Practice Paper of the Academy of Nutrition and Dietetics: Social Media and the Dietetics Practitioner: Opportunities, Challenges, and Best Practices

The Impact of Following Instagram Influencers on Women's Body Dissatisfaction and Eating Disorder Symptoms

According to the Tripartite Influence Model, social media is one of the primary sources influencing women's body dissatisfaction. However, the role of social media influencers as a potential driver for impacting users' body image evaluation when disseminating content on social networks has been little investigated. The present research aims to explore the relationship between following three Instagram influencers (i.e., nutrition, fitness, and entertainment) and eating disorder (ED) symptoms and body dissatisfaction among a group of female users. A sample of 5060 women (mean age = 35.33 ± 9.33) were recruited with the collaboration of three Italian influencers, and self-reported questionnaires were administered. Women who followed the nutritional influencer account reported significantly higher scores on ED symptoms and body dissatisfaction than women who followed the fitness and entertainment influencer accounts (η2 = 0.05 and η2 = 0.02, respectively). Overall, following nutrition and fitness accounts (compared to entertainment accounts) and spending more time daily on social networks positively predicts ED symptoms (β = 0.28, p < 0.001, β = 0.10, p < 0.001, β = 0.11, p < 0.001, respectively) and body dissatisfaction (β = 0.07, p < 0.001, β = 0.04, p < 0.001, β = 0.07, p < 0.001, respectively). Moreover, following nutritional influencers compared to fitness influencers positively predicts ED symptoms (β = 0.17, p < 0.001) but not body dissatisfaction. The current results suggest that being exposed to dieting and weight loss topics on social media might be particularly harmful for individuals with specific vulnerabilities. Practical implications will be discussed.

The role of social media in the professional sphere of Finnish registered dietitians

BACKGROUND

With the widespread use of social media, understanding how healthcare professionals, such as dietitians, utilise these platforms for their work has gained interest. The aim of the current study was to describe how Finnish registered dietitians utilise various social media channels for professional purposes. The study also investigated the perceived social media skills of dietitians.

METHODS

A cross-sectional study was conducted using an online survey administered between December 2022 and February 2023. The participants were 107 Finnish registered dietitians who held a master's degree suitable for the profession. The Fisher's exact test was employed for categorical variables, whereas the Kruskal-Wallis test was used for ordinal variables with multiple groups.

RESULTS

Out of the 107 participants, 62 (58%) reported using social media for professional purposes. The primary purposes across various social media channels were interaction with colleagues (80%) on Facebook, networking with professionals from other fields (86%) on LinkedIn and general monitoring of the field on Instagram (91%), Twitter (77%) and YouTube (58%). Dietitians' perceived social media skills were found to have a statistically significant relationship with age (p < 0.05) for all channels, except Twitter.

CONCLUSIONS

The findings suggest that Finnish dietitians predominantly utilise social media for passive monitoring of the field, rather than actively sharing content with the public. Professional communication tends to take place within their own professional groups. Incorporating social media use into the official job description could serve as an encouraging factor to enhance the professional utilisation of social media among dietitians.

Determinants for Mediterranean diet adherence beyond the boundaries: a cross-sectional study from Sharjah, the United Arab Emirates

BACKGROUND

Substantial evidence embraced the nutrition competence of the Mediterranean diet (MD) as a healthy model for decreasing the risk of chronic diseases and increasing longevity, with the bonus of ensuring environmental sustainability. Measuring adherence to this diet is marginally investigated in the Arabian Gulf region, an area away from the Mediterranean region. The current study aimed to assess the MD adherence among adults in Sharjah/the United Arab Emirates (UAE), and to identify the most influential predictors for MD adherence among the study participants.

METHODS

A cross-sectional study design was employed using a self-reported, web-based electronic questionnaire that questioned sociodemographics, lifestyle factors, and familiarity with the MD. The MD adherence was assessed by the Mediterranean Diet Adherence Screener validated questionnaire. The adherence level was classified as low for a total score of [0-5], medium [score 6-7], and high (8-13).

RESULTS

The study included 1314 participants (age 25-52 years) comprised 822 (62.6%) females and 492 (37.4%) males. There was a moderate adherence score (5.9 ± 1.9) among the study participants. The food constituent expressed the lowest contribution to the MD was fish (9.3%), followed by fruits (12.3%), and legumes (18.3%). The multivariable linear regression analysis showed an overall significant linear trend for the association between the MD adherence score and physical activity, while nutrition information from dietitians and social media were the most two strongly related predictors for the higher adherence (β = 0.747; 95% CI 0.51-0.98, and β 0.60; 95% CI 0.269-0.93; p < 0.001, respectively). On the other side, being a smoker and from a non-Mediterranean country was associated with lower adherence scores (β = 0.538; 95% CI 0.252-0.82, p < 0.001).

CONCLUSION

The findings of the current study showed a moderate adherence, low proportion for high adherence, and a gap in the familiarity with the diet name. Being married, physically active, non-smoker, and getting nutrition information from dietitians and social media were the strongest predictors for higher adherence. It is warranted that public health and nutrition specialists/dietitians to tailor new modern approaches for promoting healthy dietary behaviours consistent with the MD.

Nutrition Messaging by Healthcare Students: A Mixed-Methods Study Exploring Social Media Usage and Digital Competence

AIM

The COVID-19 pandemic leads to a significant digital transformation in higher education and healthcare practices. This study aimed to investigate the level of digital competence, views and experiences, social media usage, and perceived barriers to digital communication among healthcare students.

METHOD

Employing a mixed-methods approach, quantitative data were gathered through an online survey, while qualitative insights were gleaned from semi-structured questionnaire responses obtained during focus group discussions. A total of 143 nursing and midwifery students from Turkey, along with 54 dietetics students from various European countries, participated in the study.

RESULTS

A significant proportion of nursing (43.5%) and midwifery (55.2%) students advocated for integrating digital technology training into university curricula. Instagram has emerged as the predominant platform for sharing healthcare/nutrition information among students. However, concerns have been raised regarding the prevalence of "before/after" posts on social media promoting weight loss, which were identified as low-quality content by participants.

CONCLUSIONS

These findings underscore the importance of integrating digital technologies and social media into healthcare, nutrition education, and practice. Additionally, there is a pressing need to establish professional and ethical standards for digital nutritional communication. By addressing these challenges, educators can better equip healthcare students to navigate the complexities of modern healthcare practices and enhance patient-care outcomes.

Prevalence and Correlates of Dietary and Nutrition Information Seeking Through Various Web-Based and Offline Media Sources Among Japanese Adults: Web-Based Cross-Sectional Study

BACKGROUND

The advent of the internet has changed the landscape of available nutrition information. However, little is known about people's information-seeking behavior toward healthy eating and its potential consequences.

OBJECTIVE

We aimed to examine the prevalence and correlates of nutrition information seeking from various web-based and offline media sources.

METHODS

This cross-sectional study included 5998 Japanese adults aged 20 to 79 years participating in a web-based questionnaire survey (February and March 2023). The dependent variable was the regular use of web-based and offline media as a reliable source of nutrition information. The main independent variables included health literacy, food literacy, and diet quality, which were assessed using validated tools, as well as sociodemographic factors (sex, age, education level, and nutrition- and health-related occupations).

RESULTS

The top source of nutrition information was television (1973/5998, 32.89%), followed by web searches (1333/5998, 22.22%), websites of government and medical manufacturers (997/5998, 16.62%), newspapers (901/5998, 15.02%), books and magazines (697/5998, 11.62%), and video sites (eg, YouTube; 634/5998, 10.57%). Multivariable logistic regression showed that higher health literacy was associated with higher odds of using all the individual sources examined; odds ratios (ORs) for 1-point score increase ranged from 1.27 (95% CI 1.09-1.49) to 1.81 (95% CI 1.57-2.09). By contrast, food literacy was inversely associated with the use of television (OR 0.65, 95% CI 0.55-0.77), whereas it was positively associated with the use of websites of government and medical manufacturers (OR 1.98, 95% CI 1.62-2.44), books and magazines (OR 2.09, 95% CI 1.64-2.66), and video sites (OR 1.53, 95% CI 1.19-1.96). Furthermore, diet quality was positively associated with the use of newspapers (OR 1.02, 95% CI 1.01-1.03) and books and magazines (OR 1.03, 95% CI 1.02-1.04). Being female was associated with using television and books and magazines, whereas being male was associated with using websites of government and medical manufacturers, newspapers, and video sites. Age was positively associated with using newspapers and inversely associated with using websites of government and medical manufacturers and video sites. People with higher education were more likely to refer to websites of government and medical manufacturers and newspapers but less likely to use television and video sites. Dietitians were more likely to use websites of government and medical manufacturers and books and magazines than the general public but less likely to use television and video sites.

CONCLUSIONS

We identified various web-based and offline media sources regularly used by Japanese adults when seeking nutrition information, and their correlates varied widely. A lack of positive associations between the use of the top 2 major sources (television and web searches) and food literacy or diet quality is highlighted. These findings provide useful insights into the potential for developing and disseminating evidence-based health promotion materials.

An Investigation of the Effectiveness of Distance Learning on Nutrition Quality of Hemodialysis Patients during the COVID-19 Pandemic: A Single-Blind Randomized Clinical Trial

Introduction

The COVID-19 pandemic has limited hemodialysis patient's attendance in healthcare centers and receiving diet education. This study was conducted to investigate the effectiveness of distance learning on the nutrition quality of hemodialysis patients during the COVID-19 pandemic.

Methods

In the single-blind randomized clinical trial, 60 patients undergoing hemodialysis were randomly divided into control (n=30) and experimental (n=30) groups. Before and after the intervention, Dialysis Malnutrition Score (DMS), Malnutrition-Inflammation Score (MIS) (primary outcome), albumin, the total iron-binding capacity of the blood (TIBC), and body mass index (BMI) (Secondary outcome) were investigated. The experimental group received educational content through social networks for three months, whereas the control group received routine care and training.

Results

There was no significant difference between the two groups in terms of the mean of DMS, MIS, albumin, and TIBC before the intervention. Pre-test BMI had a confounding effect; therefore, an analysis of covariance was performed to eliminate that effect. This analysis showed significant differences in the post-test mean DMS, MIS, TIBC, and BMI between the two groups. In the control group, significant differences were observed in MIS and BMI toward deterioration. The results also indicated a significant relationship between education level and age with TIBC and between marital status and albumin index.

Conclusion

Distance learning can be considered by healthcare managers and police makers as a suitable alternative to the classic face-to-face learning method to enhance hemodialysis patients' nutrition quality during the COVID-19 pandemic.

The Future of Social Media, Anesthesiology, and the Perioperative Physician

Social media has rapidly developed in the past decade to become a powerful and influential force for patients, physicians, health systems, and the academic community. While the use of social media in health care has produced many positive changes, such as rapid dissemination of information, crowd-sourced sharing of knowledge, learning, and social interaction, social media in health care has also negative effects. Recent examples of negative impacts of social media include rapid and unchecked information dissemination leading to patient misinformation and inadvertent reputational harm for health care professionals due to engaging in controversial topics on public platforms. Members of the anesthesiology community, like other medical specialties, have rapidly adopted social media at many different levels. However, most anesthesiologists, health systems, and academic communities have little education, preparation, and guidelines on optimizing the use of social media technology while minimizing the risks of social media. Anesthesiology has been and will continue to be impacted by the forces of technology and the cultural influences of social media for the foreseeable future. The purpose of this article was to examine the recent history of social media adoption in anesthesiology and perioperative medicine, understand the current impact of social media across our specialty, and consider how the future development of technology and evolving social and cultural dynamic influences of social media will have on anesthesiology over the next quarter century.

Nutrition knowledge and health vulnerability of mothers of pre-school children in north-central, Nigeria

OBJECTIVE

This study explores the contribution of nutrition knowledge to the health status of pre-school children's mothers in Niger State, North-Central, Nigeria.

DESIGN

The study is a descriptive cross-sectional design using a quantitative data collection method.

SETTING/PARTICIPANTS

A multi-stage sampling technique was used to recruit 450 mothers of pre-school children across Niger state, Nigeria. Chi-square and linear regression were used to test the level of statistical significance (at p < 0.05). Socioeconomic and demographic information, anthropometric indices and nutrition knowledge were obtained using semi-structured questionnaires. Feeding patterns were also assessed using a qualitative 7-day dietary recall.

RESULT

The results showed that the majority (63.8%) of the mothers were within 26-35 years, and more than half (51.6%) of the mothers lacked knowledge of a "balanced diet". Fruits, vegetables, and dairy products were the least consumed food group among the mothers (7.1% and 9.1%, respectively). Place of residence, occupation, and method of waste disposal were significantly associated with maternal minimum dietary diversity adequacy (p<0.05). Over half (57.6%) of the mothers were within the normal BMI range, and the mean waist/hip ratio was 0.82± 0.08. Social media/online was the most (36.4%) explored source of nutrition information among the mothers. This study shows no significant association between nutrition knowledge and adequacy of minimum dietary diversity among the mothers of preschool children (p = 0.09, χ2 = 13.682).

CONCLUSION

Dietary diversity among mothers was associated with the socioeconomic status and BMI of the mothers, which were strong determinants of meal quality and health outcomes in Nigeria and other developing countries experiencing food insecurity.

Interactions Between Nutrition Professionals and Industry: A Scoping Review

BACKGROUND

In recent years, interactions between nutrition professionals (NPs) and the food industry, such as sponsorship arrangements, have raised concerns, particularly as these may negatively impact the trustworthiness and credibility of the nutrition profession. This study aimed to map the literature and identify knowledge gaps regarding interactions between NPs and industry. We sought to examine the nature of such interactions and NPs perspectives about these, as well as the risks and solutions.

METHODS

We conducted a scoping review according to a pre-registered protocol, searching eight electronic databases and grey literature sources in March 2021 to identify documents for inclusion. Two independent reviewers screened citations for inclusion and conducted data extraction. Quantitative and qualitative syntheses were conducted.

RESULTS

We identified 115 documents for analysis, published between 1980 to 2021, with a majority from the United States (n=59, 51%). Only 32% (n=37) were empirical studies. The food industry was the most frequent industry type discussed (n=91, 79%). We identified 32 types of interactions between NPs and industry, such as continuing education provided by industry and sponsorship of professional bodies and health and nutrition organizations. The financial survival of nutrition organizations and continuing education access for NPs were the most frequently cited advantages of industry-NPs interactions. On the other hand, undermining public trust, NPs credibility and public health nutrition recommendations were pointed out as risks of these interactions. Following a code of ethics, policies, or guidelines was the most frequently proposed solution for managing these interactions.

CONCLUSION

Despite the increasing attention given to this issue, few empirical papers have been published to date. There is a need for more research to better and systematically document industry interactions with NPs and the impacts associated with these, as well as more research on effective management strategies. Registry Name and Number: Interactions between nutrition professionals and industry actors: A scoping review protocol. doi:10.17605/OSF.IO/Q6PUA.

Evaluation of a Media Training Workshop for Nutrition Students and Trainees in Nova Scotia

Gaps in communication training have been identified in Canadian and international academic and practicum dietetics programs. A workshop was developed to pilot supplementary media training to nutrition students/trainees studying in Nova Scotia. Students, interns, and faculty from two universities participated in the workshop. Data on perceived learning, media knowledge/skill use, and workshop feedback were collected immediately post-workshop using a mixed-form questionnaire. A modified questionnaire was administered eight months post-workshop to obtain information on utility of the perceived acquired knowledge/skills. Closed-ended responses underwent descriptive analysis, while open-ended responses underwent thematic analysis. Twenty-eight participants completed the questionnaire post-workshop, and six completed it at follow-up. All participants rated the workshop positively (7-point Likert scale) and reported learning something new (perceived). Perceived learning emphasized general media knowledge/skills and communication skills. Follow-up data suggested participants had applied perceived media knowledge/skills in message development and media and job interviews. These data suggest that nutrition students/trainees may benefit from supplementary communications and media training and provide a stimulus for ongoing curriculum review and discussion.

Multifaceted Role of Social Media in Healthcare: Opportunities, Challenges, and the Need for Quality Control

Social media, leveraging Web 2.0 technologies, plays a vital role in healthcare, medical education, and research by fostering collaboration and enabling research dissemination. Healthcare professionals use these platforms to improve public health literacy, but concerns about misinformation and content accuracy persist. In 2023, platforms like Facebook (Meta Platforms, Inc., Menlo Park, California, United States), YouTube (Google LLC, Mountain View, California, United States), Instagram (Meta Platforms, Inc.), TikTok (ByteDance Ltd, Beijing, China), and Twitter (X Corp., Carson City, Nevada, United States) have become essential in healthcare, offering patient communication, professional development, and knowledge-sharing opportunities. However, challenges such as breaches of patient confidentiality and unprofessional conduct remain. Social media has transformed medical education, providing unique networking and professional development opportunities. Further studies are needed to determine its educational value. Healthcare professionals must follow ethical and professional guidelines, particularly regarding patient privacy, confidentiality, disclosure rules, and copyright laws. Social media significantly impacts patient education and healthcare research. Platforms like WhatsApp (Meta Platforms, Inc.) effectively improve patient compliance and outcomes. Yet, the rapid dissemination of false news and misinformation on social media platforms presents risks. Researchers must consider potential biases and content quality when extracting data. Quality control and regulation are crucial in addressing potential dangers and misinformation in social media and healthcare. Stricter regulations and monitoring are needed due to cases of deaths resulting from social media trends and false news spread. Ethical frameworks, informed consent practices, risk assessments, and appropriate data management strategies are essential for responsible research using social media technologies. Healthcare professionals and researchers must judiciously use social media, considering its risks to maximize benefits and mitigate potential drawbacks. By striking the right balance, healthcare professionals can enhance patient outcomes, medical education, research, and the overall healthcare experience.

Use of Instagram to convey nutrition information to collegiate athletes

Background: Nutrition professionals, who work with collegiate athletes, use Instagram to provide nutrition information. Although, limited focus is on the engagement of these athletes. The purpose of this descriptive study was to investigate collegiate athletes' engagement, as indicated by the total number of likes received on posts, based on the nutrition content posted on Instagram. Methods: Over a five-week period, 15 randomly selected accounts were examined daily for posts made within specific research-defined categories (n = 12). The number of posts and subsequent post likes were summed and tabulated per category. Results: The food feature post category received the highest number of likes (n = 1,130) and posts (n = 33), whereas the macronutrient post category received the fewest number of likes (n = 43) and posts (n = 2). A two-sample t-test assuming unequal variances was conducted to compare account engagement as defined by the mean number of post likes within the same conferences. Two conferences had differences in the number of posts (p < 0.05). Discussion: Posting on a weekly basis and within specific categories appeared to produce a higher degree of engagement on collegiate sports nutrition Instagram accounts. Future research is needed to determine the percentage of athletes following these Instagram accounts and the impact these nutrition posts influences dietary behaviors.

The Use of Social Media in Delivering Rehabilitation Services by Healthcare Professionals at a Rehabilitation Healthcare City in Riyadh, Saudi Arabia

Background:

The growing popularity of social media has been welcomed by medical professionals. With an increase in the number of healthcare providers addressing healthcare issues by using social media, such as Facebook, Twitter, YouTube, Snapchat, and Instagram, as well as communicating and educating patients on public health, this new technology has a substantial impact on improving the overall public health.

Objective:

The primary purpose of this study was to examine the challenges and benefits of using social media in delivering rehabilitation healthcare services from the perspective of healthcare workers at a private institution in a rehabilitation healthcare city in Riyadh, Saudi Arabia.

Methods:

A cross-sectional study was conducted among rehabilitation department staff working at a selected rehabilitation healthcare city in Riyadh, Saudi Arabia. An online web-based questionnaire was developed based on previous studies. The survey was distributed to the employees of the rehabilitation department via their work email addresses.

Results:

The study population was 108 healthcare providers. Overall, 77.78% of participants had used social media for over five years. Participants reported using social media for numerous purposes. The majority (35.19%) used it for education purposes, 30.56% used it for networking, and others used it for other things, such as communication with patients, online consultations, and job hunting. Furthermore, 49.07% of participants were already using social media to deliver rehabilitation services.

Conclusion:

The study found that most healthcare providers agreed on the benefits of utilizing social media in the healthcare sector. Most of the benefits were expanding the knowledge of both healthcare workers and patients, easier communication with patients, and also a cost-effective means of communication. However, some of the concerns that were raised by healthcare providers were regarding patients’ privacy and confidentiality, the dissemination of false or misleading information, and legal and ethical considerations.

Impact of the virtual anti-hypertensive educational campaign towards knowledge, attitude, and practice of hypertension management during the COVID-19 pandemic

BACKGROUND

One of the efforts to reduce hypertension rates in the community is through an educational campaign that refers to the NIH's National Heart, Lung, and Blood Institute curricula or abbreviated as NHLBI. However, during the coronavirus disease 2019 (COVID-19) pandemic, one of the hardest hit areas is health promotion, and there is a significant obstacle regarding the most effective way to transfer knowledge, attitude and practice towards society without transmitting the virus.

AIM

To evaluate the impact of the virtual anti-hypertensive educational campaign towards knowledge, attitude, and the practice of hypertension management in the primary care setting during the COVID-19 pandemic.

METHODS

An online action research with a randomized crossover-controlled trial using a pretest-posttest control group design. The study was conducted in October 2020-April 2021. The population in this study were patients with hypertension who were treated in the Mojo primary health care setting. A purposive sampling technique was done to receive 110 participants using an online questionnaire and invitation letter.

RESULTS

A total of 110 participants were included in the analysis, 55 in the intervention group and 55 in the control group. Following the Virtual Anti-Hypertensive Educational Campaign implementation, the only parameter that showed significant improvement was knowledge and attitude (P < 0.001). There is no significant change in the practice parameters (P = 0.131).

CONCLUSION

The Virtual Anti-Hypertensive Educational Campaign implementation in our study population seems to be effective to improve knowledge and attitude of participants, nevertheless, this program seems to be ineffective to improve the practice of hypertension management aspect in participants. Future study with longer durations and more comprehensive programs need to be done to scrutinize the clinical impact of this program nationwide.

Eating Concerns Associated with Nutritional Information Obtained from Social Media among Saudi Young Females: A Cross-Sectional Study

Eating disorders have been highly prevalent in young females for decades for many reasons. Social media platforms have an enormous impact on users, especially young adults, who use them every day. In Saudi Arabia, social media is popular, with an estimated 72% of users being active in 2020. Therefore, the primary aim of this study was to assess the relationship between using social media to search for nutritional information and eating concerns. A nationwide study was conducted on 1092 young Saudi females aged 18-30 years from five administrative regions in the Kingdom of Saudi Arabia. Data were collected using an online validated questionnaire, and symptoms of eating concerns were assessed using two brief instruments: SCOFF [Sick, Control, One Stone, Fat, Food] and Eating disorders Screen for Primary care [ESP]. The prevalence of eating concerns was 49.6% among Saudi females. Moderate eating concerns were more prevalent in the central region 24.8%, whereas high eating concerns were more prevalent in the southern region 27.6%. Personal accounts of dietitian/nutritionists (OR = 1.170; 95% CI 1.071-1.277; p ≤ 0.001), interaction with offered experiments about new meals/restaurants, and diets on social media that were mostly promoted by celebrities/influencers (OR = 1.554; 95% CI 1.402-1.723; p ≤ 0.000) were the most prominent risk factors associated with being more likely to suffer from eating concerns. The present study recommends opening clinics specializing in nutrition on social media platforms that target young females to provide nutritional counselling and encourage a healthy lifestyle. In addition, it is important to plan awareness campaigns intended to educate young females on how to deal with messages that circulate on social media without any evidence regarding their truthfulness.

The association between social media addiction and orthorexia nervosa, eating attitudes, and body image among adolescents

AIM

This study was planned to determine the relationship between social media addiction and orthorexia nervosa (ON), eating attitude and body image among adolescents.

METHOD

This cross-sectional study was conducted with 1232 high school-going adolescents. Data were collected using the Social Media Addiction Scale for Adolescents, Eating Attitude Test-26 (EAT-26), Body Image Scale (BIS) and ORTO-11 questionnaire.

RESULTS

Social media addiction levels were higher in girls than in boys (p < 0.05). Multiple linear regression analysis showed that a better body image was associated with lower social media addiction scores (β =  - 0.268, p < 0.001). Social media addiction was significantly associated with a greater risk of eating behavior disorders (OR: 1.07, 95% Cl: 1.04-1.10) and ON tendency (OR: 1.02, 95% Cl = 1.00-1.04). Adolescents who stated that they always or often read nutrition-related posts on social media had an increased likelihood of eating behavior disorder risk (OR: 6.77, 95% CI: 3.84-11.94) and ON tendency (OR: 5.49, 95% CI: 3.39-8.88).

CONCLUSION

This study demonstrated that social media addiction was associated with a higher eating behavior disorder risk, ON tendency and lower body image. Moreover, frequent reading of posts about nutrition on social media was positively associated with ON tendency and eating behavior risk. These results highlight that adolescents should be educated about social media use and its content to minimize the negative effects of constant exposure to unrealistic body images and nutrition-related misinformation and reduce the risk of eating disorders and ON among adolescents. Level of evidence Level V, cross-sectional descriptive study.

#Healthpromotion: A qualitative exploration of how dietitians can use social media to positively influence women aged 18-35 years

Aims

To understand how young adult women use social media, including which nutrition and health‐related content they prefer to view and why. Findings are intended to support dietitians to use social media more effectively for health promotion to reach, educate and positively influence young adult women.

Methods

Qualitative research was conducted through semi‐structured interviews involving 10 women aged 18–35 years via Zoom videoconferencing. The interviews were recorded, transcribed verbatim and analysed using an interpretative phenomenological approach.

Results

Young adult women use social media daily to view a wide variety of content, including nutrition and health‐related content. Three themes were identified: authenticity, engaging content, and affecting trust through selling products.

Conclusion

To effectively use social media for health promotion, dietitians need to share their authentic voice while maintaining professional standards. Recommendations for effective social media engagement include using engaging content, infographics, and videos with closed captions. More research is needed to assess whether health promotion deployed via social media is effective at increasing nutrition knowledge, improving health literacy, and producing behaviour change.

Benefits of gamification in medical education

Medical education is changing at a fast pace. Students attend medical school with a high degree of technological literacy and a desire for a diverse educational experience. As a result, a growing number of medical schools are incorporating technology-enhanced active learning and multimedia education tools into their curriculum. Gamified training platforms include educational games, mobile medical apps, and virtual patient scenarios. We provide a systematic review of what is meant by gamification in this era. Specific educational games, mobile apps, and virtual simulations that may be used for preclinical and clinical training have been discovered and classified. The available data were presented in terms of the recognized platforms for medical education's possible benefits. Virtual patient simulations have been shown to enhance learning results in general. Gamification could improve learning, engagement, and cooperation by allowing for real-world application. They may also help with promoting risk-free healthcare decision-making, remote learning, learning analytics, and quick feedback. We account for Preclinical training which included 5 electronic games and 4 mobile apps, while clinical training included 5 electronic games, 10 mobile applications, and 12 virtual patient simulation tools. There were additionally nine more gamified virtual environment training products that were not commercially accessible. Many of these studies have shown that utilizing gamified media in medical education may confer advantages. This collection of hyperlinked resources may be utilized by medical students, practitioners, and instructors at all levels.

The Impostor Phenomenon in the Nutrition and Dietetics Profession: An Online Cross-Sectional Survey

The impostor phenomenon (IP) (also known as impostor syndrome) describes high-achieving individuals who, despite their objective successes, fail to internalize their accomplishments and have persistent self-doubt and fear of being exposed as a fraud or impostor. This study aimed to assess the prevalence and predictors of IP within a sample of nutrition and dietetics students and practitioners. An online cross-sectional survey was conducted and utilized a non-random, convenience sampling approach. A total of 1015 students, dietetic interns, and currently practicing and retired registered dietitian nutritionists and nutrition and dietetic technicians registered provided complete responses. IP was assessed with the Clance Impostor Phenomenon Scale (CIPS). Self-reported job satisfaction and well-being were assessed using validated scales. Average CIPS score was 66.0 ± 16.3 (range 22−99), and higher scores indicate more frequent or severe IP experiences. Frequent or intense IP was reported by 64% of survey respondents (n = 655). Older age, greater educational attainment and professional level, and membership in Academy of Nutrition and Dietetics groups were associated with lower IP scores. Greater social media use was associated with higher IP scores. Job satisfaction and overall well-being were inversely correlated with IP (p < 0.001). Findings suggest that IP experiences were common among a majority of nutrition and dietetics students and practitioners surveyed. Additional research and development of preventative strategies and interventions is needed.

Use of Social Networks in the Context of the Dietitian's Practice in Brazil and Changes During the COVID-19 Pandemic: Exploratory Study

Background

Social networks have been pointed out as 1 of the greatest means of spreading information. A large part of the population is already present on these platforms, looking up subjects such as health, nutrition, and food. To reach this audience, it may be important for dietitians to explore social networks. However, there is a gap in scientific studies on exploring the ways in which these platforms are used by dietitians in Brazil, and the roles they play in the profession have not been well defined.

Objective

This study aims to describe the roles that social networks play in dietitians' practice in Brazil and their mode of use of social networks. This study also aims to identify professionals’ perceptions and opinions regarding the use of these tools, as well as changes in behavior on social network usage caused by the COVID-19 pandemic.

Methods

We carried out a quantitative cross-sectional study, collecting data through an online questionnaire, submitted between October 2020 and January 2021 to dietitians registered on the Federal Council of Dietitians. All participants included in the study answered questions about the use of social networks in their professional context.

Results

In total, 264 (91.7%) of the 288 participants reported using social networks for professional practice. Instagram was the social network most often used by professionals (224/264, 84.8%). Dietitians (N=288) related to the use of social networks (always to almost always) for sharing information about their services (n=114-72 [39.6%-25%], respectively), following the work of other dietitians (n=172-64 [59.7%-22.2%], respectively), and writing about topics related to food and nutrition (n=166-53 [57.6%-18.4%], respectively). The roles played by social networks in the professional context of dietitians were attracting more clients (210/289, 72.7%) and keeping in touch with them (195/289, 67.5%). Furthermore, 227 (78.5%) of the 289 dietitians strongly agreed that social networks are good tools to promote their services. During the COVID-19 pandemic, 216 (74.7%) of the 289 participants noticed changes in their behavior, feelings, or beliefs on the use of social networks related to professional practice, and 149 (51.6%) have increased the frequency of sharing information about nutrition and health in general on social networks.

Conclusions

The main roles of social networks in the professional context of dietitians are to attract clients and to facilitate the contact between professional and client. The modes of use reported by the professionals included sharing information about their services, following the work of professional colleagues, and writing about topics related to nutrition. Most of them reported believing that social networks are an effective way to disseminate their services. Moreover, most professionals claimed to have noticed changes in their behaviors or beliefs on social media during the COVID-19 pandemic.

Nutrition-Related Content on Instagram in the United States of America: Analytical Cross-Sectional Study

Background: The Internet is today the largest platform for food distribution, and there are concerns about the impact that digital marketing has in the field of nutrition by promoting non-evidence-based recommendations. The purpose of this study was to describe the user profile that draws on Instagram to follow nutrition-related content versus not, and to analyze the frequency and type of content of the information provided by nutritional influencers. Methods: A cross-sectional study involving randomly selected United States residents having an Instagram account was performed. Participants completed an anonymous online survey link. Results: From 898 respondents, 78.7% were women, and 75.6% were Millennials. Scientific evidence present in the posts was 14.3%. Influencers promoted a product or a brand in more than 90% of posts. Women followed more nutrition-related content than men (p < 0.001). Millennials, followed by Generation-Z, followed more nutrition-related content (p < 0.001). There were no significant relationships between the following status of nutrition-related content with BMI, type of job, household income, education degree, or smoking habits. Conclusions: Women and Millennials followed more nutrition-related content. Scientific evidence was scarce and commercial interest in the network was evident. The vast majority of the posts were not based on scientific evidence and instead promoted a product/supplement.

Perception of Healthcare Providers About the Use of Social Media to Manage a Healthy Diet in Saudi Arabia

Purpose: The objective of this study is to investigate the perceptions of healthcare providers about the use of social media for healthy diet management in Saudi Arabia.

Participants and Methods: A cross-sectional study was designed to investigate the use of social media healthy diet management. The sample constituted 308 healthcare professionals from Saudi Arabia. The social media application, WhatsApp is employed to distribute the questionnaire, which has achieved a response rate of 50.61%. Out of the total participants, 55% of the participants were under 30 years of age, 71% were females, and 55% of the participants had a bachelor's degree.

Results: Among the total respondents, 66% used social networking applications more than four hours a day, and 78% utilized social media to get information about a healthy diet. The respondents employed the following platforms for this purpose: Instagram (27%), YouTube (19%), Snapchat (19%), WhatsApp (18%), Twitter (8%), and Facebook (5%). The respondents considered that social media is very helpful to educate (44%), communicate with specialists (33%), and get applications for a healthy diet (38%). They held an opinion that social media is very helpful in improving knowledge about a healthy diet (47%), creating diet awareness (42%), and achieving healthy diet outcomes (37%) and lifestyle (37%).

Conclusion: According to the perception of health providers, social media can be used to promote healthy diet management in Saudi Arabia. Also, the growing use of social media in Saudi Arabia represents the potential to create programs that encourage and promote healthy eating habits in the Kingdom of Saudi Arabia. Instagram, YouTube, Snapchat, and WhatsApp platforms can be used for this purpose.

Social Media Use for Health Purposes: Systematic Review

Background

Social media has been widely used for health-related purposes, especially during the COVID-19 pandemic. Previous reviews have summarized social media uses for a specific health purpose such as health interventions, health campaigns, medical education, and disease outbreak surveillance. The most recent comprehensive review of social media uses for health purposes, however, was conducted in 2013. A systematic review that covers various health purposes is needed to reveal the new usages and research gaps that emerge in recent years.

Objective

This study aimed to provide a systematic review of social media uses for health purposes that have been identified in previous studies.

Methods

The researchers searched for peer-reviewed journal articles published between 2006 and 2020 in 12 databases covering medicine, public health, and social science. After coding the articles in terms of publication year, journal area, country, method, social media platform, and social media use for health purposes, the researchers provided a review of social media use for health purposes identified in these articles.

Results

This study summarized 10 social media uses for various health purposes by health institutions, health researchers and practitioners, and the public.

Conclusions

Social media can be used for various health purposes. Several new usages have emerged since 2013 including advancing health research and practice, social mobilization, and facilitating offline health-related services and events. Research gaps exist regarding advancing strategic use of social media based on audience segmentation, evaluating the impact of social media in health interventions, understanding the impact of health identity development, and addressing privacy concerns.

Privacy versus Convenience: A Historical Perspective, Analysis of Risks, and an Informatics Call to Action

BACKGROUND

The pace of technological change dwarfs the pace of social and policy change. This mismatch allows for individual harm from lack of recognition of changes in societal context. The value of privacy has not kept pace with changes in technology over time; individuals seem to discount how loss of privacy can lead to directed personal harm.

OBJECTIVE

The authors examined individuals sharing personal data with mobile health applications (mHealth apps) and compared the current digital context to the historical context of harm. The authors make recommendations to informatics professionals to support consumers who wish to use mHealth apps in a manner that balances convenience with personal privacy to reduce the risk of harm.

METHODS

A literature search focused by a historical perspective of risk of harm was performed throughout the development of this paper. Two case studies highlight questions a consumer might ask to assess the risk of harm posed by mobile health applications.

RESULTS

A historical review provides the context for the collective human experience of harm. We then encapsulate current perceptions and views of privacy and list potential risks created by insufficient attention to privacy management.

DISCUSSION

The results provide a historical context for individuals to view the risk of harm and shed light on potential emotional, reputational, economic, and physical harms that can result from naïve use of mHealth apps. We formulate implications for clinical informaticists.

CONCLUSION

Concepts of both harm and privacy have changed substantially over the past 20 years. Technology provides methods to invade privacy and cause harm unimaginable a few decades ago. Only recently have the consequences become clearer. The current regulatory framework is extremely limited. Given the risks of harm and limited awareness, we call upon informatics professionals to support more privacy education and protections and increase mHealth transparency about data usage.

The P.O.S.T Guidelines for Nutrition Blogs: A Modified e-Delphi Study

BACKGROUND

Blogs are being used increasingly to disseminate nutrition information to consumers, including by registered dietitians (RDs). Guidelines in authoring blogs are important for dietetics professionals so that they effectively communicate evidence-based nutrition information in this format.

OBJECTIVE

The aim of this study was to obtain consensus from experts comprising RDs with active blog-writing experience on a set of guidelines for use by RDs when authoring a healthy eating or nutrition information blog.

DESIGN

A modified e-Delphi technique with a consensus-based approach was used in this study undertaken between June and October 2019. The purpose-built, pilot-tested e-Delphi survey was informed by a literature review and included statements from 3 domains comprising blog readers and communication; purpose and healthy eating messages; and structure, voice, and tone. Expert participants were identified purposively and via snowballing. In each survey round, statements that achieved 80% consensus were accepted.

PARTICIPANTS/SETTING

A total of 19 experts consented to participate. Experts resided in the United States, Australia, and United Kingdom. Experts were mainly women aged between 30 and 49 years and working in private practice and/or research or teaching areas of nutrition and dietetics.

RESULTS

Across 3 domains, a total of 33 statements were accepted, comprising a final set of guidelines named the P.O.S.T (purpose, community, structure, and tone) Guidelines for Nutrition Blogs.

CONCLUSIONS

Consensus from a panel of dietetics experts resulted in the P.O.S.T Guidelines for Nutrition Blogs, which can support RDs in authoring healthy eating blogs. This will ensure that evidence-based nutrition messages provided to consumers are engaging and effective.

#Healthy: smart digital food safety and nutrition communication strategies-a critical commentary

This paper explores how food safety and nutrition organisations can harness the power of search engines, games, apps, social media, and digital analytics tools to craft broad-reaching and engaging digital communications. We start with search engines, showing how organisations can identify popular food safety and nutrition queries, facilitating the creation of timely and in-demand content. To ensure this content is discoverable by search engines, we cover several non-technical aspects of search engine optimisation (SEO). We next explore the potential of games, apps, social media, and going viral for reaching and engaging the public, and how digital data-based tools can be used to optimise communications. Throughout, we draw on examples not only from Europe and North America, but also China. While we are enthusiastic about the benefits of digital communications, we recognise that they are not without their drawbacks and challenges. To help organisations evaluate whether a given digital approach is appropriate for their objectives, we end each section with a discussion of limitations. We conclude with a discussion of General Data Protection Regulation (GDPR) and the practical, philosophical, and policy challenges associated with communicating food safety and nutrition information digitally.

Are you ready for the challenge? Social Media Health Challenges for Behaviour Change

Challenges are one of the most common strategies used by Opinion Leaders on Social Media to engage users. They are often found in different areas; in the Health field, the use of challenges is growing, namely through initiatives aiming at eating behaviour change. Instagram is considered to be one of the most used Social Media applications to develop these initiatives, allowing Opinion Leaders to communicate and engage with their online followers. Despite this scenario, little is known regarding how Health Challenges are being used and what is their impact on behaviour change. Previous research has already shown how Opinion Leaders use Instagram to promote eating behaviour change. The purpose of this paper is to conceptualize, describe and discuss Social Media Health Challenges, aiming to analyse Instagram challenges on healthy eating. The study was organized in two phases: the first one is a literature review based on Prisma method that supported the conceptualisation of Social Media Challenges and the design for the second phase where Social Media Health Challenges of Opinion Leaders, such as Nutritionists, Health Lifestylers and Patient Opinion Leaders (POLS) were analysed. Results showed that most of the challenges are promoted by Patient Opinion Leaders and Health Lifestylers. Followers adhere to Social Media Health Challenges related to weight loss, engaging with Opinion Leaders. The psychological-cognitive components (such as habits, motivation, and self-control) were found in the analysed challenges, and Instagram is one of the used tools to promote these Initiatives. These results point to new paths regarding future research on other behaviour change online initiatives.

Nutrimedia: A novel web-based resource for the general public that evaluates the veracity of nutrition claims using the GRADE approach

The objective of Nutrimedia is to evaluate, based on the scientific evidence, the veracity of nutrition claims disseminated to the public by the media. In this article, we describe the methodology, characteristics and contents of this web-based resource, as well as its web traffic and media impact since it was launched. Nutrimedia uses a systematic process to evaluate common beliefs, claims from newspapers and advertising identified and selected by its research team, as well as questions from the public. After formulating a structured question for each claim, we conduct a pragmatic search, prioritizing guidelines and/or systematic reviews. We evaluate the certainty of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, and classify the veracity of each claim into seven categories (true, probably true, possibly true, possibly false, probably false, false, and uncertain). For each evaluation, we develop a scientific report, a plain language summary, a summary of findings table, and, in some cases, a video. From November 2017 to May 2019, we published 30 evaluations (21 were related to foods, six to diets, and three to supplements), most of which were triggered by questions from the public (40%; 12/30). Overall, nearly half of the claims were classified as uncertain (47%; 14/30). Nutrimedia received 47,265 visitors, with a total of 181,360 pages viewed. The project and its results were reported in 84 written media and 386 websites from Spain and 14 other countries, mostly from Latin America. To our knowledge, Nutrimedia is the first web-based resource for the public that evaluates the certainty of evidence and the veracity of nutrition claims using the GRADE approach. The scientific rigor combined with the use of friendly presentation formats are distinctive features of this resource, developed to help the public to make informed choices about nutrition.

The experts' perspective of "ask-an-expert": An interview-based study of online nutrition and vaccination outreach

Social media allow experts to form communities and engage in direct dialogue with publics, which can promote mutual understanding between sciences and publics. However, little is known about experts' participation in online communities, or effective ways to prepare them for public engagement. Here, we explored these issues with experts who voluntarily engage with publics on social media, to understand their public engagement practices. Stimulated recall interviews were conducted with 20 experts who participate in question-and-answer Facebook groups dedicated to vaccines and nutrition. The findings suggest that experts employ diverse considerations in their outreach, partly to establish epistemic trustworthiness. These can be grouped into three goals and two constraints: countering misinformation, establishing benevolence, and establishing competence while maintaining integrity and clarity. Empathic failure and burnout both emerged as factors that impair establishing benevolence. We discuss implications for community-level science literacy and for preparing scientists for "bounded engagement with publics."

Klassen K, Cowan S, Gibson S. Using the Internet: Nutrition Information-Seeking Behaviours of Lay People Enrolled in a Massive Online Nutrition Course

People's accessibility to nutrition information is now near universal due to internet access, and the information available varies in its scientific integrity and provider expertise. Understanding the information-seeking behaviours of the public is paramount for providing sound nutrition advice. This research aims to identify who learners in a nutrition-focused Massive Open Online Course (MOOC) turn to for nutrition information, and how they discuss the information they find. A multi-methods approach explored the information-seeking and sharing behaviours of MOOC learners. Summative content analysis, and an exploratory, inductive, qualitative approach analysed learners' posts in MOOC discussion forums. From 476 posts, the majority (58.6%) of nutrition information sources learners reported were from websites. Providers of nutrition information were most commonly (34%) tertiary educated individuals lacking identifiable nutrition qualifications; 19% had no identifiable author information, and only 5% were from nutrition professionals. Qualitative themes identified that learners used nutrition information to learn, teach and share nutrition information. Consistent with connectivist learning theory, learners contributed their own sources of nutrition information to discussions, using their own knowledge networks to teach and share information. Nutrition professionals need to understand the principles of connectivist learning behaviours in order to effectively engage the public.

Long-term effects of a healthy eating blog in mothers and children

In the context of low consumption of vegetables and fruits and milk and alternatives among Canadian mothers and children, novel strategies are needed to improve maternal and child nutrition. This study evaluated the long‐term effects of an evidence‐informed healthy eating blog on dietary intakes and food‐related behaviours of mothers and their child. The study presents a secondary outcome analysis of a randomised controlled trial in which 84 mothers (mean age of 37.6 ± 6.7 years) of 2‐ to 12‐year‐old children living in Quebec City, Canada, were randomly assigned to a dietary intervention delivered through a healthy eating blog written by a registered dietitian (RD; n = 42) or a control group (n = 42) during a period of 6 months. Dietary intakes, maternal eating behaviours, food parenting practices, and body weight were measured at baseline, 3 months, at the end of the intervention (6 months), and 6‐month post‐intervention (12 months). Differences between groups were assessed with mixed linear models. Globally, this study found no evidence of long‐term differences in mean dietary intakes in mothers exposed to the blog and their children as well as other food‐related outcomes and body weight compared with the control condition. Potential predictors of adherence to dietary recommendations in mothers and children (e.g., involvement of children in household food activities) were identified. In conclusion, a healthy eating blog written by an RD did not result in evidence of any long‐term differences in dietary intakes and food‐related behaviours in mothers and their children compared with the control condition.

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.

Social Media as a Nutrition Resource for Athletes: A Cross-Sectional Survey

Social media contains a wealth of nutrition information and proposes a cost-effective, highly engaging platform to deliver nutrition information to athletes. This study used an online questionnaire to determine whether New Zealand athletes are using social media as a source of nutrition information and to understand perceptions of social media as a nutrition resource. Quantitative data were analyzed using t tests, chi-squared tests, and logistic regression analysis. Inductive thematic analysis was adopted for the qualitative data. From the 306 athletes who completed the questionnaire, 65% reported social media use for nutrition purposes in the past 12 months. Social media use was predicted by both athlete status and gender. Female athletes were more likely to have used social media for nutrition purposes (odds ratio = 2.7, 95% confidence interval [1.52, 4.62], p = .001) than males. Elite athletes were less likely to have used social media for nutrition (odds ratio = 0.44, 95% confidence interval [0.24, 0.83], p = .011) than recreational athletes. Athletes commonly used social media for practical nutrition purposes, including recipes and information about restaurants/cafes. Perceived advantages of social media as a nutrition resource included ease of access, well-presented information, personal connectedness, and information richness. Athletes' primary concern for obtaining nutrition information from social media was information unreliability.

Social media in dietetics: Insights into use and user networks

AIM

Social media has transformed the interaction between healthcare professionals and consumers, yet research of its use in dietetics is limited. The aim of this study was to investigate the influence of dietetic user networks on use of social media and test the applicability of a social media metrics tool to determine influential users.

METHODS

An online survey about social media use and practices based on the scientific literature was developed and implemented online with dietitians. Feasibility of a social media metrics analysis was conducted via Twitter using the NodeXL metrics tool to determine influential dietetic networks based on four measures of network centrality (betweenness, eigenvector, closeness and degree).

RESULTS

The survey (n = 340) revealed social networking sites were the most widely used (by user) (n = 282) and micro-blogging was the most regularly used (by frequency of use). Among respondents who used social media in a professional capacity (n = 130), the greatest benefit was communicating internationally and remotely while the delivery of health care was of least benefit. The majority of respondents (87.3%) indicated their primary efforts were to maintain e-professionalism. Time restraints (18.6%) and not knowing where to start (18.6%) were common barriers to use. Highly influential connections between users were observed from network visualisations of dietitians in Australia and the United States.

CONCLUSIONS

Professional use of social media among dietitians needs to be monitored over time for shifts of influential networks. Influential users from key networks can be identified from metrics analyses and should be engaged via professional bodies to upskill new users.

What images and content do professional dietitians share via Instagram?

Purpose

In the age of information, where people can have an easy access to knowledge, the ethical and content-based examination of dietitians’ sharing in the social media is an important step in determining what to share in the social media in the future. The purpose of this study was to analyse the content of Instagram shares of dietitians, a profession group that is becoming more and more widespread in Turkey.

Design/methodology/approach

Publicly available dietitian Instagram profiles, aiming specifically at those with =500 followers, were included in the study. The hashtag was chosen as #onlinediyet (Turkish for online diet). A total of 1,986 images were identified for analysis. When these images were identified, 883 images were excluded. Thus, overall 1,103 Instagram images were chosen to analyse during a week’s period. Each Instagram image was classified into one of seven categories by authors as food, individual, nutrition information, motivational, miscellaneous, physical activity and recipe. Food and individual groups were also coded into subgroups.

Findings

A descriptive analysis of the 1,103 online-diet-related images shared by dietitians showed that 53.5 per cent of the images were in food category. There were no differences between female and male dietitians in terms of categories of shared images (p > 0.05). Dietitians also shared individual images (34.5 per cent) including weight loss follow-up (56.2 per cent), self-portrait (22.0 per cent) and conversation with clients (14.0 per cent) images on Instagram.

Originality/value

The results of this study set a baseline for future studies. Given the rapid growth of this platform in recent years, not only the field of dietetics but also other health-care fields would benefit from clear guidelines about what information can or cannot be shared on social media.

Social Media and Obesity in Adults: a Review of Recent Research and Future Directions

PURPOSE OF REVIEW

Social media is widely used and has potential to connect adults with obesity with information and social support for weight loss and to deliver lifestyle interventions. The purpose of this review is to summarize recent observational and intervention research on social media and obesity.

RECENT FINDINGS

Online patient communities for weight loss abound but may include misinformation. Systematic reviews and meta-analyses suggest that social media-delivered lifestyle interventions modestly impact weight, yet how social media was used and participant engagement varies widely. The rapidly changing social media landscape poses challenges for patients, clinicians, and researchers. Research is needed on how patients can establish supportive communities for weight loss and the role of clinicians in these communities. Emerging research on meaningful engagement in, and the efficacy and cost-effectiveness of, social media-delivered lifestyle interventions should provide insights into how to leverage social media to address the obesity epidemic.

Users, Uses, and Effects of Social Media in Dietetic Practice: Scoping Review of the Quantitative and Qualitative Evidence

BACKGROUND

Social media platforms are increasingly used by registered dietitians (RDs) to improve knowledge translation and exchange in nutrition. However, a thorough understanding of social media in dietetic practice is lacking.

OBJECTIVE

The objective of this study was to map and summarize the evidence about the users, uses, and effects of social media in dietetic practice to identify gaps in the literature and inform future research by using a scoping review methodology.

METHODS

Stages for conducting the scoping review included the following: (1) identifying the research question; (2) identifying relevant studies through a comprehensive multidatabase and gray literature search strategy; (3) selecting eligible studies; (4) charting the data; and (5) collating, summarizing, and reporting results for dissemination. Finally, knowledge users (RDs working for dietetic professional associations and public health organizations) were involved in each review stage to generate practical findings.

RESULTS

Of the 47 included studies, 34 were intervention studies, 4 were descriptive studies, 2 were content analysis studies, and 7 were expert opinion papers in dietetic practice. Discussion forums were the most frequent social media platform evaluated (n=19), followed by blogs (n=13) and social networking sites (n=10). Most studies targeted overweight and obese or healthy users, with adult populations being most studied. Social media platforms were used to deliver content as part of larger multiple component interventions for weight management. Among intervention studies using a control group with no exposition to social media, we identified positive, neutral, and mixed effects of social media for outcomes related to users' health behaviors and status (eg, dietary intakes and body weight), participation rates, and professional knowledge. Factors associated with the characteristics of the specific social media, such as ease of use, a design for quick access to desired information, and concurrent reminders of use, were perceived as the main facilitators to the use of social media in dietetic practice, followed to a lesser extent by interactions with an RD and social support from fellow users. Barriers to social media use were mostly related to complicated access to the site and time issues.

CONCLUSIONS

Research on social media in dietetic practice is at its infancy, but it is growing fast. So far, this field of research has targeted few social media platforms, most of which were assessed in multiple-component interventions for weight management among overweight or obese adults. Trials isolating the effects and mechanisms of action of specific social media platforms are needed to draw conclusions regarding the effectiveness of those tools to support dietetic practice. Future studies should address barriers and facilitators related to the use of social media written by RDs and should explore how to make these tools useful for RDs to reach health consumers to improve health through diet.

Women's Perceptions of Usefulness and Ease of Use of Four Healthy Eating Blog Characteristics: A Qualitative Study of 33 French-Canadian Women

BACKGROUND

Healthy eating blogs are knowledge translation tools used by nutrition and dietetics practitioners for helping people improve their health behaviors and food choices.

OBJECTIVE

Our aim was to explore women's perceptions of the usefulness and ease of use of healthy eating blog (HEB) characteristics that might increase potential users' intention to use them as tools to improve their dietary habits.

DESIGN

We conducted qualitative research using semi-structured individual interviews.

PARTICIPANTS

Thirty-three women (mean age of 44 years; range=27 to 61 years) living in the Quebec City, Canada, metropolitan area were studied.

INTERVENTION

Four existing HEBs, written by French-Canadian registered dietitians (RDs) whose main objective was the promotion of a healthy diet, were explored by women during individual interviews. A standardized open-ended interview questionnaire based on the Technology Acceptance Model was used to identify women's perceptions about characteristics of type of blog content delivery, RD blogger's delivery of information, blog layout, and blog design.

MAIN OUTCOME MEASURES

Women's perceptions toward the contribution of HEB characteristics to the usefulness and ease of use of those tools to improve their dietary habits were measured.

ANALYSES PERFORMED

Interviews were audiorecorded, transcribed verbatim, coded, and analyzed through an inductive content analysis using NVivo software.

RESULTS

The most useful characteristics of type of blog content delivery identified by women were recipes, hyperlinks, and references. Among characteristics of RD blogger's delivery of information, most women reported that interaction between blog readers and the RD blogger created a sense of proximity and of connection that was helpful for improving their dietary behaviors. Women's perceptions toward various characteristics of blog layout and design were also discussed.

CONCLUSIONS

Incorporating specific characteristics when designing HEBs should be considered by RDs and future research to promote the use of those tools to support dietary behavior change efforts of internet users.