Social media and nutrition (mis)information: navigating the maze

Social media has become an integral part of modern society, transforming the way individuals access and disseminate information, including nutrition-related content. Social media platforms offer numerous benefits, such as easy access to a wide range of dietary information, peer support and the potential for behavioural change.¹ However, the unrestricted nature of social media also exposes users to a barrage of conflicting, inaccurate or even harmful nutrition information and advice.

In 2023, an estimated 4.9 billion people use social media across the world and this number is expected to rise to approximately 5.85 billion users by 2027. The average social media user spends approximately 145 minutes on social media every day.² In South Africa, in 2023, close to 25.8 million internet users used social media with approximately 26% of users falling within the 18–24 years age category.³

Social media platforms have become a treasure trove of nutrition information. From Instagram to YouTube, individuals can access an array of nutrition information that ranges from ‘expert’ advice to personal anecdotes. With no policies in place to regulate the type of nutrition information shared on social media, nutrition misinformation is abundant, and users find it difficult to distinguish between what is accurate and credible information and what is not. However, being able to rely on credible and trustworthy sources can help individuals make better nutritional decisions, reducing risky behaviours and adopt healthy behaviours.^4,5

Globally, many registered dietitians (RDs), nutritionists and other health professionals utilise social media to share expert nutrition advice. They offer evidence-based information, tips and guidelines on various aspects of nutrition, such as meal planning, dietary guidelines and nutrition myths. These experts often cite scientific studies and provide credible references to support their claims.⁶ Research conducted across the United Kingdom and Ireland in 2017⁷ found that of the 1 005 responses received, 80% of RDs and 96% of student dietitians (SDs) were users of social media at the time. Among these, 41% of RDs used social media for their practice, and 45% of SDs used it for educational goals. One can argue that these numbers have increased since the COVID pandemic. The majority (66%) of the participants agreed that social media contributed to the promoting of the profession, while 36% expressed concern on the role of social media in establishing and maintaining the confidence of the public in their activities.⁷ Social media usage of South African dietitians is currently unknown.

In South Africa, RDs are bound by the Guidelines for Good Practice in the Healthcare Professions: Ethical guidelines on social media Booklet 16⁸ and the Social Media and Communication Guidelines⁹ published by the Association for Dietetics in South Africa (ADSA) to promote integrity, transparency, respect, responsibility and confidentiality when using digital platforms.¹⁰ However, these guidelines can be restrictive and limiting when healthcare professionals want to distinguish themselves from influencers or other so-called ‘experts’ who can post whatever they like on their social media pages.

Limited research has been conducted to date in South Africa to investigate how social media users interact with nutrition information on social media and how they determine what advice/information to follow. The Kreft et al.¹¹ study collected baseline data on an important demographic (young adults) population and the findings, reported in the current issue of the SAJCN, were insightful.

The most relevant findings of the study were that 96% of the participants used social media to access nutrition information, with active use of social media for sourcing nutrition information reported by 17%. More than half of participants indicated that they read the nutrition information if it happened to appear on their feed. These findings reiterate what we already know and experience, namely that nutrition information is widely accessible on social media even when one is not looking for it, and, as such, that potentially dangerous misinformation can spread quickly and is unchecked. Additionally, misinformation can have indirect and often unanticipated effects, including the promotion of mistrust in science or credible sources of health and nutrition information.¹² Kreft and colleagues also highlighted the need for more healthcare professionals to share their knowledge and expertise on social media, because the number of influencers (and so-called ‘experts’) outweigh the number of qualified professionals.

This research also found that social media users in this demographic population want relatable and personal content from social media pages and value good quality videos and photos. A study conducted in 2022 in Australia on young adults also found that video-style posts in particular were more likely to be engaged with and preferred compared with other post styles.¹³

Qualified healthcare professionals, including dietitians, should heed these suggestions in order to compete for the attention of social media users, being cognisant of any ethical pitfalls while posting on social media.¹⁴ Training for dietitians and other healthcare professionals (as part of the undergraduate curriculum or as a continuous professional development activity) on social media marketing and use (as well as the ethical guidelines on social media use), could improve dietitians’ confidence in utilising social media as a tool for sharing stories, their expert knowledge and marketing the profession while creating content that is more attractive and appealing for social media users. Based on these findings, and the restrictive nature of the current social media guidelines, the recommendation from Kreft and colleagues to reassess these guidelines is warranted.

It is encouraging that 97% of respondents from the research conducted by Kreft and colleagues reported feeling most comfortable adopting nutrition information if the source was someone with a dietetics degree. It was also reported that trust in a claim increased if it was made by a professional in the field of nutrition/health or supported by a qualified party or scientific literature. In contrast, nutritionists and ‘qualified people’ were the most followed on social media for nutrition advice. Participants also indicated that they found it difficult to determine whether nutrition information online is in fact scientific and correct. Therefore, the need for some form of verification (in the form of a verification tick) was expressed by the participants in order to identify credible nutrition sources online.

The research conducted by Kreft and colleagues¹¹ was descriptive in nature, and data were collected by means of an online survey. The self-reported nature of online surveys has its limitations, and the findings should therefore be interpreted taking that into consideration. That being said, the research has paved the way for future research in South Africa to explore this topic further. Future research should focus on other demographic groups as well as South African dietitians’ use of social media and the impact of social media on food choice(s). Further research on the use of a verification system to authenticate health professionals’ social media pages and their effectiveness is also urgently needed.

With social media use expected to increase significantly in the coming years, all opportunities should be explored and utilised to promote the sharing of evidence-based nutrition information online and to have a better understanding of the South African social media user. Social media’s influence on nutrition information is undeniable. It offers convenience, peer support and motivation for adopting healthier dietary behaviours, but it also exposes users to misinformation and confirmation bias. To harness the benefits of social media while mitigating its drawbacks, it is crucial to promote credible nutrition information, enhance educational initiatives and adapt platform algorithms.