# Assessing Appetite–Validation of a Picture-Based Appetite Assessment Tool for Children Aged 6–9 Years—A Pilot Study

## TL;DR

This pilot study validates a picture-based tool to assess children's hunger and satiety, showing it effectively captures changes in appetite.

## Contribution

The study introduces and validates a Hebrew-language picture-based appetite assessment tool for children aged 6–9.

## Key findings

- Children could accurately identify hunger and fullness in a story-based scenario.
- Hunger levels decreased significantly after lunch consumption.
- Older girls reported greater satiety after lunch compared to younger girls.

## Abstract

Background: Recognizing and balancing internal and external appetite cues is critical for controlling food intake in young children. The main aim of this pilot study was to validate a Hebrew-language Picture-Based Appetite Assessment (PBAA) for 6–9-years-old children. Specifically, the scale’s ability to reflect changes in perceptions of hunger and satiety based on a story and on their actual eating experiences. Methodology: In Part 1 (n = 99), a PBAA was used to rate a character’s hunger level according to a story. In Part 2 (n = 46), the child’s hunger level before and after lunch was assessed, and in Part 3 (n = 55), the child’s hunger level before and after unrestricted snack consumption was assessed. Results: After hearing a story, participants could identify whether a character in a story was hungry (95%) or full (85%) (Part 1). Their reported appetite levels decreased after consuming lunch (p-value < 0.001) (Part 2). When participants were given unrestricted access to snacks, they preferred highly processed sweets with no difference in hunger level before (Part 3). There were no differences between girls and boys except for the reported satiety after lunch, which was greater in older girls compared to younger girls, yet similar between older and younger boys. Conclusions: Participants successfully interpreted the PBAA scale based on the story character and reported lower hunger after eating lunch. Among girls, older age was associated with a greater difference in hunger levels before and after lunch. Most participants reported satiety after consuming unrestricted snacks, which was not related to their hunger level before.