Dietary interventions in adolescents

Abstract

The adverse health impact of obesity in young people remains a global health priority. This work aims to contribute towards a spectrum of evidence-based weight management treatment alternatives. These may include weight-neutral approaches promoting non-weight related health improvement as well as interventions involving intensive dietary restriction. Nutrition-related social media content may influence dietary behaviours in young people. However, its impact is unclear and this medium remains underutilised by health professionals. The aims of this thesis were to: 1. undertake a systematic review of weight-neutral interventions in young people with high body mass index 2. describe high-engagement social media imagery related to mindful and intuitive eating, visible to young people on the social media platform Instagram. The systematic review identified three pilot studies of short duration (6 or 12 weeks), each with 33 to 37 adolescents. Although feasibility and acceptability appeared promising, conclusions are based on limited data from small studies of modest methodological quality. Instagram images categorised under the hashtags ‘mindfuleating’ and ‘intuitiveeating’ were searched using the ‘top posts’ view and then coded collaboratively. The content emphasised average-bodied White young female adults and healthy lifestyles without a focus on weight, with modest representation of males, or diverse body types, ages, and racial/ethnic populations. This lack of pictorial diversity may reduce the acceptability of mindful and intuitive eating in broader populations. Recommendations arising from this thesis include: 1) building a stronger evidence base to support clinicians in using weight-neutral strategies for health improvement in young people with obesity; and 2) investigating the utility of Instagram for health professionals to disseminate culturally and demographically inclusive, evidence-based health promotion and nutrition information to young people.