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The assessment of dietary carotenoid intake of the cardio-med ffq using food records and biomarkers in an australian cardiology cohort: a pilot validation.

• Teagan Kucianski , Hannah L. Mayr , Audrey Tierney , Hassan Vally , Colleen J. Thomas , Leila Karimi , Lisa G. Wood , Catherine Itsiopoulos
• Journal of Nutritional Science , Volume 13

Processed food consumption and risk of non-communicable diseases (NCDs) in South Africa: evidence from Demographic and Health Survey (DHS) VII

• Swapnil Godbharle , Hema Kesa , Angeline Jeyakumar

Impact of lipid emulsions in parenteral nutrition on platelets: a literature review

• Betul Kisioglu , Funda Tamer

Only two in five pregnant women have adequate dietary diversity during antenatal care at Hiwot Fana Specialized University Hospital in Eastern Ethiopia

• Sinetibeb Mesfin , Dawit Abebe , Hirut Dinku Jiru , Seboka Abebe Sori

Changing sustainable diet behaviours during the COVID-19 Pandemic: inequitable outcomes across a sociodemographically diverse sample of adults

• Elizabeth Ludwig-Borycz , Ana Baylin , Andrew D. Jones , Allison Webster , Anne Elise Stratton , Katherine W. Bauer

The effects of nutrition and health education on the nutritional status of internally displaced schoolchildren in Cameroon: a randomised controlled trial

• Mirabelle Boh Nwachan , Richard Aba Ejoh , Ngangmou Thierry Noumo , Clementine Endam Njong

Advancing assessment of responsive feeding environments and practices in child care

• Julie E. Campbell , Jessie-Lee D. McIsaac , Margaret Young , Elizabeth Dickson , Sarah Caldwell , Rachel Barich , Misty Rossiter

Professor William Philip Trehearne James, FRSE FMedSci CBE (1938–2023)

• Paul Trayhurn

Journal of Nutritional Science Blog

Meet Bernard Corfe: Editor-in-Chief of the Journal of Nutritional Science

• 22 November 2023, Bernard Corfe
• I was always interested in core biological processes, from school years, genetics was the area of biology I found most inspiring and through my BSc and PhD...

Nutrition Society Paper of the Month

Can mechanistic research in nutrition contribute to a better understanding of relationships between diet and non-communicable diseases (NCD)?

• 21 May 2024, Christine M Williams
• Most of the evidence linking diet with complex diseases such as heart disease and cancer (non-communicable diseases (NCD)) is based on findings from epidemiological...

Nutrition blog

Recent evidence on selenoneine highlights the need to consider selenium speciation in research and dietary guidelines

• 16 April 2024, Matthew Little, Pierre Ayotte and Mélanie Lemire
• There are numerous essential vitamins and minerals that play crucial roles in maintaining our health and wellbeing. Among these, selenium stands out as a lesser...

Can health-related food taxes green our diets?

• 27 March 2024, Margreet R Olthof, Michelle Eykelenboom, Derek Mersch, Reina E Vellinga, Elisabeth HM Temme, Ingrid HM Steenhuis and Alessandra Grasso
• In a world increasingly concerned with both health and environmental sustainability, the way we eat plays a critical role. However, in our search for solutions...

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Nutrition Journal

Climate-friendly diet for healthier planet.

Dr. Gao won the Irwin H. Rosenberg Pre-doctoral Award from the Jean Mayor USDA Human Nutrition Research Center on Aging at Tufts(2006), the Wayne A. Hening Sleep Medicine Investigator Award from the American Academy of Neurology (2011), the Leadership/Expertise Alumni Award from the Tufts Nutrition School (2012), and the Samuel Fomon Young Physician Investigator Award from American Society for Nutrition(2015). He was selected into the Tufts Honorable Alumni Registry in 2015.   

Dr. Gao received his M.S. in Epidemiology from Peking Union Medical College and his M.D. from Shanghai Second Medical University. He received his Ph.D. in nutritional epidemiology from Tufts University. 

Qi Sun, MD, Sc.D., Co-Editor-in-Chief

Dr. Qi Sun is Associate Professor of Medicine in Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School. He is also Associate Professor in the Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health. Dr. Sun’s primary research interests include identifying and examining biomedical risk factors, particularly dietary biomarkers, in relation to type 2 diabetes, obesity, and cardiovascular disease through epidemiological investigations. His research is primarily based on several large-scale cohort studies including the Nurses’ Health Studies and the Health Professionals Follow-up Study. Dr. Sun is also interested in understanding the role of environmental pollutants, such as perfluoroalkyl substances and legacy persistent organic pollutants, in the etiology of weight change and type 2 diabetes. In the era of precision nutrition, Dr. Sun develops a new research interest of understanding the role of microbiome in mediating and modulating diet-health associations. Dr. Sun is currently leading a few NIH-funded projects that focus on food biomarker discovery and validation, diet-microbiome-health inter-relationships, as well as associations between obesogens and weight change in human populations.

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• v.4(5); 2013 Sep

Nutrition research to affect food and a healthy lifespan 1, 2

Sarah d. ohlhorst.

3 American Society for Nutrition, Bethesda, MD

Robert Russell

4 NIH Office of Dietary Supplements, Bethesda, MD, and Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA

Dennis Bier

5 USDA/Agricultural Research Service Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX

David M. Klurfeld

6 Human Nutrition Program, USDA/Agricultural Research Service, Beltsville, MD

Zhaoping Li

7 Center for Human Nutrition, University of California Los Angeles, and David Geffen School of Medicine at UCLA, Los Angeles, CA

Jonathan R. Mein

8 Monsanto Center for Food and Nutrition Research, Monsanto Vegetable Seed, Kannapolis, NC

John Milner

9 NIH National Cancer Institute, Bethesda, MD

A. Catharine Ross

10 Department of Nutritional Sciences, Pennsylvania State University, University Park, PA; and

Patrick Stover

11 Division of Nutritional Sciences, Cornell University, Ithaca, NY.

Emily Konopka

Proper nutrition offers one of the most effective and least costly ways to decrease the burden of many diseases and their associated risk factors, including obesity. Nutrition research holds the key to increasing our understanding of the causes of obesity and its related comorbidities and thus holds promise to markedly influence global health and economies. After outreach to 75 thought leaders, the American Society for Nutrition (ASN) convened a Working Group to identify the nutrition research needs whose advancement will have the greatest projected impact on the future health and well-being of global populations. ASN’s Nutrition Research Needs focus on the following high priority areas: 1 ) variability in individual responses to diet and foods; 2 ) healthy growth, development, and reproduction; 3 ) health maintenance; 4 ) medical management; 5 ) nutrition-related behaviors; and 6 ) food supply/environment. ASN hopes the Nutrition Research Needs will prompt collaboration among scientists across all disciplines to advance this challenging research agenda given the high potential for translation and impact on public health. Furthermore, ASN hopes the findings from the Nutrition Research Needs will stimulate the development and adoption of new and innovative strategies that can be applied toward the prevention and treatment of nutrition-related diseases. The multidisciplinary nature of nutrition research requires stakeholders with differing areas of expertise to collaborate on multifaceted approaches to establish the evidence-based nutrition guidance and policies that will lead to better health for the global population. In addition to the identified research needs, ASN also identified 5 tools that are critical to the advancement of the Nutrition Research Needs: 1 ) omics, 2 ) bioinformatics, 3 ) databases, 4 ) biomarkers, and 5 ) cost-effectiveness analysis.

INTRODUCTION

The attainment of good nutrition depends on and encompasses the entire food supply. Plant and animal foods and their various components are the primary vehicles that provide nourishment to human beings. Nutrition is vital, not only in the growth and development of humans and animals but also in the prevention and treatment of disease. Nutrition is also fundamental to the maintenance of good health and functionality. Basic and applied research on the interrelations between nutrition and noncommunicable diseases, nutrient composition, and nutrition monitoring represents the underpinnings for healthy populations and robust economies. Thus, innovative nutrition research and education provide the basis for solutions to larger health-related issues, allowing individuals to live healthier, more productive lives.

The importance of nutrition, as an integral part of the solution to many societal, environmental, and economic challenges facing the world, has just started to be fully appreciated. The American Society for Nutrition (ASN) has identified the “grand” challenges facing nutrition research and science in the 21st century, termed “Nutrition Research Needs.” Findings from these Nutrition Research Needs will elucidate strategies that can be applied toward the prevention and treatment of both infectious and noncommunicable diseases, including cardiovascular disease, diabetes, and cancer. Nutrition research holds the key to increasing our understanding of the underlying causes of obesity and its related comorbidities and thus holds promise to markedly influence global economies. Knowledge about adequate nutrition also has an important role in reducing or ending global and domestic food insecurity through direct and purposeful agricultural practices. Population growth will undeniably lead to increased global demand for a safe, available, sustainable, and affordable food supply, while continuing to demand nutritional adequacy.

The ASN Nutrition Research Needs project was originally conceptualized by ASN’s Public Policy Committee to identify worldwide nutrition research needs. This effort will be used to educate and communicate to policy makers and other stakeholders the need and value of increased nutrition research funding to meet societal needs. ASN’s Public Policy Committee reached out to nearly 75 thought leaders in September 2011 to develop a draft list of nutrition research needs.

In February 2012, ASN convened a Working Group of nutrition scientists and researchers representing a cross-section of the Society’s membership to determine the nutrition research needs that will have the greatest impact on the health and well-being of global populations. The names of the Working Group members are listed in the Acknowledgments. Starting with the draft list, the Working Group narrowed down and pulled together 6 nutrition research needs for which advancement would have the greatest projected impact on future health and well-being.

The ASN then informed its membership of the 6 priority research needs and sought further member input. A workshop was held during ASN’s 2012 Scientific Sessions and Annual Meeting in San Diego, CA, with nearly 250 attendees. The research needs were also shared via ASN’s member newsletter, which reaches the entire membership base of nearly 5000 individuals, to inform and seek input from members who did not attend the annual meeting or the workshop. Member feedback on the Nutrition Research Needs was incorporated during development of the final document.

THE TOP NUTRITION RESEARCH NEEDS

The top 6 nutrition research needs cut across the entire research spectrum from basic science to health policy, from discovery to application. Specific research areas are listed under each research need. These 6 nutrition research needs are highlighted in the hope that they will prompt scientists from all disciplines to collaborate to advance these challenging research needs that have high potential for translation and public health impact. Although the topics presented focus principally on human nutrition research, the Working Group recognized that nutrition research using animal models is an essential foundation for making new discoveries that can be translated to advances in human nutrition. Further, the importance of animal nutrition research is emphasized within these research needs in particular: “Understanding the role of nutrition in health maintenance” and “Understanding the food supply/environment.” The research community will benefit from clearly articulated nutrition research priorities that will lead to science-based information, help to shape policy and enhance future funding for nutrition research, and thereby further promote the field of nutrition science.

1) Understanding variability in individual responses to diet and foods

A top priority for future nutrition research is the need to better understand variability in metabolic responses to diet and food. Enormous variability exists in individual responses to diet and food components that affect overall health. Discoveries underpinning this variability will lead to advances in personalized nutrition interventions and will better inform health and food policies, including Dietary Reference Intakes (DRIs) for nutrient needs and, ideally, future recommendations for known bioactive food components. Research in the following areas is necessary to determine the origins and architecture of variability and to explain similar or dissimilar responses to diet and food components by subpopulations, as influenced by genetic, epigenetic, and ethnic and/or racial differences.

Omics research, such as nutrigenetics and nutrigenomics (e.g., epigenetics, transcriptomics, proteomics, and metabolomics), will help to determine how specific nutrients interact with genes, proteins, and metabolites to predict an individual’s health. Omics provide information on individualized nutrient requirements, including how nutrients are digested, absorbed, and metabolized, and their functions in the body. Omics will help to determine and reflect an individual’s nutritional status and will aid in the creation of new nutritional and disease biomarkers.

Microbiome.

Diverse microbes, such as bacteria and viruses, live in and on the body and contribute to the microbiome, which is estimated to have 10 times as many cells as the body itself ( 1 ). Microbes can vary in type and quantity, making each organism’s microbiome unique—although subpopulations may have similar microbiome characteristics. The microbiota needs to be better defined, and changes due to diet, age, physiologic state, and disease need to be determined. Research is needed to determine the microbiome’s role in varying biological responses to diet and food components and its importance in disease prevention and progression. Conversely, research is also needed to determine how the microbiome is influenced by diet and other environmental factors.

Biological networks.

Basic research is needed to provide a better understanding of biological networks, such as an individuals’ genome (DNA/RNA protein profiles), and how these networks affect metabolic responses to diet and food. Environmental interactions, including nutrients and other dietary components, bacteria, viruses, and chemical contaminants, all may affect the responsiveness of biological networks to specific foods and the entire diet.

Tissue specificity and temporality.

Research is needed to describe the mechanisms by which dietary factors affect variability in development and functioning, including which tissues are most influenced by dietary factors and when during the most critical stages in life this influence occurs.

2) Understanding the impact of nutrition on healthy growth, development, and reproduction

Epigenetics/imprinting..

Epigenetics and imprinting research examines how exposures to dietary components during critical periods of development may “program” long-term health and well-being. Research is needed to determine how early nutritional events contribute to disease later in life and alter normal developmental progression.

Early nutrition.

Research is necessary to better understand the role of diet and individual food components on normal growth and development. This includes the role of parent’s preconception diets, the maternal diet during pregnancy, and early nutritional events. Studies indicate that the timing of an infant’s introduction to solid foods may increase the likelihood of becoming obese later in life ( 2 ). These findings are important given that the number of overweight children in the United States has increased dramatically in recent years ( 3 ). Research is now needed to determine the best approaches to influence these factors during early life. The important role of nutrition throughout early life on growth and development, as well as on health and well-being, needs to be continually assessed.

Nutrition and reproductive health.

The impact of nutrition on reproductive health, including before and after conception, requires further research. Nutrition has a direct impact on both maternal and paternal fertility and the ability to conceive and also plays a key role in preventing diseases related to reproductive organs, including prostate and ovarian cancers. Although numerous studies have investigated how fruit and vegetable consumption may affect risk of breast, prostate, and other cancers, there is no clear consensus in the scientific literature. Thus, well-designed controlled intervention studies are needed to determine whether effects are limited to subpopulations, what factors influence a response and what mechanisms may account for changes in health.

3) Understanding the role of nutrition in health maintenance

Health maintenance includes noncommunicable disease prevention and treatment as well as weight management. The role that food components, particularly novel ingredients, contribute to health maintenance requires continuing research. Researchers and the public rely on dietary guidance, including the DRIs, to guide nutrition recommendations and health policy. Research is needed to better define the nutrient needs that best support health maintenance in all populations and their subgroups, from infancy throughout life. Nutrition across life is a fundamental issue that requires investigation so that recommendations will “match” with true biological needs.

Optimal bodily function.

Research is needed to determine the roles that nutrition and fitness, both singularly and together, have in maintaining bodily functions, including cognitive, immune, skeletal, muscular, and other functions. Evolving research areas include prevention of disease-related processes, such as inflammation, and definition of mechanisms that have an important role in health maintenance, such as immunocompetence. Animal models are used to understand the requirements for optimal health in humans and production animals.

Energy balance.

Research is also needed to examine the use of a systems approach to achieve energy balance including and integrating environmental, biological, psychosocial, and food system factors. A systems approach is preferable because the standard experimental approach of varying one factor at a time has accomplished little to address the populationwide problem of energy imbalance. A solution-oriented approach that is comprehensive in nature and takes into account the complexities of achieving energy balance must be created. Although far more research is needed to identify systemwide changes that maximize energy balance, intriguing examples exist. “Shape Up Somerville, MA,” effectively reduced weight gain in high-risk children through a multifaceted community-based environmental change campaign ( 4 ). Shape Up Somerville increased the community’s physical activity and healthful eating through physical infrastructure improvements and citywide policy and programming changes.

4) Understanding the role of nutrition in medical management

The rapid translation of nutrition research advances into evidence-based practice and policy is a priority for ensuring optimal patient care and effective disease management. Nutrition researchers have a key role in bridging the gap between disease prevention and disease treatment by fostering clinical research, providing innovative education for caregivers and patients, and delineating best practices for medical nutrition in primary care settings.

Disease progression.

To improve the medical management of disease, research is needed to determine how nutritional factors influence both disease initiation and progression, as well as how nutrition affects a patient’s response to therapy. Genetic and epigenetic variations among individuals can result in both positive and negative responses to diets, to specific foods, and to novel food components. The issue of individual variability is of considerable importance in refining medical management, including nutrition support, and requires continuing research.

Expanded research will allow us to better understand and minimize unfavorable impacts of both reduced and elevated nutrient intakes on disease progression and overall health. Disease/mortality response curves are U-shaped for many nutrients (that is, there is an increased risk of adverse outcomes if the nutrient is ingested in either too low or too high amounts). The importance of achieving a proper nutrient balance is seen in the example of chronic inflammation. Chronic inflammation contributes to many noncommunicable diseases and can result from high intakes of proinflammatory omega-6 fatty acids in the face of low intakes of anti-inflammatory omega-3 fatty acids ( 5 ). Research will help to determine the desired intake for essential and nonessential nutrients alone and when combined with other nutrients in the diet.

Nutrition support for special subgroups.

Nutrition research is needed to establish the required nutritional needs that best support survival, growth, and development in subpopulations, such as in chronically diseased patients, in children, and in aging adults. With the success of medical advances, as have been seen with in vitro fertilization and neonatal care, caring for preterm infants presents a new challenge in early nutritional management. Preterm infants have special nutrition needs that will greatly affect their future growth and development, as well as their eventual health status as adults.

5) Understanding nutrition-related behaviors

Drivers of food choice..

Understanding the link between behavior and food choices can help tackle obesity and other nutrition-related issues that are a public health priority. Individual food choices can be influenced by a number of different drivers including the following:

• Government policy
• Environmental cues
• Cultural differences
• Communication tools, such as social networking and food marketing

Research is needed to identify the impact of these various drivers and understand how they work alone or together to influence nutrition-related behavior. Research will show how these drivers should be altered to have the highest positive influence on individual behavior and therefore public health. For example, the state of Mississippi recorded a 13% decline in obesity among elementary school students from 2005 to 2011 ( 6 ). Multiple changes in the environment occurred, such as the setting of standards for foods sold in school vending machines, setting a requirement for more school exercise time, mandating healthier environments in childcare settings, and establishing programs that encouraged fruit and vegetable consumption. The challenge now is to determine what effect these combined actions will have on obesity-related behaviors in the long run.

Nutrition and brain functioning.

Further explorations of the biochemical and behavioral bases for food choices and intake over time are essential. Brain function as it relates to food desire and choice needs to be clarified through research, and the multiple hormones that affect eating require further study as well. Factors such as meal frequency and size, speed of meal consumption, and how these factors are influenced by social cues require objective data, which can only be provided by research. Understanding how the marketing of healthy behaviors could help consumers achieve dietary guidance goals should be a priority. As part of this approach, innovative and practical methods for accurately measuring and evaluating food purchases and eating occasions must be developed.

Imprinting.

Because of the high propensity of obese children remaining obese as adults ( 7 ), additional research is needed to determine how eating and satiety behaviors are imprinted during critical periods of development and to show how food components affect neural biochemistry and brain functioning—and therefore shape behavior. This research will provide us with a better understanding of how and why an individual makes particular food choices. Although scientists recently validated the concept that food availability during pregnancy has permanent effects on gene expression in children ( 8 ), human studies are needed to confirm or refute the hypothesis that fetal programming, resulting from maternal obesity, leads to excess weight in children and into adulthood.

6) Understanding the food supply/environment

Food environment and food choice..

Simply knowing or understanding what constitutes a healthy diet is not enough to change an individual’s diet or lifestyle. Understanding how the food environment affects dietary and lifestyle choices is necessary before effective policies can be instituted that will change a population’s diet in a meaningful way. Examples of key questions that should be addressed include the following:

• Is current dietary guidance an effective way of communicating dietary change?
• Do food assistance programs promote positive dietary patterns or have negative dietary and health consequences?
• What role does food advertising play in food decision-making among different age groups and educational levels?
• How do farm-to-fork food systems, with an increased emphasis on local agricultural production and consumption, influence dietary patterns and behaviors?
• How can farm-to-fork food systems ultimately be used to promote healthy behaviors and improve public health?
• How can we most effectively measure, monitor, and evaluate dietary change?

Food composition and novel foods and food ingredients.

Having an affordable, available, sustainable, safe, and nutritious food supply is also an important underpinning for making significant changes to a population’s diet and lifestyle. Examples of key research areas to address include the following:

• Enhancing our knowledge of the nutrient and phytonutrient content and bioavailability of foods produced, processed, and consumed
• Studying how to better align and foster collaboration between nutrition and agricultural production
• Can shifting agricultural focus from principally agronomic to include quality factors (such as taste, flavor, and nutritional value) have positive effects on fruit and vegetable consumption?
• Can we leverage technologies, such as biotechnology and nanotechnology, to develop novel foods and food ingredients that will improve health, both domestically and abroad, and provide credible, tangible functional health benefits?

Public/private partnerships.

To tackle these enormous challenges requires the coordinated efforts of public and private partners. The development of public/private partnerships between food and agricultural industries, government, academia, and nongovernmental organizations has the potential to advance nutrition research, enabling meaningful changes to be made to American and global diets (e.g., increased fruit and vegetable consumption to match government recommendations). We need to examine successful examples of public/private partnerships that have resulted in improved nutritional status and food security in specific populations ( 9 ).

CROSS-CUTTING TOOLS TO ADVANCE NUTRITION RESEARCH

Nutrition research is truly a cross-cutting discipline, and the Working Group identified several tools that are also necessary to advance the priority needs in nutrition research. Adequately powered intervention trials continue to be essential for validating research theories arising from experimental and epidemiologic studies. However, the development of new, impactful tools will help us to more effectively quantify dietary intake and food waste and to determine the effectiveness of nutrition standards, such as DRI values and the Dietary Guidelines for Americans . Although not a traditional tool, multidisciplinary partnerships among scientific societies, government, industry, academia, and others are fundamental to advance the nutrition research agenda. ASN and its membership must be proactive not only in efforts to advance nutrition research (including initiating and leading partnerships) but also in developing the tools needed to enhance the field. ASN recognizes the need to facilitate effective communication among academia, industry, government agencies, consumers, and other stakeholders to advance nutrition.

Omics (especially genomics, proteomics, and metabolomics) will enable us to determine how specific nutrients interact with genes, proteins, and metabolites to predict the future health of an individual. A field of study that encompasses technological advances as well as omics-based research, it is sometimes referred to as personalized nutrition. Omics hold the keys to major nutrition breakthroughs in noncommunicable disease and obesity prevention. Omics provide information on how well nutrients are digested, absorbed, metabolized, and used by an individual. Moreover, omics will lead to new biomarkers that reveal a person’s nutritional status and health status all at one time.

2) Bioinformatics

Bioinformatics is an interdisciplinary field that uses computer science and information technology to develop and enhance techniques to make it easier to acquire, store, organize, retrieve, and use biological data. Bioinformatics will enable nutrition researchers to manage, analyze, and understand nutrition data and to make connections between diet and health that were not previously possible. Databases are necessary to gain the full benefits of bioinformatics, because they make nutrition data easily accessible in a machine-readable format.

3) Databases

Accurate, up-to-date food and nutrient databases are essential to track and observe trends related to the nutrition and health of individuals. Databases link food and supplement composition and intake data to health outcomes. Nutrient databases should be expanded to cover more foods and their bioactive components, including nonessential nutrients. Nutrition data must be incorporated into databases related to novel research areas, such as nutrigenomics and the microbiome, to adequately link these areas with nutrition. Data collection must also be improved with enhancements such as photographic food intake documentation, direct upload of food composition and sensory characteristics (if not proprietary) from food manufacturers, and biological sample collection.

4) Biomarkers

Intake, effect, and exposure biomarkers allow us to determine and monitor the health and nutritional status of individuals and subpopulations, including ethnic and racial minorities. Biomarkers that are responsive to diet and nutrition will help assess disease progression and variability in response to treatment, while improving early diagnosis and prevention. Biomarkers must continue to be developed and validated to accurately track food and nutrient intake given our rapidly changing food supply.

5) Cost-effectiveness analysis

Cost-effectiveness analysis is a tool used to calculate and compare the relative costs and benefits of nutrition research interventions. Cost effectiveness analysis helps to determine the most cost-effective option that will have the greatest benefit to public health.

CONCLUSIONS

The multidisciplinary nature of nutrition research requires collaboration among research scientists with differing areas of expertise, many different stakeholders, and multifaceted approaches to develop the knowledge base required for establishing the evidence-based nutrition guidance and policies that will lead to better health and well-being of world populations. Proper nutrition offers one of the most effective and least costly ways to decrease the burden of chronic and noncommunicable diseases and their risk factors, including obesity. Although there is skepticism about the ability to complete large, well-controlled dietary interventions at a reasonable cost in the United States, the success of the Lyon Diet Heart study in France ( 10 , 11 ) and the PREvención con DIeta MEDiterránea (PREDIMED) study in Spain ( 12 ), both of which used variations of the Mediterranean diet, show this approach can be successful, even in the presence of drug treatment of cardiovascular risks in the latter study. Both of these studies showed significant reductions in cardiovascular disease (and cancer in the Lyon study) after relatively modest dietary changes.

Perhaps the greatest barrier to advancing the connections between food and health is the variability in individual responses to diet; it is also the origin of public skepticism to acceptance of dietary advice and the opportunity for entrepreneurship in the private sector. Imagine being able to identify, with certainty, those most likely to benefit from prescriptive nutrition advice through the various omic technologies and then providing these groups of people with customized nutrition advice based on their metabolic risk profiles. This is the new frontier of the nutritional sciences that offers the opportunity to predictably engineer our physiologic networks for health through diet. The confidence this approach would bring to the skeptical consumer would improve adherence to weight management and disease treatment techniques and improve the chances of success for disease prevention. To realize the full positive impact of achieving good nutrition on disease prevention and the health of populations, we must have the will to invest in and support the 6 key areas of nutrition research that have been outlined above.

Acknowledgments

The Nutrition Research Needs Working Group consisted of Dennis Bier, David M Klurfeld, Zhaoping Li, Jonathan R Mein, John Milner, A Catharine Ross, Robert Russell (Chair), and Patrick Stover. They were supported by ASN staff members Sarah D. Ohlhorst and Emily Konopka.

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• Published: 06 December 2017

Healthy food choices are happy food choices: Evidence from a real life sample using smartphone based assessments

• Deborah R. Wahl 1   na1 ,
• Karoline Villinger 1   na1 ,
• Laura M. König   ORCID: orcid.org/0000-0003-3655-8842 1 ,
• Katrin Ziesemer 1 ,
• Harald T. Schupp 1 &
• Britta Renner 1  

Scientific Reports volume  7 , Article number:  17069 ( 2017 ) Cite this article

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• Health sciences
• Human behaviour

Research suggests that “healthy” food choices such as eating fruits and vegetables have not only physical but also mental health benefits and might be a long-term investment in future well-being. This view contrasts with the belief that high-caloric foods taste better, make us happy, and alleviate a negative mood. To provide a more comprehensive assessment of food choice and well-being, we investigated in-the-moment eating happiness by assessing complete, real life dietary behaviour across eight days using smartphone-based ecological momentary assessment. Three main findings emerged: First, of 14 different main food categories, vegetables consumption contributed the largest share to eating happiness measured across eight days. Second, sweets on average provided comparable induced eating happiness to “healthy” food choices such as fruits or vegetables. Third, dinner elicited comparable eating happiness to snacking. These findings are discussed within the “food as health” and “food as well-being” perspectives on eating behaviour.

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Introduction.

When it comes to eating, researchers, the media, and policy makers mainly focus on negative aspects of eating behaviour, like restricting certain foods, counting calories, and dieting. Likewise, health intervention efforts, including primary prevention campaigns, typically encourage consumers to trade off the expected enjoyment of hedonic and comfort foods against health benefits 1 . However, research has shown that diets and restrained eating are often counterproductive and may even enhance the risk of long-term weight gain and eating disorders 2 , 3 . A promising new perspective entails a shift from food as pure nourishment towards a more positive and well-being centred perspective of human eating behaviour 1 , 4 , 5 . In this context, Block et al . 4 have advocated a paradigm shift from “food as health” to “food as well-being” (p. 848).

Supporting this perspective of “food as well-being”, recent research suggests that “healthy” food choices, such as eating more fruits and vegetables, have not only physical but also mental health benefits 6 , 7 and might be a long-term investment in future well-being 8 . For example, in a nationally representative panel survey of over 12,000 adults from Australia, Mujcic and Oswald 8 showed that fruit and vegetable consumption predicted increases in happiness, life satisfaction, and well-being over two years. Similarly, using lagged analyses, White and colleagues 9 showed that fruit and vegetable consumption predicted improvements in positive affect on the subsequent day but not vice versa. Also, cross-sectional evidence reported by Blanchflower et al . 10 shows that eating fruits and vegetables is positively associated with well-being after adjusting for demographic variables including age, sex, or race 11 . Of note, previous research includes a wide range of time lags between actual eating occasion and well-being assessment, ranging from 24 hours 9 , 12 to 14 days 6 , to 24 months 8 . Thus, the findings support the notion that fruit and vegetable consumption has beneficial effects on different indicators of well-being, such as happiness or general life satisfaction, across a broad range of time spans.

The contention that healthy food choices such as a higher fruit and vegetable consumption is associated with greater happiness and well-being clearly contrasts with the common belief that in particular high-fat, high-sugar, or high-caloric foods taste better and make us happy while we are eating them. When it comes to eating, people usually have a spontaneous “unhealthy = tasty” association 13 and assume that chocolate is a better mood booster than an apple. According to this in-the-moment well-being perspective, consumers have to trade off the expected enjoyment of eating against the health costs of eating unhealthy foods 1 , 4 .

A wealth of research shows that the experience of negative emotions and stress leads to increased consumption in a substantial number of individuals (“emotional eating”) of unhealthy food (“comfort food”) 14 , 15 , 16 , 17 . However, this research stream focuses on emotional eating to “smooth” unpleasant experiences in response to stress or negative mood states, and the mood-boosting effect of eating is typically not assessed 18 . One of the few studies testing the effectiveness of comfort food in improving mood showed that the consumption of “unhealthy” comfort food had a mood boosting effect after a negative mood induction but not to a greater extent than non-comfort or neutral food 19 . Hence, even though people may believe that snacking on “unhealthy” foods like ice cream or chocolate provides greater pleasure and psychological benefits, the consumption of “unhealthy” foods might not actually be more psychologically beneficial than other foods.

However, both streams of research have either focused on a single food category (fruit and vegetable consumption), a single type of meal (snacking), or a single eating occasion (after negative/neutral mood induction). Accordingly, it is unknown whether the boosting effect of eating is specific to certain types of food choices and categories or whether eating has a more general boosting effect that is observable after the consumption of both “healthy” and “unhealthy” foods and across eating occasions. Accordingly, in the present study, we investigated the psychological benefits of eating that varied by food categories and meal types by assessing complete dietary behaviour across eight days in real life.

Furthermore, previous research on the impact of eating on well-being tended to rely on retrospective assessments such as food frequency questionnaires 8 , 10 and written food diaries 9 . Such retrospective self-report methods rely on the challenging task of accurately estimating average intake or remembering individual eating episodes and may lead to under-reporting food intake, particularly unhealthy food choices such as snacks 7 , 20 . To avoid memory and bias problems in the present study we used ecological momentary assessment (EMA) 21 to obtain ecologically valid and comprehensive real life data on eating behaviour and happiness as experienced in-the-moment.

In the present study, we examined the eating happiness and satisfaction experienced in-the-moment, in real time and in real life, using a smartphone based EMA approach. Specifically, healthy participants were asked to record each eating occasion, including main meals and snacks, for eight consecutive days and rate how tasty their meal/snack was, how much they enjoyed it, and how pleased they were with their meal/snack immediately after each eating episode. This intense recording of every eating episode allows assessing eating behaviour on the level of different meal types and food categories to compare experienced eating happiness across meals and categories. Following the two different research streams, we expected on a food category level that not only “unhealthy” foods like sweets would be associated with high experienced eating happiness but also “healthy” food choices such as fruits and vegetables. On a meal type level, we hypothesised that the happiness of meals differs as a function of meal type. According to previous contention, snacking in particular should be accompanied by greater happiness.

Eating episodes

Overall, during the study period, a total of 1,044 completed eating episodes were reported (see also Table  1 ). On average, participants rated their eating happiness with M  = 77.59 which suggests that overall eating occasions were generally positive. However, experienced eating happiness also varied considerably between eating occasions as indicated by a range from 7.00 to 100.00 and a standard deviation of SD  = 16.41.

Food categories and experienced eating happiness

All eating episodes were categorised according to their food category based on the German Nutrient Database (German: Bundeslebensmittelschlüssel), which covers the average nutritional values of approximately 10,000 foods available on the German market and is a validated standard instrument for the assessment of nutritional surveys in Germany. As shown in Table  1 , eating happiness differed significantly across all 14 food categories, F (13, 2131) = 1.78, p  = 0.04. On average, experienced eating happiness varied from 71.82 ( SD  = 18.65) for fish to 83.62 ( SD  = 11.61) for meat substitutes. Post hoc analysis, however, did not yield significant differences in experienced eating happiness between food categories, p  ≥ 0.22. Hence, on average, “unhealthy” food choices such as sweets ( M  = 78.93, SD  = 15.27) did not differ in experienced happiness from “healthy” food choices such as fruits ( M  = 78.29, SD  = 16.13) or vegetables ( M  = 77.57, SD  = 17.17). In addition, an intraclass correlation (ICC) of ρ = 0.22 for happiness indicated that less than a quarter of the observed variation in experienced eating happiness was due to differences between food categories, while 78% of the variation was due to differences within food categories.

However, as Figure  1 (left side) depicts, consumption frequency differed greatly across food categories. Frequently consumed food categories encompassed vegetables which were consumed at 38% of all eating occasions ( n  = 400), followed by dairy products with 35% ( n  = 366), and sweets with 34% ( n  = 356). Conversely, rarely consumed food categories included meat substitutes, which were consumed in 2.2% of all eating occasions ( n  = 23), salty extras (1.5%, n  = 16), and pastries (1.3%, n  = 14).

Left side: Average experienced eating happiness (colour intensity: darker colours indicate greater happiness) and consumption frequency (size of the cycle) for the 14 food categories. Right side: Absolute share of the 14 food categories in total experienced eating happiness.

Amount of experienced eating happiness by food category

To account for the frequency of consumption, we calculated and scaled the absolute experienced eating happiness according to the total sum score. As shown in Figure  1 (right side), vegetables contributed the biggest share to the total happiness followed by sweets, dairy products, and bread. Clustering food categories shows that fruits and vegetables accounted for nearly one quarter of total eating happiness score and thus, contributed to a large part of eating related happiness. Grain products such as bread, pasta, and cereals, which are main sources of carbohydrates including starch and fibre, were the second main source for eating happiness. However, “unhealthy” snacks including sweets, salty extras, and pastries represented the third biggest source of eating related happiness.

Experienced eating happiness by meal type

To further elucidate the contribution of snacks to eating happiness, analysis on the meal type level was conducted. Experienced in-the-moment eating happiness significantly varied by meal type consumed, F (4, 1039) = 11.75, p  < 0.001. Frequencies of meal type consumption ranged from snacks being the most frequently logged meal type ( n  = 332; see also Table  1 ) to afternoon tea being the least logged meal type ( n  = 27). Figure  2 illustrates the wide dispersion within as well as between different meal types. Afternoon tea ( M  = 82.41, SD  = 15.26), dinner ( M  = 81.47, SD  = 14.73), and snacks ( M  = 79.45, SD  = 14.94) showed eating happiness values above the grand mean, whereas breakfast ( M  = 74.28, SD  = 16.35) and lunch ( M  = 73.09, SD  = 18.99) were below the eating happiness mean. Comparisons between meal types showed that eating happiness for snacks was significantly higher than for lunch t (533) = −4.44, p  = 0.001, d  = −0.38 and breakfast, t (567) = −3.78, p  = 0.001, d  = −0.33. However, this was also true for dinner, which induced greater eating happiness than lunch t (446) = −5.48, p  < 0.001, d  = −0.50 and breakfast, t (480) = −4.90, p  < 0.001, d  = −0.46. Finally, eating happiness for afternoon tea was greater than for lunch t (228) = −2.83, p  = 0.047, d  = −0.50. All other comparisons did not reach significance, t  ≤ 2.49, p  ≥ 0.093.

Experienced eating happiness per meal type. Small dots represent single eating events, big circles indicate average eating happiness, and the horizontal line indicates the grand mean. Boxes indicate the middle 50% (interquartile range) and median (darker/lighter shade). The whiskers above and below represent 1.5 of the interquartile range.

Control Analyses

In order to test for a potential confounding effect between experienced eating happiness, food categories, and meal type, additional control analyses within meal types were conducted. Comparing experienced eating happiness for dinner and lunch suggested that dinner did not trigger a happiness spill-over effect specific to vegetables since the foods consumed at dinner were generally associated with greater happiness than those consumed at other eating occasions (Supplementary Table  S1 ). Moreover, the relative frequency of vegetables consumed at dinner (73%, n  = 180 out of 245) and at lunch were comparable (69%, n  = 140 out of 203), indicating that the observed happiness-vegetables link does not seem to be mainly a meal type confounding effect.

Since the present study focuses on “food effects” (Level 1) rather than “person effects” (Level 2), we analysed the data at the food item level. However, participants who were generally overall happier with their eating could have inflated the observed happiness scores for certain food categories. In order to account for person-level effects, happiness scores were person-mean centred and thereby adjusted for mean level differences in happiness. The person-mean centred happiness scores ( M cwc ) represent the difference between the individual’s average happiness score (across all single in-the-moment happiness scores per food category) and the single happiness scores of the individual within the respective food category. The centred scores indicate whether the single in-the-moment happiness score was above (indicated by positive values) or below (indicated by negative values) the individual person-mean. As Table  1 depicts, the control analyses with centred values yielded highly similar results. Vegetables were again associated on average with more happiness than other food categories (although people might differ in their general eating happiness). An additional conducted ANOVA with person-centred happiness values as dependent variables and food categories as independent variables provided also a highly similar pattern of results. Replicating the previously reported analysis, eating happiness differed significantly across all 14 food categories, F (13, 2129) = 1.94, p  = 0.023, and post hoc analysis did not yield significant differences in experienced eating happiness between food categories, p  ≥ 0.14. Moreover, fruits and vegetables were associated with high happiness values, and “unhealthy” food choices such as sweets did not differ in experienced happiness from “healthy” food choices such as fruits or vegetables. The only difference between the previous and control analysis was that vegetables ( M cwc  = 1.16, SD  = 15.14) gained slightly in importance for eating-related happiness, whereas fruits ( M cwc  = −0.65, SD  = 13.21), salty extras ( M cwc  = −0.07, SD  = 8.01), and pastries ( M cwc  = −2.39, SD  = 18.26) became slightly less important.

This study is the first, to our knowledge, that investigated in-the-moment experienced eating happiness in real time and real life using EMA based self-report and imagery covering the complete diversity of food intake. The present results add to and extend previous findings by suggesting that fruit and vegetable consumption has immediate beneficial psychological effects. Overall, of 14 different main food categories, vegetables consumption contributed the largest share to eating happiness measured across eight days. Thus, in addition to the investment in future well-being indicated by previous research 8 , “healthy” food choices seem to be an investment in the in-the moment well-being.

Importantly, although many cultures convey the belief that eating certain foods has a greater hedonic and mood boosting effect, the present results suggest that this might not reflect actual in-the-moment experiences accurately. Even though people often have a spontaneous “unhealthy = tasty” intuition 13 , thus indicating that a stronger happiness boosting effect of “unhealthy” food is to be expected, the induced eating happiness of sweets did not differ on average from “healthy” food choices such as fruits or vegetables. This was also true for other stereotypically “unhealthy” foods such as pastries and salty extras, which did not show the expected greater boosting effect on happiness. Moreover, analyses on the meal type level support this notion, since snacks, despite their overall positive effect, were not the most psychologically beneficial meal type, i.e., dinner had a comparable “happiness” signature to snacking. Taken together, “healthy choices” seem to be also “happy choices” and at least comparable to or even higher in their hedonic value as compared to stereotypical “unhealthy” food choices.

In general, eating happiness was high, which concurs with previous research from field studies with generally healthy participants. De Castro, Bellisle, and Dalix 22 examined weekly food diaries from 54 French subjects and found that most of the meals were rated as appealing. Also, the observed differences in average eating happiness for the 14 different food categories, albeit statistically significant, were comparable small. One could argue that this simply indicates that participants avoided selecting bad food 22 . Alternatively, this might suggest that the type of food or food categories are less decisive for experienced eating happiness than often assumed. This relates to recent findings in the field of comfort and emotional eating. Many people believe that specific types of food have greater comforting value. Also in research, the foods eaten as response to negative emotional strain, are typically characterised as being high-caloric because such foods are assumed to provide immediate psycho-physical benefits 18 . However, comparing different food types did not provide evidence for the notion that they differed in their provided comfort; rather, eating in general led to significant improvements in mood 19 . This is mirrored in the present findings. Comparing the eating happiness of “healthy” food choices such as fruits and vegetables to that of “unhealthy” food choices such as sweets shows remarkably similar patterns as, on average, they were associated with high eating happiness and their range of experiences ranged from very negative to very positive.

This raises the question of why the idea that we can eat indulgent food to compensate for life’s mishaps is so prevailing. In an innovative experimental study, Adriaanse, Prinsen, de Witt Huberts, de Ridder, and Evers 23 led participants believe that they overate. Those who characterised themselves as emotional eaters falsely attributed their over-consumption to negative emotions, demonstrating a “confabulation”-effect. This indicates that people might have restricted self-knowledge and that recalled eating episodes suffer from systematic recall biases 24 . Moreover, Boelsma, Brink, Stafleu, and Hendriks 25 examined postprandial subjective wellness and objective parameters (e.g., ghrelin, insulin, glucose) after standardised breakfast intakes and did not find direct correlations. This suggests that the impact of different food categories on wellness might not be directly related to biological effects but rather due to conditioning as food is often paired with other positive experienced situations (e.g., social interactions) or to placebo effects 18 . Moreover, experimental and field studies indicate that not only negative, but also positive, emotions trigger eating 15 , 26 . One may speculate that selective attention might contribute to the “myth” of comfort food 19 in that people attend to the consumption effect of “comfort” food in negative situation but neglect the effect in positive ones.

The present data also show that eating behaviour in the real world is a complex behaviour with many different aspects. People make more than 200 food decisions a day 27 which poses a great challenge for the measurement of eating behaviour. Studies often assess specific food categories such as fruit and vegetable consumption using Food Frequency Questionnaires, which has clear advantages in terms of cost-effectiveness. However, focusing on selective aspects of eating and food choices might provide only a selective part of the picture 15 , 17 , 22 . It is important to note that focusing solely on the “unhealthy” food choices such as sweets would have led to the conclusion that they have a high “indulgent” value. To be able to draw conclusions about which foods make people happy, the relation of different food categories needs to be considered. The more comprehensive view, considering the whole dietary behaviour across eating occasions, reveals that “healthy” food choices actually contributed the biggest share to the total experienced eating happiness. Thus, for a more comprehensive understanding of how eating behaviours are regulated, more complete and sensitive measures of the behaviour are necessary. Developments in mobile technologies hold great promise for feasible dietary assessment based on image-assisted methods 28 .

As fruits and vegetables evoked high in-the-moment happiness experiences, one could speculate that these cumulate and have spill-over effects on subsequent general well-being, including life satisfaction across time. Combing in-the-moment measures with longitudinal perspectives might be a promising avenue for future studies for understanding the pathways from eating certain food types to subjective well-being. In the literature different pathways are discussed, including physiological and biochemical aspects of specific food elements or nutrients 7 .

The present EMA based data also revealed that eating happiness varied greatly within the 14 food categories and meal types. As within food category variance represented more than two third of the total observed variance, happiness varied according to nutritional characteristics and meal type; however, a myriad of factors present in the natural environment can affect each and every meal. Thus, widening the “nourishment” perspective by including how much, when, where, how long, and with whom people eat might tell us more about experienced eating happiness. Again, mobile, in-the-moment assessment opens the possibility of assessing the behavioural signature of eating in real life. Moreover, individual factors such as eating motives, habitual eating styles, convenience, and social norms are likely to contribute to eating happiness variance 5 , 29 .

A key strength of this study is that it was the first to examine experienced eating happiness in non-clinical participants using EMA technology and imagery to assess food intake. Despite this strength, there are some limitations to this study that affect the interpretation of the results. In the present study, eating happiness was examined on a food based level. This neglects differences on the individual level and might be examined in future multilevel studies. Furthermore, as a main aim of this study was to assess real life eating behaviour, the “natural” observation level is the meal, the psychological/ecological unit of eating 30 , rather than food categories or nutrients. Therefore, we cannot exclude that specific food categories may have had a comparably higher impact on the experienced happiness of the whole meal. Sample size and therefore Type I and Type II error rates are of concern. Although the total number of observations was higher than in previous studies (see for example, Boushey et al . 28 for a review), the number of participants was small but comparable to previous studies in this field 20 , 31 , 32 , 33 . Small sample sizes can increase error rates because the number of persons is more decisive than the number of nested observations 34 . Specially, nested data can seriously increase Type I error rates, which is rather unlikely to be the case in the present study. Concerning Type II error rates, Aarts et al . 35 illustrated for lower ICCs that adding extra observations per participant also increases power, particularly in the lower observation range. Considering the ICC and the number of observations per participant, one could argue that the power in the present study is likely to be sufficient to render the observed null-differences meaningful. Finally, the predominately white and well-educated sample does limit the degree to which the results can be generalised to the wider community; these results warrant replication with a more representative sample.

Despite these limitations, we think that our study has implications for both theory and practice. The cumulative evidence of psychological benefits from healthy food choices might offer new perspectives for health promotion and public-policy programs 8 . Making people aware of the “healthy = happy” association supported by empirical evidence provides a distinct and novel perspective to the prevailing “unhealthy = tasty” folk intuition and could foster eating choices that increase both in-the-moment happiness and future well-being. Furthermore, the present research lends support to the advocated paradigm shift from “food as health” to “food as well-being” which entails a supporting and encouraging rather constraining and limiting view on eating behaviour.

The study conformed with the Declaration of Helsinki. All study protocols were approved by University of Konstanz’s Institutional Review Board and were conducted in accordance with guidelines and regulations. Upon arrival, all participants signed a written informed consent.

Participants

Thirty-eight participants (28 females: average age = 24.47, SD  = 5.88, range = 18–48 years) from the University of Konstanz assessed their eating behaviour in close to real time and in their natural environment using an event-based ambulatory assessment method (EMA). No participant dropped out or had to be excluded. Thirty-three participants were students, with 52.6% studying psychology. As compensation, participants could choose between taking part in a lottery (4 × 25€) or receiving course credits (2 hours).

Participants were recruited through leaflets distributed at the university and postings on Facebook groups. Prior to participation, all participants gave written informed consent. Participants were invited to the laboratory for individual introductory sessions. During this first session, participants installed the application movisensXS (version 0.8.4203) on their own smartphones and downloaded the study survey (movisensXS Library v4065). In addition, they completed a short baseline questionnaire, including demographic variables like age, gender, education, and eating principles. Participants were instructed to log every eating occasion immediately before eating by using the smartphone to indicate the type of meal, take pictures of the food, and describe its main components using a free input field. Fluid intake was not assessed. Participants were asked to record their food intake on eight consecutive days. After finishing the study, participants were invited back to the laboratory for individual final interviews.

Immediately before eating participants were asked to indicate the type of meal with the following five options: breakfast, lunch, afternoon tea, dinner, snack. In Germany, “afternoon tea” is called “Kaffee & Kuchen” which directly translates as “coffee & cake”. It is similar to the idea of a traditional “afternoon tea” meal in UK. Specifically, in Germany, people have “Kaffee & Kuchen” in the afternoon (between 4–5 pm) and typically coffee (or tea) is served with some cake or cookies. Dinner in Germany is a main meal with mainly savoury food.

After each meal, participants were asked to rate their meal on three dimensions. They rated (1) how much they enjoyed the meal, (2) how pleased they were with their meal, and (3) how tasty their meal was. Ratings were given on a scale of one to 100. For reliability analysis, Cronbach’s Alpha was calculated to assess the internal consistency of the three items. Overall Cronbach’s alpha was calculated with α = 0.87. In addition, the average of the 38 Cronbach’s alpha scores calculated at the person level also yielded a satisfactory value with α = 0.83 ( SD  = 0.24). Thirty-two of 38 participants showed a Cronbach’s alpha value above 0.70 (range = 0.42–0.97). An overall score of experienced happiness of eating was computed using the average of the three questions concerning the meals’ enjoyment, pleasure, and tastiness.

Analytical procedure

The food pictures and descriptions of their main components provided by the participants were subsequently coded by independent and trained raters. Following a standardised manual, additional components displayed in the picture were added to the description by the raters. All consumed foods were categorised into 14 different food categories (see Table  1 ) derived from the food classification system designed by the German Nutrition Society (DGE) and based on the existing food categories of the German Nutrient Database (Max Rubner Institut). Liquid intake and preparation method were not assessed. Therefore, fats and additional recipe ingredients were not included in further analyses, because they do not represent main elements of food intake. Further, salty extras were added to the categorisation.

No participant dropped out or had to be excluded due to high missing rates. Missing values were below 5% for all variables. The compliance rate at the meal level cannot be directly assessed since the numbers of meals and snacks can vary between as well as within persons (between days). As a rough compliance estimate, the numbers of meals that are expected from a “normative” perspective during the eight observation days can be used as a comparison standard (8 x breakfast, 8 × lunch, 8 × dinner = 24 meals). On average, the participants reported M  = 6.3 breakfasts ( SD  = 2.3), M  = 5.3 lunches ( SD  = 1.8), and M  = 6.5 dinners ( SD  = 2.0). In comparison to the “normative” expected 24 meals, these numbers indicate a good compliance (approx. 75%) with a tendency to miss six meals during the study period (approx. 25%). However, the “normative” expected 24 meals for the study period might be too high since participants might also have skipped meals (e.g. breakfast). Also, the present compliance rates are comparable to other studies. For example, Elliston et al . 36 recorded 3.3 meal/snack reports per day in an Australian adult sample and Casperson et al . 37 recorded 2.2 meal reports per day in a sample of adolescents. In the present study, on average, M  = 3.4 ( SD  = 1.35) meals or snacks were reported per day. These data indicate overall a satisfactory compliance rate and did not indicate selective reporting of certain food items.

To graphically visualise data, Tableau (version 10.1) was used and for further statistical analyses, IBM SPSS Statistics (version 24 for Windows).

Data availability

The dataset generated and analysed during the current study is available from the corresponding authors on reasonable request.

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Acknowledgements

This research was supported by the Federal Ministry of Education and Research within the project SmartAct (Grant 01EL1420A, granted to B.R. & H.S.). The funding source had no involvement in the study’s design; the collection, analysis, and interpretation of data; the writing of the report; or the decision to submit this article for publication. We thank Gudrun Sproesser, Helge Giese, and Angela Whale for their valuable support.

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Deborah R. Wahl and Karoline Villinger contributed equally to this work.

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Department of Psychology, University of Konstanz, Konstanz, Germany

Deborah R. Wahl, Karoline Villinger, Laura M. König, Katrin Ziesemer, Harald T. Schupp & Britta Renner

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B.R. & H.S. developed the study concept. All authors participated in the generation of the study design. D.W., K.V., L.K. & K.Z. conducted the study, including participant recruitment and data collection, under the supervision of B.R. & H.S.; D.W. & K.V. conducted data analyses. D.W. & K.V. prepared the first manuscript draft, and B.R. & H.S. provided critical revisions. All authors approved the final version of the manuscript for submission.

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Correspondence to Deborah R. Wahl or Britta Renner .

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Wahl, D.R., Villinger, K., König, L.M. et al. Healthy food choices are happy food choices: Evidence from a real life sample using smartphone based assessments. Sci Rep 7 , 17069 (2017). https://doi.org/10.1038/s41598-017-17262-9

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DOI : https://doi.org/10.1038/s41598-017-17262-9

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