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The use of visual analogue scales to assess motivation to eat in human subjects: a review of their reliability and validity with an evaluation of new hand-held computerized systems for temporal tracking of appetite ratings

  • R. J. Stubbs (a1), D. A. Hughes (a1), A. M. Johnstone (a1), E. Rowley (a1), C. Reid (a2), M. Elia (a3), R. Stratton (a3), H. Delargy (a4), N. King (a4) and J. E. Blundell (a4)
  • DOI:
  • Published online: 01 March 2007

This present paper reviews the reliability and validity of visual analogue scales (VAS) in terms of (1) their ability to predict feeding behaviour, (2) their sensitivity to experimental manipulations, and (3) their reproducibility. VAS correlate with, but do not reliably predict, energy intake to the extent that they could be used as a proxy of energy intake. They do predict meal initiation in subjects eating their normal diets in their normal environment. Under laboratory conditions, subjectively rated motivation to eat using VAS is sensitive to experimental manipulations and has been found to be reproducible in relation to those experimental regimens. Other work has found them not to be reproducible in relation to repeated protocols. On balance, it would appear, in as much as it is possible to quantify, that VAS exhibit a good degree of within-subject reliability and validity in that they predict with reasonable certainty, meal initiation and amount eaten, and are sensitive to experimental manipulations. This reliability and validity appears more pronounced under the controlled (but more artificial) conditions of the laboratory where the signal: noise ratio in experiments appears to be elevated relative to real life. It appears that VAS are best used in within-subject, repeated-measures designs where the effect of different treatments can be compared under similar circumstances. They are best used in conjunction with other measures (e.g. feeding behaviour, changes in plasma metabolites) rather than as proxies for these variables. New hand-held electronic appetite rating systems (EARS) have been developed to increase reliability of data capture and decrease investigator workload. Recent studies have compared these with traditional pen and paper (P&P) VAS. The EARS have been found to be sensitive to experimental manipulations and reproducible relative to P&P. However, subjects appear to exhibit a significantly more constrained use of the scale when using the EARS relative to the P&P. For this reason it is recommended that the two techniques are not used interchangeably.

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*Corresponding author: Dr R. James Stubbs, fax +44 (0) 1224 715349, email
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J de Castro and DK Elmore (1988) Subjective hunger relationships with meal patterns in the spontaneous feeding behaviour of humans, evidence for a casual connection. Physiology and Behaviour 43, 159165.

C De Graaf , A Schreurs and GH Blauw (1993) Short term effects of different amounts of sweet and non sweet carbohydrates on satiety and energy intake. Physiology and Behaviour 54, 833843.

HE Drummond , S Ghosh , A Ferguson , D Brackenridge and B Tiplady (1995) Electronic quality of life questionnaires: a comparison of pen-based electronic questionnaires with conventional paper in a gastrointestinal study. Quality of Life Research 4, 2126.

MT Freyd (1923) The graphic rating scale. Journal of Educational Psychology 14, 83102.

P Leathwood and P Pollet (1988) Effects of slow release carbohydrates in the form of bean flakes on the evolution of hunger and satiety in man. Appetite 10, 111.

R Mattes (1990) Hunger ratings are not a valid proxy measure of reported food intake in humans. Appetite 15, 103113.

EE Ohnhaus and R Alder (1975) Methodological problems in the measurement of pain: a comparison between the verbal rating scale and the visual analogue scale. Pain 1, 379384.

X Pi-Sunyer , HR Kissileff , J Thornton and GP Smith (1982) C-terminal octopeptide of cholescystokinin decreases food intake in obese men. Physiology and Behaviour 29, 627630.

BJ Rolls , M Hetherington and LJ Laster (1988) Comparison of the effects of aspartame and sucrose on appetite and food intake. Appetite 11, 6267.

TA Speigel , AJ Stunkard , EE Shrager , CP O'Brian , MF Morrison and E Stellar (1987) Effect of naltrexone on food intake, hunger and satiety in obese men. Physiology and Behaviour 40, 135141.

RJ Stratton , RJ Stubbs , DA Hughes , N King , JE Blundell and M Elia (1998) Comparison of the traditional paper visual analogue scales questionnaires with an Apple Newton electronic rating system (EARS) in free living subjects feeding. ad libitum. European Journal of Clinical Nutrition 52, 737741.

RJ Stubbs , AM Johnstone , CG Harbron and C Reid (1998) Covert manipulation of the mixed energy density diets: effect on. ad libitum food intake in "pseudo free-living" humans. International Journal of Obesity 22, 980987.

DA Thompson and RG Campbell (1977) Hunger in humans induced by 2 deoxy-D-glucose glucoprivic control of taste p and food intake. Science 198, 10651068.

DA Thompson , Sl Welle , U Lilavivat , L Penicaud and RG Campbell (1982) Opiate receptor blockade in man reduces 2-deoxy-D-glucose induced food intake but not hunger, thirst, and hypothermia. Life Sciences 31, 847852.

E Trenchard and T Silverstone (1983) Naloxone reduces the food intake of normal human volunteers. Appetite 4, 4350.

MR Yeomans , RW Gray , CJ Mitchell and S True (1997) Independent effects of palatability and within meal pauses on intake and appetite ratings in human volunteers. Appetite 29, 6176.

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British Journal of Nutrition
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