الفهرس 
FOOD INTAKE, EATING BEHAVIOR, AND MARKETING INFLUENCEOnly 14 pages are availabe for public view
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Abstract
The current environment promotes overconsumption of energy-dense foods, leading to overweight and diet-related health issues. Food advertising, especially on social media, significantly influences young people’s food choices, potentially harming their health.
Exposure to digital food marketing on platforms like Facebook, YouTube, Instagram, and Twitter encourages unhealthy eating habits and may impact body image and disordered eating behaviors. This digital marketing trend is fueled by its cost-effectiveness, personalized messages, and the high percentage of young social media users. Food companies create engaging content seamlessly integrated into young people’s lives, making unhealthy food ads more memorable than healthy ones.
The current study aimed at describing the pattern of exposure to and degree of engagement with digital food marketing on Social Networking Sites and determining the relation between exposure to digital food marketing on these platforms on eating behavior among students at the faculty of medicine, Ain Shams University.
A cross-sectional study was conducted and included a convenience sample of 706 medical students. Data collection was conducted through an online survey that was self-administered and presented in Arabic through a Microsoft Form. This survey was distributed across various platforms, including Facebook, WhatsApp, and the students’ e-learning portal. The questionnaire was structured into three sections. The first section focused on gathering information about the participants’ sociodemographic characteristics, anthropometric measures, and health status. The second section focused on social media usage patterns and exposure to and engagement with digital food marketing. Lastly, the third section utilized the ”Scale of Effects of Social Media on Eating Behavior” (SESMEB) to evaluate how social media usage influences participants’ eating behavior.
The study population consisted of 706 medical students with a mean age of 20.77±1.98 years. More than half of the participants (409, 57.93%) were females and 627 (88.81%) were Egyptians. Body mass index (BMI) was calculated from self-reported weight and height, and 43.20% of the participants were either overweight or obese while only 4.11% were underweight.
Most participants (628, 88.95%) mainly used a phone or a tablet to access SNSs. The mean age at first social media usage was 13.36 ± 2.95 years. Regarding the number of social media accounts, 59.07% of the respondents had three accounts or less, and (40.93%) had more than three accounts. More than half of the participants (57.93%) spent more than two hours per day on social media. 99.29% of the participants used at least one SNS daily. WhatsApp, Facebook, and Instagram were the most frequently used social networking sites among the participants, with daily usage rates of 94.5%, 67.4%, and 40.9%, respectively.
More than half of the participants reported exposure to digital food marketing at least weekly, of whom 22.24% of total sample reported daily exposure. When considering daily exposure, cooking lessons (7.6%) and food bloggers (7.8%) were the highest, followed by fast food, desserts, and beverages. More than half (377, 53.40%) of the participants were engaged at some level with digital food marketing at least weekly, of whom 112 (15.86% of total sample) did so on daily basis. The proportions of daily engagement were as follows: 13.2% for acknowledgement (watching video or liking), 2.7% for association (commenting/replying or using brand hashtags), 1.4% for amplification (sharing), and 3.5% for action (subscribing, purchasing post-viewing promotional offers, or using food delivery apps).
There was no statistically significant association between age and daily exposure, or high engagement with digital food marketing. Daily exposure was significantly associated with permanent foreign residence and following a dietary regimen. Students who used SNSs for more than two hours per day were more likely to report daily exposure to SNS food marketing.
Female students were more likely to fall in the high engagement category compared to male students. The same tendency was also seen in students from Upper Egypt, and those with fewer than five household members. Furthermore, students who work, do not practice sports, and those who have chronic illnesses were more likely than their peers to fall into the high engagement category. Additionally, students with more than three SNS accounts and those who were exposed to SNSs before the age of 13 were more likely to fall in the high engagement category, as well as those who used SNSs for more than 120 minutes per day on average.
The mean (±SD) SESMEB score for the study participants was 40.80±12.77.
Female students had higher mean scores, as well as students with fewer than five household members and those with average monthly expenses ranging from 1201 to 2400 EGP. Also, obese/overweight students, as well as those who do not practice sports were more likely than their peers to have higher mean scores. Additionally, students with more than three SNS accounts, those who were exposed to SNSs before the age of 13, as well as those who managed food content related pages and who showed interest in the food content were more likely to have higher mean scores.
Using a binary logistic regression model, overweight/obesity was associated with behavioral predisposition to be Influenced by SNS food marketing, rather than with the mere amount of exposure or engagement with such marketing. There was no statically significant association was found between daily exposure and high engagement and overweight/obesity outcome with adjustment for age, gender, and physical activity.
The SESMEB tool, which linked exposure to digital food marketing via social media and the effect on eating behavior, demonstrated that digital food marketing could influence dietary habits, consequently leading to obesity, the incriminating risk factor for numerous non-communicable diseases in childhood and adulthood.