% showed no relationship between rated appetite and energy intake.Whilst this report is incomplete, fewer than half of the 442 papers assessed showed a relationship between rated appetite and energy intake. If the trend holds throughout the SLR, the analysis suggests that appetite is not a reliable predictor of EI. Future work will use text mining approaches and appreciative inquiry to explore the possibility of a "gold standard" experimental design.
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