When Health Becomes a Hashtag

At first glance, my Instagram account and Lee Tilghman’s are not all that different. We’re both amateur chefs. We both like to write about our travels. We like to eat new foods and try new products. But while I share my posts with around 500 followers, mostly friends and family, Lee has an ever-growing audience of over 313,000 people, who follow along with her life through her intentional yet effortless Instagram profile.

Since 2014,Tilghman has been the foodie, yogi, and photographer behind “Lee From America.” Technically, Lee From America is a blog and a brand name, but it would be more accurate to describe it as a kind of marketable lifestyle. Photos of oozy egg yolks and body-positive swimsuit selfies offer windows into Tilghman’s picture-perfect life.

313,000 aspirational followers can’t all be Tilghman. But can they buy a life just like hers?

According to Mediakix.com, an online management platform for social media influencers, the number of sponsored posts on Instagram is projected to reach 32.3 million in 2019 — in 2016, this number was only 9.7 million. And these are only the posts marked by one of the hashtags #ad, #sponsored, #spon, or #sp.

Although many followers take to Instagram seeking answers to their health questions and insecurities, the information offered can be tainted. The online wellness community, through the filters of social media, has become a tangled web of sponsorships and unverified health claims. Some of the worst offenders are supplements: highly expensive and poorly studied, they can gain popularity when marketed by attractive “influencers” with little experience but large follower counts.

More often than not, Insta idols in the wellness sphere have no hard qualifications for doling out nutritional advice. Their Instagram stories are just that: stories, not dietary guidelines. As a media-obsessed culture, it is time to start acknowledging these limitations.

The Individual Brand: From Tony the Tiger to Today

The origins of influencer marketing may be traced back to as early as the late nineteenth century. Mascots like Quaker and Aunt Jemima turned brands into characters — suddenly, big companies could sell their products through friendly, recognizable faces, overcoming impersonal corporate associations.

As brands realized the power of these invented spokespeople, they dreamed up even friendlier characters like Tony the Tiger or Snap, Crackle, and Pop. Cartoons gained consumers’ trust, and brand loyalty soon followed.

It did not take long for brands to figure out that celebrities could also serve as product ambassadors. Celebrities already had the trust of their fan bases; an effective brand endorsement could reach millions and easily convert them into new customers.

Today, though, the growth of social media has challenged conventional ideas of celebrity. New waves of Instagram influencers lead relatively normal lives; indeed, by making normalcy photogenic, they have caught the attention of thousands of followers. Never before has happiness seemed so tantalizingly close; rather than emulating pop stars, consumers can find idols who look like them — people who have perfected life as stay-at-home moms, college students, and 9-to-5’ers.

Big brands have noticed, too.  Companies can pay influencers less per ad than a conventional celebrity, while still reaching thousands of viewers who will see their product in the context of daily life, as an integral part of an accessible role model’s routine. If what separates a normal person’s life from an influencer’s is just a handful of products, the incentive to buy surges.

I’m not a Doctor, But…

The main way conventional brands communicate with customers is through packaging. When they make a health claim on their label, though, they must seek evaluation by the FDA, or make it clear that they have not done so. Gaining approval involves submitting a petition and showing “significant scientific agreement among qualified experts that the claim is supported by the totality of publicly available scientific evidence.”

The FDA categorically prohibits some health claims, like anything about the diagnosis, cure, mitigation, or treatment of a disease. But claims that do qualify will go through an evidence-based review system that involves identifying relevant studies, weeding out the ones whose results are insignificant, and evaluating the methods, reliability, and strength of those still remaining. Only after this painstaking process can a brand print alleged benefits on its product packaging.

By contrast, Instagram influencers have no such process. Jeanette Ogden is an Adidas brand ambassador and the woman behind the incredibly popular Instagram account @shutthekaleup, also known as “STKU.” Her product verification process has significantly lower standards than the FDA’s — “by research I just mean going online and Googling things, random things,” she explained in a “story” on her profile.

Ogden is about to show viewers a medicine cabinet full of her Sun Potion powders and extracts. It is an impressive collection, and considering that a single bottle can cost upwards of $60, her whole apothecary must be worth a small fortune — although it’s unclear from the video how many have been provided for free by Sun Potion. Thrown together in varying combinations and mixed into her morning coffee, the extracts are presented as an essential part of Ogden’s complicated supplement ritual. She turns the camera back to herself before running through the lineup.

“Before I begin, I want to disclose that I’m not a doctor, not an herbalist, not a potion-ist. I just use them and I wanted to share my experience with them,” Ogden explains to her almost 300,000 followers.

Her collection features ashwagandha herb, pine pollen, chaga (a mushroom extract), chlorella, rhodiola (a root that grows in the Arctic), and about a dozen other powdered substances, packaged in jet black jars and labeled with golden seals. When she gets to lion’s mane, another mushroom extract, Ogden holds it up to her phone camera. “I’m taking it for brain function,” she explains. “Because this girl can use all the help she can get … My mind is always racing, I’m like, ‘What day is it?’”

That’s not all lion’s mane can do, apparently. The mushroom’s other alleged benefits include combatting anxiety and stress while boosting mental clarity, concentration, athletic recovery, and balanced mood. Ogden reads these last few properties right off the label. Of course, a constellation of asterisks on the bottle lets you know that “these statements have not been approved by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.” This disclaimer does not make it into Ogden’s video.“Take a half teaspoon every day,” she advises.

In a traditional personal conversation, there’s nothing insidious about sharing anecdotal experiences with health products like this. Word of mouth has always been a major source of brand awareness and loyalty. But even with Ogden’s “not-a-doctor” disclaimer, Instagram has changed the dynamic by providing her with a platform of hundreds of thousands of followers, some of whom take the words of their Insta idols as unquestionable fact.

Take one STKU fan for example. In a video on her story, the follower announced that she was about to place an order for beef liver capsules, which Ogden had recommended “for reasons like skin, hair, nail, and joint health.” But the precise reasons were immaterial to the follower. “I guess I like beef liver now,” she said, shrugging. “Because STKU takes it.”

Nutrition: Fact and Fiction

Wellness is highly personal and variable, meaning that what works for one person is not always guaranteed to have universal effectiveness. But there is still a distinction between fact and unfounded belief.

“The bottom line is [that] nutrition is a science, not an opinion,” said Angela Lemond, RD, national spokesperson for the Academy of Nutrition and Dietetics, in an interview with the HPR.

This means nutrition is still subject to the same scientific principles as any other field of research. To make any real progress, you must ask questions, form a hypothesis, test that hypothesis, and draw reasonable conclusions from the resulting data. Evidence-based nutritionists look to the “gold standard” — a double-blind, randomized, controlled experiment — when evaluating research. That means you give half the population an active treatment and the other half a placebo, and it is only after the study that you reveal who was getting which treatment.This kind of research is harder to come by than a #sponsored post on Instagram touting the benefits of lion’s mane extract. But the distinction is highly important; in some cases, inaccurate information can have serious consequences.“At best, it’s going to be a bunch of wasted money. At worst, it can kill somebody,” said Lemond.

Take herbal supplements, for example. According to systematic reviews of the scientific literature, the actual data on these extracts leaves much to be desired. One often-cited study on lion’s mane only showed minor improvements in 30 women’s moods, and they weren’t even taking it in pill form; instead, they ate mushroom-infused cookies. Another review claimed that the observed anti-depressive effects of lion’s mane may have been “secondary to attenuating menopausal symptoms.”

Some herbs lack any relevant research at all. WebMD goes so far as to say that for the many ailments rhodiola is supposed to cure, “there isn’t enough scientific evidence to determine whether it is effective for any of them.”

As for collagen, Mark Moyad, researcher at the University of Michigan and author of The Supplement Handbook, says that “the science is truly in its infancy.” Plus, many studies of its efficacy have been funded by industry. Conclusive, independent research has yet to surface, but in the meantime, consumers continue to spend millions of dollars every year on ground-up cow hooves, hides, nerve tissues — not only an unappetizing blend, but a potentially dangerous one, as these animal parts may sponge up heavy metals or carry bovine spongiform encephalopathy, known commonly as “mad cow disease.”

And then there is the question of how to take herbal extracts. Ogden’s routine involves dissolving them in coffee with a scoop of “healthy fats,” by which she means butter, ghee, and coconut oil, all of which are still linked to coronary heart disease, despite the dairy industry’s desperate campaign to prove otherwise.

Ogden, Tilghman, and others nod to the inconclusive nature of nutritional research by encouraging viewers to “do your own research” and “decide what’s right for you.” This is better than nothing, but glosses over the complete lack of conclusive information available, and ignores the powerful psychological effect carried by their stamp of approval.

Meet the Influencers

“I’m incredibly deflated by [this] community right now,” said influencer Jessie May Snyder in an interview with the HPR. “They’re being influenced more by brands than by science.”

Snyder runs the Instagram account @jessiemaysnyder. The photos on her page are clean, white, and polished images of her ultra-organized refrigerator and bird’s-eye views into the contents of her Vitamix.

It did not begin this way. At the start, Snyder just wanted a place where she could share her interest in food with friends and family. As Instagram boomed, so did her following. Now, her wealth of recipe ideas, meal prep tips, and tours of farmer’s markets — her overall “food philosophy,” in other words — have made her a de facto wellness authority. At times, this puts Snyder in an uncomfortable position. “It’s a little nerve-racking not to be certified,” said Snyder. “I’m not a nutritionist, I didn’t go to school to become a doctor, I’m not an RD,” Snyder admitted. “I’m just someone who’s read a lot.”

To some extent, influencers can be held responsible for the information (or misinformation) they disseminate through their channels. But there are no prerequisites for starting an Instagram account. The world of social media is a noisy place, and viewers have to exercise a certain degree of discretion in who they choose to listen to.

“We should always question what anyone says,” Snyder said. To her credit, she makes sure to check that the advice offered in her posts is consistent with available evidence-based nutritional studies. Many other influencers agree. But as JJ Beasley of @beazysbites noted in an interview with the HPR, “the spreading of false information is not just in the influencer realm.” The health and nutrition field is notoriously rife with misinformation and bias, and even well-intentioned “research” can yield inaccurate or misleading conclusions.

“Taking everything with a grain of salt is so important,” said Beasley.

#WhatNow?

We follow health and wellness Instagram blogs because they are fun to follow and because they can introduce us to new products, recipes, and wellness strategies. But in an era where doing your own research has come to mean “just going online and Googling things, random things,” it’s more important than ever to be skeptical.

Nonexperts like so many of these Instagram influencers, can provide anecdotes, but not evidence. As Lemond put it, “science needs to dictate the topic and the claims” rather than personal experience. The idea that Instagram’s guidance will always be useful or accurate is false. Instagram users must recognize the important distinction between opinion and fact when it comes to their social media feeds, especially in the wellness sphere. “Trendy af” or not, until we know more, it may be prudent to swap our extra scoops of ashwagandha for daily doses of skepticism.

Image Credit: Unsplash/Rawpixel

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