Construction of Nutrition Literacy Indicators for College Students in Taiwan: A Delphi Consensus Study

Turkish version of a short nutrition literacy scale for young adults: cultural adaptation and validation

Background

Recent changes in nutrition trends may lead to health issues. In particular, the unhealthy eating habits of young adults suggest that future generations may be at risk. Therefore, the importance and necessity of nutrition literacy is becoming increasingly apparent.

Purpose

The purpose of this study was to create a Turkish version of a short nutrition literacy (S-NutLit-Tr) scale for young adults developed by Vrinten et al (2023).

Methods

This research involved 115 young adults from Istanbul Gelişim University, who were selected through convenience sampling, a non-probability sampling method. After the original S-NutLit scale was translated into Turkish, the validity and reliability of the determined factor structure were tested on 115 young adults. Internal consistency was examined with the Cronbach Alpha coefficient. Confirmatory factor analysis was employed to validate the two sub-scale structures. Finally, measurement invariance was tested concerning participants' gender, aiming to ascertain whether the scale captured equivalent characteristics across different groups.

Results

As a result of the reliability analysis conducted with the scale of S-NutLit-Tr, the Cronbach Alpha coefficient was obtained as 0.86 for the scale of S-NutLit-Tr. Additionally, it was found to be 0.84 and 0.77 for the "information skills" and "expert skills" sub-scales, respectively. Accordingly, the scale of S-NutLit-Tr was found to be reliable. To examine the two sub-scale factor structures of the S-NutLit-Tr scale, fit indices were examined: χ2/df (1.246), GFI (0.923), IFI (0.975), TLI (0.967), CFI (0.974), RMSEA (0.046), and SRMR (0.055) and it was observed that the indices were within acceptable limits. In the analysis results obtained through the multi-group confirmatory factor analysis for measurement invariance, it was observed that the ∆CFI and ∆TLI values across all indices were less than or equal to 0.01. Consequently, it was observed that the item-factor structure, factor loadings, variances, covariances, and error variances of the scale were equivalent for both male and female young adults.

Conclusion

The study found that the scale of S-NutLit-Tr for young adults was a valid and reliable measurement tool in Turkish culture.

Assessing the Quality of ChatGPT's Dietary Advice for College Students from Dietitians' Perspectives

BACKGROUND

As ChatGPT becomes a primary information source for college students, its performance in providing dietary advice is under scrutiny. This study assessed ChatGPT's performance in providing nutritional guidance to college students.

METHODS

ChatGPT's performance on dietary advice was evaluated by 30 experienced dietitians and assessed using an objective nutrition literacy (NL) test. The dietitians were recruited to assess the quality of ChatGPT's dietary advice, including its NL achievement and response quality.

RESULTS

The results indicate that ChatGPT's performance varies across scenarios and is suboptimal for achieving NL with full achievement rates from 7.50% to 37.56%. While the responses excelled in readability, they lacked understandability, practicality, and completeness. In the NL test, ChatGPT showed an 84.38% accuracy rate, surpassing the NL level of Taiwanese college students. The top concern among the dietitians, cited 52 times in 242 feedback entries, was that the "response information lacks thoroughness or rigor, leading to misunderstandings or misuse". Despite the potential of ChatGPT as a supplementary educational tool, significant gaps must be addressed, especially in detailed dietary inquiries.

CONCLUSION

This study highlights the need for improved AI educational approaches and suggests the potential for developing ChatGPT teaching guides or usage instructions to train college students and support dietitians.

Predicting willingness to consume healthy brand foods using the theory of planned behavior: the role of nutritional literacy

Introduction

The willingness to consume healthy foods has highlighted the growing importance of health, even more so when it comes to food choice, and predicting the willingness to consume foods of a healthy brand represents an action that leads to the practice of conscious eating habits, but what is behind this willingness? To answer this question and based on previous studies such as the theory of planned behavior and nutritional literacy, this study aimed to build a predictive model through an empirical study to examine the influence of nutritional literacy (NL) on attitude (ATT), subjective norm (SN) and perceived behavioral control (PBC), as well as to determine the influence of the three variables of the theory of planned behavior (TPB) on the willingness to consume healthy brand foods (WCHBF) in the Peruvian market.

Methods

The research focused on the population that stated that they were consumers of the Unión brand (a brand whose value proposition is the sale of healthy foods), obtaining 482 consumers. The study was conducted under a quantitative, non-experimental, cross-sectional design approach.

Results

The results support the existence of a positive and significant effect of NL on ATT, SN, and PBC, finding the exact behavior of SN and PBC in WCHBF; however, in the proposed model, it is observed that ATT has no impact on WCHBF.

Conclusion

Applying strategies that lead to a change in consumer behavior towards healthy brands is a matter of time and will. In this context, the findings indicate that nutritional literacy plays an essential role in the willingness to consume healthy foods, which sheds more light on the design of educational interventions and awareness campaigns that independently inform about nutritional benefits and empower consumers, allowing them to make informed and healthy choices.

Preliminary evaluation of a scenario-based nutrition literacy online programme for college students: a pilot study

OBJECTIVE

This study aimed to develop and evaluate a scenario-based nutrition literacy (NL) online programme for Taiwanese college students.

DESIGN

A randomised pilot trial design was used in this study.

SETTING

The study was conducted at a university in Taiwan. The intervention consisted of a five-unit web-based NL programme including videos of real-life scenario-based stories, situational analysis teaching and after-unit quizzes. Theme-related website information and smartphone apps (both iOS and Android systems) were offered for reference in every unit. The NL measure consisted of a self-rated scale, a scenario-based test and a healthy eating behaviour survey. Paired sample t-tests and ANCOVA were performed to test the effects on NL and healthy eating behaviour.

PARTICIPANTS

Participants were ninety-eight students, with a retention rate of 98 %. The ratio of men to women was 0·2:1. Most students were freshmen (48 %).

RESULTS

Compared with the control group, the experimental group showed significant post-intervention improvements in the NL and healthy eating behaviours after controlling for pretest scores.

CONCLUSIONS

This pilot study offers preliminary evidence of the potential positive effects of implementing a scenario-based NL online programme for college students. It offers a possibly novel strategy to enhance health-promoting behaviours in Taiwanese universities. Further research with larger sample sizes and more rigorous designs is warranted to confirm and build upon these initial findings.

Nutrition literacy differs based on demographics among University students in Bengbu, China

Background

Nutrition literacy (NL) encompasses the knowledge and skills that inform individuals' food choices. This cross-sectional study explored factors associated with NL among Chinese university students in Bengbu, China.

Methods

A cross-sectional survey was carried out. Two thousand one hundred thirty-three university students were selected by stratified cluster sampling. A 43-item NL questionnaire was used to assess NL. Binary logistic regression was used to determine odds ratios (ORs) along with 95% confidence intervals (CIs) for NL and to test the interaction effects of multiple factors on total NL and its six dimensions.

Results

Of these participants, 1,399 (65.6%) were women and 734 (34.4%) were men. Students who were from urban areas (OR = 1.36, 95% CI: 1.08-1.72), were living with both parents (OR = 1.30, 95% CI: 1.02-1.65), and had high academic performance (OR = 1.85, 95% CI: 1.34-2.57) were more likely to report higher NL levels than did other students. The ORs for NL (OR = 1.60, 95% CI: 1.06-2.41), nutrition knowledge (OR = 1.51, 95% CI: 1.00-2.26), obtaining skills (OR = 1.76, 95% CI: 1.16-2.65), and critical skills (OR = 1.59, 95% CI: 1.05-2.39) were higher for medical students who had received nutrition education than for other students. The ORs for NL (OR = 2.42, 95% CI: 1.21-4.84), nutrition understanding (OR = 2.59, 95% CI: 1.28-5.25), and interactive skills (OR = 2.06, 95% CI: 1.04-4.08) were higher for only-child students and those with a monthly expenditure of >¥1500.

Conclusions

NL of university students differed in terms of place of origin, living arrangement, nutrition education, academic performance, and household income, and the findings imply that universities should have all students take a basic nutrition course to improve their NL.

Translation, Adaptation, and Validity of the Short Food Literacy Questionnaire for Brazil

Food literacy refers to the knowledge and skills related to healthy food choices. The aim of this study is to present the process of the cross-cultural adaptation and content validation of the Short Food Literacy Questionnaire (SFLQ) for the Brazilian population. The process of adaptation and validation of the SFLQ was conducted in four steps: (1) conceptual and item equivalence; (2) translation with semantic equivalence; (3) operational equivalence; (4) measurement equivalence. The study involved ten judges (food and nutrition experts) and 20 subjects (general population) in evaluating the semantic equivalence of the SFLQ. The semantic equivalence was assessed by calculating the content validity coefficient (CVC). All the items had a CVC greater than 0.80 considering all the evaluated parameters. The SFLQ has been adapted for the Brazilian context and guidelines. The adapted version of the questionnaire was referred to as the SFLQ-Br. The operational equivalence was conducted with 120 subjects using an online approach. The measurement equivalence was assessed using confirmatory factor analysis, a reliability assessment, and an instrument stability assessment. A single factor was extracted, and all the items had a factor loading of >0.40 and appropriate goodness-of-fit values. All the equivalence results show that the SFLQ-Br can be used in the Brazilian population as a reliable, consistent, and stable instrument to measure food literacy.

Development and Validation of Nutrition Literacy Assessment Instrument for Chinese Pregnant Women

The study was designed to develop and validate the nutrition literacy assessment instrument for pregnant women in China (NLAI-P). The dimension, components and questions of NLAI-P were identified via literature review and expert consultation. A panel of experts evaluated the content validity. The construct validity was evaluated by using the exploratory factor analyses (EFA) and confirmatory factor analyses (CFA). Cronbach’s α coefficient and split-half reliability were applied for examining the reliability. The NLAI-P was divided into 3 dimensions including knowledge, behavior and skill dimension. Findings showed NLAI-P possessed the satisfactory content validity (content validity index = 0.98, content validity ratio = 0.97), acceptable construct validity (χ2/df = 1.82, GFI = 0.86, AGFI = 0.84, RMSEA = 0.046) and good reliability (Cronbach’s α coefficient = 0.82). The average scores of NLAI-P were 46.59 ± 9.27. With the adjustment of confounding factors, education level presented a significantly positive correlation with NLAI-P scores. In conclusion, NLAI-P were valid and reliable to inspect NL level of pregnant women in China. Poor NL was prevalent among Chinese pregnant women. Based on the education level, taking targeted propaganda and education measures would achieve the optimal effect. NLAI-P can be applied as the tool for monitoring and assessing NL of pregnant women, and facilitate the designation of targeted interventions policies.

Development of Nutrition Literacy Scale for Middle School Students in Chongqing, China: A Cross-Sectional Study

Background

Information on nutrition literacy of middle schoolers is limited and tools for measuring nutrition literacy of middle schoolers are inadequate. Nutrition literacy has a positive effect on health. Improving children's nutrition literacy can help them to master the necessary nutritional knowledge, develop a healthy lifestyle, and learn to supplement nutrition according to their own needs for healthy growth.

Objectives

To develop the Chongqing Middle school student Nutrition Literacy Scale (CM-NLS).

Methods

Three experiments were conducted. A theoretical framework and an initial item pool of CM-NLS were established based on the literature review. And the two-round Delphi method was used to explore the suitable acceptance indicators and items. Item evaluation and reduction were performed using the classical test theory. Then, the items in the final CM-NLS were tested for their validity and reliability amongst 462 middle school students. The construct validity was assessed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The internal consistency reliability and split-half reliability were evaluated using Cronbach's alpha coefficients.

Results

The final CM-NLS consisting of 52 items that were based on three primary items (functional, interactive and critical) and six sub-items (obtain, understand, apply, interact, medial literacy and critical skill) was developed and validated. EFA suggested six factors explaining 69.44% of the total variance (Kaiser-Meyer-Olkin test = 0.916, Bartlett's test χ2 = 5,854.037, P < 0.001). CFA showed that the model fit the data adequately, with χ2/df = 1.911, root mean square error of approximation = 0.063, goodness-of-fit index = 0.822 and adjusted goodness of fit index = 0.790. The total CM-NLS Cronbach's alpha values of internal consistency and split-half reliability were 0.849 and 0.521, respectively, with reasonable reliability.

Conclusions

CM-NLS is a valid and reliable instrument for assessing nutrition literacy among middle school students in Chongqing. Specifically, it could be used by practitioners for needs assessment before the implementation of a nutrition education program.

The Validation and Improvement of a Food Literacy Behavior Checklist for Food Literacy Programs

Food literacy is a multidimensional construct required to achieve diet quality. The Food Sensations^® for Adults (FSA) program aims to improve the food literacy of low to middle-income adults living in Western Australia and is funded by the Western Australian Department of Health. The original published behavior checklist used to measure change in food literacy has been revised based on experience of the facilitators and the iterative development of the program. This research sought to assess the validity and reliability of the improved food literacy behavior checklist. A total of 1,359 participants completed the checklist over an 18-month period. Content, face, and construct validity were considered in the re-development of the checklist. An exploratory factor analysis of the checklist identified three factors: (1) Plan and Manage, (2) Selection, and (3) Preparation. Cronbach’s alpha coefficients of 0.883, 0.760, and 0.868 were found for each of the three factors respectively. These coefficients indicated good internal consistency and were higher than those found in the original checklist analysis. An external validation was undertaken with the original food literacy behavior checklist, and a strong positive relationship between the two tools was found. In addition to being used to evaluate FSA, this revised and extensively validated tool could provide guidance to others evaluating similar food literacy programs and contribute to international measurement research.

Health Literacy and Food Literacy for K-12 Schools in the COVID-19 Pandemic

BACKGROUND

Food literacy, a sub-area of health literacy, is achieving attention in schools, academia, research, health care, businesses, and governments worldwide. Against the current COVID-19 pandemic backdrop, the relevance of food literacy's interconnected attributes such as nutritional knowledge, food skills, and food environment is gaining traction. Enhancing health and food literacy in the K-12 school environment are important empowerment tools with the potential to reduce health inequalities as vulnerable people are at risk of limited health literacy.

METHODS

We aim to clarify the meaning of food literacy and its relationship to health literacy and other factors influencing eating behavior.

RESULTS

We offer a proposed conceptual model depicting connections between relevant theories and constructs in the field of health and nutrition. Concrete actions are offered that contemporary schools can take guided by the utility of the model.

CONCLUSIONS

This visual can help guide schools' multidimensional health and food literacy efforts while considering the realities of the current COVID-19 pandemic context and beyond. This model will provide an overarching reference for schools to consider key constructs to support practice, research, policy, and intervention efforts to advance their health and food literacy agendas.

Development and Validation of Food and Nutrition Literacy Assessment Tool for Iranian High-school Graduates and Youth

Background:

Food and nutrition literacy (FNL) is an emerging concept that emphasizes not only on personal knowledge, but food and nutrition skills about. This study aimed to develop and validate a food and nutrition literacy assessment tool (FNLAT) for youth and high-school graduates in Iran.

Methods:

The study protocol included the following steps: First, FNL components for Iranian high-school graduates and youth were identified through literature review and interviews with experts. Delphi method was used in order to achieve consensus about FNL components. Then, the questionnaire items were generated, and its content and face validity were assessed. Construct validity of the questionnaire was evaluated through applying principal component analysis (PCA) and confirmatory factor analyses (CFA) in the next step. Finally, reliability of the FNLAT was assessed by calculating Cronbach's Alpha and evaluating test-retest reliability.

Results:

A 104-item questionnaire was developed. S-CVI was ≥90 which confirmed content validity of the questionnaire. PCA suggested that it was constructed of 6 factors, one in knowledge domain (food and nutrition knowledge) and five in skill domain (functional skills, interactive skills, advocacy, critical analysis of information, and food label reading skills). On the basis of CFA, the fit indices of the model had acceptable fit and confirmed construct validity of the FNLAT (X²/df = 1.58, RMSEA = 0.041; P = 1.00, RMR = 0.034, GFI = 0.79). The values of Cronbach's Alpha and intraclass correlation coefficient (ICC) confirmed internal consistency and time stability of the FNLAT and its subscales.

Conclusions:

The developed FNLAT is a valid and reliable tool to assess FNL in Iranian late adolescents and youth.

Towards the Implementation of a Conceptual Framework of Food and Nutrition Literacy: Providing Healthy Eating for the Population

Existing definitions of food literacy (FL) and nutrition literacy (NL) in particular refer to individual knowledge, motivation, competences, and awareness, which determine the relationship between individuals and food, the food system, and nutrition information. Several authors proposed specific conceptualization of the terms. Nevertheless, the description of analogies and differences between FL and NL is still lacking, as is an integrated framework which highlights the meaning of the concepts. This work aims to describe and discuss evidence provided by the literature in order to develop and propose a comprehensive conceptualization of FL and NL to the scientific community. We systematically reviewed six databases, considering the search terms of FL and NL. We collected the antecedents, components, and consequences of both FL and NL. We underlined and traced similarities of the concepts as well as prerogative features through the content analysis of definitions. We obtained 14 definitions of NL and 12 definitions of FL; 42 papers presented antecedents and 53 papers contained consequences. We observed that NL could be considered a specific form of FL. In addition, we noted that the consequences of NL are included in the subset of the consequences of FL and the conceptual limits of FL correspond to the outcome of healthful diet. We conclude that FL and NL build a multifaceted concept which implies both individual and public perspectives. We propose a conceptualization which could be useful to develop an executive framework aimed at providing healthy eating for the population.

Towards the measurement of food literacy with respect to healthy eating: the development and validation of the self perceived food literacy scale among an adult sample in the Netherlands

Background

Food literacy refers to the capability to make healthy food choices in different contexts, settings and situations. The aim of this study is to develop and validate the self-perceived food literacy (SPFL) scale, to assess individuals’ level of food literacy, including a knowledge, skills and behavior to plan, manage, select, prepare and eat food healthfully.

Methods

An initial set of 50 items for the SPFL scale were generated based on expert insights and literature. A cross-sectional online survey was conducted among a sample of Dutch adults (n = 755) in order to determine convergent, divergent and criterion validation against psychosocial variables that were expected to correlate with food literacy (self-control, impulsiveness) and against the expected outcome of high food literacy, namely healthy food consumption. Principal Component Analyses (PCA), Pearson correlation tests and linear regression analyses were conducted. The capacity to distinguish of the SPFL scale was determined by comparing SPFL scores of the general population with that of a sample of dieticians (n = 207).

Results

The participants in the general sample had an average age of 44.8 (SD:16.1), the majority were women (90.7%), they had a healthy weight (61.4%) and were highly educated (59.1%). Of the initial 50 items, 29 items remained after PCA and reflected eight domains of food literacy. SPFL was positively correlated with self-control (r = 0.51, p = <.001) and negatively with impulsiveness (r = − 0.31, p = <.01). Participants with higher levels of food literacy reported a significantly higher frequency of fruit consumption (≥5 times/week), vegetable consumption (≥5times/week) and fish consumption (≥1times/week) and consumed larger portions of fruit (≥2pieces/day) and vegetables ≥200 g/day) in comparison with participants who had lower levels of food literacy. Dieticians had slightly higher scores on SPFL than general adults (B = 0.08, SE = 0.03, t = 2.83, 95%-CI = 0.03 to 0.14).

Conclusions

The 29 item SPFL scale is a validated, expert-based and theory-driven tool for measuring self-perceived food literacy with respect to healthy eating among adults. Higher levels of food literacy were associated with more self-control, less impulsiveness and healthier food consumption. Additional research is needed to validate the SPFL scale in different populations (different age groups, socioeconomic groups, male populations) and in different contexts.

Electronic supplementary material

The online version of this article (10.1186/s12966-018-0687-z) contains supplementary material, which is available to authorized users.