Novel Methodological Considerations Regarding the Use of Visual Analog Scale (VAS) Appetite Questionnaires in Tightly Controlled Feeding Trials

Abstract

Visual analog scale (VAS) questionnaires are widely used in nutrition research to assess appetite and subsequent food intake. However, a number of methodological considerations exist. The study aims were to test whether 1 ) appetite VASs alter subsequent food intake and 2 ) viewing previous appetite responses influences subsequent responses. Twelve healthy adults (age: 22 ± 3 y; BMI: 22.0 ± 3.1 kg/m 2 ) completed the randomized crossover study. On separate days, participants were provided breakfast preloads and completed appetite VASs every 30 min for 4 h or did not complete the questionnaires. When completing VASs, the participants were shown their previous responses (PR) or were not (No-PR). After 4 h, an ad libitum lunch was provided. Hunger, fullness, desire to eat, and prospective food consumption were not different between PR and No-PR. All data are reported as mean ± SEM. VASs did not affect lunch intake (484 ± 50 kcal) compared with no VASs (500 ± 53 kcal, nonsignificant). Thus, neither past appetite responses nor the use of appetite VASs influenced ingestive behavior in healthy adults. This trial was part of a larger acute, randomized crossover trial registered at clinicaltrials.gov as NCT03154606.

Predictive Validity of Image-Based Motivation-to-Eat Visual Analogue Scales in Normal Weight Children and Adolescents Aged 9–14 Years

“…Of 462 studies in a recent systematic review that measured both appetite ratings and FI, 97.3% did not report directly on such a relationship [33]. Limitations in this study include that there have been concerns that repeated measurements of appetite by VASs may influence FI by way of continually cuing one's state of hunger or fullness [5,36]. This is an important methodological consideration, as participants in the current study completed three VAS instruments at five time-points.…”

“…This is an important methodological consideration, as participants in the current study completed three VAS instruments at five time-points. However, a recent study showed that completion of multiple VASs at a time does not have any significant bearing on subsequent FI [5]. In the present study, the VAS instruments were presented in a random order for each participant at every time-point to reduce the risk of instrument order effects.…”

“…'; 'Urge to eat'; and 'Preoccupation with thoughts of food' [2]. In recent years, variations of the original motivation-to-eat VAS have been used in appetite trials [3][4][5][6][7][8][9][10]. Overall, paper-based VASs assessing motivation-to-eat show good within-subject reliability and predictive ability for subsequent food intake in adults [11,12].…”

The Efficacy of GLP-1 Analogues on Appetite Parameters, Gastric Emptying, Food Preference and Taste Among Adults with Obesity: Systematic Review of Randomized Controlled Trials

“…26 All the studies used a 100-m VAS tool, [16][17][18]20,[23][24][25][26][27][28][29] a widely used tool to assess appetite and subsequent food intake in nutrition research. 32 VAS questionnaires were used in the behavior research to evaluate the pre-and postprandial hunger, fullness, prospective food consumption, and desire to eat, and in controlled studies. 33,34 It has been established that this approach has been validated in the literature and considered as the best strategy to assess appetite and satiety.…”

Impact of acute consumption of beverages containing plant-based or alternative sweetener blends on postprandial appetite, food intake, metabolism, and gastro-intestinal symptoms: Results of the SWEET beverages trial

“…The trapezoid method (Wolever, Jenkins, Jenkins, & Josse, 1991) was used for calculation of the incremental area under the curve (iAUC, excluding fasting values to remove bias or differences at baseline) for glucose, insulin and the triglyceride and glucose (TyG) index. For appetite ratings, the net incremental AUC (niAUC) was used to account for negative values (Brouns et al, 2005;Douglas & Leidy, 2019).…”