The association between social media use and attitudes toward nutrition among university students in Saudi Arabia

Abstract

BACKGROUND:

The increasing consumption of social media among students has caused concerns about its influence on nutrition-related attitudes and behaviors. Research suggests that exposure to food trends, diet culture, and health influencers on platforms, like Instagram and Facebook, can shape students’ perceptions of nutrition. This study examines the relationship between social media use and dietary attitudes, exploring its potential impact on eating habits and nutritional choices.

MATERIALS AND METHODS:

Study design was a cross-sectional and data collection was done from a public sector university; a stratified sample technique was used to recruit a sample size of 509. Validated and organized questionnaires were used. Correlation and regression analyses were used to examine the relationship between social media engagement and attitudes toward nutrition.

RESULTS:

Study result revealed that higher social media use was significantly associated with increased odds of disordered eating behaviors, with those using social media for 1–3 h/day having an adjusted odd ratio (AOR) of 2.31 (95% confidence interval [CI]: 1.02–11.36; P = 0.004) and those using it for more than 3 h/day showing an AOR of 5.31 (95% CI: 1.00–28.13; P = 0.050). Married individuals have an AOR of 5.76 (95% CI: 1.68–19.77; P = 0.005) for developing eating disorders.

CONCLUSION:

The study highlights a substantial association between high social media use and disordered eating behaviors, with prolonged engagement (more than 3 h/day) contributing to increased risk. Marital status emerged as an important predictor. This result emphasizes the need for further research to explore the effect of social media and other sociodemographic factors on eating behaviors, particularly in the context of prevention and intervention strategies.

Introduction

The emergence of digital technology has made the impact of smartphones and social networks a constant focus of investigation, as they serve as highly revealing communication channels.[1] Social networks are used as an occupational and preservation resource, the same for people or businesses.[2] User suffering has become one of the effects related to maladapted use of social network concerning workload and personal stress.[3] But on the education level, a less than helpful implication is greater levels of tension with 24/7 availability and after-work hours, leading to emotional exhaustion.[4] The diseases of addiction are one set of the effects.[3] Additionally, the stakes of engaging on social media range from using it in a relatively casual way to something as consequential and life-threatening.[5] A variety of problematic uses are also thrown into the mix, broadening the potential hazards at a time when use has even more variability in how it is applied.[6]

Social media platforms often promote content related to dietary practices, fitness trends, and eating habits, influencing users’ perceptions and behaviors around food. Researcher developed a questionnaire to assess the nature of social media engagement and found that individuals who primarily use SNS for diet-related purposes exhibited higher scores on eating disorder scales.[6] Similarly, previous studies T reported that prolonged exposure to fitness and diet accounts was correlated with an increased likelihood of engaging in restrictive eating practices.[7,8]

Engagement with social media, particularly activities involving health and fitness communities, has been linked to increased disordered eating symptoms. A previous study[9] revealed that time spent on social media predicted disordered eating behaviors over time, particularly in individuals who actively participated in online diet challenges. Additionally, another study[10] reported that adolescents who followed fitness influencers were prone to engage in restrictive eating practices and adopt unhealthy dietary practices.

The mechanism behind this association is partly explained by the reinforcement of dietary norms and trends propagated through social media. Content promoting extreme dieting, detox regimens, and unverified nutritional advice can contribute to disordered eating patterns. A previous study[11] highlighted the role of peer influence in online diet communities, where individuals often share restrictive eating strategies and offer validation for unhealthy behaviors.

Furthermore, social media platforms facilitate the dissemination of misinformation regarding nutrition and health. Research[12] indicated that individuals with higher levels of trust in social media sources were more likely to adopt harmful dietary practices, such as extreme calorie restriction or the use of unregulated supplements. The interactive nature of these platforms can create echo chambers where misinformation circulates unchecked.

In contrast, some research[2,13] have suggested potential benefits from social media when used for health education. Previous study[2] found that exposure to evidence-based nutritional content and participation in moderated health forums could support healthier eating behaviors. Educational interventions promoting digital literacy have been recommended to help users critically evaluate online dietary information and resist adopting harmful practices.

This information situated around weight and nutrition is also easy to internalize, resulting in a direct pathway between social media use and concerns related to both nutrition and body weight. To what extent can social media influence eating choices and thus dietary intake quality? Also, may be at risk for disordered eating patterns the people who are somewhat more regular users of social media? This study seeks to address this question by revealing the relationship between use of multiple social media platforms and attitudes toward food choices, body weight, and eating—three salient aspects pertinent in most discussions pertaining to diets.[14,15] The data concern a sample of health sciences university students, focusing on a homogeneous subgroup of females and males. For students, high usage and a poor diet (working in strong conjunction with monitoring body weight), particularly among students, are indicators of disordered eating tendencies: These results provide valuable information for future studies examining a double-edged impact of high social media use on the nutrition and body image.

Materials and Methods

Study design and setting

It is a cross-sectional study and was done in different colleges of health science at the public sector university in the city of Hail, university have 15,000 students enrolled, in college of health sciences total number of students registered around 1000.

Study subject

Study participants were students of health sciences, who were selected via stratified cluster sampling. Both male and female students were included in the study. World health organization software for sample size was used, 5% margin of error with 99% confidence interval (CI|) and 25.8% prevalence of social media use from previous study[15] and 10% eating disorder, margin of error was 5% and nonresponse rate was 10%, the total sample size is 509.

Study participants and sampling

The rule for participants was selected as being a student at University of Hail in different colleges, such as college of medicine, college of dentistry, college of pharmacy, and college of nursing, being able to complete the questionnaires; and giving consent giving to participate in the study. Those students were giving incomplete form and other students with different no health colleges were excluded from the study. Permission were granted from administration of colleges, questionnaires were sent to leader of each academic year it’s also include one page informed consent. Class leader were collected the questionnaire from students.

Data collection tools and techniques

Questionaries consist of four segments, first segment consists of sociodemographic characteristic, second segment consist of validated scale of social media use,[15] reliability and validity of this scale were assessed in other previous studies,[16,17] and Cronbach’s s alpha coefficients of was 0.85 and reliability was 0.90. Total questions in this scale were 19; rating calculated of every question on five-point Likert scale ranges from 1 to 5, there are three sub-domains in this scale: frequency of use social media (questions 1–5), from questions 6–12 type of use, and questions 13–20 level of user trust. Score ranges from 10 to 95. If participants score between 19 and 38, its mean rare frequency used of social media, if the score between 38 and 57 which showed that medium frequency used of social media and if the score above 57 which revealed that high frequency used of social media on experience of past six month.

Attitude toward nutrition disorder scale was used (EAT-26). This questionnaire comprised of 26 questions and 3 components, which include food habitation, hunger, and oral control. Range of score from zero to 78. If participants score above 21, it referred to nutrition clinic and investigation of disorder and treatment. This scale validity and reliability of the EAT was 0.91, which showed that perfect reliability. The validity of the this scale confirmed by previous studies.[16,17]

Data entry was performed using Epi-data software, and data analysis was conducted using the Statistical Package for the Social Sciences (SPSS) version 26.0 (IBM SPSS Statistics for Windows, version 22.0, Armonk, NY, USA: IBM Corp). Two types of analysis were done first descriptive, in which calculate mean, standard deviation, frequency, and percentage. Second inferential, in which logistic regression were used to analyze the association between social medial used and eating disorders. P < 0.05 were measured as statistical significance.

Ethics consideration

This study was approved by the ethical approval committee of University of Hail with approval number is H-2024-485 and all participants were given informed consent to participate before entering in the study. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Results

Out of total 509 study subjects, with the majority being female (69%) and 31% male. The mean age was 21.83 years (standard deviation ± 1.34), with most participants (63.1%) between 21 and 25 years of age. Regarding academic year distribution, the largest proportion of participants were in their fourth year (29.5%), followed by third-year students (24%). The majority of participants were single (94.9%), while 5.1% were married. Smoking prevalence was low, with only 9% of participants reporting ever smoking. Most participants’ fathers were employed in office work (80.2%), and 19.8% were involved in business. A past medical or surgical history was noted in 19.6% of participants, while 6.5% reported a family history of psychological disorders. Body mass index (BMI) distribution showed 63.9% of participants within the normal range, with 11.8% underweight, 18.1% overweight, and 6.3% obese [Table 1].

Table 1.

Sociodemographic characteristics of the study participants (n=509)

Variable		n (%)
Gender
Male		158 (31)
Female		351 (69)
Age (mean 21.83 SD ±1.34)
17–20		188 (36.9)
21–25		321 (63.1)
Academic year
First		71 (13.9)
Second		78 (15.3)
Third		122 (24)
Fourth		150 (29.5)
Fifth		88 (17.3)
Marital status
Single		483 (94.9)
Married		26 (5.1)
Smoking
Ever		46 (9)
Never		463 (91)
Father occupation
Office work		408 (80.2)
Business		101 (19.8)
Past medical or surgical history
Yes		100 (19.6)
No		409 (80.4)
Family history of psychological disorder
Yes		33 (6.5)
No		476 (93.5)
BMI
<18.5		60 (11.8)
18.5–24.9		325 (63.9)
25–29.9		92 (18.1)
>30		32 (6.3)

BMI=Body mass index, SD=Standard deviation

Among the 281 participants identified as high social media users, social media usage was significantly associated with eating disorders. Participants with average social media use (1–3 h/day) had an adjusted odds ratio (AOR) of 2.31 (95% CI: 1.02–11.36; P = 0.004) for developing eating disorders compared to those with normal use (<1 h/day). Excessive social channels use (>3 h/day) showed a more substantial correlation, with an AOR of 5.31 (95% CI: 1.00–28.13; P = 0.050). Marital status demonstrated a substantial relationship with eating disorders, where married participants had an AOR of 5.76 (95% CI: 1.68–19.77; P = 0.005) compared to single participants [Table 2].

Table 2.

Association of eating disorder with social media use and sociodemographic characteristics among study participants (n=281 participants only have high social media used)*

Characteristics		Eating disorder Un-Adjusted Odd Ratio OR[95%Confidence interval CI](P value)		Eating disorder Adjusted odd Ratio AOR[95% Confidence interval CI](P value))
Social media use
Normal (<1 h/day)		1		1
Average (1–3 h/day)		3.91 (1.80–18.57; 0.004)		2.31 (1.02–11.36; 0.004)
High (>3 h/day)		11.71 (2.47–55.41; 0.002)		5.31 (1.00–28.13; 0.050)
Age category (years)
17–20		1		1
21–25		1.31 (0.74–2.32; 0.354)		1.46 (0.62–3.44; 0.384)
Gender
Female		1		1
Male		1.22 (0.70–2.11; 0.474)		1.25 (0.67–2.14; 0.115)
Marital status
Single		1		1
Married		1.54 (0.67–3.84; 0.007)		5.76 (1.68–19.77; 0.005)
Academic year
First		1		1
Second		0.75 (0.33–1.74; 0.519)		0.76 (0.44–1.31; 0.336)
Third		1.22 (0.43–3.42; 0.703)		1.15 (0.61–2.16; 0.651)
Fourth		1.63 (0.60–4.36; 0.332)		1.14 (0.57–2.29; 0.535)
Final		1.22 (0.50–2.97; 0.659)		1.79 (0.44–1.31; 0.469)
Smoking status
Ever		1		1
Never		1.06 (0.57–1.97; 0.836)		1.25 (0.61–2.34; 0.589)
Father occupation
Office work		1		1
Business		1.47 (0.95–2.29; 0.081)		1.62 (0.79–3.29; 0.635)
Past medical and surgical history
No		1		1
Yes		1.30 (0.83–2.02; 0.244)		1.37 (0.69–2.70; 0.358)
BMI
18–24.9		1		1
25–29.9		2.19 (0.54–8.87; 0.272)		4.56 (0.57–11.10; 0.194)
≥30		1.19 (0.31–4.52; 0.797)		1.45 (0.36–5.79; 0.598)

*P value less than 0.005 is significance. BMI=Body mass index, CI=Confidence interval

Other sociodemographic factors such as age, gender, academic year, smoking status, father’s occupation, past medical history, and BMI did not show statistically significant associations with eating disorders.

Correlation analysis revealed significant positive relationships connecting social media use and eating disorders. Frequency of social channels use found a average positive association with eating disorder symptoms (r = 0.343, P < 0.01). Additionally, type of social media use (r = 0.195, P < 0.01) and level of use (r = 0.243, P < 0.01) were also notably correlated with eating disorder symptoms [Table 3].

Table 3.

Correlation of social media used with eating disorder among study participants

Variables		Frequency use		Type of use		Level of use		Eating disorder
Frequency use
Pearson correlation		1		0.388**		0.305**		0.343**
Significant (two-tailed)				0.000		0.000		0.000
n		509		509		509		509
Type of use
Pearson correlation		0.388**		1		0.532**		00.195**
Significant (two-tailed)		0.000				0.000		00.000
n		509		509		509		509
Level of use
Pearson correlation		0.305**		0.532**		1		0.243**
Significant (two-tailed)		0.000		0.000				0.000
n		509		509		509		509
Eating disorder
Pearson correlation		0.343**		0.195**		0.243**		1
Significant (two-tailed)		0.000		0.000		0.000
n		509		509		509		509

**Correlation is significant at the 0.01 level (two-tailed)

Figures 1 and 2 illustrate the prevalence of social channel use and eating turmoil among study participants, highlighting the higher prevalence of disordered eating behaviors in individuals with increased social media engagement.

Figure 1.

Prevalence of social media used among study participants

Figure 2.

Prevalence of eating disorder among study participants

Discussion

The results of this research indicate a significant relationship between social media use and eating disorders among young adults. The increased odds of disordered eating with higher social media engagement align with previous research that has identified social media as a potential risk factor for unhealthy eating behaviors.[18] Prolonged contact with content in social media correlated to diet, fitness, and nutrition may contribute to disordered eating patterns by promoting restrictive diets, detox regimens, and unhealthy comparisons.[19]

The significant association observed between high social media use and eating disorders is consistent with the results reported by previous study. Who found that individuals spending more than 3 h daily on social media had higher rates of disordered eating.[20] The interactive nature of social media platforms allows users to engage with content that often lacks scientific basis, potentially influencing dietary habits and attitudes.[21]

Marital status emerged as a significant factor, with married individuals showing higher odds of developing eating disorders compared to single individuals. This finding may reflect the potential stressors associated with marital responsibilities and lifestyle changes, which can influence eating behaviors.[22,23,24] However, further research is needed to explore this relationship in greater depth.

The absence of significant associations with other sociodemographic factors, such as age, gender, academic year, and smoking status, suggests that social media use is a more salient predictor of disordered eating behaviors than these demographic variables.[23,24,25] This highlights the pervasive influence of digital media on eating habits, irrespective of background characteristics.

The correlation analysis demonstrated positive associations between social media usage patterns and eating disorder symptoms. Frequency, type, and level of social media use were all significantly related to disordered eating behaviors, indicating that both the amount and nature of engagement with social media content are relevant to understanding these patterns.[24,25]

The results of our study indicate significant patterns regarding social media use and eating disorders among participants. The prevalence of social media use was highest among those using it for more than 3 h/day (55.20%), followed by 42.60% using it for 1–3 h/day, and only 2.20% using it for less than one hour per day. These findings suggest a potential relationship between extended social media use and increased risk of eating disorders.[26,27]

Regarding eating disorder components, food habitation (dieting) was the most prevalent at 66.80%, followed by oral control at 65.20%, and hunger or desire to eat (bulimia) at 63.30%. This distribution highlights the diverse ways in which disordered eating behaviors manifest among individuals with high social media engagement.[26,27,28,29,30,31,32,33,34]

Limitations and recommendation

This research have several limitations; first information bias and the design of study was cross-sectional which have causality problem. Second, common biases such as selection bias, recall bias, and confounding influence the results. When a research sample is not representative of the entire population, Selection bias occurs. To mitigate this, researchers can resort to random sampling and there is need for longitudinal studies to determine the causality between outcome and independent variables.

Conclusion

In conclusion, the study highlights a significant relationship between social media use and disordered eating behaviors among students, with higher engagement correlating with increased odds of developing eating disorders. The results emphasize the importance of social media use as a key predictor of disordered eating, underscoring the need for further research into these associations.

Conflicts of interest

There are no conflicts of interest.

Funding Statement

Nil.