Received: 2 September 2021
| Revised: 29 November 2021 | Accepted: 3 December 2021
DOI: 10.1002/hpja.563
RESEARCH ARTICLE
Communication of nutrition information by influencers on
social media: A scoping review
Alice Rogers
| Shelley Wilkinson
School of Human Movement and Nutrition
Science, The University of Queensland,
Brisbane, Queensland, Australia
Correspondence
Alice Rogers, School of Human Movement
and Nutrition Science, The University of
Queensland, Brisbane, QLD, Australia.
Email: alice.rogers@uq.edu.au
| Olivia Downie | Helen Truby
Abstract
Issue addressed: Although government promoted public health, social media and
media campaigns have communicated nutrition information, the Australian population remains chronic under-­consumers of fruit and vegetables and overconsumers of
ultra-­processed foods. This scoping review aimed to determine how social media influencers (SMI) communicate nutrition information and the factors that influence the
popularity of messages. Identified factors could inform how governments may utilise
social media to impact positively on food choices.
Methods: Nine databases were searched in the past 5 years (2016-­2021). After relevant sources were identified, entire texts of the grey literature and the “Results” sections of the academic literature were coded. Using Microsoft Word, each key feature
of the relevant text was highlighted, and the relevant code was recorded. Inductive
coding was utilised where codes were created based on the text itself. These codes
were then sorted iteratively into relevant themes and subthemes.
Results: Eleven studies were included. From these sources, five themes were identified. These were, (i) promoting dietary change, (ii) certain modes/styles of content delivery, (iii) an attractive individual, (iv) language features and (v) appearing connected
to the audience.
Conclusion: SMI are selective in their content and communication techniques to ensure their nutrition messages are popular with social media users. These methods
exhibited by SMI could inform strategies to build trust in government messages about
food and nutrition.
KEYWORDS
communication, diet, health education, nutritional sciences, social media
1 | I NTRO D U C TI O N
Institute of Health and Welfare reported that a poor diet, that is
Sub-­optimal food choices over a lifetime has been recognised as an
one low in nutritious foods such as fruits and vegetables and high
underpinning factor in the development of chronic diseases such as
in energy-­dense and nutrient poor processed foods—­as the cause
cardiovascular disease, diabetes, obesity and certain cancers.1 While
of 5.4% of the total burden of disease, nationally.4 Sub-­optimal and
there have been numerous health promotion campaigns by govern-
habitual food choices can therefore lead to significant ill health and
ments in Australia, the population is still under consuming healthful
economic burdens to society largely through increased health care
foods (fruits, vegetables, grains, lean meats and dairy) while over-
costs and loss of productivity.5
consuming highly processed foods with high amounts of added
In recognition of this burden that preventable chronic diseases
sugars, saturated fat and salt. 2,3 Based on 2018 data, the Australian
have on society, the Australian Academy of Science Committee for
Health Promot J Austral. 2022;33:657–676.
wileyonlinelibrary.com/journal/hpja
© 2021 Australian Health Promotion Association
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|
ROGERS et al.
Nutrition has developed a Decadal Plan for the Science of Nutrition.6
This plan proposes a strategy for utilising nutrition science in im-
So what?
proving long-­term health and wellbeing globally and delivering envi-
SMI are able to nurture trust and exert influence on follow-
ronmental, social and economic benefits nationally.6 One key aspect
of the plan is to provide a “trusted voice” to the Australian public.
ers. It may be possible to leverage existing SMI to deliver
6
specific nutrition messages to their audiences.
This is to provide credible, evidence-­based nutrition information,
attempt to counteract misinformation in what is a contested media
space, and improve the nutrition literacy of society.6 It is through
these nuanced messages the public can be supported and guided
for communicating evidence-­based nutrition and food information
to be confident to make healthful nutrition decisions. Studies on
to the public.
psychological influence have found that intentions, perceived be-
Doctors are commonly cited as a source of trusted health and
havioural control and confidence are predictors of healthy eating.7 A
nutrition information to the public but lack capacity and the specific
challenge to communicating evidence-­based nutrition messages to
capability to deliver specific dietary advice to each and every pa-
the public and building trust is the plethora of nutrition information
tient.17 The ability to influence dietary behaviours on a population
7
available. Messages from governments, public health professionals,
level has great appeal. It is known that the delivery of information
the food industry and food advertising all differ due to varying ex-
alone does not result in behaviour change.18 Large scale behaviour
7
pertise, goals, perspectives and competing interests. Food advertis-
change is gaining appeal with “nudge” approaches,18 however, the
ers and marketers have been communicating nutrition information
ability to change attitudes and beliefs as well as behaviours is re-
via “health claims” for decades in which a number of papers have
quired. One element that supports change is trust and credibility of
looked into how consumers respond to these claims.8 One area that
the communicator.19 The aim of this scoping review is to answer the
is yet to be extensively explored is communication of nutrition in-
following research questions (i) how do SMI communicate nutrition in-
formation by social media influencers (SMI). SMI are defined as in-
formation? And, (ii) what factors influence the popularity of these mes-
dividuals with a presence on social media that have the ability to
sages with social media users?
influence the behaviour or opinions of others.9 They commonly have
over 10 000 followers.10
Exploring the online space is important as online nutrition information seeking is becoming increasingly common.11,12 In Australia
there has been dramatic increase in online information seeking of
2
|
M E TH O D S
2.1 | Protocol
nutrition information.11,12 Pollard et al12 reports on this being less
than 1% in 1995-­2001 to 33.7% of all adults in 2012. These figures
This study adopted a scoping review methodology. A scoping re-
are suspected to have further increased to the current day due to
view has the ability to identify gaps in the literature and establish
the global rise in social media use.13 A systematic review by Endres14
where information on a topic is available. 20 It is useful for broad
examined the communicated contents and communication struc-
topics and new areas of exploration, such as this topic of review.
tures on the topic of healthy diet and weight loss on social media.
Levac et al (2010)20 highlights six steps to a scoping review including
They found that communication on healthy diet is characterised by
identifying the research question, identifying relevant studies, study
rigid dietary requirements and strict implementation.14 In terms of
selection, charting the data and collating, summarising and report-
communication structures, Endres reported on community, repre-
ing the results. 20 The protocol for this scoping review was devel-
senting authentic experiences, exhibitionism, creating intimate rela-
oped using the Preferred Reporting Items for Systematic Reviews
tionships, creating discussions and being an expert.14 However, this
(PRISMA) checklist for Scoping Reviews.
study did not look into SMI specifically per se, but social media users
as a whole.14
Unlike governments and advertisers, SMI appear to have a
2.2 | Eligibility criteria
greater ability to engage with users and develop a high level of trust
with their followers.15 Therefore, it is thought that nutrition infor-
To be included in this review, articles needed to (i) clearly discuss
mation communicated by SMI is more likely to be popular with social
how SMI communicated nutrition information and/or the factors
media users. SMI have been able to translate their nutrition messages
used in communication; (ii) identify SMI by ensuring they had ac-
into commercial successes through business ventures such as cook-
counts with over 10 000 followers on a single social media plat-
books and mobile phone Apps.16 Those SMI with 10 000-­100 000
form or it was clear that the SMI being discussed had evidence
followers on a single platform are considered “micro-­influencers”
of their high influence; (iii) these accounts were not solely brand
and are noted as having high levels of trust with audiences compared
accounts selling products, government organisations or public
to mega influencers that have over 1 million followers.10 SMI may
health agencies and (iv) sources were published recently (within
provide exemplars of different strategies to communicate nutrition
the last 5 years 2016-­2021). This time frame was selected as the
information which can be used to inform implementation strategies
social media landscape evolves rapidly and findings needed to
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658
be relevant to the contemporary social media landscape. It was
2.5 | Data extraction
deemed necessary that SMI were truly influential in their field,
as this was an indication that the strategies they were using were
A data charting form was developed in Excel to extract key informa-
resonating with a large audience. Brand accounts, government
tion from the identified sources after the full text screening. Charting
organisations or public health agencies did not fit the definition
was conducted by one author (AR). From the sources, the following
chosen for “influencer” for this review, as they often have differ-
was extracted: the citation, the country of the publication, the aim
ent intentions and communicate nutrition information differently
of the publication, the type of source (eg book chapter), detail of the
to individual SMI.
social media profiles explored by the source, the number of social
The first research question concerning how nutrition informa-
media posts analysed (if a content analysis study), the character-
tion is communicated included findings about the particular mes-
istics of these social media profiles and posts such as the specific
sages and content that were shared as well as the modes utilised
SMI explored and their follow counts (if included), the population
to communicate this (eg Images, Video, Reels etc). The second re-
studied and their characteristics if the source used participants in
search question concerning the factors that influence popularity of
their study, the study design (if a research study), the relevant codes
messages with social media users included any specific techniques
applied to each article and a summary of key findings of each source
or styles the SMI utilised to communicate their messages. Articles
that were relevant to the research questions. An appraisal of quality
were excluded if (i) the research question is not answered, (ii) the full
of the articles was not conducted as many were drawn from the grey
text was not available, (iii) the article was not available in English and
literature and were from a variety of study types.
(iv) the definition of influencer did not fit with our definition. When
screening the full text, the reasons for exclusion were recorded.
2.3 | Search strategy
2.6 | Synthesis of results
Due to the range of studies and findings from this scoping review, a
thematic analysis in a narrative format was most relevant to present
To identify potentially relevant sources of information, several da-
the results and address the aim of the review. Data were analysed
tabases were searched. This included both peer-­reviewed articles in
utilising an inductive thematic analysis approach as posed by Braun
academic databases and the grey literature in business and market-
and Clarke. 21 This involved two stages, coding the data and then de-
ing databases. The database search was from 2016 to 8 April 2021.
veloping themes from these codes. 21
The academic databases included Pubmed, Embase, Scopus, Cinahl,
In the first stage, a coding process was completed for all selected
PsycInfo and Web of Science. The grey literature databases included
sources. For the grey literature which included a book chapter and
ABI/Inform, Business Source Complete and Emerald Insight. These
a news article, the entire source was extracted and coded. For the
databases and development of individual search strategies were
academic research studies, the relevant findings from each “Results”
chosen based on consultation with the university librarian. The
section for each article were extracted and coded. A coding process
initial search was conducted on PubMed and adapted for all other
was utilised to identify features of the data that were relevant to the
databases. Librarian support identified the key words and index
research questions. Codes are defined as the most basic segment or
terms for the searches. The final search strategies are presented in
element of the raw data that can be assessed in a meaningful way. 21
Table 1. Once searches were complete, the results were exported
This coding process was conducted in Microsoft Word, where each
into Endnote.
key feature was highlighted, and the relevant code was recorded.
Inductive coding was utilised where codes were created based on
2.4 | Study selection
the text itself. The codes created for the first source could then be
applied to subsequent sources. New codes were then also created
on subsequent sources. This process was repeated for all sources
The screening of articles took place on the web-­program Covidence
until a final code list was created and applied to each source.
(https://www.covid​ence.org/), and all duplicates were removed
In the second stage, themes were identified from these codes.
using the in-­built automated tool. All screening was conducted by
First, this involved creating a mind-­map of codes. Individual codes
one person. Screening was initially conducted on title and abstracts
were written down and similar codes were grouped together. Links
only and then against the full texts for sources identified as poten-
between different groups were then identified. From this, themes
tially relevant. Full texts were included if it contained information
and subthemes were developed using an iterative process to encom-
that was relevant to either one or both research questions. If there
pass all codes into themes of findings. Coding and development of
was any question of whether a source was relevant to the scoping
themes was completed with consultation with another member of
review, a member of the extended research team was consulted
the research team (OD). Refinement of themes and naming also in-
(SW, HT or OD).
volved consultation with SW and HT.
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ROGERS et al.
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ROGERS et al.
TA B L E 1 Search strategies for identifying relevant sources
PubMed
((("Social Media"[Mesh]) OR (influencer[Title/Abstract]) OR
"Social Media"[Title/Abstract]) AND ("Nutritional Sciences"[Mesh]
OR "Diet"[Mesh] OR nutrition*[Title/Abstract] OR diet*[Title/Abstract]))
AND (("Health Education"[Mesh]) OR (educate[Title/Abstract] OR education
[Title/Abstract] OR influence*[Title/Abstract] OR campaign*[Title/Abstract]
OR program*[Title/Abstract] OR promot*[Title/Abstract] OR engag*[Title/Abstract]
OR strateg*[Title/Abstract] OR communicat*[Title/Abstract]))
Embase
('social media':ab,ti OR 'social media'/exp OR influencer:ab,ti)
AND (nutrition*:ab,ti OR diet*:ab,ti OR 'nutrition'/mj
OR 'feeding behavior'/exp OR 'diet'/exp OR 'dietary intake'/exp
OR 'child nutrition'/exp OR 'food intake'/exp OR'nutrient'/exp
OR 'nutriomics'/exp OR 'nutritional requirement'/exp
OR 'nutritional status'/exp) AND (educate:ab,ti
OR education:ab,ti OR influence*:ab,ti OR campaign*:ab,ti
OR program*:ab,ti OR promot*:ab,ti OR engag*:ab,tiOR strateg*:ab,ti
OR communicat*:ab,ti OR 'health education'/exp)
Scopus
( ( TITLE ( "social media" ) OR TITLE ( influencer ) OR ABS ( "social media" )
OR ABS ( influencer ) ) ) AND ( ( TITLE ( nutrition* ) OR TITLE ( diet* )
OR ABS ( nutrition* ) OR ABS ( diet* ) ) ) AND ( ( ( TITLE ( educate )
OR TITLE ( education ) OR TITLE ( influence* ) OR TITLE ( campaign* )
OR TITLE ( program* ) OR TITLE ( promot* ) OR TITLE ( engag* )
OR TITLE ( strateg* ) OR TITLE ( communicat* ) ) ) OR ( ( ABS ( educate )
OR ABS ( education ) OR ABS ( influence* ) OR ABS ( campaign* )
OR ABS ( program* ) OR ABS ( promot* ) OR ABS ( engag* ) OR ABS ( strateg* )
OR ABS ( communicat* ) ) ) )
Cinahl
((MH "Social Media+") OR TI "social media" OR TI influencer OR AB "social media"
OR AB influencer ) AND (MH "Nutrition+") OR ((MH "Diet+") OR TI nutrition*
OR TI diet* OR AB nutrition* OR AB diet* ) AND (MH "Health Education+")
OR TI educate OR TI education OR TI influence* OR TI campaign*
OR TI program* OR TI promot* OR TI engag* OR TI strateg*
OR TI communicat* OR AB educate OR AB education OR AB influence*
OR AB campaign* OR AB program* OR AB promot* OR AB engag*
OR AB strateg* OR AB communicat*)
PsycInfo
((((title: ("social media"))) OR ((title: (influencer))) OR ((abstract: ("social media")))
OR ((abstract: (influencer)))) OR (((IndexTermsFilt: ("Social Media"))
OR (IndexTermsFilt: ("Online Social Networks")))))
AND((((IndexTermsFilt: ("Nutrition")) OR (IndexTermsFilt: ("Diets"))))
OR (((title: (nutrition*))) OR ((abstract: (nutrition*))) OR ((title: (diet*)))
OR ((abstract: (diet*))))) AND ((((((abstract: (educate))))
OR (((abstract: (education)))) OR (((abstract: (influence*))))
OR (((abstract: (campaign*)))) OR (((abstract: (program*))))
OR(((abstract: (promot*)))) OR (((abstract: (engag*))))
OR (((abstract: (strateg*)))) OR(((abstract: (communicat*)))))
OR ((((title: (educate)))) OR (((title: (education)))) OR(((title: (influence*))))
OR (((title: (campaign*)))) OR (((title: (program*)))) OR(((title: (promot*))))
OR (((title: (engag*)))) OR (((title: (strateg*)))) OR (((title: (communicat*))))))
OR (((IndexTermsFilt: ("Health Education")))))
Web of
Science
TI=("social media" OR influencer) OR AB=("social media" OR influencer)
AND ((WC=(Nutrition & Dietetics) OR (TI=(diet* OR nutrition*) OR AB=(diet* OR nutrition*)))
AND TI=(educate OR education OR influence* OR campaign* OR program*
OR promot* OR engag* OR strateg* OR communicat*) OR AB=(educate
OR education OR influence* OR campaign* OR program* OR promot* OR engag* OR strateg*
OR communicat*)
ABI/Inform
(MAINSUBJECT.EXACT("Social networks") OR (ab("social media") OR ab(influencer:)
OR ti("social media") OR ti(influencer:))) AND ((MAINSUBJECT.EXACT("Diet")
OR MAINSUBJECT.EXACT("Nutrients") OR MAINSUBJECT.EXACT("Nutrition"))
OR ab(diet*) OR ti(diet*) OR ab(nutrition*) OR ti(nutrition*))
AND ((MAINSUBJECT.EXACT("Health education")
OR MAINSUBJECT.EXACT("Nutrition education")) OR (ab(educate)
OR ab(education) OR ab(influence*) OR ab(campaign*) OR ab(program*)
OR ab(promot*) OR ab(engag*) OR ab(strateg*) OR ab(communicat*))
OR (ti(educate) OR ti(education) OR ti(influence*) OR ti(campaign*)
OR ti(program*) OR ti(promot*) OR ti(engag*) OR ti(strateg*) OR ti(communicat*)))
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660
TA B L E 1 (Continued)
Business
Source
Complete
( DE "SOCIAL media in business" OR DE "SOCIAL media in marketing" ) OR TI "social media" OR TI influencer OR AB "social
media" OR AB influencer )
AND (TI nutrition* OR AB nutrition* OR TI diet* OR AB diet*) AND (TI educate
OR TI education OR TI influence* OR TI campaign* OR TI program*
OR TI promot* OR TI engag* OR TI strateg* OR TI communicat*
OR AB educate OR AB education OR AB influence* OR AB campaign* OR AB program* OR AB promot* OR AB engag* OR AB
strateg* OR AB communicat* )
Emerald
Insight
((title:"social media") OR (abstract:"social media") OR (title:"influencer")
OR (abstract:"influencer")) AND ((title:"nutrition*") OR (abstract:"nutrition*")
OR (title:"diet*") OR (abstract:"diet*")) AND ((title:"educate") OR (title:"education") OR (title:"influence*") OR (title:"campaign*")
OR (title:"program*") OR (title:"promot*") OR (title:"engag*") OR (title:"strateg*") OR (title:"communicat*") OR
abstract:"educate" OR (abstract:"education") OR (abstract:"influence*") OR (abstract:"campaign*") OR (abstract:"program*")
OR (abstract:"promot*") OR (abstract:"engag*") OR (abstract:"strateg*") OR (abstract:"communicat*"))
F I G U R E 1 PRISMA Flow Diagram
for the Identification of eligible
studies
3
|
R E S U LT S
3.1 | Selection of sources of evidence
3.2 | Characteristics of sources of evidence
In total, 11 articles were found to be relevant to the research
question.16,22-­31
16,22-­31
Nine
were
research
studies
Four of these centred on blogs,
from
23,24,28,30
scientific
The PRISMA flow diagram for the identification of evidence can be
databases.
seen in Figure 1.
solely on Instagram25-­27,29 and one utilised the social media platforms,
four focused
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| 661
ROGERS et al.
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ROGERS et al.
Instagram and Facebook in their study.22 Seven of the research stud-
content modes, popular influencer Carlos Ríos is reported to have
ies involved qualitative and/or quantitative content analysis of SMI
found great success through utilising a number of different content
accounts.22,24,25,27-­30 Bissonnette-­Maheux et al23 and Jenkins et al26
modes including recipe photos, videos, screenshots and infograph-
gathered participant feedback on perceptions of SMI communicating
ics. 27 The second theme focused on the style of posted content.
nutrition information for their findings. Two articles from the market-
Mete et al28 reported in their content analysis that blogs were char-
ing/business databases were considered relevant. One of these is a
acterised by clear single message posts. Most blog posts focused
book section16 and the other is an article concerns one popular health
on a single message which were communicated early in the post-
and fitness influencer (Kayla Itsines).31 Characteristics of sources can
ing. 28 Post headings were simple and to the point including practical
be found in Table 2 and relevant codes and findings from each source
ways to increase fruit and vegetable intake; simple time saving food
in Table 3.
preparation recommendations; and practical ways to improve or add
excitement into mealtimes. 28 Mete et al28 also reported that SMIs
applied a consistent visual layout and structure. A style element re-
3.3 | Synthesis of results
ported by Barklamb et al22 was short captions under 100 characters.
Five key themes were identified to address the research questions.
These themes were, (i) promoting dietary change, (ii) certain modes/
3.3.3 | Theme 3: An attractive individual
styles of content delivery, (iii) an attractive individual, (iv) language features and (v) appearing connected to the audience. Within each theme,
A theme that arose is that the appearance of the SMI was consist-
several sub-­themes have been identified. These can be seen in Table 4.
ently stereotypically culturally attractive individuals that were relatable to the audience they engaged with. Within this theme, the
sub-­theme of appealing character traits arose. Carey et al16 high-
3.3.1 | Theme 1: Promoting dietary change
lights that SMI appeared to be approachable and genuine to their
audiences. In their content analysis, Pilgrim et al29 reports SMI as
There were three sub-­themes within the theme “promoting dietary
representing the socially accepted attitude of their target audience.
change.” These were supporting specific diets, providing practical
The next sub-­theme is that SMI were themselves, physically attrac-
advice and establishing credibility.
tive according to societal standards. Pilgrim et al29 reports on SMI
The first sub-­theme, supporting specific diets, can be illustrated by
representing an external perfectionism. Almost 90% of analysed
the study by Sabbagh et al,30 who in their content analysis of nine SMI,
social media content depicted SMI with at least one exposed body
four promoted specific diets or dietary patterns to their audience.30 These
part, usually characterised by pronounced muscularity in the arms
included gluten-­free, dairy-­free, refined sugar free, plant-­based diets and
or core musculature. 29 Carey et al16 reports on food bloggers over-
30
the palaeo approach.
The nutritional risks such as potential for specific
nutrient deficiency associated with such dietary patterns was not men30
tioned by the SMI.
whelmingly conforming to Western standards of beauty—­
being
young, thin and light skinned.16
The second sub-­theme, providing practical advice,
is reported by Chan et al24 In this study, the dietitians reported on strategies to simplify home cooking within the context of a busy lifestyle.24
3.3.4 | Theme 4: Language features
The tips provided included pre-­planning meals, one-­pot meals, batch
cooking as well as quick and easy recipes.24 Finally, when promoting di-
An identified theme is that SMI were using certain language features
etary change, a third sub-­theme was identified, which was the SMI were
when communicating to audiences. There were two sub-­themes
establishing credibility. This was done by listing their “professional” cre-
identified (i) the tone of the message and, (ii) language techniques. A
dentials and including scientific language, references or facts. SMI listing
specific tone of messages was identified in eight sources.16,22,25-­29,31
24
credentials have been identified in the studies completed by Chan et al,
Such tones included positive, 22,28,29 humorous, 22,27 inspirational,16
Mete et al28 and Sabbagh et al30 Credentials listed included “Dietitian,”24
motivational, 25,28,29,31 accusatory27 and heroic. 26 O’Connor31 identi-
24,28,30
“Nutritionist,
24
28
” “Culinary Nutrition Expert,” Naturopath, Wellness
fies influencer Kayla Itsines as using a motivational tone alongside her
Coach,28 and “Medical Doctor.”30 Including scientific language, references
nutrition messaging by posting quotes such as: “You are good enough,
or facts was reported in the SMI, in the papers published by Bissonnette-­
smart enough, beautiful enough and strong enough. Believe it and never
23
22
24
30
Maheux et al, Barklamb et al, Chan et al and Sabbagh et al
let insecurity ruin your life.” Alternatively Marauri-­C astillo et al27 identifies Carlos Ríos as using an accusatory tone in their messaging.
In a post from January 2019, Carlos Ríos blames a supermarket for
3.3.2 | Theme 2. Certain modes/styles
content delivery
making healthy eating more difficult for the public by advertising
yogurt with added sugar as a healthy choice. 27 In this post he states,
“This labelling… is misleading advertising because it suggests those dairy
Across the included literature, it appears that the SMI were delivering
are healthy and are not… This should only be REAL FOOD…”27 As for
content with different modes and styles. As for the first sub-­theme,
the second subtheme of language techniques, examples include
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662
To explore women's
Qualitative Interview
perceptions of the
Research Study
usefulness and ease of
use of healthy eating blog
(HEB) characteristics
Canada
Bissonnette-­
Maheux
et al. 23
Four healthy eating
blogs (HEBs)
To identify the strategies
Quantitative and
40 Instagram and
associated with higher
Qualitative Content
40 Facebook
engagement in food and
Analysis Research
profiles
nutrition-­related posts on
Study
Instagra.
Australia
Profiles
Barklamb
et al. 22
Type of source
736
Posts
Subjective and objective post strategies
were coded on 736 posts. This was
done in two data collection periods.
Strategies utilised in the posts were
identified using an adapted coding
framework which was iteratively
refined during the coding process.
Posts were reviewed by two authors.
If there were any discrepancies, the
authors discussed, and if a consensus
was not reached, another author
provided input
Study design
(Continues)
Two healthy eating blogs (HEBs)
33 participants.
Qualitative semi-­s tructured individual
written by independent female
Women living
interviews were conducted with
RDs (Registered Dietitians)
in Quebec
participants. Participants were
and two written by female RDs
City, Canada,
recruited through the mailing list of the
embedded in a larger health
metropolitan area;
Institute of Nutrition and Functional
website.
mean age 44;
Foods at Laval University and through
HEBs were chosen by typing the
range 27-­61.
ads in local newspaper. Women were
following key words into the
chosen if 18 or older, had internet
Google search engine: blog or
access and used it more than once a
blogue and nutritionniste or
week, and consumed five or fewer
dietetiste. Six blogs that met the
F/V per day assessed by RD. Blogs
following criteria were included:
were explored by women during the
written in French by a Canadian
interviews. Questionnaire was used to
RD, targeted human nutrition
identify women's perceptions about
as the unique topic, had main
characteristics of type of content
objective overall promotion
delivery, RD blogger's delivery of
of a healthy diet, published a
information, blog layout and blog
minimum of one new post per
design
month and a minimum of 12
posts since blog creation before
data collection
Accounts were FIB (Food
Industry Brands), HO (Health
Organisations), LP (Lifestyle
Personalities) and NP (Nutrition
Professionals). The 10 most
popular Facebook profiles
amongst Australian users for
each field chosen. Popularity
was determined by number of
followers each profile had at
data collection. If profiles did not
have an equivalent Instagram
profile, they were excluded from
the Instagram analysis. The six
most popular posts on Facebook
and Instagram were identified
Participants (if
Characteristics of profiles and posts applicable)
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Aim
Country
Citation
TA B L E 2 Characteristics of the sources
ROGERS et al.
24
To understand the impact
of the main Spanish
Realfooders through
social network Instagram
on Spanish youth,
according to their
location, age, gender,
interests and motivations
To analyse the strategies,
interests, positioning
and empowerment of
digital marketing used
by Spanish Realfooders
to position themselves
as opinion leaders in the
field of nutrition and
healthy lifestyle
Quantitative and
Nine Instagram
Qualitative Content
accounts
Analysis Research
Study
10 dietitian
blogs and 10
nondietitian
blogs
Profiles
Spain
Type of source
Qualitative Content
Analysis Research
Study
Aim
The United
To compare nutrition advice
States of
communicated on blogs
America
by RD (Registered
Dietitian) and non-­RD
bloggers
Country
54
400
Posts
Spanish “Realfooders”-­influencers
that focused on the healthy
field of nutrition and influencing
the dietary pattern of its young
followers were included in
this study. The most followed
accounts were chosen. These
accounts included Paloma
Quintana (48.83 k), Marco Ortiz
(162.40 k), Inmifit (25.66 k),
Futurlife (359.94 k), Fit_Happy_
Sisters (462.48 k), Carlos Ríos
(1.44 M), Blanca Nutri (259.12 k),
Ana Cruzado (5.21 k) and Alex
Yanez (103.34 k). The posts
included in this study were those
the influencers posted relating
to breakfast. The reason for
this selection is because of the
consideration of breakfast as a
fundamental part of the daily
diet
Blogs chosen were identified
through blog ranking site,
Feedspot to identify the most
popular or widely viewed
nutrition blogs. Thirteen blogs
were US based. All bloggers in
RD (Registered Dietitian) group
listed credentials as an RD and
four reported having Master's
degrees in nutrition. Non-­RDs
credentials included Certified
Holistic Nutritionist, Master
Nutrition Therapist, Culinary
Nutrition Expert, Personal
Trainer and Registered Massage
Therapist. The 20 most recent
nutrition related posts were
selected from each blog
Participants (if
Characteristics of profiles and posts applicable)
Quantitative analysis of accounts including
follower demographics and message
variables. After describing impact,
the researchers developed a visual
analysis of content of 54 posts. They
analysed 9281 words and 57 images
or audio-­visual productions. The
software “Influencity” was used to
measure quantitative data and obtain
the results. Interpretation of data
was conducted with the software
UCINET. Content analysis was done by
identifying content that work better
in an organic way and respond well
from a communicative perspective.
This considered attractiveness, the
persuasion model used, the sequence
of presentation and motivational
support
All posts in sample were printed and given
identification codes. A text-­based
content analysis using open coding
was applied to each post to identify
trends in the data and develop themes.
Analysis involved three coders. From
the final codes, the researchers worked
together to establish themes
Study design
|
ROGERS et al.
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Gil-­Quintana
et al. 25
Chan et al.
Citation
TA B L E 2 (Continued)
664
26
Australia
Country
Type of source
To understand the differences Quantitative Cross-­
in consumer's perceptions
Sectional Study
of NPs (Nutrition
Professionals) and SMIs
(Social Media Influencers)
on Instagram through
exploring authenticity and
trustworthiness
Aim
Two Instagram
account.
Profiles
2
Posts
Study design
(Continues)
An Instagram account for a Nutrition 149 participants.
Recruitment of participants was done by
Professional (91.2k followers)
Participants
a convenience sample. Participants
and a Social Media Influencer
were marketing
attended a 30-­minute session of
(11.3 million followers) was
research methods
their choice and completed an online,
chosen. As per Socialbakers, the
students enrolled
self-­administered questionnaire that
highest performing accounts
in a Bachelor
had been generated on Qualitrics.
with Instagram by followers
of Business at
Participants were shown screenshots
from both categories were
a Metropolitan
of real-­life Instagram posts from a SMI
chosen to be included in the
University in
and NP.
questionnaire. Socialbakers
Australia. The
The final questionnaire included 75
was utilised to determine the
median age was
questions covering 14 topics. The
highest performing posts (based
20. Approximately
main outcomes of survey were post
on engagement, ie the sum of
half identified
trustworthiness and post authenticity
likes and comments) on each of
as female and
assessed using validated scales as well
the profiles. These posts were
were born in
as perceived message appeal used in
included in the questionnaire.
Australia. There
the Instagram post (measured by eight
The NP’s profile biography
was no difference
individual items on a 5-­point Likert
stated that she was a dietitian,
in proportion of
scale ranging from “strongly disagree”
body positive, and an author
participants in BMI
to “strongly agree”) for affiliation, hope,
of a nutrition-­related book,
category between
humour, heroic, convenience, guilt,
and her post included in the
male and female.
sorrow, fear. Participants also answered
questionnaire discussed body
The majority
questions related to their own nutrition
image and body positivity.
of participants
knowledge, healthy eating behaviours
The SMI’s profile biography
studied full time
and quality of life-­also assessed
included her relationship status,
(98%) and engaged
via statements on a 5-­point Likert
her pregnancy progress, and
in part time or
scale. Participant demographic data
advertising for her fitness
casual work
such as gender, age, country of birth,
program, and her post discussed
(62.1%). Self-­
employment status and self-­reported
her long-­term relationship
reported quality of
weight and height were also recorded
life was generally
high. Participants
believed they
had high levels
of nutrition
knowledge, with
females rating
significantly higher
than males
Participants (if
Characteristics of profiles and posts applicable)
| 665
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Jenkins et al.
Citation
TA B L E 2 (Continued)
ROGERS et al.
To identify the key aspects
of Carlos Ríos’ nutrition
posts on Instagram
Spain
Australia
Marauri-­
Castillo
et al. 27
Mete et al. 28
Profiles
Five blogs
Quantitative and
One Instagram
Qualitative Content
account
Analysis Research
Study
Type of source
76
164
Posts
The search terms to identify blogs
included “Australian Healthy
Eating Blogs” and “Top 100
Australian Healthy Eating Blogs.”
Blogs were chosen by focusing
on the first page of each search
engine (Google, Bing and Yahoo).
The blogs were chosen based
on the following eligibility
criteria: (i) the author identified
as a healthy professional, (ii)
the blog was written by a single
author, (iii) the blog was written
by an Australian author, (iv)
the blog had a minimum of one
post per month and (v) the blog
focused on communicating
healthy eating information to the
general adult population. Blog
authors included a Nutritionist,
Naturopath, Personal Trainer or
Wellness Coach. Posts that were
published in the 3-­month period
of the study and adhered to
eligibility criteria were included
in the analysis
The account belonged to Carlos Ríos’
who had 1.4 million followers
when article was written.
Analysis was of the messages
published in the first half of
2019
Participants (if
Characteristics of profiles and posts applicable)
A coding scheme was derived from
previous research on the content of
information communicated within
health websites. The Health-­Related
Website Evaluation Form (HRWEF) and
the Suitability Assessment of Material
(SAM) were adapted to create a coding
scheme to help guide analysis. The
HRWEF evaluates content, credibility,
currency, accuracy, reliability,
readability and design of health-­related
websites, based on a scoring system.
The SAM tool evaluates literacy,
readability, writing style, vocabulary,
context, graphics and illustrations,
layout, typography, interaction and
cultural appropriateness of health-­
related websites. Each variable was
coded through a scoring system which
reflected the degree they aligned
with criteria adapted from HRWEF
and SAM. Coding was conducted
by two researchers with university
training (blinded for peer review)
using Microsoft Excel. Differences in
code assignments were resolved by
the two researchers by discussing the
rationale behind the coding decision
and determining an agreed coding
assignment
A content analysis was conducted using
quantitative and qualitative techniques.
The sharp rise in followers in 2019 was
the reason for choosing that year in the
study timescale. A research analysis
sheet was designed for the following
six variables: date; number of likes;
number of comments; type of image;
predominant topic of the message and
the style of the message
Study design
|
ROGERS et al.
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To explore the characteristics Qualitative Content
of popular healthy eating
Analysis Research
blogs and inform the
Study
provision of healthy
eating information in the
Australian context
Aim
Country
Citation
TA B L E 2 (Continued)
666
29
To better understand health-­
related communication
characteristics of
influencers in social
networks
Aim
The United
This study aimed to evaluate
Kingdom
the credibility of key
SMI weight management
(WM) blogs
Germany
Country
Profiles
Quantitative and
Nine blogs
Qualitative Content
Analysis Research
Study
Quantitative and
50 Instagram
Qualitative Content
accounts
Analysis Research
Study
Type of source
The top 50 accounts by individuals
(by number of followers) were
chosen who publish in German
and whose account name or
description contains one of the
defined keywords. Keywords
include gym, fit, fitness,
nutrition, train, food. The 50th
account had 100 000 followers.
The newest 20 posts within each
account, showing either food or
sportswear, made up the final
sample
Participants (if
Characteristics of profiles and posts applicable)
180 posts and Influencers were identified using
90 recipes
SMI website “influence.co”
filtered by United Kingdom and
nutrition. This was followed by
Instagram and Google searches
using combinations of the terms
“nutrition,” “diet,” “physical
activity,” “weight management,”
“obesity,” “blog” and “influencer.”
The inclusion criteria required
SMI to be United Kingdom based
with a currently active WM blog
with at least one new post per
month. SMI were included if
blue tick verification on >2 social
media and an active WM blog.
The lowest cut off was 80 000
followers. The 20 most recent
blog posts were analysed from
information sections of the blog.
The most recent entries for
three breakfasts and lunches
and four evening meals were
selected from each influencer
(10 meal recipes)
1000
Posts
Blogs and individual posts were coded
systematically, by a single coder,
against a pre-­prepared checklist of
credibility indicators. There were
13 credibility indicators under four
themes: “transparency,’ “use of other
resources,” “trustworthiness and
adherence to nutritional criteria”
and “bias.” Indicators were yes/no
questions to determine an overall
credibility percentage for each SMI.
The 10 most recent meal recipes from
each blog were evaluated against Public
Health England's (PHE) calorie targets
and the UK “traffic light” food labelling
scheme to assess nutritional quality
Mixed Method Research was conducted
using both quantitative and qualitative
methods. In the quantitative content
analysis, 38 items were coded.
Based on the identified engagement
frequencies, content was chosen for a
qualitative analysis. The sample was not
chosen by quota but rather theoretical
saturation. The final 27 cases were 18
extreme and nine typical cases based
on results of qualitative analysis
Study design
| 667
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Sabbagh
et al. 30
Pilgrim et al.
Citation
TA B L E 2 (Continued)
ROGERS et al.
|
ROGERS et al.
exaggeration and rhetorical devices. Pilgrim et al29 identifies SMI as
using rhetorical devices such as a hypophora,32 where SMI would
answer a self-­asked question. 29 Exaggeration is a language technique identified by Chan et al24 In blogs of non-­Registered Dietitians,
there is exaggeration of the outcomes of following certain dietary
patterns. Vivid imagery and dramatic adjectives were used such as
Study design
“toxic,” “dangerous,” “culprit,” “damaging” and “death.”24
Participants (if
Characteristics of profiles and posts applicable)
3.3.5 | Theme 5: Appearing connected
to the audience
A key theme that has been identified is that SMI are appearing connected to their audiences. Within this, a subtheme is that SMI are
Account belonged to Kayla Itsines
who had 6.6 million followers
as of Mar 2017 when the article
was written
appearing similar to the audience. Often this is done through detailing personal experiences. SMI detailing personal experiences is highlighted in six sources.16,23,27-­30 In various blogs, Mete et al28 found
that SMI were using statements such as: “… I’m passionate about
healthy eating …” and “I’ve personally watched…” The second sub-­
theme is SMI are creating a sense of community with followers. This
is done by engaging with followers through the comment sections
or encouraging followers to engage with community hashtags. For
women in the qualitative interview study by Bissonnette-­Maheux, 23
a majority perceived interaction in the comment section as fostering
a connection between blog readers and Registered Dietitian bloggers. In the pieces written about Carlos Ríos27 and Kayla Itsines,31
Posts
both highlighted the SMI encouraging the use of their community
hashtags. Carlos Ríos invited followers to post videos of them imitat-
News article
The United
To describe of the rise to
States of
success of Australian
America
influencer Kayla Itsines
O'Connor. 31
To explore food culture in
Book Chapter
social media through
a book chapter. This
chapter explores the
affordances offered by
social media platforms
to create, develop and
negotiate individual digital
identities, which mediate
personal, social and
professional relationships
with and investment
in food, nurture and
wellbeing
England
Carey et al.
16
Country
Citation
TA B L E 2 (Continued)
Aim
Type of source
Profiles
1 Instagram
account
ing his dancing with the hashtag #MangoChallenge. 27 Kayla Itsines
encouraged users to post updates of their fitness progress using her
Bikini Body Training Guide Program with the hashtag #bbg.31 As of
March 2017, #bbg and related hashtags had been used in well over
10 million Instagram posts.31
4
|
DISCUSSION
The aim of this scoping review was to explore how successful SMI are
communicating nutrition information and what factors influence the
popularity of these messages with the public. From the five themes
and sub-­themes identified, it is clear that SMI are both selective in
their content and communication techniques, so that their messages
are popular with social media users. This has been a highlighted
strategy in the social media communication literature.33 Whether
it is conscious or unconscious, SMI are sharing content and communicating in a way that consistently supports their desired identify and manage the impression that their followers have of them.34
The methods utilised by SMI can provide innovative strategies for
evidence-­based nutrition information communication to target audiences by mimicking these techniques. Alternatively, the existing SMI
may be utilised to promote key health messages via their networks
thus amplifying public health messages.
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668
The most useful characteristics of blog content delivery identified by women were recipes,
hyperlinks and references. Women liked links to other social media sites. Some women liked
videos to show cooking techniques. They thought the inclusion of scientific references was
essential for enhancing credibility. Most women preferred a narrative approach where the
blog writer would detail personal experience. Most women reported that interaction between
blog readers and the blogger created a sense of proximity and connection that was helpful for
improving their dietary behaviours. It was important to women that the blogs were clear and
easy to use and visually appealing
Recipe Content
Inclusion of Hyperlinks
Links to other social media channels
Video content
Inclusion of Scientific references
Inclusion of scientific facts
Detailing personal experiences
Direct response to comments
Ease of use
Describing expertise in the area
Visually appealing content
Recommend increasing fruit and vegetables
Recommend focusing on food quality and purity
Recipe content
Giving practical advice for dietary change
Describing benefits of eating fruit and vegetables
Posts Containing Advertising
Linking dietary change to health outcomes
Promoting a lifestyle
Listing credentials
Simple language
Discussing foods in terms of macronutrients and food groups
Utilising terms used in government recommendations
Encouragement to eat all foods
Advocating alternative medicine and therapies
Exaggeration
Discussing foods in terms of micronutrients
Describing expertise in area
Using scientific language
Encouraging food restriction
Bissonnette-­
Maheux
et al. 23
Chan et al. 24
| 669
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(Continues)
All bloggers listed credentials on their site. Nutrition recommendations and service promotion/
sponsorship were found in both RD (Registered Dietitian) and non-­RD blogs. RD blogs were
primarily lifestyle blogs that promoted healthy lifestyles. RD bloggers also used nontechnical
language with simple explanations. RDs focused on strategies to simplify home cooking with
a busy lifestyle. The RD bloggers alluded to government recommendations and also spoke
of food in terms of macronutrients. Eating in moderation was also an identified theme and a
“lifestyle” was promoted. Alternatively, non-­RD blogs focused on challenging conventional
medicine while promoting alternative medicine, establishing their credibility by referring to
“studies” and “research” and listing their expertise, and had conflicting messaging. They also
used exaggeration in their posts and focused on micronutrients. Non-­RDs were also utilising
technical language
Text only posts were used by Nutrition Professionals. The majority of caption counts were
fewer than 100 words. Links to health information came from Nutrition Professionals. The
promotion of products was seen by Lifestyle Personalities. Lifestyle Personalities had similar
proportions of core and noncore foods posted. As expected, Nutrition Professionals primarily
posted health-­promoting content. The Lifestyle Personalities reported similar proportions
of health-­promoting content to nonhealth-­promoting content (eg jokes, memes). Balanced
food choices were seen posted by the Nutrition Professionals. Trying to induce emotions or
hedonic sensations was common, with most fields attempting this in a positive way. Nutrition
Professions were seen to negatively induce emotion with core foods. Most Facebook posts
of noncore foods were classified as positive by Nutrition Professionals (83%). All Instagram
posts of noncore foods came under a positive classification. The majority of posts, across all
platforms and fields, had a positive or less often a neutral tone. Lifestyle Personalities and
Nutrition Professionals provided relatable content. Nutrition Professionals commonly used
statistics/facts, particularly on Facebook posts
Text only posts
Short captions
Links to other health information
Posts containing Advertising
Posting of core and noncore foods
Health-­promoting content
Humorous content
Inducing emotion
Positive tone
Relatable content
Inclusion of scientific facts
Barklamb
et al. 22
Key findings relevant to the research question
Relevant codes
Citation
TA B L E 3 Summary of thematic coding and relevant findings
ROGERS et al.
The Nutrition Professional was perceived as more authentic and trustworthy than the Social
Media Influencer. In terms of perceived message appeal, the Nutrition Professional was more
likely to use a heroic message appeal. The Social Media Influencer was more likely to use
affiliation (feelings of love, belonging and togetherness) and guilt/shame message appeals
Through content analysis it can be seen that the adaptation of language, display of information
with infographics and videos, humour, the use of references to of popular culture and the
construction of a story with good and bad characters are some of the characteristics that
define Ríos’ successful style
Heroic messaging
Creating a perceived connection to the influencer
Guilt/Shame Messaging
Posts Containing Advertising
Informal language
Humorous content
Giving practical advice for dietary change
Recipe Content
Discursive tone
Argumentative tone
Accusatory tone
Conveying closeness with a personal address
Infographics comparing healthy and unhealthy food
Resharing follower content
Posting amateur quality videos
Sharing screenshots of messages on other platforms
Using different content modes
Encouraging followers to engage with hashtags
Detailing personal experience
Inducing emotion
Listing credentials
Clear Posts
Understanding the audience
Consistent Style
Giving Practical Advice for Dietary Change
Acknowledging reader comments
Encouraging comments
Informal language
Simple language
Detailing personal experiences
Positive tone
Recipe content
Motivational content
Jenkins
et al. 26
Marauri-­
Castillo
et al. 27
Mete et al. 28
|
ROGERS et al.
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After examining the characteristics of these blogs, the following four main features were
identified: (i) clearly conveying the purpose of each post; (ii) developing a strong understanding
of the reader base and their preferences; (iii) employing a consistent writing style; use of
vocabulary and layout; and (iv) communicating healthy eating information in a practical manner
The content generated by “Realfooders” has been increasing its impact using advertising and
marketing techniques for awaking consumer's interest. It was observed that the aesthetic
component of posts was relevant. This is especially for content showing dishes. It was
observed that there is an interactive dialogue between followers and Instagrammers. The
approach of these profiles is to share recipes, food and creation of dishes considered by them
as healthy. Advertising posts were coupled with great motivational and persuasive content.
These posts also encompassed slogans, audio-­visual productions, images, and other types of
illustrations that awaken the interest of consumers
Aesthetic content
Interacting with followers
Recipe content
Posts Containing Advertising
Motivational content
Persuasive content
Using different content modes
Gil-­Quintana
et al. 25
Key findings relevant to the research question
Relevant codes
Citation
TA B L E 3 (Continued)
670
Of the analysed social media influencers, two were male and seven were female. Two identified as
personal trainers, one as a medical doctor, two as chefs, one registered associate nutritionist
and one nutritional therapist. Each influencer had at least seven methods of communication
including Facebook, Twitter, Instagram, Snapchat, Pinterest, YouTube, Google+, the blog itself
and email newsletters. Only one SMI provided calorie information, while four stated that they
did not believe in counting calories, or low-­c alorie diets. Four female SMI advocated specific
diets, with rationales surrounding nourishment and healing. Similarly, four female influencers
included personal stories on their blogs; three described their own “philosophy” in relation to
overall diet. Every post author was clear, and five SMI included a personal statement detailing
their experience or knowledge in the field. Five influencers did not cite references or evidence-­
based references when providing information in blog posts. Two did not provide any relevant
information-­based posts, meaning only two SMI cited evidence-­based references on posts.
SMI-­5 provided no references on any posts analysed. Six SMI did not distinguish between
fact and opinion, providing no, or inadequate, references. Two did not disclose advertising, as
identified through affiliate links
Female
Listing credentials
Links to other social media channels
Providing calorie information
Not believing in counting calories
Support of specific diets
Detailing personal experiences
Describing diet in terms of a philosophy
Describing expertise in the area
Not distinguishing between fact and opinion
Inclusion of scientific references
Disclosing advertising
ot disclosing advertising
Sabbagh
et al.30
| 671
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(Continues)
Influencers gain trust and friendship of followers by designing body-­shape visual content and
targeted communication techniques. Exercise and diet are identified as factors to be controlled
for body perfection. Influencers promise a simplified way to optimise appearance and achieve
happiness. This is through consuming dietary supplements and wearing tight-­fitting branded
sportswear. SMIs were identified as using a range of communication techniques for the
positioning of advertising and increasing attractiveness and trustworthiness
Focus on food as a means to achieve physical goals
Presenting visually attractive attributes
Positioning as expert
Create a sense of similarity
Create a sense of familiarity
Convey sympathy
Generating commitment
Sharing expert information
Activation by an asking a question
Activation through self-­promotion
Representing socially accepted attitude
Answering a self-­asked question
Conveying closeness through personal address
Positive Tone
Motivational content
Direct response to comments
Pilgrim
et al. 29
Key findings relevant to the research question
Relevant codes
Citation
TA B L E 3 (Continued)
ROGERS et al.
16
Focus on food as a means to achieve physical goals
Encouraging followers to engage with hashtags
Recipe content
Informal language
Motivational content
Aesthetic images
Promoting a lifestyle
Counsels followers about how to change their diet
Support of particular diets
Recommendations based on experience
Inspirational Content
Easy to follow advice
Friendly advice
Details personal experience
Advice not underpinned by evidence
Recipe Content
Simple messages
Desirable food rules
Support of particular diets
Advising what to eat and what not to eat
eemingly amateur advice
Posts Containing Advertising
Healthy eating, food safety and nutritional advice
Relevant codes
Kayla Itsines has found success through her Bikini Body Training Guide where she asks followers
to update their progress using the hashtag #bbg. She decided to build a presence on Instagram
and Facebook in order to share training and nutrition methods. This involved uploading client
transformations, healthy eating ideas and training tips. Through this she was able to inspire
thousands of women to move towards a healthier lifestyle. She is known to use the heart-­
eyes emoji, and in between fitness tips and photos of fruit plates or beach vistas, she posts
motivational quote.
Food bloggers are commonly an attractive, approachable and genuine young woman who seems
effortlessly to turn her hobby or flair for food into a photogenic lifestyle site which becomes
in its turn a source of expertise and authority. There is a lack of any rigorous factual evidence
underpinning lifestyles propagated by self-­appointed health gurus. Information and advice on
food choice is prominent and guidance and support of particular (principally weight loss) diets
Key findings relevant to the research question
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ROGERS et al.
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O'Connor31
Carey et al.
Citation
TA B L E 3 (Continued)
672
TA B L E 4 Themes and Subthemes
identified
Themes
Sub-­themes
Promoting dietary change
-­ Supporting Specific Diets
-­ Providing Practical Advice
-­ Establishing Credibility
Certain modes/styles of content delivery
-­ Content Modes
-­ Content Styles
An attractive individual
-­ Appealing Character Traits
-­ Physically Attractive
Language features
-­ Tone of the Message
-­ Language Techniques
Appearing connected to the audience
-­ Appearing Similar to the Audience
-­ Creating a Sense of Community with Followers
Through the identification of themes, SMI are capable of pro-
are presumed to have happier and live more successful lives. “The
moting dietary change, especially through restrictive type of diets
beauty is good effect” has since been recognised in further psycho-
or dietary patterns. A similar sentiment was previously identified in
logical studies in this area.39-­41 Based on this finding, the public may
14
the review by Endres et al,
where communication on healthy diet
be more likely to engage with nutrition content or advice that is com-
online was characterised by promotion of rigid dietary requirements
municated by a culturally appropriate and physically attractive SMI,
and strict implementation.14 In Social Media, Social Comment and the
by believing their lives will improve by adhering to the SMI advice or
Moralising Media-­Scape by Carey et al,16 it is suggested that followers
recommendations.
of SMI are drawn to promotion of restrictive diets due to their sim-
There were certain language features that were identified as
plicity and desirability of curated rules which makes adherence to
being used by the SMI. One of these language features is using spe-
the diet plan appear achievable. Carey et al16 alludes to the idea that
cific tones in messages. Pollard et al42 explored tonal preferences
people believe they are making healthier choices by following such
for nutrition text messages among young adult focus groups. In this
diets, but are often unaware of potential nutritional risks. Adherence
study, a tone of empathy was favoured to motivate nutrition be-
to dietary change can also appear more manageable with the provi-
haviour change across all participants.42 However, it was identified
sion of practical implementation strategies and advice provided by
that different tones resonated with different people.42 Our review
the SMI, which was the second sub-­theme identified. Audiences may
has similar findings, with different SMI finding success with different
be likely to identify with nutrition information provided by the SMI
tones in their messaging. Therefore, by using a particular tone that is
due to establishment of their “credibility.” In a systematic literature
suitable to their followers, increases engagement with the nutrition
review into trust and credibility in web-­health information, the au-
messages communicated by SMI. The use of language techniques
thority of the author—­that is the represented level of expertise of
of rhetorical devices and exaggeration has also been identified.
the person writing the information—­had a positive effect on trust
Rhetorical devices enable a key message to stand out, drawing at-
and credibility of the message.
35
tention to it and engage the attention of audiences.43 In advertis-
The second theme recognised that SMI used certain modes and
ing, rhetoric can be used to make audiences purchase something.43
styles of content delivery to communicate nutrition messages. These
Exaggeration has also been identified as an advertising technique
SMI can be called “content creators” which is defined as “someone
to help persuade people to do something.44 It appears that using
who produces entertaining or educational material and are respon-
exaggeration can make immediate action seem necessary. 24,44 Both
Similar to
techniques appear to be involved in persuasion,43,44 which explains
techniques in brand marketing, SMI can attract audiences to con-
why it can lead to greater engagement with the messages of SMI
nect with their nutrition message via the content they post and the
that use apply these techniques successfully.
sible for the contribution of information to any media.”
particular style utilised. In a study by Vraga et al,,
37
36
they found atten-
The last theme is that SMI appeared connected to the audience.
tion to social media relied on both the post topic and its style. They
First, this is seen through the SMI appearing physically similar to
found that posts that contain pictures or external links receive more
their audiences. Psychological research has indicated that people
attention, particularly in conjunction with topics of interest.37
have closer relationships with people who are similar to them.45-­47
The third theme, an attractive individual, explored how SMI
Curry et al45 found that similarity is a significant predictor of
were identified to have attractive qualities. Usually, this is in terms
emotional closeness in social networks. This sense of similarity
of physical attractiveness which aligns with the cultural norms of
followers feel towards SMI may influence the sense of feeling of
their followers. Nutrition messages may be more popular with fol-
connected with them, despite having thousands, to even million
lowers due to the positive attitude's society holds towards physically
followers. Creating a community with followers can also create a
attractive individuals. This sentiment was first observed by Dion
sense of connectedness. When Facebook was founded in 2004
et al 197438 who reported that physically attractive individuals are
the mission was “to give people the power to build community and
judged to have more socially desirable character traits and that they
bring the world closer together.37” Building an online “community”
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| 673
ROGERS et al.
|
ROGERS et al.
which has been facilitated by social media, has been recognised as
is comprehensive and of high quality. Another strength is that by
48
using a scoping review methodology, grey literature was searched
It is thought that individuals satisfy several needs by participating
and subsequently included. The grey literature were able to provide
in specialised communities; hence, the social network offers addi-
additional information to answer the research questions and offer
tional benefits and user loyalty.48 The social interactions between
unique marketing and media perspectives compared to traditional
community members foster a positive customer relationship and
research studies. Additionally, to our knowledge, there have been
attitude towards the brand and its products.49 This has the abil-
no other scoping reviews conducted on this topic, so the findings
ity to build strong and lasting relationships. 50 This “brand” could
are novel. Limitations have also been identified. First, screening,
be likened to SMI and the product they are selling can be likened
extraction and synthesis were predominantly conducted by one
to their “nutrition message.” Hence, this may explain why nutrition
author, meaning individual biases have influenced the selection of
messages are popular when there is a sense of community between
sources and subsequent analyses of data. However, each stage was
the SMI and their followers. In terms of communication structures,
conducted with collaborations with the research team which com-
Endres14 also reported on community, representing authentic ex-
prised of two Master of Dietetics Studies student dietitians and two
periences, creating intimate relationships and creating discussions
Advanced Accredited Practicing Dietitians. Another key limitation
being common in communication of healthy eating.
is that there has been no analysis of engagement or subsequent be-
a successful marking strategy used by many large food brands.
Using these themes and sub-­themes as a guide, to improve the
haviour change of followers. Hence, it is just an assumption that by
uptake of evidence-­based nutrition information, organisations could
integrating these nutrition communication methods into the “trusted
adopt certain behaviours to communicate nutrition information to
voice,” food behaviour change will occur.
improve engagement with the public.
By consistently adopting a range of influencing strategies, health
promotion agencies could create nutrition messages that deepen
5
|
CO N C LU S I O N S
engagement with specific audiences. However, before the nutrition
information is disseminated, the finding from this review suggests
The results of this novel scoping review indicate that SMI are se-
the audience of the message needs to be clearly defined, and spe-
lective in their methods of communicating nutrition information
cific groups of the population who are to be influenced needs to be
to ensure it is popular with social media users. Current strategies
deeply understood. A summary tool guide for those wishing to adopt
for nutrition communication by governments are inconsistently
techniques from SMI would include the following:
resonating with the public, so are currently insufficient to alter
food choice behaviours. The methods and techniques exhibited
1. Promote simple and clear diet or food message
by SMI could help inform strategies for the new “trusted voice for
2. Establish credibility by listing credentials and include scientific
nutrition” which is a long-­term goal of the Decadal Plan for the
facts and/or references,
Science of Nutrition. To further develop the framework of a po-
3. Implement a content style,
tential “trusted voice,” further market research into the Australian
4. Use an attractive culturally appropriate spokesperson that can
public, and more importantly, those individuals at risk of diet-­
appear like the audience,
related chronic disease, should be undertaken, to determine what
5. Utilise persuasive language techniques and a suitable tone, and
SMI methods could be employed to enhance engagement of dif-
6. Create a sense of community with two-­way communication with
ferent groups with evidence-­b ased nutrition messages via social
the public.
media.
The Australia Government has over 189 000 Instagram followers
AC K N OW L E D G E M E N T S
(as of August 2021). In influencer marketing, this level of following
We thank Tracy Bruce, Librarian, University of Queensland for as-
would be considered a “Macro Influencer.” A “Macro Influencer” is
sistance in the development of the search strategy
thought to have a specific niche with a highly targeted audience. This
following could be leveraged to engage followers in adopting healthy
C O N FL I C T O F I N T E R E S T
dietary patterns for all Australians. Additionally, popular individuals
The authors declare that there is no conflict of interest in fund-
on social media could be enlisted by public health organisations to
ing bodies. HT is an author of the Decadal Plan for the Science of
communicate evidence-­based nutrition messages to the public util-
Nutrition. HT and SW are members of the Australian Academy of
ising these techniques. As previous health promotion campaigns for
Science National Committee on Nutrition.
dietary change have not achieved the intended results, new and innovative strategies such as these are essential.
A strength of this scoping review was that it has been devel-
ORCID
Alice Rogers
https://orcid.org/0000-0001-5019-9634
oped using the PRISMA checklist for Scoping Reviews. This con-
Shelley Wilkinson
tains 20 essential reporting items to ensure the scoping review
Helen Truby
https://orcid.org/0000-0003-3365-3473
https://orcid.org/0000-0002-1992-1649
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674
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How to cite this article: Rogers A, Wilkinson S, Downie O,
Truby H. Communication of nutrition information by
influencers on social media: A scoping review. Health Promot J
Austral. 2022;33:657–­676. https://doi.org/10.1002/hpja.563
22011617, 2022, 3, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/hpja.563 by UNIVERSITA DI PADOVA Centro di Ateneo per le Bib Ca, Wiley Online Library on [04/10/2025]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
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