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

Weight Misperception is Prevalent Among Turkish Adults and Associated with Higher Age, Body Mass Index and Lower Education Status

Background

Weight misperception (WM) is common among adults, and it is associated with adverse health outcomes. Research has shown that various factors are associated with weight misperception. Turkish adult population data for weight misperception and related factors do not exist.

Methodology

We conducted a face-to-face cross-sectional descriptive survey in the general internal medicine outpatient clinics of two academic centers. Perception was analyzed both verbally and visually. Misperception was defined for both verbal and visual scales as being thinner than reality misperceptions (TTRM), fatter than reality misperceptions (FTRM), or either of them (ETFTRM). Demographics, anthropometrics, and social determinants of health were analyzed in different misperception groups.

Results

250 patients participated in the study. The median (interquartile range) age was 55 (14), and the BMI was 28.2 (6.9) for females and 26.9 (4.4) for males. 81.2% had ETFTRM, 45.2% had TTRM, and 22.4% had FTRM. Age and BMI were higher in the ETFTRM and TTRM groups, while education level was lower in both. Multivariate logistic regression showed that higher age, higher BMI, and lower education levels were associated with higher TTRM.

Discussion

WM is common among the Turkish adult population. Similar to the previous studies, aging, high BMI, and low education levels are associated with weight misperception. However, in contrast to previous studies, gender, marital status, and employment were not associated with weight misperception in our cohort.

Mitigating Harms of Social Media for Adolescent Body Image and Eating Disorders: A Review

Social media has negative effects on adolescent body image and disordered eating behaviors, yet adolescents are unlikely to discontinue engaging with these platforms. Thus, it is important to identify strategies that can reduce the harms of social media on adolescent mental health. This article reviews research on social media and adolescent body image, and discusses strategies to reduce risks associated with social media use. Topics covered include interventions aimed at mitigating social media's negative impacts, the body-positivity movement, and policies regulating adolescents' social media use. Overall, this review highlights specific factors (such as staffing, duration, modality, facilitator training, and cultural sensitivity) to consider when designing and implementing social media interventions targeting adolescents. This review also discusses psychosocial outcomes associated with body positivity on social media. Finally, policy efforts to reduce the negative impact of social media on adolescents' body image and eating behaviors are described. In sum, there is a strong need to conduct further research identifying optimal approaches to reduce the harms of social media for adolescent body image and eating behavior.

What adolescents see on Instagram: Content analysis of #intermittentfasting, #keto, and #lowcarb

AIM

To describe popular diet content visible on #intermittentfasting, #keto, and #lowcarb on adolescent social media accounts.

METHODS

An adolescent Instagram profile captured 200 'top' images from three popular diet hashtags (#intermittentfasting, #keto, and #lowcarb) across two timepoints. Images were coded using a pre-determined ontology as food (core or discretionary; common foods/food groups), people (group, individual, before/after), or informative. Descriptive statistics were used to summarise these categories across hashtags.

RESULTS

At the time of first data collection, there were 3.8 million #intermittentfasting, 19 million #keto, and 22 million #lowcarb posts on Instagram. At the second timepoint there were 4.3 million #intermittentfasting, 21.5 million #keto, and 24.3 million #lowcarb posts. Images tagged #intermittentfasting were categorised as 44% food, 39% people, 10% information; #keto were 64% food, 28% people, 5% information; and #lowcarb were 69% food, 14% people, 16% information. Food images mostly depicted animal proteins (58.6% of #intermittentfasting; 62.9% of #keto; and 40.1% of #lowcarb). Images of people were individual (44%) or before/after (39%); mostly female (77%), of white (53%) ethnicity. Across all posts, 12.5% were linked to a commercial product/program, and 2.3% provided nutrition information.

CONCLUSION

Diet-related images visible when adolescents search #intermittentfasting, #keto, and #lowcarb on Instagram promote animal-based foods with or without vegetables. These diet hashtags on Instagram do not provide nutrition information and are not helpful for young people searching for diet information online.

Nutrition and Food Literacy: Framing the Challenges to Health Communication

Nutrition and food literacy are two important concepts that are often used interchangeably, but they are not synonymous. Nutrition refers to the study of how food affects the body, while food literacy refers to the knowledge, skills, and attitudes necessary to make informed decisions about food and its impact on health. Despite the growing awareness of the importance of food literacy, food illiteracy remains a global issue, affecting people of all ages, backgrounds, and socioeconomic status. Food illiteracy has serious health implications as it contributes to health inequities, particularly among vulnerable populations. In addition, food literacy is a complex and multidisciplinary field, and there are numerous challenges to health communication that must be addressed to effectively promote food literacy and improve health outcomes. Addressing food illiteracy and the challenges to health communication is essential to promote health equity and improve health outcomes for all populations.

The Use of Social Media in Children and Adolescents: Scoping Review on the Potential Risks

In recent years, social media has become part of our lives, even among children. From the beginning of COVID-19 pandemic period, media device and Internet access rapidly increased. Adolescents connected Internet alone, consulting social media, mostly Instagram, TikTok, and YouTube. During "lockdown", the Internet usage allowed communication with peers and the continuity activities such as school teaching. However, we have to keep in mind that media usage may be related to some adverse consequences especially in the most vulnerable people, such as the young. Aim of the review is to focus on risks correlated to social media use by children and adolescents, identifying spies of rising problems and engaging in preventive recommendations. The scoping review was performed according to PRISMA guidelines, searching on PubMed the terms "social media" or "social network", "health", and "pediatrics". Excluding articles not pertinent, we found 68 reports. Out of them, 19 were dealing with depression, 15 with diet, and 15 with psychological problems, which appeared to be the most reported risk of social media use. Other identified associated problems were sleep, addiction, anxiety, sex related issues, behavioral problems, body image, physical activity, online grooming, sight, headache, and dental caries. Public and medical awareness must rise over this topic and new prevention measures must be found, starting with health practitioners, caregivers, and websites/application developers. Pediatricians should be aware of the risks associated to a problematic social media use for the young's health and identify sentinel signs in children as well as prevent negative outcomes in accordance with the family.

Does Internet Use Connect Us to a Healthy Diet? Evidence from Rural China

Dietary patterns in China have changed dramatically over the past few decades as the Internet has become rapidly available. Based on data from the China Health and Nutrition Survey (2006–2011), we use a two-way fixed effects model and an instrumental variable approach to determine the impact of Internet use on the dietary quality of rural residents. The results indicate that Internet use could significantly improve the dietary quality of Chinese rural residents, with an increase of about 10.4% in the China Food Pagoda Score (CFPS), mainly due to the increase in the dietary quality score for five food groups: fruits, meats, eggs, oil, and salt. We also found that Internet use significantly increased the consumption amounts of milk and its products (4 g), fruits (31 g), eggs (8 g), and vegetables (34 g), while also decreasing the intake of salts (2 g) and oil (6 g). A possible mechanism is that Internet use improves the dietary knowledge of rural residents, thus optimizing their dietary structure. Moreover, the effect of the Internet was greater among females and those who prepare food for a family. Rural residents without a college degree enjoyed more benefits. In summary, governments should further promote Internet penetration in rural areas for health purposes.

Croatian adolescents’ credibility judgments in making everyday life decisions

The objective of this study was to investigate how high school students judged the credibility of information obtained for help with making everyday life decisions. Semi-structured individual interviews were carried out to reveal what reasons lay behind their belief in the quality, accuracy and helpfulness of the information. The results reveal that the students preferred turning to interpersonal information sources. The information obtained was perceived to be credible in cases when the source had been characterized with attributes that expressed competence and trustworthiness (such as expertise, knowledge and precision). Other important indicators of information credibility in cases of interpersonal information sources were the characteristics that expressed personal trust and the quality of the relationship with the source. Information on social media was judged by socially generated cues that expressed reputation and popularity in the users’ community. Lastly, credibility was verified by checking the consistency of information from multiple sources.

How Helpful and What Is the Quality of Digital Sources of Healthy Lifestyle Information Used by Australian Adolescents? A Mixed Methods Study

To evaluate the digital platforms most used by adolescents for healthy lifestyle information, perceived helpfulness of platform information, helpfulness for positive behaviour changes, and quality of platforms’ lifestyle health information. Mixed-methods study including a cross-sectional online survey and content analysis. Eligible participants were 13–18-years; living in Australia; and had searched online for healthy lifestyle behaviour (nutrition, physical activity, weight management, sleep) information in the previous three months. Survey items examined the use of digital platforms, self-perceived helpfulness, usefulness for positive behaviour, and popular content. Data were analysed using descriptive statistics and ordinal logistic regression models. Content analysis was performed on popular digital content to evaluate expertise, objectivity, transparency, popularity, and relevance. In total, 297 participants completed the survey (62.3% female; 15.8 [SD1.5] years). Seventy-eight percent and 77% of participants reported using websites and social media, respectively, for seeking healthy lifestyle information. Websites and social media were rated as somewhat helpful by 43% and 46% of participants, respectively. Sixty-six percent and 53% of participants agreed/strongly agreed smartphone apps and social media were helpful for positive behaviour change, respectively. Helpfulness did not differ by age or gender. We evaluated 582 popular digital content; 38% were produced by a commercial company. Only 7% of content was from health organisations, 10% from health professionals and only 10% of content was objective, and 14% was transparent. Adolescents extensively utilise websites and social media for health information, yet popular content has limited objectivity and transparency. Governments and health organisations should consider creating age-appropriate digital information for healthy lifestyle behaviours.

Addressing psychosocial health in the treatment and care of adolescents with obesity

Obesity affects 158 million youth worldwide and is associated with psychosocial comorbidity. This review describes weight management options utilized by adolescents, including both self-directed weight loss and medically supervised obesity treatment interventions, and associated psychosocial impacts. A majority of adolescents with obesity attempt to manage weight on their own, primarily through attempting weight loss, sometimes with supplement use. Approaches such as these are associated with a degree of risk, disordered eating behaviors, and further weight gain. In contrast, medically supervised multicomponent interventions are associated with improved psychosocial health, including quality of life, self-esteem, and body image, and reduced symptoms of depression, anxiety, and eating disorders. Few studies utilizing antiobesity pharmacotherapy have reported psychosocial outcomes, and trials of bariatric surgery show some early improvements with a need for sustained psychological support following surgery. Greater access to medically supervised treatment services is required to facilitate obesity care for adolescents. Early data on psychosocial health and obesity treatment offer promising outcomes; however, larger randomized controlled trials and longer-term data are needed. Future research should include both physiological and psychosocial outcomes to assess impact of interventions on the holistic health of adolescents with obesity.

Adolescent Exposure to Weight Loss Imagery on Instagram: A Content Analysis of "Top" Images

Background: Social media is a source of weight loss information for adolescents. However, engagement with image-based social media has been associated with reduced body image. This study describes weight loss imagery visible on an adolescent Instagram account. Methods: The "top" 600 images were captured from "#weightloss" on an adolescent (16 years, gender not specified) Instagram account in August 2020. Images were categorized and coded based on a predetermined ontology as food (nutrient-dense, energy-dense), people (group, individual, before/after), or text-focused by one coder (20% in duplicate, 90% agreement). Images of people were coded for sex and ethnicity and images of individuals coded for adiposity, muscularity, and pose. Results: Of 600 images, 208 (34.7%) were of individuals, predominantly females (83%) with white (37%), non-white (23%), or unclear (41%) ethnicity. Body types were thin (31%), average (43%), or higher weight (6%) with little-to-none (25%), visible (26%), or high (7%) muscularity. Almost half of images accentuated body features with a fitness/muscle accentuating (21%) or sexualized (21%) pose or both (3%). From 165 (27.5%) food images, 71% were nutrient-dense and 29% energy-dense. Of 107 (17.8%) before/after images, 90% depicted weight loss, 4% muscle building with 85% in females. From 93 (15.5%) text-focused images, 46% related to weight loss programs/products and few provided nutrition (n = 12, 13%) or exercise (n = 2, 2%) information. Conclusions: Most "#weightloss" imagery visible to adolescents on Instagram were of people, frequently females, with almost half of body-focused poses or before/after weight loss images. Few provide nutrition and exercise-related content.