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Updated: Nov 8, 2025
Concept Development and Use of an Automated Food Intake and Eating Behavior Assessment Method
Published on: February 19, 2021
A two-component pictured-based appetite assessment tool is capable of detecting appetite sensations in younger
Lucila Triador1, Eloisa Colin-Ramirez1, Michelle L Mackenzie2
1Department of Pediatrics, University of Alberta, Edmonton T6G 2E1, Alberta, Canada.
Insights
A new picture-based appetite assessment (PBAA) tool effectively measures appetite in young children (4-10 years). This tool shows good agreement with visual analogue scales (VAS) and detects appetite changes after eating.
Area of Science:
- Pediatric Nutrition
- Appetite Regulation
- Psychometrics in Children
Background:
- Visual analogue scales (VAS) are commonly used for appetite assessment in children aged 8+, but are unreliable for younger children.
- Developing reliable appetite assessment tools for children aged 4-10 years is crucial for nutritional research and clinical practice.
Purpose of the Study:
- To develop a picture-based appetite assessment (PBAA) tool for children aged 4-10 years.
- To pilot test the PBAA tool against VAS in children aged 8-10 years.
- To evaluate the PBAA tool's ability to detect appetite changes post-consumption and its agreement with VAS.
Main Methods:
- A pilot study involving 15 children aged 4-10 years.
- Children completed the PBAA tool in a fasted state and after consuming snacks (ad libitum and limited).
- Children aged 8-10 years also completed VAS for comparison; appetite assessments were repeated at intervals post-snack.
Main Results:
- PBAA scores significantly changed over time and differed between meal types (ad libitum vs. limited snack) in all children (P < .001, P = .015).
- Good agreement (ICC > 0.75) was observed between PBAA and VAS scores at 30 and 60 minutes post-meal.
- The PBAA tool demonstrated reliability in detecting appetite changes and aligned well with the VAS instrument.
Conclusions:
- The newly developed PBAA tool is effective for assessing appetite in children aged 4-10 years.
- The PBAA tool shows good agreement with VAS in older children (8-10 years) and reliably detects appetite fluctuations.
- PBAA offers a promising alternative for appetite assessment in young children where VAS may be less reliable.
Abstract:
Visual analogue scales (VAS) have commonly been used to assess appetite in children 8 years and older; however, these tools have been considered unreliable for children 7 years old and under. The objective of this pilot study was to develop a picture-based appetite assessment (PBAA) tool for children aged 4-10 years and pilot test it compared to a VAS-based appetite assessment. The study hypothesis was that the PBAA scores would decrease following the consumption of an ad libitum snack compared to the scores in the fasted state in children 4 to 10 years old; furthermore, there would be a good level of agreement (intraclass correlation coefficients >0.75) between the appetite scores by the PBAA and VAS tools in children aged 8 years or older. At Visit 1, in a fasted state, all children (n = 15) completed the PBAA. Children who were 8-10 years old (n = 8) also completed the VAS-based appetite assessment. Then, an ad libitum snack was provided, and appetite assessments were repeated at 5-, 30- and 60-minutes post-snack. The same assessments were completed at visit 2 pre (fasting)- and post-consumption of a snack containing 25% of the amount consumed at visit 1 (limited snack). PBAA scores were different across time (P < .001) and between types of meal (ad libitum vs limited snack) (P = .015) in all children. A good agreement between the PBAA and VAS scores at 30 and 60 minutes after both types of meal was found (intraclass correlation coefficients >0.75). The PBAA tool was able to detect expected changes in appetite sensations and was in good agreement with the VAS instrument.
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