Systematic literature review shows that appetite rating does not predict energy intake

Ratings of appetite are commonly used to assess appetite modification following an intervention. Subjectively rated appetite is a widely employed proxy measure for energy intake (EI), measurement of which requires greater time and resources. However, the validity of appetite as a reliable predictor of EI has not yet been reviewed systematically. This literature search identified studies that quantified both appetite ratings and EI. Outcomes were predefined as: (1) agreement between self-reported appetite scores and EI; (2) no agreement between self-reported appetitescores and EI. The presence of direct statistical comparison between the endpoints, intervention type and study population were also recorded. 462 papers were included in this review. Appetite scores failed to correspond with EI in 51.3% of the total studies. Only 6% of all studies evaluated here reported a direct statistical comparison between appetite scores and EI. χ² analysis demonstrated that any relationship between EI and appetite was independent of study type stratification by age, gender or sample size. The very substantive corpus reviewed allows us to conclude that self-reported appetite ratings of appetite do not reliably predict EI. Caution should be exercised when drawing conclusions based from self-reported appetite scores in relation to prospective EI.

食欲评分是评估干预后食欲变化的常用手段。主观食欲评分是当前广泛应用的能量摄入（energy intake，EI）替代指标，而直接测量能量摄入往往需要耗费更多时间与资源。然而，食欲作为能量摄入可靠预测因子的有效性，尚未得到系统性综述。
本次文献检索共筛选出同时量化了食欲评分与能量摄入的相关研究。预先设定的结局指标包括：(1) 自我报告食欲评分与能量摄入间存在一致性；(2) 自我报告食欲评分与能量摄入间无一致性。同时记录了各研究在终点指标、干预类型及研究人群间开展直接统计学比较的情况。
本综述共纳入462篇文献。其中51.3%的研究显示食欲评分与能量摄入并不相符。本次纳入的研究中，仅6%开展了食欲评分与能量摄入间的直接统计学比较。卡方（χ²）分析结果表明，能量摄入与食欲间的任何关联，均不受按年龄、性别或样本量进行的研究分层影响。本次综述覆盖的海量文献样本，足以支撑我们得出结论：自我报告的食欲评分无法可靠预测能量摄入。基于自我报告食欲评分推断远期能量摄入时，需谨慎行事。