Mediterranean Diet Information on TikTok and Implications for Digital Health Promotion Research: Social Media Content Analysis

Background: The Mediterranean diet has been linked to reduced risk for several cardiometabolic diseases. The lack of a cleardefinition of the Mediterranean diet in the scientific literature and the documented proliferation of nutrition misinformation onthe internet suggest the potential for confusion among consumers seeking web-based Mediterranean diet information. Objective: We conducted a social media content analysis of information about the Mediterranean diet on the influential socialmedia platform, TikTok, to examine public discourse about the diet and identify potential areas of misinformation. We thenanalyzed these findings in the context of health promotion to identify potential challenges and opportunities for the use of TikTokin promoting the Mediterranean diet for healthy living. Methods: The first-appearing 202 TikTok posts that resulted from a search of the hashtag #mediterraneandiet were downloaded and qualitatively examined. Post features and characteristics, poster information, and engagement metrics were extracted and synthesized across posts. Posts were categorized as those created by health professionals and those created by non health professionals based on poster-reported credentials. In addition to descriptive statistics of the entire sample, we compared posts created by professionals and nonprofessionals for content using chi-square tests. Results: TikTok posts varied in content, but posts that were developed by health professionals versus nonprofessionals were more likely to offer a definition of the Mediterranean diet (16/106, 15.1% vs 2/96, 2.1%; P=.001), use scientific citations to support claims (26/106, 24.5% vs 0/96, 0%; P<.001), and discuss specific nutrients (33/106, 31.1% vs 6/96, 6.3%; P<.001) and diseases related to the diet (27/106, 25.5% vs 5/96, 5.2%; P<.001) compared to posts created by non health professionals. Conclusions: Social media holds promise as a venue to promote the Mediterranean diet, but the variability in information found in this study highlights the need to create clear definitions about the diet and its components when developing Mediterranean diet interventions that use new media structures.