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

Evolution of dietary patterns in Flanders: an ecological trend study on best-selling cookbook recipes (2008-2018) and their correlation with household purchases

BACKGROUND

With rising obesity rates in Western societies, analyzing changes in dietary patterns is paramount. While nutritional surveys have been informative, traditional cookbooks have historically shed light on national cuisines and its changes. Despite the growing popularity of online platforms for food information, cookbooks might still reflect prevalent dietary trends and the diets people follow. This study examined (1) the changes in nutritional content and food group usage in the best-selling cookbooks from 2008 to 2018, and (2) the correlation between the food groups in these cookbooks and dietary patterns (inferred from household purchases) over the same timeframe.

METHODS

An exploratory ecological study was conducted on 20 main course recipes of each of the five best-selling cookbooks in Flanders annually between 2008 and 2018. Trends in macronutrients and food group usage in these recipes were analyzed using generalized linear models. Additionally, these trends were compared to household purchase data in Flanders using correlation matrices.

RESULTS

Our results reveal a rising trend towards the use of plant-based ingredients and meat alternatives in cookbooks over the period 2008-2018. There was an increase in the usage of vegetables, nuts & seeds, and cheese. Conversely, there was a decline in the usage of meat, sugar & sweeteners, alcohol, and dairy (all p-values < 0.05). In terms of macronutrient content, there was an upswing in carbohydrate, fibre, and sugar levels, while the total fat content showed a decrease (all p-values < 0.05). The levels of protein and saturated fat remained consistent over time. Notably, shifts in plant-based and animal-based food group preferences in popular cookbook recipes align with the trends seen in actual household purchases of these food groups (all p-values < 0.05).

CONCLUSION

These findings indicate that cookbook content evolves over time, potentially reflecting shifts in population dietary patterns. Future research is needed to determine (Buisman ME, Jonkman J. Dietary trends from 1950 to 2010: a Dutch cookbook analysis. J Nutr Sci [Internet]. 2019 ed [cited 2022 Apr 19];8. https://www.cambridge.org/core/journals/journal-of-nutritional-science/article/dietary-trends-from-1950-to-2010-a-dutch-cookbook-analysis/AB281ADE0F09FF8F518B8AC4A2A5BEA8#supplementary-materials ) any causative link between cookbooks and dietary habits, and (Ashwell M, Barlow S, Gibson S, Harris C. National Diet and Nutrition Surveys: the British experience. Public Health Nutr. 2006;9(4):523-30.) the potential for cookbooks to aid in health promotion.

Meal kit subscription services and opportunities to improve family vegetable consumption

Popular commercial meal kit subscription services (MKSSs) may support families to overcome barriers to cooking and eating at home, and facilitate improved vegetable consumption. The global meal kit market has expanded rapidly creating a gap in our understanding of the health-promoting potential of MKSSs. This paper describes the contemporary MKSS market in Australia and provides a vegetable-specific content analysis of a sample of recipes. A 1-week subscription was purchased for all Australian-based MKSSs (n = 9) and websites were systematically reviewed to document key characteristics and recipe features. Vegetable content of all available recipes within a 1-week period were analysed. Our findings highlight the rapid expansion and evolution of MKSS market offerings over the past decade and their potential to support family vegetable consumption. Across all analysed recipes (n = 179), MKSSs provided a median of 2.5 vegetable serves per person (range 0.7-7.5 serves) and a median of 3 different types of vegetables from 2 vegetable subgroups (i.e. dark green, red and orange, starchy, legumes and all other vegetables). This suggests that MKSSs may support family vegetable consumption if families select recipes with a greater number and variety of vegetables. However, an opportunity remains for MKSSs to improve both vegetable quantity and variety to positively influence population health. Further research is required to describe how families use meal kits promoting a greater understanding of their potential to improve family nutrition.

Smoothies Marketed in Spain: Are They Complying with Labeling Legislation?

There is no legal definition of a smoothie, so the European legislation applicable to its labeling is that of fruit juice. The smoothie market has grown in recent years, as it can include a wide variety of ingredients: fruits, fruit purees, honey, milk and vegetable milks, vegetables, herbs, cereals, cereal flours, seaweed, and crushed ice. In this study, 57 smoothies were reviewed. All of them were purchased in supermarkets and classified into eight types according to the main ingredients. Fifteen legal statements/items were reviewed on the pack labels: eleven mandatory and three optional. Moreover, nutrition labels, nutritional claims, images, marks, and other symbols were also reviewed. Only 22.8% of the samples complied with EU and Spanish labeling legislation. More incorrectness was related to the name of the food and the fruits included as main ingredients; other errors related to the allergy/intolerance statements, and some nutritional claims concerning vitamin C were also detected to a lesser extent. General advice is provided for consumers to interpret smoothie labels correctly. Lawmakers should amend legislation to accept the term "smoothie" as a legal name.

Healthy eating blog readership: A cross-sectional survey in Australian adults

AIMS

To investigate whether members of the public read blogs for the purpose of accessing healthy eating information; examine demographic predictors of healthy eating blog readership, specifically education, gender, age, body mass index, and residential location; and explore the reasons for reading, and not reading, healthy eating blogs.

METHODS

This study used a cross-sectional online self-reported survey design collected over three time points (round 1: December 2017-March 2018, round 2: August 2018-December 2018, round 3: December 2021-March 2022). The total sample of participants comprised of 238 respondents with a mean age of 46 years old, who mostly reported gender as female (82%), being educated with a university degree (69%), and predominantly resided in urban and city areas (84%).

RESULTS

Fifty-one percent of respondents reported reading healthy eating blogs, suggesting that consumers were proactively seeking healthy eating information through this avenue. Participants who identified as female were 3.2 times more likely to read healthy eating blogs. Commonly, healthy eating blogs were read to receive practical information that aligned with current food choices. The main reason participants reported not reading healthy eating blogs was not thinking about using them (29%).

CONCLUSIONS

Understanding who is seeking healthy eating information through blogs, and their reasons doing so, is important to continue research into the potential effectiveness of blogs as a platform to communicate healthy eating and nutrition messages. This study provides direction for further investigation into how dietetics professionals could effectively use blogs to disseminate healthy eating information and positively influence consumer food choices and dietary intake.

Nutrition-Related Information on Instagram: A Content Analysis of Posts by Popular Australian Accounts

Social media is a popular source of nutrition information and can influence food choice. Instagram is widely used in Australia, and nutrition is frequently discussed on Instagram. However, little is known about the content of nutrition information published on Instagram. The aim of this study was to examine the content of nutrition-related posts from popular Australian Instagram accounts. Australian Instagram accounts with ≥100,000 followers, that primarily posted about nutrition, were identified. All posts from included accounts, from September 2020 to September 2021, were extracted and posts about nutrition were included. Post captions were analysed using Leximancer, a content analysis software, to identify concepts and themes. Text from each theme was read to develop a description and select illustrative quotes. The final sample included 10,964 posts from 61 accounts. Five themes were identified: (1) recipes; (2) food and nutrition practices; (3) body goals; (4) food literacy and (5) cooking at home. Recipes and practical information about nutrition and food preparation are popular on Instagram. Content about weight loss and physique-related goals is also popular and nutrition-related Instagram posts frequently include marketing of supplements, food and online programs. The popularity of nutrition-related content indicates that Instagram may be a useful health-promotion setting.

Healthiness and environmental impact of dinner recipes vary widely across developed countries

Contrary to food ingredients, little is known about recipes' healthiness or environmental impact. Here we examine 600 dinner recipes from Norway, the UK and the USA retrieved from cookbooks and the Internet. Recipe healthiness was assessed by adherence to dietary guidelines and aggregate health indicators based on front-of-pack nutrient labels, while environmental impact was assessed through greenhouse gas emissions and land use. Our results reveal that recipe healthiness strongly depends on the healthiness indicator used, with more than 70% of the recipes being classified as healthy for at least one front-of-pack label, but less than 1% comply with all dietary guidelines. All healthiness indicators correlated positively with each other and negatively with environmental impact. Recipes from the USA, found to use more red meat, have a higher environmental impact than those from Norway and the UK.

Analysis of Recipes Shared as 'Healthy' in a Popular Brazilian Website: A Cross-Sectional Study

Cooking is crucial to the achievement of healthy eating habits, and the internet, as host of culinary recipes websites, is a medium for the dissemination of cooking-related content. Research has revealed that most recipes available on internet sites do not have healthy characteristics when compared to recommendations for healthy eating, even the ones promoted as 'healthy'. This study investigated culinary recipes available on the 'healthy eating' section of a popular Brazilian recipe-sharing website. Recipes (n = 814) were analyzed with a validated framework based on national dietary guidelines. Ingredients (n = 5887) were classified according to the extension and purpose of their industrial processing. The recipes' titles were content analyzed to identify the health-related words and phrases used. Recipes contained ultra-processed foods and not enough unprocessed or minimally processed foods, such as legumes (4.7%, n = 380), nuts and seeds (18.4%, n = 150), and fruits (n = 32.7%, n = 263). The recipes' titles mentioned 564 health-related terms, appealing to physical characteristics, including weight loss, and fads, such as gluten-free, dukan, low-carb, detox, fitness, ripped body, and belly burner. Therefore, the 'healthy' recipes available on the Brazilian recipe-sharing website presented many aspects not in accordance with national dietary guidelines.

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

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

Ultra-Processed Foods as Ingredients of Culinary Recipes Shared on Popular Brazilian YouTube Cooking Channels

Social media platforms are readily accessible sources of information about cooking, an activity deemed crucial for the improvement of a population’s diet. Previous research focused on the healthiness of the content shared on websites and blogs, but not on social media such as YouTube®. This paper analysed the healthiness of 823 culinary recipes retrieved from 755 videos shared during a six-month period on ten popular Brazilian YouTube® cooking channels. Recipes were categorized by type of preparation. To assess recipes’ healthiness, ingredients were classified according to the extension and purpose of industrial processing, in order to identify the use of ultra-processed foods. Additionally, a validated framework developed from criteria established in both editions of the Dietary Guidelines for the Brazilian Population was employed. Recipes for cakes and baked goods, puddings, snacks and homemade fast foods, which were among the most frequently posted, contained the lowest proportion of unprocessed/minimally processed ingredients and the highest proportion of ultra-processed ingredients. Recipes containing whole cereals, fruits, legumes, nuts, and seeds were scarce. Results indicate that users should be critical about the quality of recipes shared on YouTube® videos, also indicating a need for strategies aimed at informing individuals on how to choose healthier recipes or adapt them to become healthier.

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

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

Food Media and Dietary Behavior in a Belgian Adult Sample: How Obtaining Information From Food Media Sources Associates With Dietary Behavior

Objective: We aim to relate Flemish adults’ main food information sources (e.g., celebrity chefs, experts) with their dietary behavior.

Methods: A cross-sectional online survey among 1115 Flemish adults who regularly cook, measured the food information sources the respondents used to obtain recipes, their dietary intake and dietary restrictions. Ordinal and logistic regression were used to investigate the relation between food media, dietary intake and dietary restrictions.

Results: Celebrity chefs were mentioned most often (37%) as main food information source, followed by family and acquaintances (21%) and lifestyle gurus (12%). Using lifestyle gurus as a source of dietary information is associated with more dietary restrictions and a higher intake frequency of plant-based food groups, whereas using celebrity chefs or experts is associated with a different (but less unequivocal vegetarian or healthy) dietary intake.

Conclusion: Media icons like lifestyle gurus and celebrity chefs appear to be among people’s main sources of food information. There is a significant association between using them as a source of food information and dietary behavior. Further research on the influence of media on diet is required.

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

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

Social Media and Children's and Adolescents' Diets: A Systematic Review of the Underlying Social and Physiological Mechanisms

The association between social media (SM) and children's and adolescents' diet is poorly understood. This systematic literature review aims to explore the role of SM in children's and adolescents' diets and related behaviors, considering also the underlying mechanisms. We searched Medline, Scopus, and CINAHL (2008-December 2021) for studies assessing the relation of SM exposure with food intake, food preference, dietary behaviors, and the underlying mechanisms (e.g., brain activation to digital food images-as proxy for SM food images) among healthy children and adolescents aged 2-18 y. A total of 35 articles were included. Of 4 studies, 1 found that exposure to peers' videos on healthy eating, but not SM influencers', increased vegetable intake. Most studies reported that SM was associated with skipping breakfast, increased intake of unhealthy snacks and sugar-sweetened beverages, and lower fruit and vegetable intake, independent of age. Children and adolescents exposed to unhealthy compared with healthy digital food images showed increased brain response in reward- and attention-related regions. The mechanisms underpinning the abovementioned associations were 1) physiological (appetitive state, increased neural response to portion size and energy density of food depicted) and 2) social (food advertising via SM influencers and peers). SM exposure leads to unfavorable eating patterns both in children and adolescents. The identified mechanisms may help tailor future health interventions. Downregulating SM advertising and limiting SM exposure to children and adolescents may improve food intake and subsequent health outcomes. The protocol of this review was registered in PROSPERO as CRD42020213977 (https://www.crd.york.ac.uk/prospero/).

A European perspective on "clean eating": Commentary on Negowetti et al. (2021)

Negowetti et al. (2021) have provided insightful perspectives on the public health implications of the labeling of "clean" dietary products in the United States through a scoping review, along with feasible strategies to counteract the risks of this trend. Although the European Union has already fairly strict regulations about declaration of ingredients and health claims regarding food that makes it almost impossible to label food products as "clean," the clean eating trend is alive and expanding in Europe, and usage of expressions such as "clean" or "pure" in other ways than on the label may convey similar messages that cannot be regulated by law. Increased regulation, legislation, and information through the U.S. Food and Drug Administration as suggested by Negowetti et al. (2021) is a welcome contribution and will certainly help to prevent some misinformation. However, labels are just one battle field in addressing misleading expressions and trends. Scientists should enter the relevant fields (e.g., Internet, TV, and social media) to a higher extent and provide solid, pedagogical and simple facts, and guidelines to vaccinate people against current and upcoming misleading dietary trends.

Digging up the dirt on "clean" dietary labels: Public health considerations and opportunities for increased Federal oversight

BACKGROUND

"Clean" dietary labels are often viewed by consumers as referencing products that are minimally processed, without additives, preservatives, artificial colors, or ingredients, but may also be interpreted as vegan, gluten-free, dairy-free, "real," or "natural." Although the "clean" diet trend continues to grow in popularity, there is a lack of consensus regarding the definition and use of this terminology with a corresponding lack of regulation for such labels in the United States.

METHOD

This multidisciplinary scoping review examines the public health implications of the "clean" label trend and the legal and policy landscape for regulation. We report on findings from case law and legal research generated through the Westlaw database and from the U.S. Food and Drug Administration (FDA) enforcement actions and website documents to discuss options for federal- and state-level intervention to mitigate harm.

RESULTS

One feasible avenue for change is for the FDA to provide industry guidance, disseminate public statements to debunk myths, and enforce labeling statutes to police deceptive "clean" labeling claims. We also suggest consumer-protection litigation and state-level litigation via attorneys general as alternative actions to combat the abundant misinformation associated with "clean" diets and labels.

DISCUSSION

Although the FDA has taken some enforcement actions, these efforts are insufficient given the proliferation of "clean" label products in the marketplace and the potential for adverse impacts on public health including increased risk for disordered eating. The current unregulated, undefined landscape for "clean" dietary labels thus requires urgent action by federal authorities and state attorneys general.

Mapping the digital food environment: A systematic scoping review

Food environments are directly linked to diets and health outcomes such as overweight, obesity, and noncommunicable diseases. The digitalization of food environments is becoming a central issue in public health, yet little is known about this emerging field. We performed a systematic scoping review to map the research on the digital food environment and investigate how the eight dimensions of the food environment, according to an established framework (availability, prices, vendor and product properties, marketing and regulation, accessibility, affordability, convenience, and desirability), might be shifting in the context of a digital society. We searched MEDLINE, EMBASE, Scopus, and Web of Science for studies published between 2000 and 2019, using search terms covering digital technology and food environment, which yielded 13,580 unique records. Our analysis of 357 studies shows that digitalization is taking place in all dimensions of the food environment, and enabling the emergence of new forms of buying and selling food, such as online grocery shopping and online food delivery, which may be changing availability of foods and affecting the physical distance to shops and time allocated for shopping. Systematic reviews identified indicated that digital food marketing and social media can influence food choices, preferences and consumption. Our findings suggest that digital and physical food environments are interconnected and influencing one another, but the impact of the digital on health and nutrition is yet unclear.

Gender differences in perceived food healthiness and food avoidance in a Swedish population-based survey: a cross sectional study

BACKGROUND

The aim of this work was to study potential gender differences in perceived food healthiness and food avoidance in a population-representative sample of the Swedish adult population.

METHODS

A questionnaire regarding diet and health was posted to 2000 randomly selected residents in Sweden, aged 20-65 years. Questions were posed regarding which foods or food components the participants avoided due to perceived unhealthiness and how healthy they believed the food items to be. The pre-specified food components included sugar, carbohydrate, gluten, lactose, dairy, fat, saturated fat, red meat, white flour, salt, alcohol and food additives (specifically glutamate, sweetening, preservative and coloring agents). Chi square tests were used to study differences in perceived food healthiness and food avoidance depending on gender.

RESULTS

Around 50% reported avoidance of sugar (51.6%) and sweeting agents (45.2%), whereas fewer reported avoidance of saturated fat (16.8%) and salt (10.6%). Women were more likely than men to avoid gluten (AOR [95% CI] 2.84 [1.33-6.05]), red meat (3.29 [1.86-5.80]), white flour (2.64 [1.65-4.21]), preservatives (1.7 [1.07-2.70]) and coloring agents (2.10 [1.29-3.41]) due to perceived unhealthiness. Gender differences were also apparent in perceived healthiness of sugar, gluten, dairy, red meat, white flour, alcohol and food additives, where women tended to be more negative than men in their attitudes. Women more often said to read new findings in media about diet (16% vs 9%, p = 0.029) and prioritize a healthy lifestyle (35% vs 25%, p = 0.015). More than a third of both women and men reported worrying over the healthiness of their diet, and a higher proportion of women than men (18% vs 11%, p = 0.015) agreed with the statement that they were often anxious over having an unhealthy diet.

CONCLUSIONS

Women in this population-based study of residents in Sweden were more likely than men to avoid eating gluten, red meat, white flour and food additives due to perceived unhealthiness, and reported more diet and health related anxiety. Future research to identify effective ways of promoting healthy eating for both women and men, while minimizing diet-health related anxiety, is highly warranted.

A Recipe for Success? A Nutrient Analysis of Recipes Promoted by Supermarkets

Recipe use impacts eating habits, yet there is limited research investigating the nutritional quality of recipes. Supermarket recipe magazines command large readerships, with over 4 million readers for each of the two major Australian supermarket publications. Assessing the nutrient content of featured recipes is therefore of public health interest. The nutrient content of 312 main-meal recipes from Coles^® Magazine and Woolworths Fresh^® were analyzed and compared against a traffic-light system for classifying nutrients of concern in chronic disease. Nutrient content was compared across recipe type (standard, advertorial and celebrity) and between recipes with and without health or nutrient claims. Overall compliance with the traffic-light criteria was low, with less than half of recipes meeting the target. Advertorial recipes had a higher energy (p = 0.001), saturated fat (p = 0.045) and sodium (p ≤ 0.001) content per serve, and per 100 g for sodium (p ≤ 0.001) compared to standard and celebrity recipes. Recipes with claims had greater compliance to the nutrient criteria (p < 0.001) compared to those without. These findings support previous research highlighting the poor nutritional quality of published recipes from a variety of sources.

"It's Healthy Because It's Natural." Perceptions of "Clean" Eating among U.S. Adolescents and Emerging Adults

Definitions for the culturally trendy "clean" eating phenomenon vary: whereas some characterize it as natural and healthy, others adopt more restrictive, moralizing, and affectively-laden definitions that may reflect disordered eating. We examined levels of familiarity with "clean" eating, sources of information, and perceptions of this dietary trend among a large, diverse sample of U.S. adolescents and emerging adults recruited from the National MyVoice Text Message Cohort (n = 1266; ages 14-24 years). Participants answered five questions assessing knowledge of "clean" eating, definitions, perceived healthiness vs. harm, and willingness to adopt "clean" eating, and responses were coded by three trained researchers. Results indicate that 55% of respondents had previously heard of "clean" eating, most commonly through social media, other online sources, and peers. Definitions were heterogeneous, with 40% offering "non-processed" or "whole foods" and 13% noting "non-GMO" or "organic" components. Few respondents (0.6%) expressed outright skepticism about "clean" eating, but many (30%) identified dietary avoidance and restriction as part of the definition. Overall, 71% characterized "clean" eating as a healthy approach, whereas 6% flagged it as "unhealthy", and 18% noted elements of both healthfulness and harm. Notably, 41% reported they "probably would" try "clean" eating themselves, with greater willingness to try "clean" eating among cisgender women. Present findings highlight high levels of awareness and positive attitudes toward "clean" eating among young people in the U.S., with little recognition of the potential risks of dietary restriction. Further research should examine actual dietary behaviors to clarify potential risks of "clean" eating and related trends and thus inform strategies for eating disorder prevention.

Online data collection strategies used in qualitative research of the health field: a scoping review

ABSTRACT Objective: To identify and map the online data collection strategies used in qualitative researches in the health field. Methods: This is a scoping review guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) from the Joanna Briggs Institute. We analyzed scientific articles, theses and dissertations from 12 databases. The analysis was made by descriptive statistics. Results: The final sample consisted of 121 researches. It was found that the number of publications increased sharply in the last five years, with predominance of studies from the United Kingdom. The highlight fields were psychology (28.1%), medicine (25.6%) and nursing (12.4%). The publications used 10 online data collection strategies: Online questionnaires, online forums, Facebook, websites, blogs, e-mail, online focus group, Twitter, chats, and YouTube. Conclusions: Online data collection strategies are constantly expanding and increasingly used in the health area.

A Call for a Public Health Agenda for Social Media Research

Research has revealed both the benefits and harms of social media use, but the public has very little guidance on how best to use social media to maximize the benefits to their health and well-being while minimizing the potential harms. Given that social media is intricately embedded in our lives, and we now have an entire generation of social media natives, the time has come for a public health research agenda to guide not only the public’s use of social media but also the design of social media platforms in ways that improve health and well-being. In this viewpoint we propose such a public health agenda for social media research that is framed around three broad questions: (1) How much social media use is unhealthy and what individual and contextual factors shape that relationship; (2) What are ways social media can be used to improve physical and mental well-being; and (3) How does health (mis)information spread, how does it shape attitudes, beliefs and behavior, and what policies or public health strategies are effective in disseminating legitimate health information while curbing the spread of health misinformation? We also discuss four key challenges that impede progress on this research agenda: negative sentiment about social media among the public and scientific community, a poorly regulated research landscape, poor access to social media data, and the lack of a cohesive academic field. Social media has revolutionized modern communication in ways that bring us closer to a global society, but we currently stand at an inflection point. A public health agenda for social media research will serve as a compass to guide us toward social media becoming a powerful tool for the public good.