Nutrition misinformation is nothing new, with research from the start of the century highlighting that 67% of bestseller diet books lacked an evidence base to support their claims.(1) However, the way in which we consume information has shifted. It is now reported that as much as 80% of internet users are looking online for nutrition advice, with 70% going to social media.(2)

To me, this reliance on social media for health advice is concerning, because platforms like Instagram and TikTok have exploded with influencers and ‘experts’ promoting specific diets, supplements, gadgets and solutions for health. Many of these influencers have huge numbers of followers.

Having watched this ‘boom’ unfold, I have been shocked at the scale of the widespread of misinformation, and was interested to see what the research had to say on this topic. A recent systematic review looking at 64 studies concluded that nutrition information online is often ‘inaccurate and of low quality’.(3) The analysis found that topics such as weight loss and supplements had lower quality information, whereas advice on child and maternal nutrition were more accurate.

CLICK BAIT

When it comes to social media I think it is fair to say that ‘click bait’ is a problem. This is a term that describes online content that is designed to attract attention so people read or listen to it, but it is often misleading or deceptive. It has been reported that fake information is 70% more likely to be shared in comparison to reliable news on Twitter,(4) adding to the challenge of ‘click bait’. Similarly, a recent study looked at social media posts from influencers with more than 100,000 followers. Out of 676 posts, 38.8% were classified as being poor quality, 59.2% mediocre, 6.1% of posts were ‘good’ quality and 0% were ‘excellent’.(5) The least accurate posts got the most engagement. This particular study found that the highest quality posts were made by those with recognised nutrition qualifications. This has also been found in research looking at the accuracy of sport nutrition content on YouTube,(6) where the videos presented by dietitians scored the highest in terms of education quality and reliability. This highlights the need to raise awareness of the regulations that nutrition professionals are required to adhere to.

SENSATIONAL VIDEOS

I’ve noticed a rise in influencers videoing themselves standing in supermarkets and pulling apart foods based on single ingredients, using sensational words like ‘toxic’ or ‘poison’. This language is clearly designed to elicit negative emotions from the viewers, and ignores the complexity of the factors that drive eating behaviour.

Eating Disorders dietitian, Renee McGregor, previously expressed her concerns around this in her book Orthorexia, When Healthy Eating Goes Bad, published in 2017. This was in response to the widespread promotion of the ‘clean eating’ trend. These messages typically focus on restriction and it is particularly concerning as there is evidence that demonstrates that there is an association between social media usage and poor body image, eating disorders and disordered eating behaviours.(7) A recent review concluded that ‘based on the scale of social media usage amongst young people, the issue is worthy of attention as an emerging global public health issue’.(7)

CELEBRITY INFLUENCERS

Previous research has highlighted that celebrities are frequently seen as credible sources of nutrition information.(8) However, more recently we have also seen a rise in people with impressive qualifications, who are affiliated with certain brands, providing misleading or biased advice on social media. There is already evidence that the pubic feel confused by conflicting information,(9) and this new era of misinformation is likely to exasperate this and could potentially lead to people disengaging from health promoting behaviours.(10)

HEALTH INEQUALITY

As someone with experience in Public Health, I can’t help but feel like there is a topic that is missing in the space of nutrition messages online: that is poverty and the impact it has on eating behaviours. With all the diet promises, new books, fancy supplements and modern gadgets, it seems that one of the biggest health challenges in this country is being overshadowed.

Last year, the Trussell Trust distributed their highest number of food parcels on record.(11) New data in Scotland has found that children who experience food poverty by the age of two are four times more likely to experience obesity at age four and 14 in comparison to those who do not.(12) Although the sample size from this research was small, it certainly raises serious concern about the impact that food poverty has on child health.

Health inequalities are a significant contributor to poor health outcomes in this country, so we cannot be speaking about solutions to health without acknowledging this.

So what do we do about this? A logical approach would be for public health organisations to take proactive measures to partner with social media and marketing experts to promote dietary guidelines. Furthermore, as nutrition professionals, we need to continue to raise awareness of how to spot misinformation online and aggressive marketing tactics.

I started my career working in schools, and when delivering education sessions my focus was on healthy eating messages and the functions of food groups. I would now argue that we should be raising awareness around how to spot nutrition misinformation when working with young people. Developing critical thinking skills around health advice can be done by explaining the hierarchy of evidence in science and by exploring the social model of health. Highlighting the importance of having a healthy relationship with food, where food is about nourishment, connection and creativity will put young people in a better position to say ‘no’ to misinformation.

Hazel Long, RNutr

Hazel Long is a registered nutritionist working part time in the NHS and
as a freelancer in her private practice HCL Nutrition. She is passionate about
evidence-based nutrition and supporting individuals to have a
positive relationship with food.

Instagram: hcl_nutrition

References:

1. Goff S et al (2006) Brief Report: Nutrition and Weight Loss Information in a Popular Diet Book: Is It Fact, Fiction, or Something in Between? Journal of General Internal Medicine. 21(7) 769-774. doi.org/10.111/j.1525-1497.2006.00501.x
2. Adamski M el at (2020) Using the Internet: Nutrition Information-Seeking Behaviours of Lay People Enrolled in a Massive Online Nutrition Course. Nutrients. 12;12(3):750. doi: 10.3390/nu12030750. PMID: 32178291
3. Denniss E et al (2023) Quality and Accuracy of Online Nutrition-Related Information: a Systematic Review of Content Analysis Studies. Public Health Nutr. 26(7):1345-1357. doi: 10.1017/S1368980023000873. PMID: 37138366
4. Soroush V et al 2018. "The Spread of True and False News Online." Science. 359 (6380): 1146-51. doi:10.1126/science.aap9559
5. Denniss E et al (2024) #Fail: The Quality and Accuracy of Nutrition-Related Information by Influential Australian Instagram Accounts. Int J Behav Nutr Phys Act. 14;21(1):16. doi: 10.1186/s12966-024-01565-y. PMID: 38355567
6. Kiss A et al (2023) Evaluation of the Reliability and Educational Quality of YouTube™ Videos on Sport Nutrition Topics. J Int Soc Sports Nutr. 20(1):2278632. doi: 10.1080/15502783.2023.2278632. PMID: 37953602
7. Dane A (2023) A Scoping Review to Investigate the Association Between Social Media, Body Image and Eating Disorders Amongst Young People. 22;3(3). doi: 10.1371/journal.pgph.0001091. PMID: 36962983
8. Hoffman SJ (2015). Biological, Psychological and Social Processes that Explain Celebrities' Influence on Patients' Health-Related Behaviors. Arch Public Health. 19;73(1):3. doi: 10.1186/2049-3258-73-3. PMID: 25973193
9. Dinkovski N (2018) Conflicting Nutrition Advice Confuses Consumers. Food Manufacture. Foodmanufacture.co.uk Date Accessed 26/06/2024
10. Vijaykumar S et al (2021) Associations Between Conflicting Nutrition Information, Nutrition Confusion and Backlash Among Consumers in the UK. Public Health Nutr. 24(5):914-923. doi: 10.1017/S1368980021000124.PMID: 33431107
11. Trussell Trust (2024) Latest Stats. Trussell Trust. www.trusselltrust.org/news-and-blog/latest-stats/ Date accessed 26/06/2024
12. Miall N et al (2024) Understanding Childhood Weight in Scotland: What Can Longitudinal Data Tell Us. Obesity Action Scotland. www.obesityactionscotland.org Date Accessed 26/06/2024