Twitter Trends for Celiac Disease and the Gluten-Free Diet: Cross-sectional Descriptive Analysis

Abstract

Background: Few studies have systematically analyzed information regarding chronic medical conditions and available treatments on social media. Celiac disease (CD) is an exemplar of the need to investigate web-based educational sources. CD is an autoimmune condition wherein the ingestion of gluten causes intestinal damage and, if left untreated by a strict gluten-free diet (GFD), can result in significant nutritional deficiencies leading to cancer, bone disease, and death. Adherence to the GFD can be difficult owing to cost and negative stigma, including misinformation about what gluten is and who should avoid it. Given the significant impact that negative stigma and common misunderstandings have on the treatment of CD, this condition was chosen to systematically investigate the scope and nature of sources and information distributed through social media.

Objective: To address concerns related to educational social media sources, this study explored trends on the social media platform Twitter about CD and the GFD to identify primary influencers and the type of information disseminated by these influencers.

Methods: This cross-sectional study used data mining to collect tweets and users who used the hashtags #celiac and #glutenfree from an 8-month time frame. Tweets were then analyzed to describe who is disseminating information via this platform and the content, source, and frequency of such information.

Results: More content was posted for #glutenfree (1501.8 tweets per day) than for #celiac (69 tweets per day). A substantial proportion of the content was produced by a small percentage of contributors (ie, "Superuser"), who could be categorized as self-promotors (eg, bloggers, writers, authors; 13.9% of #glutenfree tweets and 22.7% of #celiac tweets), self-identified female family members (eg, mother; 4.3% of #glutenfree tweets and 8% of #celiac tweets), or commercial entities (eg, restaurants and bakeries). On the other hand, relatively few self-identified scientific, nonprofit, and medical provider users made substantial contributions on Twitter related to the GFD or CD (1% of #glutenfree tweets and 3.1% of #celiac tweets, respectively).

Conclusions: Most material on Twitter was provided by self-promoters, commercial entities, or self-identified female family members, which may not have been supported by current medical and scientific practices. Researchers and medical providers could potentially benefit from contributing more to this space to enhance the web-based resources for patients and families.

Keywords: Twitter; accuracy; celiac disease; content; credibility; diet; education; gluten-free; infodemiology; online; social media; social networking site.