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Public Health Implications of Health Misinformation – A Focus on Fad Diets


Let’s begin with an example:


Ranney, J. (2023, September 20). TikTok debunked: Is the 'egg diet' a safe way to lose weight? An expert weighs in. https://ca.style.yahoo.com/tiktok-debunked-egg-diet-health-expert-190100600.html

 

The above article details what was previously a popular TikTok trend: the egg diet. This diet promotes rapid weight loss through limiting daily food intake to eggs for every meal, along with a few other minimally allowable food/drinks, including apples and green tea (Ranney, 2023). Platform users lauded the diet as highly successful, in one instance captioning it as a way to 10kg in 10 days (Ranney, 2023). The egg diet is but one of hundreds, if not thousands (or more) fad diets circulating daily on social media – many (most) of which can have serious negative implications for health and well-being if followed for a prolonged period or at all.

 

What does the scientific literature say?

 

Fad diets are those which advertise a quick fix to obesity and other long-term (weight-related) health problems (Spadine & Patterson, 2022; Tahreem et al., 2022). These diets promote rapid weight loss in absence of physical activity, generally focusing on consumption of one (type of) food or the elimination of specific foods or food types (Spadine & Patterson, 2022; Tahreem et al., 2022). Fad diets are rarely backed by scientific evidence, relying instead on popularity as a means of substantiation (Tahreem et al., 2022) as well as societal or peer pressure as a mechanism of adoption (Spadine & Patterson, 2022) . There have been many fad diets that have risen to popularity or notoriety over time. These diets, despite demonstrating a potential for successful, albeit short-term, weight loss and health improvements, have generally failed to demonstrate sustained impact or long-term behavioural change (Anderson, 2023; D’Souza et al., 2020; Spadine & Patterson, 2022;  et al., 2022). Compliance represents a main concern of these diets given their restrictive and often nutritionally-deficient nature (D’Souza et al., 2020; Tahreem et al., 2022). Additionally, there exists concern for those with comorbidities (beyond obesity) as these diets have often not been extensively studied and their implementation is rarely overseen by a health professional (Anderson, 2023; D’Souza et al., 2020’ Tahreem et al., 2022).

 

There exist both short and long-term consequences of following fad diets. Short-term concerns include risk of dehydration, depression, irritability, and fatigue among others (Spadine & Patterson, 2022). Long-term consequences include the development of disordered eating behaviours, as well as physical damage to the kidneys and other internal organs, and increased levels of cholesterol, which can lead to the development of other serious conditions including heart disease and stroke (D’Souza et al., 2020; Spadine & Patterson, 2022).

 

In 2020, more than 40% of Americans reported following some form of fad diet, generally for aesthetic reasons (Spadine & Patterson, 2022). Use of social media is seen as specifically influencing this trend given its creation of expanded social influence and associated development of unhealthy and unsafe behaviours – especially as these concern diet and weight loss (Spadine & Patterson, 2022).

 

What are the potential public health implications of health misinformation?

 

While social media can be effectively used as a means of increasing health literacy, self-efficacy, and treatment adherence, it can also present health and social risks where misinformation is widely shared and improperly used to influence health and other decision-making (Suarez-Lledo & Alvarez-Galves, 2021). False or misleading health information spreads more easily on social media platforms (Suarez-Lledo & Alvarez-Galvez, 2021) and far outpaces the spread of available, credible research evidence (Vallance et al., 2018). Additionally, the influence of social media has been seen to outweigh that of parents and at times peers (Spadine & Patterson, 2022) – a trend that is especially concerning when considering the health behaviours of younger individuals. Where misinformation is normalized or legitimized by widespread sharing across social media platforms, confusion around or public doubt in public health recommendations begins to increase (Vallance et al., 2018). Additionally, the spread of misleading or unsubstantiated claims serves to distort or trivialize an understanding and/or acceptance of risks of well-researched, harmful behaviours (Vallance et al., 2018).

 

Specifically applied to the adoption of fad diets, the continual spread of misinformation has resulted in public confusion as to what constitutes optimal eating patterns (Anderson, 2023). Additionally, popularity of these diets, achieved through virality or influencer endorsement, leads to inferences by social media consumers that a diet’s claims are achievable, a specific diet is healthy, or that the recommended dietary habits are safe (Anderson, 2023). The advertisement of fad diets as “miracle cures” also negates focus on other important lifestyle changes required for weight reduction and improved health, such as exercise, improved sleep hygiene, and stress reduction, and overshadows the important consideration that these diets may not be appropriate for all individuals, given factors including medical history (Anderson, 2023).

 

Use of “healthful” terms such as ‘sugar-free’, ‘whole foods’, or ‘plant-based’ further blind social media consumers to potentially harmful ways of eating (Anderson, 2023) – a practice similar to that of using scientific terms to legitimize online conspiracies, notably those which surround the efficacy of vaccines. As consumer belief in quick fix diets overshadows trust in evidence-based recommendations, health promotion professionals are challenged to combat these unhealthy trends, or to promote the removal of individual, social, and environmental barriers to healthy and balanced eating that may serve to improve population health (sans crash diets) if meaningfully addressed (Spadine & Patterson, 2022).

 

Conclusion

 

In recent years, a growing evidence base has allowed for some defense against social media diet misinformation, with generally similar recommendations emerging from various medical organizations – all of these backed by sound scientific research (Anderson, 2023). However, the uphill battle continues to debunk the fad diet myth, or alternatively, to direct social media consumers to evidence-based recommendations for healthy eating choices and behaviours. Collaboration between public health outlets and social media platforms seems a likely path to successful intervention, along with further study of these trends to influence increased public sector action in future.

 

References

 

Anderson, K. (2023). Popular fad diets: An evidence-based perspective. Progress in Cardiovascular Diseases, 77, 78–85. https://doi.org/10.1016/j.pcad.2023.02.001

 

D'Souza, M. S., Dong, T. A., Ragazzo, G., Dhindsa, D. S., Mehta, A., Sandesara, P. B., Freeman, A. M., Taub, P., & Sperling, L. S. (2020). From fad to fact: Evaluating the impact of emerging diets on the prevention of cardiovascular disease. The American Journal of Medicine, 133(10), 1126–1134. https://doi.org/10.1016/j.amjmed.2020.05.017

 

Ranney, J. (2023, September 20). TikTok debunked: Is the 'egg diet' a safe way to lose weight? An expert weighs in. https://ca.style.yahoo.com/tiktok-debunked-egg-diet-health-expert-190100600.html

 

Spadine, M., & Patterson, M. S. (2022). Social influence on fad diet use: A systematic literature review. Nutrition and Health, 28(3), 369–388. https://doi.org/10.1177/02601060211072370

 

Tahreem, A., Rakha, A., Rabail, R., Nazir, A., Socol, C., Maerescu, C., & Aadil, R. (2022). Fad diets: Facts and fiction. Frontiers in Nutrition, 9, 1-14. https://doi.org/10.3389/fnut.2022.960922

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