NHD-EXTRA: SKILLS AND LEARNING
APPS AND SOCIAL MEDIA: FRIEND OR FOE IN NUTRITION? Emma Berry Student, University of Aberdeen
Emma is currently studying MSc Human Nutrition. She has an interest in Public Health nutrition and health promotion within the community. Emma hopes to work within the community setting to improve nutritional wellbeing and health.
For full article references please email info@ networkhealth group.co.uk
Young adults are the highest users of social media out of all generations, with over 90% shown to be active in a 2015 survey,1 with a variety of different applications (apps) used to communicate with friends, family or strangers, both in real life and in virtual reality. Although social media carries risks, it also presents a new way of engaging young adults with important issues regarding their health.2 Apps are most commonly found on transportable devices such as smart phones, allowing constant access to Facebook, Twitter, Snapchat, Whatsapp and many more virtual communication devices. These apps allow the posting of video, images, voice recordings as well as the written word, allowing the thoughts and opinions of young adults to be viewed by any number of interested parties. Adolescence and emerging adulthood presents an important stage of life where nutrition and weight can have effects in later life.3 Malnutrition, in the forms of both under- and overnutrition, can have serious implications in this age group. Ensuring that these young adults take an interest in their nutritional wellbeing and what they eat, is important to ensure their future health.3,4 Young adults also have the quickest rate of weight gain out of all the age groups and, therefore, could be targeted to try and reduce the risk of obesity in later life.5 The use of apps and social media could not only improve awareness of healthy eating from governmental bodies such as Change4Life,6 but also aid in improving dietary behaviours through increasing self-efficacy and supporting behaviour change techniques. APPS FOR IMPROVING SELF-EFFICACY
Changing health behaviours in a young adult population is a difficult task. Even though there are many efforts to 56
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improve healthy eating behaviours in the school setting, young adults are still defined as a at risk for developing a poor diet.9 Recent healthy eating campaigns are often presented as images targeted for families and children, making young adults believe they are not intended for them.10 One factor which can influence behaviour and behaviour change is self-efficacy.9 Studies have shown that young adults are more likely to improve their healthy eating behaviours when self-efficacy is higher.11 However, attempts to improve self-efficacy should be targeted towards the population of interest. Studies have shown that young adults face unique barriers for adopting healthy eating behaviours, such as perceptions of cost, time, peer pressure and competing factors including alcohol consumption.10 Targeting these barriers and demonstrating how these can be overcome could improve self-efficacy of young adults to make a change in their eating habits. An individual’s self-efficacy can also be improved through demonstrating change in a relatable character.12 Individuals having access to such examples of change is increased through apps such as Instagram, where individuals can post pictures of healthy food or weight changes. This may increase individuals’ awareness and knowledge of healthy food preparation. Young adults have reported having access to more recipes through using
social media, including ones for specific diets such as vegan or paleo.7 These apps allow individuals to follow each other, so they can find people who inspire them or who they can relate too. However, these apps can also have a negative effective on young adults, as they may find some images damaging to their self-esteem.13 As app users have their own accounts, there is limited controls on what is posted and shared, therefore, unhealthy food pictures or advice can also be posted, and therefore may also have a negative impact on nutritional wellbeing. Individuals posting pictures of certain foods such as desserts or chocolate cake could cause an increased feeling of hunger despite not being hungry.7 APPLICATIONS FOR IMPROVING INTAKE
Although improving self-efficacy and encouraging healthy behaviour change can be targeted through apps and social media, they can also have a role for supporting individuals at times of change. There are various apps which encourage and support individuals when attempting to improve their nutritional intake. Improving intake and health through the use of apps and social media still follows the same principles of any healthy behaviour intervention.14 Although using apps and social media for nutritional purposes is fairly new, similar behaviour change techniques are employed, such as self-monitoring, goal setting and having a support network.15 There are apps which are purposely designed for this, such as MyFitnessPal, which encourages the use of self-monitoring, self-weighing, goal setting and sharing progress with other users. However, some individuals use social media accounts, such as Instagram or Facebook, for such purposes. Communities within these social media apps have risen to support individuals who are looking to lose weight, or improve their health. These are often formed through a shared interest in losing weight or getting healthier.16 There has been evidence that individuals who post online regarding weight loss receive more support than discussing weight loss in person with their social networks.16 Again, the principles of behaviour change are the same such as stating goals on their social media, updating regularly with achievements and failures to their online support network.15
In theory, the idea of using social media to support healthy behaviour changes is a great way to encourage and support a large number of individuals. The use of apps on their smartphones means that individuals have access to this network at any time. However, many of these social media accounts and apps are not monitored. Apps such as MyFitnessPal can have various foods and their content input by users – meaning that the foods added may not have the correct information.17 Social media account users can also post anything relating to food without having to verify that it is fact, or scientifically accurate.7 Many social media stars - who use the platform as a base for selfpromotion - have become well known for their food posts and restrictive diets without necessarily having scientific grounding.7 Although these accounts and apps may not cause a problem if individuals choose to listen to it for one meal, over a longer period of time this could have an impact on an individuals’ nutritional wellbeing. SOCIAL MEDIA AND APPS IN RESEARCH
In recent years, there has been a move towards using social media and apps to improve health behaviours in research.18 Studies which have discussed the use of social media in promoting healthy eating have discussed various aspects of their use, for example, as a form of recruitment, encouraging forms of engagement and as a form of intervention itself.19 However, relatively few studies have looked at platforms which already exist and their effects on behaviours themselves.19 There is evidence to suggest that the retention of studies which used platforms that already exist in everyday life (such as Facebook, Twitter) is quite high.18 This suggests that using social media platforms which already exist could be an exciting way to reach young adults and engage them for future research on nutrition. Although these small initial studies are important to determine how social media can be used to engage young adults, larger trials are needed. Evaluating the use of social media as a form of improving nutritional wellbeing in young adults could further current efforts such as the Change4Life campaign. This would allow governing bodies to better target this age group, improve their eating choices and long-term health outcomes. www.NHDmag.com October 2016 - Issue 118
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NHD-EXTRA: SKILLS AND LEARNING CONCLUSIONS
Social media and apps could have a role in improving nutritional wellbeing in young adults. They have the potential to improve self-efficacy through the sharing of pictures, recipes and tips from inspirational and relatable figures. There are apps which are specifically designed to support and encourage healthy behaviour change, and apps which develop their own social media communities around relatable behaviours. These communities provide invaluable support that may be more encouraging than an individual’s
family or friend network in-person. These platforms also have the potential to improve engagement with young adults in health research. However, apps and social media can have negative effects. There is the potential to damage an individual’s self-esteem, and expose followers to nutritional information which is incorrect or dangerous. It is important that individuals who offer nutrition-based advice should be able to verify their claims, and that consumers of these messages are trained to be wary of claims without scientific backing.
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www.NHDmag.com October 2016 - Issue 118