Using Social Network Analysis to Understand Peer Relationships on Dietary Patterns in Early Adolescents: A Systematic Review

Context A paucity of studies explore peer influence and the role of social networks in shaping dietary patterns among early adolescents. Unhealthy dietary patterns, characterized by high intakes of added sugars, saturated fat, and sodium and low intakes of nutrient-dense foods, are prevalent among adolescents in the United States. These patterns contribute to increased weight gain that predispose adolescents to obesity and related comorbidities. Objective The main objective of this systematic review is to understand the influence of peer social networks on early adolescent dietary patterns. Data Sources A comprehensive search was used to identify relevant literature on social network analysis, dietary patterns, and early adolescents aged 10–14 years. Five major electronic databases were utilized: PubMed, Web of Science, CINAHL Complete, APA PsycINFO, and Scopus. The search was limited to empirical peer-reviewed journal articles published in English between 2010 and 2024. Data Extraction Data were extracted for exposure (explanatory/independent) variables and measurements and outcome (dependent) variables and measurements. Effect measures such as risk ratio (relative risk), odds ratio, correlation coefficients, and prevalence ratio were extracted if available. Social network measures and any key findings relevant to the review question were also extracted. Data Analysis Eleven studies met the inclusion criteria. The studies used 2 types of distinct relations within the peer social networks: friendship and influential peer relations. In general, significant positive associations occurred between adolescents and their friends’ unhealthy food intake, while the associations varied for healthy food intake. Using influential peers to promote water intake within their social network was generally nonsignificant and did not correspond to a decrease in sugar-sweetened beverage intake. Only 3 studies focused on determining standard social network measures, with reciprocity common among friendship networks. The effect of popularity within the peer social networks on adolescent dietary intake varied. Conclusion Friends’ unhealthy eating habits appear to influence early adolescents’ dietary patterns, with a stronger effect observed among males. More longitudinal studies are needed for definitive conclusions on early adolescent social networks and healthy food intake. The findings reinforce considerations of social network analysis of adolescents if meaningful changes in adolescent dietary patterns are anticipated.