The Use of Social Media Technologies on Management of the National and

Regional Obesity Crisis

Clinical Science Background:

Daniel A. Terreros MD, PhD

Social Systems Technologies:

Holly E. Russo, RN, MSN, MSECS

Lecture Aims• Why obesity is now considered a disease and which are its

molecular causes!• Understand Social Media in Health Care!• Social Media has a place in Obesity Management!• Trends in ownership and use of smartphones, tablets,

computers!• Use of apps in tracking food consumption, exercise and more!• Combining social networks with other applications!• Interactive Gaming Engagement!• What has been studied thus far and where do we need to

continue to explore; the future!

Obesity Crisis!

Obesity Causes Metabolic Syndromeand T2D

Obesity is Main Cause of T2D

Professor David BarkerType 2 diabetes mellitus:

The thrifty phenotype hypothesis. Diabetologia 35:595 601 1992‐

“Nutrition at certain stages of pregnancy programs the fetus… for more efficient utilization and storage of energy”

The Thrifty Genotype Single-Hit Hypothesis

Obesity is a state of inflammation Cytokines TNF alpha, and IL6 are elevated in obesity and cause genetic programing to Type 2

diabetes

Malnutrition is a state of inflammation Cytokine IL-6 is elevated in malnutrition and causes genetic programing to type 2 diabetes

The El Paso Epigenetic Nutritional Hypothesis:

“Both Malnutrition and Obesity at Certain Stages of Pregnancy and through Inflammatory Cytokines Programs the Fetus for a more Efficient Utilization and Storage of Energy”

D.A. Terreros

The Borderland Paradox

Nutrition and Obesity Epigenetic Programing Paradox

• Malnourished Mother • Obese Mother

High IL-6Low Glucose

Low Insulin

High TNF High IL-6High Glucose

H or L Insulin

Low Birth Weight High Birth Weight

Epigenetic Driven Teen and Adult Obesity

Insulin &GFs

Epigenetic Two-Hit Obesity Crisis HypothesisMalnutrition-i.e. Inmigrant s &Others

Obesity- Following Border Generations

EL Paso’s Future ?

Increased HC Expenditures, Less HC Access and Lower Productivity

Lecture Aims

• Why obesity is now considered a disease!• Understand Social Media in Health Care!• Social Media has a place in Obesity Management!• Trends in ownership and use of smartphones, tablets,

computers!• Use of apps in tracking food consumption, exercise and more!• Combining social networks with other applications!• Interactive Gaming Engagement!• What has been studied thus far and where do we need to

continue to explore; the future!

Social Media in Healthcare

• The term social media refers to the use of Web-based and mobile technologies that are commonly used for interaction and communication within networks.

• Research underscores strong associations between participation in social networks and preventive health behavior.

• Alters may provide emotional support, instrumental support (financial or practical), informational support, or appraisal (decision-making) support.

Digital Social Integration and Capital

• Social integration, can increase access to health information and promote self-worth and self-care on the basis of societal norms and expectations.

• Social capital has been defined as the resources obtained by a group or an individual through a network of social relationships, as well as the number and quality of the relationships in the network.

Lecture Aims

• Why obesity is now considered a disease!• Understand Social Media in Health Care!• Social Media has a place in Obesity Management!• Trends in ownership and use of smartphones, tablets,

computers!• Use of apps in tracking food consumption, exercise and

more!• Combining social networks with other applications!• Interactive Gaming Engagement!• What has been studied thus far and where do we need to

continue to explore; the future!

Obesity and Social Media

• An analysis of the Framingham Heart Study, which included only adults, found that spouses, siblings, and friends were at greater risk for obesity if their alters were obese.

• Among children and adolescents, body mass index (BMI) is associated with school-based friendship clusters; school friends are significantly similar in terms of their BMI, with friends of the highest BMI appearing to be most similar.

Digital Integration of Obesity Population Control

• Internet-based programs and other electronic technologies have been used in both the treatment and prevention of overweight and obesity in youth.

• Benefits from these interactive electronic interventions include their widespread availability in the school and home, popularity among youth, ability to engage and immerse participants, and ability to provide immediate tailored feedback.

Obesity Digital in Community Integrative Programs

• Obesity-related health behaviors are also associated with adolescent social networks, including participation in organized sports, fast food consumption, and computer/video game screen time.

• Social networks therefore may be critical in shaping young people’s eating behaviors and body weight and vice versa, and their role suggests the potential of social network–based health promotion interventions.

• Combining social network analysis with environmental assessment can identify interventions for childhood obesity treatment or prevention.

• Geocaching, an activity during which individuals or groups search for items described on Web sites using navigational tools, such as GPS tracking devices, also leverages social networks and the built environment to increase physical activity

• In addition to targeting existing social networks, future interventions could be based on the development of social networks purposefully developed to address obesity.

Lecture Aims

• Why obesity is now considered a disease!• Understand Social Media in Health Care!• Social Media has a place in Obesity Management!• Trends in ownership and use of smartphones, tablets,

computers!• Use of apps in tracking food consumption, exercise and

more!• Combining social networks with other applications!• Interactive Gaming Engagement!• What has been studied thus far and where do we need to

continue to explore; the future!

Adult Statistics

• 59% of U.S. Adults have looked online for health information.

• 60% of U.S. adults say they track their weight, diet, or exercise online.

• 85% of U.S. adults own a cell phone. Of those, 53% own smartphones.

• One in three cell phone owners (31%) have used their phone to look for health information. Source: Fox, S & Duggan M. Mobile Health 2012. Pew Internet and Life Project .

Published November 8, 2012

Trends in Adulth Ownership of Media

Trends in Teens Ownership of Media

• 78% of teens now have a cell phone, and almost half (47%) of those own smartphones.

• One in four teens (23%) have a tablet computer, a

level comparable to the general adult population.

• Nine in ten (93%) teens have a computer or have access to one at home

Source: Madden, M., Lenhart,A., Duggan M.,Cortesi, S., and Gasser, U. Teens and Technology 2013. March 13, 2013. Pew Research Center and Berkman Center for Internet and Society at Harvard University

Lecture Aims• Why obesity is now considered a disease!• Understand Social Media in Health Care!• Social Media has a place in Obesity Management!• Trends in ownership and use of smartphones, tablets,

computers!• Trackers of Health Data• Use of apps in tracking food consumption, exercise and more!• Combining social networks with other applications!• Interactive Gaming Engagement!• What has been studied thus far and where do we need to

continue to explore; the future!

Who is Tracking Health Data• The Pew Internet survey shows that people living with one or more chronic

conditions are no more likely than other U.S. adults to track their weight, diet, or exercise routine.

• Nearly half (45%) of U.S. adults are dealing with at least one chronic condition.

• In the general population, women and men are equally likely to report tracking their weight, diet, or exercise routine.

• Non-Hispanic whites and African Americans are more likely than Latinos to track these basic health indicators: 62%, 59%, and 51% of each group respectively do so.

• Sixty-eight percent of college graduates track their weight, diet, or exercise routine, compared with 54% of adults with a high school diploma and 43% of those who have not graduated from high school.

Lecture Aims

• Why obesity is now considered a disease!• Understand Social Media in Health Care!• Social Media has a place in Obesity Management!• Trends in ownership and use of smartphones, tablets,

computers!• Trackers of Health Data• Use of apps in tracking food consumption, exercise and more!• Combining social networks with other applications!• Interactive Gaming Engagement!• What has been studied thus far and where do we need to

continue to explore; the future!

Use of Apps in Obesity

• Lubans et al. provided adolescents with an intervention incorporating pedometers and e-mail support on physical activity, sedentary behavior, and healthy eating.

• Among those in the intervention group, boys increased their step counts by 956±4107 steps per day and girls by 999±1999 steps per day. The intervention significantly decreased the number of energy-dense/low-nutrient snacks consumed by boys (P=0.043) and increased the amount of fruit consumed by girls (P=0.028). The intervention did not have a statistically significant effect on sedentary behavior.

Lecture Aims• Why obesity is now considered a disease!• Understand Social Media in Health Care!• Social Media has a place in Obesity Management!• Trends in ownership and use of smartphones, tablets,

computers!• Use of apps in tracking food consumption, exercise and

more!• Combining social networks with other applications!• Interactive Gaming Engagement!• What has been studied thus far and where do we need to

continue to explore; the future!

Combining Social Networks

• One in five trackers in the general population (21%) say they use some form of technology to track their health data, which matches our 2010 finding.

• Specifically: – 8% of trackers use a medical device, like a glucose meter – 7% use an app or other tool on their mobile phone or

device – 5% use a spreadsheet – 1% use a website or other online tool

Lecture Aims• Why obesity is now considered a disease!• Understand Social Media in Health Care!• Social Media has a place in Obesity Management!• Trends in ownership and use of smartphones, tablets,

computers!• Use of apps in tracking food consumption, exercise and

more!• Combining social networks with other applications!• Interactive Gaming Engagement!• What has been studied thus far and where do we need to

continue to explore; the future!

Interactive Game Engagement

• Active video games enjoy widespread appeal to youth and have been demonstrated to increase energy expenditure and physical activity compared with sedentary video gaming.

• Several of these technologies also offer Internet connectivity, including Nintendo Wii Fit and Microsoft Kinect, and the ability to join an online gaming service that allows one to play games against other members in its online community with the use of an avatar.

Lecture Aims• Why obesity is now considered a disease!• Understand Social Media in Health Care!• Social Media has a place in Obesity Management!• Trends in ownership and use of smartphones, tablets,

computers!• Use of apps in tracking food consumption, exercise and

more!• Combining social networks with other applications!• Interactive Gaming Engagement!• What has been studied thus far and where do we need to

continue to explore; the future!

Available Apps Thus Far

Tracking Weight, Diet and Exercise

Impact of Health Tracking

Obesity Apps studied thus far - Cyclemeter

• Bicycle tracking app

• You can use Cyclemeter to track walks, runs, and other activities.

• Available on: iOS• http://www.abvio.com/cyclemeter/

• This iOS-only app has you complete a test workout, in which you rate different exercises as easy, tough, impossible, or "need to learn," which then informs the app going forward how difficult your workouts should be.

• Georges St-Pierre uses the principles of gymnastics, bodyweight exercises and High Intensity Interval Training

• You can choose workouts of 20, 40, or 60 minutes

http://gspofficial.com/touchfit

Obesity Apps Studied Thus Far – Touchfit GSP

• Designed for counting calories and logging exercise, can help you lose weight, especially if you tend to eat name-brand American foods.

• Available on: Android, iOS, Kindle, Nook, and Web.

Obesity Apps Studied Thus Far- Lose it

Obesity Apps Studied Thus Far- “My Plate”

• A calorie tracker App

• Available on: Android, BlackBerry, iOS, Windows Phone, and Web

• @ Livestrong.com/thedailyplate

Obesity Apps Studied Thus Far- Counteat.calories

• Helps you estimate, rather than count, how many calories you consume at each meal

• Helps you find a range, rather than a precise target, for how much you should eat.

• Available on: iOS

Obesity Apps Studied Thus Far- Endomondo Sports Tracker

• Members use GPS features to track how much they run, cycle, jog, and so forth, and share their progress with others.

• Languages: English, Spanish, others

• Available on: Android, BlackBerry, iOS, Windows Phone, and Web

Obesity Apps Studied Thus Far- The Eatery

• Use The Eatery to snap photos of your food. We’ll give you something much more helpful than calorie counts.

• Invite friends to follow and support you.

• Get insight into your eating habits.

• Available on: iOs

Obesity Apps Studied Thus Far- Fitbit.com

• If you do own one of the Fitbit gadgets, you can sync it so that the data it collects automatically appears on your account.

• On its own, the Fitbit site gives you the ability to record your personal data to keep track of your fitness goals.

• Available on: Android, iOS, and Web.

Obesity Apps Studied Thus Far- Fitocracy

• Uses game-like stats to spur on friendly competition and increase your dedication to working out.

• You post what you did or did not do much like Facebook.

• Available on: Android, iOS, and Web.

Obesity Apps Studied Thus Far- Fitsby

• You and your friends decide how much money you want to wager, and the person who checks into the gym the most in a given period of time wins the pot.

• Available on: Android

Obesity Apps Studied Thus Far- Gain Fitness

• Workout coaching app and website.

• AIN Fitness runs as you actually work out.

• You listen to or read its instructions and it helps you keep track of repetitions and even includes a timer when appropriate

• Available on: iOS and Web.

Obesity Apps Studied Thus Far- Map MyFitness

• Map My Fitness will give you the widest range of supported activities

• Let’s you track different sports and workouts.

• uses GPS to track the routes you travel, and shows you a map of the ground you covered when you're done. It also displays length, in both time and distance, as well as pace, maximum speed, and a few other statistics.

• Available on: Android, iOS, Windows Phone

Obesity Apps Studied Thus Far- My Fitness Pal

• All-in-one calorie counter and exercise tracker for the iPhone.

• Available on: Android, BlackBerry, iOS, Windows Phone, and Web.

Obesity Apps Studied Thus Far- Nike+

• The Nike+ Running app, which is available on iPhone and Android phones, tracks your distance, pace, time, and calories burned while you run.

• It uses GPS to map your route

• Integrates with Nike Fuelband

• Available on: iPhone, Android

Obesity Apps Studied Thus Far- RunMeter Pro

• Tracks your run or walks, bicycle rides, and 5K training.

• Has maps, graphs, splits, intervals, laps, announcements, zones, training plans and more.

• Available on: iPhone

Obesity Apps Studied Thus Far- Runtastic PRO

• Runtastic PRO lets you measure and track your runs, walks, and other exercises.

• Also acts as coaching app to motivate you to keep working toward your goals.

The Future

Thank You For Your Kind AttentionWe hope that you can visit our apps display and

use the available cellphone software

• Hollyeve7@aol.com

• Daniel.terreros@ttuhsc.edu