Back in 2012, I wondered aloud about creating a scoring system for dietary enjoyment. I blogged about it a few times here and there, and happily, a wonderful team of researchers in New Zealand took notice. Now, thanks to the hard work of Michelle Jospé, along with Jillian Haszsard, and Rachel Taylor, the first step towards its formal use has been taken.
Our paper, A tool for assessing the satisfaction of a diet: Development and preliminary validation of the Diet Satisfaction Score, was published late last year and it details our Diet Satisfaction Score’s preliminary reliability and validity.
With the help of the 1,604 people (spanning 24 different countries!) who answered our survey questions, as well as 6 diverse experts (thanks to Melanie Dubyk, Kevin Hall, Scott Kahan, Silke Morrison, Marion Nestle, Sherry Pagoto, Arya Sharma and Ethan Weiss), we arrived on the following questions geared to address various aspects of dietary adherence and satisfaction
The simplest way to think of the Diet Satisfaction Score’s use is the higher the overall score (each question is answered on a 5 point Likert scale and the final DSS score is calculated by way of taking the mean of all available items yielding a total score between 1 and 5), the greater an individual’s satisfaction/enjoyment of that diet is. The hypothesis then would be higher scores correlating with better adherence and consequently better/sustained weight loss.
And that’s what our preliminary findings suggest whereby each 1-point higher Diet Satisfaction Score correlated with a 1.7 week longer diet duration. It was also found that compared with those who had abandoned their diets, those maintaining them reported larger losses.
The value of a simple and quick score like this to individuals would be as a means to assess how much (or how little) they were enjoying their diets taking into account more than just whether they like the foods they’re eating, but also the impact their chosen diet might be having on related aspects of life (socializing, time, cost, etc.). Those evaluating their new diets and finding their scores low, might explore means to tweak their diets, or to try new ones.
The DSS score’s value to clinicians would be as a quick means to screen their patients’ efforts and perhaps to use the tool to help trouble shoot, or to triage referrals to professional resources such as registered dietitians.
The value of the DSS score to researchers would be using this tool with shorter term studies as a means to predict whether or not their studied diets are likely to be sustainable (as who really cares how much weight a person might lose on a particular short term diet if few people would actually sustain it).
Of course now what’s required is the repeated use of the Diet Satisfaction score in a long-term prospective trial. The good news is that because the tool, like me, is diet agnostic, it can be administered with any and all dietary strategies. Should you be interested in using the Diet Satisfaction Score in your trial Dr. Jospe is the person to contact and her contact information is just this one click away.
As has been my tradition, in December I repost old favourites from years gone by. This year am looking back to 2016
Two weeks ago Kevin Hall and I had our diet commentary published in The Lancet. Not surprisingly, we upset some folks – primarily low-carbers. Some accused us of being low-fat cheerleaders. Others that we fostered an “animus” towards low-carb diets.
While I can’t speak for Kevin, I can honestly state that I’m totally fine with low-carb diets. For some people they’re a life changer and our office is happy to work with patients on them. I’ve also got nothing against low fat, Paleo, intermittent fasting, vegan, gluten-free, or any other diet that has a name.
What matters most to me, and what was also the crux of our commentary, is whether or not a person likes their chosen diet enough to sustain it. Food is not simply fuel. Food is comfort, food is celebration, and food serves as the foundation of a huge part of our social lives. Regardless of whether or not one diet vs. another diet affords a person an additional few pounds of loss (or even whether or not it confers specific health benefits) pales in importance to whether or not a person likes that diet’s style of eating enough to live with it for good
As noted in our piece, every diet out there has its long term success stories, and so moving forward, if you see anyone out there suggesting their diet is the best (or that your diet is the worst) rest assured they have an agenda. Their agenda might simply reflect an n=1 mentality of, “it worked for me therefore it’s what you should do“, it might reflect basic post-purchase rationalization, or it might reflect genuine science and studies that infer greater short term losses or potential health benefits. But if they can’t wrap their heads around adherence (which on an individual basis is an expression of whether or not you like what you’re eating and don’t miss what you’re not) as any diet’s long term’s most critical component, their ideology is showing.
Temporary efforts will only yield temporary outcomes no matter how exciting the outcomes might be in the short run.