0254/2024 - Search for information on food and nutrition and its intersections with eating behavior and body image
Busca por informações sobre alimentação e nutrição e suas intersecções com o comportamento alimentar e imagem corporal
Autor:
• Keila Priscila dos Santos Avelar - Avelar, K. P. S - <keilaavelar94@gmail.com / keilaavelar@usp.br>ORCID: https://orcid.org/0009-0001-6834-8711
Coautor(es):
• Maria Fernanda Laus - Laus, F. L. - <ferlaus@gmail.com / mlaus@unaerp.br>ORCID: https://orcid.org/0000-0002-4947-1642
Resumo:
This quantitative study associated the search for information about food and nutrition with body image and eating behavior in men and women. An online survey was conductedDecember 2021 to March 2022, with 518 adults participating via social media and email invites. The survey included demographic questions, information-seeking behavior, beauty ideals, media influence, body satisfaction, investment in appearance, and disordered eating. Two-way ANOVAs and Path analysis were used. Most participants were women, white, heterosexual, and single, with an average age of 31 years and body mass index (BMI) of 25.9 kg/m². Most participants looked up information about food and nutrition (81.7%; n = 423) and used Google® as their primary source (45.2%; n = 191). Path analysis revealed that searching for information is positively associated with satisfaction with appearance, BMI, media pressure, and time spent on social networks. Conversely, there is a negative relationship between satisfaction with appearance and seeking information and between investment in appearance and searching for such information. These data demonstrate that searching for information about food and nutrition on the internet can significantly influence several aspects of eating behavior and body image.Palavras-chave:
Diet, Food, and Nutrition. Information Seeking Behavior. Eating Behavior. Body Image.Abstract:
Este estudo quantitativo associou a busca por informações sobre alimentação e nutrição com a imagem corporal e o comportamento alimentar em homens e mulheres. Para isso, foi realizada uma pesquisa online divulgada nas redes sociais e por e-mail entre dezembro de 2021 e março de 2022 com 518 adultos. A pesquisa incluiu perguntas demográficas, comportamento de busca de informação, influência da mídia, comportamento alimentar e imagem corporal. Elas foram analisadas por meio de ANOVAs de duas vias e de análise de caminhos. A maioria dos participantes eram mulheres, brancas, heterossexuais e solteiras, com idade média de 31 anos, e o índice de massa corporal (IMC) de 25,9 kg/m². A maioria dos participantes buscavam informações sobre alimentação e nutrição (81,7%; n=423) e utilizavam o Google® como sua principal fonte (45,2%; n=191). A análise de caminhos revelou que a busca por informações sobre alimentação e nutrição online está positivamente associada à satisfação com a aparência, IMC, pressão da mídia e tempo gasto nas redes sociais. Por outro lado, ela estava associada negativamente à satisfação e investimento na aparência. Pesquisar sobre alimentação e nutrição online pode influenciar significativamente como as pessoas comem e percebem seus corpos.Keywords:
Nutrição, Dieta e Alimentação. Comportamento de Busca de Informação. Comportamento alimentar. Imagem corporal.Conteúdo:
The internet has become a vast platform for gathering information about food and nutrition. A study conducted by Nestlé 1 analyzed the sources used by 500 Brazilian adults from various regions to acquire knowledge on healthy eating. The survey results showed that most participants mainly searched for such information on the internet, using search engines, social networks, and traditional media.
Finding information about restrictive diets through traditional and social media is easy nowadays. Many of these diets promise immediate results, which can be tempting for individuals who want to achieve an ideal body. It is concerning, however, that much of the information on food and nutrition found on these platforms is based on something other than scientific knowledge. Moreover, such information is often associated with unrealistic body ideals that are hard to attain naturally. It is important to note, however, that disseminating information regarding body ideals can alter eating behavior and body image 1,2.
The recommended eating patterns are often restrictive or labeled as "miraculous," which can lead to quick weight loss or muscle gain. However, many people follow these diets without seeking proper nutritional guidance and follow-up 3, which can lead to unsuccessful long-term results and negatively affect a person's body image and eating behavior 4,5.
1.1 Food and nutrition information and body image
Body image is a multifaceted construct related to an individual's identity. Through one's evaluation of his/her image, a person can have positive or negative feelings and sensations related to the appearance 6. The internet and social media considerably influence body image, as photos and videos of women with lean bodies and slightly toned abdomens and men with muscular V-shaped bodies are shared. These ideals are often associated with health, professional success, and good relationships 7,8.
The internalization of beauty ideals can affect satisfaction levels with one's appearance 9, especially among those highly invested in their appearance, who consider the body a crucial factor in success in various contexts 10. The psychological investment in appearance is associated with body satisfaction, which is also related to weight. In this sense, women tend to report greater dissatisfaction with their appearance and the desire to have a lower Body Mass Index (BMI) (even those in a normal weight range), and men tend to report greater dissatisfaction with a lower BMI, both influenced by the current standard of beauty 11, 12.
The media often presents food as the solution to achieving an ideal body. When searching for food and nutrition information to modify body parts or BMI, people find motivational content featuring influencers and models with training tips and inspirational phrases 13. Exposure to this content can lead to internalization, dissatisfaction with appearance, and change in one's relationship with food 13.
1.2 Food and nutrition information and eating behavior
Eating behavior refers to how people behave when they eat, such as eating with others at a particular time. These actions are influenced by people's emotions, knowledge, and beliefs about food 4, 5. The search for food and nutrition information can influence eating behavior, such as choosing food to consume. This search is usually done on the internet, through search engines and social networks, in traditional media, and in magazines that have an editorial focused on this topic 1, 2. When searching for food and nutrition information, individuals may encounter restrictive eating patterns that are unbalanced about macro and micronutrients, causing calorie deficits and nutritional deficiencies 14. Many adhere to these diets without checking their actual demands or having an assessment done by a field professional 2.
Adherence to restrictive diets and a lack of proper monitoring may be motivated by weight management. However, it can trigger metabolic and psychological problems, favoring the emergence of eating disorders 3. Restrictive diets can even have quick results because of a large calorie deficit. However, they are challenging to maintain and can lead to weight cycling. In addition to the physiological risks, such as the high risk of developing cardiovascular diseases, they can cause several changes in eating behavior, such as bingeing and food restriction 3, 15.
Dietary patterns generally differ between men and women; men's diets are generally focused on macronutrients, especially protein consumption, to gain muscle mass, while women's diets aim for a calorie deficit to lose weight and conform to the body model of beauty 15.
1.3 The present study
With frequent internet and social media use, people increasingly rely on them for information about food and nutrition. However, much of this information needs a more scientific basis. Some studies verified that people search for food and nutrition information and associate this search with aspects of eating behavior and body image 2, 5, 13, 16. However, none directly associated this search with other aspects of body image, such as psychological investment in appearance, or considered other variables affecting body image and eating behavior, such as time spent using social networks and BMI. Therefore, this study aimed to evaluate the effect of searching for food and nutrition information on body image and eating behavior.
2. Methods
2.1 Participants
Sample size was determined using the formula n = N Z² p (1-p) / [(N-1) e² + Z² p (1-p)]. In this formula, "n" represents the calculated sample size, "N" is the size of the population, "Z" is the normal variable, "p" is the actual probability of the event, and "e" is the sampling error17. As a result, the required sample size was at least 385 individuals.
The inclusion criteria for participants were to be between 18 and 50 years old, agree to participate, and give their informed consent. Exclusion criteria included not answering at least 80% of the questionnaires, being pregnant or nursing, having a health condition that directly affected their diet (such as food allergies, Crohn's disease, irritable bowel disease, or diabetes), having any medical condition that directly or indirectly influenced their physical appearance (such as AIDS, cancer, rheumatological or autoimmune diseases, or severe burns), and preparing for or having undergone bariatric surgery.
The study initially had 738 participants. However, 220 individuals had to be excluded based on the pre-established exclusion criteria. Of these, 174 individuals had some health conditions that could affect their eating behavior and body image. Twenty-five participants did not answer one or more of the questionnaires, 13 individuals refused to participate in the study, and 8 individuals were either above or below the age range specified for the study. The final sample comprised 518 valid participants.
2.2 Materials
Sample characterization questionnaire. The questionnaire was developed by the researchers themselves and contained questions about age, weight, height, gender, skin color, marital status, sexual orientation, and education. It also asked if participants sought information about food, where this search was done, and how often (“Do you seek information about food/nutrition?”; “What type of information do you seek?”; “Where do you seek this information?”; “How often do you seek information related to food and nutrition on this type of platform?”; “How often do you use social media? (Facebook, Instagram, TikTok, Twitter, WhatsApp)?”; “How many hours per day do you use social media? (Facebook, Instagram, TikTok, Twitter, WhatsApp)?”; “How many hours per day do you spend on social media searching/viewing content related to food and nutrition?”; “On social media, do you follow profiles of people who post content about food and nutrition?”).
Multidimensional Body Shape Relationships Questionnaire – Appearance Scales (MBSRQ-AS). The questionnaire was developed by Brown et al. 18 and revised by Cash 19, having been adapted for Brazil by Laus et al. 20. The questionnaire has five subscales, however, only the "Appearance Evaluation" subscale was used, which assesses feelings about satisfaction/dissatisfaction with appearance, and contains five questions. The subscale score was measured using a five-point Likert scale, which ranged from "strongly disagree" (1 point) to "strongly agree" (5 points). The final score corresponded to the mean of the items. High scores indicated greater satisfaction with appearance, while low scores indicated overall unhappiness with physical appearance. In the present sample, the internal consistency (McDonald’s Omega) of the subscale was .878.
Sociocultural Attitudes Towards Appearance Questionnaire-4 (SATAQ-4). The questionnaire was developed by Schaefer et al. 21 and adapted for Brazil by Barra et al. 22 and contains five subscales. In this study, the following subscales were used: "Media Pressure" and "Internalization: Thin/Low Body Fat". Each one has four items, which allow to verify the pressure that the media exerts on body image and the idealization of a thin body ideal. The score of these subscales was measured using a five-point Likert scale, which ranged from "strongly disagree" (1 point) to "completely agree" (5 points). The final score corresponded to the mean of the items, and the higher the score, the greater the internalization of body ideals and media pressure concerning appearance. In the present sample, the internal consistency (McDonald’s Omega) of the subscales was .935 for the Media Pressure subscale and .835 for the Internalization: Thin/Low Body Fat subscale.
Appearance Schemas Inventory - Revised (ASI – R). The questionnaire was developed by Cash et al. 23 and adapted to the Brazilian population by Laus et al. 24. The questionnaire has two subscales, however, in the present study, only the "Self-Evaluative Salience of Appearance" subscale was used, which reflects the intensity with which beliefs about appearance influence the individual's social and personal life through six questions. The items were scored on a Likert scale ranging from "strongly disagree" (1 point) to "strongly agree" (5 points). The score resulted from the mean of the items and the higher the result, the greater the importance that the individual gave to his or her appearance. In the present sample, the internal consistency (McDonald’s Omega) of the subscale was .874
Disordered Eating Attitudes Scale (DEAS). The scale was developed by Alvarenga et al. 25 for women and validated by Alvarenga et al. 26 for men, containing 25 questions, divided into five subscales, however, in this research, only one subscale was used. The "Restrictive and compensatory practices" subscale evaluates food restriction, calories, and attitudes to compensate for a large or uncontrolled food intake. The items are designed to be classified on a Likert scale, with the final score of the subscale being the sum of the points. Higher scores indicate more dysfunctional attitudes. In the present sample, the internal consistency (McDonald’s Omega) of the subscale was .347.
2.3 Procedures
The project was approved by the Institutional Ethics (CAAE nº 46354621.4.0000.5407), and all participants were provided access to the virtual Informed Consent Form at the beginning of the research. They could either accept and proceed with participation or decline without any consequences. Participant recruitment took place virtually between December 2021 and March 2022. The study was promoted on social media platforms (Facebook®, Twitter®, and Instagram®) and via email, providing a link for virtual responses using the REDCap platform.
2.4 Data analysis
The data were downloaded from the REDCap platform to the SPSS software version 25.0, where the analyses were performed, considering the alpha value of .05. Descriptive statistics (mean and standard deviation) were performed for continuous variables and frequency and percentage analyses were performed for categorical variables. Internal consistency of the subscales was measured using McDonald's omega, with values expected to be above 0.7.
Pearson correlation tests were conducted for all variables except "Search for nutritional information," for which biserial correlation tests were employed to check the correlations between the variables.
The relationship between the search for information on food and nutrition, sociodemographic variables, body image, and eating behavior was analyzed using structural equations (Path Analysis). For the present study, the tests and acceptance values were Chi-square test (?2) > 0.05 for quality of fit, Chi-square ratio/degree of freedom (?2 /gl) < 5, Standardized Root Mean Square Residual (SRMR) ? 0.10, Root Mean Square Error of Approximation (RMSEA) ? 0.08, Comparative Fit Index (CFI) ? 0.90 and Tucker-Lewis Index (TLI) ? 0.90 27. Initially, a model was proposed with all the variables of the study. However, this model showed inadequate adjustment indexes. Therefore, non-significant relationships were removed individually, starting from those with the highest p-values.
3. Results
The study included 518 individuals of both genders, aged between 18 and 50. The average age of the participants was 31.2 years old, and their mean Body Mass Index (BMI) was 25.9 kg/m². Most of the participants were women, White, single, and heterosexual. Additionally, most participants had a college or postgraduate degree, as shown in Table 1.
Regarding the search for information on food and nutrition, most participants (81.7%; n = 423) reported seeking this type of information, with the main search sources being internet sites (45.2%; n = 191) (e.g., Google®, Bing®, Ecosia®) and social media networks (25.3%; n = 107) (Facebook®, Instagram®, WhatsApp®, and TikTok®). Consult with nutritionists, television, and others (e.g., scientific papers, YouTube®, food labels, books, courses, and other health professionals) were also mentioned (Table 2).
Regarding the frequency of searching for information on food and nutrition, more than one-third of the participants searched for such information less than once a week (39.0%; n = 165). The most searched information was healthy eating (45.2%; n = 191) followed by diets or weight loss tips (21.3%; n = 90). When asked if they follow profiles that disclose information about food and nutrition, the majority answered yes (56.5%; n = 292) (Table 2). As for social network use, time spent working aside, less than a third of the participants used less than two hours a day (22.8%; n = 118), followed by about an hour (18%; n = 93) (Table 2).
The means (SD) of the measures are described in Table 3. Women exhibit higher levels of internalization of thinness and low body fat ideals. They also experience greater pressure from media sources to adhere to beauty standards and display a higher level of dysfunctional investment in appearance compared to men. Conversely, men reported greater satisfaction with their appearance. The correlation between the study variables can be seen in Table 4.
The adjustment indices of the analysis of structural equations indicate a significant ?2 (p < .01), however, considering the sample size greater than 200, the model was maintained 27. The other adjustment indices showed adequate values, except for the low TLI (CFI = 0.90; RMSEA = 0.073; TLI = 0.84; ?2/gl = 3.7 and IFI = 0.94). Results demonstrated both unidirectional and bidirectional, positive and negative effects. The interrelationship between participants' sociodemographic, body image, and eating behavior variables and their estimate and statistical significance are presented in Table 5. It is worth noticing that the search for information on food and nutrition was positively correlated with satisfaction with appearance. A negative correlation was also found between searching for food and nutrition information and satisfaction with appearance. Both effects were significant. Another positive correlation was found between search for information on food and nutrition and BMI. This correlation was also significant. Self-evaluative salience was negatively correlated with the search for information on food and nutrition. Another important positive correlation was found between internalizing thinness and restrictive practices. Finally, a positive correlation was also found between the use of social networks and media pressure. All the correlations mentioned were significant, as can be seen in Table 5.
4. Discussion
Most of the participants searched for information about food and nutrition, followed profiles that disseminate information about food, and their main sources of search were sites such as Google®, followed by social media. These data are not surprising, since the number of social media users in Brazil increased by 58% in 2020 28 and Instagram® is the most used social network, especially among young people/adults 29.
Searching for information on the internet has become a routine practice these days, as many people choose to conduct preliminary research before scheduling appointments with healthcare professionals. In addition, it is common for them to seek to learn about the work of these professionals through their social networks 30. Given this scenario, the need to make users aware of the importance of adopting a critical stance concerning the information found is highlighted.
In the present study, the most searched information was about healthy eating, followed by diets to lose weight. These two themes are usually associated and often a healthy diet can be confused with weight loss diets 31. This may occur due to imposed stereotypes, such as the association between thinness and health, often reproduced even by health professionals, as we are inserted in a culture that highly values appearance, imposes body standards, and excludes people who do not fit into these molds 10, 32.
Regarding the frequency of searching for information about food and nutrition, just over a third of the participants (39%) searched less than once a week, followed by one to two days a week (35.7%) and 3 to 6 days a week (13.5%). The frequency of active search for information about food and nutrition was not daily, however, most of the participants followed profiles that disseminate information about food, so they may receive information indirectly, through the feed. This data is worrisome since following profiles that post content about food is enough to modify eating behavior and body image 16. Many profiles that post information about food, exercise, and healthy lifestyle fit into the fitspiration movement, which corresponds to making publications to promote a healthy lifestyle, with motivational phrases, training tips, and nutrition 13. At first, this movement arose to combat others who preach thinness, however, the effect was reversed, because the way information is shared, it can lead to internalization of thinness and muscularity, which can affect the eating behavior and body image of both men and women.
The study found that individuals who were more satisfied with their appearance tended to search for nutritional information more frequently. This could be attributed to the connection between body image and food consumption. For example, a study conducted by Resende et al. 34 sought to associate levels of body satisfaction with food in gym-goers and found that participants with higher levels of body satisfaction ate more fruits, vegetables, and greens, while those who were dissatisfied ate foods high in fats and sugars. In this sense, it is plausible to suppose that people who consume mostly fresh foods, a choice often limited only to nutrients35, do so considering exclusively the caloric value of these foods, to obtain the desired body.
Interestingly, the relationship between the search for nutritional information and satisfaction with appearance was negative, so that the more information about food and nutrition these individuals sought, the lower the satisfaction with their appearance. This relationship can be explained by the way this information is disseminated, usually associated with idealized body models, where the food or product is a means of obtaining a certain body shape, being limited to only nutrients 5, 36.
A study was conducted to analyze the profiles of three influencers who post content about food and have millions of followers. These influencers include a businesswoman, a nutritionist who was pursuing a master's degree in nutrition, and a YouTube® channel host. The study found that many of their posts were aimed at advertising light, diet, or high-fiber products. In the profile of the professional nutritionist, the publications were about diets, and food was treated only as a source of nutrients for the body, ignoring sociocultural aspects 37. In addition, advertising is usually done by associating the product with the sculptural bodies of digital influencers, who post their photos with a molded environment to convey credibility, in postures that favor the image of thinness and definition, conveying the idea that it is easy to have an ideal body, work, and have time for family 8.
The relationship between BMI and the search for information about food and nutrition can occur through dissatisfaction with weight, which can lead people to search for food to reduce BMI. There is a well-established relationship in the literature between high BMI and dissatisfaction with appearance 9, 38, also found in the present study. These findings may reflect the current social standard established on thinness, which associates it with health and beauty, while fat bodies are usually associated with diseases, laziness, moral failures, and sloppiness, and often these individuals are judged and socially excluded, and as a result, they may feel dissatisfied with their appearance 10. Also, this relationship may explain the positive correlation found between the search for information on food and nutrition and BMI, in which the higher the BMI, the greater the search for information on food and nutrition.
The search for information about food and nutrition was also negatively correlated with self-evaluative salience, so the less information about food and nutrition these participants searched for, the greater their self-evaluative salience. These results are interesting as they differ from previous research findings39, 40 and may provide a greater understanding of the relationship between seeking information related to nutrition and body image. It is worth noting that almost half of the participants reported seeking information about healthy eating. This broader approach to health may decrease the emphasis placed on physical appearance as a primary factor in self-evaluation., which could result in a lower psychological investment 41. Furthermore, the negative correlation between seeking information about nutrition and body satisfaction underscores the complexity of the construct, demonstrating that different components may independently influence body image. Indeed, one of the premises for the development of the Appearance Schemas Inventory by Cash and colleagues23 focused on the fact that a person can be dissatisfied with their body yet not be highly psychologically invested in appearance.
These significant relationships between the search for information about food and nutrition and different components of body image may have an impact on individuals' eating behavior, as food can be used to obtain the desired body/weight or better health. A recent systematic review 42 showed a positive relationship between engaging with health-related content (i.e., nutrition content, clean eating images) and body image concerns. Also, the study described that content related to clean eating (a style of eating that promotes the consumption of whole and unprocessed food), often viewed as a healthy dietary approach, has been linked to dietary restraint and disordered eating symptoms. Nutritional information and food advertisements are also positively associated with eating concerns. Exposure to low-calorie-density food images has been shown to increase disordered eating intentions. Furthermore, many healthy living blogs convey unhealthy nutrition messages, and numerous health influencers offering nutrition advice on social media need more proper qualifications. These data demonstrate the harmful potential of consuming online content related to food and nutrition regarding body image and eating behavior, even when such content pertains to "healthy eating."
Regarding the effect found between internalization of thinness and restrictive practices, the greater the internalization of thinness, the greater the restrictive practices, it may have occurred due to the strong association between internalization of thinness and restrictive eating practices. The internalization of thinness refers to the belief that there is an ideal beautiful body, which is thin 43. This belief is more common among women and is often linked to personal and professional success.
With the increased use of social media, the pressure to conform to beauty standards has increased, since this body model is used in advertisements and receives positive comments and likes from users of these networks 44. However, people often adopt restrictive eating practices to obtain the desired lean body, following strict diets, excluding food groups, and fasting periods. These practices are extremely harmful to health, causing anxiety and mood swings, as well as nutritional deficiencies 45, 46.
It has been found that the more time one spends browsing social media, the greater the pressure felt to conform to the ideal body. This is not surprising, as even using social media to keep in touch with family and friends can increase the pressure to change one's appearance 47. The rapid reach and ease with which users can give their opinions on what others share, as well as the constant bombardment of idealized body photos and videos, can create a fear of not being accepted. This pressure and fear generated by social media use can lead to a desire to conform to unrealistic beauty standards.
This study has some limitations. Firstly, the sample mainly consisted of highly educated White women, so we cannot generalize the results to the Brazilian population. Secondly, the internal consistency on the DEAS subscale was lower than .70. However, we decided to keep the questionnaire because other measures that assess eating disorders, such as the EDE-Q and the EAT-26, are not validated for the Brazilian population nor among this age group. There are two possible explanations for the low value obtained. The first reason is that the consistency of the DEAS in men was low in previous studies 26, 48. Our sample included both men and women, which may have influenced the analysis since the scale was originally developed for women. The second explanation is that the scale was developed using questions from a clinical population with ED, which means some people may not relate to some of the questions. Thirdly, participants were asked to select only one option regarding where they usually search for information, which could have resulted in some sources of information being underrepresented. Also, we should have asked about participants' professional activities, which could have influenced the results as some professions are biased towards food and nutrition. Finally, given the nature of the study, we cannot assume that participants who researched the theme changed their eating behavior. Therefore, it is essential to conduct further research to increase the sample's representativeness and address a broader range of search options and professional activities. Also, future research should measure food consumption and use an experimental design.
5. Conclusion
The findings of the study suggest that most participants searched for information about food and nutrition, primarily on search tools and social media, and the most searched information was about healthy eating followed by diets or weight loss tips. The study also revealed a positive correlation between the search for information about food and nutrition and satisfaction with appearance, BMI, media pressure, time spent on social media, and internalization of thinness and restrictive practices. Contrarily, there was a negative correlation between satisfaction with appearance and the search for information about food and nutrition, as well as investment in appearance and the search for information about food and nutrition.
These data demonstrate that searching for information about food and nutrition on the internet is associated with several aspects of eating behavior and body image. Thus, it is up to health professionals and digital influencers to use these tools ethically, disseminating evidence-based content, to promote a pleasurable relationship with food, without reducing it to nutrients, and without associating it with bodies.
Funding
The authors acknowledge financial support from CNPQ (130254/2021-5), PROEX/CAPES, and the University of Ribeirão Preto – UNAERP. Sponsors had no participation in the study design, in the collection, analysis, and interpretation of data, in the report's writing, and in the decision to submit the article for publication.
Declaration of Generative AI and AI-assisted technologies in the writing process
While preparing this work, the authors used Grammarly to improve grammar, spelling, usage, wordiness, style, punctuation, and tone. They also used the "improve" command to enhance readability. After using this service, the authors reviewed and edited the content as needed and take full responsibility for the publication.
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