Influencing gone wrong? How social media can affect nutrition and the medical field.

Social media includes many websites and apps that allow users to post and interact with others digitally. They give people the chance to connect to others across the globe, no matter the distance [2]. Many popular forms of social media use an algorithm to personalize the content shown to users and show posts that users interact with frequently. As a result, it is easy for one person to spread information across thousands, even millions of other users. This information may or may not be verified or supported with facts, and could even be blatantly incorrect.

This is common with people asking for advice with health-related issues, especially with physical and nutritional health. If one were to merely search up “fitness” or “health” on a platform like TikTok or Instagram, they would be bombarded with posts on tips to lose weight, eat better, look healthier, and more. It is intimidating, even more so for those who cannot afford an appointment with a specialist who can give them verified dietary advice. The access to information which is married to access to the internet is overwhelming and may cause people to trust the first thing they see that sounds reasonable. The problem with this, however, is the bias that often permeates this information.

The vast majority of teenagers and young people use social media [1], especially in the United States of America, and they are a target for those that try to spread misinformation for their own gain. This – combined with how little effort it takes for one to spread information on social media – can have negative effects on the eating habits of young people. One of these is the increased prevalence of eating disorders. There have been plenty of papers and studies that show a link between body image and social media [1]. This happens because any user can convince others that they are only healthy if they look a certain way, which then generates guilt when eating. Alternatively, unhealthy eating habits can be learned from what celebrities post on social media [1]. They may praise a certain fad diet that ultimately has no scientifically proven benefits. It is too easy for people to say anything that the site allows, and this may lead to people, young and old, to unintentionally harm their bodies with poor diet advice that they believe is reliable.

Despite this, social media has been used for positive impacts on eating as well. Sure, social media can be easily flooded with misinformation. However, it is possible for some information to be true and helpful so long as viewers take the time to do their own research. Some studies have shown that social media platforms, especially those with platforms that allow for easy discussion and text communication, have caused an increase in eating healthier foods [2]. This is especially true with vegetables and other food groups that many people may be lacking in their diets. However, this trend does not extend to decreasing consumption of unhealthy foods and drink [2].

Knowing these benefits and harms of social media, one might begin to wonder what to do. This is especially true for those pursuing or working in the medical field, since social media can be used to their advantage. For the rest of us, however, it is best to do extra research and validate the claims of social media posts. Alternatively, reaching out to medical professionals or, if possible, a nutritionist or other specialist is a great way to get verified information. As for individuals involved with the medical field, there are many ways that this phenomenon can be countered. For one, there are many individuals who also take to social media to verify other posts or create their own.

The Office of Disease Prevention and Health Promotion’s website provides a document of guidelines for medical professionals who are looking to spread better information [3]. These guidelines give helpful advice for bringing up the topic of healthy eating and what it truly looks like, as well as how to approach it in a helpful way [3]. It is important to be open-minded with these conversations to avoid misunderstandings. Due to the shame people experience related to their eating habits on social media [1], primarily those who do not fit the standards of a “healthy body” due to their size, it is crucial that these conversations allow for honest communication.

Knowing this, what should be done in the future? Whether you are looking to pursue the medical field or are merely a concerned individual, it is incredibly important that all information is taken from a valid source. Misinformation hurts the medical field, and it is best to encourage others to find a better source if they have the resources and means to do so. Also, users looking to post their own dietary advice on social media should also double-check their information to help prevent these problems at source.

Edited by: Wendy House

Designed By: Haynes Lewis

References:

[1] Hashim, S., & Pachisia, J. A Comprehensive Review on The Influence of Social Media on Eating Habits.

[2] Hsu, M. S. H., Rouf, A., & Allman-Farinelli, M. (2018). Effectiveness and Behavioral Mechanisms of Social Media Interventions for Positive Nutrition Behaviors in Adolescents: A Systematic Review. Journal of Adolescent Health, 63(5), 531–545. https://doi.org/10.1016/j.jadohealth.2018.06.009

[3] DIETARY GUIDELINES FOR AMERICANS. (2015). https://odphp.health.gov/sites/default/files/2019-10/DGA_Conversation-Starters.pdf

Unlocking the Potential of the Microbiome for Human Health

While we might like to think we know ourselves and what we are made of, looking into the components that make up our bodies tells a different story. While estimates vary, it is clear that microorganisms make up a significant portion of our bodies, likely outnumbering human cells [1]. While “microbiome” has become a buzzword used in settings ranging from academic research to the probiotic section of the grocery store, this wasn’t always the case. When Antoine van Leeuwenhoek first observed microbiota under his handcrafted microscopes in the 17th century, he discovered what he called “little living animalcule”[2]. Little did he know, he would set the stage for the great advances in our understanding of the microscopic world of bacteria, viruses, archaea, and fungi now known as the microbiome.

In recent years, the microbiome has become intimately implicated in human health, associated with many of the chronic diseases that pose the greatest burden to society. For this reason, it has become a hub of innovation, with several universities creating centers for microbiome innovation and the White House creating the National Microbiome Initiative in 2016 to advance research and translation. There is also a growing list of companies that seek to harness the role of the microbiome as it relates to human health, such as Pendulum Therapeutics in the realms of diabetes and weight loss and veMico in the field of skincare. AI, machine learning, and deep learning are being applied as tools to further fuel innovation, as they can help to derive insights from the trillions of microbial cells in the body [3]. The ability to harness the vast amounts of data available has also led to exciting possibilities for making comparisons between individuals that can be used to tailor precision medicine approaches.

Just as advances in genetic sequencing technology fueled the rise of direct-to-consumer (DTC) DNA testing companies like 23andMe, a multitude of companies offering DTC microbiome analysis have sprung up in recent years. As of January 2024, the University of Maryland, Baltimore identified 31 microbiome-based DTC companies in existence, with most operating according to a model where customers send in a biospecimen which is then analyzed to generate a report with personalized recommendations and health insights [4]. Similar to the case of DTC genetic testing, these DTC microbiome-based companies offer consumers the promise of unlocking important knowledge about their health that would otherwise be hidden and inaccessible. 

While the microbiome offers an exciting arena for innovation and insight into human health, the rise of the DTC landscape has brought up many of the same ethical and regulatory issues associated with DTC genetic testing. One important aspect is ensuring that the tests are analytically and clinically valid, which refers to the fact that the tests measure what they intend to measure and that the results are accurately indicative of healthy versus disease states [4]. Calls for regulation of these DTC companies cite the fact that there is not yet consensus among researchers about what constitutes a healthy versus an unhealthy microbiome, leading DTC companies to market their results as “recommendations” rather than “diagnostic”, a distinction that the average consumer may not understand [4]. In addition to these quality concerns, there have also been flags raised around consumer data privacy, possible psychological impacts of results delivered without the counsel of a healthcare provider, and the difficulty of delivering enough information to consumers to obtain true informed consent [5]. While all of the previous concerns apply to both DTC genetic and microbiome testing, there are also additional ethical issues uniquely related to the microbiome, as it opens up a new philosophical conversation on the relative importance of microorganisms in our conception of self [6]. Given the popularity of DTC genetic testing, it is likely that microbiome-based DTC testing will continue to expand and gain attention over the coming years. Because regulation continues to lag behind innovation in this space, it will be up to consumers to do the work of informing themselves about the possible risks and benefits before choosing whether to have their microbiomes analyzed before this type of analysis becomes integrated into clinical care. 

Reviewed By: Connor Barritt

Designed By: Allison Chin

References

[1] Abbott, A. (2016). Scientists bust myth that our bodies have more bacteria than human cells. Nature. https://doi.org/10.1038/nature.2016.19136

[2] Pariente, N. (2019). A field is born. Nature Portfolio. https://www.nature.com/articles/d42859-019-00006-2 

[3] Abavisani, M., Khoshrou, A., Foroushan, S. K., Ebadpour, N., & Sahebkar, A. (2024). Deciphering the gut microbiome: The revolution of artificial intelligence in microbiota analysis and intervention. Current Research in Biotechnology, 7. https://doi.org/10.1016/j.crbiot.2024.100211

[4] Hoffmann, D.E., Von Rosenvinge, E. C., Roghmann, M. C., Palumbo, F. B., Mcdonald, D., & Ravel, J. (2024). The DTC microbiome testing industry needs more regulation. Science, 383(6688), 1176-1179. https://doi.org/10.1126/science.adk4271

[5] Panacer K. S. (2023). Ethical Issues Associated With Direct-to-Consumer Genetic Testing. Cureus, 15(6), e39918. https://doi.org/10.7759/cureus.39918

[6] Ma, Y., Chen, H., Lan, C., & Ren, J. (2018). Help, hope and hype: ethical considerations of human microbiome research and applications. Protein & cell, 9(5), 404–415. https://doi.org/10.1007/s13238-018-0537-4

Chemical Straitjackets: Psychotropic Overmedication in Foster Care Children

Behind the closed doors of the 19th-century asylums, the brutal “treatments” administered to patients can oftentimes be recognized with a single emblem: the straitjacket. In spite of being originally intended to protect patients from bringing harm to themselves [1], their inhumane use can now be seen to reflect society’s ignorance of the patients. The modern-day straitjacket takes on a different form but captures this same notion. The modified term includes the word, “chemical,” applying their historical use of violently restraining patients to the overprescription of psychotropic medication [2]. This has become a greater problem over recent decades, especially as we have realized that some parts of our society are more susceptible to overprescription than others. In the case of children, the focus should be placed on the already more vulnerable population in foster care.

The general issue of overprescription remains a pervasive concern in the United States. For instance, the use of psychotropic medications have increased 22% in the last decade, with 1 in 5 adults currently consuming at least one psychotropic medication [3]. The issue started when the Food and Drug Administration (FDA) approved the prescription of Prozac—an antidepressant advertised to have minimal side effects—in 1987 [3]. While effective, its prescription has quadrupled in the United States since being released, making antidepressants the second most commonly prescribed drug [3]. This surge applauds the nation’s technological advancements, yet raises the concern that patients may be prescribed medications more often than needed without being prompted to carefully consider other evidence-based non-pharmaceutical treatments. In addition, as many psychotropic medications are accompanied with an array of side effects, patients can be seen to further seek out additional medications, leading to a dangerous prescription cascade.

Overprescription becomes an even greater issue when considering the susceptibility of children in foster care. 1 in 4 children in foster care is currently taking at least one psychotropic medication, which is a rate that is four times higher than that for all children in the United States [4]. The medication records of children in foster care also show higher doses than other children, despite research demonstrating that higher doses can result in serious long-term side effects especially when administered during developmental phases [4]. The explanation behind this difference lies within the structure of the foster care system as an institution. The system fails to provide sufficient informed consent and monitoring as part of their responsibility in providing care for the children [5]. For instance, several states were found not to require practitioners to follow the guidelines from the American Academy of Child and Adolescent Psychiatry when releasing prescriptions for children in foster care [5]. This questions whether children in foster care are receiving even the basic levels of care when it comes to issues that directly affect their long-term health.

The inadequacies of the foster care system in providing proper medical care should be further evaluated in context of the greater mental health needs demonstrated by these children. Even before entering the system, many of the children have experienced traumatic events. Instead of fulfilling these needs, the system reacts with administering psychotropic medications as a form of first-line intervention despite numerous research advising against such use. This models the use of psychotropic medications as chemical straitjackets; foster care children receive medication after medication to keep them from “acting out.” This can be seen in the first class action lawsuit in 2017 during which one of the plaintiffs stated that he had been prescribed more than six psychotropic medications when in foster care, being heavily medicated at all times without awareness about other treatment options [5]. The failure of the system to provide proper education continues to the foster care parents, who are rarely given any information nor directions about the medications consumed by the children in their care [3]. This makes it extremely difficult for these guardians to provide sufficient oversight to the children, continuing the problem even outside the legal system itself. 

Observing this lack within the foster care system, we are faced with a question that should not have to be asked: Do foster care children not deserve the same level of care as any other children in our nation? Despite the obvious answer, our nation’s actions have illustrated that the very systems built to protect these children have failed. The combined ignorance that has perpetuated this issue for decades further emphasizes that even ignorance is oftentimes a crime. Seeing these children in chemical straitjackets, we as a nation must reconsider whether we are truly making decisions for the well-being of the children, or for the convenience of the system.

Reviewed by Zachary Deutsch

References:

[1] Science + Media Museum. (2022, December 15). From asylums to anarchy: The straitjacket and popular culture. https://www.scienceandmediamuseum.org.uk/objects-and-stories/straitjacket-and-popular-culture 

[2] United States House Committee on Ways & Means. (2014, May). Reichert opening statement: Caring for our kids: Are we overmedicating children in foster care? https://waysandmeans.house.gov/2014/05/29/reichert-opening-statement-caring-for-our-kids-are-we-overmedicating-children-in-foster-care/ 

[3] Smith, B. L. (2012, June). Inappropriate prescribing. American Psychological Association. https://www.apa.org/monitor/2012/06/prescribing 

[4] Edelman, M. W. (n.d.) Overmedicating children in foster care. Children’s Defense Fund. https://www.childrensdefense.org/overmedicating-children-in-foster-care/ 

[5] LaFortune, K. A., & Fields, S. (January). Mismanagement of psychotropics in the foster care system. American Psychological Association Judicial Notebook, 52(1), 19. https://www.apa.org/monitor/2021/01/jn