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

Relationships among nutrition knowledge level, healthy eating obsessions, body image, and social media usage in females: a cross-sectional study

BACKGROUND

This study examined the relationships among female's nutrition knowledge levels, diet practices, healthy eating obsessions, body perceptions, and social media usage.

SUBJECTS AND METHODS

The study included 613 voluntarily participating females aged 18-60 years. Data including demographic information, anthropometric measurements, whether they follow a diet or not, and ORTO-R, Body Shape Questionnaire (BSQ-34), Bergen Social Media Addiction Scale (BSMAS), and General and Sport Nutrition Knowledge (GeSNK) Scale scores were collected.

RESULTS

The participants' mean age was 28.47 ± 9.38 years. Mean scores were 17.5 ± 5.1 for the ORTO-R scale, 89.2 ± 40.2 for the BSQ-34, 38.6 ± 12.5 for the GeSNK, and 17.3 ± 6.1 for the BSMAS. Statistically significant differences were found among the participants' total ORTO-R, BSQ-34, and GeSNK scores according to body mass index (BMI) and education level. Statistically significant relationships were also found among total ORTO-R, BSMAS, BSQ-34, and GeSNK scores. ORTO-R scores were positively correlated with BSMAS (r = 0.475, p < 0.05) and BSQ-34 (r = 0.685, p < 0.05) scores, while they were negatively correlated with GeSNK scores (r = -0.117, p < 0.05). There was a positive correlation between BMI and BSQ-34 scores (r = 0.380, p < 0.001) and between BMI and ORTO-R scores (r = 0.130, p < 0.001), while there was a negative correlation (r = -0.176, p < 0.001) between BMI and GeSNK scores.

CONCLUSIONS

Social media is a fast, important, and effective tool for the sharing of information. Thus, social media may be effective in strengthening individuals' nutrition knowledge, nutrition obsessions, body perceptions. Therefore, it would be beneficial to provide training for individuals to use social media consciously and providing nutritional literacy will be effective.

Uncovering the Top Nonadvertising Weight Loss Websites on Google: A Data-Mining Approach

BACKGROUND

Online weight loss information is commonly sought by internet users, and it may impact their health decisions and behaviors. Previous studies examined a limited number of Google search queries and relied on manual approaches to retrieve online weight loss websites.

OBJECTIVE

This study aimed to identify and describe the characteristics of the top weight loss websites on Google.

METHODS

This study gathered 432 Google search queries collected from Google autocomplete suggestions, "People Also Ask" featured questions, and Google Trends data. A data-mining software tool was developed to retrieve the search results automatically, setting English and the United States as the default criteria for language and location, respectively. Domain classification and evaluation technologies were used to categorize the websites according to their content and determine their risk of cyberattack. In addition, the top 5 most frequent websites in nonadvertising (ie, nonsponsored) search results were inspected for quality.

RESULTS

The results revealed that the top 5 nonadvertising websites were healthline.com, webmd.com, verywellfit.com, mayoclinic.org, and womenshealthmag.com. All provided accuracy statements and author credentials. The domain categorization taxonomy yielded a total of 101 unique categories. After grouping the websites that appeared less than 5 times, the most frequent categories involved "Health" (104/623, 16.69%), "Personal Pages and Blogs" (91/623, 14.61%), "Nutrition and Diet" (48/623, 7.7%), and "Exercise" (34/623, 5.46%). The risk of being a victim of a cyberattack was low.

CONCLUSIONS

The findings suggested that while quality information is accessible, users may still encounter less reliable content among various online resources. Therefore, better tools and methods are needed to guide users toward trustworthy weight loss information.

Familiarity with the internet and health apps, and specific topic needs are amongst the factors that influence how online health information is used for health decisions amongst adolescents

BACKGROUND

Many adolescents believe that online health information is reliable, particularly when they are familiar with the source of information.

OBJECTIVE

To analyse the degree of influence of online health information on high school students' health decisions and examine whether socio-demographic characteristics, digital literacy, use of different websites and interest in specific health topics are associated with a stronger influence of online health information on adolescents' health-related decisions.

METHODS

Participants were students from four public high schools in Belgrade, Serbia. Socio-demographic and behavioural questionnaire as well as the e-health literacy scale (eHEALS) were used to collect data.

RESULTS

The study sample comprised 702 students. A total of 79.6% of students reported that online health information influenced their health decisions to a certain extent (from 'a little' to 'a lot'). Being a boy, using the internet since younger age, better self-perceived e-health literacy, using health apps, Google, health forums, websites of health institutions, social media and YouTube, being interested in diet/nutrition, sexually transmitted infections and cigarettes were the characteristics associated with a stronger influence of online health information on students' health decisions.

CONCLUSION

This study provides clues about how online health-related information can be used to adjust and enhance health promotion amongst adolescents.

Body Size Perceptions Associated with Body Mass Index and Weight Loss Intentions Among Two Immigrant Populations

BACKGROUND

The rates of obesity among immigrant populations within the USA rise with increasing duration of residency. The aims of this study were to examine weight self-perception and body image discrepancy within a large community sample of Hispanic and Somali predominantly immigrant adults.

METHODS

Utilizing a community-based participatory research (CBPR) approach to collect survey data from a sample of adults who self-identified as Hispanic, Latino, or Somali in Southeast Minnesota. Correlations among actual body mass index (BMI), perceived weight category, and perceived body size were assessed with Spearman rank correlation coefficients. Associations of weight loss intentions with actual BMI, perceived weight category, perceived body size, and body image discrepancy were assessed using Kruskal-Wallis nonparametric tests.

RESULTS

A total of 1256 adults completed the survey and biometric measurements (610 Hispanic, 646 Somali); 81% (457) and 50% (328) had a BMI in the overweight or obese category in the Hispanic and Somali cohorts, respectively. Among participants with a BMI of > 25, more participants reported a perceived body size that was overweight or obese than a perceived weight category that was in the overweight or obese category (79% vs. 48%, p =  < 0.0001). Body image discrepancy, but not actual BMI, was associated with weight loss intentions for both groups. Perceived body size and perceived weight category were associated with weight loss intentions for Hispanic participants only.

CONCLUSIONS

Perceived body size is a more accurate self-report proxy of BMI-defined weight status compared with the perceived weight category among Hispanic and Somali immigrant groups. Body image discrepancy may be more predictive of weight loss intentions than actual BMI.

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.

Intermittent fasting: consider the risks of disordered eating for your patient

This is a commentary on "Intermittent fasting: is there a role in the treatment of diabetes? A review of the literature and guide for primary care physicians" by Albosta et al. While this article adequately summarized the biochemical clinical advantages and limitations, we feel it failed to mention a few drawbacks, primarily the risk for disordered eating and eating disorders. Here we delve into the emerging data on intermittent fasting or time-restricted feeding in patient populations and urge clinicians to consider these risks prior to encouragement of intermittent fasting.

Eating disorder risks and awareness among female elite cyclists: an anonymous survey

Background

Eating disorders (EDs) are an increasingly recognized concern in professional sports. Previous studies suggests that both female gender and endurance sports put athletes at risk. Female elite cyclists are hence of specific interest. The present study aimed at evaluating the distribution of the individual risk of ED in this group. Further the association between individual risk and both the awareness for the topic ED and the deviation from “normal” weight was depicted.

Methods

Female cyclists registered with the Union Cycliste Internationale were contacted via email or facebook and asked to complete a survey comprising age, weight, the Eating-Attitude-Test (EAT-26), and questions regarding ED awareness. The observed distribution of the EAT-26 score was compared to results from previous studies in normal subjects and athletes. The distribution of the ED awareness was described and ED awareness was correlated with the EAT-26 score. Both the deviation from ideal weight and the body mass index (BMI) were correlated with the EAT-26 score.

Results

Of the 409 registered athletes 386 could be contacted, 122 completed the questionnaire. Age ranged from 20-44yrs, BMI from 17.0 to 24.6 kg/m². In the EAT-26, 39 cyclists (32.0%) scored above 20 points indicating a potential benefit from clinical evaluation, 34 cyclists (27.9%) scored 10–19 points suggesting disordered eating. Sixteen athletes (13.2%) had been treated for an ED. About 70% of athletes had been pressured to lose weight. The mean EAT-26 score was above the average observed in normal female populations. It was also above the average observed in many female athlete populations, but lower than in other leanness focussed sports. More than 80%of athletes perceived elite cyclists at risk for developing ED. Increased ED awareness and deviation from the ideal weight were associated with higher EAT-26 scores, but not the body mass index.

Conclusion

Female cyclists are at risk of developing ED and they are aware of this risk. To improve their health and well-being, increased efforts to support elite cyclists and their teams in preventive activities and early detection are crucial.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13102-022-00563-6.

Evaluation of Web-Based Health Information From the Perspective of Women With Eating Disorders: Thematic Analysis

Background

Users with experience of eating disorders use the internet as a source of information, whether for prorecovery activities (such as web-based treatment, looking for information, support, and sharing) or activities that promote eating disorder behavior as a desirable lifestyle choice (such as pro–eating disorder communities and reading and creating pro–eating disorder posts). Their assessment of web-based eating disorder–related information is crucial for understanding the context of the illness and for health professionals and their web-based interventions.

Objective

This study aimed to understand the criteria young women with the experience of eating disorders use in evaluating eating disorder–related web-based information and what eating disorder–related characteristics of these women are involved in their evaluation.

Methods

We analyzed 30 semistructured individual interviews with Czech women aged 16 to 28 years with past or present eating disorder experience using a qualitative approach. Thematic analysis was adopted as an analytical tool.

Results

The specifics of eating disorder phases (the disorder stage and the treatment process) emerged as important aspects in the process of information assessment. Other specific characteristics of respondents (eg, motivation, abilities, and resources) addressed how the respondents arrived at certain web-based information and how they evaluated it. In addition, the respondents described some content cues as features of information (eg, novelty and social information pooling). Another finding is that other users’ attitudes, experiences, activities, and personal features are involved in the information evaluation of these users and the information presented by them. Finally, the respondents evaluated the websites’ visual look and graphic components.

Conclusions

This study shows that web-based information evaluation reported by women with experience of eating disorders is a complex process. The assessment is influenced by current personal characteristics related to the illness (mainly the motivation for maintaining or curing the eating disorder) using cues associated with information content, other users, and website look. The study findings have important implications for health professionals, who should ask their clients questions about web-based communities and their needs to understand what information and sources they choose.

Problematic usage of the internet and eating disorder and related psychopathology: A multifaceted, systematic review and meta-analysis

Eating disorders are widespread illnesses with significant impact. There is growing concern about how those at risk of eating disorders overuse online resources to their detriment. We conducted a pre-registered systematic review and meta-analysis of studies examining Problematic Usage of the Internet (PUI) and eating disorder and related psychopathology. The meta-analysis comprised n = 32,295 participants, in which PUI was correlated with significant eating disorder general psychopathology Pearson r = 0.22 (s.e. = 0.04, p < 0.001), body dissatisfaction r = 0.16 (s.e. = 0.02, p < 0.001), drive-for-thinness r = 0.16 (s.e. = 0.04, p < 0.001) and dietary restraint r = 0.18 (s.e. = 0.03). Effects were not moderated by gender, PUI facet or study quality. Results are in support of PUI impacting on eating disorder symptoms; males may be equally vulnerable to these potential effects. Prospective and experimental studies in the field suggest that small but significant effects exist and may have accumulative influence over time and across all age groups. Those findings are important to expand our understanding of PUI as a multifaceted concept and its impact on multiple levels of ascertainment of eating disorder and related psychopathology.

Eating disorders with over-exercise: A cross-sectional analysis of the mediational role of problematic usage of the internet in young people

Eating disorders are widespread illnesses with significant global impact. There is growing concern about how young people overuse online resources leading to mental health sequelae. We gathered data from 639 individuals from a population cohort. Participants were all young adults at the point of contact and were grouped as having probable eating disorder with excessive exercise (n = 37) or controls (n = 602). We measured obsessionality, compulsivity, impulsivity, and problematic internet use. Group differences in these domains were evaluated; and structural equation modelling (SEM) was used to assess structural relationships between variables. Cases had higher scores of obsessional thoughts of threat (Cohen's d = 0.94, p < 0.001), intolerance towards uncertainty (Cohen's d = 0.72; p < 0.001), thoughts of importance and control (Cohen's d = 0.65, p < 0.01), compulsivity (Cohen's d = 0.72; p < 0.001), negative urgency (Cohen's d = 0.75, p < 0.001), and higher problematic usage of the internet (Cohen's d = 0.73; p-corrected <0.001). Our SEM showed significant partial mediation of problematic internet use on both the effect of obsessionality latent factor on cases (z-value = 2.52, p < 0.05), as well as of sensation seeking latent factor on cases (z-value = 2.09, p < 0.05). Youth with eating disorder and heightened exercise levels have increased obsessive thoughts of threat, compulsivity traits and sensation seeking impulsivity. The association between obsessive thoughts and eating disorders, as well as sensation seeking and eating disorders were partially mediated by problematic internet use. Problematic internet use may be playing a role in the development or maintenance of eating disorder symptoms in the background of obsessional thoughts and sensation seeking impulsive traits.

Expressions of Individualization on the Internet and Social Media: Multigenerational Focus Group Study

Background

Growing individualization within the past decades has been described as a fundamental shift in society. Studies have reported how the digital age promotes new forms of individualism with self-tracking technologies and self-presentation in social networks. Potential harmful effects on the mental health of young adults have already been at the forefront of research. However, 2 questions that remain unanswered are how emotional experiences and expressions of self-relatedness differ among generations in their usage of the internet and social media, and if an increasing individualism can be observed by this.

Objective

The aim of this study is to examine whether the use of the internet and social media has led people to be more concerned about themselves than former generations. The potential consequences of mental and emotional distress among different age groups are analyzed.

Methods

A focus-group approach was chosen to study the following age groups: Baby Boomers (those born in 1950-1965), Generation X (those born in 1966-1980), and Digital Natives (those born in 1981-2000). We organized 6 focus groups with 36 participants who discussed their private usage of the internet and social media, different devices, platforms and functions, communication behavior, and self-tracking. We applied inductive category formation and followed the Standards for Reporting Qualitative Research (SRQR) checklist.

Results

We found differences in the 3 studied generations regarding the reasons for their use of the internet and social media, the effects of this use, personal feelings and experiences, expressions of self-relatedness, and social relationships. The Baby Boomers voiced a wish to stay autonomous while being in contact with their personal network. Generation X included enthusiastic members who appreciate self-tracking for curiosity and fascination, as well as people who felt fears about data surveillance. The Digital Natives reported a wish to optimize their own body by self-tracking while being faced with norms and expectations that were communicated via the internet and social media.

Conclusions

All generations expressed self-relatedness, yet by different means. The Baby Boomers expressed less individualism than Generation X and the Digital Natives, who felt the highest strain due to social comparisons. However, all generations reported specific, potentially problematic consequences for their mental health. Age-specific coping strategies are necessary to promote a mentally healthy way of using the internet and social media.

Relationship between Body Image and Body Weight Control in Overweight ≥55-Year-Old Adults: A Systematic Review

Objective: To assess the scientific evidence on the relationship between body image and body weight control in overweight ≥55-year-old adults. Methods: The literature search was conducted on MEDLINE database via PubMed, using terms related to body image, weight control and body composition. Inclusion criteria were scientific papers, written in English or Spanish, made on older adults. Exclusion criteria were eating and psychological disorders, low sample size, cancer, severe diseases, physiological disorders other than metabolic syndrome, and bariatric surgery. Results: Fifty-seven studies were included. Only thirteen were conducted exclusively among ≥55-year-old adults or performed analysis adjusted by age. Overweight perception was related to spontaneous weight management, which usually concerned dieting and exercising. More men than women showed over-perception of body image. Ethnics showed different satisfaction level with body weight. As age increases, conformism with body shape, as well as expectations concerning body weight decrease. Misperception and dissatisfaction with body weight are risk factors for participating in an unhealthy lifestyle and make it harder to follow a healthier lifestyle. Body image disturbance also made it more likely to underreport calorie intake. Conclusions: Aging is associated with a decrease in weight concerns and lower overweight perception, especially in women. However, when designing a program to improve body image in overweight ≥55-year-old adults, three items ought to be considered: physical activity, dietary and behavioral treatments.