• Lina Abdul-Samad, Dina Zidan, and Mary Odette-Abedrabbo.
• Department of Nutrition, Faculty of Pharmacy, Nursing, and Health Professions, Birzeit University, Birzeit, occupied Palestinian territory. Electronic address: linaabdulsamad1@gmail.com.
• Lancet. 2021 Jul 1; 398 Suppl 1: S1.

BackgroundEating at fast food restaurants has become a worldwide phenomenon. To understand the factors that influence such behaviour is an important part of modern nutritional research. Social media may influence human eating behaviours in ways that have yet to be investigated. This study tests the possible relationship between two modern trends: social media usage and eating at fast food restaurants.FindingsA cross-sectional study was conducted in April, 2017. Undergraduate students aged 17-30 years in the West Bank, occupied Palestinian territory, completed a self-administered online Google Forms survey of 18 questions. Four universities were chosen to represent the four areas of interest; Birzeit University (central West Bank), Al-Quds University (East Jerusalem), An-Najah University (northern West Bank), and Hebron University (southern West Bank). Permission was sought from the administrators of the two most popular Facebook groups for each university (those with the highest number of members). After permission was granted, the survey was posted on each Facebook group. We used convenience sampling; students were requested to complete the survey on a voluntary basis. The surveys were closed when 150 students had filled forms or when the completion rate stagnated despite the survey being re-posted up to five times. The settings on Google Forms were adjusted so that every question had to be answered to complete the survey. The survey aimed to measure the types of social media that students used (use of Facebook services, and of the four other most popular social media platforms), the time spent on social media, and behaviour relating to eating at restaurants. A five-point Likert-type scale was used to record responses to the questions. Descriptive statistics were gathered, and Pearson's chi squared test was used to test for associations. Ethical approval for the project was obtained from Birzeit University, and informed written consent was obtained from all participants.FindingsIn total, 399 students completed the survey; a completion rate of 67% (399 of 600). 26% (105 of 399) were male and 76% (294) were female. There were 150 participants at Birzeit University, 136 participants at Al-Quds University, 83 participants at An-Najah University, and 32 participants at Hebron University. Significant associations were found between using Facebook Messenger to call or message Facebook friends to invite them to eat at fast food restaurants, and uploading pictures of fast food meals (p=0·0010), and eating out at fast food restaurants (p=0·027). Furthermore, there was a significant association between time spent on Facebook and eating at restaurants (p=0·050). However, there was no significant association between time spent on Facebook and eating at fast food restaurants (p=0·21).InterpretationThe findings suggest that aspects of food-related lifestyle for students, such as eating at restaurants, are influenced by their use of Facebook as both a communication tool and as a visual platform. Whether social media can be used in interventions to promote healthy eating should be investigated.FundingNone.Copyright © 2021 Elsevier Ltd. All rights reserved.

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