Can eating pleasure be a lever for healthy eating? A systematic scoping review of eating pleasure and its links with dietary behaviors and health

This was not an experiment but a systematic scoping review. The authors mapped the existing scientific literature to answer three questions:

1. **What are the key dimensions of eating pleasure?** (i.e., what do people mean when they say they get pleasure from eating?)

2. **What are the associations between eating pleasure (and its dimensions) and dietary outcomes (e.g., fruit/vegetable intake, diet quality) and health outcomes (e.g., BMI, weight change, chronic disease risk)?**

3. **What intervention strategies have been tested that use eating pleasure to promote healthy eating?**

The review included both peer-reviewed studies and grey literature (dissertations, reports). They did not test a single intervention themselves; instead, they synthesized findings across 119 documents.

The review included 119 documents total. These covered a wide range of populations:

**For the mapping of eating pleasure dimensions:** 119 documents, including qualitative studies, surveys, and theoretical papers. Populations ranged from general adult populations (e.g., French adults, Canadian adults) to specific groups (e.g., older adults, adolescents, pregnant women, people with eating disorders, culinary professionals).

**For the associations with diet and health:** 45 studies, of which 62.2% were cross-sectional, 24.4% were longitudinal, and 13.3% were experimental. Sample sizes ranged from small qualitative studies (n=20–50) to large population surveys (e.g., n=5,000+ in the French NutriNet-Santé cohort).

**For intervention strategies:** 11 independent intervention studies, with sample sizes ranging from 30 to 1,500 participants. Populations included healthy adults, university students, people with type 2 diabetes, and low-income women.

**Specific example from one included study:** One intervention (the "Savorez" program) studied 96 healthy adults aged 18–65 in Quebec, Canada, who were randomized to a mindful eating intervention or a control group.

Since this is a scoping review, the "measurement" was the systematic search and coding of existing literature. The authors used:

**Search strategy:** 8 databases (Medline, PsycInfo, Embase, ERIC, Web of Science, CINAHL, ABI/Inform global, Sociology Abstract) plus grey literature (ProQuest Dissertations & Theses, Google). Two independent reviewers screened 28,908 records.

**Data extraction:** For each included document, they extracted: study design, population, dimensions of eating pleasure measured, instruments used, and associations with dietary/health outcomes.

**Coding framework:** They inductively coded all mentions of eating pleasure into sub-dimensions, then grouped these into 22 key dimensions. For example, "sensory experiences" included sub-dimensions like taste, texture, aroma, appearance, and temperature.

**Specific instruments used in included studies (examples):**

**Food pleasure scale:** A 10-item scale measuring pleasure from eating (e.g., "I enjoy the taste of food," "Eating is a pleasurable experience"), scored on a 5-point Likert scale.

**Mindful Eating Questionnaire (MEQ):** 28 items measuring mindful eating behaviors (e.g., "I notice when the food I eat affects my mood"), scored 1–4.

**Food Frequency Questionnaires (FFQs):** For dietary intake (e.g., servings of fruits/vegetables per day).

**24-hour dietary recalls:** For detailed nutrient intake.

**BMI (kg/m²):** Measured or self-reported.

**Weight change:** In longitudinal and intervention studies.

**Study design:** Systematic scoping review following the Joanna Briggs Institute methodology and PRISMA-ScR guidelines. This is not a meta-analysis (which would pool statistical results) but a scoping review (which maps the breadth of literature, identifies gaps, and summarizes findings narratively).

**Search and screening:**

28,908 records identified from databases and grey literature.

After removing duplicates, 18,731 records were screened by title/abstract.

1,149 full-text articles were assessed for eligibility.

119 documents met inclusion criteria and were included.

**Inclusion criteria:**

Published in English or French.

Any study design (qualitative, quantitative, mixed-methods, reviews).

Addressed eating pleasure (or related terms like "food enjoyment," "hedonic eating," "food satisfaction") in relation to dietary behaviors or health.

No date restriction (searched up to June 2020).

**Exclusion criteria:**

Studies focused solely on clinical populations (e.g., eating disorders, cancer patients) unless they also included general population data.

Studies focused only on food addiction or pathological overeating.

Animal studies.

**Data synthesis:** The authors used narrative synthesis (not statistical pooling) because the studies were too heterogeneous in design, populations, and outcome measures. They calculated frequencies (e.g., "sensory experiences appeared in 50.9% of documents") and reported the direction of associations (favorable, unfavorable, or null) for diet and health outcomes.

**What this design can and cannot prove:**

**Can prove:** This review can identify what dimensions of eating pleasure have been studied, how they relate to diet and health in existing research, and what intervention strategies have been tried. It can highlight gaps and suggest future research directions.

**Cannot prove:** Because most included studies were cross-sectional (62.2%), this review cannot establish causality. Even the longitudinal and experimental studies were limited in number and quality. The review cannot tell you whether eating pleasure *causes* healthier eating, or whether people who already eat healthily simply report more pleasure from healthy foods. It also cannot provide a single pooled effect size (like "eating pleasure increases fruit/vegetable intake by X servings/day").

**Major methodological weaknesses (of the review itself):**

**Heterogeneity:** The included studies used vastly different definitions and measures of eating pleasure, making synthesis difficult.

**Publication bias:** Studies finding positive associations may be more likely to be published.

**Language bias:** Only English and French studies were included.

**No quality assessment:** Scoping reviews typically do not assess the quality of included studies, so the review cannot distinguish between high-quality and low-quality evidence.

**Cross-sectional dominance:** 62.2% of the association studies were cross-sectional, meaning they measure a single point in time and cannot establish temporal order.

**1. Dimensions of eating pleasure (from 119 documents):**

22 key dimensions were identified, grouped from 89 sub-dimensions.

**Most frequently reported dimensions:**

- Sensory experiences: 50.9% of documents (e.g., taste, texture, aroma, appearance)

- Social experiences: 42.7% (e.g., eating with others, sharing meals, cultural traditions)

- Food characteristics (non-sensory): 27.3% (e.g., freshness, quality, origin, organic)

- Food preparation process: 19.1% (e.g., cooking, baking, gardening)

- Novelty: 16.4% (e.g., trying new foods, exotic flavors)

- Variety: 14.5% (e.g., different foods, colors, textures on the plate)

- Mindful eating: 13.6% (e.g., paying attention to food, eating slowly)

- Visceral eating: 12.7% (e.g., satisfying cravings, eating for comfort)

- Place: 11.8% (e.g., eating in a pleasant environment, restaurant dining)

- Memories: 10.9% (e.g., foods associated with childhood, family traditions)

**2. Associations with dietary outcomes (from 45 studies):**

**57.1% of studies reported favorable associations** between eating pleasure and dietary outcomes (e.g., higher fruit/vegetable intake, better diet quality, more varied diet).

**28.6% reported null associations** (no significant relationship).

**14.3% reported unfavorable associations** (e.g., higher pleasure linked to higher intake of unhealthy foods, especially for "visceral eating" dimensions like cravings).

**Key nuance:** The direction of association depended on the *dimension* of pleasure studied. For example:

- Pleasure from sensory experiences (taste, texture) of healthy foods was associated with higher intake of fruits and vegetables.

- Pleasure from "visceral eating" (eating for comfort, satisfying cravings) was associated with higher intake of energy-dense, nutrient-poor foods.

- Pleasure from social eating was associated with both healthier (more vegetables) and less healthy (more desserts, alcohol) outcomes depending on the social context.

**3. Associations with health outcomes (from 45 studies):**

Results were **less consistent** than for dietary outcomes.

**Some studies found:** Higher eating pleasure (especially from sensory and social dimensions) was associated with lower BMI, better weight maintenance, and lower risk of obesity.

**Other studies found:** No association, or even a positive association between pleasure (especially visceral eating) and higher BMI.

**No studies found** a direct link between eating pleasure and chronic disease outcomes (e.g., diabetes, cardiovascular disease).

**4. Intervention strategies (from 11 intervention studies):**

**Most promising strategies identified:**

- **Sensory-based interventions:** Teaching people to appreciate the taste, texture, and aroma of healthy foods (e.g., "sensory education" programs). One study found a 1.5-serving/day increase in vegetable intake after a 6-week sensory training program.

- **Cooking and sharing activities:** Hands-on cooking classes and communal meals. One study found a 0.8-serving/day increase in fruit/vegetable intake after a 12-week cooking program.

- **Mindful eating interventions:** Training in eating slowly, paying attention to hunger/fullness cues, and savoring food. One study found a 2.3 kg weight loss over 6 months (vs. 0.5 kg in control) in a mindful eating program.

- **Positive memory interventions:** Creating positive associations with healthy foods (e.g., through storytelling, cultural traditions).

**Duration of interventions:** Ranged from 4 weeks to 12 months. Most were 8–12 weeks.

**Effect sizes:** Small to moderate. For example, mindful eating interventions produced weight loss of 1–3 kg on average, and sensory education increased vegetable intake by 0.5–1.5 servings/day.

Translating the findings into plain English:

**For dietary change:** If you focus on the *pleasure* of eating healthy foods (rather than on health or guilt), you might expect to increase your vegetable intake by about **0.5 to 1.5 servings per day** — roughly equivalent to adding one extra cup of salad or half a cup of cooked vegetables to your daily diet.

**For weight management:** Mindful eating interventions that emphasize pleasure (savoring, eating slowly) produced **1–3 kg (2–7 lbs) weight loss over 6 months** — about the same as many commercial weight loss programs, but without restrictive dieting.

**For context:** The effect of a sensory-based intervention on vegetable intake (1.5 servings/day) is roughly equivalent to the effect of a 12-week structured dietary counseling program, but the pleasure-based approach may be more sustainable because it doesn't rely on willpower.

**Important caveat:** These effect sizes come from a small number of intervention studies (only 11), and the quality of those studies varied. The 57.1% favorable association rate from cross-sectional studies does not mean you have a 57% chance of success — it means that in the existing literature, most studies found a positive link, but the evidence is not strong enough to guarantee results.

**What the authors acknowledge:**

**Heterogeneity of definitions:** "Eating pleasure" was defined differently across studies, making synthesis difficult.

**Cross-sectional dominance:** Most studies cannot establish causality.

**Publication bias:** Studies with null or negative results may be underrepresented.

**Language restriction:** Only English and French studies were included.

**No quality assessment:** As a scoping review, they did not formally assess the quality of included studies.

**What a critical reader would note:**

**Small number of intervention studies:** Only 11 interventions were found, and many had small sample sizes (n=30–100) and short durations (4–12 weeks). No long-term follow-up (>1 year) was reported.

**Self-report bias:** Dietary intake was measured via self-report (FFQs, recalls), which is prone to underreporting and social desirability bias.

**Confounding:** People who report high eating pleasure from healthy foods may also have higher income, education, and cooking skills — factors that independently predict better diet quality. The cross-sectional studies did not always control for these confounds.

**Lack of blinding:** In intervention studies, participants knew they were in a "pleasure-based" program, which could create expectancy effects.

**Industry funding:** The review did not report funding sources for individual studies, but some pleasure-based interventions (e.g., "sensory education") have been funded by food industry groups, which could introduce bias.

**Generalizability:** Most studies were conducted in Western, educated, industrialized, rich, and democratic (WEIRD) populations. Findings may not apply to non-Western cultures where food pleasure is defined differently.

For someone running their own n=1 experiment:

### What to test

**Primary intervention:** Deliberately cultivate pleasure from healthy foods using one of the following strategies (pick one to test at a time):

1. **Sensory savoring:** Before eating a healthy meal, take 30 seconds to notice the colors, smell the aroma, and appreciate the texture of each food. During the meal, eat slowly (chew 20–30 times per bite) and focus on the taste.

2. **Cooking from scratch:** Prepare one healthy meal per day from whole ingredients, focusing on the process (chopping, seasoning, plating) as a pleasurable ritual.

3. **Mindful eating:** Eat one meal per day without distractions (no phone, TV, or reading). Pay attention to hunger/fullness cues. Stop eating when you feel 80% full.

4. **Positive memory association:** Pair a healthy food you currently dislike (e.g., kale, broccoli) with a positive memory or context (e.g., eat it while listening to your favorite music, or prepare it the way your grandmother did).

**Dose:** Choose one strategy and practice it at least once per day for 4 weeks.

### Minimum meaningful duration

**4 weeks minimum** to see changes in eating behavior (based on intervention studies).

**8–12 weeks** for potential weight changes (based on mindful eating interventions).

**No studies have tested effects beyond 12 months**, so consider this a short-term experiment.

### What to measure

**Primary outcome:** Daily servings of fruits and vegetables (or another healthy food you want to increase). Use a simple tally or a food diary app.

**Secondary outcomes:**

**Eating pleasure rating:** After each meal, rate your pleasure on a 1–10 scale (1 = no pleasure, 10 = intense pleasure).

**Mindful eating score:** Use the Mindful Eating Questionnaire (MEQ, 28 items, free online) at baseline and after 4 weeks.

**Weight:** Weigh yourself once per week at the same time (morning, after bathroom, before eating).

**Craving intensity:** Rate cravings for unhealthy foods on a 1–10 scale daily.

**Control variables (measure these too):**

Daily stress level (1–10 scale)

Sleep quality (hours slept, subjective quality 1–10)

Physical activity (minutes per day)

Social context (ate alone or with others)

### Key confounds to control for

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