Effect of using the snackability app on snack quality among US college students with overweight and obesity: A randomized controlled trial.

OBJECTIVE: To determine if using the Snackability app improves snack intake among college students. PARTICIPANTS: US college students with overweight/obesity were recruited in June 2020-April 2021. METHODS: A randomized controlled trial was conducted to test the Snackability app use for 12 wk on snack scores (calculated from the app) compared to controls. We also explored the effect on diet quality (Healthy Eating Index-2015) and weight. Outcomes were compared between the intervention and the control groups at 4, 8, and 12 wk using repeated measures ANOVA. RESULTS: Participants in the app group significantly increased snack score at week 4 (p < 0.001) and week 8 (p = 0.015) and increased HEI-2020 score (p < 0.001) at week 4 compared to controls. The first 4 wk had the highest app usage. No significant differences were seen in body weight. CONCLUSIONS: The Snackability app can be used as a tool to help improve snack and diet quality in this group.

Associations between ultraprocessed and minimally processed snacks consumption and overweight/obesity among college students in South Florida.

OBJECTIVE: Evaluate the association between ultraprocessed and minimally processed snack consumption and overweight/obesity among college students. PARTICIPANTS: College students. METHODS: Cross-sectional study. Participants completed an online survey with questions on socio-demographics, beverages and snacks consumption, and weight status. ANCOVA and logistic regression was used; analyses were adjusted for age, sex, race/ethnicity, physical activity, and sleep duration. RESULTS: A total of 435 students completed all questions in the survey. Most students were female (73.3%), Hispanics (61.1%), had a mean age of 24.7-year old and 40% had overweight/obesity. Those with overweight/obesity also had higher odds of consuming soft drinks in higher frequency and quantity than those without overweight/obesity (p < .05). Never consuming unsweetened yogurt/cheese and lower frequency and consumption of fruits were associated with higher odds of overweight/obesity (p < .05). CONCLUSION: Higher frequency and consumption of soft drinks while lower frequency and consumption of unsweetened yogurt/cottage cheese and fruits were associated with overweight/obesity.

Perceived Health and Diet Quality Among Hispanics in South Florida.

There is limited information if perceived health is associated with diet quality in Hispanics. A cross-sectional study was conducted to evaluate is health perception is associated with diet quality among 109 adults in South Florida. Individuals conducting a primary grocery shopping event were asked to complete a survey about their perceived health and to provide a picture of their grocery receipt to estimate diet quality using the Grocery Purchase Quality Index 2016 (GPQI-2016). Data was analyzed using analysis of covariance, adjusting for age, gender, ethnicity, and household size. Mean age was 45.1 ± 13.5 years, 74% were female, 79% were Hispanics, and 36.7% perceived themselves as having 'Good' health. The total average GPQI-2016 score was 40.9 ± 1.0. Perceived health was not significantly associated with total average GPQI-2016 score (p > 0.05). There was no association between perceived health and total diet quality in this sample of Hispanic adults.

Disability and COVID-19: Challenges, testing, vaccination, and postponement and avoidance of medical care among minoritized communities.

BACKGROUND: People with disabilities face heightened vulnerability to COVID-19. OBJECTIVE: This study investigated (1) the relationships between disability and COVID-19-related challenges, testing, vaccination, and infection and (2) predictors of loss of healthcare coverage and postponement and avoidance of medical care during the pandemic. METHODS: This cross-sectional study was conducted in Miami, Florida, between March 2021 and February 2022 as part of the NIH Rapid Acceleration of Diagnostics-Underserved Populations initiative. Disability was defined using a standard measure that assesses six universal functions. Participants reported sociodemographic data, COVID-19 testing, infection history, challenges, and healthcare history. Vaccinations were confirmed with medical records and COVID-19 positivity was assessed using real-time reverse transcription-polymerase chain reaction. Statistical analyses included multivariable logistic regression. RESULTS: Among 1,689 participants with a median age of 57.0, 50.6% were male, and 48.9% were non-Hispanic Black. Disability was associated with greater odds of all assessed COVID-19 challenges: healthcare (aOR:1.60; 95% CI:1.23-2.07), housing (aOR:2.15; 95% CI:1.62-2.87), insufficient food (aOR:1.97; 95% CI:1.54-2.52), water scarcity (aOR:2.33; 95% CI:1.60-3.37), medications (aOR:2.04; 95% CI:1.51-2.77), and transportation (aOR:2.56; 95% CI:1.95-3.36). Those reporting employment disability were less likely to have received COVID-19 testing (81.1% vs. 85.3%, p = 0.026) or to have history of COVID-19 positivity (aOR:0.63; 95% CI:0.44-0.92). Disability predicted avoidance (aOR:2.76; 95% CI:1.95-3.91) and postponement (aOR: 2.24; 95% CI:1.72-2.91) of medical care. CONCLUSIONS: Disability is associated with higher odds of COVID-19 challenges and postponement and avoidance of medical care. Those reporting employment disability had a lower likelihood of COVID-19 testing. Public health responses to healthcare crises should prioritize the special challenges of people living with disabilities.

Acceptability and Ease of Use of an Educational Website among Women, Infants, and Children Program Participants in Puerto Rico: A Pilot Study.

OBJECTIVE: To evaluate a website for an educational intervention among participants of the Baby-Act Trial. Baby-Act is a community-based intervention to prevent infant obesity by promoting physical activity, sleep, and healthy eating behaviors in Women, Infants, and Children (WIC) program participants in Puerto Rico. The intervention was designed to be delivered through a mobile application, but after the study was launched, participants reported many difficulties, and an alternative educational platform was developed. METHODS: Participants of the WIC program completed a face-to-face structured interview consisting of several open-ended questions. After completing the interview, they were instructed on how to access the newly developed webpage and completed the lessons found therein. Then followed a survey that explored the overall experience. RESULTS: Nine participants were interviewed; they all agreed that the website was easy to access, registration was simple, and the webpage was clear; 8 were able to complete at least 1 lesson (1 participant had a very poor signal), and all 9 reported being confident in using the webpage and stated they would use it again. CONCLUSION: The study participants found this website to be user-friendly and a viable alternative for future educational intervention delivery to WIC participants.

Snacking behavior is associated with snack quality, overall diet quality, and body weight among US college students.

Snacking behavior may affect snack quality, overall diet quality, and body weight; however, the associations between these variables have not been studied among college students. The objective of this study was to associate snacking behaviors with snack quality, diet quality, and weight status among college students with overweight and obesity. We hypothesized that a higher snacking frequency, accessibility and availability of unhealthy snacks, and lack of knowledge would be associated with lower snack and diet quality, and higher weight. Participants (n = 140) completed a snack behavior questionnaire, three 24-hour dietary recalls to assess diet quality using Healthy Eating Index 2015 (HEI-2015), and snack score using an algorithm based on the US DA Smart Snack guidelines and reported weight and height to calculate body mass index (BMI). Analysis of variance and Pearson correlation was used in the analyses. After adjusting for confounders, snack frequency was not associated with snack score, HEI-2015 score, or BMI, but evening snacks had a significantly lower snack score compared with late afternoon snacks (P = .017). Also, those with more accessibility and availability of unhealthy snacks had a lower snack score (P = .001), lower HEI-2015 score (P = .006), and higher BMI (P = .019). Snacking for pleasure was significantly associated with a lower snack score (P = .037). Snack score was positively correlated with HEI-2015 score but not with BMI. In conclusion, late snacking, unhealthy snack environment, and snacking for pleasure were associated with lower snack and diet quality. These findings could be used in future intervention strategies to improve snacking behaviors and the food environment.

The association between hydration status and body composition in healthy children and adolescents.

OBJECTIVES: Children 10-20 years old in the US are currently obese, showing suboptimal hydration as 60% fail to meet the US Dietary Reference Intakes for water. Studies have shown a significant inverse association between hydration status and body composition in children, although most failed to use the Dual-X-Ray Absorptiometry Scan (DEXA), the gold standard for body composition. Limited studies used an objective marker to measure hydration, such as urine specific gravity (USG) from a 24-h urine collection. Therefore, this study aimed to examine the association between hydration status (measured from USG in a 24-h urine sample and assessed from three 24-h dietary recalls) and body fat % and lean mass (assessed from a DEXA scan) in children (10-13 years, n=34) and adolescents (18-20 years, n=34). METHODS: Body composition was measured using DEXA, total water intake (mL/d) was assessed from three 24-h dietary recalls and analyzed using the Nutrition Data System for Research (NDSR). Hydration status was objectively measured using USG via 24-h urine collection. RESULTS: Overall body fat % was 31.7 ± 7.31, total water intake was 1746 ± 762.0 mL/d, and USG score was 1.020 ± 0.011 uG. Linear regressions showed significance between total water intake and lean mass (B=12.2, p<0.05). Logistic regressions showed no significant association between body composition and USG and total water intake. CONCLUSIONS: Findings showed total water intake was significantly associated with lean mass. Future research should be conducted to explore other objective markers of hydration and with a larger sample.

Development and pilot testing of the Baby-Feed web application for healthcare professionals and parents to improve infant diets.

BACKGROUND: Diet is key in preventing rapid infant weight gain but adherence to infant dietary recommendations is difficult to follow and low in adherence. OBJECTIVE: Develop and pilot test the "Baby-Feed" web application for parents and healthcare professionals to easily evaluate infant diets and provide immediate feedback to promote adherence to current infant dietary recommendations. METHODS: Baby-Feed was developed following the ADDIE (analysis, design, development, implementation, and evaluation) model. It was pilot tested among two clinicians and 25 parents of infants aged 4 to 12 months that had a scheduled well-child visit at a community health center in Miami. After 2 weeks of using Baby-Feed, parents completed a feasibility, acceptability, satisfaction, and usability questionnaire. Parents and clinicians were also asked to suggest improvements. Descriptive analysis included frequency and median (25th, 75th percentiles). One-sample binomial tests was used to evaluate if feasible, acceptable, satisfactory, and usable. RESULTS: Twenty-three parents completed the evaluation (all were mothers), 31.0 (26.0, 33.0) years-old, 96% Hispanic, 83% had ≥ high school education, with 1.5 (1.0, 2.0) children. Infants' age was 6.1 (4.0, 9.0) months and 57% were boys. Binomial tests indicated that most parents (greater than87%) agreed that Baby-Feed was easy to use, learn, quick, would use it again, rated it as 4/5 stars. They used it greater than 1 times per week (p < 0.001). Parents suggested improving the visuals (more icons, colors, and pictures) and images of portion sizes, highlighting missing fields, being able to view/open it on their phones, and adding recipes and more information. The two clinicians (a pediatrician and a physician assistant) suggested to be open-access and to add more infant nutrition information. CONCLUSION: Baby-Feed was feasible, usable, satisfactory, and acceptable. It could be used as a tool to easily evaluate infant diets in the healthcare setting to provide immediate feedback.

The association between hydration status and total fluid intake in healthy children and adolescents.

BACKGROUND: Children 10-20 years old in the US have suboptimal hydration status. Hydration is best assessed using an objective marker, such as urine specific gravity (USG) from a 24-h urine collection. There are limited studies associating hydration from an objective marker with intake assessed from 24-h recalls in children. The objective of the study was to evaluate which foods or beverages are significantly associated with an objective marker of hydration (USG) in a sample of children and adolescents. METHODS: Intake was assessed from three 24-h dietary recalls and analyzed using the Nutrition Data System for Research (NDSR). Hydration status was objectively measured using USG via 24-h urine collection. Associations were assessed with logistic regressions. RESULTS: A total of 68 children and adolescents were recruited (50% females). Average overall USG score was 1.020 ± 0.011 uG with 39.7% categorized as dehydrated. After adjusting for age and sex, fruit juice (1.009, 95% CI: 1.001, 1.018) and all beverages (1.001, 95% CI: 1.000, 1.002) were significantly associated with higher odds of being euhydrated. CONCLUSIONS: The main predictors of hydration were fruit juice and all beverages intake. Future research should be conducted to explore differences in dietary patterns in a larger, more generalizable sample. IMPACT: Findings showed that the main predictors of hydration were water and fruit juice intake in children and water intake in adolescents in southern Florida. This is the first study to examine which type of beverages and foods are associated with USG, an objective marker of hydration status, in US children and adolescents. Provides further insight into the use of objective markers to assess hydration status, while providing data to assist epidemiological studies that may have limited resources to examine beverages and foods that contribute to hydration.

[Use of platelet concentrate in bone regeneration through exodontics. Narrative review]. / Uso de concentrados plaquetarios en la regeneración ósea por exodoncia. Revisión narrativa.

Introduction: The post-exodontic alveolar atrophy requires quality bone regeneration techniques, and therefore, it is necessary to apply platelet concentrates, which are bioactive agents in the process of preserving the alveolar bone. The use of platelet concentrates proved to be an excellent osteoinducer since it leads to three important effects for maintaining bone structure. Objective: To analyze the use of platelet concentrates in post-exodontic bone regeneration. Materials and methods: A descriptive, explanatory study. A narrative review in which data was collected from 26 scientific articles published in scientific databases such as PubMed, Redalyc, ScienceDirect, and Ovid between 2012 and 2022. Conclusions: Platelet concentrates are physiological materials that speed up the healing time of post-extraction wounds. They are autologous since they are taken from the patient him/herself, reducing the risk of postoperative reactions, and the transmission of diseases by parenteral route. They relieve both inflammation and edema as well as post-surgery symptoms that appear after a dental extraction. They also help to preserve the alveolar ridge, avoiding long-term atrophy.

Factors That "Nudge People towards the Healthier" Snacks-A Qualitative Study with Student, Faculty, and Staff Leaders and Decision Makers.

(1) College campuses pose numerous public health challenges for students, faculty and staff. The healthfulness of the snacks available on campuses is lacking, and there is a desire for change among the students and staff. The objective of this study is to understand the perspectives of the students, staff, and decision makers regarding the college campus food environment and the perceived facilitators and barriers to improving it. (2) In-depth interviews were conducted (n = 15) with decision makers in food, policy development, wellness, and nutrition at a large Hispanic-Serving University in South Florida. (3) The key stakeholders shared that educational campaigns, student buy-in, raising awareness around obesity and chronic disease, and the university's position within the community would all help to facilitate improvements to the snack food environment. However, the participants noted that the complex nature of what is considered to be healthy and what divergent consumers want are significant barriers to improving the snack food environment along with concerns over lost revenue and the corporate structure. (4) These results inform potential focal points for multi-level interventions and inform policy discussions focused on improving the snack food environment at minority-serving universities. Taking strategic actions to improve the snack food environment may aid the students and staff of the university to enhance their diet quality.

Effect of a Short Messaging Service (SMS) intervention delivered to caregivers on energy, nutrients, and food groups intake in infant participants of the WIC program.

Objectives: To test the effect of a weekly test message (SMS) intervention for improving feeding practices on infant intake of energy, nutrients, and specific food groups. Methods: This study was a multi-site, randomized clinical trial, in 202 caregivers of healthy term infants participating in either the Puerto Rico or Hawaii WIC program. Participants were randomized to receive weekly SMS about either infant's general health issues (control) or SMS for improving feeding practices (intervention) to complement WIC messages for 4 months. Anthropometrics and demographics were assessed at baseline. A validated infant food frequency questionnaire was assessed at the four-month visit to assess intake of general food groups. Data was summarized as median (25th and 75th percentiles) or percentage and differences between study arms was compared using Mann Whitney or chi-square. Results: A total of 163 participants completed the study (n = 84 control and n = 79 intervention). Baseline characteristics were similar between both groups. At 4-6 months of age, compared to the control group, the intervention group had a significantly higher intake of total grains (0.28 oz; 0.00, 0.60; P = 0.033), protein (13.5 g, 10.5, 18.3; P = 0.022), calcium (472 mg; 418, 667; P = 0.012), and zinc (4.39 mg; 2.61, 6.51; P = 0.028). No differences were seen in the other food groups, including breastmilk. Conclusions for practice: Feeding SMS to complement WIC messages led to higher intakes of some key nutrients but did not have an overall improvement in the intake of food groups. Messaging also did not delay the introduction of complimentary foods or improve breastfeeding rates. Future studies should evaluate the use of more intensive SMS interventions for continued care between WIC visits.

Skin optical properties in the obese and their relation to body mass index: a review.

SIGNIFICANCE: Obesity is a worldwide epidemic contributing directly to several cardiovascular risk factors including hypertension and type 2 diabetes. Wearable devices are becoming better at quantifying biomarkers relevant for the management of health and fitness. Unfortunately, both anecdotal evidence and recent studies indicate that some wearables have higher levels of error when utilized by populations with darker skin tones and high body mass index (BMI). There is an urgent need for a better evaluation of the limits of wearable health technologies when used by obese individuals. AIMS: (1) To review the current know-how on changes due to obesity in the skin epidermis, dermis, and subcutis that could affect the skin optical properties; (2) for the green wavelength range, to evaluate the difference in absorption and scattering coefficients from the abdominal skin between individuals with and without elevated BMI. The changes include alterations in layer thickness and cell size, as well as significant differences in chromophores and scatterer content, e.g., water, hemoglobin, collagen, and lipids. APPROACH: We have summarized literature pertaining to changes in skin and its components in obesity and report the results of our search using articles published between years 1971 and 2020. A linear model was used to demonstrate the absorption and reduced scattering coefficient of the abdominal skin of individuals with and without elevated BMI in the green wavelength range (530 to 550 nm) that is typically found in most wearables. RESULTS: The general trends indicate a decrease in absorption for both dermis and subcutis and an increase in reduced scattering for both epidermis and dermis. At 544-nm wavelength, a typical wavelength used for photoplethysmography (PPG), the absorption coefficient's relative percentage difference between high and low BMI skin, was 49% in the subcutis, 19% in the dermis, and negligible in the epidermis, whereas the reduced scattering coefficient relative difference was 21%, 29%, and 165% respectively. CONCLUSIONS: These findings suggest that there could be significant errors in the output of optical devices used for monitoring health and fitness if changes due to obesity are not accounted for in their design.

Interventions to improve calcium intake through foods in populations with low intake.

Calcium intake remains inadequate in many low- and middle-income countries, especially in Africa and South Asia, where average intakes can be below 400 mg/day. Given the vital role of calcium in bone health, metabolism, and cell signaling, countries with low calcium intake may want to consider food-based approaches to improve calcium consumption and bioavailability within their population. This is especially true for those with low calcium intake who would benefit the most, including pregnant women (by reducing the risk of preeclampsia) and children (by reducing calcium-deficiency rickets). Specifically, some animal-source foods that are naturally high in bioavailable calcium and plant foods that can contribute to calcium intake could be promoted either through policies or educational materials. Some food processing techniques can improve the calcium content in food or increase calcium bioavailability. Staple-food fortification with calcium can also be a cost-effective method to increase intake with minimal behavior change required. Lastly, biofortification is currently being investigated to improve calcium content, either through genetic screening and breeding of high-calcium varieties or through the application of calcium-rich fertilizers. These mechanisms can be used alone or in combination based on the local context to improve calcium intake within a population.

Calcium supplementation for the prevention of hypertensive disorders of pregnancy: current evidence and programmatic considerations.

Most low- and middle-income countries present suboptimal intakes of calcium during pregnancy and high rates of mortality due to maternal hypertensive disorders. Calcium supplementation during pregnancy is known to reduce the risk of these disorders and associated complications, including preeclampsia, maternal morbidity, and preterm birth, and is, therefore, a recommended intervention for pregnant women in populations with low dietary calcium intake (e.g., where ≥25% of individuals in the population have intakes less than 800 mg calcium/day). However, this intervention is not widely implemented in part due to cost and logistical issues related to the large dose and burdensome dosing schedule (three to four 500-mg doses/day). WHO recommends 1.5-2 g/day but limited evidence suggests that less than 1 g/day may be sufficient and ongoing trials with low-dose calcium supplementation (500 mg/day) may point a path toward simplifying supplementation regimens. Calcium carbonate is likely to be the most cost-effective choice, and it is not necessary to counsel women to take calcium supplements separately from iron-containing supplements. In populations at highest risk for preeclampsia, a combination of calcium supplementation and food-based approaches, such as food fortification with calcium, may be required to improve calcium intakes before pregnancy and in early gestation.

Unpacking the behavioural components and delivery features of early childhood obesity prevention interventions in the TOPCHILD Collaboration: a systematic review and intervention coding protocol.

INTRODUCTION: Little is known about how early (eg, commencing antenatally or in the first 12 months after birth) obesity prevention interventions seek to change behaviour and which components are or are not effective. This study aims to (1) characterise early obesity prevention interventions in terms of target behaviours, delivery features and behaviour change techniques (BCTs), (2) explore similarities and differences in BCTs used to target behaviours and (3) explore effectiveness of intervention components in preventing childhood obesity. METHODS AND ANALYSIS: Annual comprehensive systematic searches will be performed in Epub Ahead of Print/MEDLINE, Embase, Cochrane (CENTRAL), CINAHL, PsycINFO, as well as clinical trial registries. Eligible randomised controlled trials of behavioural interventions to prevent childhood obesity commencing antenatally or in the first year after birth will be invited to join the Transforming Obesity in CHILDren Collaboration. Standard ontologies will be used to code target behaviours, delivery features and BCTs in both published and unpublished intervention materials provided by trialists. Narrative syntheses will be performed to summarise intervention components and compare applied BCTs by types of target behaviours. Exploratory analyses will be undertaken to assess effectiveness of intervention components. ETHICS AND DISSEMINATION: The study has been approved by The University of Sydney Human Research Ethics Committee (project no. 2020/273) and Flinders University Social and Behavioural Research Ethics Committee (project no. HREC CIA2133-1). The study's findings will be disseminated through peer-reviewed publications, conference presentations and targeted communication with key stakeholders. PROSPERO REGISTRATION NUMBER: CRD42020177408.

Transforming Obesity Prevention for CHILDren (TOPCHILD) Collaboration: protocol for a systematic review with individual participant data meta-analysis of behavioural interventions for the prevention of early childhood obesity.

INTRODUCTION: Behavioural interventions in early life appear to show some effect in reducing childhood overweight and obesity. However, uncertainty remains regarding their overall effectiveness, and whether effectiveness differs among key subgroups. These evidence gaps have prompted an increase in very early childhood obesity prevention trials worldwide. Combining the individual participant data (IPD) from these trials will enhance statistical power to determine overall effectiveness and enable examination of individual and trial-level subgroups. We present a protocol for a systematic review with IPD meta-analysis to evaluate the effectiveness of obesity prevention interventions commencing antenatally or in the first year after birth, and to explore whether there are differential effects among key subgroups. METHODS AND ANALYSIS: Systematic searches of Medline, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo and trial registries for all ongoing and completed randomised controlled trials evaluating behavioural interventions for the prevention of early childhood obesity have been completed up to March 2021 and will be updated annually to include additional trials. Eligible trialists will be asked to share their IPD; if unavailable, aggregate data will be used where possible. An IPD meta-analysis and a nested prospective meta-analysis will be performed using methodologies recommended by the Cochrane Collaboration. The primary outcome will be body mass index z-score at age 24±6 months using WHO Growth Standards, and effect differences will be explored among prespecified individual and trial-level subgroups. Secondary outcomes include other child weight-related measures, infant feeding, dietary intake, physical activity, sedentary behaviours, sleep, parenting measures and adverse events. ETHICS AND DISSEMINATION: Approved by The University of Sydney Human Research Ethics Committee (2020/273) and Flinders University Social and Behavioural Research Ethics Committee (HREC CIA2133-1). Results will be relevant to clinicians, child health services, researchers, policy-makers and families, and will be disseminated via publications, presentations and media releases. PROSPERO REGISTRATION NUMBER: CRD42020177408.

Perception about the effectiveness of different vending machine interventions to promote healthier snack selection among college students.

OBJECTIVE: Evaluate college students' perception of the effectiveness of different vending machine (VM) interventions for improving snack selection. PARTICIPANTS: A total of 194 college students with the age of ≥18 years. METHOD: A cross-sectional survey among a purposive sampling near VM. RESULTS: Most students use VM frequently or occasionally (63.4%). The intervention perceived as most helpful for choosing healthier snacks was labeling (on or near) which snack is healthy (score 3.83/5) followed by lowering the price of healthy options (score 3.33/5), while the least helpful was having posters nearby explaining which snacks are healthier (2.35/5). Participants suggested including snacks high in protein (58.8%) and low in sugar (56.2%). Most would like to see more healthy options in VM (83.5%) and will purchase them if available (67%). CONCLUSIONS: Lowering the price for healthy snacks and including labels to indicate which are healthy may be the interventions to test for improving snack intake among college students.

Use of Facebook, Instagram, and Twitter for recruiting healthy participants in nutrition-, physical activity-, or obesity-related studies: a systematic review.

BACKGROUND: There are limited systematic reviews exploring the use of social media for recruiting participants specifically for nutrition-, physical activity-, and obesity-related studies. OBJECTIVES: The aim was to conduct a systematic review on the effectiveness of using social media (Facebook, Instagram, and Twitter) for recruiting healthy participants in nutrition-, physical activity-, or obesity-related studies. METHODS: Studies were identified from 5 databases and included if they reported the number of participants recruited by social media (Facebook, Instagram, or Twitter) vs. traditional (print, e-mail, etc.). The effectiveness of recruitment was compared between methods by study procedures (in-person vs. online procedures). The cost-effectiveness of methods was also explored. The protocol was published in the Prospero database (ID# CRD42020204414). RESULTS: Twenty-six studies were included. Among studies with both types of recruitment methods, 49% of the sample was reached through traditional methods, 40% through social media, and the rest by other methods. For in-person study procedures, the median number of participants recruited using social media was 19 (range: 3-278) and for online study procedures, it was 298 (range: 3-17,069). Median recruitment cost using social media (n = 14 studies) was $11.90 (range: $0-517) per participant, while this varied considerably for traditional methods depending on how it was calculated ($214, $18.9-$777). The ratio of participants reached vs. recruited was 0.12%; the overall ratio of participants interactions vs. recruited was 21.2%. CONCLUSIONS: For in-person study procedures, traditional recruitment methods were more effective than social media, but for online study procedures, about half reported that social media was more effective. While more potential participants were reached through social media, only 21.2% of those who interacted with ads were enrolled. With the increased use of social media, their use for recruitment may be more frequent; therefore, future reviews may show different results.