A content analysis of healthy living blogs: evidence of content thematically consistent with dysfunctional eating attitudes and behaviors

Does so-called "healthy" content on instagram display balanced recipes? A pilot study in relation to the risk of unhealthy eating patterns in social network users

OBJECTIVE

social networks (SN) including Instagram have increased in popularity. However, SN-mediated content may influence eating behaviors in a negative way. This study analyzed whether Instagram content claimed as "healthy" complies with nutritional guidelines.

METHODS

recipes posted in French on Instagram with the caption #healthy or similar ones were analyzed, once from February to May 2023 and again in April 2024. Health authorities' guidelines and food pyramid inclusion criteria were used for the quantitative and qualitative analysis, respectively. Recipes were then classified as balanced, partially unbalanced or unbalanced, with the two subgroups "restrictive" and "excessive", and according to the main protein source.

RESULTS

we coded a total of 114 courses (2 datasets of 57 courses each). Among these, 3 were classified as balanced main courses, 45 as partially unbalanced main courses and 66 as unbalanced main courses (21 were deemed as restrictive, 21 as excessive and 24 were otherwise inadequate), with a majority of hypocaloric courses. Approximately half of the recipes were vegetarian or vegan.

DISCUSSION

these results suggest that food recipes published on Instagram as #healthy may, at times, be far from nutritional guidelines and could rather promote unbalanced eating patterns. This suggest that food-related content on SN might be insufficiently moderated and that recipes referenced as #healthy should perhaps be accompanied by warnings and preventive measures. This observation, in addition to other detrimental behaviors displayed on SN (e.g. extreme physical activity or body image pressure) may contribute to the increased incidence of eating disorders (ED) associated with problematic SN use. Alerts on this risk and accessible tools for the prevention and early detection of ED risk in SN users are urgently needed.

'You Are Not Alone, We've Got You': Power Plays, Devotion, and Punishment on Healthy Eating and Pro-Eating Disorder Websites

Healthy eating (HE) and pro-eating disorder (pro-ED) websites are popular sources of dietary and weight loss information, social support, and lifestyle inspiration. However, the discursive styles and language used by authors/moderators and users of these two site genres have not been widely studied or compared. Forty-three HE websites and twenty-four pro-ED websites were analysed using Fairclough's model of critical discourse analysis. Findings indicate that sites share common characteristics in terms of power relations played out by authors, 'successful' dieters, and those attending these sites. These power plays encourage moral and spiritual commitment to the care of one's body, with authoritative language used to support readers' loyalty and adherence to dietary plans. On HE sites, medicinal properties were attributed to 'clean' or 'pure' foods, whereas pro-ED sites conveyed their importance for weight reduction. Healthy eating sites were largely entrepreneurial, promoting products or themselves. Pro-eating disorder sites typically featured discussions of bodily disgust, the chastisement of others, and self-discipline in the name of 'Ana', such that dieting came to be framed as part of a devotional, often punitive, body project. On both sites, morality discourses were gendered around the thin female body and the 'ideal mother', with occasional praise for muscular male bodies. Our findings indicate how transitioning from healthy eating preoccupations to eating disorders may be facilitated by normalising discussions about restrictive dieting and the shaming of bodies, overseen by self-appointed diet 'experts' and 'buddies' online.

Digging into digital buffets: A systematic review of eating-related social media content and its relationship with body image and eating behaviours

Recently, researchers have started investigating the influence of eating-focused social media content on viewers' body image and eating behaviour. The current systematic review collates the evidence for the relationship between exposure to eating-related social media content and people's body image, disordered eating, food consumption, and eating-related opinions. Following PRISMA guidelines, searches were conducted on five databases (i.e., Medline, PsycINFO, Web of Science, Scopus, and ProQuest), resulting in 38 eligible studies that examined the link between eating-related content and body image, eating behaviour and/or viewers' perceptions. Evidence showed positive relationships between exposure to certain material on social media (e.g., fast-food advertisements, clean eating, eating videos) and body image concerns, disordered eating, and consumption of, or a willingness to consume the foods seen on social media; however, studies that focused on 'healthy food' content showed no such link. Viewers expressed mixed feelings towards content such as nutrition information and mukbang videos which record hosts eating a large amount of food. Future research would benefit from a consistent measure of exposure to different eating-related content. There is also a need for more experimental research to examine the impact of watching different types of eating videos on body image, disordered eating, and food consumption.

Development and validation of a quality assessment tool to assess online nutrition information

Setting

The internet is an important source of health information but is unregulated. Little research has focused on the assessment of digital information related to nutrition.

Aim

To develop and validate a novel online quality assessment tool (OQAT) for quality assessment of online nutrition information.

Method

The OQAT was developed and validated in six distinct stages. After reviewing the literature, a framework and criteria were developed and formalised. Next, the quality assessment criteria were piloted on a subset of data and criteria refined. The established criteria were then validated against a previously validated assessment tool, and reliability was tested. Finally, the validated OQAT was used to assess the quality of articles from a 24-h collection period, 19 April 2021.

Results

The final OQAT consisted of 10 key questions. Twenty-six news articles were assessed independently by two raters. Comparison of scores found moderate internal consistency (α = 0.382). Cohen's Kappa coefficient demonstrated high interrater agreement (k = 0.653, p < 0.001). The OQAT was tested on 291 relevant Uniform Resource Locators (URLs), which were determined to be either poor 3% (n = 9), satisfactory 49% (n = 144), or high-quality 48% (n = 139) articles. There was a statistically significant difference in OQAT scores between blogs, news articles, and press releases, χ2(2) = 23.22, p < 0.001, with a mean rank OQAT score of 138.2 for blogs, 216.6 for news articles, and 188.7 for press releases.

Conclusion

This novel tool provides a reliable and objective method for assessing the quality of nutrition content online. It could potentially be used by researchers to assess the quality of online information in different settings and by organisations to inform readers of the quality of information being accessed.

Food Bloggers on the Twitter Social Network: Yummy, Healthy, Homemade, and Vegan Food

Many people now consider social networking to be an indispensable tool. There are now over 4.6 billion social media users, who leave a digital footprint through their online interactions. These big data provide enormous research potential for identifying the social and cultural aspects of the monitored topic. Moreover, the use of social media platforms has been found to have an impact on eating habits. The analysis of these social networks is thus essential to understand the factors that influence eating habits. To this aim, we identified the main topics associated with food bloggers on Twitter using the Social Media Analysis based on the Hashtag Research Framework of 686,450 Tweets captured from 171,243 unique users from 1 January 2017 to 30 May 2022. Based on the analysis of communication on Twitter, the most communicated hashtags in the food blogger sphere were as follows: #yummy, #healthy, #homemade, and #vegan. From the point of view of communities, three major clusters were identified, including (1) healthy lifestyle, (2) home-made food, and (3) fast food, and two minor clusters were identified, namely, (4) breakfast and brunch and (5) food traveling.

"Eat clean, train mean, get lean": Body image and health behaviours of women who engage with fitspiration and clean eating imagery on Instagram

The present study examined the relationship between posting or viewing fitspiration and clean eating imagery in relation to body image, disordered eating, and compulsive exercise among women. Participants (269 women aged 18-30 years) who posted and/or viewed fitspiration, clean eating or travel imagery on Instagram completed an online cross-sectional questionnaire. Results showed engaging with fitspiration and clean eating material (either posting or viewing) was significantly positively associated with increased levels of compulsive exercise and athletic-ideal internalization. However, only viewing (not posting) fitspiration and clean eating content was significantly related to thin-ideal internalization and disordered eating symptomatology. Athletic-ideal internalization mediated the relationships between posting fitspiration/clean eating and disordered eating symptomatology and compulsive exercise. Both thin-ideal internalization and athletic-ideal internalization mediated the relationship between viewing fitspiration/clean eating material and disordered eating and compulsive exercise. Overall, the findings suggest that viewing fitspiration and clean eating content on Instagram is negatively associated with thin-ideal internalization and disordered eating symptomatology, however the same relationships do not exist for people who frequently post these types of material. The mediational pathways provide a nuanced understanding of how engaging with fitspiration and clean eating material on social media influences female users' body image and health behaviour.

Food Blogs to Family Meals: A Brief Evaluation of Blogs as Resources for Home Cooking During COVID-19

This study examined the quality and healthfulness of articles and recipes on food blogs to inform nurses, other health professionals, and patients using these as resources. Recipes from 50 blogs on Feedspot.com were analyzed for nutrient content and congruency of nutrition information. Of the 178 recipes, 5.6% were low calorie, 7.3% were low in total fat, 15.2% were low sodium, and 89.3% had ≤100 kcal of total sugar. Snack recipes contained significantly less mean sodium (P = .001), and 21% of blogs provided nutrition tips with incongruent or mixed congruency recommendations. Nurses, other health professionals, and consumers should evaluate cooking blogs carefully when using them for nutrition and recipe advice.

Critical measurement issues in the assessment of social media influence on body image

Progress towards understanding how social media impacts body image hinges on the use of appropriate measurement tools and methodologies. This review provides an overview of common (qualitative, self-report survey, lab-based experiments) and emerging (momentary assessment, computational) methodological approaches to the exploration of the impact of social media on body image. The potential of these methodologies is detailed, with examples illustrating current use as well as opportunities for expansion. A key theme from our review is that each methodology has provided insights for the body image research field, yet is insufficient in isolation to fully capture the nuance and complexity of social media experiences. Thus, in consideration of gaps in methodology, we emphasise the need for big picture thinking that leverages and combines the strengths of each of these methodologies to yield a more comprehensive, nuanced, and robust picture of the positive and negative impacts of social media.

Blurred boundaries between Pro-Anorexia and Fitspiration media? Diverging cognitive and emotional effects

Social media is an emerging source of body-focused messages affecting young women. This research investigated the diverging cognitive and emotional effects of Pro-Anorexia (Pro-Ana) and Fitspiration content using linguistic analysis. Undergraduate college women (N = 129) viewed one of six experimentally-created blogs: text or images of Fitspiration, Pro-Ana, or control (Home Décor) and completed an open-ended prompt with their reaction. Linguistic analysis on post-exposure writing suggested Fitspiration blogs produced positive emotions and social comparison processes; Pro-Ana blogs produced negative and anxious emotions. Participants' history of past disordered eating behavior qualified affective (positive emotion and anxiety), but not cognitive (social comparison) outcomes. Given the cognitive and emotional impact of viewing such media, findings speak to the need for specific content of social media sites to be addressed and discussed in the treatment and prevention of eating disorders.

The "Little Red Riding Hood effect:" Fitspiration is just as bad as thinspiration for women's body satisfaction

Fitspiration is a popular form of social media which outwardly promotes the pursuit of health and strength rather than of thinness. Content analyses, however, suggest that it is thematically similar to thinspiration, which is primarily associated with thinness and presents disordered eating as a lifestyle choice. Exposure to both reduces body satisfaction, but their effect has not been compared. Further, positive body image may act as a protective factor by reducing engagement in appearance comparisons. Female undergraduate students (N = 331) were randomly assigned to view fitspiration, thinspiration, or travel images, followed by measures of state body satisfaction, state appearance comparison, and positive body image. Viewing fitspiration and thinspiration resulted in lower body satisfaction than did viewing travel images. However, whereas women with higher positive body image appeared protected from thinspiration by engaging in lower appearance comparisons than did women with lower positive body image, this same effect was not observed in women who viewed fitspiration. The fact that positive body image is not protective against fitspiration suggests that fitspiration is just as harmful, if not more, than is thinspiration and highlights the need for media literacy programs targeting fitspiration and so-called "healthy living" websites.

The use of internet sources for nutritional information is linked to weight perception and disordered eating in young adolescents

The internet serves as an accessible and confidential resource for young adolescents seeking nutritional information. However, the quality of information retrieved online is mixed and could have serious implications for users. Young adolescents who perceive themselves as overweight may be disproportionately affected as they are at greater risk for disordered eating. The current study aimed to (1) assess whether the frequency of use of different internet sources to obtain nutritional information differs between healthy weight young adolescents and those with overweight/obesity based on both objective and perceived weight status and (2) evaluate the relationships between different internet sources utilized for nutritional information and disordered eating. Young adolescents (n = 167; 10-15 years) completed the Children's Eating Attitudes Test (ChEAT; total disordered eating), indicated their perceived weight status, and reported how often they obtained nutritional information from the following internet sources: professional websites, personal websites, social media, commercial weight loss websites, and forums. Objective height and weight measurements were obtained. Young adolescents that perceived themselves to be a little overweight or overweight reported greater use of personal websites (p = .012), commercial weight loss websites (p = .011), and social media (p = .019) for nutritional information than those that did not perceive themselves to be a little overweight or overweight. The frequency of use of internet sources for nutritional information did not differ based on objective weight status. Greater use of each of the internet sources for nutritional information was related to greater disordered eating (p's < 0.05). While longitudinal research is needed to further examine these relationships, healthcare providers and teachers should provide young adolescents with guidance for interpreting and using online nutritional information to encourage valid and reliable health recommendations.

The Direct and Indirect Effects of Online Social Support, Neuroticism, and Web Content Internalization on the Drive for Thinness among Women Visiting Health-Oriented Websites

One of the debates about media usage is the potential harmful effect that it has on body image and related eating disturbances because of its representations of the “ideal body”. This study focuses on the drive for thinness among the visitors of various health-oriented websites and online platforms because neither has yet been sufficiently studied in this context. Specifically, this study aims to bring more insight to the risk factors which can increase the drive for thinness in the users of these websites. We tested the presumption that web content internalization is a key factor in this process, and we considered the effects of selected individual factors, specifically the perceived online social support and neuroticism. We utilized survey data from 445 Czech women (aged 18–29, M = 23.5, SD = 3.1) who visited nutrition, weight loss, and exercise websites. The results showed a positive indirect link between both perceived online social support and neuroticism to the drive for thinness via web content internalization. The results are discussed with regard to the dual role of online support as both risk and protective factor. Moreover, we consider the practical implications for eating behavior and weight-related problems with regard to prevention and intervention.

Appearance Framing versus Health Framing of Health Advice: Assessing the Effects of a YouTube Channel for Adolescent Girls

The present experimental study tested the effects of appearance framing of health advice on adolescent girls' state self-objectification, appearance anxiety, and preference for appearance-enhancing products. The stimuli consisted of informative YouTube-style videos about doing yoga, drinking water, or using sunscreen, and these videos were either appearance-framed (experimental condition) or health-framed (control condition). In total, 154 adolescent girls (M_age = 15.67, SD = 1.07) participated in the experiment. The effect of appearance-framed videos on state self-objectification scores was moderated by age, such that the effect of viewing the appearance-framed videos positively predicted state self-objectification among the younger adolescents. In addition, self-objectification mediated the effect of condition on appearance anxiety and on their appearance-enhancing product preferences, again with the predicted effects supported for the younger adolescents in the sample.

Health food blogger: friend or foe?

Objectives The Scientific Advisory Committee on Nutrition (SACN) and the World Health Organisation (WHO) have recently updated nutritional guidelines for a reduced sugar intake. With the increased popularity of online health-food bloggers and 'refined-sugar free' recipes, this review looked to analyse recipes from popular online bloggers to validate the veracity of their 'sugar-free' and 'healthy' claims and assess their adherence to recently implemented nutritional guidelines.Method Four bloggers were randomly selected from the Amazon top 10 booklist and their online blogs were consulted for a selection of recipes which were then nutritionally analysed in relation to their sugar and fat content.Results Eighty percent of the recipes analysed contained more fat than a Mars bar and 70% contained more fat than a popular online cake recipe, while 25% of the recipes contained over half of the recommended daily sugar intake as advised by the SACN and the WHO. None of the bloggers analysed used evidence-based approaches for the advice on their blogs.Conclusion Bloggers offer an invaluable platform to disseminate dietary advice to the public; however the recipes in this analysis were not healthy alternatives. The challenge is for government and health organisations to use this platform to promote alternative healthy eating options that align to current national and international guidance.

Reframing healthy food choices: a content analysis of Australian healthy eating blogs

BACKGROUND

Blogs are widely being used by health professionals and consumers to communicate and access nutrition information. There are numerous benefits for dietitians to establish and contribute to healthy eating blogs. In particular, to disseminate evidence-based nutrition information to promote healthier dietary practices. The aim of this study was to explore characteristics of popular healthy eating blogs and inform the provision of healthy eating information in the Australian context.

METHODS

A content analysis approach was used to identify characteristics of popular Australian healthy eating blogs. A purposive and snowball sampling approach was used to identify healthy eating blogs from search engines including Google, Bing and Yahoo. Blogs were deemed eligible if: (1) the author self-identified as a health professional; (2) the blog was written by a single author; (3) the blog was written by an Australian author; (4) the blog had a minimum of one post per month, and (5) the blog focused on communicating healthy eating information to the general adult population.

RESULTS

Five popular blogs were followed over a three-month period (December 2017-March 2018), with 76 blog posts included for analysis. Characteristics of these popular blogs were examined and four main features were identified: (i) clearly conveying the purpose of each post; (ii) developing a strong understanding of the reader base and their preferences; (iii) employing a consistent writing style; use of vocabulary and layout; and (iv) communicating healthy eating information in a practical manner. These findings reveal important insight into the features that promote effective nutrition communication within this context.

CONCLUSION

Findings from this study highlight common characteristics of popular healthy eating blogs. Future research into the development of blog guidelines which incorporate the characteristics identified in this study can support dietitians in establishing or contributing to the successful provision of evidence-based nutritional information through blogs.

Does the Healthy Body Image program improve lifestyle habits among high school students? A randomized controlled trial with 12-month follow-up

Objectives

Positive embodiment and healthy lifestyle habits seem to be related; therefore, stimulating positive embodiment should promote healthy lifestyle habits. In the current study, we delivered the Healthy Body Image (HBI) intervention among Norwegian high school students and examined the effects on healthy lifestyle habits.

Methods

The HBI intervention comprises three interactive workshops, with three overarching themes related to body image, social media literacy, and lifestyle. A total of 2446 boys (43%) and girls in grade 12 (mean age 16.8 years) from 30 high schools participated in this cluster-randomized controlled study. Schools were randomized to the HBI intervention or control study arm. Data on physical activity, eating habits, and sleep were collected at baseline, post intervention, and 3- and 12-month follow-up and analyzed using linear mixed regression models.

Results

The intervention had a minor negative effect on physical activity levels in boys at 12-month follow-up and short-term small-to-moderate positive effects on consumption of breakfast and fruit and vegetables, and sleep duration on school days.

Conclusions

In future, the lack of satisfactorily long-term effects might be better addressed using a combination of cognitive and behavioral approaches to more optimally integrate positive embodiment and lifestyle changes in the daily life of adolescents.

Trial registration: ClinicalTrials.gov ID: PRSNCT02901457. Approved by the Regional Committee for Medical and Health Research Ethics.

Personality traits and dysfunctional construal of online health promotion messages

PURPOSE

With the Internet becoming increasingly popular as a source of information, blogs offering healthy lifestyle techniques and knowledge have become popular and accessible. Despite their focus on health, these blogs portray content that may be negatively construed by viewers, especially those with or at risk for eating disorders. The present study investigated changes in affect and self-esteem after viewing a prototypic health blog. Personality traits, specifically neuroticism and conscientiousness, were also investigated.

METHODS

A prototypic health blog was constructed after extensive review of existing blogs. A parallel format was then followed to create a home décor website for a control condition. Female undergraduate students were randomly assigned to one of two blog sites, and participants completed an earlier personality assessment and post-viewing study questionnaires.

RESULTS

Contrary to the hypothesis that readers of the health blog will report more negative outcomes, no main effect of blog condition was found. However, individuals high in trait neuroticism experienced greater differences in negative affect, but not self-esteem, when viewing the health blog versus the control blog.

CONCLUSIONS

This study found that viewing health blogs did not have immediate effects on affect and self-esteem, but more neurotic individuals were more inclined to experience negative affect when viewing health promotion messages. Personality traits assessed prior to the experiment were more predictive of negative affect and self-esteem during the experiment than blog viewing conditions. No level of evidence, experimental study.

An exploration of 'fitspiration' content on YouTube and its impacts on consumers

The 'Fitspiration' movement may endorse problematic body image and behaviour. This study aims to expand the understanding of 'fitspiration' by examining its presence on YouTube. Analysis was conducted in accordance with Tiggemann and Zaccardo and Santarossa et al. Thematic analysis of videos revealed three themes; 'Fitness and beauty', 'Trust me-I'm a YouTuber', and 'Health for the right reasons'. Thematic analysis of comments revealed themes 'YouTube fitness community', 'Body appearance dissatisfaction', and 'YouTuber fitness role models'. Fitness YouTubers were found to promote unhealthy behaviours to achieve fitness, and commenters expressed belief in and replication of their advice.

Correlates of Reduced Alcohol Consumption among a Sample of Young Australians

AIMS

Population data suggest that a significant proportion of young drinkers are reducing or ceasing their alcohol use; however, there is a lack of information about the characteristics of young people who do so. Our study aimed to determine characteristics associated with self-reported attempted and successful alcohol reduction and cessation among young people in Victoria, Australia.

METHODS

Data are from a cross-sectional online survey with young people aged 15-29 years living in Victoria, Australia. Participants who reported consuming alcohol in the past 12 months were included in the analysis (N = 1,162).

RESULTS

Alcohol drinking cessation in the past 12 months was reported by 3.8% (n = 44) and reduced alcohol consumption was reported by 32.1% (n = 371) of participants. Characteristics associated with trying to reduce or cease alcohol consumption were older age, being born overseas, drinking at hazardous levels, experiencing alcohol-related harms and interest in health content on social media. Characteristics associated with successful alcohol reduction or cessation were being born overseas and experiencing alcohol-related harm, while being a member of a religious group was negatively associated.

CONCLUSIONS

Recent reduction in alcohol consumption was common among young people in this study. Recent reduction in alcohol consumption was common among young people in this study. A combination of factors appear to be correlated with recent attempts to reduce drinking young people including socio-demographic characteristics, religiosity, drinking practices and experience of harm, and interest in health.

Are Clean Eating Blogs a Source of Healthy Recipes? A Comparative Study of the Nutrient Composition of Foods with and without Clean Eating Claims

Food blogs are an increasingly popular source of information about food and nutrition. There is a perception that foods published on clean eating blogs, which promote unprocessed foods, are healthier than comparable foods without these claims. However, foods with these claims and their nutrient composition have not previously been evaluated. The purpose of the study was to describe the nutritional content of clean eating recipes compared to recipes without clean eating claims and the nutritional guidelines published by the World Health Organisation (WHO). Clean eating recipes were systematically selected from 13 popular clean eating blogs and were described and compared with control recipes without clean eating claims. The nutrient profiles from the included recipes were summarised and evaluated against criteria from WHO recommendations for chronic disease prevention and criteria from the U.K. Food Standards Agency. Data for 86 clean eating recipes were extracted that represented five food categories: breakfast, snacks, treats, desserts, and smoothies. These were matched with 86 control recipes without clean eating claims. The clean eating recipes, per portion, provide the equivalent of 15% of daily energy intake. The average serving sizes were not significantly different between clean eating and control recipes. Overall, the clean eating recipes contained significantly more protein (8.1 ± 7.3 g vs. 5.7 ± 4.1 g, p = 0.01), fat (15.8 ± 10.6 g vs. 12.4 ± 9.3 g, p = 0.03), and fibre (5.0 ± 4.3 g vs. 2.8 ± 2.9 g, p < 0.01) per serving than control recipes. There were no significant differences between clean eating and control recipes with respect to the energy (1280 ± 714 kJ vs. 1137 ± 600 kJ, p = 0.16), carbohydrate (31.5 ± 27.3 g vs. 33.9 ± 19.4 g, p = 0.51), sugar (21.1 ± 20.9 g vs. 23.2 ± 14.9 g, p = 0.46), and sodium content (196.7 ± 269 vs. 155.8 ± 160.8, p = 0.23). Less than 10% of clean eating and control recipes met the WHO constraints for proportions of energy from fat and sugar intake. A simulated nutrient profile of an average clean and control recipe shows that nutrients for both are similarly classified as moderate to high in fat, saturated fat, salt, and sugar. Foods with clean eating claims contained the same amount of energy, sugar, and sodium as foods without those claims. Clean eating claims are potentially misleading for consumers who may believe these foods are healthy alternatives, potentially undermining people’s efforts to eat a healthy diet.

The Dirt on Clean Eating: A Cross Sectional Analysis of Dietary Intake, Restrained Eating and Opinions about Clean Eating among Women

Clean eating is understood in broad terms to be an approach to eating which promotes the exclusion of processed foods. Social media and websites which promote clean eating are becoming increasingly popular as sources of nutrition information. Currently, there is a lack of knowledge regarding women's opinions about clean eating sites and their influence on eating behaviour. The aim of the present study was to investigate differences in dietary intake, dietary restraint and opinions about clean eating between women who had, and women who had never adhered to dietary advice from clean eating sites. Using a cross-sectional survey design, women (n = 762) ranging in age from 17⁻55 completed a self-report questionnaire on eating behaviour and beliefs about clean eating. Findings showed that 25.5% of the sample adhered to dietary advice from a clean eating site sometimes, often or very often. A significantly higher proportion of women who had adhered to dietary advice from clean eating sites met dietary guidelines for the consumption of fruit, meats and alternatives compared to women who had seldom or never adhered. Adherers also had significantly higher levels of restrained eating and were more positive about clean eating in general in comparison to those who seldom or never adhered. Results provide new information about exposure to clean eating sites and how they may influence women's eating practices. These preliminary findings suggest additional studies are required to better understand the influence of clean eating sites, particularly with regard to whether the information on such sites are from reputable sources and to what degree their recommendations may be problematic for individuals with eating concerns.

Young People's Experiences of Viewing the Fitspiration Social Media Trend: Qualitative Study

Background

Social media use has become ubiquitous in the lives of many people, especially young adults. A popular recent trend emerging on social media is that of posting and following ‘Fitspirational’ content - material that purports to motivate and showcase healthy lifestyle habits, particularly relating to exercise and diet. There is very limited existing literature on how engaging with this type of content influences people’s psychological and physical heath. Initial studies have focused on concerns over potential negative effects on psychological wellbeing including body image, self-esteem and eating disorders.

Objective

We aimed to address a gap in the literature for exploratory research on this topic from the perspective of users. We used a qualitative approach to explore how people experience viewing Fitspiration on social media including why and how they engage with this material and how they perceive that it affects their thoughts, emotions, behaviour and health.

Methods

We recruited 20 young adults (14 females, 6 males, aged 18-25) who self-declared themselves to be Fitspiration followers to participate in either focus groups or individual interviews. We asked detailed, open-ended questions about their motivations for following Fitspiration, experiences of viewing this content and its perceived impact. We used inductive thematic analysis to derive themes that represented common and salient features of the data set.

Results

Four main themes were developed: 1) A tool with the potential to support healthy living, 2) Unrealistic, untrustworthy content, 3) Negative effects on emotional wellbeing, and 4) Vulnerability and protective factors. Following Fitspirational posts on social media can provide young people with knowledge and motivation that may support healthy lifestyle behaviours. However, a range of harms also appeared to arise from Fitspiration viewing ranging from minor annoyances and frustrations to more meaningful negative effects on psychological & physical health. These negative effects seemed to persist despite individuals acknowledging that the material can be unrealistic, and believing that they are personally equipped to minimise harms to themselves.

Conclusions

This study suggests that Fitspiration on social media can be attractive and compelling for young people but appears to bring about negative as well as positive effects. Future research should aim to confirm the scale and intensity of positive and negative effects and investigate ways of harnessing desirable outcomes and minimising undesirable outcomes.

Messengers and Messages for Tweets That Used #thinspo and #fitspo Hashtags in 2016

INTRODUCTION

Twitter is widely used by young adults and is popular for seeking and sharing health information. The hashtags #thinspo and #fitspo provide a way to identify tweets designed to inspire thinness (thinspiration, thinspo) or fitness (fitspiration, fitspo). However, despite having different purposes, both terms may be associated with content that promotes eating disorders. We sought to 1) examine and compare the characteristics of senders and the content of tweets using these hashtags and 2) identify characteristics associated with engagement with a #thinspo or #fitspo tweet.

METHODS

In May 2016 we collected 1,035 tweets with #thinspo and #fitspo hashtags by using a constructed week sampling procedure. Using consensus coding, pairs of raters assessed each tweet's topic and associated images and videos. We used descriptive statistics to examine topics and user characteristics and inferential models to determine topics and characteristics associated with retweets, likes, and replies to tweets.

RESULTS

Of the 1,035 tweets, 696 (67.2%) were relevant to body image, fitness, food, dieting, or eating disorders. Fitspo tweets came from organizations or businesses, were promotional, and focused on nutrition and exercise, whereas #thinspo tweets came from individuals, focused on thinness and disordered eating behaviors, and contained images of extremely thin women. Rates of retweeting and liking were significantly higher for #thinspo than for #fitspo.

CONCLUSION

Characteristics of messages and messengers differed between #thinspo and #fitspo tweets; #thinspo tweets were used for messages about disordered eating. Public health professionals should consider using the #thinspo hashtag to reach the #thinspo group.

Extreme body messages: themes from Facebook posts in extreme fitness and nutrition online support groups

BACKGROUND

Extreme fitness and nutrition programs, that are said to "jump start" a healthy lifestyle, are becoming more pervasive. While some research has explored the harmful impact of fitspiration, thinspiration, and pro-anorexia/bulimia websites, no studies have examined the content associated with these extreme programs that advertised as promoting a healthy lifestyle. The objective of this study was to analyze posts found on extreme fitness and nutrition program support pages on Facebook. As these programs have become more popular, along with Facebook platforms for their participants, examining online user-generated posts related to these programs can provide information about the types of messages being promoted, and whether these can contribute to disordered eating and other harmful health behaviors.

METHODS

User data were selected from one month from public posts on two popular Facebook fitness groups. Both groups were short-term programs that set extreme guidelines for fitness and nutrition. Researchers examined the data for harmful health messages using an individual coding strategy with inter-rater reliability (Kappa =0.92).

RESULTS

Majority (88.6%) of messages analyzed promoted harmful health messages. Common categories of messages included losing weight/fat, promoting dieting/restraint, and harmful body messages, which promoted unsafe ways to attain certain body types.

CONCLUSIONS

The data analyzed in this study represent overwhelmingly negative commentary relating to harmful health and body messages. Messages in this study normalized dysfunctional behaviors and promoted fixating on certain body parts and objectifying bodies. These Facebook groups, though intended to be a sort of online support forum, provide an open space for body negativity and promotion of extreme behaviors for the sake of thinness. Most concerning, participants of these programs, which are advertised as promoting health, are expressing unhealthy thoughts and behaviors surrounding food, exercise, and body image. Given the ease of accessibility to this content using online platforms, these harmful messages can reach large groups of people and continue adding to a culture that values physical appearance to the detriment of health.

Online support for transgender people: an analysis of forums and social networks

Transgender people face a range of personal and social conflicts that strongly influence their well-being. In many cases, the Internet can become the main resource in terms of finding support. The aim of this study was to understand how transgender people give and receive help online. Between 2013 and 2015, 122 online community conversations were collected on Italian forums and Facebook groups involving transgender people, and online interviews were conducted with 16 users of these communities. A qualitative content analysis was conducted by using the software package, NVivo10. The main categories that emerged were: motivations to join an online community, online help, differences between online and offline interactions, status, conflicts and professional help. Results indicate that participation in online communities often derives from the users' need for help. This help can be given by peers who have had similar experiences, and by professionals who participate in the discussions as moderator. The need to test one's own identity, to compare oneself with others and to share one's personal experiences made online communities at risk of exposing users to invalidation and transphobic messages. Administrators and moderators try to ensure the safety of users, and suggest that they ask for professional help offline and/or online when over-specific medical advice was sought. This study confirms that transgender people might find benefit from an online platform of help and support and might minimise distance problems, increase financial convenience and foster disinhibition.

Fat is fashionable and fit: A comparative content analysis of Fatspiration and Health at Every Size® Instagram images

In step with the proliferation of Thinspiration and Fitspiration content disseminated in popular web-based media, the fat acceptance movement has garnered heightened visibility within mainstream culture via the burgeoning Fatosphere weblog community. The present study extended previous Fatosphere research by comparing the shared and distinct strategies used to represent and motivate a fat-accepting lifestyle among 400 images sourced from Fatspiration- and Health at Every Size^®-themed hashtags on Instagram. Images were systematically analyzed for the socio-demographic and body size attributes of the individuals portrayed alongside content reflecting dimensions of general fat acceptance, physical appearance pride, physical activity and health, fat shaming, and eating and weight loss-related themes. #fatspiration/#fatspo-tagged images more frequently promoted fat acceptance through fashion and beauty-related activism; #healthateverysize/#haes posts more often featured physically-active portrayals, holistic well-being, and weight stigma. Findings provide insight into the common and unique motivational factors and contradictory messages encountered in these fat-accepting social media communities.

A thematic content analysis of #cheatmeal images on social media: Characterizing an emerging dietary trend

Despite the pervasive social endorsement of "cheat meals" within pro-muscularity online communities, there is an absence of empirical work examining this dietary phenomenon. The present study aimed to characterize cheat meals, and explore the meaning ascribed to engagement in this practice. Thematic content analysis was employed to code the photographic and textual elements of a sample (n = 600) that was extracted from over 1.6 million images marked with the #cheatmeal tag on the social networking site, Instagram. Analysis of the volume and type of food revealed the presence of very large quantities (54.5%) of calorie-dense foods (71.3%) that was rated to qualify as an objective binge episode. Photographic content of people commonly portrayed highly-muscular bodies (60.7%) in the act of intentional body exposure (40.0%). Meanwhile, textual content exemplified the idealization of overconsumption, a strict commitment to fitness, and a reward-based framework around diet and fitness. Collectively, these findings position cheat meals as goal-oriented dietary practices in the pursuit of physique-ideals, thus underscoring the potential clinical repercussions of this socially-endorsed dietary phenomenon.

Skinny Is Not Enough: A Content Analysis of Fitspiration on Pinterest

Fitspiration is a relatively new social media trend nominally intended to promote health and fitness. Fitspiration messages are presented as encouraging; however, they might also engender body dissatisfaction and compulsive exercise. This study analyzed fitspiration content (n = 1050) on the image-based social media platform Pinterest. Independent raters coded the images and text present in the posts. Messages were categorized as appearance- or health-related, and coded for Social Cognitive Theory constructs: standards, behaviors, and outcome expectancies. Messages encouraged appearance-related body image standards and weight management behaviors more frequently than health-related standards and behaviors, and emphasized attractiveness as motivation to partake in such behaviors. Results also indicated that fitspiration messages include a comparable amount of fit praise (i.e., emphasis on toned/defined muscles) and thin praise (i.e., emphasis on slenderness), suggesting that women are not only supposed to be thin but also fit. Considering the negative outcomes associated with both exposure to idealized body images and exercising for appearance reasons, findings suggest that fitspiration messages are problematic, especially for viewers with high risk of eating disorders and related issues.

A Comparative Content Analysis of Vegetarian Food Blogs Written by Registered Dietitians and Non-Registered Dietitians

This purpose of this study was to compare the nutritional content of vegetarian recipes published in food blogs written by registered dietitians (RDs) and by non-registered dietitians (non-RDs). Twelve food blogs written by RDs and 12 written by non-RDs were selected using a systematic approach. For each food blog, 2 vegetarian entrée recipes per season were selected (n = 192 recipes). Descriptive analyses were performed using Fisher's exact test. Median nutritional values per serving between RDs' and non-RDs' recipes were compared using Wilcoxon-Mann-Whitney tests. RDs' recipes were significantly lower in energy, non-heme iron, vitamin C, and sodium, contained significantly more vitamin D and had a higher protein proportion than non-RDs' recipes. Disparities were also observed across type of entrée and vegetarian dietary pattern. In conclusion, this study showed that RD and non-RD food bloggers provided vegetarian recipes with few nutritional differences. Whether expanding the comparative analysis between RDs and non-RDs' blogs targeting different nutrition-related topics would yield different results remains to be investigated.

Strong is the new skinny: A content analysis of fitspiration websites

"Fitspiration" websites are media that aim to inspire people to live healthy and fit lifestyles through motivating images and text related to exercise and diet. Given the link between similar Internet content (i.e., healthy living blogs) and problematic messages, we hypothesized that content on these sites would over-emphasize appearance and promote problematic messages regarding exercise and diet. Keywords "fitspo" and "fitspiration" were entered into search engines. The first 10 images and text from 51 individual websites were rated on a variety of characteristics. Results indicated that a majority of messages found on fitspiration websites focused on appearance. Other common themes included content promoting exercise for appearance-motivated reasons and content promoting dietary restraint. "Fitspiration" websites are a source of messages that reinforce over-valuation of physical appearance, eating concerns, and excessive exercise. Further research is needed to examine the impact viewing such content has on participants' psychological health.

Go big or go home: A thematic content analysis of pro-muscularity websites

Existing content analyses of pro-eating disorder web content have focused on thinness-oriented eating disorder pathology. With the increasing prevalence of muscularity-oriented body image concerns, we conducted a systematic content analysis of 421 active pro-muscularity websites including static content websites, blogs, and online forums. Emergent coding methods were utilized (Cohen's kappa range=.78-.88), and eight distinct thematic categories were identified: rigid dietary practices (26.2%), rigid exercise rules (18.4%), the broader benefits of muscularity (16.1%), the encouragement of the drive for size (15.9%), the labeling of non-ideal body (11.4%), marginalizing other areas of life (6.1%), muscle enhancing substances (3.3%), and minimizing medical risk (2.6%). Pro-muscularity websites provide explicit material surrounding potentially non-healthful muscularity-oriented eating and exercise practices. Clinician awareness of the potentially non-healthful behaviors involved in the pursuit of muscularity may enhance the detection and treatment of male eating disorders, in particular.

A content analytic comparison of fitspiration and thinspiration websites

OBJECTIVE

"Pro-ana" or Thinspiration websites are internet sites that support weight loss and eating disorders. Fitspiration websites are a newer type of site that supposedly advocates a fit and healthy lifestyle.

METHOD

The first 10 images from a sample of 50 Fitspiration and 50 Thinspiration websites, chosen using a standard internet search protocol, were rated on a variety of weight, eating, and appearance characteristics. χ(2) analyses were conducted to compare website content.

RESULTS

Thinspiration sites featured more content related to losing weight or fat, praising thinness, showng a thin pose, and providing food guilt messages than Fitspiration sites. However, sites did not differ on guilt-inducing messages regarding weight or the body, fat/weight stigmatization, the presence of objectifying phrases, and dieting/restraint messages. Overall, 88% of Thinspiration sites and 80% of Fitspiration sites contained one or more of the coded variables.

DISCUSSION

Prior research has examined Thinspiration websites and noted the potentially hazardous messages contained on these sites. This content analysis indicates that sites supposedly devoted to healthy pursuits (fitness) may also contain thematically similar content.

Mobile Phone and Web 2.0 Technologies for Weight Management: A Systematic Scoping Review

BACKGROUND

Widespread diffusion of mobile phone and Web 2.0 technologies make them potentially useful tools for promoting health and tackling public health issues, such as the increasing prevalence of overweight and obesity. Research in this domain is growing rapidly but, to date, no review has comprehensively and systematically documented how mobile and Web 2.0 technologies are being deployed and evaluated in relation to weight management.

OBJECTIVE

To provide an up-to-date, comprehensive map of the literature discussing the use of mobile phone and Web 2.0 apps for influencing behaviors related to weight management (ie, diet, physical activity [PA], weight control, etc).

METHODS

A systematic scoping review of the literature was conducted based on a published protocol (registered at

PROSPERO

CRD42014010323). Using a comprehensive search strategy, we searched 16 multidisciplinary electronic databases for original research documents published in English between 2004 and 2014. We used duplicate study selection and data extraction. Using an inductively developed charting tool, selected articles were thematically categorized.

RESULTS

We identified 457 articles, mostly published between 2013 and 2014 in 157 different journals and 89 conference proceedings. Articles were categorized around two overarching themes, which described the use of technologies for either (1) promoting behavior change (309/457, 67.6%) or (2) measuring behavior (103/457, 22.5%). The remaining articles were overviews of apps and social media content (33/457, 7.2%) or covered a combination of these three themes (12/457, 2.6%). Within the two main overarching themes, we categorized articles as representing three phases of research development: (1) design and development, (2) feasibility studies, and (3) evaluations. Overall, articles mostly reported on evaluations of technologies for behavior change (211/457, 46.2%).

CONCLUSIONS

There is an extensive body of research on mobile phone and Web 2.0 technologies for weight management. Research has reported on (1) the development, feasibility, and efficacy of persuasive mobile technologies used in interventions for behavior change (PA and diet) and (2) the design, feasibility, and accuracy of mobile phone apps for behavioral assessment. Further research has focused exclusively on analyses of the content and quality of available apps. Limited evidence exists on the use of social media for behavior change, but a segment of studies deal with content analyses of social media. Future research should analyze mobile phone and Web 2.0 technologies together by combining the evaluation of content and design aspects with usability, feasibility, and efficacy/effectiveness for behavior change, or accuracy/validity for behavior assessment, in order to understand which technological components and features are likely to result in effective interventions.

"Exercise to be fit, not skinny": The effect of fitspiration imagery on women's body image

Fitspiration is an online trend designed to inspire viewers towards a healthier lifestyle by promoting exercise and healthy food. The present study aimed to experimentally investigate the impact of fitspiration images on women's body image. Participants were 130 female undergraduate students who were randomly assigned to view either a set of Instagram fitspiration images or a control set of travel images presented on an iPad. Results showed that acute exposure to fitspiration images led to increased negative mood and body dissatisfaction and decreased state appearance self-esteem relative to travel images. Importantly, regression analyses showed that the effects of image type were mediated by state appearance comparison. Thus it was concluded that fitspiration can have negative unintended consequences for body image. The results offer support to general sociocultural models of media effects on body image, and extend these to "new" media.

Predictors of "Liking" Three Types of Health and Fitness-Related Content on Social Media: A Cross-Sectional Study

Background

Adolescence and young adulthood are key periods for developing norms related to health behaviors and body image, and social media can influence these norms. Social media is saturated with content related to dieting, fitness, and health. Health and fitness–related social media content has received significant media attention for often containing objectifying and inaccurate health messages. Limited research has identified problematic features of such content, including stigmatizing language around weight, portraying guilt-related messages regarding food, and praising thinness. However, no research has identified who is “liking” or “following” (ie, consuming) such content.

Objective

This exploratory study aimed to identify demographics, mental health, and substance use–related behaviors that predicted consuming 3 types of health and fitness–related social media content—weight loss/fitness motivation pages (ie, “fitspiration”), detox/cleanse pages, and diet/fitness plan pages—among young social media users.

Methods

Participants (N=1001; age: median 21.06, IQR 17.64-24.64; female: 723/1001, 72.23%) completed a cross-sectional 112-question online survey aimed at social media users aged between 15-29 years residing in Victoria, Australia. Logistic regression was used to determine which characteristics predicted consuming the 3 types of health and fitness–related social media content.

Results

A total of 378 (37.76%) participants reported consuming at least 1 of the 3 types of health and fitness–related social media content: 308 (30.77%) fitspiration pages, 145 (14.49%) detox pages, and 235 (23.48%) diet/fitness plan pages. Of the health and fitness–related social media content consumers, 85.7% (324/378) identified as female and 44.8% (324/723) of all female participants consumed at least 1 type of health and fitness–related social media content. Predictors of consuming at least one type of health and fitness–related social media content in univariable analysis included female gender (OR 3.5, 95% CI 2.5-4.9, P<.001), being aged 15-17 years (OR 3.0, 95% CI 2.2-4.0, P<.001), residing outside a major city (OR 2.0, 95% CI 1.4-2.9, P<.001), having no post–high school education (OR 2.2, 95% CI 1.7-2.9, P<.001), being born in Australia (OR 2.0, 95% CI 1.2-3.2, P=.006), having a self-reported eating disorder (OR 2.4, 95% CI 1.5-3.9, P<.001), being a victim of bullying (OR 1.7, CI 1.3-2.3, P<.001), misusing detox/laxative teas or diet pills (OR 4.6, 95% CI 2.8-7.6, P<.001), never using illegal drugs (OR 1.6, 95% CI 1.2-2.0, P=.001), and not engaging in risky single occasion drinking on a weekly basis (OR 2.0, 95% CI 1.3-3.0, P=.003).

Conclusions

Consumers of health and fitness–related social media content were predominantly teenaged girls. There is a need to ensure that this social media content portrays responsible health messages and to research further the role of fitspiration pages, detox pages, and diet/fitness plan pages in influencing body image and health behaviors.

Exploring women's beliefs and perceptions about healthy eating blogs: a qualitative study

Background

Chronic diseases are the leading cause of death (63%) worldwide. A key behavioral risk factor is unhealthy eating. New strategies must be identified and evaluated to improve dietary habits. Social media, such as blogs, represent a unique opportunity for improving knowledge translation in health care through interactive communication between health consumers and health professionals. Despite the proliferation of food and lifestyle blogs, no research has been devoted to understanding potential blog readers’ perceptions of healthy eating blogs written by dietitians.

Objective

To identify women’s salient beliefs and perceptions regarding the use of healthy eating blogs written by dietitians promoting the improvement of their dietary habits.

Methods

We conducted a qualitative study with female Internet users living in the Quebec City, QC, area with suboptimal dietary habits. First, the women explored 4 existing healthy eating blogs written in French by qualified dietitians. At a focus group 2-4 weeks later, they were asked to discuss their experience and perceptions. Focus group participants were grouped by age (18-34, 35-54, and 55-75 years) and by their use of social media (users/nonusers). Using a questionnaire based on the Theory of Planned Behavior, participants were asked to identify salient beliefs underlying their attitudes (advantages/disadvantages), subjective norms (what people important to them would think), and perceptions of control (facilitators/barriers) regarding the use of a healthy eating blog written by a dietitian to improve dietary habits. Discussion groups were audiotaped, transcribed verbatim, coded, and a deductive content analysis was performed independently by 2 individuals using the NVivo software (version 10).

Results

All participants (N=33) were Caucasian women aged between 22 to 73 year. Main advantages perceived of using healthy eating blogs written by a dietitian were that they provided useful recipe ideas, improved lifestyle, were a credible source of information, and allowed interaction with a dietitian. Disadvantages included increased time spent on the Internet and guilt if recommendations were not followed. Important people who would approve were family, colleagues, and friends. Important people who could disapprove were family and doctors. Main facilitators were visually attractive blogs, receiving an email notification about new posts, and finding new information on the blog. Main barriers were too much text, advertising on the blog, and lack of time.

Conclusions

The women in this study valued the credibility of healthy eating blogs written by dietitians and the contact with dietitians they provided. Identifying salient beliefs underlying women’s perceptions of using such blogs provides an empirically supported basis for the design of knowledge translation interventions to help prevent chronic diseases.