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

The Information Sharing Behaviors of Dietitians and Twitter Users in the Nutrition and COVID-19 Infodemic: Content Analysis Study of Tweets

Background

The COVID-19 pandemic has generated an infodemic, an overabundance of online and offline information. In this context, accurate information as well as misinformation and disinformation about the links between nutrition and COVID-19 have circulated on Twitter since the onset of the pandemic.

Objective

The purpose of this study was to compare tweets on nutrition in times of COVID-19 published by 2 groups, namely, a preidentified group of dietitians and a group of general users of Twitter, in terms of themes, content accuracy, use of behavior change factors, and user engagement, in order to contrast their information sharing behaviors during the pandemic.

Methods

Public English-language tweets published between December 31, 2019, and December 31, 2020, by 625 dietitians from Canada and the United States, and Twitter users were collected using hashtags and keywords related to nutrition and COVID-19. After filtration, tweets were coded against an original codebook of themes and the Theoretical Domains Framework (TDF) for identifying behavior change factors, and were compared to reliable nutritional recommendations pertaining to COVID-19. The numbers of likes, replies, and retweets per tweet were also collected to determine user engagement.

Results

In total, 2886 tweets (dietitians, n=1417; public, n=1469) were included in the analyses. Differences in frequency between groups were found in 11 out of 15 themes. Grocery (271/1417, 19.1%), and diets and dietary patterns (n=507, 34.5%) were the most frequently addressed themes by dietitians and the public, respectively. For 9 out of 14 TDF domains, there were differences in the frequency of usage between groups. "Skills" was the most used domain by both groups, although they used it in different proportions (dietitians: 612/1417, 43.2% vs public: 529/1469, 36.0%; P<.001). A higher proportion of dietitians' tweets were accurate compared with the public's tweets (532/575, 92.5% vs 250/382, 65.5%; P<.001). The results for user engagement were mixed. While engagement by likes varied between groups according to the theme, engagement by replies and retweets was similar across themes but varied according to the group.

Conclusions

Differences in tweets between groups, notably ones related to content accuracy, themes, and engagement in the form of likes, shed light on potentially useful and relevant elements to include in timely social media interventions aiming at fighting the COVID-19-related infodemic or future infodemics.

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

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

Physical activity and disordered eating behaviours: Are Caribbean adolescents at risk?

Excessive physical activity (PA) has been linked to increased risk for disordered eating behaviours and eating disorders. This study investigates the relationship between PA and disordered eating behaviours and attitudes (DEBAs) among Jamaican adolescents. This cross-sectional study included 521 adolescents, 12-19 years. Anthropometric measurements were collected, and adolescents completed questionnaires on disordered eating behaviours (EAT-26), physical activity, self-esteem and affect. Associations were assessed using sex-specific mixed-effect linear and logistic regression models. Participants reported exercising an average of 3 days per week. Adolescents who exercised for a longer duration had greater odds of having elevated EAT-26 scores (at least 1 hour-OR = 2.04; 95% CI = 1.03, 4.06; p = .042), while a higher exercise frequency among males (3-5 days per week) was protective against DEBAs (OR 0.38; 95% CI = 0.16, 0.88; p = .025). Female adolescents reported higher prevalence of elevated EAT-26 scores than males (p < .01). Increased negative affect increased odds of an elevated EAT-26 score. Exercise duration and frequency play a role in disordered eating behaviours in Jamaican adolescents and vary by gender. Our findings have implications for weight management interventions and policies, encouraging healthcare providers to monitor PA levels as well as negative affect in adolescents who display disordered eating behaviours.

Prevalence of Health Misinformation on Social Media: Systematic Review

Background

Although at present there is broad agreement among researchers, health professionals, and policy makers on the need to control and combat health misinformation, the magnitude of this problem is still unknown. Consequently, it is fundamental to discover both the most prevalent health topics and the social media platforms from which these topics are initially framed and subsequently disseminated.

Objective

This systematic review aimed to identify the main health misinformation topics and their prevalence on different social media platforms, focusing on methodological quality and the diverse solutions that are being implemented to address this public health concern.

Methods

We searched PubMed, MEDLINE, Scopus, and Web of Science for articles published in English before March 2019, with a focus on the study of health misinformation in social media. We defined health misinformation as a health-related claim that is based on anecdotal evidence, false, or misleading owing to the lack of existing scientific knowledge. We included (1) articles that focused on health misinformation in social media, including those in which the authors discussed the consequences or purposes of health misinformation and (2) studies that described empirical findings regarding the measurement of health misinformation on these platforms.

Results

A total of 69 studies were identified as eligible, and they covered a wide range of health topics and social media platforms. The topics were articulated around the following six principal categories: vaccines (32%), drugs or smoking (22%), noncommunicable diseases (19%), pandemics (10%), eating disorders (9%), and medical treatments (7%). Studies were mainly based on the following five methodological approaches: social network analysis (28%), evaluating content (26%), evaluating quality (24%), content/text analysis (16%), and sentiment analysis (6%). Health misinformation was most prevalent in studies related to smoking products and drugs such as opioids and marijuana. Posts with misinformation reached 87% in some studies. Health misinformation about vaccines was also very common (43%), with the human papilloma virus vaccine being the most affected. Health misinformation related to diets or pro–eating disorder arguments were moderate in comparison to the aforementioned topics (36%). Studies focused on diseases (ie, noncommunicable diseases and pandemics) also reported moderate misinformation rates (40%), especially in the case of cancer. Finally, the lowest levels of health misinformation were related to medical treatments (30%).

Conclusions

The prevalence of health misinformation was the highest on Twitter and on issues related to smoking products and drugs. However, misinformation on major public health issues, such as vaccines and diseases, was also high. Our study offers a comprehensive characterization of the dominant health misinformation topics and a comprehensive description of their prevalence on different social media platforms, which can guide future studies and help in the development of evidence-based digital policy action plans.

The effects of fitspiration images on body attributes, mood and eating behaviors: An experimental Ecological Momentary Assessment study in females

Through an experimental Ecological Momentary Assessment (EMA) design, we assessed the effects of fitspiration images (relative to neutral) on body image, mood and disordered eating and whether trait body dissatisfaction, thin-ideal internalization and pressures from the media, family and peers moderated these effects. After completing trait-based measures, 85 women were prompted via a mobile application 6 times daily for 7 days to view an image (fitspiration or neutral) and report on state levels of perceived pressures to attain an idealized physique, satisfaction with various body attributes, mood and eating behavior. When participants were exposed to fitspiration images, their perceived pressure to attain an idealized physique was significantly higher than after exposure to the control images. This effect was most pronounced for women experiencing pressure from the media. Furthermore, fitspiration images lowered the extent to which women felt that idealized physiques were attainable, and decreased satisfaction with current fitness. There were no significant effects on mood and disordered eating. Exposure to fitspiration content predicted only a few adverse outcomes in terms of negative body attributes and perceived pressures to attain a similar physique, suggesting that its content is not as detrimental as initially believed, but further research is needed.

Eating Disorder Awareness Campaigns: Thematic and Quantitative Analysis Using Twitter

Background

Health awareness initiatives are frequent but their efficacy is a matter of controversy. We have investigated the effect of the Eating Disorder Awareness Week and Wake Up Weight Watchers campaigns on Twitter.

Objective

We aimed to examine whether the Eating Disorder Awareness Week and Wake Up Weight Watchers initiatives increased the volume and dissemination of Twitter conversations related to eating disorders and investigate what content generates the most interest on Twitter.

Methods

Over a period of 12 consecutive days in 2018, we collected tweets containing the hashtag #wakeupweightwatchers and hashtags related to Eating Disorder Awareness Week (#eatingdisorderawarenessweek, #eatingdisorderawareness, or #EDAW), with the hashtag #eatingdisorder as a control. The content of each tweet was rated as medical, testimony, help offer, awareness, pro-ana, or anti-ana. We analyzed the number of retweets and favorites generated, as well as the potential reach and impact of the hashtags and the characteristics of contributors.

Results

The number of #wakeupweightwatchers tweets was higher than that of Eating Disorder Awareness Week and #eatingdisorder tweets (3900, 2056, and 1057, respectively). The content of tweets was significantly different between the hashtags analyzed (P<.001). Medical content was lower in the awareness campaigns. Awareness and help offer content were lower in #wakeupweightwatchers tweets. Retweet and favorite ratios were highest in #wakeupweightwatchers tweets. Eating Disorder Awareness Week achieved the highest impact, and very influential contributors participated.

Conclusions

Both awareness campaigns effectively promoted tweeting about eating disorders. The majority of tweets did not promote any specific preventive or help-seeking behaviors.

#selfharn on Instagram: understanding online communities surrounding non-suicidal self-injury through conversations and common properties among authors

Objectives

#selfharm has been blocked by Instagram, but manoeuvring hashtags (e.g. #selfharn) are beginning to appear in order for secret non-suicidal self-injury (NSSI) communities to communicate. The purpose of this study was to (a) determine the nature of the #selfharn conversation on Instagram, (b) analyze common properties of the visual content (i.e. images and videos; n = 93) tagged with #selfharn, and (c) discover what kind of environment the authors (n = 50) of #selfharn were creating.

Methods

A multi-method approach was utilized for this study. Netlytic was used to generate a text and content analysis to examine the authors’ captions and comments (n = 8772) associated with #selfharn (collected over a seven-day period).

Results

After removing #selfharn from the dataset, the text analysis revealed that #depression (n = 3081) and #suicide (n = 2270) were the most commonly used terms associated with #selfharn. Overall, 52% (n = 4386) of the popular words/phrases related with #selfharn posts were categorized as ‘bad feelings’. Through manual coding, it was determined that the majority of #selfharn visual content (n = 92; 99%) did not generate an advisory warning but did contain a wound (n = 70; 75%). The #selfharn author analysis suggests that most were women (n = 18; 36%) with a dark-coloured profile aesthetic (n = 37; 74%) determined by an overwhelming amount of grey, black, blue, red, or purple colours.

Conclusion

According to the text and content analyses, #selfharn on Instagram may be contributing negatively to an online community of mental-health issues. More resources should be provided by Instagram to those who are involved in the NSSI Instagram community.

Social Media, Thin-Ideal, Body Dissatisfaction and Disordered Eating Attitudes: An Exploratory Analysis

Disordered eating attitudes are rapidly increasing, especially among young women in their twenties. These disordered behaviours result from the interaction of several factors, including beauty ideals. A significant factor is social media, by which the unrealistic beauty ideals are popularized and may lead to these behaviours. The objectives of this study were, first, to determine the relationship between disordered eating behaviours among female university students and sociocultural factors, such as the use of social network sites, beauty ideals, body satisfaction, body image and the body image desired to achieve and, second, to determine whether there is a sensitive relationship between disordered eating attitudes, addiction to social networks, and testosterone levels as a biological factor. The data (N = 168) was obtained using validated surveys (EAT-26, BSQ, CIPE-a, SNSA) and indirect measures of prenatal testosterone. The data was analysed using chi-square, Student’s t-test, correlation tests and logistic regression tests. The results showed that disordered eating attitudes were linked to self-esteem (p < 0.001), body image (p < 0.001), body desired to achieve (p < 0.001), the use of social media (p < 0.001) and prenatal testosterone (p < 0.01). The findings presented in this study suggest a relationship between body image, body concerns, body dissatisfaction, and disordered eating attitudes among college women.

Thinspiration and fitspiration in everyday life: An experience sampling study

We used experience sampling to examine thinspiration and fitspiration in the everyday lives of women and men. Undergraduates (N = 108, 21% men) completed a 1-week smartphone-facilitated experience sampling protocol containing self-report measures of thinspiration and fitspiration exposure, body satisfaction, and affective functioning. Multi-level, gender-adjusted models examined the unique and interactive associations of exposure to thinspiration and fitspiration. Women reported a weekly average of 8.4 thinspiration exposures and 9.5 fitspiration exposures, while men reported 2.3 and 4.9 exposures, respectively. The median self-reported duration of each exposure was 2-3 min, with no difference in exposure duration between thinspiration and fitspiration. Unique thinspiration exposure was associated with lower body satisfaction, lower positive affect, and higher negative affect (Cohen's ds = |0.07-0.09|, small). Unique fitspiration exposure was associated with lower body satisfaction and positive affect (ds = |0.03-0.04|, small), but not negative affect. The pattern of associations for interactive exposure (i.e., exposure to both thinspiration and fitspiration) was near-identical to the pattern for unique thinspiration exposure (ds = |0.06-0.08|). We conclude that women and men exposed to thinspiration and fitspiration in their everyday lives may subsequently experience lower body satisfaction and poorer affective functioning.

Micronutrient Intakes of British Adults Across Mid-Life: A Secondary Analysis of the UK National Diet and Nutrition Survey

Background: There is a tendency to report micronutrients intakes collectively for adults, with broad age ranges being used. This means that certain sub-population groups such as young adults are often overlooked. The objective of the present article was to derive and evaluate micronutrient intakes across UK adults in their twenties, thirties, forties and fifties. Methods: A secondary analysis of the UK National Diet and Nutrition Survey (years 1-6) was undertaken. Data from n = 3,238 adults was analyzed and micronutrient intakes from food sources (excluding supplements) derived as a percentage of the Reference Nutrient Intake (RNI) and percentage below the Lower Reference Nutrient Intake (LRNI) for males and females aged 20-29, 30-39, 40-49, and 50-59 years. Mean intakes were used in instances where this data was unavailable (for vitamins D and E). Results: Sizeable gaps were found for magnesium with 19% of young people in their twenties having intakes below the LRNI. Amongst UK females intakes of 9 micronutrients (riboflavin, vitamin B6, B12, folic acid, calcium, iron, magnesium, potassium, and iodine) were significantly lower than males aged 20-59 years (p < 0.001) expressed as a percentage of the RNI. Young adults in their twenties had significantly lower (p < 0.05) intakes of 8 micronutrients (vitamin A, riboflavin, folic acid, calcium, magnesium, potassium, iodine, and copper) expressed as a percentage of the RNI compared with adults in their thirties, forties and fifties. There were also considerable gaps in dietary selenium intakes with 50.3% females and 25.8% males having total intakes beneath the LRNI. A quarter of women had iron (25.3%) and potassium (24.3%) intakes below the LRNI. Conclusions: UK females and younger adults appear to be particularly vulnerable to micronutrient shortfalls from food sources alone. Clearly, improvements in dietary quality are needed across mid-life. Alongside this, fortification and supplementation strategies may be considered to help adults achieve dietary targets at this life-stage when they should be at their nutritional prime.