{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:06:30Z","timestamp":1790172390122,"version":"4.1.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Instagram use has been associated with orthorexia nervosa (ON), but prior research has generally measured exposure as overall platform use or broad health-related content. We directly compared four content categories (diet and slimming products, physical activity and sport, food in general, and fashion) within one adjusted model and provided an exploratory description of Instagram use and orthorexic symptoms in women with fibromyalgia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Cross-sectional web-based survey of 3,655 Italian adult women using Instagram as their primary social media platform. Content exposure was assessed on a 0\u20134 ordinal scale. Multivariable linear regression with HC3 robust standard errors was applied after z-scoring all predictors. A sensitivity analysis added daily Instagram use time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Diet and slimming content (B\u202f=\u202f+1.14, 95% CI [+0.91, +1.38];\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) and sport content (B\u202f=\u202f+0.91, 95% CI [+0.69, +1.12];\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) were the strongest independent predictors of I-DOS scores. General food content was also independently associated (B\u202f=\u202f+0.50;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), whereas fashion content was not (B\u202f=\u202f+0.003;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.97). Time on platform was not independently associated after content adjustment (\u0394\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=\u202f0.0006). No content difference survived Bonferroni correction in women with fibromyalgia (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f37), and their I-DOS scores did not differ significantly.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The Instagram\u2013ON association was content-specific: diet and fitness content, rather than fashion content or time on the platform, accounted for the pattern. Because the data are cross-sectional and self-reported, causal direction cannot be established.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1937445","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T13:31:57Z","timestamp":1790170317000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["What the algorithm serves: diet and fitness content on Instagram as independent predictors of orthorexia nervosa in a large Italian female sample"],"prefix":"10.3389","volume":"13","author":[{"given":"Edoardo","family":"Mocini","sequence":"first","affiliation":[{"name":"Department of Theoretical and Applied Sciences, eCampus University","place":["Novedrate, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Greco","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro","place":["Catanzaro, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianna","family":"Gagliardi","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, Sapienza University of Rome","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Titi","sequence":"additional","affiliation":[{"name":"Department of Emergency, Critical Care, and Trauma, Policlinico Umberto I","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Giannetta","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, Sapienza University of Rome","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Grazia","family":"Tarsitano","sequence":"additional","affiliation":[{"name":"Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1003","DOI":"10.1177\/1359105316639436","article-title":"\u201cStrong is the new skinny\u201d: a content analysis of #fitspiration images on Instagram","volume":"23","author":"Tiggemann","year":"2018","journal-title":"J Health Psychol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1007\/s40519-017-0364-2","article-title":"Instagram use is linked to increased symptoms of orthorexia nervosa","volume":"22","author":"Turner","year":"2017","journal-title":"Eat Weight Disord"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"3695","DOI":"10.1007\/s40519-022-01512-5","article-title":"A consensus document on definition and diagnostic criteria for orthorexia nervosa","volume":"27","author":"Donini","year":"2022","journal-title":"Eat Weight Disord"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"106134","DOI":"10.1016\/j.appet.2022.106134","article-title":"Orthorexia nervosa and eating disorder behaviors: a systematic review of the literature","volume":"177","author":"Atchison","year":"2022","journal-title":"Appetite"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1007\/s40519-018-0606-y","article-title":"Definition and diagnostic criteria for orthorexia nervosa: a narrative review of the literature","volume":"24","author":"Cena","year":"2019","journal-title":"Eat Weight Disord"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.eatbeh.2015.12.006","article-title":"On orthorexia nervosa: a review of the literature and proposed diagnostic criteria","volume":"21","author":"Dunn","year":"2016","journal-title":"Eat Behav"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"5488","DOI":"10.3390\/ijerph18105488","article-title":"Prevalence of orthorexia nervosa and its diagnostic tools: a literature review","volume":"18","author":"Niedzielski","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s10389-025-02571-5","article-title":"Growing up in rural or urban settings: differences in physical activity, sexual attitude, and orthorexia. 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