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. Author manuscript; available in PMC: 2025 Apr 1.
Published in final edited form as: Appetite. 2024 Feb 1;195:107235. doi: 10.1016/j.appet.2024.107235

Social Desirability Bias is Related to Children’s Energy Intake in a Laboratory Test Meal Paradigm

Nichole R Kelly 1,2, Kelly Jean Doty 1,2, Claire Guidinger 1,2, Austin Folger 1,2, Gabriella M Luther 1,2, Nicole R Giuliani 2,3
PMCID: PMC10922645  NIHMSID: NIHMS1964657  PMID: 38296111

Abstract

Dietary intake is notoriously difficult to measure in children. Laboratory test meals address some of the methodological concerns of self-report methods, but may also be susceptible to social desirability bias, referring to the tendency for individuals to adjust their behaviors in order to be perceived more positively. The aim of the current study was to evaluate whether social desirability bias was associated with children’s energy intake during a laboratory test meal, and whether this association varied by food type (total caloric intake, snack food intake, fruit/vegetable intake) and sex. A total of 82 children (M age = 9.45±0.85; 50% girls; 84.1% rural; 85.4% White) completed several surveys, including the Children’s Social Desirability Scale and had their body composition measured. At lunchtime, they were granted access to a multi-array test meal (>5,000 kcal). After adjusting for lean mass, fat mass, depressive symptoms, and parental food restriction, children who reported higher social desirability bias consumed fewer calories from snack foods (B = −11.58, p = .009, semi-partial correlation = −.28). Boys with higher social desirability bias consumed less calories from fruits and vegetables (B = −6.47, p = .010, semi-partial correlation = −.411); this association was not significant in girls. The desire to be perceived in a positive manner may influence children’s eating behaviors in experimental paradigms. Replication studies with larger, more diverse pediatric samples are needed, as are strategies to reduce the effects of social desirability bias on test meal intake in order to enhance the validity of this dietary assessment approach.

Keywords: child, eating, energy intake, social desirability bias, test meal

1. Introduction

Diet, referring to the food and drink products individuals consume, is an integral component of health. It is the primary means by which the body obtains and uses nutrients, and nutrients play a critical role in nearly all bodily functions. Indeed, diet quality is a risk factor for various psychological and physical conditions, such as depression (Matison et al., 2021) and type 2 diabetes (Jayedi et al., 2020), and dietary interventions are linked to a range of positive health outcomes, such as improvements in blood pressure and cancer prognosis (e.g., Castro-Espin & Agudo, 2022; Gay et al., 2016). Given the importance of diet to health and well-being, accurate assessment methods are essential to clearly understanding and effectively intervening with eating behaviors. At the same time, eating behaviors are notoriously difficult to measure, particularly among children (Ravelli & Schoeller, 2020).

Most children eat, on average, four to seven times per day (Murakami & Livingstone, 2016b; Taylor et al., 2017; Vilela et al., 2019). Yet, for a number of complex reasons, including normal developmental processes (e.g., cognitive abilities) and environmental factors (e.g., others preparing most meals and snacks, eating while engaging in other activities, like watching television), children may not be the optimum informants of what occurs during these occasions. Indeed, when using survey-based methods, like food frequency questionnaires and 24-hour dietary recalls, younger children tend to overreport their total caloric intake, while older children tend to underreport their intake (Murakami & Livingstone, 2016a; Rangan et al., 2011). Some data suggest that parents/caregivers may provide better estimates of children’s eating behaviors (Shomaker et al., 2013; Walker et al., 2018), but they are also subject to significant bias (Burrows et al., 2010; Foster & Bradley, 2018; Montgomery et al., 2005; Wallace et al., 2018). Although the degree of bias by parent proxy varies depending on method, underreporting is as high as 41% with food records while overreporting is as high as 59% with food frequency questionnaires (Burrows et al., 2010).

Given the limitations of self- and parent-report methods for capturing children’s dietary intake, others have opted to use more direct observations of eating behaviors, such as test meals. In these paradigms, various foods are carefully weighed before being presented for consumption, and then weighed again after consumption. Using large repositories of detailed nutritional information generated from manufacturer’s food labels, these pre- and post-consumption weights are then converted into a number of important dietary variables, from total calories consumed to intake of various macro- and micronutrients. Amount and type of foods served and instructions upon delivery vary depending on the research question, with some examining the intake of snacks after eating to satiety from a lunch meal, also known as eating in the absence of hunger (Shomaker, Tanofsky-Kraff, Zocca, et al., 2010), while others use specific verbal instructions to encourage children to “let go” while they eat, intended to induce an experience similar to binge eating (Tanofsky-Kraff et al., 2009).

Although there are certainly limitations to using test meals to measure children’s eating behaviors, most notably that it captures only a single instance of eating, they also offer a number of advantages over self-report methodologies, particularly a precise measurement of intake. There is also good validity for test meals such that intake patterns align with hypotheses based on theory and extant data. For example, children who endorse recent loss of control eating, a disordered eating behavior characterized as disinhibited, consume more total calories (Mirch et al., 2006) and calories from palatable snack foods during test meals than children without loss of control eating (Tanofsky-Kraff et al., 2009). Children with a higher body weight consume more calories during an eating in the absence of hunger paradigm (Shomaker, Tanofsky-Kraff, Zocca, et al., 2010), while youth who experience more pre-meal negative affect consume more “comfort” foods from a lunch array, like snacks and desserts (Ranzenhofer et al., 2013). Among children with high (vs low) self-reported emotional eating tendencies, pre-meal negative affect positively predicts total caloric intake during a test meal (Vannucci et al., 2012). Although test meals require more resources than surveys, they also offer a potential solution to the myriad of biases that are evident in self-report methods, and are less burdensome than other, highly precise methods, like the doubly labeled water technique (Burrows et al., 2020).

Arguably, one of the more significant considerations when it comes to using test meals to measure children’s food intake is concerns with social desirability bias, referring to the tendency to modify one’s behavior in an effort to avoid criticism and appear more acceptable to observants (Paulhaus, 1991). There are widespread beliefs about what foods are considered “good” or “bad” (Chan & Zhang, 2022; Pinto et al., 2021; Rawlins et al., 2013; Swanson et al., 2013) and it is reasonable to consider that children may be susceptible to adjusting their behaviors in an observational context, like a test meal, to better conform to these beliefs. Although no studies have examined this hypothesis in children using a test meal, one study found that higher social desirability bias was associated with underreporting of sugar-sweetened beverage intake in a sample of preadolescent African American girls (Klesges et al., 2004). Adults with higher social desirability bias also describe their diet quality as better (Tang et al., 2022), underreport their total caloric intake to a greater degree (Hebert et al., 1995; Mossavar-Rahmani et al., 2013), and are less likely to endorse disinhibited and emotional eating (Allison & Heshka, 1993; Freitas et al., 2017; Kowalkowska & Poínhos, 2021).

There are also good reasons to believe that the potential influence of social desirability bias on eating behaviors may vary by gender and food type. Eating smaller meals is considered more “feminine” (Vartanian et al., 2007) and girls may reduce their total caloric intake during a test meal in order to better align with these gender norms. Indeed, girls are more likely than boys to underreport their food intake using self-report methods (Rangan et al., 2011), and most studies in adults suggest that link between social desirability bias and eating behaviors is either particularly strong or only present in women (Freitas et al., 2017; Kowalkowska & Poínhos, 2021; Tang et al., 2022). When significant findings emerge within men, social desirability bias is related to overreporting of intake (Herbert et al., 1997), a pattern of findings that may more closely align with masculine gender norms and heteronormative beliefs, which emphasize the importance of consuming large quantities of unhealthy foods (Monge-Rojas et al., 2015; Zhu et al., 2015). From this perspective, the putative effects of social desirability bias on intake may vary at the intersection of both gender and food type. More specifically, girls may reduce their overall intake, as well as their consumption of “bad” or “unhealthy” foods, like sweet and savory snacks (Chan & Zhang, 2022; Pinto et al., 2021; Rawlins et al., 2013; Swanson et al., 2013), to avoid criticism for acting outside of gender-based norms. Boys, on the other hand, may experience pressure to consume more of these foods. Indeed, boys as young as four already demonstrate implicit biases for specific foods, linking the female gender with “healthy” foods, like vegetables (Graziani et al., 2021), for example.

Together, these data support the potential for social desirability bias to meaningfully affect the validity of dietary assessment methods, particularly for girls and certain food types. Evaluating whether and to what extent this social phenomenon relates to children’s intake during a test meal offers important insights into interpretation considerations for future research employing these methods. To that end, the goal of the current study was to explore whether social desirability bias is associated with children’s energy intake during a laboratory test meal, specifically their total energy intake, fruit and vegetable intake, and snack food intake, and whether these associations varied for boys and girls. It was hypothesized that social desirability bias would be inversely associated with total caloric intake and snack food intake, and that these links may be particularly strong for girls. It was also hypothesized that social desirability bias would be positively associated with fruit and vegetable intake in girls and negatively associated in boys.

2. Methods

2.1. Participants

Participants were preadolescent youth (8–10 years old) enrolled in a larger clinical trial focused on evaluating the acute impact of 20 minutes of moderate intensity physical activity on inhibitory control and subsequent energy intake (NCT03620045). Recruitment focused on youth in rural communities (defined as ≥ 10 miles from a city of ≥ 40,000 people; Oregon Office of Rural Health). Participants were deemed ineligible for the following: 1) BMI < 5th percentile; 2) major medical condition, psychiatric diagnosis, or moderate suicide risk; 3) current or recent use (<3 months) of medication known to affect appetite; 4) recent brain injuries; 5) inability to walk on a treadmill; 6) full-scale intelligence quotient score ≤ 70; 7) food allergies which would prevent them from safely consuming the test meal; and 8) responses on a questionnaire indicating that they do not like (at a moderate level) at least 50% of the food items on the lunch test meal (Kelly et al., 2020; Shomaker, Tanofsky-Kraff, Zocca, et al., 2010; Tanofsky-Kraff et al., 2009). Recruitment primarily occurred through mass mailings, flyers posted on online platforms and in local stores and offices, emails sent to parents/caregivers of elementary school children, and flyers sent home with elementary school children.

2.2. Procedures

All study procedures were approved by the University of Oregon’s Institutional Review Board (protocol #04252017.043). Interested parents and caregivers were encouraged to contact the study team via email or phone to indicate their interest in participating, hear details of the study, and complete an initial phone screen. Eligible families were scheduled for the first study visit, during which consent and assent forms were reviewed. Children and their parent/guardian who provided assent and consent, respectively, were enrolled in the current study. This study used a randomized crossover design in which all participants completed both a 20-minute physical exercise condition and a time-matched sedentary control condition on separate visits approximately 14 days apart. Both study visits began at approximately 8:30 AM (±30 minutes) and participants were instructed to fast beginning at 10:00 PM the evening before each visit. In both study visits, participants were asked to consume a standardized breakfast at approximately 9:00 AM and completed a series of surveys, interviews, body composition measurements, and neuropsychological tasks. Between 11:15 and 11:35 AM, the experimental study conditions began (reading and coloring for 20 minutes in the control condition or walking on a treadmill at a moderate intensity for 20 minutes). After each condition, participants completed a 3-minute measure of inhibitory control and then were given access to a large test meal array. Energy intake data for the current study’s analyses were only used from the sedentary condition day. Participating families received $90 for completing the first study visit, $100 for completing the second study visit, and compensation for travel (as needed). Only measures included in the current study’s analyses are described here.

2.3. Measures

2.3.1. Social desirability bias.

Social desirability was assessed using the Children’s Social Desirability Scale (Crandall et al., 1965; Miller et al., 2015). This scale probes adherence to socially desirable norms through under and over reporting of behaviors based on 14 yes/no items such as “Have you ever broken a rule?” and “Have you ever felt like saying unkind things to a person?” These items demonstrate adequate two-week test-retest reliability and estimated internal consistency (Miller et al., 2014, 2015). Alpha values in the current study were also adequate (α = 0.86 for full sample, α = 0.84 for boys, α = 0.87 for girls).

2.3.2. Energy intake.

At approximately 12:00 PM, participants were administered an ad libitum test meal including food and drink items most children like (see Figure 1 for image of test meal and details regarding food items; Mirch et al., 2006). The meal was administered in private and children were told to “Please eat until you are no longer hungry; take as much time as you need.” The size of the test meal varied slightly from prior research using similar paradigms with children up to 17 years old (Kelly et al., 2020; Shomaker, Tanofsky-Kraff, Zocca, et al., 2010; Tanofsky-Kraff et al., 2009); these meals included up to 12,000 calories of food, while the current study included approximately 5,000 calories in an effort to balance the expected consumption of 8–10-year-old children (Mirch et al., 2006) with a desire to limit food waste. Energy content and macronutrient composition for each item was determined according to data from the USDA National Nutrient Database for Standard Reference, Release 24, and from the manufacturer labels on packaged food items. Total energy intake (kcal), snack food intake (kcal intake of cookies, candies, chips, and pretzels (Tanofsky-Kraff et al., 2009), and fruit and vegetable consumption (kcal intake of lettuce, tomatoes, carrots, oranges, bananas, and grapes) were determined by subtracting the food weights (measured to the nearest tenth of a gram) after the participant’s meal from premeal weights.

Figure 1.

Figure 1.

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Lunch Test Meal

Note. Food items include white bread (4 slices); wheat bread (4 slices); potato roles (2 rolls); ham (4 slices); turkey (4 slices); American cheese (4 slices); chicken nuggets (12 pieces); creamy peanut butter (3 oz); strawberry jelly (3 oz); slices tomatoes (4 slices); green leaf lettuce (3 pieces); baby carrots (3 oz); bananas (2 each); orange (1 each, sliced); grapes (6 oz); oreo cookies (6 each); vanilla wafer cookies (10 large or 16 small each); tortilla chips (96 grams); mini pretzels (50 grams); mayonnaise (3 oz); yellow mustard (3 oz); ranch dressing (3/4 cup); barbeque sauce (3 oz); mild salsa (3/4 cup); gummy bears (5 oz); mini chocolate pieces (5 oz); water (24 oz); 2% milk (24 oz); apple juice (24 oz); lemonade (24 oz).

2.3.3. Demographic factors and covariates.

To evaluate whether results varied for boys and girls, sex was used because gender was not collected. Putative covariates included factors associated with children’s energy intake in prior research, including lean and fat mass (as measured via dual-energy x-ray absorptiometry, GE/Lunar Prodigy Pro DEXA; Shomaker, Tanofsky-Kraff, Savastano, et al., 2010), food reward sensitivity (as measured via Reward Based Eating Drive Scale for Children; De Decker et al., 2016; Epel et al., 2014), depressive symptoms (as measured via the Children’s Depression Inventory; Kovacs, 1984; Mooreville et al., 2014), pre-meal satiety (using an average of three Likert-type items assessing hunger, fullness, and thirst; Mirch et al., 2006), parent education (as one indicator of socioeconomic status associated with children’s eating behaviors; Serasinghe et al., 2023), and parental food restriction (as measured via the Child Feeding Questionnaire; Birch et al., 2001; Gubbels et al., 2011).

2.4. Data Analytic Plan

All analyses were conducted using IBM SPSS Statistics 24. Hierarchical multiple regression models were used to evaluate the associations for social desirability bias with total energy intake (kcal), snack food intake (kcal), and fruit and vegetable intake (kcal). First, models were conducted to evaluate these associations in the full sample. All covariates were entered first (sex, percentage lean mass, fat mass in kg, food reward sensitivity, depressive symptoms, pre-meal satiety, parent education, parental food restriction), and then social desirability was entered. To explore whether results varied for boys and girls, additional hierarchical regression models were conducted with main and interaction terms for social desirability bias and sex. If the interaction term was significant, the data were split by sex and the link between social desirability bias and each eating-related dependent variable was examined within boys and girls separately. In these models, sex was removed as a covariate. In an effort to maximize power, only covariates that were significant in any model were retained across all models. Effect size estimates were reported as semi-partial correlations, which describe the unique variance accounted for by social desirability bias after adjusting for covariates (.10 small, .30 moderate, .50 large; Cohen, 1988).

3. Results

3.1. Participants and Preliminary Analyses

The survey measuring the primary measure of interest, social desirability bias, was added to the study protocol shortly after enrollment began. As a result, the sample for the current study’s analyses varies slightly from the full sample from the larger clinical trial. For the current study, the sample included 82 children (M age = 9.45, SD = 0.85; 50% girls; 84.1% rural; 85.4% White, 9.8% Multiracial) and families were diverse in terms of maternal education (7.3% high school degree or less, 25.6% some college, 14.6% 2-year college degree, 34.1% 4-year college degree, 18.4% some graduate school or advanced degree). In the current study’s sample, the unadjusted average total intake was 869.16 kcal (SD = 323.23, range = 188.46 to 1994.47), average fruit and vegetable intake was 42.42 kcal (SD = 44.22, range = .24 to 222.16), and snack food intake was 277.35 kcal (SD = 323.23, range = 10.50 to 768.69).

Missing data were low. Two children were missing body composition data and two children were missing data for one survey. When missing data are minimal (<5 %), any method of handling missingness is considered appropriate (Buhi, 2008; Dong & Peng, 2013); as such, listwise deletion was employed. Evaluations of desriptive statistics indicated no significant skewness or kurtosis in the dependent variables, supporting the use of general linear models to interrogate the hypotheses.

3.2. Primary Analyses

Child sex, food reward sensivity, pre-meal satiety, and parent education were not significant in any models and thus were removed from final analyses. After adjusting for child lean mass, child fat mass, parental food restriction, and child depressive symptoms, social desirability bias was not significantly associated with total caloric intake (B = −15.46, p = .082, semi-partial correlation = −.18; see Figure 2a and Table 1 for full results). However, it was was significantly and negatively associated with both snack food intake (B = −11.58, p = .009, semi-partial correlation = −.28; see Figure 2b) and fruit and vegetable intake (B = −3.89, p = .004, semi-partial correlation = −.32; see Figure 2c).

Figure 2.

Figure 2.

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After adjusting for child lean mass, child fat mass, parental food restriction, and child depressive symptoms, social desirability bias was not significantly associated with total caloric intake (B = −15.46, p = .082, semi-partial correlation = −.18; see Figure 2a). However, it was was significantly and negatively associated with both snack food intake (B = −11.58, p = .009, semi-partial correlation = −.28; see Figure 2b) and fruit and vegetable intake (B = −3.89, p = .004, semi-partial correlation = −.32; see Figure 2c).

Table 1.

Adjusted Links between Social Desirability Bias and Energy Intake

B SE t p value Semi-Partial Correlation
Total Caloric Intake
 (Constant) −1240.136 939.509 −1.320 0.191
 Child lean mass (%) 18.434 10.406 1.771 0.081 0.182
 Child body fat (g) 0.045 0.017 2.605 0.011 0.268
 Parental food restriction 78.482 41.402 1.896 0.062 0.195
 Child depressive symptoms 12.369 6.701 1.846 0.069 0.190
 Social desirability bias −15.463 8.780 −1.761 0.082 −0.178
Snack Food Intake
 (Constant) −805.888 470.906 −1.711 0.091
 Child lean mass (%) 10.682 5.216 2.048 0.044 0.222
 Child body fat (g) 0.014 0.009 1.684 0.096 0.183
 Parental food restriction 44.571 20.752 2.148 0.035 0.233
 Child depressive symptoms 4.765 3.358 1.419 0.160 0.154
 Social desirability bias −11.578 4.284 −2.702 0.009 −0.282
Fruit and Vegetable Intake
 (Constant) −99.669 143.631 −0.694 0.490
 Child lean mass (%) 1.483 1.591 0.932 0.354 0.105
 Child body fat (g) 0.002 0.003 0.647 0.520 0.073
 Parental food restriction 10.125 6.329 1.600 0.114 0.181
 Child depressive symptoms −1.315 1.024 −1.284 0.203 −0.145
 Social desirability bias −3.893 1.293 −3.012 0.004 −0.323
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Note. B = unstandardized beta values

Models including the interaction between social desirability bias and sex were non-significant for total energy intake (p = .787; adjusted M boys = 897.97, SE = 43.57 kcal, adjusted M girls = 846.37, SE = 44.62 kcal) and snack food intake (p = .373; adjusted M boys = 275.12, SE = 22.39 kcal, adjusted M girls = 285.60, SE = 22.93 kcal). The model for calories consumed from fruits and vegetables was significant (p = .012), suggesting sex moderated the association with social desirabiity. After splitting the data by sex, the link between social desirability bias and caloric intake from fruits and vegetables was significant and negative for boys (B = −6.47, p = .010, semi-partial correlation = −.411; adjusted M = 52.15, SE = 6.89 kcal) and non-significant for girls (B = −1.30, p = .212, semi-partial correlation = −.19, adjusted M = 39.36, SE = 7.06; see Figure 3 and Table 2 for full results). Finally, in follow-up exploratory analyses, none of the adjusted intake variables significantly varied by sex (ps > .211).

Figure 3.

Figure 3.

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After adjusting for child lean mass, child fat mass, parental food restriction, and child depressive symptoms, the link between social desirability bias and caloric intake from fruits and vegetables was significant and negative for boys (B = −6.47, p = .010, semi-partial correlation = −.411) and non-significant for girls (B = −1.30, p = .212, semi-partial correlation = −.19).

Table 2.

Adjusted Association between Social Desirability Bias and Fruit and Vegetable Intake for Boys and Girls

Boys Girls
B SE t p value Semi-Partial Correlation B SE t p value Semi-Partial Correlation
Fruit and Vegetable Intake
 (Constant) −49.850 266.264 −0.187 0.853 (Constant) −154.233 109.482 −1.409 0.168
 Child lean mass (%) 1.180 2.911 0.405 0.688 0.066 Child lean mass (%) 2.011 1.222 1.646 0.109 0.250
 Child body fat (g) 0.002 0.005 0.476 0.637 0.078 Child body fat (g) 0.002 0.002 0.930 0.359 0.141
 Parental food restriction 2.230 12.510 0.178 0.859 0.029 Parental food restriction 11.554 5.110 2.261 0.030 0.343
 Child depressive symptoms −1.932 1.861 −1.038 0.306 −0.169 Child depressive symptoms −0.411 0.815 −0.505 0.617 −0.077
 Social desirability bias −6.470 2.363 −2.738 0.010 −0.411 Social desirability bias −1.302 1.021 −1.275 0.212 −0.192
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Note. B = unstandardized beta values

4. Discussion

The aim of this exploratory study was to evaluate the link between social desirability bias and energy intake during a test meal in a pediatric sample. In adults, the desire to present oneself in a more socially acceptable manner has been linked to greater misreporting of dietary intake, particularly among women (Freitas et al., 2017; Hebert et al., 1995; Herbert et al., 1997; Kowalkowska & Poínhos, 2021; Mossavar-Rahmani et al., 2013; Tang et al., 2022). Although test meals offer several advantages over self-report surveys in their ability to capture more precise measurements of dietary intake in pediatric samples, they may also be prone to social desirability bias given that they occur under the observation of researchers.

Inconsistent with hypotheses and self-report data from adults (Hebert et al., 1995; Mossavar-Rahmani et al., 2013), the link between social desirability bias and total energy intake was non-significant in all models. Consistent with hypotheses, children who endorsed greater social desirability bias also consumed less calories from snack foods, including cookies, chips, and candy. The effect size for this association was moderate, even after adjusting for child body composition, parental food restriction, and child depressive symptoms, and did not vary by child sex. The overall pattern of findings supports the notion that the potential effects of social desirability bias on children’s behavior during a test meal paradigm may be unique to certain foods – in this case, palatable snack foods, which are often viewed as “bad” or “unhealthy” (Chan & Zhang, 2022; Pinto et al., 2021; Rawlins et al., 2013; Swanson et al., 2013). Finally, in the full sample, there was a negative, moderate-size association between social desirability bias and fruit/vegetable intake. Importantly, there were significant variations in findings when conducting the same analyses separately for boys and girls. As hypothesized, boys who reported higher social desirability bias also ate less fruits and vegetables from the test meal, and this effect size was moderate-to-large. Inconsistent with hypotheses, this association was non-significant in girls. Taken together, the current study’s findings suggest that the desire to present oneself in a favorable manner is related to how children eat during a test meal, and this may be particularly pronounced for some children and certain foods.

The major implication related to the current study’s findings is the need to identify strategies to reduce the effects of social desirability bias on children’s eating behaviors during test meals in an effort to enhance the validity of this dietary assessment method. Qualitative researchers point to the importance of creating private spaces for data collection, which cannot be seen or heard by others, and maximizing research participants’ comfort by intentionally developing rapport and taking the time to thoroughly explain the purposes of the research (Bergen & Labonté, 2020). These strategies were employed in the current study and may have helped minimize social desirability bias, although this cannot be formally evaluated. Experimental researchers highlight the potential value of disguising the purpose of research studies focused on topics that are particularly prone to social desirability bias, including eating, or using “filler” surveys or procedures to better obscure the purpose (Ried et al., 2022). Reinforcing the confidentiality and anonymity of data, reassuring participants that there are no right or wrong ways of behaving, and using “preparatory cognitive interviews” before the trial begins to elicit ideas from children regarding how to minimize social desirability bias may also be helpful (Ried et al., 2022).

Researchers using test meals in their future studies may also consider implementing a measure of social desirability bias, transparently reporting on the degree to which it was related to their sample’s energy intake patterns, and adjusting for it in relevant analyses (Ried et al., 2022). If data demonstrate a consistent association between social desirability bias and children’s intake, future researchers may consider the value of energy intake adjustments based on the degree of bias. This may be a challenging undertaking, however, given that the potential effects of social desirability bias vary by both food type and sex, as the current study’s findings suggest, as well as many other factors not evaluated in the current study. Black youth, for example, perceive sugar-sweetened beverages as less healthy than their peers (Roesler et al., 2021), and this may influence their consumption in the context of test meals. This hypothesis could not be evaluated in the current study because the sample was overwhelming non-Hispanic White, consistent with the demographics of rural Oregon (United States Census Bureau, 2023). Children (Lioret et al., 2011) and adults who want to lose weight (Johansson et al., 1998), adults who are more physically active (Waterworth et al., 2022), and women with higher body image concerns (Kanellakis et al., 2021) tend to underreport their eating, and these factors may be important to consider in future investigations of the link between social desirability bias and test meal intake as well. Importantly, the potential influence of some of these variables may be better explained by some third factor(s) that reflects the experience of being a member of a marginalized community in the U.S., whether because of gender, skin color, or body size. For example, a desire to lose weight may be an artifact of weight bias, which includes beliefs that people in larger bodies are unable to control their eating behaviors (Alberga et al., 2019). Eating less food, particularly snack foods, during a test meal may reflect a desire to avoid fulfilling weight-related stereotypes, particularly when they are aware that they are being evaluated (Swanson et al., 2013). In this example, exploring whether weight bias internalization interacts with social desirability bias to influence test meal intake could be informative. For instance, it may point to a need to take body composition measurements, if they are a part of the study, after the test meal is delivered in an effort to avoid priming weight biases.

The current study’s findings also highlight the potential unhelpful roles of food stereotypes and gender norms in influencing children’s eating. The link between social desirability bias and snack intake, for example, may be a concerning artifact of demonizing certain foods. Some children may intentionally restrict the intake of sweets and salty snacks when there is fear of evaluation, and this restriction may increase their risk for subsequent disordered eating (Zunker et al., 2011). Regarding the significant finding for fruit and vegetable intake in boys, recent research suggests that boys as young as four implicitly associate these foods with the female gender (Graziani et al., 2021). Qualitative studies cite cases of children being bullied for bringing fruits and vegetables to school, and indicate that the fear of negative commentary is particularly salient for boys (Krølner et al., 2011). This may translate, as observed in the current study, to consuming less fruits and vegetables in an effort to avoid being perceived in an a critical manner. Although the current study only included a single evaluation of eating behaviors during a laboratory test meal, an uncommon occurrence for most children, children eat many of their meals under the observations of parents, caregivers, teachers, and friends, providing multiple opportunities for children to restrict and for boys to feel pressured to “eat like a man.” Unfortunately, in many, but not all studies (Ramsay et al., 2014), boys and men consume less fruits and vegetables than girls and women (Baker & Wardle, 2003; Egele & Stark, 2023; Rasmussen et al., 2006). Given the nutritional benefits of fruits and vegetables, and their role in reducing chronic disease and mortality risk (Aune et al., 2017; Lee et al., 2019; Wang et al., 2016; Zurbau et al., 2020), as well as the clear link between dietary restriction and disordered eating (Hartmann et al., 2012; Hilbert et al., 2014), targeting food stereotypes and gender norms may prove beneficial to children’s eating behaviors.

In addition to addressing the limitations noted above, particularly a need for replication studies with larger samples of more diverse children, it is also important to note that the current study enrolled a non-representative sample of 8–10 year old children, most of whom lived in rural communities. Gender identity was also not evaluated in the current study, and all of these factors are certainly relevant to the development and salience of eating preferences and gender norms, as well as variations in social desirability bias. For example, in prior studies including children of a similar age to the current study, there were no significant differences in social desirability bias based on gender, body size, academic achievement, or socioeconomic position (Miller et al., 2014, 2015). However, other studies identify differences by gender in adults (Herbert et al., 1997), suggesting that degree of social desirability bias may change as a result of time and/or context. As such, future studies should include younger and older children from more diverse communities. Additionally, it is worth noting that the current study excluded five youth (out of 168) during the phone screening process because they did not report liking to a moderate degree at least half of the 30 foods offered on our test meal. These children may represent a subsample of youth who have narrower food interests, and it therefore remains unclear whether the results of the current study generalize to this population. Future research may consider including these children and/or evaluating food preferences after children have had a chance to consume each of the foods from the test meal and consider these preferences in analyses.

Overall, findings from the current study provide some interesting and important insights into the link between social desirability bias and children’s energy intake during a test meal paradigm. Effect sizes for the significant findings after adjusting for factors closely related to children’s energy intake, including variations in body composition, underscore the robustness of the link for social desirability bias with snack intake in boys and girls, and with fruit and vegetable intake in boys.

Funding:

This work was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development (grant number R21HD094661, 2018–2022). The sponsor had no role in development of the study design; in the collection, analysis and interpretation of the data; in the writing of the manuscript; or in the decision to submit the article for publication.

Footnotes

Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Ethics Statement

The study described in this manuscript was approved by the University of Oregon’s Institutional Review Board (protocol #04252017.043), indicating that all procedures were conducted in accordance with the Declaration of Helsinki. Participating children provided informed assent and parents/caregivers provided informed consent.

Declarations of Interest Statement: none

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