Dietitians and Nutritionists Behaviour on Social Media: A Scoping

Literature Review

Inga Saboia

1,2

, Ana Margarida Pisco Almeida

, Pedro Sousa

3,4

and Cláudia Pernencar

5,6

UFC Virtual, Federal University of Ceará, Brazil

Department of Communication and Art/DigiMedia, University of Aveiro, Portugal

Center for Innovative Care and Health Technology (ciTechCare), Polytechnic Institute of Leiria, Portugal

Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Portugal

NOVA Institute of Communication (ICNOVA), Faculty of Human and Social Sciences, New University of Lisbon, Portugal

Arts and Design Research Lab (LIDA), Polytechnic Institute of Leiria, Portugal

Keywords: Dietitian, eHealth, Facebook, Instagram, Nutritionist, Social Behaviour, Social Media, Twitter.

Abstract: At its present state, Social Media (SM) is an important stage to promote user participation, acting as an open

space for the discussion of a multitude of fields, one of which being health. Professionals, like Registered

Nutritionists and Dietitians (RNDs), whose access to media was traditionally more restricted, are also more

engaged in this new context, creating a new scenario. To better understand how is this group of professionals

using social media to communicate with their audiences is the main objective of this study. To approach this

topic, a mapping was conducted, followed by a presentation of the summary of the evidence discovered: RDNs

demographic and professional profile; their most used social media tools; the reasons why they use social media;

their common behaviours and attitudes, as well as a review of the gaps and shortcomings in the literature. A

literature review, using a structured approach was also conducted. 2877 works were screened, but only 8 were

associated with answers. Of these 8, there were 2 studies that partially presented a quantitative analysis. Results

show lacks in consolidated studies that can be used to support the creation of knowledge in this field. This lead

to conclude that research about social media usage by nutritionist, at present, remains in a nascent stage and

requires further studies.

1 INTRODUCTION

There is new potential emerging through the

connection between Health and Technology, e.g.,

eHealth (Kreps & Neuhauser, 2010). In this context,

changes in user behaviour are occurring, the users are

more active on the online content search and content

creation (Sarasohn-Kahn, 2008). Social media is an

open field where, currently, the users are able to

communicate and actively create content. Nowadays,

many users can easily produce high-quality content

without being multimedia experts. Nutrition is one of

the professions where this aforementioned change

occurs, and it has been observed as an “object” of study

(Saboia, Pisco Almeida, Sousa, & Pernencar, 2018).

According to the practice paper of the American

Academy of Nutrition and Dietetics wrote by Helm

and Jones (2016), RDNs have discovered new

strategies for communicating and identified new

spaces to spread their ideas. People within this

profession are often active participants on social

media, and use it as an opportunity to interact with the

public. This behaviour is vital for their brand

promotion; to advise people; to help their colleagues;

to grow business; to support products and services and

spread public health campaigns.

With this in mind, it is worth emphasising that the

culture of nutritional science is growing and may

influence food meanings and eating practices (Dodds

& Chamberlain, 2017). This is due to the fact,

nutrition-specific language appears on several kinds of

media and not only on social networks, e.g., blogs

(Bissonnette-Maheux et al., 2015) and magazines

(Dodds & Chamberlain, 2017). Through these

opportunities, RDNs have a space to defend the “right

way of eating” based on their scientific knowledge.

In parallel, healthy eating is a topic that is gaining

visibility in social media, due not only to content

created by RDNs, but also that by Patient Opinion

Leaders and Healthy Lifestylers (Saboia et al., 2018).

This is particularly relevant, as content from the latter

has be documented to potentially instigate negative

consequences on the body image of the audience and

530

Saboia, I., Almeida, A., Sousa, P. and Pernencar, C.

Dietitians and Nutritionists Behaviour on Social Media: A Scoping Literature Review.

DOI: 10.5220/0008988305300538

In Proceedings of the 13th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC 2020) - Volume 5: HEALTHINF, pages 530-538

ISBN: 978-989-758-398-8; ISSN: 2184-4305

can be linked to several eating disorders (Holland &

Tiggemann, 2017; Koven & Wabry, 2015).

Helm and Jones (2016) recommend a list of

guidelines based on two levels for RDNs. The first

level is about following professional standards that

refer to a range of principles that should be developed,

such as ethics, privacy, confidentiality and reliability.

The second level outlines best practices to improve the

performance of these professionals on social media.

Through this list, the participation and engagement of

RDNs on social networks are encouraged. These

authors hold that RDNs are the voice of science

regarding nutrition. Because of this, it is necessary that

these professionals keep a strong position and a clear

behaviour when they provide information that are valid

and trusted.

Other studies describe that a growing number of

RDN is using social media to complement their

professional practice aiming to promote business and

achieve more customers (Helm & Jones, 2016; Saboia

et al., 2018). Although these studies did not report

much detail about the current scenario in terms of

quantitative data, this could be considered as an

interesting phenomenon. Little is known in this field,

despite some observations and guidelines targeting

RDNs posture on social media.

It is under this context that the research presented

in this paper explores two questions: (i) whether there

are studies that analyse the role of RDNs on social

media for professional purposes; (ii) how RDNs are

using digital media to communicate professionally

with the public, analysing how they are acting in social

media for their daily professional practices and how

they are using digital media field to communicate,

professionally, with their public.

One of the most significant findings that emerged

during the search process and contribute to carry out

this current literature review was Dumas et al. (2018)

study, because it showed similar research concerns..

Besides that, they invite, in their future works, other

researchers to analyse the theme, stating that “research

on social media in dietetic practice is at its infancy”. It

is worth to clarifying that their investigation did not

answer to the main question of the present work,

because they do not include statistical data representing

this reality.

The search on Scielo was also conducted using Portuguese

Keywords: "media social" "mídia social" OR "media digital"

"mídia digital" OR "facebook*" OR "instagram*" OR "rede

social" OR "twitter*") and ("nutricionista" OR "dieticista")

without range date.

Nutrícias (https://www.apn.org.pt/ver.php?cod=0E0A0D) e

Acta Portuguesa de Nutrição

(http://actaportuguesadenutricao

2 METHOD

A literature review was carried out on the main

scientific databases, using a structured approach. This

approach is based on a scoping review method that

follows these steps:

(1) Delimitation of the research question;

(2) Source definition (scientific database and grey

literature);

(3) Establishing relevant keywords and range date;

(4) Selection of eligible studies;

(5) Collating, analysing, summarizing, and reporting

results;

(6) Data representation using graphics and tables;

(7) Dissemination of the study.

The main research question of how RDNs are using

digital media to communicate with the public explores

the topic at a high level. This topic can be broken down

further to explore more detailed questions:

 Which RDN profiles are using social media in their

dietetic practice?

 Which digital tools have been used in their

practice?

 What are the purposes of their use?

 Which are their most common online behaviours?

 What attitudes do RDNs have on digital media?

To understand the professional dietetic practice on

social media, a literature review was undertaken.

The set up used was based on the following

databases: Cochrane library, Medline, PsyInfo,

PubMed – PMC (569), Scopus (46), Web of Science

(2214) and Scielo (0)1. Besides that, reference lists of

the selected works were consulting in order find out

other interesting studies.

In addition to this initial search of scientific

databases, the research extended to grey literature like

sites, journals and conferences of professional

Nutritionists Orders and Associations from Brazil and

Portugal

. The decision to select these two countries

was based on the fact that a study was found exploring

RDNs’ social media use for communicating with

general users (Saboia et al., 2018).

The following keywords arrangement were used:

("nutritionist*" OR "dietician*" OR "dietitian*") AND

("social media*" OR "digital media*" OR

.pt/) from Portuguese Nutrition Association, Rasbran Journal

from Nutrition Brazilian Association (https://www.rasbran.co

m.br/rasbran), Nutrire journal from Eating and Nutrition

Brazilian Society (https://www.springer.com/medicine/interna

l/journal/41110) Accessed in October, 3

, 2019

Dietitians and Nutritionists Behaviour on Social Media: A Scoping Literature Review

531

"Facebook*" OR "Instagram*" OR "online network*"

OR "social network*" OR "twitter*"). The initial

search and screening was limited by title, abstract and

keyword fields.

The selection process involved all scientific articles

that followed the Prisma methodology (Moher,

Liberati, Tetzlaff, Altman, & Group, 2009) and

included diagrammatical representation with distinct

phases (fig. 01). This procedure contains criteria for

inclusion and exclusion as described below:

The inclusion criteria applied were the following:

 Studies published between 2013 and 2018;

 International conference proceedings and journal

articles, both with peer-review;

 English or Portuguese written;

 Works based on RDN´s perspectives, stating

concrete evidence to show that they are one of the

main social media users. To be considered as a

user, they should produce content. i.e. when they

are posting or sharing;

 Reporting which describes real use scenarios of

social media, by presentation of descriptive

methods (Dumas et al., 2018), e.g., literature

reviews, surveys, interviews and content analysis

or expert opinions considered by Dumas et al.

(2018).

Figure 1: Literature review diagram – PRISMA (Moher et al.,

2009).

The exclusion criteria to exclusion were the following:

 Duplicated works;

 Studies that included specific health issues, such as

eating disorders, diabetes, cancer, and others;

 Work related to a specific population groups, e.g.

pregnant, adolescents, older people, and others.

 Social media users that were not RDNs;

 Studies not describing Social Media usage in real

scenarios, like: experimental and quasi-

experimental, randomized controlled trial or pilot

studies.

2.1 Categories of Analysis

The analysis was completed in two phases. First, to

enable the comprehension of the general characteristics

of the studies, a mapping was conducted following a

formal approach and using a grid with several

categories (tab. 1):

(1) Year of publication;

(2) Country of authors’ origin;

(3) The method used by researchers;

(4) Sample size in different types of information

relating to the object of study;

(5) Aim of the study (Dumas et al., 2018);

(6) Type of users (this work prioritises studies

describing Dietitians and Nutritionists as users of

social media. However, it also includes other kinds

of users (Dumas et al., 2018).

During a second phase, the analysis was structured

according to the objectives of this study. Specific

categories were created:

(1) RDN profile - gender, age, area of speciality, and

year of graduation. This category answers the

question “Which RDN profiles are using social

media in their dietetic practice?”.

(2) Social media - as described in previous works

(Dumas et al., 2018) this category intend to explore

the question “Which digital tools have been used

on their practice?”

(3) Purposes of social media use (Dumas et al., 2018)

- For this category the researchers aimed to answer

the following question “What are the purposes for

using it?”

(4) RDN Behaviours – aiming to identify the online

behaviours already described by other studies

(Kietzmann, Hermkens, McCarthy, & Silvestre,

2011), such as production, share, reading of

content. Therefore, this answered “Which online

behaviours are most common for them on digital

media?”

(5) RDN attitudes towards digital media Opinion -

whether there was any indicator of their judgement

about the role of social media. It answered the

question “What attitudes do RDNs have on digital

media?”

Some categories presented were based on literature

review previously defended by Dumas et al. (2018).

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532

Table 1: Summary of the studies found – 8 primary sources and 1 secondary (Appetite Communications & Dietitian Connection,

2018).

Study Year Country Method

Sample

size

Type of users Aim of study

Dumas et al.

(2018)

2018 Canada

Literature

review with

formal

approach

47 papers

Several target

population

Map the evidence about the users,

their uses and effects of social

media in dietetic practice

Appetite

Communications

& Dietitian

Connection (2018)

2018 Australia

Online

survey

311

RDNs

Describe the educational or

professional use of Social Media by

RDNs or student dietitians and

nutritionist (SDNs).

Knight, Brown, &

Reidlinger (2017)

2017

UK and

Ireland

Online

survey

1005

RDNs

Describe the educational or

professional use of Social Media by

RDNs or SDNs.

Helm & Jones

(2016)

2016 USA

Expert

Opinion

Not

referred

RDNs

Provide guidance for potential

applications, best practices, benefits,

and risks.

Twynstra &

Dworatzek (2016)

2016 Canada

Experience

report

48 SDNs

per class

(maximum)

RDNs

Set out which is the SDNs

experience related to Facebook as a

professional communication tool

Hand, Kenne,

Wolfram, Abram,

& Fleming (2016)

2016 USA

Content

analysis and

phone

interviews

294 tweets

and 16

interviews

Physicians and

RDNs

Depict social media health content

and attitude of health professionals

toward the use of social media as a

method to obtain health

information.

Mcgloin &

Eslami (2015)

2015 Ireland

Literature

review

Not

referred

Several target

population

Reveal opportunities based on

digital media about dietary

behaviour change.

Adzharuddina &

Ramly (2015)

2015 Malaysia

Literature

review

Not

referred

Physicians and

RDNs

Describe possible Facebook

significance for disseminating

information mainly of health theme

Harmse & Retief

(2015)

2015

South

Africa

Expert

Opinion

Not

referred

RDNs

Present some marketing and

business skills to deal with social

media

3 RESULTS AND DISCUSSION

3.1 First Phase of Analysis

The first set of analyses highlighted 2877 results from

the scientific database search. From this sample, 9

works were selected. Of these, 8 were considered as

primary sources and 1 as an additional study as an

expert opinion (Dumas et al., 2018). The other search

phase, which included a review of grey literature, did

not present any results. These evidences were laid out

in table 1.

Further analysis showed that there is a few studies

with this focus of research. Interestingly, Dumas et al.

(2018) results revealed the same delimitation found by

The term “Developed countries” is used to delineate trends in

various dimensions of the world economy by United Nations

report (2015)

the researchers of this article, even though they

performed services using a different range date: First,

it showed n=23609 results, but only 47 work, which

corresponded to 0,19%. Secondly, n=2877, from

where n=8 studies were selected from scientific

database, which represents 0,278% of the total.

Contrary to the researcher’s expectation, it is possible

to conclude that this topic remains largely unstudied.

The reached outcomes showed that this study

addresses a recent theme of research: there are no

references founded on the range date – the two first

years –from 2013 to 2014. Additionally, the fact that 6

studies came from USA= 2, Canada= 2, Ireland= 2 and

UK= 1 suggests that this topic is predominantly an area

of interest for more developed countries

Dietitians and Nutritionists Behaviour on Social Media: A Scoping Literature Review

533

In summary, the most remarkable studies that were

identified in the research were two studies that directly

explored RDNs. They provided data and analysis that

give an understanding of how RDNs utilise social

media for their professional work and the attitudes that

they have towards it.

3.2 Second Phase of Analysis

This part of the investigation analysed the research

questions previously listed. The main results are

summarized in the table available for online consultig

Besides finding that the most referred social media

tools were Facebook (8), Twitter (5), Instagram (4),

LinkedIn (4), Pinterest (4), Blogs (3) and YouTube (2),

the most surprising evidence was acknowledging the

existence of many crucial gaps for understanding this

phenomenon:

 Only one study detailed the RDN profile;

 Most of the studies did not describe on detail the

type of usage of social media (findings are mainly

limiting their report to associate social media as a

communication tool);

 the type of online behaviour carried out by RDNs

was not described, i.e. it was not possible to

understand if they are posting new contents or

sharing other contents;

 Only one study presented a RDN opinion about

social media, which is sceptical in relation to the

efficiency of social media.

The findings of the second phase provided an

opportunity to conclude that, from the 9 initial studies,

only 4 are more aligned with the main purpose of this

research, to understand how RDNs are using digital

media to communicate professionally with the public:

 Dumas et al. (2018) study, revealed to be very

important, because it showed to have similar

concerns with the current analysis. This study

involved a very wide target population and

different rage data (2000-2016), while the current

study focused on RDNs population and from 2013

to 2018 range date. Besides that, Dumas et al

research kept without answer to the main question

of the present work.

 Hand, Kenne, Wolfram, Abram, & Fleming (2016)

study clarified the judgement of social media by

RDNs

 Two other studies that present numerical

dimension related to the context of social media use

by RDNs: Appetite Communications & Dietitian

Connection (2018) and Knight et al., (2017).

For further information, please visit this link

The results of the involved works are presented in the

next sections in the following format: general

characteristics about the method used and results;

summary of the most relevant conclusion and

discussion about it.

3.2.1 Dumas et al. (2018) Study

The first work that should be mentioned came from the

authors Dumas et al. (2018). They highlighted 23609

studies, and from that, 47 were analysed.

Subsequently, this sample was divided into the

following categories: (1) intervention studies, (2)

descriptive studies, (3) content analysis studies and (4)

expert opinion papers (table 2). The last category deals

with the opinion of specialists but does not present a

numerical dimension of RDNs practice on social

media.

Dumas’ study prompted a few similar questions,

though more generic, than the current study was

looking for: “Who is using social media in dietetic

practice?” and “What are the purposes of social media

in dietetic practice?”

The method used to determine the research choices

made by Dumas et al. (2018) involved other different

topics. These are: the effects caused by social media

during health interventions and the barriers and

facilitators that could influence the use of social

media? Moreover, their analysis was very broad in

scope, because they used more keywords, a bigger

range date (2000 - 2016) and different types of social

media users.

The way Dumas planned the research and the

different objectives and approach used, took the study

to focus more on health interventions. The ongoing

study confirms the previous findings of Dumas et al

(2018): only a few works presented as the RDN as the

sole object of or the online content created by them.

This whole perspective is displayed in table 2.

Table 2: “Types of the studies” (Dumas et al., 2018).

Categories of the

selected article

Number of

studies

founded

Number of studies

presenting social

media content written

by RDNs

Interventions

studies

34 4

Descriptive

studies

4 1

Content analysis

studies

2 1

Expert opinion

papers

7 7

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It is worth to emphasising that only one of the

studies above depicted a real circumstance where a

RDN used Social Media for professional practice – in

this particular case, a blog. The study was not

considered to be included on the current research

because “blog” keyword was included as part of this

research.

Summary of the Most Relevant Conclusions of

Dumas et al. (2018) Study

There is a more significant number of expert opinion

papers that assume RDNs as a social media user that

produces content (n=7), against the description studies

(n=1), content analysis studies (n=1), and intervention

studies (n=4).

The authors did not find studies focused on

information gathering about real dimension of this

subject. This means that (i) the RDN profile, (ii) their

most used digital tools, (iii) their real purpose of

writing on social media, and (iv) their behaviours and

attitudes are not well defined yet.

There is an indication of a growing interest among

RDNs’ participation on social media, demonstrated by

the number of opinion papers published by

professional associations. These groups are concerned

with promoting an ethical and professional practice of

social media use by RDNs.

Discussion based on Dumas et al. (2018) Study

There are more opinions about the correct posture of

social media presence of RDNs, rather than scientific

studies describing the situation. Indeed, it seems that

expert opinions are mostly based on personal

experience, not on consolidated studies. One of the

gaps identified related to the lack of rigorous

information about social media content, because there

continues to be a misunderstanding about how millions

of users deal with social media tools, such as, Facebook

or Instagram. Although the study of Dumas et al.

(2018) is exhaustive and has similar questions

compared to this work, the initial questions are not yet

answered. This demonstrates the real existence of

many gaps in the literature.

3.2.2 Hand, Kenne, Wolfram, Abram, &

Fleming (2016) Study

This study intended to understand the method for the

spread of information to health professionals and

patients through social media. For this, it’s goals are

two-fold; it seeks describe the existing social media

content and of the attitude of physicians and RDNs

who are concerned with social media use to obtain

health information.

Their research was divided into 2 phases: the first

involved conducting a content analysis of 294 original

tweets to gather information about the type of content,

source and target public. The second was based on

phone interviews with RDNs and physicians to

describe their attitude toward the use of social media to

communicate general health information and specific

information related to heart failure.

Summary of the Most Relevant Conclusion of

Hand, Kenne, Wolfram, Abram, & Fleming

(2016)

The first phase of content analysis provided the

following conclusions: there is substantial information

on twitter about heart failure, but there is limited

content on nutrition. The study identified the heart

failure awareness (56.5%) and patient support (33.0%)

as two of the most frequently cited topics. The source

of this content was predominately “professional,

government, a patient advocacy organization, or

charity” (40.4%) and “patient or family” (37.9%). It is

difficult to specify the frequent target audience for this

content.

The conclusions about the interview were that: the

participants judge social media as a useful tool to

gather professional information and that health

professionals are sceptical about the potential of social

media for efficient communication with patients. This

is due to privacy issues, the difficulty for conveying an

individualized message and the judgment that their

patients are not used to social media or technology.

Discussion based on Hand, Kenne, Wolfram,

Abram, & Fleming (2016)

Twitter is not being presented as a tool that is often

used for nutrition content. This should be verified on

future works. It is interesting to better understand the

attitudes of RDN regarding to social media on a more

generalized way.

3.2.3 Knight et al. (2017) Study

From the works collected, one is very useful in

answering the research questions: the study of Knight

et al. (2017). This presents results of an online survey

with 1005 responses of 753 RDNs and 252 SDNs from

UK and Ireland. These participants considered

themselves as users of social media (80 % of RDs and

96 % of SDs). These 45 % of SDs used social media

for educational objectives and 41 % of RDs used it for

professional goals. Moreover, 66 % of them agreed that

Dietitians and Nutritionists Behaviour on Social Media: A Scoping Literature Review

535

social media engagement is essential for RDNs to

promote their profession. However, 36 % of

respondents were concerned that social media use by

RDNs could undermine the public’s confidence in their

activity.

Despite these important results, one important

point is missing on this study: distinct results for each

type of social media. Social media is seen as a single

whole. As a result of this, it is not possible to

understand which form of social media is most used,

for instance.

Summary of the Most Relevant Conclusion of

Knight et al. (2017) Study

This study argued that RDNs and the students in this

field are high users of social media. It also alleged that

this group is engaged with social media in their

professional lives. One point this study concerns itself

with is the negative consequences for their profession

that could be caused by inappropriate use of social

media. The authors recommend the development of

guidelines and training to improve the opportunities

and to manage bad results.

Discussion based on Knight et al. (2017) Study

These authors present the numeric dimension of the

reality of RDNs using social media for their

professional life. It is missing more detailed

information on what RDNs uses are, such as their

profile, the most used social media, their reason to use,

their common behaviour and attitudes.

3.2.4 Appetite and Dietitian Connection

Report

The study, A “healthy diet” of social media: Trends in

dietitians’ social media habits (2018), was included in

this research due to the affinity with the initial

questions and their findings in numeric results.

It is worth clarifying that it was a secondary source

that was found through reading the reference list from

Dumas et al. (2018). Another important point to

consider is that this study has not been included in the

literature review list from Dumas et al. (2018).

Perhaps, this differentiation is caused by the source’s

type of origin, which is more professional rather than

academic in nature. Additionally, Dumas et al. (2018)

referred to a report from 2016, but our study is based

on a more current report from 2018.

This report is based on an online survey that was

sent to approximately 6.600 professional, of which 311

completed the questions. This study examined

important aspects such as: a) How, when, where RDNs

use social media, b) Their preferred social media

platform, c) Their purpose of use, d) What information

are most sought by them on social media.

Summary of the Most Relevant Conclusion of

Appetite and Dietitian Connection Report

This study highlighted some aspects of object of this

study: almost all respondents accessed social media for

personal and professional purposes (95%). RDNs

frequently check social media each day (8 in 10

checked 4 times a day). The average age of the most

part of respondents is less 40 (78%). Five years is the

average length of a university degree course (51%).

There are two main areas of speciality: hospital and

private practice (respectively 29% and 22%).

More than half respondents have a social media

page for professional reasons (54%). The most used

platform is Facebook for personal reasons (97%), but

LinkedIn is most used for professional purposes,

followed by Instagram and then Facebook. Instagram’s

popularity is increasing. Participants’ usage of

Instagram has increased over the last 4 years (about

22%); nearly half of RDNs use Instagram for

professional purposes. RDNs are leaving to use blogs,

YouTube and Twitter.

Discussion based on Appetite and Dietitian

Connection Report

This study has many pros and cons. At one hand, it

identifies important points relating to the research

questions. In this case, it represents the RDNs profiles,

their habits of use, their most preferred platforms, and

behaviours and attitudes associated with social media.

On the other hand, this work demonstrates how

important social media is for RDNs’ life. They

describe the RDNs’ profile that uses social media. It

identifies the leading social media platforms that have

been used (Facebook, Instagram and LinkedIn).

Unfortunately, this study requires a more theoretical

and methodological grounding because it is a

professional report that uses only a small sample from

within the area of RDN (311 respondents). Aside from

this, the nature of this sample could be biased, because

the respondents are into this universe of people that

assume themselves as RDN and who are registered on

newsletter list of the company’s site. Moreover, the

reality described is related to one country, Australia.

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4 FINAL CONCLUSIONS,

FUTURE WORKS AND

LIMITATIONS

The mapping described in this paper demonstrated the

potential of the object of study: a small number of

researches was gathered. More research is needed to

better understand RDNs practices on social media.

There are also missing points to answer the initial

question “how are RDNs using digital media to

communicate with their public?”. Both the literature

review and the analysis by Dumas et al. (2018)

underline this gap. One of the main conclusions is,

therefore, the need to deep knowledge about RDNs

contexts and attitudes related to social media, such as:

their profile, the most used social media, their reason

to use, and their common behaviour and attitudes.

This theme should be explored in more detail, and

its study should be continued through conception,

planning and submission of a survey for a RDNs

database. Their objective could be to understand how

RDNs are using social media to communicating with

an audience on commercial social media with millions

of users.

In addition, it is recommended that other

researchers, namely the ones from the social media

field, may approach this topic by choosing to analyse

the social media tools more used by RDNs (Appetite

Communications & Dietitian Connection, 2018).

This study also has some limitations, it is possible

that there are missing works in this review, because:

the range date and the keywords arrangement were

very restricted; therefore future studies are needed to

search for bigger period (than January 2013 to July

2018) and for more strings.

ACKNOWLEDGEMENTS

This work has been supported by Fundação para a

Ciência e a Tecnologia (FCT), from the Ministério da

Ciência, Tecnologia e Ensino Superior (MCTES) and

from European Union through Programa Operacional

Capital Humano (POCH), funded with the grant nº.

SFRH/BD/137451/2018.

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