Nudging or 'choice architecture' refers to strategic changes in the environment that are anticipated to alter people's behaviour in a predictable way, without forbidding any options or significantly ...changing their economic incentives. Nudging strategies may be used to promote healthy eating behaviour. However, to date, the scientific evidence has not been systematically reviewed to enable practitioners and policymakers to implement, or argue for the implementation of, specific measures to support nudging strategies. This systematic review investigated the effect of positional changes of food placement on food choice. In total, seven scientific databases were searched using relevant keywords to identify interventions that manipulated food position (proximity or order) to generate a change in food selection, sales or consumption, among normal-weight or overweight individuals across any age group. From 2576 identified articles, fifteen articles comprising eighteen studies met our inclusion criteria. This review has identified that manipulation of food product order or proximity can influence food choice. Such approaches offer promise in terms of impacting on consumer behaviour. However, there is a need for high-quality studies that quantify the magnitude of positional effects on food choice in conjunction with measuring the impact on food intake, particularly in the longer term. Future studies should use outcome measures such as change in grams of food consumed or energy intake to quantify the impact on dietary intake and potential impacts on nutrition-related health. Research is also needed to evaluate potential compensatory behaviours secondary to such interventions.
Aim
Negative body image increases the risk of engaging in unhealthy dieting and disordered eating patterns. This review evaluated the impact of habitual social media engagement or exposure to ...image‐related content on body image and food choices in healthy young adults (18‐30 years).
Methods
A systematic search of six databases of observational literature published 2005‐2019, was conducted (PROSPERO Registration No. CRD42016036588). Inclusion criteria were: studies reporting social media engagement (posting, liking, commenting) or exposure to image‐related content in healthy young adults. Outcomes were: body image (satisfaction or dissatisfaction) and food choices (healthy eating, dieting/restricting, overeating/binging). Two authors independently screened, coded and evaluated studies for methodological quality.
Results
Thirty studies were identified (n = 11 125 participants). Quantitative analysis (n = 26) identified social media engagement or exposure to image‐related content was associated with higher body dissatisfaction, dieting/restricting food, overeating, and choosing healthy foods. Qualitative analysis (n = 4) identified five themes: (i) social media encourages comparison between users, (ii) comparisons heighten feelings about the body, (iii) young adults modify their appearance to portray a perceived ideal image, (iv) young adults are aware of social media's impact on body image and food choices, however, (v) external validation via social media is pursued. Most studies (n = 17) controlled for some confounding variables (age, gender, BMI, ethnicity).
Conclusions
Social media engagement or exposure to image‐related content may negatively impact body image and food choice in some healthy young adults. Health professionals designing social media campaigns for young adults should consider image‐related content, to not heighten body dissatisfaction.
Social media has been widely adopted by young adults, consequently health researchers are looking for ways to leverage this engagement with social media for the delivery of interventions and health ...promotion campaigns. Weight gain and sub-optimal dietary choices are common in young adults, and social media may be a potential tool to facilitate and support healthier choices.
We conducted a mixed-methods systematic review of studies examining social media use for nutrition-related outcomes in young adults. Seven databases EBscohost, ERIC, ProQuest Central, PubMed, Ovid, Scopus, and Emerald were systematically searched; 1225 abstracts were screened, and 47 full-text articles were assessed for eligibility. Study designs included both quantitative, such as experimental and observational studies, and qualitative, such as focus groups and interviews, approaches. Quality was assessed using the Mixed Methods Appraisal Tool. Quantitative and qualitative results were examined separately, and then synthesized.
Twenty-one studies were included although their use of social media was highly variable. The main purpose of social media was to provide information and social support to participants. In the nine randomized controlled trials, social media was used as one aspect of a multi-faceted intervention. Interventions had a positive statistically significant impact on nutritional outcomes in 1/9 trials. Engagement with the social media component of interventions varied, from 3 to 69%. Young adults appear to be open to receiving healthy eating and recipe tips through social media, however, they are reluctant to share personal weight-related information on their online social networks.
Information-dissemination is now an acceptable use of social media by young adults. Using social media effectively for social support, either via private groups or public pages, requires careful evaluation as its effectiveness is yet to be demonstrated in experimental designs. Concerns about public social media use may be a contributing factor to poor engagement with social media in research intervention studies aimed at influencing weight. Future research should consider how to best engage with young adults using social media, how to more effectively use social media to support young adults and to facilitate social and peer-to-peer support in making healthier choices.
Issue addressed: Although government promoted public health, social media and media campaigns have communicated nutrition information, the Australian population remains chronic under-consumers of ...fruit and vegetables and overconsumers of ultra-processed foods. This scoping review aimed to determine how social media influencers (SMI) communicate nutrition information and the factors that influence the popularity of messages. Identified factors could inform how governments may utilise social media to impact positively on food choices.
Methods: Nine databases were searched in the past 5 years (2016-2021). After relevant sources were identified, entire texts of the grey literature and the "Results" sections of the academic literature were coded. Using Microsoft Word, each key feature of the relevant text was highlighted, and the relevant code was recorded. Inductive coding was utilised where codes were created based on the text itself. These codes were then sorted iteratively into relevant themes and subthemes.
Results: Eleven studies were included. From these sources, five themes were identified. These were, (i) promoting dietary change, (ii) certain modes/styles of content delivery, (iii) an attractive individual, (iv) language features and (v) appearing connected to the audience.
Conclusion: SMI are selective in their content and communication techniques to ensure their nutrition messages are popular with social media users. These methods exhibited by SMI could inform strategies to build trust in government messages about food and nutrition.
The relationship between alcohol consumption and body weight is complex and inconclusive being potentially mediated by alcohol type, habitual consumption levels and sex differences. Heavy and regular ...alcohol consumption has been positively correlated with increasing body weight, although it is unclear whether this is due to alcohol consumption per se or to additional energy intake from food. This review explores the effects of alcohol consumption on food energy intake in healthy adults. CINAHL Plus, EMBASE, Medline and PsycINFO were searched through February 2018 for crossover and randomised controlled trials where an alcohol dose was compared with a non-alcohol condition. Study quality was assessed using the Effective Public Health Practice Project tool. A total of twenty-two studies involving 701 participants were included from the 18 427 papers retrieved. Studies consistently demonstrated no compensation for alcoholic beverage energy intake, with dietary energy intake not decreasing due to alcoholic beverage ingestion. Meta-analyses using the random-effects model were conducted on twelve studies and demonstrated that alcoholic beverage consumption significantly increased food energy intake and total energy intake compared with a non-alcoholic comparator by weighted mean differences of 343 (95 % CI 161, 525) and 1072 (95 % CI 820, 1323) kJ, respectively. Generalisability is limited to younger adults (18-37 years), and meta-analyses for some outcomes had substantial statistical heterogeneity or evidence of small-study effects. This review suggests that adults do not compensate appropriately for alcohol energy by eating less, and a relatively modest alcohol dose may lead to an increase in food consumption.
The nutrition education landscape is changing due to advances in technology. Massive Open Online Courses (MOOCs) are an example of new education opportunities, made possible by advances in online ...learning environments. This research aimed to evaluate a nutrition-focused MOOC, applying Kirkpatrick’s theoretical model of learning, to comprehensively describe learners’ reactions, knowledge and behaviours. A mixed-methods approach explored learners’ experiences of participating in a global nutrition MOOC. Quantitative survey data, using descriptive statistics, measured pre-course nutrition knowledge, post-course satisfaction and learning, and changes to fruit/vegetable intake. Qualitative data from discussion forums and semi-structured interviews were thematically analysed and explored participant experiences and perceived impacts on dietary behaviours and nutrition knowledge. All results were mapped to Kirkpatrick’s model. Surveys measuring perceived knowledge, satisfaction, and fruit and vegetable intake were completed by 4941, 1003 and 1090 participants, respectively. Overall reactions to the course were positive. Perceived vegetable intake increased for 62% of participants. Twelve interviews and six hundred and forty-seven forum comments were analysed, identifying eight themes highlighting changes to knowledge and dietary behaviours, and the importance of peer-to-peer learning. All results mapped to Levels 1–3 of Kirkpatrick’s model. MOOCs can be an effective platform to communicate evidence-based nutrition information to large, global audiences.
Objectives To examine relationships between dietary intake, growth and body composition patterns in patients with inborn errors of intermediary protein metabolism and to determine a safe ...protein:energy ratio (P:E ratio) associated with optimal growth outcomes. Study design Retrospective longitudinal data of growth and dietary intake in patients (n = 75) with isovaleric acidemia (IVA; n = 7), methylmalonic acidemia/propionic acidemia (MMA/PA; n = 14), urea cycle defects (UCD; n = 44), classical maple syrup urine disease (MSUD; n = 10) were collected. Prospective longitudinal data of growth, dietary intake, and body composition from 21 patients: IVA (n = 5), MMA/PA (n = 6), UCD (n = 7), and MSUD (n = 3) were collected at clinic visits. Results Fifty-two of 75 (66%), 49 of 74 (68%), and 44 of 65 (68%) patients had a z -score of 0 (±1) for lifetime weight, height, and body mass index, respectively. Patients with MMA/PA had the lowest median height and weight z -scores, and MSUD patients had highest median body mass index z -score at all ages. In IVA, MMA/PA, and UCD, total natural protein intake met or exceeded the Food and Agriculture Organization of the United Nations (FAO)/World Health Organization (WHO)/United Nations University (UNU) recommended safe levels. Median percentage fat mass was 17.6% in IVA, 20.7% in MMA/PA, 19.4% in UCD, and 17.8% in MSUD. There was a significant negative correlation between percentage fat mass and total protein intake in IVA, MMA/PA, and UCD (r = −0.737; P = .010). The correlation between the P:E ratio and growth variables in IVA, MMA/PA, and UCD suggest a safe P:E ratio (>1.5 to < 2.9) g protein:100 kcal/day. Conclusion Growth outcomes in inborn errors of intermediary protein metabolism are not always ideal. Most patients with IVA, MMA/PA, and UCD consume sufficient natural protein to meet FAO/WHO/UNU recommendations. A P:E ratio range of (>1.5 to < 2.9)g protein/100 kcal/day correlates with optimal growth outcomes.
Excessive maternal gestational weight gain (GWG) contributes to generational obesity. Our aim was to explore efficacy and intervention characteristics (trimester, duration, frequency, intensity, and ...delivery method) of interventions to prevent excessive GWG. CINAHL, Cochrane, EMBASE, LILACS, MEDLINE, PsycINFO, and Scopus were searched up to May 2018 (no date or language restrictions). Keywords and MeSH terms for diet, GWG, intervention, lifestyle, maternal, physical activity, and pregnancy were used to locate randomized-controlled trials (RCTs). The Cochrane Collaboration tool for assessing risk of bias was applied. Eighty-nine RCTs were included. Meta-analysis (60 trials) estimated that women in diet only (WMD: -3.27; 95% CI: -4.96, -1.58,
< 0.01), physical activity (PA) (WMD: -1.02; 95% CI: -1.56, -0.49,
< 0.01), and lifestyle interventions (combining diet and PA) (WMD: -0.84; 95% CI: -1.29, -0.39,
< 0.01) gained significantly less weight than controls. The three eHealth interventions favored neither intervention nor control (WMD: -1.06; 95% CI: -4.13, 2.00,
= 0.50). Meta-regression demonstrated no optimal duration, frequency, intensity, setting, or diet type. Traditional face to face delivery of weight management interventions during pregnancy can be successful. Delivery via eHealth has potential to extend its reach to younger women but needs further evaluation of its success.
This study aimed to compare the use of the bioelectrical impedance device (BIA) seca
mBCA 515 using dual X-ray absorptiometry (DXA) as a reference method, for body composition assessment in adults ...across the spectrum of body mass indices. It explores the utility of simple anthropometric measures (the waist height ratio (WHtR) and waist circumference (WC)) for the assessment of obesity. In the morning after an overnight fast (10 h), 30 participants underwent a body composition DXA (GE iDXA) scan, BIA (seca 515), and anthropometric measures. Compared to the DXA reference measure, the BIA underestimated fat mass (FM) by 0.32 kg (limits of agreement -3.8 kg, 4.4 kg); overestimated fat free mass (FFM) by 0.43 kg (limits of agreement -8.2 kg, 4.3 kg). Some of the variation was explained by body mass index (BMI), as for FM, the mean difference of the normal range BMI group was smaller than for the overweight/obese group (0.25 kg and 0.35 kg, respectively) with wider limits of agreement (-4.30 kg, 4.81 kg, and -3.61 kg, 4.30 kg, respectively). There were significant differences in visceral adipose tissue (VAT) volume measurements between methods with BIA systematically overestimating VAT compared to DXA. WC was more strongly correlated with DXA FM (rho = 0.90,
< 0.001) than WHtR (rho = 0.83,
< 0.001). BIA had some agreement with DXA; however, they are not equivalent measures for the range of BMIs explored, with DXA remaining the more informative tool. WC is a useful and simple assessment tool for obesity.
People's accessibility to nutrition information is now near universal due to internet access, and the information available varies in its scientific integrity and provider expertise. Understanding ...the information-seeking behaviours of the public is paramount for providing sound nutrition advice. This research aims to identify who learners in a nutrition-focused Massive Open Online Course (MOOC) turn to for nutrition information, and how they discuss the information they find. A multi-methods approach explored the information-seeking and sharing behaviours of MOOC learners. Summative content analysis, and an exploratory, inductive, qualitative approach analysed learners' posts in MOOC discussion forums. From 476 posts, the majority (58.6%) of nutrition information sources learners reported were from websites. Providers of nutrition information were most commonly (34%) tertiary educated individuals lacking identifiable nutrition qualifications; 19% had no identifiable author information, and only 5% were from nutrition professionals. Qualitative themes identified that learners used nutrition information to learn, teach and share nutrition information. Consistent with connectivist learning theory, learners contributed their own sources of nutrition information to discussions, using their own knowledge networks to teach and share information. Nutrition professionals need to understand the principles of connectivist learning behaviours in order to effectively engage the public.
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