Abstract

This work aimed at identifying, describing and analyzing news content associated with Google search cycles linked to eight types of diet: ketogenic; moon; protein; soup; detox; points; paleo; and Dukan. They were selected because they were pointed out by Google Trends® (GT) as the most often associated with the term “diet”. The content of sites linked to the highest search peaks was pointed out by Google News®. The volume of search attempts for diets was estimated by the GT with region filters (Brazil) and theme (Health) considering the period from 01/01/2012 to 01/01/2017. Results: hits portray ephemeral cycles, with hundreds of peaks and declining interest in the eight fad diets. The emphasis is on guidelines for quick weight loss in favor of optimal health as a proxy for an esthetic ideal. The scale of the risks associated with the more restrictive diets is often quoted and validated by expert information. The exposure and influence of the opinion of celebrities reporting their dietary experiences stand out. Contrary to the ideal of moderation, variety, and balance, fad diets portray the pressure for food self-control as a resource for building an idealized body typified by celebrity images.

Key words
Fad diets; Social media; Consumer health information; Internet

Introduction

The internet has become an abundant and accessible source of health information in the midst of which many issues of food and nutrition have been placed at a distinctive level of exposure and concern¹1 Beck F, Richard J-B, Nguyen-Thanh V, Montagni I, Parizot I, Renahy E. Use of the Internet as a Health Information Resource Among French Young Adults: Results From a Nationally Representative Survey. J Med Internet Res 2014; 16(5):e128.^,22 Rangel-S ML, Lamego G, Gomes ALC. Alimentação saudável: acesso à informação via mapas de navegação na internet. Physis 2012; 22(3):919-39.. Access to sufficient information seems to shape demands and establish gaps in the idea of healthy eating³3 Santos LA . Educação alimentar e nutricional no contexto da promoção de práticas alimentares saudáveis. Rev Nutr 2005; 18(5):681-692. because of the quantity, diversity and centrality of certain types of information widely available to specialists, lay consumers and health content replicators⁴4 Vasconcellos-Silva PR, Castiel LD, Bagrichevsky M, Griep RH. As novas tecnologias da informação e o consumismo em saúde. Cad Saude Publica 2010; 26(8):1473-1482.. In this field, information on diets - whether for weight loss, detoxification, control of morbid conditions or similar purpose - fill hundreds of thousands of sites with contents that seek to attend to various types of fruition⁵5 Santos LA . Os programas de emagrecimento na Internet: um estudo exploratório. Physis 2007; 17(2):353-372..

Increasingly sophisticated algorithms have been developed in recent years to analyze search trends for words and terms in Google, as a proxy for the cycles of collective interest directed to certain subjects. The massive volume of data produced by georeferenced daily search attempts (i.e. search attempts associated with specific regions) registered by Google Trends (GT - https://www.google.com/trends) can provide insightful insights into what, where and when (as well as associated with what) are linked to search attempts of a given population - a term already consecrated in the literature as seeking behavior⁶6 Abedi V, Mbaye M, Tsivgoulis G, Male S, Goyal N, Alexandrov AV, Zand R. Internet-based information-seeking behavior for transient ischemic attack. Int J Stroke 2015; 10(8):1212-1216.

7 Brownstein JS, Freifeld CC, Madoff LC. Digital Disease Detection - Harnessing the Web for Public Health Surveillance. N Engl J Med 2009; 360(21):2153-2157.

8 Medlock S, Eslami S, Askari M, Arts DL, Sent D, de Rooij SE, Abu-Hanna A. Health Information-Seeking Behavior of Seniors Who Use the Internet: A Survey. J Med Internet Res 2015; 17(1):e10.

9 Pan S, Xu J-J, Han X-X, Zhang J, Hu Q-H, Chu Z-X, Hai Y-Q, Mao X, Yu Y-Q, Geng W-Q, Jiang Y-J, Shang H. Internet-Based Sex-Seeking Behavior Promotes HIV Infection Risk: A 6-Year Serial Cross-Sectional Survey to MSM in Shenyang, China. BioMed Res Int 2016; 2016:2860346.

10 Salwa B, Suha A, Maha A, Ma’an A, Khaled A, Mowafa H. The Prevalence of Internet and Social Media Based Medication Information Seeking Behavior in Saudi Arabia. Stud Health Technol Inform 2016; 226:275-278.

11 Soleymani M, Garivani A, Zare-Farashbandi F. The Effect of the Internet Addiction on the Information-seeking Behavior of the Postgraduate Students. Mater Socio Medica 2016; 28(3):191.^-1212 Vasconcellos-Silva PR, Castiel LD, Griep RH, Zanchetta M. Cancer prevention campaigns and Internet access: promoting health or disease? J Epidemiol Community Health 2008; 62(10):876-881.. Search trends can - in a simple, transparent and inexpensive way - predict the present in a variety of ways and under several aspects, by providing support for the analysis of sociocultural phenomena seldom studied by such means¹³13 Askitas N, Zimmermann KF. Google Econometrics and Unemployment Forecasting. Appl Econ Q 2009; 55(2):107-120.

14 Choi H, Varian H. Predicting the Present with Google Trends: predicting the present with Google Trends. Econ Rec 2012; 88(s1):2-9.

15 Cooper CP, Mallon KP, Leadbetter S, Pollack LA, Peipins LA. Cancer Internet Search Activity on a Major Search Engine, United States 2001-2003. J Med Internet Res 2005; 7(3):e36.

16 Ettredge M, Gerdes J, Karuga G. Using web-based search data to predict macroeconomic statistics. Commun ACM 2005; 48(11):87-92.

17 Ginsberg J, Mohebbi MH, Patel RS, Brammer L, Smolinski MS, Brilliant L. Detecting influenza epidemics using search engine query data. Nature 2009; 457(7232):1012-1014.

18 Gunther E. Infodemiology: Tracking Flu-Related Searches on the Web for Syndromic Surveillance. AMIA Annu Symp Proc 2006; 2006:244-248.

19 Hulth A, Rydevik G, Linde A. Web Queries as a Source for Syndromic Surveillance. PLoS ONE 2009; 4(2):e4378.^-2020 Polgreen PM, Chen Y, Pennock DM, Nelson FD. Using Internet Searches for Influenza Surveillance. Clin Infect Dis 2008; 47(11):1443-1448.. Several authors perceive that estimates of the volume of public health search attempts appear promising concerning cultural aspects relevant to the formulation of public policies, complementing and broadening the understanding of existing databases²¹21 Bragazzi NL, Bacigaluppi S, Robba C, Nardone R, Trinka E, Brigo F. Infodemiology of status epilepticus: A systematic validation of the Google Trends-based search queries. Epilepsy Behav 2016; 55:120-123.

22 Nghiem LTP, Papworth SK, Lim FKS, Carrasco LR. Analysis of the Capacity of Google Trends to Measure Interest in Conservation Topics and the Role of Online News. Gao Z-K, organizador. PLOS ONE 2016; 11(3):e0152802.

23 Schootman M, Toor A, Cavazos-Rehg P, Jeffe DB, McQueen A, Eberth J, Davidson NO. The utility of Google Trends data to examine interest in cancer screening. BMJ Open 2015; 5(6):e006678.

24 Toosi B, Kalia S. Seasonal and Geographic Patterns in Tanning Using Real-Time Data From Google Trends. JAMA Dermatol 2016; 152(2):215.

25 Troelstra SA, Bosdriesz JR, de Boer MR, Kunst AE. Effect of Tobacco Control Policies on Information Seeking for Smoking Cessation in the Netherlands: A Google Trends Study. PLOS ONE 2016; 11(2):e0148489.^-2626 Vasconcellos-Silva PR, Carvalho DBF, Trajano V, de La Rocque LR, Sawada ACMB, Juvanhol LL. Using Google Trends Data to Study Public Interest in Breast Cancer Screening in Brazil: Why Not a Pink February? JMIR Public Health Surveill 2017; 3(2):e17.. Until recently, the study of search terms swings was used solely by marketing specialists, for marketing purposes, in order to identify product consumption trends in collateral associations with elements of the fruition culture. However, the so-called search behavior has also proved useful in outlining time series that indicate cycles of collective interest (CCI) driven by fashions, rumors, journalistic material and, above all, the behavior of influential celebrities²⁷27 Ayers JW, Althouse BM, Noar SM, Cohen JE. Do celebrity cancer diagnoses promote primary cancer prevention? Prev Med 2014; 58:81-84.

28 Cooper CP, Gelb CA, Lobb K. Celebrity Appeal: Reaching Women to Promote Colorectal Cancer Screening. J Womens Health 2015; 24(3):169-173.

29 Dunlop K, Kirk J, Tucker K. In the wake of Angelina Managing a family history of breast cancer. Aust Fam Physician 2014; 43(1):76-78.^-3030 Juthe RH, Zaharchuk A, Wang C. Celebrity disclosures and information seeking: the case of Angelina Jolie. Genet Med 2015; 17(7):545-553.. Although of limited value in the qualitative analysis of socially constructed meanings, it is sensitive to influences related to themes of collective health interest, in the role of markers of ephemeral cultural phenomena and, therefore, under-dimensioned³¹31 Chiu TML, Eysenbach G. Theorizing the health service usage behavior of family caregivers: A qualitative study of an internet-based intervention. Int J Med Inf 2011; 80(11):754-764.

32 Eysenbach G. Infodemiology and Infoveillance. Am J Prev Med 2011; 40(5):S154-158.

33 Goel S, Hofman JM, Lahaie S, Pennock DM, Watts DJ. Predicting consumer behavior with Web search. Proc Natl Acad Sci 2010; 107(41):17486-17490.

34 Liu S, Dunford SD, Leung YW, Brooks D, Thomas SG, Eysenbach G, Nolan RP. Reducing Blood Pressure With Internet-Based Interventions: A Meta-analysis. Can J Cardiol 2013; 29(5):613-621.^-3535 Nolan RP, Payne AY, Ross H, White M, D’Antono B, Chan S, Barr SI, Gwadry-Sridhar F, Nigam A, Perreault S, Farkouh M, McDonald M, Goodman J, Thomas S, Zieroth S, Isaac D, Oh P, Rajda M, Chen M, Eysenbach G, Liu S, Zbib A. An Internet-Based Counseling Intervention With Email Reminders that Promotes Self-Care in Adults With Chronic Heart Failure: Randomized Controlled Trial Protocol. JMIR Res Protoc 2014; 3(1):e5.. Thus, this work aimed to identify, describe and analyze news content associated with peaks of interest in fad diets, by examining the role played by social actors under the media lenses on the consumption of information in this field.

Methods

Google Trends (GT) shows estimates that allow you to size up search trends on topics of interest broken down into geographical boundaries (states, countries, or worldwide); thematic categories (health, science, news, travel among others) as well as temporal delimitations (specific periods, last five years, last week, and so forth). The GT algorithms normalize data from a total number of search attempts in a particular region/period on a scale ranging from 0 (search volume less than 1% regarding the peak of popularity) to 100 (peak hits) shown as Relative Search Volumes (RSV).

By definition, RSVs are always smaller than 100 (Y-axes of charts), depicting search attempts in relative values, comparable to higher-access volumes over a period. The representation in proportions corrects the absolute number of search attempts considering a swinging number of Internet accesses in a given region. The methodology used by the GT is described in detail on its website³⁶36 Google. Google Trends [Internet]. 2017. [acessado 2017 Jan 10]. Disponível em: https://trends.google.com/trends/
https://trends.google.com/trends/... as well as in several other works of the literature¹⁴14 Choi H, Varian H. Predicting the Present with Google Trends: predicting the present with Google Trends. Econ Rec 2012; 88(s1):2-9.^,2121 Bragazzi NL, Bacigaluppi S, Robba C, Nardone R, Trinka E, Brigo F. Infodemiology of status epilepticus: A systematic validation of the Google Trends-based search queries. Epilepsy Behav 2016; 55:120-123.

22 Nghiem LTP, Papworth SK, Lim FKS, Carrasco LR. Analysis of the Capacity of Google Trends to Measure Interest in Conservation Topics and the Role of Online News. Gao Z-K, organizador. PLOS ONE 2016; 11(3):e0152802.

23 Schootman M, Toor A, Cavazos-Rehg P, Jeffe DB, McQueen A, Eberth J, Davidson NO. The utility of Google Trends data to examine interest in cancer screening. BMJ Open 2015; 5(6):e006678.

24 Toosi B, Kalia S. Seasonal and Geographic Patterns in Tanning Using Real-Time Data From Google Trends. JAMA Dermatol 2016; 152(2):215.

25 Troelstra SA, Bosdriesz JR, de Boer MR, Kunst AE. Effect of Tobacco Control Policies on Information Seeking for Smoking Cessation in the Netherlands: A Google Trends Study. PLOS ONE 2016; 11(2):e0148489.^-2626 Vasconcellos-Silva PR, Carvalho DBF, Trajano V, de La Rocque LR, Sawada ACMB, Juvanhol LL. Using Google Trends Data to Study Public Interest in Breast Cancer Screening in Brazil: Why Not a Pink February? JMIR Public Health Surveill 2017; 3(2):e17..

The fad diets were chosen based on bibliographical reviews and lay literature, also considering the stories and news associated with the term diet by Google Trends. A clean search was performed in the data collection after deleting navigation data and cookies that could influence the search history. The eight diets with the highest visibility were chosen, that is, the ones that returned with sufficient data volume to the analysis: ketogenic diet; moon diet; protein diet; soup diet; detox diet; points diet; Dukan diet and paleo (Paleolithic) diet. We selected search terms - in Brazilian Portuguese - that refer specifically to these diets in the forms of spelling that generated the most substantial results (e.g., the term paleo diet was used for search attempts on paleolithic diet), as usually described in other works. Diets cycles were searched from the last 261 weeks (from January 01, 2012 to January 01, 2017) with region filters (Brazil) and subject topic (Health). The data were imported as CSV files (Comma-separated values) for spreadsheets (MS Excel®) and the annual means with standard deviations and trend lines (second-order polynomials) were calculated there. Diet curves were tabulated in eight independent series, knowing that GT produces results comparing access curves to the most famous peak - which could underestimate the estimates of less popular diets.

News items (Chart 1) related to the study object were also analyzed. The same search descriptors were used for the diets to select the stories, and the first four news items mentioned in Google News® were included in the search in the peak search periods of each fad diet, also considering those that preceded the search peaks by up to two days, totaling 32 news items.

The option of Google tools was based on their technical and innovation possibilities in approaching the proposed theme. Also, as pointed out in ranking surveys of Alexa³⁷37 Alexa. Top Sites in Brazil [Internet]. 2018. [acessado 2017 Jan 10]. Disponível em: https://www.alexa.com/topsites/countries/BR
https://www.alexa.com/topsites/countries... - Web analytics services provider - this is the most accessed site in Brazil and the world to search for information through direct access via Google.com.br or Google.com.

Results and discusion

The relative volume of search attempts of the diets and cycles of attention

The most evident results - somewhat familiar to all diets - point to fleeting interest, with no CCIs sustained for long periods (Figures 1 to 8). There are numerous peaks of access to each diet that express the ephemeral nature of interest (usually linked to weight loss) and not committed to sustained hegemonic attention. In general, peaks of attention occur mainly between September and January, eminently in the months nearing the year-end, which could be described as a kind of summer effect or end of year festivities effect.

The ketogenic diet had a slow upward trend line with dozens of sporadic peaks with the highest concentration in the last months of 2016 between 247^th and 255^th week (Figure 1). All of the stories associated with these peaks refer to weight loss. This diet is categorized as restrictive - rich in fats, low in carbohydrates and minimally adequate in proteins³⁸38 Sampaio LPB. Ketogenic diet for epilepsy treatment. Arq Neuropsiquiatr 2016; 74(10):842-848. and was described in the 1920s as a supplementary alternative to the control of epilepsy, especially in the treatment of refractory epilepsy in childhood³⁸38 Sampaio LPB. Ketogenic diet for epilepsy treatment. Arq Neuropsiquiatr 2016; 74(10):842-848.

39 Kossoff EH, Doerrer SS, Turner Z. How do parents find out about the ketogenic diet? Epilepsy Behav 2012; 24(4):445-448.

40 Kossoff EH, McGrogan JR. Worldwide use of the ketogenic diet. Epilepsia 2005; 46(2):280-289.^-4141 Magrath G, MacDonald A, Whitehouse W. Dietary practices and use of the ketogenic diet in the UK. Seizure 2000; 9(2):128-130..

The moon diet evidenced a slightly declining trend punctuated by sporadic RSV peaks, especially between the 114^th and 204^th week and the end of 2016 (Figure 2). The moon diet presupposes the influence of the lunar cycle on body fluids and the need to adjust the diet to each phase change - which implies exclusive consumption of juices, soups and liquids for 24 hours in 4 days per month⁴²42 Vestir e maquiar. Dieta da lua [Internet]. 2015 [acessado 2017 Jan 10]. Disponível em: https://www.vestiremaquiar.com.br/dieta-da-lua/
https://www.vestiremaquiar.com.br/dieta-... with the promise of a monthly loss of 4 kg. Also, the stories indicate that you should stop eating when you feel satiated and not consume any food after 6 pm. In the waning phases, practitioners must drink much water to eliminate the toxins⁴³43 Terra. Madonna segue dieta que promete eliminar 3 kg em 24h, diz fonte [Internet]. 2014 [acessado 2017 Jan 10]. Disponível em: https://saude.terra.com.br/dietas/madonnasegue-dieta-que-promete-eliminar-3-kg-em-24h-dizfonte,c22bada65bec3410VgnVCM10000098cceb0aRCRD.html
https://saude.terra.com.br/dietas/madonn... . Anyway, the guidelines are generalized and - which is a common point with others -this is their limitation in meeting individual demands.

The protein diet - although with significant peaks of RSVs around the 44^th week (in 2012) shows a decreasing trend curve over the years (Figure 3). As the ketogenic, this restrictive diet modality recommends the semi-unrestricted consumption of foods such as fatty meats, butter and other dairy products, limiting the daily intake of carbohydrates to less than 30g⁴⁴44 Astrup A, Larsen TM, Harper A. Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss? Lancet 2004; 364(9437):897-899.. Weight loss would be related to the thermogenic effect of protein metabolism⁴⁵45 Mikkelsen PB, Toubro S, Astrup A. Effect of fat-reduced diets on 24-h energy expenditure: comparisons between animal protein, vegetable protein, and carbohydrate. Am J Clin Nutr 2000; 72(5):1135-1141. and the ketogenic nature of this diet⁴⁴44 Astrup A, Larsen TM, Harper A. Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss? Lancet 2004; 364(9437):897-899. - derived from the assumptions established in 1970 by Dr. Atkins⁴⁶46 Atkins RC. Dr. Atkins’ new diet revolution. New York: Avon Books; 2002.: emphatic restriction of carbohydrates and recommendation of high protein intake. The stories related to the diet did not show specific descriptions of their composition, but cite their effects and possible variations:

I lost 11kg with the protein diet. I implemented it strictly for three months until I achieved a weight of 48kg (she’s 1.70m tall)⁴⁷47 Ramos N. Mesmo magérrima, Bárbara Evans aposta na dieta que a fez perder 11kg: Quando dá uma engordada, modelo apela para a dieta da proteína por uma semana. [Internet]. 2012 [acessado 2017 Jan 12]. Disponível em: http://entretenimento.r7.com/receitas-edietas/noticias/mesmo-magerrima-barbara-evans-aposta-na-dieta-que-a-fez-perder-11kg20121109.html?question=0
http://entretenimento.r7.com/receitas-ed... .

Far less radical than the original created by Dr. Atkins, the high biological value protein diet reduces carbohydrate intake, rather than purely abolishing them, as well as limits fat consumption, rather than free pass...⁴⁸48 Cavalheiro T. Dieta da proteína: enxuga 7 quilos em 14 dias: direto de Harvard, esta dieta sacode o metabolismo, fazendo você emagrecer até 7 quilos em 14 dias [Internet]. 2014 [acessado 2017 Nov 12]. Disponível em: https://boaforma.abril.com.br/dieta/dieta-da-proteina-enxuga-7-quilos-em-14-dias/
https://boaforma.abril.com.br/dieta/diet... .

In this case, a variation of the original protein diet (by Dr. Atkins) is shown, in which the preference for proteins of high biological value and less restriction of carbohydrates is recommended, to fight against adverse effects of the traditional diet, such as dizziness, weariness and memory lapses⁴⁸48 Cavalheiro T. Dieta da proteína: enxuga 7 quilos em 14 dias: direto de Harvard, esta dieta sacode o metabolismo, fazendo você emagrecer até 7 quilos em 14 dias [Internet]. 2014 [acessado 2017 Nov 12]. Disponível em: https://boaforma.abril.com.br/dieta/dieta-da-proteina-enxuga-7-quilos-em-14-dias/
https://boaforma.abril.com.br/dieta/diet... .

Interest in the soup diet (Figure 4) also showed a declining trend line of its cycles of attention after high initial RSVs (more frequent access in 2012, in the 25^th week). The reports indicated on the websites indicate that this dietary proposal was elaborated by researchers from the University of São Paulo for patients with heart problems who had to lose weight to perform surgical procedures⁴⁹49 Aqui saudável. Sopa para emagrecer em 7 dias [Internet]. 2017 [acessado 2017 Nov 12]. Disponível em: http://www.aquisaudavel.com.br/sopa-para-emagrecer/
http://www.aquisaudavel.com.br/sopa-para... . Studies done with Asian and European populations have revealed a relationship between soup consumption and a lower risk of obesity and overweight, suggesting that this balanced diet provides health benefits⁵⁰50 Zhu Y, Hollis JH. Soup Consumption Is Associated with a Reduced Risk of Overweight and Obesity but Not Metabolic Syndrome in US Adults: NHANES 2003-2006. PLoS ONE 2013; 8(9):e75630.^,5151 Bertrais S, Galan P, Renault N, Zarebska M, Preziosi P, Hercberg S. Consumption of soup and nutritional intake in French adults: consequences for nutritional status. J Hum Nutr Diet 2001; 14(2):121-128.. It recommends the intake of soups at least twice a day (mainly lunch and dinner) for a certain period⁴⁹49 Aqui saudável. Sopa para emagrecer em 7 dias [Internet]. 2017 [acessado 2017 Nov 12]. Disponível em: http://www.aquisaudavel.com.br/sopa-para-emagrecer/
http://www.aquisaudavel.com.br/sopa-para... in which the consumption of some fruits, vegetables, meats, juices and teas without sugar is acceptable⁴⁹49 Aqui saudável. Sopa para emagrecer em 7 dias [Internet]. 2017 [acessado 2017 Nov 12]. Disponível em: http://www.aquisaudavel.com.br/sopa-para-emagrecer/
http://www.aquisaudavel.com.br/sopa-para... .

Regarding the points diet, lower access with a downward trend curve from significant initial peaks (Figure 5) was observed. This diet does not restrict the consumption of specific foods or nutrients as long as the daily stipulated daily limit⁵²52 Betoni F, Zanardo VPS, Geni GC. Avaliação de utilização de dietas da moda por pacientes de um ambulatório de especialidades em nutrição e suas implicações no metabolismo. ConScientiae 2010; 3:430-440. assigned to each food is not exceeded. One of the definitions available in the virtual environment is as follows: The points diet is well known because you can eat what you want. For those who are on a diet, knowing that one can do this, wanting to eat and being able to eat is hard to believe. The only thing that is not allowed is eating trans-fat foods⁵³53 Emagrecimento na saúde. A dieta dos pontos funciona de verdade? [Internet]. 2017 [acessado 2017 Jan 12]. Disponível em: https://emagrecimentonasaude.com/dietas/dieta-dos-pontos/
https://emagrecimentonasaude.com/dietas/... . It is worth noting that, in a study by Santana et al.⁵⁴54 Santana HMM, Mayer MB, Camargo KG. Avaliação da adequação nutricional das dietas para emagrecimento veiculadas pela internet. ConScientiae Saúde 2003; 2:99-104., the points diet was among the most frequently found on the internet.

Unlike the others, the detox diet aroused keen interest in short periods: the most expressive was at the 97^th week and two more at the 198^th and 206^th week (Figure 6). Detox diets assume short-term restrictive practices aimed at eliminating toxins from the body for weight loss and health promotion⁵⁵55 Klein AV, Kiat H. Detox diets for toxin elimination and weight management: a critical review of the evidence. J Hum Nutr Diet 2015; 28(6):675-686.. Detoxification strategies have existed for thousands of years in different cultures and the guidelines range from absolute fasting diets to juice-based diets⁵⁶56 Allen J, Montalto M, Lovejoy J, Weber W. Detoxification in Naturopathic Medicine: A Survey. J Altern Complement Med 2011; 17(12):1175-1180..

The Dukan diet, on the other hand, had initially increasing RSV between the 78^th and 99^th week although, from there, a trend line drop with short sporadic peaks (Figure 7) is noted. While it has a more procedural characteristic than other fad diets, the Dukan diet also prescribes low amounts of carbohydrates and high protein value⁵⁷57 Freeman TF, Willis B, Krywko DM. Acute intractable vomiting and severe ketoacidosis secondary to the Dukan Diet(c). J Emerg Med 2014; 47(4):e109-112.^,5858 Wyka J, Malczyk E, Misiarz M, Zolotenka-Synowiec M, Calyniuk B, Baczynska S. Assessment of food intakes for women adopting the high protein Dukan diet. Rocz Panstw Zakl Hig 2015; 66(2):137-142.. It originated from the Dukan method that was proposed by nutrologist doctor Pierre Dukan from studies carried out in the last 40 years⁵⁹59 Dieta Dukan. Método Dukan [Internet]. 2017 [acessado 2017 Dez 11]. Disponível em: http://www.dietadukan.com.br/metodo-dukan
http://www.dietadukan.com.br/metodo-duka... . It is based on four phases. The first phase (attack) lasts from 3 to 7 days and consumes only proteins - without quantitative restriction. There is a recommended intake of 2 liters of water and 20 minutes of walking. In phase 2 (cruise), besides recommendations of phase 1, one adds vegetables to the menu and a 30-minute walk is recommended. Phase 3 (consolidation) lasts days, and one is allowed to consume protein, vegetables, two fruits per day, two slices of whole grain bread, 40g of cheese, two weekly servings of carbohydrates, such as pasta, and two weekly gala meals, with one starter, one main course, a dessert and a drink [...] is allowed every 25-minute walk⁶⁰60 Frozza F. Conheça a dieta Dukan, feita por Kate Middleton e Jennifer Lopez [Internet]. 2017 [acessado 2017 Dez 11]. Disponível em: https://www.terra.com.br/vida-eestilo/saude/dietas/conheca-a-dieta-dukan-feita-por-kate-middleton-e-jenniferlopez,dce73bb55005a310VgnVCM20000099cceb0aRCRD.html
https://www.terra.com.br/vida-eestilo/sa... ). Phase 4 (stabilization) should be continuous - lasts for the rest of one’s life and one can normally eat - as long as three rules are observed: consuming only protein on Thursdays; doing at least a 20-minute walk daily and use stairs instead of elevators and consume three tablespoons of oat bran⁶⁰60 Frozza F. Conheça a dieta Dukan, feita por Kate Middleton e Jennifer Lopez [Internet]. 2017 [acessado 2017 Dez 11]. Disponível em: https://www.terra.com.br/vida-eestilo/saude/dietas/conheca-a-dieta-dukan-feita-por-kate-middleton-e-jenniferlopez,dce73bb55005a310VgnVCM20000099cceb0aRCRD.html
https://www.terra.com.br/vida-eestilo/sa... .

In the aforementioned definition, especially since it appears as a ritual with prospects of lifelong continuity, the Dukan diet seems to be approaching the presuppositions of dietary re-education. Also, it has a clear association of the diet with the prescription of regular physical activity - a combination considered as pillars for the construction of the idealized body, as observed by Santos⁵5 Santos LA . Os programas de emagrecimento na Internet: um estudo exploratório. Physis 2007; 17(2):353-372..

The paleo diet has been the subject of increasing search attempts in the last years of 2016 with a peak of interest in the last week of the series (Figure 8). The Paleolithic diet is a reference to the diet model of modern men, prescribing a nutritional standard based on plants and wild animals consumed over 10,000 years ago⁶¹61 Opie LH. Lifestyle and diet. Cardiovasc J Afr 2014; 25(6):298-301.. In this case, there would be no restriction related to the proportion of macronutrients, for example, but to the type of food. It is recommended to avoid foods that were not consumed by our ancestors, such as cereals (wheat, rice, rye, oats, and so forth); legumes (beans, grains, lentils, and so forth); dairy products: (milk, yogurt, cheese, cream); fats: (vegetable oil and margarine) and processed products⁶²62 Marie Clarie. O carboidrato é vilão ou aliado?: Dra. Esthela Conde, especialista em nutrologia e nossa colunista, fala esta semana sobre carboidratos [Internet]. 2016. [acessado 2017 Out 1]. Disponível em: http://revistamarieclaire.globo.com/Beleza/noticia/2016/11/gordura-e-vila-ao-aliada.html
http://revistamarieclaire.globo.com/Bele... .

Contradicting some scientific statements that affirm the unhealthiness of fad diets, especially because of their restrictive nature⁶³63 Farias SJSS, Fortes RC, Fazzio DMG. Análise da composição nutricional de dietas da moda divulgadas por revistas não científicas. Nutrire 2014; 39(2):196-202.^,6464 Moyad MA. Fad diets and obesity-Part IV: Low-carbohydrate vs. low-fat diets. Urol Nurs Off J Am Urol Assoc Allied 2005; 25(1):67-70., the Paleolithic diet is cited in one of the stories as a protective factor for some diseases:

The Paleolithic diet can bring long-term benefits in obesity-related problems, including reducing the risk of diabetes and cardiovascular diseases, explains study author Caroline Blomquist, of the University of Umea, Sweden⁶⁵65 Uol Notícias. Dieta paleolítica ajuda mulheres na menopausa, diz estudo [Internet]. 2016. [acessado 2017 Jan 13]. Disponível em: https://noticias.uol.com.br/ultimasnoticias/ansa/2016/04/07/dieta-paleolitica-ajuda-mulheres-na-menopausa-diz-estudo.jhtm
https://noticias.uol.com.br/ultimasnotic... .

The main restriction is the intake of processed foods, which, according to the Food Guide for the Brazilian Population⁶⁶66 Brasil. Ministério da Saúde (MS). Guia alimentar para a população brasileira [Internet]. Ministério da Saúde; 2014. [acessado 2017 Out 1]. Disponível em: http://bvsms.saude.gov.br/bvs/publicacoes/guia_alimentar_populacao_brasileira_2ed.pdf
http://bvsms.saude.gov.br/bvs/publicacoe... , should have limited consumption, emphasizing the preference for fresh or minimally processed foods. However, the story reinforces the controlling character of diets with the total ban of a particular food group while bringing the idea of continuity of such a long-term diet in order to achieve its benefits.

Diets as risk, dietary re-education as creed and celebrities

Unlike dietary management as a recommended therapeutic procedure based on scientific evidence that legitimizes it and, in some way, institutionalizes the decision-making about the pertinence of its uses, the choice for fad diets usually takes on a private nature and is an individual responsibility.

Thus, with the problem set, the consumer would have to decide on the weights of risks and their rewards -living... and managing risks⁶⁷67 Miranda AC, Minayo MCS. Saúde e ambiente sustentável: estreitando nós. Rio de Janeiro: SciELO Books - Editora Fiocruz; 2002.; as a price required to follow the contemporary values of society (risk, show, control, networks, information, and so forth), the consumer always assumes provisional decisions, pending new information on new and emerging diets. As described by Giddens, in reflexive modernity, social practices are constantly examined and reformed in the light of renewed data about these very practices, thereby altering their nature⁶⁸68 Castiel LD, Diaz CA-D. A saúde persecutória: os limites da responsabilidade. Rio de Janeiro: Fiocruz; 2012.).

Despite the efforts to minimize the risks, these are inherent to the restrictive diets seen in the virtual environment. In general, with different designs, fad diets refer to the need for diet self-control - or self-interdiction - as a way of building the body desired and saturated with images of celebrities who show them as a result of their experiences.

In the last decades, body dissatisfaction seems to have increased exponentially, especially among women who adhere blindly to restrictive food abstention⁶⁹69 Contreras J, Gracia M. Alimentação, sociedade e cultura. Rio de Janeiro: Fiocruz; 2011., self-control mechanisms immersed in a setting in which dietary and body marketing discourses exert an intense influence on construction (sometimes, paradoxically, producing destruction) of the subjects’ identity⁶⁹69 Contreras J, Gracia M. Alimentação, sociedade e cultura. Rio de Janeiro: Fiocruz; 2011.. In addition to the body’s physical form, a healthy diet should contribute to the symbolic construction of the subjects’ well-being with themselves -, social acceptance and the construction of happiness itself⁵5 Santos LA . Os programas de emagrecimento na Internet: um estudo exploratório. Physis 2007; 17(2):353-372. are sought in the reflexive construction of the body; however, healthy eating concepts often assume normative, essentially energetic-quantitative aspects.

Authors⁷⁰70 Azevedo E. Riscos e controvérsias na construção social do conceito de alimento saudável: o caso da soja. Rev Saude Publica 2011; 45(4):781-788.^,7171 Kuwae CA, Carvalho MCVS, Prado SD, Ferreira FR. Concepções de alimentação saudável entre idosos na Universidade Aberta da Terceira Idade da UERJ: normas nutricionais, normas do corpo e normas do cotidiano. Rev Bras Geriatr E Gerontol 2015; 18(3):621-630. point out that understanding the interfaces between food and health requires the analysis of political, socio-cultural and nutritional realms that may even diverge on what is considered good or not for the body. However, in modernity, nutritional rationality is highlighted in the elaboration of definitions of healthy eating, although related practices are more distant from the world of life⁷²72 Habermas J, MacCarthy T, Habermas J. Lifeworld and system: a critique of functionalist reason. Boston: Beacon; 2005..

As an essential imperative to asceticism to achieve the ideal body, the idea of a diet as part of a temporary ritual finds its contrast with the perennial creed in dietary re-education - which is vaguely found in statements about the Dukan diet and detox diet.

The detox is implemented for a certain period, which is followed by dietary re-education [...] Several types of detox diets are available. The traditional detox is lactose-free, gluten-free and animal protein-free. That is, no milk and dairy products, no food based on wheat flour, barley, oats, and no meat whatsoever.

Regarding the moon diet, Google News® pointed out the story: André Marques sobre cirurgia para emagrecer: Eu ia morrer (Free translation: André Marques on weight loss surgery: I was going to die)⁷⁴74 G1. André Marques sobre cirurgia para emagrecer: "Eu ia morrer": Três meses e meio depois de fazer uma cirurgia de redução de estômago, o apresentador André Marques se prepara para a volta à TV. [Internet]. 2014. [acessado 2017 Jan 13]. Disponível em: http://g1.globo.com/fantastico/noticia/2014/03/andre-marques-sobrecirurgia-para-emagrecer-eu-ia-morrer.html
http://g1.globo.com/fantastico/noticia/2... . In the interview, the host lists his unsuccessful attempts (including the moon diet) at losing weight before undergoing bariatric surgery. [...] I had tried all the methods you can think of. Orthomolecular diet, moon diet, a glass of water under the sink. I took all the medications that you can think of⁷⁴74 G1. André Marques sobre cirurgia para emagrecer: "Eu ia morrer": Três meses e meio depois de fazer uma cirurgia de redução de estômago, o apresentador André Marques se prepara para a volta à TV. [Internet]. 2014. [acessado 2017 Jan 13]. Disponível em: http://g1.globo.com/fantastico/noticia/2014/03/andre-marques-sobrecirurgia-para-emagrecer-eu-ia-morrer.html
http://g1.globo.com/fantastico/noticia/2... . However, in some of the stories on the moon diet, nutritionists’ opinions are dismissed as a paradox: Unfortunately, the moon diet is not approved by scientists and nutritionists, but remains an effective and healthy method⁴²42 Vestir e maquiar. Dieta da lua [Internet]. 2015 [acessado 2017 Jan 10]. Disponível em: https://www.vestiremaquiar.com.br/dieta-da-lua/
https://www.vestiremaquiar.com.br/dieta-... .

As already mentioned, stories - especially those that encourage adherence to dietary rites, or the consumption of products or foods - often refer to celebrities in their titles. The experience of the cultural icons of the perfect body is often conjured. Of the 32 news items selected, only 12 did not refer directly to the diets of models, actors, actresses, hosts, sportsmen or former participants of reality shows. Although the dissemination of health information through celebrities is not necessarily detrimental, one should consider other variables. According to Rayner⁷⁵75 Rayner G. Does celebrity involvement in public health campaigns deliver long term benefit? BMJ 2012; 345:e6364., several Australian celebrities get media attention because of personal experiences related to the conditions of they had been victims. In this context, they also manage to catch the attention by taking on concerns about the prevention of ills - and seize the opportunity to market products enhanced by the celebrity status. In general, the contribution of celebrities in this field is discussed in the scientific setting, especially in the field of public interventions for disease prevention⁷⁶76 Baker JA, Lepley CJ, Krishnan S, Victory KS. Celebrities as Health Educators: Media Advocacy Guidelines. J Sch Health 1992; 62(9):433-435.. The participation of famous people associated with product marketing is far from being considered a health promoter because it ends up referring to the consumption incentive⁷⁷77 May ACW. Health campaigns entrench the role of celebrities in consumer marketing. BMJ 2012; 345:e6904.. We notice that the content of the stories presented to the search process is related to the aesthetics referring to reductionist and medicalized health conceptions - focused on biological aspects.

In the contents directed to health promotion, one perceives the more significant presence of professional opinions and results of scientific studies. In this respect, it is worth reflecting on professional action, since professionals themselves can foster the consumption of health information and services, which, depending on their level of involvement in daily practices, may characterize medicalization⁷⁸78 Conrad P. The medicalization of society: on the transformation of human conditions into treatable disorders. Baltimore: Johns Hopkins University Press; 2007. - a process in which issues that are not necessarily medical problems are treated as such, usually interpreted as diseases or disorders⁷⁸78 Conrad P. The medicalization of society: on the transformation of human conditions into treatable disorders. Baltimore: Johns Hopkins University Press; 2007..

In the field of Food and Nutrition, this idea can be translated by the aforementioned nutritional rationality⁷⁹79 Viana MR, Neves AS, Camargo-Junior KR, Prado SD, Mendonça ALO. A racionalidade nutricional e sua influência na medicalização da comida no Brasil. Cien Saude Colet 2017; 22(2):447-56.: dietary practices attentive to the permanent care in maintaining the balance of nutrients in food to the detriment of the pleasure of eating and the values with which the food marks the social interaction associated with it. Viana et al.⁷⁹79 Viana MR, Neves AS, Camargo-Junior KR, Prado SD, Mendonça ALO. A racionalidade nutricional e sua influência na medicalização da comida no Brasil. Cien Saude Colet 2017; 22(2):447-56. place the nutritionist’s role as a medicalizer when the sphere of prevention is sidelined to give way to strict dietary interventions - always supported by the media - that convert the risk into quasi-disease in the administration of daily living through health standards.

In some stories, the realm of food dangers is sensationalistically conjured. It also allows us to observe what is understood by some authors as commoditization of science⁸⁰80 Mendonça ALO, Camargo-Júnior KR. O complexo médico industrial no contexto da comoditização da ciência: relativizando o relativismo. Rev Bras Ciênc Tecnol E Soc 2011; 2:7-31., a process by which scientific knowledge, in the midst of power plays, is used in favor of market interests. While at the service of a capitalist perspective, science would be geared to the development of products that meet the consumption needs⁷⁹79 Viana MR, Neves AS, Camargo-Junior KR, Prado SD, Mendonça ALO. A racionalidade nutricional e sua influência na medicalização da comida no Brasil. Cien Saude Colet 2017; 22(2):447-56. of social groups, and these needs are often built from economic marketing strategies in which food products can be easily observed.

Final considerations

Google Trends has proved to be a relevant tool in the analysis of interests on health issues and an alternative for researching the vast field of studies that is the Internet.

Expert opinion and celebrity exposure is reified by fad diets, which assume similarities and differences from which they swing in the vast symbolic market of healthy eating. The novelties - whether in the form of differentiated regimens, changes in meal intervals, or changes in dietary balance - add symbolic value effectively in arousing the interest of Internet users for healthy, fast weight-loss diets. The consumption of this type of information well reflects values central to the liquid society described by Bauman⁸¹81 Bauman Z. Vida para consumo: a transformação das pessoas em mercadorias. Rio de Janeiro: Jorge Zahar; 2008., based on consumerism and the incessant and uncontrollable need to generate and supply desires. It reveals the immediacy of consumers in search of the ephemeral in the midst of the marketing cycles applied by digital marketing, such as dietary AIDAs (Attention, Interest, Desire, Action), whose products will guide new search attempts and new desires in a succeeding generation.

Further studies are required to investigate consumers’ repercussions of this information consumption on their daily lives and eating practices.

References

Publication Dates

History