JMIR Publications

ABSTRACT

Background:

Management and prevention of hypertension are important public health issues. Healthy dietary habits are one of modifiable factors. As Twitter is an online platform that can influence public eating behavior, there is a knowledge gap regarding the information about foods and nutrients recommended for hypertension control and who disseminates them on Twitter.

Objective:

This study aimed to investigate the nature of the information people are exposed to on Twitter regarding hypertension, nutrients, and foods.

Methods:

A total of 147,898 Japanese tweets were extracted from 2022/01/01 to 2022/12/31. The final sample of 2347 tweets with at least one retweet were manually coded into categories of food groups, nutrients, user characteristics, and themes. The number and percentage of tweets, retweets, and themes in each category were calculated.

Results:

89.8% (2107 tweets) mentioned foods, which were categorized into 17 different food groups. Seasonings and spices, including salt, were most frequently mentioned (64.4%, n=1356), including salt. This was followed by vegetable and fruit consumption. 19 kinds of nutrients were mentioned, and potassium was the largest proportion, 24.5% (n=132). There was misinformation regarding salt intake for hypertension, accounting for 21.2% (n=549) of the final sample, which recommended salt intake for lowering blood pressure. 75.0% (n=21) of tweets from “doctors” mentioned salt reduction is effective for hypertension control, while 32.2% (n=73) of tweets from “health, losing weight and beauty-related users,” 25.9% (n=429) of tweets from “general public” and 23.5% (n=4) tweets from “dietitian or registered dietitian” denied salt reduction for hypertension. Misinformation was more widely disseminated in high numbers of retweets than that of evidence-based positive tweets about salt reduction and was posted primarily by self-proclaimed health experts.

Conclusions:

The large number of tweets in this study indicates a high interest in nutrients and foods for blood pressure control. Misinformation was more widely disseminated in high numbers of retweets and was posted primarily by self-proclaimed health experts. The number of tweets from nutritionists, registered dietitians, and doctors who were expected to correct misinformation and promote salt reduction was relatively low, and their messages were not always positive towards salt reduction. There is a need for communication strategies to combat misinformation, promote correct information on salt reduction, and for training healthcare professionals to effectively communicate evidence-based information on this topic.