Exploring nutrition-related interests of the transgender and gender-diverse community: a content analysis of a transgender-centric discussion forum on Reddit.

OBJECTIVE: The solicitation of nutrition-related health advice on social media platforms is on the rise. However, there is a paucity of research on the distinctive nutrition-related concerns and needs faced by transgender and gender-diverse individuals. Understanding patterns of nutrition-related information-seeking behaviour is vital to advancing health promotion efforts within this community. This study aimed to characterise the nutrition-related questions posed by the transgender community on a prominent social media outlet, Reddit. DESIGN: A qualitative, cross-sectional content analysis was conducted, focusing on the top 100 submissions (ranked by popularity) within a transgender-centric online subreddit (r/asktransgender). Data extraction was facilitated using the Application Programming Interface Pushshift. The content analysis was conducted using NVivo. SETTING: The study was situated within the discussion forum of the social media platform, Reddit. RESULTS: A total of 148 references from 90 eligible posts were identified and coded. The major themes included the effects of hormone replacement therapy (HRT) on nutritional health (n 66), weight status (n 45), dietary needs and behaviours (n 21), physical activity and weight loss on body shape (n 9), social undermining (n 4) and effects of health behaviours on HRT (n 3). CONCLUSION: This study underscores the pressing need for tailored and evidence-based nutrition guidelines and communication toolkits that specifically address the distinct needs and experiences of transgender individuals, particularly those undergoing HRT.

A narrative review of clinic-community food provision interventions aimed at improving diabetes outcomes among food-insecure adults: examining the role of nutrition education.

BACKGROUND: Food provision interventions (eg, produce/food prescriptions, food pharmacies, food voucher programs) that bridge clinic and community settings for improved nutritional health outcomes of at-risk patients have gained momentum. Little is known about the role of nutrition education and potential augmented impact on patient outcomes. OBJECTIVE: To describe intervention designs and outcomes of direct food provision clinic-community programs aimed at improving diabetes-related outcomes (glycated hemoglobin [HbA1c] levels) among patients with type 2 diabetes (T2DM) or prediabetes and food insecurity, and to compare nutrition education components across interventions. METHODS: The PubMed and Academic Search Complete databases were systematically searched for original peer-reviewed articles (published during 2011-2022) that described the impact of clinic-community food provision programs (ie, produce/food prescriptions, food pharmacies, and food voucher programs) onHbA1c values among adults diagnosed with T2DM or prediabetes and who screened positive for food insecurity or low income. Study designs, intervention approaches, program implementation, and intervention outcomes were described. RESULTS: Ten studies representing 8 distinct programs were identified. There was a high degree of variation in the studies' design, implementation, and evaluation. Across the 8 programs, 6 included nutrition education; of these, 1 used a theoretical framework, and 3 incorporated goal setting. Nutrition education covered multiple topical contents, including general nutrition knowledge, fruit and vegetable consumption, and accessing resources (eg, enrolling in the Supplemental Nutrition Assistance Program). Furthermore, the education was delivered through various formats (from 1-on-1 to group-based sessions), educators (community health workers, registered dietitians, physicians), and durations (from a single session to biweekly). All programs with a nutrition education component reported reduced participant HbA1c, and 4 demonstrated an increase in fruit and vegetable purchases or improved dietary quality. The remaining 2 programs that did not include nutrition education yielded mixed results. CONCLUSION: The majority of programs included a nutrition education component; however, there was a high degree of heterogeneity in terms of content, educator, and duration. Patients who participated in programs that included nutrition education had consistent reductions in HbA1c. These observational trends warrant further exploration to conclusively determine the impact of nutrition education on patient outcomes participating in clinic-community food provision programs.

Nutrition-Related Messages Shared Among the Online Transgender Community: A Netnography of YouTube Vloggers.

Purpose: Nutrition care guidelines for the transgender population do not exist, despite significant nutrition-related clinical and psychosocial considerations. Social networking sites (SNSs) provide multidirectional communication and have expanded in popularity among transgender users as a resource for health information and support. The nature of the content shared among the online transgender community is unknown, but may suggest the nutrition-related areas that are of most importance to the transgender population. The objective of this qualitative netnography was to describe the food and nutrition messages shared among the transgender community using video blogs (vlogs) on the SNS, YouTube. Methods: Public vlogs were assessed using the constant comparative method. Pseudoquantitative methods were used to capture the prevalence of each subtheme; quotes were documented verbatim. Data were collected from transgender users' public vlogs (n=30) self-published on YouTube from 2013 to 2018. Results: Six major themes were generated from the data analysis. These included the following: functions of diet and exercise; diet and exercise philosophies; "how to" vlogs; advice for success; using dietary supplements; and effects of hormone therapy. Conclusions: Nutrition-related messages are widely shared among the online transgender community through YouTube. The identified themes reflect topics of interest and expressed needs of transgender individuals. SNSs provide health care providers with a platform to improve patient education and health literacy. Health care providers may actively engage in online discussions to build trust, answer questions, and provide a source of accurate and evidence-based information.