Abstract: Social media provide a platform for users to express their opinions and share information. Understanding public health opinions on social media, such as Twitter, offers a unique approach to characterizing common health issues such as diabetes, diet, exercise, and obesity (DDEO), however, collecting and analyzing a large scale conversational public health data set is a challenging research task. The goal of this research is to analyze the characteristics of the general public's opinions in regard to diabetes, diet, exercise and obesity (DDEO) as expressed on Twitter. A multi-component semantic and linguistic framework was developed to collect Twitter data, discover topics of interest about DDEO, and analyze the topics. From the extracted 4.5 million tweets, 8% of tweets discussed diabetes, 23.7% diet, 16.6% exercise, and 51.7% obesity. The strongest correlation among the topics was determined between exercise and obesity. Other notable correlations were: diabetes and obesity, and diet and obesity DDEO terms were also identified as subtopics of each of the DDEO topics. The frequent subtopics discussed along with Diabetes, excluding the DDEO terms themselves, were blood pressure, heart attack, yoga, and Alzheimer. The non-DDEO subtopics for Diet included vegetarian, pregnancy, celebrities, weight loss, religious, and mental health, while subtopics for Exercise included computer games, brain, fitness, and daily plan. Non-DDEO subtopics for Obesity included Alzheimer, cancer, and children. With 2.67 billion social media users in 2016, publicly available data such as Twitter posts can be utilized to support clinical providers, public health experts, and social scientists in better understanding common public opinions in regard to diabetes, diet, exercise, and obesity.

Introduction: The global prevalence of obesity has doubled between 1980 and 2014, with more than 1.9 billion adults considered as overweight and over 600 million adults considered as obese in 2014 BIBREF0 . Since the 1970s, obesity has risen 37 percent affecting 25 percent of the U.S. adults BIBREF1 . Similar upward trends of obesity have been found in youth populations, with a 60% increase in preschool aged children between 1990 and 2010 BIBREF2 . Overweight and obesity are the fifth leading risk for global deaths according to the European Association for the Study of Obesity BIBREF0 . Excess energy intake and inadequate energy expenditure both contribute to weight gain and diabetes BIBREF3 , BIBREF4 . Obesity can be reduced through modifiable lifestyle behaviors such as diet and exercise BIBREF4 . There are several comorbidities associated with being overweight or obese, such as diabetes BIBREF5 . The prevalence of diabetes in adults has risen globally from 4.7% in 1980 to 8.5% in 2014. Current projections estimate that by 2050, 29 million Americans will be diagnosed with type 2 diabetes, which is a 165% increase from the 11 million diagnosed in 2002 BIBREF6 . Studies show that there are strong relations among diabetes, diet, exercise, and obesity (DDEO) BIBREF7 , BIBREF4 , BIBREF8 , BIBREF9 ; however, the general public's perception of DDEO remains limited to survey-based studies BIBREF10 . The growth of social media has provided a research opportunity to track public behaviors, information, and opinions about common health issues. It is estimated that the number of social media users will increase from 2.34 billion in 2016 to 2.95 billion in 2020 BIBREF11 . Twitter has 316 million users worldwide BIBREF12 providing a unique opportunity to understand users' opinions with respect to the most common health issues BIBREF13 . Publicly available Twitter posts have facilitated data collection and leveraged the research at the intersection of public health and data science; thus, informing the research community of major opinions and topics of interest among the general population BIBREF14 , BIBREF15 , BIBREF16 that cannot otherwise be collected through traditional means of research (e.g., surveys, interviews, focus groups) BIBREF17 , BIBREF18 . Furthermore, analyzing Twitter data can help health organizations such as state health departments and large healthcare systems to provide health advice and track health opinions of their populations and provide effective health advice when needed BIBREF13 . Among computational methods to analyze tweets, computational linguistics is a well-known developed approach to gain insight into a population, track health issues, and discover new knowledge BIBREF19 , BIBREF20 , BIBREF21 , BIBREF22 . Twitter data has been used for a wide range of health and non-health related applications, such as stock market BIBREF23 and election analysis BIBREF24 . Some examples of Twitter data analysis for health-related topics include: flu BIBREF25 , BIBREF26 , BIBREF27 , BIBREF28 , BIBREF29 , BIBREF30 , mental health BIBREF31 , Ebola BIBREF32 , BIBREF33 , Zika BIBREF34 , medication use BIBREF35 , BIBREF36 , BIBREF37 , diabetes BIBREF38 , and weight loss and obesity BIBREF39 , BIBREF40 , BIBREF41 , BIBREF42 , BIBREF21 . The previous Twitter studies have dealt with extracting common topics of one health issue discussed by the users to better understand common themes; however, this study utilizes an innovative approach to computationally analyze unstructured health related text data exchanged via Twitter to characterize health opinions regarding four common health issues, including diabetes, diet, exercise and obesity (DDEO) on a population level. This study identifies the characteristics of the most common health opinions with respect to DDEO and discloses public perception of the relationship among diabetes, diet, exercise and obesity. These common public opinions/topics and perceptions can be used by providers and public health agencies to better understand the common opinions of their population denominators in regard to DDEO, and reflect upon those opinions accordingly.

Question: How were topics of interest about DDEO identified?
Answer: using topic modeling model Latent Dirichlet Allocation (LDA)