The Perceived Impact of Eating Pleasure on Healthy Eating: Development and Validation of a Questionnaire for the French-Speaking Québec Adult Population

Abstract

The present research aimed to develop and validate a questionnaire examining French-speaking Québec adults’ perceptions of how the various dimensions of eating pleasure influence healthy eating habits. Items were developed based on dimensions of eating pleasure, identified through a literature review. Content validity was evaluated by an expert committee, followed by a pre-test among 30 participants to assess face validity. The questionnaire was then administered twice (2–4 weeks apart) to 298 participants. Exploratory factor analysis identified a six-factor structure reflecting the multidimensional nature of eating pleasure in relation to healthy eating: (1) emotional/situational eating and reward (eight items), (2) sensory experiences (six items), (3) ideologies/interest in food (eight items), (4) autonomy, freedom, and individual preferences (seven items), (5) social experiences (five items), and (6) mindful eating (three items). The results showed an adequate internal consistency, a good test–retest reliability, and a good construct validity. Participants perceived all factors except Factor 1, “emotional/situational eating and reward”, as supporting healthy eating. Overall, these findings indicate that the questionnaire assessing the perceived impact of eating pleasure on healthy eating is a suitable instrument for use among French-speaking adults of the province of Québec, in Canada.

1. Introduction

The health impacts of specific nutrients, foods, and food patterns have been well documented [1,2,3,4]. However, this knowledge does not translate into optimal food choices in the population, and the overall success of interventions aimed at improving dietary habits remains low [5,6,7,8,9]. The disproportionate importance attributed to the healthiness of food compared with other properties or roles that contribute to human experiences, preferences, practices, and cultures can foster the belief that healthiness is not compatible with other food attributes, such as taste, convenience, and familiarity [10]. A notable example of this phenomenon comes from studies showing that food labeled as “healthy” is frequently perceived as less tasty than food labeled as “unhealthy” [11,12,13,14]. This perception can jeopardize efforts to adhere to healthy eating, given the importance of taste and eating pleasure in daily food choices [15,16]. As a result, an increasing number of researchers argue that the role of pleasure should be given greater focus in the promotion of healthy eating [16,17,18,19,20]. In addition, eating pleasure is now incorporated into the dietary guidelines of some countries [21,22]. Among others, Canada’s food guide now integrates some dimensions of the pleasure of eating, such as “Enjoy your food” and “Eat meals with others”, as healthy eating recommendations [22]. Similarly, the Mediterranean diet emphasizes conviviality and the pleasure of sharing meals with loved ones [23].

Prior research indicates that the conceptualization used to define eating pleasure significantly impacts its association with healthy eating. For instance, Cornil and Chandon [24] have investigated two distinct conceptualizations of eating pleasure, namely visceral eating pleasure, defined as visceral impulses triggered by external or emotional factors driven by biological preferences for high-sugar, high-fat, and high-sodium foods, and epicurean eating pleasure, defined as the enduring pleasure derived from the esthetic appreciation of the sensory and symbolic value of food. Their results showed that, in contrast to visceral eating tendencies, epicurean eating tendencies are linked to a preference for smaller portions and better well-being, without being associated with a higher BMI [24]. To establish a comprehensive understanding of eating pleasure, we conducted a systematic scoping review in 2020 with the aim of identifying key dimensions of the pleasure of eating and analyzing their associations with healthy eating behaviors [25]. This systematic literature review revealed the multidimensional concept of eating pleasure, encompassing 22 different dimensions. It also identified a gap in the availability of comprehensive questionnaires that address all these dimensions [25]. Furthermore, the literature review highlighted that only a limited number of studies, predominantly cross-sectional, have investigated the connections between eating pleasure and eating behaviors, with many dimensions remaining underexplored [25]. However, according to the existing literature, it seems that, depending on the dimensions of eating pleasure studied, the link with dietary behaviors differs. More precisely, when authors used the visceral impulses driven by external stimuli or emotional cravings as dimensions of the pleasure of eating, this is then linked to poor diet quality [25]. However, when studies are interested in other dimensions of the pleasure of eating, such as the pleasure linked to social experiences, food preparation processes (e.g., cooking), mindful eating, memories, and sensory experiences, these factors are then more likely to be associated with positive dietary behaviors [25].

Based on the findings of this literature review, we subsequently developed two comprehensive questionnaires that address all 22 dimensions of eating pleasure, each serving different purposes and measuring distinct concepts. The first questionnaire aimed to assess the extent to which these 22 dimensions are endorsed by the French-speaking adult population in Québec, Canada (Eating Pleasure Questionnaire (EPQ) [26]). In that questionnaire, each item, representing one dimension of eating pleasure, is rated by participants on a scale with four levels, ranging from “does not bring me pleasure” to “brings me a lot of pleasure”. The development and validation of this first questionnaire provides valuable insight into the specific aspects of eating pleasure that are most valued or meaningful to our population [26]. However, given the growing advocacy for integrating pleasure into the promotion of healthy eating and the existing literature suggesting that the conceptualization of eating pleasure significantly impacts its association with healthy eating, it was also essential to explore the population’s perceptions of how these different dimensions of eating pleasure influence their ability to adopt healthy eating habits. This information, which was unattainable using the first questionnaire, described in the paper of Grégoire et al. [26], is crucial for developing tailored interventions. Indeed, this kind of questionnaire is essential to identify the dimensions of eating pleasure perceived as the most helpful by our population for the adoption of healthy eating, which should be integrated into interventions. Additionally, this questionnaire would facilitate the identification of the dimensions of eating pleasure that are believed to thwart healthy eating, providing crucial insights for the development of future interventions. Accordingly, a second questionnaire, focusing on the population’s perceptions regarding the extent to which the 22 different dimensions of eating pleasure may influence their ability to eat healthily, was also developed.

The present study documents the development and validation of this second questionnaire, assessing French-speaking Québec adults’ perceptions of how the different dimensions of eating pleasure influence the adoption of healthy eating habits. More precisely, this study aimed to capture the questionnaire’s structure and evaluate its content validity, face validity, reliability (internal consistency and temporal test–retest stability), and construct validity. Additionally, differences in the scores of the newly developed questionnaire were explored based on sex, age, and BMI to identify potential patterns and variations within diverse demographic groups.

2. Methods

2.1. Questionnaire Development

The newly developed questionnaire presented in this paper was developed and validated simultaneously with a different questionnaire, the EPQ, which assesses the extent to which the 22 dimensions of the pleasure of eating were endorsed by Québec’s adult French-speaking population [26]. Both questionnaires were administered to the same participants during the same data collection sessions, and using identical methodological procedures [26].

The questionnaire was developed by a team comprising two researchers (AB, SL) and one master student (LMG), with expertise in developing and validating questionnaires. The three members of the development team were Registered Dietitians and contributed to our previously published systematic scoping review on the pleasure of eating and its associations with eating behaviors [25].

The five steps proposed by Di Iorio [27] for the development and validation of the questionnaire were followed. The first two steps involved the identification and analysis of each concept, aiming to formulate items that could be used to collect the population’s perceptions about how the 22 dimensions of the pleasure of eating identified in the scoping review [25] influence their ability to embrace healthy eating habits. The dimensions of the pleasure of eating include the following: (1) sensory experiences, (2) social experiences, (3) food characteristics besides sensory attributes, (4) the process of preparing food, (5) novelty, (6) variety, (7) mindful eating, (8) visceral eating, (9) the place where food is consumed, (10) memories associated with eating, (11) the atmosphere in which food is consumed, (12) psychological and physical state during eating, (13) food anticipation, (14) special occasions, (15) having a choice, (16) the structure of eating, (17) taking time, (18) health considerations, (19) food preferences, (20) psychological and physical state after eating, (21) respecting one’s eating habits, and (22) ideological considerations [25]. These two first steps were followed by a third step: writing items. To define the format of the questionnaire responses, the strategies proposed by McColl et al. [28] were applied. We took care to include at least one item representing each of the 22 dimensions of the pleasure of eating. However, given the complexity of some dimensions, one item alone was sometimes insufficient to adequately capture them. In such cases, additional items were crafted to ensure a thorough representation of these dimensions. As a result, each dimension was represented by between one and seven items. One general item about eating pleasure was also included in the questionnaire (In general, having pleasure when eating […]). A general item was included to provide a broad assessment of how participants perceive the relationship between eating pleasure and healthy eating, and to facilitate comparison with existing questionnaires, which often include similar general items. Each item was rated using a five-point scale ranging from “makes it very difficult for me to eat healthily” to “helps me a lot to eat healthily”. A “Not applicable” option was also provided. As a result, fifty items were generated and incorporated into our questionnaire, which we titled “Perceived Impact of Eating Pleasure on Healthy Eating Questionnaire”. Step 4 was the evaluation of content and face validity. In this study, content validity was evaluated by a panel of experts (see Section 2.2), and face validity was assessed during a pre-test study (see Section 2.3). The last steps involved analyzing the questionnaire’s structure and evaluating its reliability and construct validity. These steps were completed during a validation study (see Section 2.4).

2.2. Evaluation by a Panel of Experts: Content Validity

A panel of experts was formed to assess the content validity of the newly developed questionnaire. This included four researchers (in the fields of communication, nutrition, and psychology), sharing expertise in health promotion, the development and validation of questionnaires, and intervention development. All members were actively engaged in our prior studies on eating pleasure [25,29]. Furthermore, the panel included two nutrition students—one at the graduate level and one at the undergraduate level—engaged in eating pleasure research as part of the principal investigator’s (SL) program.

First, the development team presented a draft of the questionnaire to the experts in a meeting to collect initial feedback. After making adjustments, each expert individually assessed the content validity, i.e., whether the item appropriately assessed the population’s perceptions about the influence of that dimension of eating pleasure on their ability to embrace healthy eating habits (relevance of items). The experts also evaluated the clarity and language level of each item. Each expert scored each of the 50 items on a four-point scale based on three criteria: relevance, clarity, and language level. A score of ‘1’ meant that the item was irrelevant, unclear, or too complex; ‘2’ meant that it needed significant revisions; ‘3’ suggested that only small adjustments were required; and ‘4’ indicated that the item was fully relevant, clear, and appropriately worded. The content validity index (CVI) was computed using the relevance scores attributed by each expert [27]. For each item, the proportion of experts assigning a score of “3” or “4” was computed. In addition, the CVI was computed for the entire questionnaire by calculating, for each expert, the proportion of items rated “3” or “4”, and then averaging these percentages across all experts. According to Di Iorio [27], any item with a score below 90% should undergo modification or removal. In addition to the recommendation, we also considered the panel’s suggestions. Consequently, items with scores below 90% may remain unchanged based on expert opinions, while other items scoring above 90% might be reformulated. The panel also provided feedback on the scale, instructions, and item order, and suggested whether any items should be added or removed.

2.3. Pre-Test: Face Validity

Face validity was assessed by soliciting feedback from the target population. Following the recommendation of Vogt et al. [30], participant feedback was sought to confirm the comprehensibility of the items, as well as their relevance and representativeness of the concept. The same participant sample (n = 30; 50% women; 46.0 ± 11.5 y) was used as in the study by Grégoire and collaborators [26]. Inclusion criteria were that participants were (1) aged between 18 and 65 years, (2) fluent in French, and (3) able to access the Internet. Given the questionnaire’s intended use in an intervention study aimed to improve eating behaviors, we targeted individuals who perceived their eating behaviors as suboptimal. Exclusion criteria included a history of eating disorders, current pregnancy or breastfeeding, and being a Registered Dietitian or a nutrition student. Participants were recruited from the internal email list of the Institute of Nutrition and Functional Foods (INAF).

Participants completed three questionnaires online. They first completed a sociodemographic and medical status questionnaire, followed by two randomly ordered questionnaires: the Eating Pleasure Questionnaire (EPQ [26]), which assessed the extent to which the 22 dimensions of the pleasure of eating were endorsed by the population, and the Perceived Impact of Eating Pleasure on Healthy Eating Questionnaire, developed and validated in this study. When participants completed these two questionnaires, they provided written feedback on any difficulties encountered, suggested improvements, and commented on the instructions, item order, and response options. A follow-up telephone interview conducted by the research team (LMG) within 72 h after completing the questionnaire allowed for the clarification of comments and additional input. Participants were compensated with CAD 25. The pre-test study was approved by the Research Ethics Board of Université Laval (#2020-091/05-06-2020). Participants provided implicit informed consent.

2.4. Validation Study

2.4.1. Participants and Procedure

The online validation study involved the same sample of 300 participants (50% women) as in the study by Grégoire and collaborators [26]. This sample size is considered adequate by Comrey and Lee [31], and aligns with Di Iorio’s [27] recommendation, which suggests that a sample of 300 participants is sufficient in the context of a validation study. It also exceeds the five-to-one participant-to-item ratio recommended by Hair et al. [32]. The same inclusion and exclusion criteria were applied as in the pre-test, with two additional exclusion criteria: (1) suffering from depression, as a diminished ability to experience pleasure is a common symptom of depression, and (2) having participated in the pre-test study. Participants were recruited via INAF’s internal email list, Université Laval’s institutional distribution lists, and social networks.

Participants first completed a questionnaire on their sociodemographic and health characteristics, body weight, height, and eating behaviors. They then filled out the EPQ reported by Grégoire et al. [26], followed by the Perceived Impact of Eating Pleasure on Healthy Eating Questionnaire. This fixed order was chosen based on the pretest results, where some participants who completed the Perceived Impact of Eating Pleasure on Healthy Eating Questionnaire first and then the EPQ reported by Grégoire et al. [26] mentioned that they would have preferred completing the EPQ first, while no participant commented on the sequence when the EPQ was completed first. Additional questionnaires included the Well-Being related to Food Questionnaire (Well-BFQ) [33], the Regulation of Eating Behavior Scale (REBS [34]), the Three-Factor Eating Questionnaire (TFEQ [35]), the Health and Taste Attitudes Questionnaires (HTAS [36]), the Intuitive Eating Scale-2 (IES-2 [37]), and two web-based 24 h food recalls [38,39]. For this study, only data from the Well-BFQ and REBS were used (see Section 2.4.2). Between 2 and 4 weeks after the first completion of the questionnaires, each participant was requested to fill out the EPQ reported by Grégoire et al. [26], followed by the Perceived Impact of Eating Pleasure on Healthy Eating Questionnaire a second time to assess temporal test–retest stability. Each participant received CAD 25 compensation. This validation study was approved by the Université Laval Research Ethics Board (2020-091 phase II/02-09-2020). Participants gave their implicit consent by returning the study questionnaire.

2.4.2. Questionnaires

To evaluate construct validity, as our questionnaire aims to gauge perceptions regarding how the various dimensions of the pleasure of eating contribute to healthy eating habits, we compared its results with those of other tools that also explore perceptions regarding the interplay between pleasure and health. The Well-BFQ assesses the two primary domains of food well-being: pleasure and health [40]. We hypothesized that there would be positive associations between the perception that eating pleasure contributes to healthy eating and food well-being. We also used the REBS, specifically its intrinsic motivation subscale [34], which refers to undertaking an activity (here, “healthy eating behaviors”) for its inherent interest and enjoyment [41,42]. Accordingly, we hypothesized that there would be a positive association between the perception that eating pleasure helps to eat healthily and intrinsic motivation.

For that purpose, the adapted and validated version of the Well-BFQ [33] for the French-speaking Québec adult population was used. This 59-item adapted version measures two distinct factors: food well-being related to physical and psychological health (27 items) and food well-being related to the symbolism/pleasure of food (32 items). Higher scores indicate higher food-related well-being. In this study, the internal consistency was excellent, as demonstrated by a Cronbach’s α of 0.95 for the total scale, 0.96 for the first factor, and 0.93 for the second factor.

The REBS [34] is a 24-item questionnaire assessing the six regulation styles outlined in the self-determination theory, namely intrinsic motivation, integrated, identified, introjected and external regulations, and amotivation [41]. Higher scores indicate a greater inclination to rely on that specific type of motivation for regulating eating behaviors. For construct validity, we used only the intrinsic motivation subscale (e.g., Because I enjoy preparing healthy meals), which showed good internal consistency (Cronbach’s α = 0.88) in this study.

2.4.3. Statistical Analyses

The questionnaire’s structure was examined through an exploratory factor analysis (EFA). The unweighted least square (ULS) extraction method was employed as it does not assume normality in the distribution of variables. Factor retention was determined using multiple criteria: the Kaiser Criterion [43], the scree plot [44], the shared variance [45], the minimum average partial (MAP) analysis [46], and the parallel analysis [47]. Specifically, the Kaiser Criterion recommends that an eigenvalue greater than 1.0 serves as a reliable lower bound for determining the relevance of a factor [43,45]. The scree plot consists of finding where the curve flattens, also known as the “elbow”. The recommended number of factors to keep corresponds to the number of points above the “elbow” [44,45]. For the shared variance [45], the default setting of 100% of common variance in SAS was used to assess this criterion. The MAP analysis involves gradually removing the common variance as each subsequent component is created, and continuing until a minimum is reached, which serves as the criterion for determining the number of factors to retain [45,46,48]. Averages of the square (MAP2) were used, as well as the fourth-powered (MAP4) [46,49]. Finally, parallel analysis was used to generate a random set of uncorrelated data to compare eigenvalues. Only factors with eigenvalues that were significantly higher than the average eigenvalues of the random dataset were kept [45,47].

A total score was initially calculated by including all items, even those that did not load onto any factor identified by the EFA. A second total score was calculated using only the items that loaded onto one of the factors. Each item was rated on a five-point scale: “makes it very difficult for me to eat healthily” (1), “makes it a little difficult for me to eat healthily” (2), neutral (3), “helps me a little to eat healthily” (4), and “helps me a lot to eat healthily” (5). The “not applicable” option was assigned a rating of “3” (i.e., neutral), as the dimension was assumed not to influence their perception of how eating pleasure contributes to healthy eating. The total score was calculated as the average of all items (range: 1–5). Subscores were also calculated for each factor revealed by the EFA, with each subscore reflecting the average of all items within that factor (range: 1–5). A score > 3 indicates that participants perceived these dimensions of eating pleasure as supporting healthy eating, whereas a score < 3 indicated that they were seen as hindering healthy eating. Following best practices for handling missing data in validation studies [50], total scores and subscores were not computed for participants with incomplete responses to the relevant items.

Cronbach’s α coefficient was used to assess internal consistency [51,52]. In addition, McDonald’s ordinal omega was calculated to further evaluate internal consistency [53]. Based on hierarchical factor models, this method estimates the proportion of variance in the observed scores that is attributable to a general underlying factor. This method is particularly recommended for Likert-type scales and other ordinal or categorical data [53]. Higher values for both Cronbach’s α (range: 0–1) coefficient and McDonald’s ordinal omega values (range: 0–1) indicate greater internal consistency. Temporal test–retest stability was evaluated using the intraclass correlation coefficient (ICC) and was categorized as follows: poor (<0.50), moderate (0.50–0.75), good (0.75–0.90), and excellent (≥0.90) [54]. Construct validity and inter-factor associations were evaluated using the Pearson correlation coefficient. Based on Cohen’s classification [55], correlations were classified as small (0.1–<0.3), moderate (0.3–<0.5), or strong (≥0.5). Analyses were performed to identify potential patterns and variations within diverse demographic groups. Differences between men and women were analyzed using Student’s t-test procedure, while differences by age groups (18–34 y, 35–49 y, and 50–65 y) and BMI categories (≤24.9 kg/m², 25.0–29.9 kg/m², and ≥30.0 kg/m²) were examined with the generalized linear model (GLM). All statistical analyses were performed using SAS Studio (version 3.81, SAS Institute Inc., Cary, NC, USA) and statistical significance was set at p < 0.05.

3. Results

3.1. Evaluation by the Panel of Experts—Content Validity

The average CVI score for the total scale was 93.3%, surpassing the target value of 90%. Upon the examination of individual items, one item displayed a very low CVI (33%) and was therefore removed. To enhance relevance, clarity, and language level, the committee’s experts provided comments that resulted in the rewording of a total of 23 items and the clarification of instructions. Their recommendations prompted the addition of two items to better consider the complexity of some dimensions of eating pleasure in relation to healthy eating. Details of these changes are presented in Supplemental Table S1.

3.2. Pre-Test—Face Validity

Participant feedback led to the clarification of instructions and the reformulation of one item for greater clarity. Since participants encountered difficulties in responding to the item related to the perceived impact of the dimension ”psychological/physical state during food intake” on healthy eating, this item was no longer included. Details of these changes are presented in Supplemental Table S1. The revised version contains 50 items.

3.3. Validation Study

3.3.1. Participants’ Characteristics

Two participants did not complete the Perceived Impact of Eating Pleasure on Healthy Eating Questionnaire. Therefore, we used data from 298 participants (age range: 18–65 y). Participants’ characteristics are presented in

Table 1. Participant characteristics (n = 298) for the validation study.

Characteristics
Age (y; mean ± SD)	35.9	13.0
	n	%
Sex (female)	149	50.0
Ethnicity
Caucasian	268	89.9
Black	16	5.4
Asian	6	2.0
Latino	6	2.0
Other	2	0.7
Body Mass Index category 1
<18.5 kg/m2	9	3.2
18.5–24.9 kg/m2	114	40.4
25.0–29.9 kg/m2	103	36.5
≥30.0 kg/m2	56	19.9
Highest level of education
High school	34	11.4
CEGEP 2	87	29.2
University	177	59.4
Household income (CAD)
0–19,999	53	17.8
20,000–39,999	39	13.1
40,000–59,999	33	11.1
60,000–79,999	35	11.7
80,000–99,999	35	11.7
≥100,000	85	28.5
Prefer to not answer	18	6.0

¹ n = 284 for body mass index values due to missing values for height and/or body weight. ² In the Québec education system, CEGEP represents the first level of postsecondary education, encompassing both pre-university programs and technical programs.

. Based on login time, the median time to fill out the questionnaire was 6 min 22 s (interquartile range = 4 min 24 s).

3.3.2. Exploratory Factor Analysis

The Kaiser test of sampling adequacy yielded a value of 0.86, indicating that the sampling was sufficient for EFA (a value between 0.8 and 0.9 is considered good) [56,57]. The Kaiser Criterion, the scree plot, the MAP2, and the parallel method all suggested a six-factor structure. The shared variance suggested an 11-factor structure and the MAP4 suggested a seven-factor structure. As the seven- and eleven-factor structures included at least one factor with a single item, the six-factor structure was retained. Given that factors did not exhibit strong correlations with each other (ranging between 0.02 and 0.47), indicating their distinctiveness, an orthogonal varimax rotation was employed. Items with loadings of less than 0.4 on all factors, and items with loadings of 0.4 or more on at least two factors, were considered non-loading items.

The six-factor structure represented the perceived multidimensional nature of pleasure’s association with healthy eating and was labeled as follows: Factor 1—perceived impact of emotional/situational eating and reward on healthy eating (eight items); Factor 2—perceived impact of sensory experiences on healthy eating (six items), Factor 3—perceived impact of ideologies/interest in food on healthy eating (eight items), Factor 4—perceived impact of autonomy, freedom and individual preferences on healthy eating (seven items), Factor 5—perceived impact of social experiences on healthy eating (five items), and Factor 6—perceived impact of mindful eating on healthy eating (three items). The six-factor structure contained a total of 37 items. These factors are presented in

Table 2. Structure of the questionnaire.

Factor	Factor Loading	Cronbach’s α
Factor 1: Perceived impact of emotional/situational eating and reward on healthy eating (eight items)		0.86
30. Eating to congratulate myself, to reward myself… (“makes it very difficult for me to eat healthily” to “helps me a lot to eat healthily”) 1	0.69
31. Eating to calm my negative emotions, my stress…	0.65
32. Allowing myself to eat foods that are normally off-limits for me…	0.64
33. Eating when I’m travelling…	0.63
34. Eating in restaurants…	0.60
36. Eating on a special occasion (e.g., Christmas, Easter, birthday party) …	0.71
37. Eating food and dishes that bring back good memories …	0.64
38. Eating in a pleasant atmosphere (e.g., decoration, music, lighting) …	0.50
Factor 2: Perceived impact of sensory experiences on healthy eating (six items)		0.85
In general, having pleasure when eating…	0.59
2. Eating food that tastes good…	0.71
3. Eating food that looks good…	0.54
4. Eating food that has a pleasant texture…	0.71
5. Eating food that smells good…	0.72
7. Eating food that is at the right temperature…	0.53
Factor 3: Perceived impact of ideologies/interest in food on healthy eating (eight items)		0.76
13. Knowing where my food comes from…	0.52
15. Eating fresh food…	0.53
16. Eating local food…	0.58
17. Eating minimally processed or unprocessed food…	0.42
26. Learning more about food and dishes…	0.51
27. Eating a variety of foods…	0.43
49. Eating according to my values, ideologies…	0.44
50. Making food choices that are good for the health of our planet…	0.56
Factor 4: Perceived impact of autonomy, freedom and individual preferences on healthy eating (seven items)		0.79
14. Eating alone…	0.59
22. Cooking…	0.46
23. Doing my food shopping…	0.52
35. Eating at home…	0.53
41. Organizing my meals and snacks into my day the way I want to…	0.53
42. Having the freedom to choose what I eat…	0.57
45. Eating according to my food preferences…	0.53
Factor 5: Perceived impact of social experiences on healthy eating (five items)		0.78
8. Sharing a meal in good compagny…	0.68
9. Preparing a meal in good company…	0.64
10. Eating according to my family traditions…	0.47
11. Having guests over for a meal…	0.58
12. Serving my loved ones food they like…	0.55
Factor 6: Perceived impact of mindful eating on healthy eating (three items)		0.77
28. Taking time to savor each bite…	0.60
29. Being fully attentive to my meal when I eat (e.g., without the distraction of television, computer or telephone screens)…	0.61
44. Relaxing and taking my time at mealtime…	0.70
Total of the 6-factor structure (thirty-seven items)		0.90
Non loading items (13)
6. Eating food that make a pleasant sound…
18. Eating meals that require little or no preparation…
19. Eating food that is familiar to me…
20. Eating food that I don’t often get to eat…
21. Eating filling food that satisfy my hunger…
24. Growing my own food like vegetables, herbs, or fruits …
25. Discovering new food or dishes …
39. Including both healthy and unhealthy food in my diet …
40. Being on a diet…
43. Thinking positively about my next meal or snack…
46. Eating to feel good in my head and body after a meal …
47. Eating until I am satiated without being too full…
48. Having a certain routine in my eating habits…
Total of the questionnaire (50 items)		0.91

N = 296, as two participants had missing values. ¹ Item was rated using a five-point scale ranging from (1) “makes it very difficult for me to eat healthily” to (5) “helps me a lot to eat healthily”. The items were initially validated in French; however, for the purpose of this paper, the development team provided an English translation.

. Thirteen items failed to load onto any factor.

In the subsequent analyses, we sought to verify whether the inclusion of non-loading items would impact internal consistency, test–retest reliability, and construct validity. Therefore, for comparative purpose, both the total score, encompassing all 50 items of the questionnaire, and the six-factor score, consisting only of the 37 items, were included (Table 2,

Table 3. Total score and subscores at the first and second measurement, and intraclass correlation coefficients (ICC) between the two measurements.

	Factor	Mean Score Measurement 1 Mean ± SD	Inter-Factor Correlations at Measurement 1						Mean Score Measurement 2 Mean ± SD	ICC
			Factor 1	Factor 2	Factor 3	Factor 4	Factor 5	Factor 6
Factor 1	Perceived impact of emotional/situational eating and reward on healthy eating	2.56 ± 0.77	---						2.58 ± 0.72	0.79
Factor 2	Perceived impact of sensory experiences on healthy eating	4.03 ± 0.81	0.42 *	---					4.06 ± 0.75	0.69
Factor 3	Perceived impact of ideologies/interest in food on healthy eating	4.30 ± 0.48	0.13 ‡	0.33 *	---				4.26 ± 0.49	0.70
Factor 4	Perceived impact of autonomy, freedom and individual preferences on healthy eating	3.80 ± 0.75	0.37 *	0.45 *	0.37 *	---			3.84 ± 0.72	0.80
Factor 5	Perceived impact of social experiences on healthy eating	3.76 ± 0.85	0.48 *	0.38 *	0.17 †	0.19 ⁑	---		3.70 ± 0.86	0.64
Factor 6	Perceived impact of mindful eating on healthy eating	3.91 ± 0.71	0.17 †	0.22 *	0.37 *	0.28 *	0.22 ⁑	---	3.95 ± 0.72	0.65
Total of the six-factor structure		3.68 ± 0.48							3.67 ± 0.47	0.78
Total of the questionnaire		3.68 ± 0.44							3.67 ± 0.44	0.79

Items were rated on a five-point scale ranging from (1) “makes it very difficult for me to eat healthily” to (5) “helps me a lot to eat healthily”. Score range for each of the Perceived Impact of Eating Pleasure on Healthy Eating Questionnaire scale = 0 to 5. Because of missing data, n = 296 to 298 for measurement 1 and n = 281 to 284 for measurement 2. The number of days between measurement 1 and measurement 2 ranged from a minimum of 11 to a maximum of 159, with a median of 14 days and an interquartile range of 3 days. Pearson correlation coefficients were used to examine inter-factor correlation between factors: * p < 0.0001, ⁑ p < 0.001, † p < 0.01, and ‡ p < 0.05.

,

Table 4. Construct validity.

		Well-BFQ			REBS
	Factor	Food Well-Being Related to Physical and Psychological Health	Food Well-Being Related to Symbolic/Pleasure of Food	Food Well-Being Total Score	Intrinsic Motivation Subscale
Factor 1	Perceived impact of emotional/situational eating and reward on healthy eating	0.26 *	0.21 ⁑	0.28 *	0.20 ⁑
Factor 2	Perceived impact of sensory experiences on healthy eating	0.33 *	0.39 *	0.43 *	0.37 *
Factor 3	Perceived impact of ideologies/interest in food on healthy eating	0.32 *	0.52 *	0.51 *	0.41 *
Factor 4	Perceived impact of autonomy, freedom and individual preferences on healthy eating	0.49 *	0.48 *	0.58 *	0.56 *
Factor 5	Perceived impact of social experiences on healthy eating	0.13 ‡	0.17 †	0.18 †	0.14 ‡
Factor 6	Perceived impact of mindful eating on healthy eating	0.23 *	0.22 ⁑	0.27 *	0.20 ⁑
Total of the six-factor structure		0.45 *	0.49 *	0.57 *	0.48 *
Total of the questionnaire		0.45 *	0.48 *	0.56 *	0.48 *

Well-BFQ, Well-Being related to Food Questionnaire; REBS, Regulation of Eating Behavior Scale. Items were rated on a five-point scale ranging from (1) “makes it very difficult for me to eat healthily” to (5) “helps me a lot to eat healthily”. The Pearson correlation coefficient was used. Up to 10% of missing values were allowed in the calculation of scores for all questionnaires, except for the Perceived Impact of Eating Pleasure on Healthy Eating Questionnaire, for which no missing values were allowed in the score calculation. N ranged from 283 to 295. * p < 0.0001, ⁑ p < 0.001, † p < 0.01, and ‡ p < 0.05.

and

Table 5. Comparisons of the Perceived Impact of Eating Pleasure on Healthy Eating Questionnaire scores based on sex, age, and body mass index.

Variable	n	Factor 1 Perceived Impact of Emotional/Situational Eating and Reward on Healthy Eating	Factor 2 Perceived Impact of Sensory Experiences on Healthy Eating	Factor 3 Perceived Impact of Ideologies/Interest in Food on Healthy Eating	Factor 4 Perceived Impact of Autonomy, Freedom and Individual Preferences on Healthy Eating	Factor 5 Perceived Impact of Social Experiences on Healthy Eating	Factor 6 Perceived Impact of Mindful Eating on Healthy Eating	Total Score of the 6-Factor Structure	Total Score of the Questionnaire
Sex
Women	149	2.47 ± 0.80 a	4.00 ± 0.86	4.35 ± 0.47	3.81 ± 0.79	3.70 ± 0.86	3.88 ± 0.76	3.65 ± 0.50	3.66 ± 0.46
Men	149	2.65 ± 0.73 b	4.06 ± 0.75	4.25 ± 0.48	3.80 ± 0.70	3.81 ± 0.83	3.95 ± 0.67	3.71 ± 0.44	3.69 ± 0.41
p-value		0.0352	0.4953	0.0740	0.9912	0.2390	0.4498	0.3290	0.4930
Age
18–34 years	157	2.49 ± 0.82 a	3.94 ± 0.80 a	4.28 ± 0.50	3.68 ± 0.78 a	3.77 ± 0.81 a	3.85 ± 0.74	3.62 ± 0.48 a	3.62 ± 0.44 a
35–49 years	84	2.44 ± 0.64 a	3.89 ± 0.87 a	4.28 ± 0.45	3.80 ± 0.66 a	3.50 ± 0.98 b	4.00 ± 0.68	3.60 ± 0.46 a	3.60 ± 0.42 a
50–65 years	57	2.94 ± 0.71 b	4.48 ± 0.51 b	4.37 ± 0.45	4.15 ± 0.67 b	4.11 ± 0.55 c	3.99 ± 0.70	3.97 ± 0.39 b	3.94 ± 0.36 b
p-value		0.0001	<0.0001	0.4616	0.0002	0.0001	0.2032	<0.0001	<0.0001
BMI
≤24.9 kg/m2	124	2.58 ± 0.79	4.07 ± 0.76	4.37 ± 0.48	3.93 ± 0.76 a	3.81 ± 0.81	3.94 ± 0.72	3.74 ± 0.47	3.73 ± 0.44
25.0–29.9 kg/m2	103	2.59 ± 0.80	3.99 ± 0.80	4.29 ± 0.46	3.79 ± 0.74 a	3.61 ± 0.86	3.93 ± 0.70	3.66 ± 0.49	3.66 ± 0.45
≥30.0 kg/m2	54	2.38 ± 0.67	4.01 ± 0.91	4.21 ± 0.49	3.54 ± 0.67 b	3.84 ± 0.87	3.90 ± 0.73	3.58 ± 0.46	3.59 ± 0.42
p-value		0.1972	0.7019	0.1233	0.0056	0.1215	0.9396	0.0925	0.1317

Items were rated on a 5-point scale ranging from (1) “makes it very difficult for me to eat healthily” to (5) “helps me a lot to eat healthily”. n = 298, except for BMI due to missing values, n = 281; BMI: body mass index. Score range for each of the Perceived Impact of Eating Pleasure on Healthy Eating Questionnaire scale = 0 to 5. Differences between men and women were analyzed using Student’s t-test procedure, while differences according to age and BMI were assessed with the generalized linear model (GLM). Values with different letters are statistically different.

).

Cronbach’s α coefficient was 0.91 for all 50 items, while it was 0.90 when only the 37 items that loaded onto the six factors were taken into consideration (Table 2). Cronbach’s α coefficient varied between 0.76 and 0.86 for individual factors, demonstrating good internal consistency. Similar results were obtained using the McDonald’s ordinal omega method (0.91 for the 50-item total score, 0.90 for the 37-item total score, 0.87 for Factor 1, 0.87 for Factor 2, 0.76 for Factor 3, 0.80 for Factor 4, 0.78 for Factor 5, and 0.78 for Factor 6).

All factors, except Factor 1—perceived impact of emotional/situational eating and reward on healthy eating—exhibited a mean score greater than 3, indicating that participants perceived these dimensions of eating pleasure as helpful for healthy eating (Table 3). Inter-factor correlations ranged from 0.13 (between Factor 1—perceived impact of emotional/situational eating and reward on healthy eating—and Factor 3—perceived impact of ideologies/interest in food on healthy eating) to 0.48 (between Factor 1—perceived impact of emotional/situational eating and reward on healthy eating—and Factor 5—perceived impact of social experiences on healthy eating; Table 3).

Of the 298 participants, 284 completed the questionnaire a second time (retention percentage of 95.3%). There was a median interval of 14 days between the two completions, with an interquartile range of three days. The ICC value for the total questionnaire was 0.79, and for the six-factor structure, it was 0.78, with both indicating good test–retest reliability. The ICC values for each factor ranged from 0.64 to 0.80, indicating moderate to good reliability. Even after excluding those with an interval greater than 28 days (17 participants), the ICC values remained similar (±0.01). Detailed results are provided in Table 3.

In terms of construct validity, both the total score and the six-factor score exhibited moderate to strong correlations with the food well-being total score and its two subscale scores (r = 0.45 to 0.57; p < 0.0001). All factor scores were positively associated with the food well-being total score and its two subscale scores (r = 0.13 to 0.58; p < 0.03). In addition, the total score and the six-factor score showed moderate associations with the intrinsic motivation subscale (both r = 0.48; p < 0.0001). All factor scores were also associated in a positive manner with the intrinsic motivation subscale (0.14 to 0.56; p < 0.02). The results can be found in Table 4.

Subgroup analyses are detailed in Table 5. No differences between men and women were observed, except for Factor 1—perceived impact of emotional/situational eating and reward on healthy eating—where men had a higher score than women. In addition, compared to younger participants, older participants reported higher scores for all the Perceived Impact of Eating Pleasure on Healthy Eating Questionnaire subscales, except for Factor 3—perceived impact of ideologies/interest in food on healthy eating—and Factor 6—Perceived impact of mindful eating on healthy eating—where no differences were noted. Both the six-factor 37-item score and the 50-item total score were higher in older participants compared to younger ones. Finally, individuals with BMI ≥ 30 exhibited a lower score for Factor 4—perceived impact of autonomy, freedom, and individual preferences on healthy eating—than participants with a lower BMI. No differences were found between BMI subgroups for the other subscales, as well as for the six-factor 37-item score and the 50-item total score.

4. Discussion

This study aimed to develop and validate a comprehensive questionnaire that assesses perceptions of how various dimensions of the pleasure of eating may influence the adoption of healthy eating habits. The findings indicate that this questionnaire has good psychometric properties, making it a suitable instrument for use in the French-speaking adult population of the province of Québec, in Canada.

The EFA has a six-factor structure, including 37 of the 50 items. The factors represented the perceived multidimensional nature of pleasure in its association with healthy eating and were labeled as follows: Factor 1—perceived impact of emotional/situational eating and reward on healthy eating; Factor 2—perceived impact of sensory experiences on healthy eating; Factor 3—perceived impact of ideologies/interest in food on healthy eating; Factor 4—perceived impact of autonomy, freedom, and individual preferences on healthy eating; Factor 5—perceived impact of social experiences on healthy eating; and Factor 6—perceived impact of mindful eating on healthy eating. These six factors include 17 of the 22 dimensions previously identified in our scoping review [25], namely sensory experiences, social experiences, food characteristics, the process of preparing food, novelty, variety, mindful eating, visceral eating, place, memories, atmosphere, special occasions, having a choice, structure of eating, taking time, food preferences, and ideological considerations. It is noteworthy that both versions of the questionnaire, i.e., the total 50-item version and the six-factor structure, 37-item version, exhibit adequate internal consistency and good test–retest reliability, and are associated with food-related well-being and intrinsic motivation in expected directions, highlighting their good construct validity. These results underline that both versions could be used in future research. More precisely, researchers aiming to explore perceptions across all 22 dimensions of the pleasure of eating that were previously identified in the literature may prefer to use the 50-item version of this questionnaire. However, those who are more interested in the six main factors could opt for the shorter, 37-item version. Additionally, for researchers interested in the specific factors identified by the EFA, it is also interesting to point out that each of these factors demonstrated adequate internal consistency, a moderate to good level of reliability between test and retest, and good construct validity. This supports their individual use in future research within the French-speaking Québec adult population.

We investigated the associations between the scores of our newly developed questionnaire and some eating-related outcomes that are closely associated with the concept under study. All the expected associations were found, supporting the good construct validity of our questionnaire. More precisely, as pleasure and health are the two major domains of food well-being [40], it was expected that the perception that eating pleasure helps to eat healthily would be associated with food well-being. Accordingly, we observed moderate to strong associations between these two concepts. In addition, we also expected that the perception that eating pleasure helps to eat healthily would be positively associated with intrinsic motivation. Intrinsic motivation relates to undertaking an endeavor, here “healthy eating behaviors”, for its inherent interest and enjoyment [41,42], and has been previously associated with more favorable dietary behaviors [34,58]. Again, moderate associations between the total scores of our new questionnaire and intrinsic motivation were observed. Interestingly, the score for each factor was positively associated with food well-being and intrinsic motivation in our population. Notably, Factor 4—perceived impact of autonomy, freedom and individual preferences on healthy eating—demonstrated the strongest association with intrinsic motivation, aligning with the fundamental need for autonomy according to the self-determination theory [41,42].

Differences in scores based on sex, age, and BMI were further examined. While no significant differences were observed overall between men and women, men reported a higher score for Factor 1—perceived impact of emotional/situational eating and reward on healthy eating. This finding aligns with previous research suggesting that women are often more influenced by restrictive eating norms [59,60], which could lead them to perceive emotional and situational eating as a greater threat to healthy eating compared to men. However, it is important to highlight that both men and women considered this factor as a threat to healthy eating, as indicated by the scores below 3 for both sexes. Regarding age, older participants had higher scores across all subscales, except for Factor 3—perceived impact of ideologies/interest in food on healthy eating—and Factor 6—perceived impact of mindful eating on healthy eating. Higher scores among older participants may reflect a more balanced and integrated approach to food with age, where pleasure plays a central role in maintaining healthy habits. However, the absence of differences for Factors 3 and 6 could be explained by the fact that younger adults are more engaged in food-related ideologies (e.g., vegetarianism and sustainable eating) [61,62] and the increased popularity of mindful eating [63]. As a result, these dimensions of eating pleasure may already be integrated into their perception of healthy eating despite their younger age. Finally, individuals with a high BMI exhibited a lower score for Factor 4—perceived impact of autonomy, freedom, and individual preferences on healthy eating—compared to those with a lower BMI. This result may be explained by the fact that individuals with a higher BMI may adopt stricter dietary strategies to control weight, which may reduce their perception that pleasure in eating freely according to their preferences can be associated with healthy eating. In line with our results, previous research has also highlighted differences in well-being related to food and intrinsic motivation based on sex [33,64,65], age [64], and BMI [33,66,67]. Taken together, these findings underscore the importance of considering sociodemographic characteristics, such as gender, age, and BMI, when developing nutritional interventions that integrate eating pleasure. This will ensure the creation of intervention messages and activities that are well-tailored to the target population.

We previously developed and validated another questionnaire aimed at assessing the endorsement of the dimensions of eating pleasure revealed in our systematic scoping review by the French-speaking adult population in Québec [26]. The questionnaire that was designed and validated in the present study has a different objective, focusing on the perceptions of this population regarding the extent to which the different dimensions of eating pleasure can contribute to healthy eating. Used together, these two questionnaires could provide relevant information for the development of meaningful and well-tailored interventions. More precisely, these questionnaires could help to identify the dimensions of eating pleasure that are perceived as important for the population (with the previous questionnaire) and facilitate the adoption of healthy eating (with the questionnaire presented in this study). These dimensions could be integrated into interventions promoting healthy eating. Also, these questionnaires could help identify the dimensions of the pleasure of eating that are important to the population of interest, but that are believed to thwart healthy eating, and that also need to be addressed in future interventions to facilitate the adoption of healthy eating behaviors. In addition, data from these questionnaires could be informative in guiding public health messages in Canada. As Canada’s food guide now integrates “Enjoy your food” as a healthy eating recommendation [22], the results could highlight the dimensions of eating pleasure that should be emphasized in line with this overarching recommendation. In this study, five out of six factors (all except Factor 1—perceived impact of emotional/situational eating and reward on healthy eating) exhibited a mean score greater than 3, indicating that participants perceived these dimensions of eating pleasure as helpful for healthy eating. These results indicate that the dimensions encompassed by these five factors could be leveraged to promote healthy eating, especially those in Factor 3, related to ideologies and interest in food, which participants perceived as the greatest ally to healthy eating. It is interesting to note that Factor 1, related to emotional/situational eating and reward, exhibited a mean score lower than 3 in our sample, suggesting that this conceptualization of eating pleasure is believed to thwart healthy eating, providing crucial insights for the development of our future interventions. For instance, it could be particularly relevant to help our population to recognize and overcome challenges related to these dimensions of eating pleasure, while encouraging them to adopt healthier eating habits. These findings align with our systematic scoping review, which showed that most studies report favorable associations between eating pleasure and dietary outcomes across various tools [25]. However, when pleasure is driven by external stimuli or emotional cravings, it tends to be linked to poor diet quality [25]. Validating our questionnaires in other Canadian populations would be relevant to obtain a broader representation of perceptions about the role of eating pleasure in healthy eating for Canadians.

One of the key innovations of our work is the development and validation of the first questionnaire, assessing perceptions of how the different dimensions of eating pleasure influence healthy eating. In addition to this contribution, this study has several major strengths, including a rigorous development and validation process, a substantial sample size, and a sample that is representative of our population in terms of sex, ethnicity, and BMI. Nonetheless, this study is not without its limitations. First, our sample comprised a large proportion of participants with a university degree (59.4% vs. 25.5% in the province of Québec). As a result, the findings of this study should be generalized with caution, and further validation studies should be conducted in less educated populations. Second, this study was carried out during the COVID-19 pandemic, which could have influenced the results obtained. Performing a confirmatory factor analysis to validate the questionnaire’s structure in our population post-pandemic could provide valuable insights. Third, conducting cognitive interviews during the questionnaire’s development might have been beneficial. This would have revealed respondents’ response processes and ensured that the questions in our newly developed questionnaire were interpreted as intended by our target population. Finally, another limitation of our study is the potential order effect introduced by administering two questionnaires related to eating pleasure consecutively to the same participants. Indeed, the feedback from subjects in the pretest led us to use a fixed order for the administration of our two questionnaires in the validation study. In the validation study, the respondents first completed the EPQ from Grégoire et al. [26], which assessed the extent to which the 22 dimensions of eating pleasure were endorsed by the French-speaking Québec adult population, followed by the questionnaire designed and validated here, assessing perceptions of how the different dimensions of eating pleasure influence the adoption of healthy eating habits. Participants may have experienced fatigue after completing the first questionnaire, which could affect their attention and response quality on the second. Additionally, the responses to the first questionnaire might have influenced the responses to the second, potentially introducing a bias.

5. Conclusions

The Perceived Impact of Eating Pleasure on Healthy Eating Questionnaire is a valid instrument, which can be used to measure perceptions about the impact of the dimensions of eating pleasure on healthy eating in the French-speaking Québec adult population. Considering the increasing focus on incorporating the pleasure of eating into promoting healthy eating [16,17,18,19,20], this questionnaire will be of great help to develop nutritional interventions that are meaningful and well-tailored to the population. Moreover, the recent update to Canadian dietary guidelines now provides a more holistic perspective on healthy eating, incorporating recommendations related to eating pleasure [22], which emphasizes the relevance of the use of validation tools like this questionnaire within the Canadian population. It is important to mention that before extending the use of this questionnaire to other populations, including different Canadian groups, a validation process should be undertaken in a representative sample of the respective target population.