Frontiers in nutrition · 2026
What the algorithm serves: diet and fitness content on Instagram as independent predictors of orthorexia nervosa in a large Italian female sample.
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Mocini Edoardo, Greco Francesca, Gagliardi Arianna, Titi Luca, Giannetta Elisa, Tarsitano Maria Grazia
Аннотация
OBJECTIVE: Instagram use has been associated with orthorexia nervosa (ON), but prior research has generally measured exposure as overall platform use or broad health-related content. We directly compared four content categories (diet and slimming products, physical activity and sport, food in general, and fashion) within one adjusted model and provided an exploratory description of Instagram use and orthorexic symptoms in women with fibromyalgia.
METHODS: Cross-sectional web-based survey of 3,655 Italian adult women using Instagram as their primary social media platform. Content exposure was assessed on a 0-4 ordinal scale. Multivariable linear regression with HC3 robust standard errors was applied after z-scoring all predictors. A sensitivity analysis added daily Instagram use time.
RESULTS: Diet and slimming content (B = +1.14, 95% CI [+0.91, +1.38]; p < 0.001) and sport content (B = +0.91, 95% CI [+0.69, +1.12]; p < 0.001) were the strongest independent predictors of I-DOS scores. General food content was also independently associated (B = +0.50; p < 0.001), whereas fashion content was not (B = +0.003; p = 0.97). Time on platform was not independently associated after content adjustment (ΔR 2 = 0.0006). No content difference survived Bonferroni correction in women with fibromyalgia (n = 37), and their I-DOS scores did not differ significantly.
DISCUSSION: The Instagram-ON association was content-specific: diet and fitness content, rather than fashion content or time on the platform, accounted for the pattern. Because the data are cross-sectional and self-reported, causal direction cannot be established.
METHODS: Cross-sectional web-based survey of 3,655 Italian adult women using Instagram as their primary social media platform. Content exposure was assessed on a 0-4 ordinal scale. Multivariable linear regression with HC3 robust standard errors was applied after z-scoring all predictors. A sensitivity analysis added daily Instagram use time.
RESULTS: Diet and slimming content (B = +1.14, 95% CI [+0.91, +1.38]; p < 0.001) and sport content (B = +0.91, 95% CI [+0.69, +1.12]; p < 0.001) were the strongest independent predictors of I-DOS scores. General food content was also independently associated (B = +0.50; p < 0.001), whereas fashion content was not (B = +0.003; p = 0.97). Time on platform was not independently associated after content adjustment (ΔR 2 = 0.0006). No content difference survived Bonferroni correction in women with fibromyalgia (n = 37), and their I-DOS scores did not differ significantly.
DISCUSSION: The Instagram-ON association was content-specific: diet and fitness content, rather than fashion content or time on the platform, accounted for the pattern. Because the data are cross-sectional and self-reported, causal direction cannot be established.