Scientists warn of misleading nutrition advice on TikTok

A growing body of research supports the Mediterranean diet as a healthy eating pattern that helps to prevent heart disease and other chronic health conditions. But a new study reveals that people browsing the popular social media platform TikTok for information about the diet are likely to find advice that is neither aligned with the Mediterranean diet nor particularly healthful.

"People will not be able to follow the Mediterranean diet unless they understand what it is and how to integrate it into their home food environment," said Margaret Raber, DrPH, assistant professor in the Children's Nutrition Research Center at the Agricultural Research Service of the U.S. Department of Agriculture and Baylor College of Medicine, the study's lead author. "Our findings suggest that while users will find some high-quality content created by health professionals, they will also encounter conflicting, vague or even misleading information when exploring #mediterraneandiet on TikTok."

Raber will present the findings online at Nutrition 2022 Live Online, the flagship annual meeting of the American Society for Nutrition held June 14-16.

The Mediterranean diet is a dietary pattern that emphasizes minimally processed, plant-based foods—think veggies, fruits, whole grains and beans—while minimizing added sugars, refined carbohydrates and saturated fats. Olive oil features prominently and fish, dairy and poultry can be included in moderation.

While the diet derives its name from the traditional eating patterns of some countries bordering the Mediterranean Sea, not all of the diverse cuisines of the Mediterranean region reflect the Mediterranean diet as scientists and doctors understand it. This has led to confusion about what constitutes the Mediterranean diet.

To assess how this plays out in social media, researchers analyzed the first 200 videos appearing on TikTok under the hashtag #mediterraneandiet in August 2021. They found that most posts (78%) were related to health in some way, but less than 9% offered a definition of what the Mediterranean diet entails. One in 5 posts were not about health at all, focusing exclusively on food and culture from countries bordering the Mediterranean Sea.

"Alarmingly, a large portion (69%) of these 'culture' posts promoted foods that are not part of the healthy eating pattern promoted by the Mediterranean diet, such as red meat, refined carbohydrates, sweets and processed foods," said Raber. For example, lamb kebab and pita bread are popular foods in some Mediterranean countries but are not aligned with the Mediterranean diet.

In general, the study found that content created by posters who claimed health credentials tended to be more detailed and of higher quality. Just over half (53%) of posters listed health credentials in their account information page, though these posters actually mentioned their health credentials in less than half of their posts, making it difficult for TikTok users to determine which videos were created by posters with health credentials.

For people exploring nutrition information on social media, Raber suggested looking for content by posters with health credentials and asking your own healthcare provider if the information seems conflicting or confusing. For public health practitioners and clinicians, she said the study points to a need for new strategies to communicate about nutrition and counter misinformation online.

"We need to be vigilant about the information found on social media, particularly if it influences health and wellness decisions," said Raber. "I don't think we can fully harness the power of social media for health promotion unless we address the issue of information quality and give the public tools to help navigate these new types of media."