Avoid Food Bloggers When Looking for Nutritional Advice

GLASGOW, Scotland — People looking for nutritional advice to help with weight management should not turn to social media influencers, warn UK researchers, who found these influencers often had no relevant qualifications and their blogs lacked credibility and included unhealthy recipes.

Presenting the findings here at the European Conference on Obesity (ECO) 2019, Christina Sabbagh, MSc, University of Glasgow, said nine leading UK weight management blogs were assessed using 12 credibility indicators and given a score.

In addition, the 10 most recent recipes posted by the social media influencers were compared against official calorie and nutritional content criteria.

Only one of the nine blogs, which the authors did not name for legal reasons, passed their credibility test for being transparent, trustworthy, and unbiased. Of note, it was the only one run by an accredited nutritionist.

Moreover, just three blogs assessed recipes that met the nutritional criteria, with more than half exceeding recommended kilocalorie limits.

During a press conference, Sabbagh said her findings show that "social medical influencers' weight management blogs cannot really be recommended as credible resources for weight management."

Noting that even one blog run by a medical doctor did not pass their test, she added, "it might be the case that a credible title might not actually provide credible information online."

She underlined: "We cannot ignore the online environment and social media influencers. They exist and they have a huge influence, and this influence can cause misinformation to spread, which could be harmful."

Calls for Regulation of Such Influencers, Verification Schemes

"The results," said Sabbagh, "justify further research in this area, particularly over the influence of behaviors in weight management, and there are implications for policymakers to regulate and influence weight management output online."

She told Medscape Medical News that she would support the introduction of a verification scheme to inform the public which weight management blogs offer reliable information.

"Some of these people seem like they're very credible, some of them have millions of followers online and a long career, and one of them was a medical doctor, so you wouldn't necessarily think to question that person.

"You could put up a credibility badge on the blog itself so that the public could then go onto it and see...and they can then choose whether they want to take that information or not," she suggested.

Asked for his thoughts, Stuart Flint, PhD, senior research fellow in public health and obesity, Leeds Beckett University, UK — who was not involved in the study — told Medscape Medical News that many of the people who use social media to find health information are "vulnerable."

"We know that there are people engaged with social media who have body image concerns [and] are engaging in risky eating behaviors...so there’s a major concern, I think, if people are disseminating inaccurate information."

He also pointed out that, often, online influencers recommend one diet as being the perfect one to follow, which does not take into account the reality that "we all need different things."

"There's no one diet that is right for everybody or one diet to follow. We need to ensure it is relevant to the person's background or what they're engaging in. People will need different amounts of fats, carbohydrates, proteins, and so on, and so to suggest that [any one diet]...is a great diet for everybody is going to be very inaccurate," he said.

Flint believes that, because social media is so widespread and easy to access, action needs to be taken on several fronts to ensure dietary advice found online is credible.

"There's more that we need to do to educate the public. There's more individuals need to do in terms of taking some responsibility about what they're putting out there and realizing when you're not an expert in something," he stressed.

"And there's certainly something that can be done around social media itself taking action to regulate this type of information.

"I think that social media platforms such as Twitter, Instagram, and so on, need to be doing more to try and regulate or police information when it's not correct," or this may lead to damaging consequences, he advised.

Only Two of Nine Bloggers Deemed Adequate to Advise

Sabbagh said survey data from the British Dietetic Association suggests 58% of UK adults would trust nutritional advice from an under-qualified person, such as a personal trainer or fitness instructor. And this figure rose to 75% among respondents aged 18-24 years.

Moreover, 41% people in that age group said they would trust advice from a healthy eating blogger.

But there is no requirement for people setting up such blogs to be qualified on the topics they are advising on, and there are questions about the integrity of such online information and the opinion-based nature of the advice.

The researchers therefore set out to examine the credibility and quality of dietary advice and recipes published on healthy eating and weight management blogs.

Between May and June 2018, they conducted a comprehensive search on the Influence.co platform for social media influencers, as well as on Instagram and Google, for UK influencers with weight management blogs.

Influencers were selected if they had more than 80,000 followers on at least one social media site, blue tick verification for being influential in their field on at least two sites, and an active weight management blog.

After excluding five blogs because half the posts were not nutrition- or physical activity-related, researchers were left with nine to assess.

These nine blogs were examined for credibility using 12 indicators in three groups:

Transparency, including clear identification of the author and any cited references, as well as their quality.
Trustworthiness and adherence to nutritional criteria, including the author's qualifications and whether any recipes met nutritional standards.
Bias, including whether the blog differentiates between advertising and content, and between fact and opinion.

The indicators were framed as yes/no questions, and an acceptable pass mark of 70% was set to identify influencers who met most of the criteria.

The results showed that just two of the nine weight management blogs were run by influencers who could be rated as adequately qualified to provide such advice.

Moreover, five blogs failed to provide any form of disclaimer, and seven did not provide any evidence-based references for their claims.

Just One Blog Passed "Credibility" Test, Recipes Fell Short Too

Overall, just one of the nine weight management blogs passed the credibility test, with a mark of 83%. The blog was run by the only influencer who had a formal degree in nutrition and was registered with the Association for Nutrition.

Six of the other blogs scored between 42% and 58%, including one that was run by a medical doctor.

The final blog had a mark of just 25% on the credibility indicators, which was run by a person without any nutritional qualifications.

Next, researchers looked at the nutritional quality of the 10 latest recipes from each of the blogs, assessing them against the recommendations in the One You calorie reduction campaign by Public Health England (PHS).

The recipes were also analyzed for energy, carbohydrates, protein, fat, saturated fat, fiber, sugar, and salt content against the UK Food Standards Agency's Traffic Light Scheme.

This analysis revealed that four blogs failed to meet the nutritional criteria with all of their recipes, only one gave any kind of nutritional information, and four stated they were against counting calories.

Taking the example of breakfast recipes, the team found that more than 50% were above the highest recommended kilocalorie limit.

One recipe provided more than 1062 kcal, which is greater than half of the recommended total dietary daily intake for nondieting women.

The evening meal recipe with the highest energy content, calculated to contain 1592 kcal, was found on the same blog. A lunch recipe containing 1024 kcal was also on that site. Researchers calculated that if someone used the recipes on the blog and the PHS recommended 400 kcal/day for snacks, they could end up consuming 4078 kcal/day — a surplus of 2078 kcal/day over the recommended daily intake for women of 2000 kcal/day.

Sabbagh also noted that, in many cases, the accompanying pictures showed "far more" food than was in the recipes. "So we can't tell if people were consuming just that recipe or if they were looking at the pictures and maybe overconsuming."

No funding for the study was declared. The authors have reported no relevant financial relationships.

ECO 2019. Presented April 30, 2019. Abstract OS8.06.

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