The Seasonal Periodicity of Healthy Contemplations About Exercise and Weight Loss: Ecological Correlational Study

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.

A New Body Weight Lifelog Outliers Generation Method: Reflecting Characteristics of Body Weight Data

Lifelogs are generated in our daily lives and contain useful information for health monitoring. Nowadays, one can easily obtain various lifelogs from a wearable device such as a smartwatch. These lifelogs could include noise and outliers. In general, the amount of noise and outliers is significantly smaller than that of normal data, resulting in class imbalance. To achieve good analytic accuracy, the noise and outliers should be filtered. Lifelogs have specific characteristics: low volatility and periodicity. It is very important to continuously analyze and manage them within a specific time. To solve the class imbalance problem of outliers in weight lifelog data, we propose a new outlier generation method that reflects the characteristics of body weight. This study compared the proposed method with the SMOTE-based data augmentation and the GAN-based data augmentation methods. Our results confirm that our proposed method for outlier detection was better than the SVM, XGBOOST, and CATBOOST algorithms. Through them, we can reduce the data imbalance level, improve data quality, and improve analytics accuracy.

Anosmia-related internet search and the course of the first wave of the COVID-19 pandemic in the United States

Background

The current pandemic of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was first reported in Wuhan, China. Although the first case in the United States was reported on Jan 20, 2020 in Washington, the early pandemic time course is uncertain. One approach with the potential to provide more insight into this time course is the examination of search activity. This study analyzed US search data prior to the first press release of anosmia as an early symptom (March 20, 2020).

Methods

Daily internet search query data was obtained from Google Trends (September 20th to March 20th for 2015 to 2020) both for the United States and on a state-by-state basis. Normalized anosmia-related search activity for the years prior to the pandemic was averaged to obtain a baseline level. Cross-correlations were performed to determine the time-lag between changes in search activity and SARS-CoV-2 cases/deaths.

Results

Only New York showed both significant increases in anosmia-related terms during the pandemic year as well as a significant lag (6 days) between increases in search activity and the number of cases/deaths attributed to SARS-CoV-2.

Conclusions

There is no evidence from search activity to suggest earlier spread of SARS-CoV-2 than has been previously reported. The increase in anosmia-related searches preceded increases in SARS-CoV-2 cases/deaths by 6 days, but this was only significant over the background noise of searches for other reasons in the setting of a very large outbreak (New York in the spring of 2020).

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Recent work has suggested using digital epidemiology to follow pandemics.

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In our view, these previous studies have several methodological errors.

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They used correlations long after anosmia symptoms were well documented in the media.

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We demonstrated significant issues with digital surveillance during such a high interest event.

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A large signal is required to overcome noise introduced by searches for other reasons.

Seasonal variation in lifestyle behavior in Poland: Google searches and market sales analysis

BACKGROUND

Detection of the seasonal patterns of healthy and unhealthy behavior could be helpful for designing individual and population health interventions programs. This study investigates the seasonal variation in sales of common types of products in Poland and Polish Google queries related to healthy behavior.

METHODS

Data of index sales from a large Polish retail store franchise, from January 2014 to August 2019, has been analyzed. The commercial data included twelve types of products. The interest of Google users was investigated using Google Trends statistics for the same period for six lifestyle-related topics. The seasonality was checked using time series analysis.

RESULTS

Six of the consumer goods (dairy, ready-made meals, salty snacks, meats, beer, and cigarettes) were most commonly purchased in summer months, four (processed fish, food fats, wine, and alcohol 30%+) in December, and two (bread and sweets) in October. The lowest sales indexes were observed mostly in February. The interest in four topics that have been analyzed ("Diet," "Dietitian," "Weight loss," and "Gym"), was highest in January, while interest in "Dietary supplements" was high in February, and "Running" in May. The search volume of the Google topics were the lowest in December.

CONCLUSION

The purchase of food, drinks, and cigarettes, and the interest in information regarding different components of a healthy lifestyle has seasonal variation. New Year and Lent might be good periods to encourage healthy behavior. The motivation may decrease in summer and during Christmas.

Analysis of primary care prescription trends in England during the COVID-19 pandemic compared against a predictive model

Objectives

The COVID-19 pandemic has had an unprecedented impact across primary care. Primary care services have seen an upheaval, and more and more patients are engaging in telephone consultations in order to maintain social distancing. In the present study, we seek to quantify the effect of the pandemic on primary care prescribing.

Design

We conducted a retrospective analysis of the English Prescribing Dataset from January 2014 to November 2020, totalling 7 542 293 921 prescriptions. Data were separated into prepandemic and pandemic sets. A Holt-Winters predictive model was used to forecast individual drug prescribing based on historic trends. Observed data were compared with the forecast quantitatively and qualitatively.

Setting

All prescriptions signed in England and dispensed during the years 2014–2020.

Participants

All residents of England who received a prescription from primary care facilities during 2014–2020.

Results

Prescribing of numerous health-critical medications was above predicted in March 2020, including salbutamol (53.0% (99% CI (41.2% to 66.9%))), insulin aspart (26.9% (99% CI (18.5% to 36.6%))) and tacrolimus (18.6% (99% CI (8.3% to 31.1%))). Medications for end-of-life symptom control increased in April, including levomepromazine hydrochloride (94.7% (99% CI (54.6% to 163.0%))). Medications requiring face-to-face visits decreased, including the local anaesthetic bupivacaine hydrochloride (86.6% (99% CI (89.3% to 82.0%))). There was no observed change in medications relating to type 2 diabetes, hypertension or mental health conditions.

Conclusions

Significantly increased prescribing of several medications was observed, especially among those critical for health. A dramatic spike in end-of-life prescribing highlights the adversity faced by community practitioners during 2020. Medications involving face-to-face consultations declined, as did contraceptives, travel-related vaccines and drugs used in dementia and Parkinson’s disease. Drugs relating to type 2 diabetes, hypertension and mental health were unchanged.

Global Dieting Trends and Seasonality: Social Big-Data Analysis May Be a Useful Tool

We explored online search interest in dieting and weight loss using big-data analysis with a view to its potential utility in global obesity prevention efforts. We applied big-data analysis to the global dieting trends collected from Google and Naver search engines from January 2004 to January 2018 using the search term “diet,” in selected six Northern and Southern Hemisphere countries; five Arab and Muslim countries grouped as conservative, semi-conservative, and liberal; and South Korea. Using cosinor analysis to evaluate the periodic flow of time series data, there was seasonality for global search interest in dieting and weight loss (amplitude = 6.94, CI = 5.33~8.56, p < 0.000) with highest in January and the lowest in December for both Northern and Southern Hemisphere countries. Seasonal dieting trend in the Arab and Muslim countries was present, but less remarkable (monthly seasonal seasonality, amplitude = 4.07, CI = 2.20~5.95, p < 0.000). For South Korea, seasonality was noted on Naver (amplitude = 11.84, CI = 7.62~16.05, p < 0.000). Our findings suggest that big-data analysis of social media can be an adjunct in tackling important public health issues like dieting, weight loss, obesity, and food fads, including the optimal timing of interventions.

Google Trends on Obesity, Smoking and Alcoholism: Global and Country-Specific Interest

Unhealthy habits or lifestyles, such as obesity, smoking, and alcohol consumption, are involved in the development of non-communicable diseases. The aim of this study was to analyze different communities' interest in seeking obesity, smoking, and alcohol-related terms through relative search volumes (RSVs) of Google Trends (GT). Internet search query data on obesity, smoking, and alcohol-related terms were obtained from GT from the period between 2010 and 2020. Comparisons and correlations between different topics were calculated considering both global searches and English-, Spanish-, and Italian-speaking areas. Globally, the RSVs for obesity and alcohol-related terms were similar (mean RSVs: 76% and 77%), but they were lower for smoking (65%). High RSVs were found in winter for obesity and smoking-related terms. Worldwide, a negative correlation was found between alcohol and smoking terms (r = -0.72, p < 0.01). In Italy, the correlation was positive (r = 0.58). The correlation between obesity and alcohol was positive in all the cases considered. The interest of global citizens in obesity, smoking, and alcohol was high. The RSVs for obesity were globally higher and correlated with alcohol. Alcohol and smoking terms were related depending on the area considered.

Cardiovascular-related health behaviors and lifestyle during the COVID-19 pandemic: An infodemiology study

Background

Reports have suggested decreasing attention to CVD comorbidities during the COVID-19 pandemic, despite their association with worse virus-related outcomes. Using nowcasting tools, we sought to explore temporal trends in public interest by studying use of online search terms related to CVD comorbidities during the pandemic time period.

Methods

We queried Google Trends for recent (October 2019–October 2020) and seasonal (October 2016–October 2020) trends of search terms pertaining to cardiovascular-related behaviors or clinical care including clinical diagnostic and therapeutic-related terms. Additionally, we acquired data from Google Shopping Insights to explore consumer behavior. Data for search results in the US were compared using mean relative search volumes (RSV), tabulated by month.

Results

Online search interest in the terms “Exercise” and “Cigarettes” changed by +18.0% and −52.5%, respectively, comparing March–April with January–February 2020. Key terms related to CVD-related care, including diagnostic and therapeutic-related terms such as “Statin”, “Lipid profile”, “Low-density lipoprotein”, and “Hemoglobin A1C” declined to a four-year low in late March 2020 but regained pre-pandemic search query frequency by July 2020. Results were supported by Google Shopping analysis; for example, online consumer shopping-related searches for tobacco products reached at an all-year low after May 2020.

Conclusion

We report an increase in search interest for an overall healthier CVD-related lifestyle starting in March 2020, supported by online consumer shopping behavior. However, a months-long trough in public interest for CVD care-related search terms from March–May 2020 suggests a transient but substantial decrease in public focus on cardiovascular-related healthcare engagement. Future research is needed to understand if these mixed signals will persist into 2021 and how they potentially translate into real-world CVD-related event rates.

Population's health information-seeking behaviors and geographic variations of stroke in Malaysia: an ecological correlation and time series study

Stroke has emerged as a major public health concern in Malaysia. We aimed to determine the trends and temporal associations of real-time health information-seeking behaviors (HISB) and stroke incidences in Malaysia. We conducted a countrywide ecological correlation and time series study using novel internet multi-timeline data stream of 6,282 hit searches and conventional surveillance data of 14,396 stroke cases. We searched popular search terms related to stroke in Google Trends between January 2004 and March 2019. We explored trends by comparing average relative search volumes (RSVs) by month and weather through linear regression bootstrapping methods. Geographical variations between regions and states were determined through spatial analytics. Ecological correlation analysis between RSVs and stroke incidences was determined via Pearson's correlations. Forecasted model was yielded through exponential smoothing. HISB showed both cyclical and seasonal patterns. Average RSV was significantly higher during Northeast Monsoon when compared to Southwest Monsoon (P < 0.001). "Red alerts" were found in specific regions and states. Significant correlations existed within stroke related queries and actual stroke cases. Forecasted model showed that as HISB continue to rise, stroke incidence may decrease or reach a plateau. The results have provided valuable insights for immediate public health policy interventions.

Social-Ecological Correlates of Regular Leisure-Time Physical Activity Practice among Adults

This study calculated the exposure-response rates of social-ecological correlates of practicing regular (>150 min/week) leisure-time physical activity (PA) in 393,648 adults from the 27 Brazilian state capitals who participated in a national survey between 2006 and 2016. Regular PA encouraging factors were inputted into an exposure-response model. Growth rates for the odds ratio and prevalence of regular PA were calculated for each increase of one encouraging factor. Regular PA was reported by 22% of the participants (25% of men and 20% of women). More than 40% of men and 30% of women with higher intra-personal encouraging conditions reported practicing regular PA. There was a 3% (ages 18–32 years) to 5% (ages 46–60 years) increase in regular PA practice in men for each increase in an encouraging climate factor (temperature from 21 °C to 31 °C, humidity from 65% to 85%, 2430 to 3250 h of sun/year, and from 1560 to 1910 mm of rain/year). Encouraging intra-personal factors and favorable climate conditions had larger effects on regular PA practice than the built environment and socio-political conditions; the latter two had independent effects, but did not have a cumulative effect on PA.

Seasonal variation and trends in the Internet searches for losing weight: An infodemiological study

OBJECTIVES

This study sought to examine the variation trends and seasonality of losing weight by using the data from Google Trends tool.

METHODS

According to the search term of [lose weight+weight loss], Google Trends data were obtained. Search activity was conducted within the USA, the UK, Canada, Ireland, Australia, and New Zealand from January 01, 2004, to December 31, 2018, utilizing the health category.

RESULTS

Dynamic series analysis and the plot of seasonal decomposition of time series show that relative search volume of [lose weight+weight loss] increased from 2004 to 2018 at both national and hemispherical levels. Statistically significant seasonal variations in relative search volume for the term [lose weight+weight loss] were observed using cosinor analyses in the USA (p<0.001), the UK (p<0.001), Canada (p<0.001), Ireland (p<0.001), Australia (p<0.001), and New Zealand (p<0.001), peaking in the spring months and reaching the lowest level in the autumn months. The highest level in spring and the lowest level in autumn were reversed by 6 months in both hemisphere countries, consistent with a seasonal pattern.

CONCLUSION

Our results indicate that Internet search queries for losing weight increased within the timeframe of 2004 to 2018, likely reflecting the rising global public interest. In addition, the present research provided preliminary evidence that there is a seasonality of losing weight with a peak in the spring months.

Infodemiology and Infoveillance: Scoping Review

BACKGROUND

Web-based sources are increasingly employed in the analysis, detection, and forecasting of diseases and epidemics, and in predicting human behavior toward several health topics. This use of the internet has come to be known as infodemiology, a concept introduced by Gunther Eysenbach. Infodemiology and infoveillance studies use web-based data and have become an integral part of health informatics research over the past decade.

OBJECTIVE

The aim of this paper is to provide a scoping review of the state-of-the-art in infodemiology along with the background and history of the concept, to identify sources and health categories and topics, to elaborate on the validity of the employed methods, and to discuss the gaps identified in current research.

METHODS

The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to extract the publications that fall under the umbrella of infodemiology and infoveillance from the JMIR, PubMed, and Scopus databases. A total of 338 documents were extracted for assessment.

RESULTS

Of the 338 studies, the vast majority (n=282, 83.4%) were published with JMIR Publications. The Journal of Medical Internet Research features almost half of the publications (n=168, 49.7%), and JMIR Public Health and Surveillance has more than one-fifth of the examined studies (n=74, 21.9%). The interest in the subject has been increasing every year, with 2018 featuring more than one-fourth of the total publications (n=89, 26.3%), and the publications in 2017 and 2018 combined accounted for more than half (n=171, 50.6%) of the total number of publications in the last decade. The most popular source was Twitter with 45.0% (n=152), followed by Google with 24.6% (n=83), websites and platforms with 13.9% (n=47), blogs and forums with 10.1% (n=34), Facebook with 8.9% (n=30), and other search engines with 5.6% (n=19). As for the subjects examined, conditions and diseases with 17.2% (n=58) and epidemics and outbreaks with 15.7% (n=53) were the most popular categories identified in this review, followed by health care (n=39, 11.5%), drugs (n=40, 10.4%), and smoking and alcohol (n=29, 8.6%).

CONCLUSIONS

The field of infodemiology is becoming increasingly popular, employing innovative methods and approaches for health assessment. The use of web-based sources, which provide us with information that would not be accessible otherwise and tackles the issues arising from the time-consuming traditional methods, shows that infodemiology plays an important role in health informatics research.

Weekly, Seasonal, and Geographic Patterns in Health Contemplations About Sundown Syndrome: An Ecological Correlational Study

Background

Sundown syndrome (ie, agitation later in the day) is common in older adults with dementia. The underlying etiology for these behaviors is unclear. Possibilities include increased caregiver fatigue at the end of the day and disruption of circadian rhythms by both age and neurodegenerative illness.

Objective

This study sought to examine circumseptan (weekly) patterns in search volumes related to sundown syndrome, in order to determine if such searches peaked at the end of the weekend, a time when caregiver supports are least available. We also sought to examine both seasonal differences and associations of state-by-state search activity with both state latitude and yearly sun exposure.

Methods

Daily Internet search query data was obtained from Google Trends (2005-2017 inclusive). Circumseptan patterns were determined by wavelet analysis, and seasonality was determined by the difference in search volumes between winter (December, January, and February) and summer (June, July, and August) months. Geographic associations between percent sunny days and latitude were done on a state-by-state basis.

Results

“Sundowning” searches showed a significant increase at the end of the weekend with activity being 10.9% (SD 4.0) higher on Sunday as compared to the rest of the week. Search activity showed a seasonal pattern with search activity significantly highest in the winter months (36.6 [SD 0.6] vs 13.7 [SD 0.2], P<.001). State-by-state variations in “sundowning” searches showed a significant negative association with increasing mean daily sunlight (R²=.16, β=-.429 [SD .149], P=.006) and showed a positive association with increasing latitude (R²=.38, β=.648 [SD .122], P<.001).

Conclusions

Interest in “sundowning” is highest after a weekend, which is a time when external caregiver support is reduced. Searches related to sundown syndrome also were highest in winter, in states with less sun, and in states at more northerly latitudes, supporting disrupted circadian rhythms as another contributing factor to these behaviors.

Sociodemographic, Attitudinal, and Behavioral Correlates of Using Nutrition, Weight Loss, and Fitness Websites: An Online Survey

Background

Nutrition, diet, and fitness are among the most searched health topics by internet users. Besides that, health-related internet users are diverse in their motivations and individual characteristics. However, little is known about the individual characteristics associated with the usage of nutrition, weight loss, and fitness websites.

Objective

The aim of this study was to examine the individual factors associated with the usage of nutrition, weight loss, and fitness websites.

Methods

An invitation to an online survey was published on 65 websites and discussion forums. In total, we employed data from 623 participants (aged 13 to 39 years, mean 24.11 [SD 5.26]). The measures included frequency of usage of nutrition, weight loss and fitness websites, excessive exercise, eating disorder symptomatology, internalization of the beauty ideal, weight status, and perceived online social support. Participants’ data were used as predictors in a base linear regression model.

Results

The final model had an acceptable fit (χ²₁₀ =14.1; P=.17; root mean square error of approximation=0.03; comparative fit index=0.99; Tucker-Lewis index=0.99). Positive associations were found between usage of (1) nutrition websites and being female, higher levels of excessive exercise, and perceived online social support; (2) weight loss websites and excessive exercise, internalization, being female, eating disorder symptomatology, and being overweight or obese; and (3) fitness websites and levels of excessive exercise, internalization, and frequency of internet use.

Conclusions

The results highlighted the importance of individual differences in the usage of health-related websites.

Seasonal and Geographic Patterns in Seeking Cardiovascular Health Information: An Analysis of the Online Search Trends

OBJECTIVE

To ascertain whether temporal and geographic interest in seeking cardiovascular disease (CVD) information online follows seasonal and geographic patterns similar to those observed in real-world data.

METHODS

We searched Google Trends for popular search terms relating to CVD. Relative search volumes (RSVs) were obtained for the period January 4, 2004, to April 19, 2014, for the United States and Australia. We compared average RSVs by month and season and used cosinor analysis to test for seasonal variation in RSVs. We also assessed correlations between state-level RSVs and CVD burden using an ecological correlational design.

RESULTS

RSVs were 15% higher in the United States and 45% higher in Australia for winter compared with summer (P<.001 for difference for both). In the United States, RSVs were 36% higher in February compared with August, while in Australia, RSVs were 75% higher in August compared with January. On cosinor analysis, we found a significant seasonal variability in RSVs, with winter peaks and summer troughs for both the United States and Australia (P<.001 for zero amplitude test for both). We found a significant correlation between state-level RSVs and mortality from CVD (r=0.62; P<.001), heart disease (r=0.58; P<.001), coronary heart disease (r=0.48; P<.001), heart failure (r=0.51; P<.001), and stroke (r=0.60; P<.001).

CONCLUSION

Google search query volumes related to CVD follow strong seasonal patterns with winter peaks and summer troughs. There is moderate to strong positive correlation between state-level search query volumes and burden of CVD mortality.

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.