Although the Mediterranean diet has demonstrated health benefits, there is confusion on the internet about what exactly it entails, researchers reported during the virtual meeting of the American Society of Nutrition.
Margaret Raber, MPH, DrPH, an assistant professor of pediatrics-nutrition at Baylor College of Medicine, and colleagues analyzed the content of the first 200 TikTok videos that appeared under the hashtag #mediterraneandiet during a search in August 2021. They found that people often conflated its health benefits with cuisine that is found in the region of the Mediterranean Sea but is not actually part of the diet.
“We wanted to explore the quality and characteristics of content on TikTok,” Raber told Healio. “We chose to examine Mediterranean diet (MD)-related content because although the MD is increasingly recommended for heart health, there is no widely accepted definition in the scientific literature.”
The Mediterranean diet is a term that incorporates some — but not all — of the eating habits of countries situated near the Mediterranean Sea. It typically involves fruits, vegetables, whole grains, olive oil, poultry and fish, as well as alcohol in moderation, such as red wine. Research has shown that the diet can reduce the risk for major cardiovascular events by one-third compared with a low-fat diet, and it can reduce the risk for preeclampsia by 22%.
“So just imagine, your doctor tells you to try the Mediterranean diet, and what do you do? You look it up online of course! So doing surveillance on online discourse about health topics is extremely important in order to understand areas of potential misinformation, as well as opportunities for public health messaging,” Raber said.
Most TikTok videos included in the analysis — 78% — were related to health in some way, but less than 9% offered a definition of the Mediterranean diet, according to a press release. Additionally, one in five videos had nothing to do with health but were instead focused on the food and culture of Mediterranean countries.
At the time, Raber found that last finding surprising, although it was obvious in retrospect.
“Relatedly, there is some misinterpretation of the MD happening on TikTok wherein dieters make health-related videos but present the MD as just eating foods from the Mediterranean region,” she said. “In a U.S. context, this often looks like Greek or Italian takeout, including non-MD foods such as lamb, beef, sweets and refined grains. One nutritionist TikTok-er in our sample addressed this directly — saying she wished they had called the Mediterranean diet something else because her patients were so confused about what they should, or should not, eat on the MD.”
Results also showed that people who claimed to have medical or nutrition credentials generally posted higher quality and more detailed videos. According to the release, 53% of those who posted content about the Mediterranean diet listed their credentials on their account information page, but less than half of those with credentials mentioned them in the post itself. The findings suggest that users may have difficulty determining if qualified health professionals created the videos.
Although the analysis was focused on consumers, Raber said there is a message in the findings for clinicians.
“Clinicians should be aware of consumer confusion about dietary recommendations, especially when it comes to the Mediterranean diet,” she said. “It is likely that without guidance, some portion of your patients may think you mean Greek cuisine! Dietary recommendations should come with clear guidance, practical resources, and of course providers should be open to answering questions or concerns related to online information.”