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Liu Y, Zhang L, Xu K, Ding Y, Li F, Zhang T. Cross-cultural adaptation and validation of the short nutritional literacy scale for young adults (18-35years) and analysis of the influencing factors. BMC Public Health 2024; 24:2158. [PMID: 39118062 PMCID: PMC11312225 DOI: 10.1186/s12889-024-19686-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 08/02/2024] [Indexed: 08/10/2024] Open
Abstract
OBJECTIVES This study translated the short nutrition literacy scale for young adults (18-35 years) into Chinese, examined its reliability and validity, and analyzed its influencing factors. METHODS The scale was translated using a modified Brislin translation model. A convenience sample of 508 cases was selected for the survey. Content validity, structural validity, Cronbach's alpha coefficient, and test-retest reliability were used to evaluate the scale's reliability and validity. To screen the factors influencing nutrition literacy in young people. RESULTS The Chinese version of the Item-Level Content Validity Index (I-CVI) was 0.833 ~ 1, and the Scale-Level Content Validity Index/Average (S-CVI/Ave) was 0.908. The cumulative variance contribution of the scale was 51.029%, and the model was generally well-fitted. The Cronbach's alpha coefficient and retest reliability of the scale were 0.826 and 0.818. The results showed that the level of education, mother's education, nutrition-related courses, and frequency of attention to nutritional health information were the factors influencing the nutritional literacy of young people. CONCLUSION The Chinese version of the S-NutLit Scale can effectively assess the nutrients of young Chinese people. Low levels of education, low levels of education of mothers, lack of exposure to nutrition-related courses, and low frequency of attention to nutritional health information can lead to lower levels of nutritional literacy among young people.
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Affiliation(s)
- Yaoyao Liu
- Department of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou, 121001, Liaoning, China
| | - Lei Zhang
- Department of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou, 121001, Liaoning, China.
| | - Kaiyan Xu
- Department of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou, 121001, Liaoning, China
| | - Yiqian Ding
- Department of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou, 121001, Liaoning, China
| | - Fangyan Li
- Department of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou, 121001, Liaoning, China
| | - Tinglin Zhang
- Department of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou, 121001, Liaoning, China
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Kirby AN, DeBellis J, Wolter K, Mount G, Wang CH, Bishop J, Barkhouse J, Wirth K, Nguyen N, Cacciatore C, Kraus K. Assessing nutrition literacy and nutrition counseling proficiency following an interdisciplinary culinary medicine elective. J Osteopath Med 2024; 0:jom-2023-0094. [PMID: 38676937 DOI: 10.1515/jom-2023-0094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 03/12/2024] [Indexed: 04/29/2024]
Abstract
CONTEXT Culinary medicine (CM) is a growing field of education that aims to bridge the gap between the clinical need for nutritional counseling and the lack of education on the topic. Healthcare professionals can aid in nutrition-related noncommunicable disease (NCD) prevention by improving a patient's dietary behavior. However, the presence of nutrition education in healthcare curricula is lacking. Early evidence indicates that CM could address this gap. OBJECTIVES The objectives of this study are to determine if the provision of an interdisciplinary CM elective will improve student knowledge and confidence with counseling on nutrition and culinary principles, and to improve personal dietary habits of students. METHODS This was a one-group pretest-posttest quasi-experimental design. First- and second-year osteopathic medical students (OMS) and nurse practitioner students were recruited to participate in a CM elective via email. Participants were excluded if they were not in good academic standing at their respective institutions. Twelve individuals (n=8 medical; n=4 nursing) were enrolled in the course. Participants completed pre- and postcourse surveys to determine changes in nutrition literacy (Nutrition Literacy Assessment Instrument [NLit42]), nutrition counseling proficiency (Nutrition Survey for Family Practitioners), and dietary quality (Automated Self-Administered 24-h dietary assessment tool; ASA24®). A two-sided, paired t test was conducted to determine changes in outcome variables. RESULTS All 12 participants completed the precourse assessments, and 8 participants completed the postcourse assessments. Culinary activity attendance was 94.5 %. Participants exhibited a statistically significant increase in their overall nutrition literacy scores after completing the CM elective (p=0.006). Literacy subcategories indicated that the improvement came from the participant's ability to understand household measurements (p=0.005) better. Increases in self-reported proficiency were observed for participants' confidence to counsel on nutrition and prevention/wellness (p=0.02) and macronutrients in health and food safety (p=0.01). No statistically significant changes in the personal dietary pattern or quality were observed. CONCLUSIONS The interdisciplinary CM elective improved nutrition literacy and some aspects of counseling proficiency. Although small shifts in dietary variables were observed, the elective did not statistically improve participants' dietary pattern. However, some changes that were observed may lead to clinically relevant outcomes if maintained long-term. These findings are encouraging. Implementing CM as an educational tool could improve healthcare practitioners' ability to understand and counsel patients on nutrition to prevent the nutrition-related NCDs.
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Affiliation(s)
- Anna N Kirby
- Department of Cell Biology and Physiology and Preventative Medicine and Public Health, Edward Via College of Osteopathic Medicine, Auburn, AL, USA
| | - Joy DeBellis
- 1383 College of Nursing at Auburn University , Auburn, AL, USA
| | - Katie Wolter
- Department of Clinical Affairs in the Discipline for Pediatrics, Edward Via College of Osteopathic Medicine, Auburn, AL, USA
| | - Gary Mount
- Department of Pharmacology, Edward Via College of Osteopathic Medicine, Auburn, AL, USA
| | - Chih-Hsuan Wang
- College of Education, 1383 Auburn University , Auburn, AL, USA
| | | | | | - Kathryn Wirth
- Edward Via College of Osteopathic Medicine, Auburn, AL, USA
| | - Nancy Nguyen
- Edward Via College of Osteopathic Medicine, Auburn, AL, USA
| | | | - Kristyn Kraus
- Edward Via College of Osteopathic Medicine, Auburn, AL, USA
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Baguley BJ, Benna-Doyle S, Drake S, Curtis A, Stewart J, Loeliger J. Access to nutrition services and information after active cancer treatment: a mixed methods study. J Cancer Surviv 2024; 18:176-185. [PMID: 36823493 PMCID: PMC10866769 DOI: 10.1007/s11764-023-01352-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/16/2023] [Indexed: 02/25/2023]
Abstract
PURPOSE Evidence-based guidelines for cancer strongly support nutrition and dietetic services for people with cancer and carers in order to improve patient-centred and health service outcomes. Access to nutrition services and information after completing active cancer treatment is relatively unknown in Australia. This study aimed to determine the availability, accessibility, barriers, and preferences to nutrition services and information after cancer treatment in Australia. METHODS Utilising mixed methods, people with cancer and carers completed a cross-sectional survey, and a sub-group of participants completed a semi-structured interview. The survey evaluated the availability of nutrition services, nutrition information searched, barriers, and preferences for nutrition information. Semi-structured interviews explored participant experience with nutrition services and information. RESULTS The 149 participants (including 10 carers) were predominately male and with a diagnosis of prostate cancer (63%). Overall, 23% of participants received nutrition information from a dietitian after cancer treatment. Participants (78%) indicated that accessing a nutrition specialist is the main barrier to receiving nutrition care after treatment. Most searched nutrition information on the internet (55%) and found the information easy to understand (89%), but conflicting (52%). Thematic analysis of interviews in fourteen cancer patients revealed three key themes pertaining to (1) preferred referral and timing of nutrition services, (2) lack of confidence in publicly available nutrition information, and (3) streamlining nutrition services for greater access. CONCLUSION Access to a dietitian and evidence-based information after cancer treatment is limited for people with cancer and carers in Australia, despite the high interest and need for ongoing nutrition care. IMPLICATIONS FOR CANCER SURVIVORS Models of care evaluating the provision of appropriate nutrition care and information provision after cancer treatment are needed to address this unmet survivorship need.
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Affiliation(s)
- Brenton J Baguley
- Institute for Physical Activity and Nutrition, Deakin University, VIC, 3220, Geelong, Australia.
- School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, VIC, 3125, Burwood, Australia.
| | - Sarah Benna-Doyle
- School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, VIC, 3125, Burwood, Australia
| | - Shani Drake
- Nutrition and Speech Pathology Department, Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia
| | - Annie Curtis
- Institute for Physical Activity and Nutrition, Deakin University, VIC, 3220, Geelong, Australia
- School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, VIC, 3125, Burwood, Australia
| | - Jane Stewart
- Nutrition and Speech Pathology Department, Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia
| | - Jenelle Loeliger
- School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, VIC, 3125, Burwood, Australia
- Nutrition and Speech Pathology Department, Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia
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Sanlier N, Kocaay F, Kocabas S, Ayyildiz P. The Effect of Sociodemographic and Anthropometric Variables on Nutritional Knowledge and Nutrition Literacy. Foods 2024; 13:346. [PMID: 38275713 PMCID: PMC10814858 DOI: 10.3390/foods13020346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/21/2023] [Accepted: 05/24/2023] [Indexed: 01/27/2024] Open
Abstract
Nutrition literacy, which is one of the important components of health literacy, includes basic nutritional information and understanding, interpreting and having the ability to make healthy decisions on nutrition-related issues. This study aims to dwell upon the relationship between sociodemographic and anthropometric variables and nutritional knowledge and nutrition literacy. A total of 1600 people aged 19-64 years, 934 women and 666 men, voluntarily participated in the research in the capital city of Turkey. The mean age is 28.2 ± 10.9 years. More than half of the participants (57.4%) have a university graduate/postgraduate education level, and 66.2% are unemployed. This cross-sectional study evaluated demographic information, anthropometric measurements, nutritional information and nutrition literacy. Nearly all the respondents (94.6%) were determined to have sufficient nutrition literacy. Body mass index (BMI) and age were negatively associated with nutrition literacy, whilst nutrition knowledge was positively associated. Respondents with nutrition education at school had the highest nutrition knowledge and nutrition literacy scores, and primary school graduates had the lowest. Participants who received nutrition education scored higher in all the subgroups of the GNKQ. Age, gender, marital status, education status, employment status, BMI and nutrition education were significantly associated with nutrition literacy. The results will be useful in developing food and nutrition policies that will pave the way for making decisions on the most useful themes of health and nutrition campaigns.
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Affiliation(s)
- Nevin Sanlier
- Department of Nutrition and Dietetics Ankara, Faculty of Health Sciences, Ankara Medipol University, Ankara 06050, Turkey
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Mostafazadeh P, Jafari MJ, Mojebi MR, Nemati-Vakilabad R, Mirzaei A. Assessing the relationship between nutrition literacy and eating behaviors among nursing students: a cross-sectional study. BMC Public Health 2024; 24:18. [PMID: 38166862 PMCID: PMC10759699 DOI: 10.1186/s12889-023-17468-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 12/12/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Eating behavior is an essential aspect of life that can have long-term effects on health outcomes. Nutrition literacy is crucial for better health and well-being. It empowers individuals to make informed decisions about their nutrition and take control of their eating habits. OBJECTIVES This study aimed to assess the relationship between nutritional literacy and eating behavior among nursing students at the nursing faculties of Ardabil University of medical sciences. METHODS A cross-sectional correlational study was conducted in Ardabil province, northwest Iran. The study collected data through simple random sampling at nursing schools in Ardabil province, with 224 nursing students participating. The study collected data from a demographic information form, the nutritional literacy self-assessment questionnaire for students (NL-SF12), and the adult eating behavior questionnaire (AEBQ). The data were analyzed using SPSS version 14.0 software. RESULTS Based on the results, nutritional literacy explains 44% of the variance in eating behavior and shows significant explanatory power in two sub-scales of eating behavior. The adjusted R2 values for food approach and food avoidance scales were 0.33 and 0.27, respectively. CONCLUSION Given the significant relationship between nutritional literacy and eating behaviors among nursing students, nursing faculty managers and health policymakers should develop new public health strategies to increase nutritional literacy among nursing students.
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Affiliation(s)
- Pouya Mostafazadeh
- Students Research Committee, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mohammad Javad Jafari
- Students Research Committee, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mohammad Reza Mojebi
- Students Research Committee, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Reza Nemati-Vakilabad
- Students Research Committee, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
- Student Research Committee, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Alireza Mirzaei
- Department of Emergency Nursing, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran.
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Sarma R, Willis N, Holthaus TA, Cannavale CN, Gibbs HD, Khan N. Memory Abilities Are Selectively Related to Food Label and Numeracy Nutrition Skills. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:861-868. [PMID: 37921796 DOI: 10.1016/j.jneb.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE We investigated the relationship between nutrition literacy, diet quality, carotenoid status, and cognition. METHODS Adults aged 37.5 ± 17.0 years (n = 52) completed the 42-item Nutrition Literacy Assessment Instrument (NLit). The Dietary History Questionnaire III was analyzed to determine the Healthy Eating Index. Skin carotenoids were assessed as a diet quality biomarker. Selective attention, relational memory, and pattern separation abilities were assessed using the flanker, spatial reconstruction, and mnemonic similarity tasks, respectively. Statistical adjustments included age, sex, education, and body mass index. RESULTS No correlations were observed for NLit scores and NLit subscales with Healthy Eating Index and skin carotenoid status. However, the NLit's food label and numeracy subscale was related to greater pattern separation abilities (ρ = 0.33, r2 = 0.11, P = 0.03). CONCLUSIONS AND IMPLICATIONS Comprehension of food labels and numeracy information was associated with memory abilities. Future work is needed to test whether targeting working memory and attentional processes during memory retrieval in larger samples may facilitate the acquisition of nutrition knowledge.
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Affiliation(s)
- Rhea Sarma
- Kinesiology and Community Health, University of Illinois, Urbana, IL
| | - Nathaniel Willis
- Division of Nutritional Sciences, University of Illinois, Urbana, IL
| | - Tori A Holthaus
- Division of Nutritional Sciences, University of Illinois, Urbana, IL
| | | | - Heather D Gibbs
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS
| | - Naiman Khan
- Kinesiology and Community Health, University of Illinois, Urbana, IL; Division of Nutritional Sciences, University of Illinois, Urbana, IL; Neuroscience Program, University of Illinois, Urbana, IL.
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Haldeman L. Separating Fact From Fiction: Enhancing Nutrition Literacy to Navigate Healthy Eating Decisions. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:698. [PMID: 37806708 DOI: 10.1016/j.jneb.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Affiliation(s)
- Lauren Haldeman
- Journal of Nutrition Education and Behavior Advancing Research, Practice, and Policy
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Li Z, Zhou Y, Tan Y, Zhu X, Liu W, Chen Y, Qin Y, Li R, Yu L, Zhao R, Xu Y. Development and Validation of Nutrition Literacy Assessment Instrument for Chinese Lactating Women: A Preliminary Study. Nutrients 2023; 15:3488. [PMID: 37571425 PMCID: PMC10421061 DOI: 10.3390/nu15153488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 08/13/2023] Open
Abstract
This study focused on the development and validation of a nutrition literacy assessment instrument for Chinese lactating women (NLAI-L). A comprehensive literature review and group discussion by experts in relevant fields were adopted to determine the dimension, topics and questions of NLAI-L. Content validity was evaluated by a panel of experts. The exploratory factor analyses (EFA) and confirmatory factor analyses (CFA) were used to evaluate the construct validity. Cronbach's α and split-half reliability were applied to examine the reliability of NLAI-L. The final NLAI-L consisted of 38 questions covering three dimensions: knowledge, behavior and skill. The EFA revealed four sub-domains for knowledge, one sub-domain for behavior and four sub-domains for skill. The results showed that NLAI-L had satisfactory content validity (CVI = 0.98, CVR = 0.96), good reliability (Cronbach's α coefficient = 0.84) and acceptable construct validity (χ2/df = 2.28, GFI = 2.81, AGFI = 0.79, RMSEA = 0.057). In the application part, the average NL score was 46.0 ± 9.3. In multivariate linear regression, education level, age, postnatal period and occupation were the potential influencing factors of NL for Chinese lactating women. The study established an effective and reliable assessment instrument for Chinese lactating women (NLAI-L) through qualitative and quantitative methods. The establishment of NLAI-L will provide an effective tool for exploring the role of NL in health or disease and provide a basis for the formulation of targeted nutrition interventions.
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Affiliation(s)
- Zhao Li
- School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100083, China; (Z.L.); (Y.Z.); (Y.T.); (X.Z.); (W.L.); (Y.C.); (Y.Q.); (R.L.); (L.Y.); (R.Z.)
| | - Yalin Zhou
- School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100083, China; (Z.L.); (Y.Z.); (Y.T.); (X.Z.); (W.L.); (Y.C.); (Y.Q.); (R.L.); (L.Y.); (R.Z.)
| | - Yuwei Tan
- School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100083, China; (Z.L.); (Y.Z.); (Y.T.); (X.Z.); (W.L.); (Y.C.); (Y.Q.); (R.L.); (L.Y.); (R.Z.)
| | - Xiaoyu Zhu
- School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100083, China; (Z.L.); (Y.Z.); (Y.T.); (X.Z.); (W.L.); (Y.C.); (Y.Q.); (R.L.); (L.Y.); (R.Z.)
| | - Wei Liu
- School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100083, China; (Z.L.); (Y.Z.); (Y.T.); (X.Z.); (W.L.); (Y.C.); (Y.Q.); (R.L.); (L.Y.); (R.Z.)
| | - Yuhan Chen
- School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100083, China; (Z.L.); (Y.Z.); (Y.T.); (X.Z.); (W.L.); (Y.C.); (Y.Q.); (R.L.); (L.Y.); (R.Z.)
| | - Yong Qin
- School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100083, China; (Z.L.); (Y.Z.); (Y.T.); (X.Z.); (W.L.); (Y.C.); (Y.Q.); (R.L.); (L.Y.); (R.Z.)
| | - Ruijun Li
- School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100083, China; (Z.L.); (Y.Z.); (Y.T.); (X.Z.); (W.L.); (Y.C.); (Y.Q.); (R.L.); (L.Y.); (R.Z.)
| | - Lanlan Yu
- School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100083, China; (Z.L.); (Y.Z.); (Y.T.); (X.Z.); (W.L.); (Y.C.); (Y.Q.); (R.L.); (L.Y.); (R.Z.)
| | - Runlong Zhao
- School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100083, China; (Z.L.); (Y.Z.); (Y.T.); (X.Z.); (W.L.); (Y.C.); (Y.Q.); (R.L.); (L.Y.); (R.Z.)
| | - Yajun Xu
- School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100083, China; (Z.L.); (Y.Z.); (Y.T.); (X.Z.); (W.L.); (Y.C.); (Y.Q.); (R.L.); (L.Y.); (R.Z.)
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, No. 38 Xueyuan Road, Beijing 100083, China
- PKUHSC—China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, No. 38 Xueyuan Road, Beijing 100083, China
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Carroll AM, Rotman Y. Nutrition Literacy Is Not Sufficient to Induce Needed Dietary Changes in Nonalcoholic Fatty Liver Disease. Am J Gastroenterol 2023; 118:1381-1387. [PMID: 36719072 PMCID: PMC10338638 DOI: 10.14309/ajg.0000000000002182] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 01/06/2023] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Dietary and lifestyle changes are the first line of therapy for nonalcoholic fatty liver disease (NAFLD), the most prevalent liver disease in the western world. Nutrition literacy is the ability to understand nutrition information and implement that knowledge. We aimed to compare indicators of nutrition literacy in subjects with and without NAFLD in a representative US cohort. METHODS In a cross-sectional study using data from the National Health and Nutrition Examination Survey 2017-2018 cycle, we included 2,938 adult subjects with complete dietary and vibration-controlled transient elastography data and no alternative reason for hepatic steatosis. Nutrition literacy was assessed using questionnaires. Diet perception accuracy was assessed by comparing self-reported diet quality with objective diet quality scores-the Healthy Eating Index and alternative Mediterranean diet score-to assess real-world application of nutrition knowledge. RESULTS Nutrition literacy was not different between subjects with or without NAFLD ( P = 0.17): more than 90% of subjects reported using nutrition labels, and most of them correctly identified the meaning of daily value. Subjects with NAFLD had a lower-quality diet (Healthy Eating Index, P = 0.018; alternative Mediterranean diet, P = 0.013) and rated their diet as poorer ( P < 0.001). On self-assessment, only 27.8% of subjects overestimated their diet quality, while 37.5% consumed more calories than their self-assessed needs. Both accuracy measures were similar between subjects with NAFLD and those without ( P = 0.71 and 0.63, respectively). Subjects with NAFLD were more likely to report being advised to lose weight (42.1% vs 16.5%, P < 0.001) or to attempt losing weight (71.9% vs 60.9%, P < 0.001). Diet quality was not better in subjects with NAFLD who received dietary recommendations. DISCUSSION Subjects with NAFLD have poor diet quality despite receiving medical recommendations to lose weight and having nutrition literacy and perception that are comparable with subjects without NAFLD. Educational approaches may not be sufficient to promote weight loss and improve diet quality in NAFLD.
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Affiliation(s)
- Allison M Carroll
- Liver & Energy Metabolism Section, Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Yaron Rotman
- Liver & Energy Metabolism Section, Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
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Mourouti N, Michou M, Lionis C, Kalagia P, Ioannidis AG, Kaloidas M, Costarelli V. An educational intervention to improve health and nutrition literacy in hypertensive patients in Greece. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:234. [PMID: 37727406 PMCID: PMC10506746 DOI: 10.4103/jehp.jehp_14_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 05/19/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Suboptimal control of blood pressure (BP) is a public health challenge in Greece. This educational intervention attempts to improve health literacy (HL) and nutrition literacy (NL) in primary healthcare (PHC) patients with hypertension (HTN). MATERIALS AND METHODS This was a proof-of-concept (PoC) educational intervention. Twenty-four patients with HTN and low or medium levels of HL agreed to participate in this 6-week educational intervention. The program was delivered by a general practitioner (GP) in group A and by a qualified nurse in group B. Group C was the control group. The levels of HL of NL, adherence to the Mediterranean diet, and perceived stress were assessed using the European Health Literacy Survey Questionnaire 16 (HLS_EU_Q16) and part B (reading a medication label) of the High Blood Pressure-Health Literacy Scale (HBP-HLS), the Nutrition Literacy Scale-Greek (NLS-Gr), the Mediterranean Diet Adherence Screener (MEDAS), and the Perceived Stress Scale (PSS-14), respectively, together with certain socioeconomic, dietary, and lifestyle characteristics. The Kruskal-Wallis and Wilcoxon nonparametric, the Chi-square, and the McNemar-Bowker tests were used. The analysis was done with the STATA software, version 14 (MP & Associates, Sparta, Greece). RESULTS No statistically significant differences were found in the total score of HL and NL before and after the intervention; however, the results indicate a slight improvement in HL and NL levels in the two intervention groups, together with small improvements in knowledge and behaviors related to HTN and dietary salt. A trend of improvement in the MEDAS levels in the GP's group and the HBP-HLS levels in the nurse's group was also reported. CONCLUSION A slight improvement in HL and NL levels in the two intervention groups has been reported, and the changes, however, were not statistically significant.
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Affiliation(s)
- Niki Mourouti
- Human Ecology Laboratory, Department of Economics and Sustainable Development, Harokopio University, Athens, Greece
| | - Maria Michou
- Human Ecology Laboratory, Department of Economics and Sustainable Development, Harokopio University, Athens, Greece
| | - Christos Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion 71003, Crete, Greece
| | | | | | | | - Vassiliki Costarelli
- Human Ecology Laboratory, Department of Economics and Sustainable Development, Harokopio University, Athens, Greece
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Silva P. Food and Nutrition Literacy: Exploring the Divide between Research and Practice. Foods 2023; 12:2751. [PMID: 37509843 PMCID: PMC10378922 DOI: 10.3390/foods12142751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/13/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
This study addresses the growing recognition of the importance of food and nutrition literacy, while highlighting the limited research in this field, particularly the gap between research and practice. A bibliometric analysis of publications on food and nutrition literacy research from the Scopus database was carried out. Endnote 20, VOSviewer, and Harzing's Publish or Perish were used to analyze the results. The growth of publications, authorship patterns, collaboration, prolific authors, country contributions, preferred journals, and top-cited articles were the bibliometric indicators used. Subsequently, articles aimed at measuring food or nutrition literacy-implemented programs were analyzed. Existing studies have primarily concentrated on defining and measuring food or nutrition literacy. Although interventions targeting food and nutritional literacy have shown promise in promoting healthy eating, further research is required to identify effective approaches in diverse populations and settings. This study emphasizes the need for additional research to measure intervention program efficacy to enhance the policies and practices in this critical area of public health. These findings underscore the importance of understanding food/nutrition literacy and developing effective interventions to promote healthy eating habits. By bridging the research-practice divide, this study provides valuable insights for policymakers, practitioners, and researchers to address the gaps and improve food/nutrition literacy in various contexts.
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Affiliation(s)
- Paula Silva
- Laboratory of Histology and Embryology, Department of Microscopy, School of Medicine and Biomedical Sciences (ICBAS), University of Porto (U.Porto), Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal
- iNOVA Media Lab, ICNOVA-NOVA Institute of Communication, NOVA School of Social Sciences and Humanities, Universidade NOVA de Lisboa, 1069-061 Lisbon, Portugal
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12
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Forray AI, Coman MA, Cherecheș RM, Borzan CM. Exploring the Impact of Sociodemographic Characteristics and Health Literacy on Adherence to Dietary Recommendations and Food Literacy. Nutrients 2023; 15:2853. [PMID: 37447180 DOI: 10.3390/nu15132853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/13/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
This study investigates food literacy-related abilities and adherence to dietary recommendations in relation to sociodemographic characteristics and health-related features (health literacy, self-rated health and morbidity) in the North-Western region of Romania. This is a secondary analysis of cross-sectional data collected in 2019 from a representative and randomised sample of 1572 individuals. A questionnaire was employed to record participants' sociodemographic characteristics, food-related and health-related features. Most participants were non-adherent to dietary recommendations for fruit and vegetables (83.5%), fish and seafood (61.3%), and water intake (67.9%). However, most participants reported an adequate ability to understand the connection between nutrition and health (89.1%), to distinguish between healthy and less healthy options (84.4%), and to acquire nutrition information (75.6%). Non-adherence to dietary recommendations and low food literacy abilities were more prevalent in disadvantaged groups (older age, rural settings, retirement or social welfare, low educational attainment, formerly married). Health literacy was negatively associated with not adhering to dietary recommendations and poor self-rated food literacy abilities. The study suggests that low socioeconomic status negatively impacts food literacy and adherence to dietary recommendations among Romanian adults. Identifying target populations to improve food-related abilities and health literacy can aid public health services in improving health outcomes.
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Affiliation(s)
- Alina Ioana Forray
- Discipline of Public Health and Management, Department of Community Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Mădălina Adina Coman
- Department of Public Health, Faculty of Political, Administrative and Communication Sciences, Babeș-Bolyai University, 400132 Cluj-Napoca, Romania
| | - Răzvan Mircea Cherecheș
- Department of Public Health, Faculty of Political, Administrative and Communication Sciences, Babeș-Bolyai University, 400132 Cluj-Napoca, Romania
| | - Cristina Maria Borzan
- Discipline of Public Health and Management, Department of Community Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
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13
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Chaves CDS, Camargo JT, Zandonadi RP, Nakano EY, Ginani VC. Nutrition Literacy Level in Bank Employees: The Case of a Large Brazilian Company. Nutrients 2023; 15:nu15102360. [PMID: 37242243 DOI: 10.3390/nu15102360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 05/11/2023] [Accepted: 05/13/2023] [Indexed: 05/28/2023] Open
Abstract
Nutrition Literacy (NL) positively impacts diet quality and has the potential to promote health and prevent nutrition-related chronic diseases. Brazil is one of the countries with the highest rates of nutrition-related chronic diseases. Nevertheless, in Brazil, few studies have explored the NL levels of its population. To provide remote access to the Nutrition Literacy Assessment Instrument for Brazilians (NLit-Br) and assess Brazilian bank employees, we conducted a study to estimate the validity of the NLit-Br online and to investigate whether bank employees have an adequate NL level. In the first step, we randomly assigned 21 employees from three financial institution branches to two groups to complete NLit-Br paper and online versions. After an interval period, both groups completed the NLit-Br with an opposite delivery method (paper vs. online). We compared the validity of the digital and paper versions of the NLit-Br by the Intraclass Correlation Coefficient (ICC), and the reliability by Kuder-Richardson formula 20. Second, we evaluated 1174 bank employees using the NLit-Br online version. We found an excellent absolute agreement (ICC ≥ 0.75) between the paper and online versions. The questionnaire had good internal consistency (KR-20 = 0.64). The sample was characterized as mostly male (61.0%), married/cohabitant (73.8%), and white (69.8%), with high household income (85.2%), and graduated or postgraduate (97.4%). The mean age of the population was 42.1 (SD = 7.6) years. Subjects predominantly had possibly inadequate NL (62.3%). The online NLit-Br total score was significantly associated with gender, age, and household income (p < 0.05). Women and individuals with higher incomes had a higher degree of NL. Subjects over 50 years old had a lower degree of NL. There was no significant association between the NLit-Br score and the participants' education. The NLit-Br online is a valid instrument to assess NL remotely. The population studied showed a high prevalence of inadequacy of the NL. Therefore, there is a need for targeted actions to improve the NL of bank employees.
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Affiliation(s)
| | - Juliana Teruel Camargo
- National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Dr/MSC 1825, Bethesda, MD 20892, USA
- School of Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas, KS 66160, USA
| | - Renata Puppin Zandonadi
- University of Brasília, Faculty of Health Sciences, Department of Nutrition, Campus Universitario Darcy Ribeiro, Brasilia 70910-900, Brazil
| | | | - Verônica Cortez Ginani
- University of Brasília, Faculty of Health Sciences, Department of Nutrition, Campus Universitario Darcy Ribeiro, Brasilia 70910-900, Brazil
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14
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Lu Y. Impacts of parental breakfast consumption literacy on children's home breakfast consumption. Nutr Health 2023:2601060231159943. [PMID: 36823982 DOI: 10.1177/02601060231159943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Aim: This study aimed to investigate the relationship between parental breakfast consumption literacy and their children's home breakfast consumption. Methods: This study, employing a cross-sectional design, conducted in September 2021, consisted of a total of 275 children aged 6-7 years and 275 parents. One-way analysis of variance and independent-sample t-test were applied to compare children's home breakfast consumption amongst sub-groups. The relationship between parental breakfast consumption literacy and children's home breakfast consumption was assessed utilising multiple linear regression models controlling for socio-demographic factors. All data were analysed by the software of R Commander. Results: Parents with inadequate breakfast consumption literacy had less children's home breakfast consumption (p = 0.006), such relationship (p = 0.002, 95% CI: 4.76-7.65) had significance controlling for socio-demographic factors. Living in urban areas (p = 0.006, 95% CI: 6.43-9.92), parental unemployment (p = 0.004, 95% CI: 5.47-9.43), and low parental educational level (p = 0.005, 95% CI: 2.34-4.76) were significantly associated with less children's home breakfast consumption. Conclusion: Adequate parental breakfast consumption literacy was associated with more children's home breakfast consumption. Parental-based health education interventions show promise in promoting home breakfast consumption in the family setting. Residential status, parental level of education, and parental employment were associated with children's home breakfast consumption. Future research should understand more about the experiences and contexts of children's home breakfast consumption within the family environments, with a focus on employing qualitative approaches.
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Affiliation(s)
- Yanming Lu
- 1974The University of Queensland, Herston, QLD, Australia
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15
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Papežová K, Kapounová Z, Zelenková V, Riad A. Nutritional Health Knowledge and Literacy among Pregnant Women in the Czech Republic: Analytical Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3931. [PMID: 36900942 PMCID: PMC10001919 DOI: 10.3390/ijerph20053931] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 02/18/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
Adequate nutrition and the nutritional status of pregnant women are critical for the health of both the mother and the developing foetus. Research has shown a significant impact of nutrition on the child's health and the future risk of developing chronic noncommunicable diseases (NCDs), such as obesity, diabetes, hypertension, and cardiovascular disease. There is currently no data on the level of nutritional knowledge of Czech pregnant women. This survey aimed to evaluate their level of nutritional knowledge and literacy. An analytical cross-sectional study was conducted in two healthcare facilities in Prague and Pilsen between April and June 2022. An anonymous self-administered paper-form questionnaire for assessing the level of nutritional knowledge (40 items) and the Likert scale for assessing nutrition literacy (5 items) were used. A total number of 401 women completed the questionnaire. An individual's nutritional knowledge score was calculated and compared with demographic and anamnestic characteristics using statistical methods. The results showed that only 5% of women achieved an overall nutritional score of 80% or more. University education (p < 0.001), living in the capital city (p < 0.001), experiencing first pregnancy (p = 0.041), having normal weight and being overweight (p = 0.024), and having NCDs (p = 0.044) were statistically significantly associated with a higher nutritional knowledge score. The lowest knowledge scores were found in the areas of optimal energy intake, optimal weight gain, and the role of micronutrients in diet during pregnancy. In conclusion, the study shows limited nutrition knowledge of Czech pregnant women in some areas of nutrition. Increasing nutritional knowledge and nutrition literacy in Czech pregnant women is crucial for supporting their optimal course of pregnancy and the future health of their offspring.
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Affiliation(s)
- Klára Papežová
- Department of Public Health, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
- Department of Social Medicine, Department of Social and Assesment Medicine, Charles University, 323 00 Pilsen, Czech Republic
| | - Zlata Kapounová
- Department of Public Health, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Veronika Zelenková
- Department of Public Health, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Abanoub Riad
- Department of Public Health, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
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16
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Vrinten J, Van Royen K, Pabian S, De Backer C, Matthys C. Development and validation of a short nutrition literacy scale for young adults. Front Nutr 2023; 10:1008971. [PMID: 37020809 PMCID: PMC10067712 DOI: 10.3389/fnut.2023.1008971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 02/23/2023] [Indexed: 04/07/2023] Open
Abstract
Background Due to their high media use, young adults are frequently exposed to contradictory or even erroneous nutrition information. To properly handle and critically assess nutrition information, young adults (both general population and patient populations) need adequate levels of nutrition literacy. Currently there is a lack of suitable instruments to measure nutrition literacy in young adults (18-25 years). Therefore the aim of this study was to develop and validate a Short Nutrition Literacy (S-NutLit) scale for use in this age group. Methods Development and validation of the S-NutLit consisted of six phases: (1) item generation based on literature, (2) expert assessments to evaluate content validity, (3) cognitive interviews with the target population to assess face validity and readability, (4) pre-test to reduce the number of items, (5) validation survey to assess dimensionality with exploratory factor analyses, internal reliability with Cronbach alpha, construct and criterion validity by examining associations with age, gender, education level, health literacy, general literacy, dietary behaviors and physical activity with correlations, ANOVAs, and t-tests, (6) two-week follow-up survey to assess test-retest reliability with intra-class correlations. Results Starting from an initial pool of 53 items, expert assessments and cognitive interviews led to the reformulation, removal, and construction of items. Young adults aged 18-25 years participated in cognitive interviews (n = 12), pre-test (n = 101), validation survey (n = 300), and reliability survey (n = 92). The final S-NutLit consisted of 11 items rated on a 5-point scale distributed across two subscales (i.e., information skills and expert skills). Cronbach alpha values ranged from 0.79 to 0.83 and intraclass correlations from 0.61-0.79 (p < 0.001). Significant associations were observed with health literacy (r = 0.27, p < 0.001), general literacy and numeracy (rs = 0.12, p = 0.046), and education level (rs = 0.13, p = 0.025). Conclusion Findings indicate that the S-NutLit is a valid and reliable tool to assess nutrition literacy among young adults. The S-NutLit fills a gap in the field by offering a short measure of nutrition literacy and may be incorporated in digital technology to support the nutrition care process.
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Affiliation(s)
- Jules Vrinten
- Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
- Department of Communication Sciences, University of Antwerp, Antwerp, Belgium
| | - Kathleen Van Royen
- Karel de Grote University College, Research Centre The Cycle of Care, Antwerp, Belgium
| | - Sara Pabian
- Department of Communication Sciences, University of Antwerp, Antwerp, Belgium
- Tilburg Centre for Cognition and Communication, Tilburg University, Tilburg, Netherlands
| | - Charlotte De Backer
- Department of Communication Sciences, University of Antwerp, Antwerp, Belgium
| | - Christophe Matthys
- Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
- Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
- *Correspondence: Christophe Matthys,
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Gao T, Duan Y, Qi Q, Mo G, Han S, Liu H, Zhang M. Nutrition literacy differs based on demographics among University students in Bengbu, China. Front Public Health 2023; 11:1113211. [PMID: 36935682 PMCID: PMC10020653 DOI: 10.3389/fpubh.2023.1113211] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 02/16/2023] [Indexed: 03/06/2023] Open
Abstract
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.
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Affiliation(s)
- Tianjing Gao
- School of Public Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Ying Duan
- School of Public Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Qi Qi
- School of Public Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Guangju Mo
- School of Public Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Siyue Han
- School of Public Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Huaqing Liu
- School of Public Health, Bengbu Medical College, Bengbu, Anhui, China
- *Correspondence: Huaqing Liu
| | - Min Zhang
- School of Health Management, Bengbu Medical College, Bengbu, Anhui, China
- Min Zhang
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18
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The Nutrition Literacy Assessment Instrument for Brazilians, NLit-Br: An Exploratory Cross-Cultural Validity Study. Nutrients 2022; 14:nu14224914. [PMID: 36432600 PMCID: PMC9693279 DOI: 10.3390/nu14224914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/10/2022] [Accepted: 11/15/2022] [Indexed: 11/22/2022] Open
Abstract
This study aimed to test the validity of the cross-cultural adapted Nutrition Literacy Assessment Instrument for Brazilians (NLit-Br). An observational cross-sectional study was performed in chronic disease clinics from the Brazilian Public Health System in two phases: (1) linguistic and cultural adaptation and (2) validity testing. Six registered dietitians and thirty adult patients diagnosed with at least one chronic disease participated in the study using the nutrition literacy assessment instrument (NLit-Br) and the short assessment of health literacy for Portuguese-speaking adults (SAHLPA-18). Sample descriptive variables: age, sex, race, income, education, and occupation. To adapt the instrument to the Brazilian Portuguese and Brazilian culture, we tested cognitive interviewing and the Scale Content Validity Index (S-CVI) with a group of dietitians and patients. To test the tool’s validity, health literacy (SAHLPA-18) was used as a construct that presents similarities and differences with nutrition literacy (NLit-Br). The correlation of NLit-Br and the SAHLPA-18 was tested (Spearman’s Rho). Internal consistency was measured by Kuder−Richardson Formula 20 (KR-20). The NLit-Br content validity (S-CVI = 0.85) and internal consistency (KR-20 = 0.868) were confirmed. Additionally, NLit-Br presented a significant and robust correlation with SAHLPA-18 (r = 0.665, p < 0.001). Therefore, the NLit-Br was considered a linguistic, cultural, and valid instrument to measure Brazilian’s nutrition literacy.
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19
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Itzkovitz A, Maggio V, Roy-Fleming A, Legault L, Brazeau AS. Nutrition and food literacy among young Canadian adults living with type 1 diabetes. Diabet Med 2022; 39:e14921. [PMID: 35870142 DOI: 10.1111/dme.14921] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 06/23/2022] [Accepted: 07/21/2022] [Indexed: 11/29/2022]
Abstract
AIM Nutrition and food literacy encompasses knowledge, skills and confidence to prepare healthy meals. This project aimed to assess and compare the proportion of young Canadian adults (18-29 years old) living with type 1 diabetes and without diabetes (controls) who demonstrated adequate nutritional health literacy. METHODS This cross-sectional study involved participants completing an online survey that included questions on socio-economic status, nutrition knowledge, confidence and skills in meal preparation and the Short Food Literacy Questionnaire (SFLQ). Proportion of participants with adequate SFLQ score (i.e. ≥34/52) was compared between the groups (two-sample t-test). RESULTS Among the 236 people living with type 1 diabetes and 191 controls (81.5% women), mean age was 24 ± 3 years for people living with type 1 diabetes and 22 ± 3 years for controls (p < 0.001). More people living with type 1 diabetes reported adequate SFLQ score (people living with type 1 diabetes 88.0% vs. Controls 68.0%; p < 0.001). Similarly, majority of people living with type 1 diabetes prepared their own meals compared to the controls (74.5% vs. 47.6%; p < 0.001). Enhanced SFLQ score was associated with higher cooking skills (p = 0.02) and confidence (p < 0.01) in preparing healthy meals. CONCLUSIONS Living with type 1 diabetes was associated with greater SFLQ scores among young Canadian adults. Having the independence, the confidence and skills in meal preparation were contributing factors.
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Affiliation(s)
| | - Vanessa Maggio
- School of Human Nutrition, McGill University, Montreal, Quebec, Canada
| | | | - Laurent Legault
- Department of Pediatrics, McGill University, Montreal, Quebec, Canada
| | - Anne-Sophie Brazeau
- School of Human Nutrition, McGill University, Montreal, Quebec, Canada
- Montreal Diabetes Research Center, Montreal, Quebec, Canada
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20
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Camargo JT, Ramirez M, Gajewski BJ, Sullivan DK, Carlson SE, Gibbs HD. Nutrition Literacy Among Latina/x People During Pregnancy Is Associated With Socioeconomic Position. J Acad Nutr Diet 2022; 122:2097-2105. [PMID: 35589070 DOI: 10.1016/j.jand.2022.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 05/04/2022] [Accepted: 05/11/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND During pregnancy, Latina/x people experience nutrition and nutrition-related health inequities. Nutrition literacy is a potential factor impacted by these inequities. However, the nutrition literacy level of Latina/x people during pregnancy is not well investigated. OBJECTIVES The study aimed to assess the nutrition literacy level of Latina/x people during pregnancy and explore the association of nutrition literacy with socioeconomic position. DESIGN This was a cross-sectional study of data collected from 2016 to 2018 within the double-blinded, randomized clinical trial Assessment of Docosahexaenoic Acid on Reducing Early Preterm Birth. PARTICIPANTS/SETTING A total of 112 Latina/x people during pregnancy from the Kansas City metro area were included in this study. MAIN OUTCOME MEASURES Nutrition literacy level assessed between 12 and 20 gestational weeks using the Nutrition Literacy Assessment Instrument, both in English and Spanish. STATISTICAL ANALYSES PERFORMED Descriptive measures were used to describe the nutrition literacy level during pregnancy. Multiple logistic regression models were used to examine the association between low nutrition literacy and socioeconomic position, adjusting for age and race. RESULTS In this study, most participants demonstrated low nutrition literacy during pregnancy. Those with low nutrition literacy were 2 times more likely to have low annual household income (odds ratio [OR] = 2.74, 95% confidence interval [CI]: 0.99-7.59), 3 times more likely to prefer Spanish as their primary language of communication (OR = 3.03, 95% CI: 0.95-9.67), and 7 times more likely to be uninsured (OR = 7.47; 95% CI: 1.57-35.64). CONCLUSIONS Nutrition literacy scores during pregnancy were associated with variables of socioeconomic position. Future research should focus on nutrition literacy associations with health outcomes during pregnancy and interventions to improve the nutrition literacy level of primarily Spanish-speaking people who have low household incomes and are uninsured.
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Affiliation(s)
- Juliana T Camargo
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas; Department of Urology, University of Kansas Medical Center, Kansas City, Kansas
| | - Mariana Ramirez
- JUNTOS Center for Advancing Latino Health, Department of Population Health, University of Kansas Medical Center, Kansas City, Kansas
| | - Byron J Gajewski
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, Kansas
| | - Debra K Sullivan
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas
| | - Susan E Carlson
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas
| | - Heather D Gibbs
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas.
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21
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Teruel Camargo J, Taylor MK, Gajewski BJ, Carlson SE, Sullivan DK, Gibbs HD. Higher Diet Quality in Latina Women during Pregnancy May Be Associated with Sociodemographic Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192113895. [PMID: 36360774 PMCID: PMC9657950 DOI: 10.3390/ijerph192113895] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 06/12/2023]
Abstract
Acculturation contributes to low diet quality and can foster health inequities for Latina women during pregnancy. Conversely, nutrition literacy (NL) increases diet quality and could promote health equity. This study assessed the associations between the diet quality, acculturation, and NL of Latina women (n = 99) participating in the Assessment of Docosahexaenoic Acid On Reducing Early Preterm Birth (ADORE) study. Acculturation and nutrition literacy factored together tended to modify diet quality, but this was not statistically significant. Diet quality was associated with acculturation, age, and nativity. Most (76.8%) demonstrated low nutrition literacy. Women who were bicultural and were born in Latin American countries other than Mexico had lower diet quality scores than women who had lower acculturation and were born in Mexico. Women who were 35 years or older had better diet quality than those who were younger. Future studies are needed to explore diet quality differences for pregnant Latina women with high nutrition literacy and high acculturation, as well as for women from the Caribbean, Central and South American countries living in the US, to promote nutrition and maternal health for Latina women.
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Affiliation(s)
- Juliana Teruel Camargo
- Department of Dietetics & Nutrition, School of Health Professions, University of Kansas Medical Center, Kansas City, KS 66160, USA
- Department of Urology, School of Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Matthew K. Taylor
- Department of Dietetics & Nutrition, School of Health Professions, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Byron J. Gajewski
- Department of Biostatistics & Data Science, School of Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Susan E. Carlson
- Department of Dietetics & Nutrition, School of Health Professions, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Debra K. Sullivan
- Department of Dietetics & Nutrition, School of Health Professions, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Heather D. Gibbs
- Department of Dietetics & Nutrition, School of Health Professions, University of Kansas Medical Center, Kansas City, KS 66160, USA
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22
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Zwierczyk U, Sowada C, Duplaga M. Eating Choices—The Roles of Motivation and Health Literacy: A Cross-Sectional Study. Nutrients 2022; 14:nu14194026. [PMID: 36235678 PMCID: PMC9573739 DOI: 10.3390/nu14194026] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/17/2022] [Accepted: 09/24/2022] [Indexed: 11/29/2022] Open
Abstract
Food choices are determined by intrinsic and extrinsic product characteristics, biological and physiological features, psychological factors, and situational and socio-cultural factors. Self-determination theory offers the explanation of health behavior change identifying motivations located along a continuum of autonomy. Another approach to the motivations guiding health behaviors, including food choices, relies on distinguishing thematic categories. Health motivations seem to be an obvious determinant of health behaviors, but final decisions regarding health are also the effect of other types of motivations such as economic, cultural, or emotional. The role of marketing pressure in modern society is perceived to be an important source of motivation for purchasing food and other products. The Motivation–Opportunity–Ability (MOA) framework was initially proposed in order to explain the processing of brand information from advertisements and was later expanded to other areas, including health and nutritional behaviors. The aim of this study was the analysis of determinants of food choices. We have developed a common regression model including six categories of motivations addressed by the Eating Motivations Scale and three health literacy types corresponding with element of ability from the MOA framework, adjusted for socio-demographic factors, health status, and the use of the Internet and TV. The analysis was performed on data from a computer-assisted web-based interviewing (CAWI) survey among 2008 adult Internet users completed in May 2022. The uni- and multivariate linear regression models were developed with the Index of Unhealthy Food Choices (IUFC), calculated based on the responses to items asking about the frequency of the consumption of twelve food categories. Univariate modeling revealed that IUFC is significantly associated with health, food, and e-health literacies and with five out of six eating motivations. However, the multivariate regression model yielded significant associations only for eating motivations but not for the three literacy scores. Health motivation was negatively associated with IUFC (B, standard error (SE): 0.83, 0.07; 95% confidence interval (95% CI): 0.98–0.69), but positively with emotional (B, SE: 0.22, 0.04; 95% CI: 0.14–0.3), economic (B, SE: 0.41, 0.08; 95% CI: 0.25–0.56), and marketing (B, SE: 0.62, 0.08; 95% CI: 0.47–0.78) motivations. Our findings suggest that motivations guiding food choices may prevail over the element of ‘ability’ distinguished in the frameworks and models that explain people’s behaviors, including behaviors relating to health. Thus, it is essential to emphasize development of appropriate motivations and not only to provide knowledge and skills. Furthermore, one should also remember motivations other than health motivations when searching for the determinants of health behaviors.
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Affiliation(s)
- Urszula Zwierczyk
- Department of Health Promotion and e-Health, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Skawińska Str. 8, 31-066 Krakow, Poland
| | - Christoph Sowada
- Department of Health Economics and Social Security, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Skawińska Str. 8, 31-066 Krakow, Poland
| | - Mariusz Duplaga
- Department of Health Promotion and e-Health, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Skawińska Str. 8, 31-066 Krakow, Poland
- Correspondence:
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Mo G, Han S, Gao T, Sun Q, Zhang M, Liu H. Development and validation of a novel short-form nutrition literacy measurement tool for Chinese college students. Front Public Health 2022; 10:962371. [PMID: 36159278 PMCID: PMC9500412 DOI: 10.3389/fpubh.2022.962371] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 08/22/2022] [Indexed: 01/24/2023] Open
Abstract
Objectives To develop and validate a short-form nutrition literacy (NL) assessment tool for Chinese college students based on a 43-item NL measurement scale. Methods To develop and validate short-form NL scale, 1359 college students were surveyed, the data were analyzed using exploratory factor analysis, linear regression analysis, Item analysis, confirmatory factor analysis, and Pearson correlation. Results The 12-item short-form NL scale (NL-SF12) was developed using factor analysis and regression analysis, which accounted for 96.4% of the variance. The correlation coefficient between the NL-SF12 and NL-43 was 0.969, indicating satisfactory criterion-related validity. The NL-SF12 had a Cronbach's α of 0.890, suggesting strong internal consistency reliability, and content validity index was greater than 0.9, indicating that each domain accurately reflects the connotation of nutrition literacy. The model-data fit and convergent validity of the confirmatory factor analysis results were both good. Conclusion The NL-SF12 is an effective measurement tool with a good reliability and acceptable validity to assess comprehensively NL for college students, and is applicable to quick, widespread use in population study and practice with low respondent burden.
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Affiliation(s)
- Guangju Mo
- School of Public Health, Bengbu Medical College, Bengbu, China,The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Siyue Han
- School of Public Health, Bengbu Medical College, Bengbu, China
| | - Tianjing Gao
- School of Public Health, Bengbu Medical College, Bengbu, China
| | - Qing Sun
- School of Public Health, Bengbu Medical College, Bengbu, China
| | - Min Zhang
- School of Health Management, Bengbu Medical College, Bengbu, China,*Correspondence: Min Zhang
| | - Huaqing Liu
- School of Public Health, Bengbu Medical College, Bengbu, China,Huaqing Liu
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Zwierczyk U, Kobryn M, Duplaga M. Validation of the Short Food Literacy Questionnaire in the Representative Sample of Polish Internet Users. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159710. [PMID: 35955064 PMCID: PMC9367856 DOI: 10.3390/ijerph19159710] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/02/2022] [Accepted: 08/04/2022] [Indexed: 06/12/2023]
Abstract
Analogous to health literacy, food literacy can be defined as a set of cognitive and social skills associated with the ability to acquire and understand information about food and nutrition to make appropriate nutritional decisions. In the literature, several terms such as food, nutrition, or nutritional literacy are used in parallel, differing in some aspects of their meaning. Food literacy is an important measure of the effectiveness of nutritional education interventions and appropriate instruments for its measurement should be available in every society. The aim of this study was the assessment of the validity and testing of a proposed model of the Short Food Literacy Questionnaire (SFLQ) culturally adapted into Polish. The analysis was performed on data from an online survey in a representative sample of 1286 adult internet users. Exploratory (EFA) and confirmatory factor (CFA) analyses were performed on two different subsets obtained through random splitting of the initial dataset. The Polish version of the SFLQ had good internal consistency (Cronbach's α 0.841; Guttman split-half coefficient was 0.812). The EFA revealed that the tool had a three-factor latent structure. The distinguished dimensions were 'information accessing', 'knowledge', and 'information appraisal'. The subscales also showed acceptable internal consistency based on the values of the Cronbach's α coefficients (ranging from 0.768 to 0.845). The CFA confirmed a good fit of the three-factor model with at least five indexes achieving acceptable levels (CFI = 0.972, GFI = 0.963, AGFI = 0.940, NFI = 0.959, and RMSEA = 0.059). The validation of the Polish version of the SFLQ revealed, contrary to earlier reports, not a single but a three-factor structure of the instrument. The SFLQ will be an important tool for the assessment of the effectiveness of educational interventions and population studies analyzing the determinants of food literacy in Poland.
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McWhorter JW, LaRue DM, Almohamad M, Danho MP, Misra S, Tseng KC, Weston SR, Moore LS, Durand C, Hoelscher DM, Sharma SV. Training of Registered Dietitian Nutritionists to Improve Culinary Skills and Food Literacy. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:784-793. [PMID: 35644786 DOI: 10.1016/j.jneb.2022.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 03/28/2022] [Accepted: 04/03/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To understand if a culinary medicine training program increases food literacy, culinary skills, and knowledge among practicing registered dietitian nutritionists (RDN). METHODS Prepost study design evaluating pilot test of RDN train-the-trainer curriculum from September, 2019 to January, 2020. RESULTS On average, results indicate an increase in culinary nutrition skills (mean difference, 6.7 ± 4.4; P < 0.001; range, 10-30) and a significant increase in 5 of the 8 food literacy factors. Through process evaluation, RDNs rated the training as extremely useful to their practice (mean, 4.4 ± 0.3). CONCLUSIONS AND IMPLICATIONS Registered dietitian nutritionist participants increased culinary nutrition skills with statistically significant scores across all individual measures. This study describes an RDN training curriculum in culinary medicine across a diverse group of practicing RDNs from a large county health care system. Culinary medicine shows a promising impact on promoting nutrition skills and confidence; however, it warrants further assessment.
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Affiliation(s)
- John Wesley McWhorter
- Department of Health Promotion and Behavioral Sciences, and Nourish Program, UTHealth School of Public Health, Houston, TX.
| | - Denise M LaRue
- Population Health Transformation, Harris Health System, Houston, TX
| | - Maha Almohamad
- Department of Epidemiology, Human Genetics, and Environmental Sciences, UTHealth School of Public Health, Houston, TX
| | - Melisa P Danho
- Department of Epidemiology, Human Genetics, and Environmental Sciences, UTHealth School of Public Health, Houston, TX
| | - Shweta Misra
- Population Health Transformation, Harris Health System, Houston, TX
| | - Karen C Tseng
- Department of Epidemiology, Human Genetics, and Environmental Sciences, UTHealth School of Public Health, Houston, TX
| | | | - Laura S Moore
- Department of Health Promotion and Behavioral Sciences, and Nourish Program, UTHealth School of Public Health, Houston, TX
| | - Casey Durand
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Houston, TX
| | - Deanna M Hoelscher
- Michael and Susan Dell Center for Healthy Living, UTHealth School of Public Health, Austin, TX
| | - Shreela V Sharma
- Department of Epidemiology, Human Genetics, and Environmental Sciences, UTHealth School of Public Health, Houston, TX
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Zanella CP, Sampaio HADC, Lima JWOD, Moreira TMM. Cultural adaptation and content validity evidence of the Nutritional Literacy Scale Brazilian version. Rev Bras Enferm 2022; 75:e20210657. [PMID: 35858028 DOI: 10.1590/0034-7167-2021-0657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 03/21/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To investigate the evidence of content validity and reliability of the Brazilian version of the Nutritional Literacy Scale (NLS) after the cultural adaptation process. METHODS Psychometric study of 1,197 users of the National Health Service (Brazilian SUS). The NLS was culturally adapted to Brazilian Portuguese and six items of the original scale were modified to improve its understanding, giving rise to the Brazilian version of the scale named NLS-BR. The analysis of evidence of content validity of the NLS-BR was performed using the Item Response Theory (IRT). RESULTS The final version of the NLS-BR had 23 items and proved to be adequate to assess nutritional literacy in adults assisted by the Brazilian SUS. FINAL CONSIDERATIONS The NLS-BR proved to be of adequate understanding and demonstrated evidence of content validity and reliability for users of the Brazilian SUS.
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Zhou Y, Lyu Y, Zhao R, Shi H, Ye W, Wen Z, Li R, Xu Y. Development and Validation of Nutrition Literacy Assessment Instrument for Chinese Pregnant Women. Nutrients 2022; 14:nu14142863. [PMID: 35889821 PMCID: PMC9320244 DOI: 10.3390/nu14142863] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 06/28/2022] [Accepted: 07/11/2022] [Indexed: 01/27/2023] Open
Abstract
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.
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Affiliation(s)
- Yalin Zhou
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, NO. 38 Xueyuan Road, Beijing 100083, China; (Y.Z.); (Y.L.); (R.Z.); (H.S.); (W.Y.); (Z.W.); (R.L.)
- PKUHSC-China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, NO. 38 Xueyuan Road, Beijing 100083, China
| | - Ying Lyu
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, NO. 38 Xueyuan Road, Beijing 100083, China; (Y.Z.); (Y.L.); (R.Z.); (H.S.); (W.Y.); (Z.W.); (R.L.)
| | - Runlong Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, NO. 38 Xueyuan Road, Beijing 100083, China; (Y.Z.); (Y.L.); (R.Z.); (H.S.); (W.Y.); (Z.W.); (R.L.)
| | - Hanxu Shi
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, NO. 38 Xueyuan Road, Beijing 100083, China; (Y.Z.); (Y.L.); (R.Z.); (H.S.); (W.Y.); (Z.W.); (R.L.)
| | - Wanyun Ye
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, NO. 38 Xueyuan Road, Beijing 100083, China; (Y.Z.); (Y.L.); (R.Z.); (H.S.); (W.Y.); (Z.W.); (R.L.)
| | - Zhang Wen
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, NO. 38 Xueyuan Road, Beijing 100083, China; (Y.Z.); (Y.L.); (R.Z.); (H.S.); (W.Y.); (Z.W.); (R.L.)
| | - Rui Li
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, NO. 38 Xueyuan Road, Beijing 100083, China; (Y.Z.); (Y.L.); (R.Z.); (H.S.); (W.Y.); (Z.W.); (R.L.)
| | - Yajun Xu
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, NO. 38 Xueyuan Road, Beijing 100083, China; (Y.Z.); (Y.L.); (R.Z.); (H.S.); (W.Y.); (Z.W.); (R.L.)
- PKUHSC-China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, NO. 38 Xueyuan Road, Beijing 100083, China
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, NO. 38 Xueyuan Road, Beijing 100083, China
- Correspondence: ; Tel.: +86-010-82802552
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McNamara J, Kunicki ZJ, Neptune L, Parsons K, Byrd-Bredbenner C. Development and Validation of the Young Adult Nutrition Literacy Tool. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:691-701. [PMID: 35469757 DOI: 10.1016/j.jneb.2022.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 01/19/2022] [Accepted: 01/30/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To create a tool to measure college students' functional, interactive, and critical nutrition literacy. DESIGN (1) Focus group: item generation, (2) expert review, (3) exploratory factor structure analysis, (4) item refinement and modification, (5) factor structure validation, and (6) criterion validation. SETTING Two land-grant college campuses. PARTICIPANTS College students aged between 18 and 24 years. MAIN OUTCOME MEASURES Survey data was used to assess nutrition literacy. ANALYSIS Exploratory factor analysis, confirmatory factor analysis (CFA), item response theory (IRT) analyses, and correlations. RESULTS One-hundred and twenty-three items were generated and tested in an online survey format. Items were eliminated on the basis of face validity, expert feedback, exploratory factor analysis, and CFA/IRT. The 3 measures (functional, interactive, and critical) were analyzed separately. All 3 measures showed reasonable model fit in the CFA/IRT models. Criterion validity showed small to medium effect sizes between measures and fruit/vegetable intake. Reliability estimates met reasonable standards for each measure. CONCLUSIONS AND IMPLICATIONS The Young Adult Nutrition Literacy Tool is a novel instrument that measures all 3 domains of nutrition literacy. Strengths include a rigorous 6-step development process, reasonable psychometric properties, and a large breadth of items.
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Affiliation(s)
- Jade McNamara
- School of Food and Agriculture, University of Maine, Orono, ME.
| | - Zachary J Kunicki
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI
| | - Leigh Neptune
- School of Food and Agriculture, University of Maine, Orono, ME
| | - Kayla Parsons
- School of Food and Agriculture, University of Maine, Orono, ME
| | - Carol Byrd-Bredbenner
- Department of Nutritional Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ
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Giazitzi K, Chrysanthakopoulou V, Boskou G. A Hypothetical Tavern Menu for the Evaluation of Calorie Selection through Menu Labelling. Foods 2022; 11:foods11111624. [PMID: 35681374 PMCID: PMC9180666 DOI: 10.3390/foods11111624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 05/27/2022] [Accepted: 05/30/2022] [Indexed: 02/05/2023] Open
Abstract
The purpose of the present study is to evaluate calories selection according to the type of menu labelling applied on a hypothetical Greek tavern menu. Three questionnaires were designed and each one included a hypothetical menu of Greek tavern food. Menu A did not include any nutritional information, Menu B included calorie posting and Menu C had the “NB” mark next to dishes that were Nutritionally Balanced choices. A total of 437 participants were recruited in the study. The mean calories selection was significantly lower on Menu B (1874 Kcal) and C (1787.7 Kcal) compared to Menu A (2157.3 Kcal). The overweight and obese participants ordered significantly fewer calories on Menu B (−504 Kcal and −404 Kcal) and C (−451.3 Kcal and −393 Kcal) than on the Menu A. Menu labelling should be assessed in real-life settings in Greece. It could be a policy for the prevention and control of obesity in European countries.
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Wang T, Zeng M, Xie C, Zhu Y, Shi Z, Sharma M, Zhao Y. Development of Nutrition Literacy Scale for Middle School Students in Chongqing, China: A Cross-Sectional Study. Front Nutr 2022; 9:888137. [PMID: 35669068 PMCID: PMC9165640 DOI: 10.3389/fnut.2022.888137] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
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.
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Affiliation(s)
- Tiankun Wang
- College of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Mao Zeng
- College of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Changxiao Xie
- College of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Yuzhao Zhu
- College of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Zumin Shi
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Manoj Sharma
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV, United States
| | - Yong Zhao
- College of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Child Nutrition and Health, Children's Hospital of Chongqing Medical University, Chongqing, China
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Zhang Y, Zhang Z, Xu M, Aihemaitijiang S, Ye C, Zhu W, Ma G. Development and Validation of a Food and Nutrition Literacy Questionnaire for Chinese Adults. Nutrients 2022; 14:nu14091933. [PMID: 35565900 PMCID: PMC9104569 DOI: 10.3390/nu14091933] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/02/2022] [Accepted: 05/03/2022] [Indexed: 02/01/2023] Open
Abstract
The purpose of this study aimed to develop and validate the Food and Nutrition Literacy Questionnaire for Chinese adults (FNLQ). The dimensions and core components of Food and Nutrition Literacy were constructed though literature review and qualitative consensus study. A cross-sectional survey of 8510 participants was conducted. The reliability of the questionnaire was determined by internal consistency, the construct validity was assessed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and the content validity was assessed by the Pearson correlation coefficient. From the literature review and qualitative methods, 20 core components and 50 questions of the FNLQ were developed, including 1 dimension of knowledge and 3 practice dimensions (ability of selection, preparing food and eating). The overall FNLQ questionnaire had good reliability and validity (Cronbach’s α = 0.893, χ2/DF = 4.750, RMSEA = 0.048, GFI = 0.891 and AGFI = 0.876). The average FNLQ score of all participants was (64.08 ± 12.77), and the score for the knowledge and understanding dimension was higher than that for the practice dimensions. In addition, 80 was set as the nutritional literacy threshold, and only 12.2% met this threshold in this survey. Sociodemographic and health status characteristics were predictors of FNLQ (R2 = 0.287, F = 244.132, p < 0.01). In conclusion, the FNLQ built in this study had good validity and reliability. It could be considered as a reliable tool to assess Food and Nutrition Literacy of Chinese adults.
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Cyrkot S, Gidrewicz D, Anders S, Marcon M, Turner JM, Mager DR. Food Environment and Youth Intake May Influence Uptake of Gluten-Free Food Guide Recommendations in Celiac Disease. CAN J DIET PRACT RES 2022; 83:186-192. [PMID: 35503896 DOI: 10.3148/cjdpr-2022-011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
A gluten-free (GF) food guide for children and youth (4-18 years) living with celiac disease (CD) has been developed and extensively evaluated by stakeholders, including registered dietitians. A case study analysis was conducted on data from 16 households of youth with CD to examine how factors related to parental food literacy, the home food environment, and food purchasing patterns may influence food guide uptake by Canadian youth with CD and their families. Households were of higher socioeconomic status, parents had good food literacy, and the home food availability of fruits, vegetables and GF grains was diverse. However, households also had a diverse supply of convenience foods and snack options. Youth reported consuming a larger proportion of these foods (>35% dietary intake) and had suboptimal diet quality. Dietary intake of fruits and vegetables were below GF plate model recommendations by over 30%. Despite limited economical barriers, good parental food literacy, and diverse food availability, meeting fruit and vegetable recommendations based on the pediatric GF food guide remains a major challenge. Findings inform that effective strategies and healthy public policies to support the uptake of GF food guide recommendations are needed to improve the health outcomes of youth with CD.
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Affiliation(s)
- Samantha Cyrkot
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB
| | - Dominica Gidrewicz
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB.,Section of Pediatric Gastroenterology, Hepatology and Nutrition, South Health Campus, Calgary, AB
| | - Sven Anders
- Department of Resource Economics and Environmental Sociology, University of Alberta, Edmonton, AB
| | - Margaret Marcon
- Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, ON
| | - Justine M Turner
- Department of Pediatrics, University of Alberta, Edmonton, AB.,Division of Pediatric Gastroenterology and Nutrition, Stollery Children's Hospital, Edmonton, AB
| | - Diana R Mager
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB.,Department of Pediatrics, University of Alberta, Edmonton, AB
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Pedro-Botet L, Muns MD, Solà R, Fontané L, Climent E, Benaiges D, Flores-Le Roux JA, Pedro-Botet J. Level of understanding and consumption of ultra-processed food in a Mediterranean population: A cross-sectional study. Nutr Metab Cardiovasc Dis 2022; 32:889-896. [PMID: 35078675 DOI: 10.1016/j.numecd.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/16/2021] [Accepted: 11/04/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND AIMS Since the population may not be aware of ultra-processed food (UPF) consumption as a result of ignorance or non-recognition, this study aimed to ascertain the main characteristics of subjects regarding their knowledge of different easily acquired foods through a questionnaire in Google Forms format with 52 questions. Secondary objectives were to determine whether the profile of UPF consumers can be defined based on sex, age, sociodemographic factors, and lifestyle. METHODS AND RESULTS Responses were received from 1037 participants from a convenience sample; of these, 83 (8.0%) were sporadic or non-users, and 954 (92.0%) were frequent UPF consumers. The participants of the upper tertile correctly matched >12 food items, those of the medium tertile matched 12-9 items, and those of the lower tertile matched <9 items. Factors independently associated with participants who better identified UPF (upper tertile) compared to those of the lower tertile (reference) were female sex (OR: 2.54, 95%CI: 1.70-3.79; p < 0.001), age between 21 and 50 (OR: 3.63, 95% CI: 2.56-5.15; p < 0.001), living with family (OR: 0.64, 95% CI: 0.41-9.96; p = 0.033), and eating more fruit (≥3 pieces/day, OR: 2.30, 95% CI: 1.61-3.27; p < 0.001). CONCLUSIONS These findings highlight the high consumption and low degree of awareness of UPF among consumers based mainly on food composition.
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Affiliation(s)
| | - Maria D Muns
- Endocrinology Department. Hospital del Mar, Passeig Marítim, 25-29; 08003 Barcelona, Spain.
| | - Rosa Solà
- Facultat de Medicina i Ciències de la Salut, Department de Medicina i Cirurgia, Universitat Rovira i Virgili, Grup Nutrició Funcional, Oxidació i Malalties Cardiovasculars (NFOC-Salut), Institut d'Investigació Sanitaria Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, Reus, 43204, Spain.
| | - Laia Fontané
- Endocrinology Department. Hospital del Mar, Passeig Marítim, 25-29; 08003 Barcelona, Spain.
| | - Elisenda Climent
- Endocrinology Department. Hospital del Mar, Passeig Marítim, 25-29; 08003 Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona. Campus Universitari Mar. Dr. Aiguader, 80, 08003 Barcelona, Spain.
| | - David Benaiges
- Endocrinology Department. Hospital del Mar, Passeig Marítim, 25-29; 08003 Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona. Campus Universitari Mar. Dr. Aiguader, 80, 08003 Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM). Dr. Aiguader, 80, 08003 Barcelona, Spain.
| | - Juana A Flores-Le Roux
- Endocrinology Department. Hospital del Mar, Passeig Marítim, 25-29; 08003 Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona. Campus Universitari Mar. Dr. Aiguader, 80, 08003 Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM). Dr. Aiguader, 80, 08003 Barcelona, Spain.
| | - Juan Pedro-Botet
- Endocrinology Department. Hospital del Mar, Passeig Marítim, 25-29; 08003 Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona. Campus Universitari Mar. Dr. Aiguader, 80, 08003 Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM). Dr. Aiguader, 80, 08003 Barcelona, Spain.
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Zanella CP, Sampaio HADC, Lima JWOD, Moreira TMM. Adaptação cultural e evidências de validade de conteúdo da Nutritional Literacy Scale versão brasileira. Rev Bras Enferm 2022. [DOI: 10.1590/0034-7167-2021-0657pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo: Investigar evidências de validade de conteúdo e confiabilidade da versão brasileira da Nutritional Literacy Scale (NLS) após processo de adaptação cultural. Métodos: Estudo psicométrico com 1197 usuários do Sistema Único de Saúde (SUS). A NLS foi adaptada culturalmente para a língua portuguesa do Brasil e seis itens da escala original foram modificados para melhorar seu entendimento, originando a versão brasileira da escala, denominada NLS-BR. A análise das evidências de validade de conteúdo da NLS-BR se deu via Teoria de Resposta ao Item (TRI). Resultados: A versão final da NLS-BR ficou com 23 itens e se mostrou adequada para avaliar letramento nutricional em adultos brasileiros atendidos pelo SUS. Considerações finais: A NLS-BR mostrou-se de entendimento adequado, podendo ser considerada com evidências de validade de conteúdo e dotada de confiabilidade para usuários do SUS.
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Marchello NJ, Daley CM, Sullivan DK, Nelson-Brantley HV, Hu J, Gibbs HD. Nutrition Literacy Tailored Interventions May Improve Diet Behaviors in Outpatient Nutrition Clinics. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:1048-1054. [PMID: 34521594 DOI: 10.1016/j.jneb.2021.07.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Nutrition literacy examines the intersection of nutrition knowledge and skills; however, no evidence shows interventions tailored to nutrition literacy deficits affect diet behaviors. This study examined the effects of nutrition interventions tailored to individual nutrition literacy deficits on improving diet-related behaviors. METHODS Five outpatient clinics were randomized to 2 arms. The nutrition literacy and diet behaviors of patients were assessed before intervention with a dietitian and again 1 month later. Intervention-arm dietitians received patient nutrition literacy levels and tailored interventions toward nutrition literacy weaknesses. Differences in diet behaviors between arms were analyzed using Mann-Whitney U-tests and within-arms using Wilcoxon signed-rank tests. RESULTS Intervention-arm patients improved 10 of 25 measured diet behaviors; control-arm patients improved 6 behaviors. Similarly, intervention-arm patients reported increased green vegetable consumption from baseline to follow-up (z = 2.00; P = 0.04). CONCLUSIONS AND IMPLICATIONS Nutrition interventions tailored toward nutrition literacy deficits may play an important role in improving patient diet behaviors.
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Affiliation(s)
- Nicholas J Marchello
- School of Nutrition, Kinesiology, and Psychological Science, University of Central Missouri, Warrensburg, MO
| | - Christine M Daley
- Department of Family Medicine Research, University of Kansas Medical Center, Kansas City, KS
| | - Debra K Sullivan
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS
| | | | - Jinxiang Hu
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, KS
| | - Heather D Gibbs
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS.
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Nutrition Literacy and Healthy Diet: Findings from the Validation of a Short Seniors-Oriented Screening Tool, the Spanish Myths-NL. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212107. [PMID: 34831865 PMCID: PMC8624156 DOI: 10.3390/ijerph182212107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/13/2021] [Accepted: 11/15/2021] [Indexed: 12/23/2022]
Abstract
A good level of nutrition literacy (NL) is proposed as a determinant factor for following a healthy diet. Improving seniors’ NL might be particularly pertinent to enhance the quality of their diets. This study aimed to systematically design and validate a short seniors-oriented questionnaire as a screening tool to evaluate NL. We developed the Myths-NL questionnaire, composed of 10 widespread nutrition myths, and checked for its content and face validity. An observational cross-sectional study was conducted to explore the validity and the test–retest reliability, involving a community-dwelling group of 316 individuals aged 65 years and over. Construct validity was proved by establishing both discriminant and convergent validity. Cronbach α = 0.61 and Spearman r = 0.79 (p = 0.02) demonstrated internal consistency and test–retest reliability. Participants who had secondary/university studies scored significantly higher compared with those with primary (p < 0.001), and a significant linear relationship (R2 = 0.044, p = 0.001) with a positive slope (β = 0.209) between Mediterranean Diet Adherence Screener (MEDAS) and Myths-NL scores was observed, proving construct validity. In conclusion, the Myths-NL questionnaire is a valid and reliable tool to screen NL in Spanish seniors and it might be useful as an assessment NL tool for designing and implementing lifestyle interventions to promote healthy eating.
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Pawellek M, Kopf FM, Egger N, Dresch C, Matterne U, Brandstetter S. Pathways linking parental health literacy with health behaviours directed at the child: a scoping review. Health Promot Int 2021; 37:6403923. [PMID: 34668013 DOI: 10.1093/heapro/daab154] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Health literacy (HL) is thought to be crucial for the management of the manifold demands relating to child health which parents are faced with. Albeit many studies have investigated parental HL and health behaviours (HBs) directed at the child, knowledge about the pathways which link parental HL with HB is scarce. The aim of this scoping review was to identify and comprehensively describe the variety of pathways linking parental HL with HBs directed at the child which were empirically analysed in previous studies. Following established scoping review methods database searches were conducted in MEDLINE, EMBASE, PsycINFO and WebofScience on 5 March 2020. Eligibility criteria included primary, empirical studies assessing parental HL and HB directed at the child in the general parent population. Titles and abstracts were screened independently by six reviewers for potentially relevant publications and data were extracted using standardized data extraction forms. The search identified 6916 articles for title and abstract screening. After full-text review, 50 studies were included in this review. Most studies (N = 24) assumed a direct association between HL and HBs and only few studies (N = 4) used more complex models investigating different pathways or mediation and/or moderation models. Overall, the evidence on the underlying pathways linking parental HL and HBs directed at the child is mixed and fairly limited. Therefore, hypothesis-driven research and integration of results into theoretical frameworks is needed for advancing both the research on HL and public health practice.
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Affiliation(s)
- Maja Pawellek
- University Children's Hospital Regensburg (KUNO), University of Regensburg, Klinik St. Hedwig, Steinmetzstr. 1-3, Regensburg 93049, Germany.,Member of the Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
| | - Felicitas Maria Kopf
- University Children's Hospital Regensburg (KUNO), University of Regensburg, Klinik St. Hedwig, Steinmetzstr. 1-3, Regensburg 93049, Germany
| | - Nina Egger
- Department of Public Health and Health Education, Freiburg University of Education, Kunzenweg 21, Freiburg 79117, Germany
| | - Carolin Dresch
- Department of Research Methods, Freiburg University of Education, Kunzenweg 21, Freiburg 79117, Germany
| | - Uwe Matterne
- Medical Faculty, Institute of Social Medicine and Health Systems Research, Otto von Guericke University, Leipziger Str. 44, Magdeburg 39120, Germany
| | - Susanne Brandstetter
- University Children's Hospital Regensburg (KUNO), University of Regensburg, Klinik St. Hedwig, Steinmetzstr. 1-3, Regensburg 93049, Germany.,Member of the Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
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Michou M, Panagiotakos DB, Lionis C, Costarelli V. Low health literacy and perceived stress in adults: is there a link? Cent Eur J Public Health 2021; 29:195-200. [PMID: 34623119 DOI: 10.21101/cejph.a6692] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 08/19/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Mental stress, low health literacy (HL) and nutrition literacy (NL) are associated with serious negative health outcomes. The aim of this study was to investigate HL and NL levels, in relation to levels of perceived stress, in adults. METHODS This cross-sectional study was conducted in the urban area of the Attica region, Greece. The sample consisted of 1,281 individuals, aged ≥ 18 years. The European Health Literacy Questionnaire 47, the Greek version of the Nutrition Literacy Scale and the Perceived Stress Scale 14 were used. Socio-demographic characteristics were also assessed. Nonparametric Mann-Whitney U and Kruskal-Wallis tests, Pearson chi-square and multiple linear regression models were used. RESULTS The sample's perceived stress mean value (SD) was 26.47 (7.27) with women scoring statistically significantly higher than men. The mean HL and NL scores were 32.28 (8.28) and 22.11 (5.67), respectively. Linear regression analysis has shown that perceived stress was significantly negatively associated with HL (p < 0.001) but not with NL levels (p = 0.675) after adjusting for a series of confounding variables. CONCLUSIONS Low health literacy seems to be very significantly associated with high levels of perceived stress. The reasons behind this association require further investigation.
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Affiliation(s)
- Maria Michou
- Human Ecology Laboratory, Department of Home Economics and Ecology, Harokopio University, Athens, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Christos Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Vassiliki Costarelli
- Human Ecology Laboratory, Department of Home Economics and Ecology, Harokopio University, Athens, Greece
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Self-Rated Diet Quality and Cardiometabolic Health Among U.S. Adults, 2011-2018. Am J Prev Med 2021; 61:563-575. [PMID: 34246527 PMCID: PMC8523030 DOI: 10.1016/j.amepre.2021.04.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Self-rated health has been extensively studied, but the utility of a similarly structured question to rate diet quality is not well characterized. This study aims to assess the relative validity of self-rated diet quality, compared with that of a validated diet quality measure (Healthy Eating Index-2015) and to examine the associations with cardiometabolic risk factors. METHODS Analyses were conducted in 2020-2021 using cross-sectional data from the National Health and Nutrition Examination Survey, 2011-2018. Nonpregnant adults who responded to the question: How healthy is your overall diet? and provided 2 dietary recalls were eligible (n=16,913). Associations between self-rated diet quality (modeled as a 5-point continuous variable, poor=1 to excellent=5) and Healthy Eating Index-2015 scores and cardiometabolic risk factors were assessed by linear regression, accounting for the complex survey design and adjusting for demographic and lifestyle characteristics. RESULTS Self-rated diet quality was positively associated with total Healthy Eating Index-2015 scores (p < 0.001) and with all components except with Dairy (p=0.94) and Sodium (p=0.66). Higher self-rated diet quality was associated with lower BMI, waist circumference, glucose, insulin, triglycerides, and HbA1c and with higher high-density lipoprotein cholesterol (all p<0.01). Positive associations with total diet quality persisted across all racial/ethnic groups, although the associations with individual dietary components varied. Higher self-ratings were most consistently associated with better-scored diet quality among individuals with BMI <30 kg/m2. CONCLUSIONS Self-rated diet quality was associated with Healthy Eating Index-2015 scores and cardiometabolic disease risk factors. This single-item assessment may be useful in time-limited settings to quickly and easily identify patients in need of dietary counseling to improve cardiometabolic health.
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Rivera Rivero B, Makarova A, Sidig D, Niazi S, Abddelgader R, Mirza S, Joud H, Urfi M, Ahmed A, Jureyda O, Khan F, Swanson J, Siddique M, Weare-Regales N, Mirza AS. Nutritional Literacy Among Uninsured Patients With Diabetes Mellitus: A Free Clinic Study. Cureus 2021; 13:e16355. [PMID: 34414041 PMCID: PMC8364779 DOI: 10.7759/cureus.16355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/15/2021] [Indexed: 11/05/2022] Open
Abstract
Objective Evaluate nutrition literacy in uninsured subjects with diabetes mellitus (DM) who presented to free diabetes management classes. Design This single-site, cross-sectional observational study recruited thirty subjects from a free clinic for uninsured patients to attend diabetes mellitus, self-management classes. Before starting the classes, DM care-related data were collected, and subjects were administered the Nutrition Literacy Assessment Instrument (NLit). The assessment covers six subscales in nutrition and categorizes results into three possible categories: the likelihood of poor nutrition literacy (NLit Score ≤ 44), the possibility of poor nutrition literacy (NLit Score- 45-57), and the likelihood of good nutrition literacy (NLit score ≥ 58). Results Median glycated haemoglobin (HbA1c) was 7.45% for study participants. The mean NLit score was 38.1 (SD ± 9.4), correlating with a likelihood of poor nutrition literacy. All participants had either likelihood or the possibility of poor nutrition literacy based on the NLit Assessment. There were no participants who scored in the range of likelihood of good nutrition literacy. Subjects who scored in the range of likelihood of poor nutrition literacy had a significantly higher mean HbA1c (8.6 %) than those who scored in the possibility of poor nutrition literacy (6.9 %, p=0.005). Conclusions Poor nutrition literacy is associated with worse glycemic control among uninsured subjects with diabetes mellitus.
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Affiliation(s)
| | - Alena Makarova
- Medicine, University of South Florida Morsani College of Medicine, Tampa, USA
| | - Dina Sidig
- General Medicine, Red Crescent Clinic, Tampa , USA
| | - Saniya Niazi
- General Medicine, Red Crescent Clinic, Tampa, USA
| | | | - Sabbir Mirza
- Medicine, University of South Florida Morsani College of Medicine, Tampa, USA
| | - Hadi Joud
- Medicine, University of South Florida Morsani College of Medicine, Tampa, USA
| | - Mustafa Urfi
- Miscellaneous, University of South Florida College of Arts and Sciences, Tampa, USA
| | - Abdillahi Ahmed
- Medicine, University of South Florida Morsani College of Medicine, Tampa, USA
| | - Omar Jureyda
- Miscellaneous, University of South Florida College of Arts and Sciences, Tampa, USA
| | - Firaas Khan
- Medicine, University of South Florida Morsani College of Medicine, Tampa, USA
| | - Justin Swanson
- Miscellaneous, University of South Florida College of Public Health, Tampa, USA
| | - Maqsood Siddique
- Cardiology, James A. Hailey Veterans Affairs Medical Center, Tampa, USA
| | - Natalia Weare-Regales
- Endocrinology, Diabetes and Metabolism, James A. Hailey Veterans Affairs Medical Center, Tampa, USA
| | - Abu-Sayeef Mirza
- Internal Medicine, University of South Florida Morsani College of Medicine, Florida, USA
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Abstract
Objective: To determine the status of nutritional literacy and its affecting factors among the adolescents who are in the 9th grade in Çivril, in Denizli province, in Turkey. Design: This is a cross-sectional study that determines the sociodemographic characteristics, nutritional habits, nutritional behaviour, nutritional literacy status of adolescents and affecting factors. Setting: Denizli, Turkey. Participants: We included 523 adolescents in ninth grade in this study. Results: Half (49·7 %) of the participants were female; 47 %, in normal BMI; and 68·1 %, non-smokers. The mean (sd) Adolescent Nutrition Literacy Scale score was 67·6 (sd 7·9). Nutrition literacy status was related to mothers’ education level (P 0·021); health perceptions (P 0·008); positive body perception (P 0·032); unhealthy food consumption status (P 0·017); information barriers (undecided about effort for information gathering (P 0·026), undecided about the difficulty of understanding information (P 0·042) and thinking it is difficult to understand (P 0·003)), trust in nutrition, diet information sources (nutrition and diet expert, dietitian trusting (according to others) (P 0·001), nutrition and diet expert, dietitian neutral to trust (compared with others) (P 0·011) and trust in textbooks (P 0·023)). Conclusions: The level of nutrition literacy status of participants was moderate. It is important to carry out interventions to increase the education level of women, positive body perceptions and general health perceptions of adolescents and to remove information barriers related to nutrition.
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Namdar A, Naghizadeh MM, Zamani M, Montazeri A. Exploring the relationship between health literacy and fast food consumption: a population-based study from southern Iran. BMC Public Health 2021; 21:757. [PMID: 33879106 PMCID: PMC8056591 DOI: 10.1186/s12889-021-10763-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 04/05/2021] [Indexed: 11/10/2022] Open
Abstract
Background Health literacy (HL) may affect the consumption of fast food. We aimed to evaluate the effect of HL on fast food consumption among adult populations in Iran. Methods We evaluated HL and fast food consumption in 421 adult participants with age range of 18–65 years old in Fasa, Fars Province, southern Iran. Two-step cluster and systematic sampling was performed to recruit the study sample. Data were collected using a fast food consumption checklist, and the Health Literacy Instrument for Adults (HELIA) by face-to-face interviews. Population data across groups with and without fast food intake were compared. Results Most participants used fast food every few months (49.9%). People with low or unstable income consumed more fast food than others (P < 0.05). Sandwich and hotdog were the most consumed fast food (60.8%) followed by pizza (34.9%). Sausage and soda were the most seasoning food (66.7%). Most participants used fast food as dinner (67.9%) and with family (72.2%), suggesting the institutionalized consumption of this type of food in the family. Fun was the most frequent reason for the use of fast food (66.5%). Most participants completely knew about the raw materials for fast food and their adverse effects. Finally, we found that overall health literacy was lower among those who used fast food than those who did not. Consumed fast food (68.16 ± 23.85 vs. 73.15 ± 20.15; p = 0.021). This difference was also observed for some components of health literacy including reading skills, and decision-making subscales. Conclusions The findings suggest there is a negative relationship between general health literacy and fast food consumption indicating that who possess lower level of health literacy is likely to consume more fast food. Specifically, the findings suggest that reading skills, and decision-making (behavioral intention) are more associated with decreased or increased fast food intake. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10763-3.
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Affiliation(s)
- Azam Namdar
- Department of Community Medicine, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran.
| | | | - Marziyeh Zamani
- Department of Nutrition, School of Medicine, Jahrom University of Medical Science, Jahrom, Iran
| | - Ali Montazeri
- Population Health Research Group, Health Metrics Research Center, Institute for Health Sciences Research, ACECR, Tehran, Iran. .,Faculty of Humanity Sciences, University of Science and Culture, Tehran, Iran.
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Shahavandi M, Ghorbaninejad P, Mohammadpour S, Djafari F, Shahinfar H, Sheikhhossein F, Djafarian K, Shab-Bidar S. Higher health literacy score is associated with better healthy eating index in Iranian adults. Nutrition 2021; 90:111262. [PMID: 33975063 DOI: 10.1016/j.nut.2021.111262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 03/01/2021] [Accepted: 03/29/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Although there is some evidence for the importance of health literacy (HL), many health complications and nutrition knowledges such as portion size assessment, knowing the food labels, and choosing the nutrition sources affecting diet quality, data about HL and healthy eating index (HEI) are limited and controversial. The aim of this study was to evaluate the associations between HL and HEI in adults. METHODS This cross-sectional study included 261 adults 18 to 65 y of age from five districts of Tehran, Iran. HL was estimated using the Health Literacy for Iranian Adult (HELIA) questionnaire. Dietary intake, sociodemographic data, physical activity, and anthropometric measurements were collected using validated questionnaires. Diet quality was assessed based on HEI-2015 scores using data from a food frequency questionnaire. RESULTS Despite components of HEI-2015, the association between HEI-2015 and HL tertiles was significant (P of crude model = 0.007) even after adjustment for possible confounders. Multivariate regression showed a positive relationship between HL and HEI-2015 that was significant before (β = 0.12, P = 0.04) and after controlling for the confounding effect in model 1 (β = 0.14, P = 0.03). Additionally, a positive association between physical activity and HL was shown (β = 0.12, P = 0.03) and finally among the HEI components, only saturated fats were significantly related to HL (β = -0.11, P = 0.01). CONCLUSION Findings from the present study confirmed a considerable association between HL and HEI and shows HL levels have an important role in adherence to the Iranian Dietary Guidelines.
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Affiliation(s)
- Mahshid Shahavandi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Parivash Ghorbaninejad
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Saba Mohammadpour
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Farhang Djafari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hossein Shahinfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Sheikhhossein
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
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Vettori V, Lorini C, Gibbs HD, Sofi F, Lastrucci V, Sartor G, Fulvi I, Giorgetti D, Cavallo G, Bonaccorsi G. The Nutrition Literacy Assessment Instrument for Italian Subjects, NLit-IT: Exploring Validity and Reliability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073562. [PMID: 33808072 PMCID: PMC8036908 DOI: 10.3390/ijerph18073562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 12/13/2022]
Abstract
The aim of this study was to test validity and reliability of the adapted version of the Nutrition Literacy Assessment Instrument (NLit) for Italian people (NLit-IT). An observational cross-sectional study was conducted, involving a convenience sample of adults (n = 74). To explore the validity of the tool, we considered both diet quality as an outcome of NL, and health literacy (HL) as a construct that presents similarities and differences with NL. Diet quality was measured by adherence to the Mediterranean Diet (Med diet) through the validated Mediterranean Diet Literature-based adherence score (MEDI-Lite). The relationship between NL level and adherence to Med diet was assessed by linear regression analysis and computing correlations between NLit-IT and MEDI-Lite scores (Spearman's Rho). Additionally, we evaluated the correlation between NLit-IT score and the level of HL (Spearman's Rho). Internal consistency and reliability were measured by Cronbach's alpha and intraclass correlation coefficient (ICC) respectively. Internal consistency (ρT = 0.78; 95% CI, 0.69-0.84) and reliability (ICC = 0.68, 95% CI, 0.46-0.85) were confirmed. In addition, NLit-IT total score was correlated with MEDI-Lite score (Rho = 0.25; p-value = 0.031) and multivariate regression analysis confirmed that NL significantly contributed to MEDI-Lite score (R2 = 0.13; β = 0.13; p-value = 0.008). There was no significant association between the level of HL and NL. In conclusion, NLit-IT showed validity and reliability as a measure of NL for Italian people.
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Affiliation(s)
- Virginia Vettori
- Department of Health Sciences, University of Florence, 48 Morgagni Blvd, 50134 Florence, Italy; (C.L.); (V.L.); (I.F.); (G.C.); (G.B.)
- Correspondence:
| | - Chiara Lorini
- Department of Health Sciences, University of Florence, 48 Morgagni Blvd, 50134 Florence, Italy; (C.L.); (V.L.); (I.F.); (G.C.); (G.B.)
| | - Heather D. Gibbs
- Department of Dietetics and Nutrition, University of Kansas Medical Center, 3901 Rainbow Blvd/MS4013, Kansas City, KS 66160, USA;
| | - Francesco Sofi
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy;
- Unit of Clinical Nutrition, University Hospital of Careggi, 50134 Florence, Italy
- Don Carlo Gnocchi Foundation Italy, Onlus IRCCS, 50134 Florence, Italy
| | - Vieri Lastrucci
- Department of Health Sciences, University of Florence, 48 Morgagni Blvd, 50134 Florence, Italy; (C.L.); (V.L.); (I.F.); (G.C.); (G.B.)
- Global Health Center, Meyer University Hospital, 24 Gaetano Pieraccini Blvd, 50134 Florence, Italy
| | - Gino Sartor
- School of Specialization in Hygiene and Preventive Medicine, University of Florence, 48 Morgagni Blvd, 50134 Florence, Italy; (G.S.); (D.G.)
| | - Ilaria Fulvi
- Department of Health Sciences, University of Florence, 48 Morgagni Blvd, 50134 Florence, Italy; (C.L.); (V.L.); (I.F.); (G.C.); (G.B.)
| | - Duccio Giorgetti
- School of Specialization in Hygiene and Preventive Medicine, University of Florence, 48 Morgagni Blvd, 50134 Florence, Italy; (G.S.); (D.G.)
| | - Giuseppe Cavallo
- Department of Health Sciences, University of Florence, 48 Morgagni Blvd, 50134 Florence, Italy; (C.L.); (V.L.); (I.F.); (G.C.); (G.B.)
| | - Guglielmo Bonaccorsi
- Department of Health Sciences, University of Florence, 48 Morgagni Blvd, 50134 Florence, Italy; (C.L.); (V.L.); (I.F.); (G.C.); (G.B.)
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Chrissini MK, Panagiotakos DB. Health literacy as a determinant of childhood and adult obesity: a systematic review. Int J Adolesc Med Health 2021; 33:9-39. [PMID: 33592684 DOI: 10.1515/ijamh-2020-0275] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 01/26/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To assess whether Health Literacy (HL) acts as a determinant of obesity in adults and children by synthesizing the results of recent scientific evidence. CONTENT This is a systematic qualitative review following the MOOSE guidelines. A systematic, computer-assisted literature search via PubMed scientific database, between January 1st, 2000, and September 30th 2020, was conducted. Only cross-sectional epidemiologic research studies that were published in the English language, investigating HL's possible role as a determinant of childhood and adult obesity, were included. SUMMARY After screening 725 citations from the PubMed database, 39 (n=39) studies in total were included in this literature review; Four (n=4) studies were conducted in the children population, seven (n=7) studies were performed in children-parent/caregiver dyads, and 28 studies (n=28) enrolled adults. There is significant evidence that HL knowledge and skills determine the consequent management of obesity and BMI rates in children and adult populations. OUTLOOK Despite policies and action plans put in place by countries globally, overweight and obesity continue to be a pressing public health issue and one of the critical drivers of non-communicable diseases, constituting a health, social and economic burden worldwide. Health Literacy as an essential health policy and promotion agenda item and a critical empowerment strategy could increase children's and adults' control over their overall health and awareness to overcome obesity issues. Initiatives to improve HL levels could be useful tools in managing the obesity epidemic, starting from integrating HL in the school curriculum and further in family and community action plans.
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Affiliation(s)
- Maria K Chrissini
- Department of Nutrition & Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Demosthenes B Panagiotakos
- Biostatistics, Medical Research Methods & Epidemiology, Department of Nutrition & Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
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Association Between Restaurant Menu Item Descriptions and Their Nutrient Content. Am J Prev Med 2021; 60:232-240. [PMID: 33482981 DOI: 10.1016/j.amepre.2020.08.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 08/18/2020] [Accepted: 08/21/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Item descriptions on restaurant menus often include claims about health and other attributes, and these are much less regulated than the language on packaged food labels. This study tests whether menu items with claims have different nutritional content from items without claims. METHODS Investigators compiled a data set of menu items, their claims, and their nutrition content using MenuStat. Data included 84,788 item-year observations at up to 96 of the top-selling restaurant chains from 2012 to 2018. Items were identified with general health, health-related ingredients, nutrient content, product sourcing, and vegan or vegetarian claims through a matching algorithm. Mixed-effects models were used to examine the effect of claims on calories, nutrients to limit (e.g., saturated fat and sodium), and other nutrients by dish types (sides, main dishes, desserts). RESULTS Most dishes with claims were lower in calories; however, items with claims were not consistently lower in other nutrients to limit (sodium, saturated fat, sugar, or trans fat). Vegan or vegetarian desserts had 128 mg (95% CI=20.9, 235.1) more sodium than desserts without this claim. Main and side dishes with claims had equivalent or higher sugar content than items without claims. Many items with claims were lower in saturated fat, especially main dishes with a nutrient content claim (-2.8 percentage points, 95% CI= -3.4, -2.2). CONCLUSIONS Items with claims were high in nutrients to limit. Additional efforts to increase transparency around excessive ingredients, such as the sodium warning labels, could be implemented by the restaurant industry.
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Bedoyan J, McNamara J, Olfert MD, Byrd-Bredbenner C, Greene GW. Establishing criterion validity for the Revised Critical Nutrition Literacy Tool in U.S. college students. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:37. [PMID: 33688546 PMCID: PMC7933612 DOI: 10.4103/jehp.jehp_632_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 12/16/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Critical nutrition literacy (CNL) plays an important role in how college students make everyday decisions about nutrition choices. Increasing CNL is an aim of many introductory nutrition courses, but there are limited instruments measuring this construct. This study aimed to assess the changeability of CNL and the relationship between CNL and markers of diet quality in young adults. DESIGN This was a two-phase research project consisting of a nonexperimental, pre-post study and a cross-sectional assessment from 2018 to 2019. Participants were U.S. college students, 18-24 years old, recruited from introductory-level courses from three participating universities, located in Rhode Island, West Virginia, and New Jersey. SUBJECTS AND METHODS Interventions consisted of (1) a 4-credit, 13-week nutrition course and (2) a cross-sectional, online behavior, environment, and perception survey. CNL was measured using the Revised CNL Tool (CNLT-R) instrument across both phases. Measures for phases include: (1) the changeability of CNL and (2) the relationship between CNL and markers of diet quality. ANALYSIS Paired t-tests and multivariate analysis of variance were utilized through SPSS version 25.0. RESULTS CNL score significantly increased from baseline to postintervention from 3.38 ± 0.48 to 3.61 ± 0.55 (P = 0.014). There was an overall significant effect of CNL on markers of diet quality, such as cups of fruits and vegetables (F/V) and teaspoons of added sugar (F [2,1321] = 3.12, P < 0.05; Wilks' Λ = 0.99). CONCLUSIONS This research found that an introduction to nutrition course was associated with an increase in CNL and that CNL is related to diet quality. The instrument could be used by nutrition educators as an outcome assessment. Future research should investigate other components of the CNL construct as well as predictive validity.
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Affiliation(s)
- Janette Bedoyan
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, USA
| | - Jade McNamara
- School of Food and Agriculture, University of Maine, Orono, ME, USA
| | - Melissa D. Olfert
- Division of Animal and Nutritional Sciences, Davis College of Agriculture, Natural Resources, and Design, West Virginia University, Morgantown, WV, USA
| | - Carol Byrd-Bredbenner
- Department of Nutritional Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Geoffrey W. Greene
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, USA
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Liu T, Su X, Li N, Sun J, Ma G, Zhu W. Development and validation of a food and nutrition literacy questionnaire for Chinese school-age children. PLoS One 2021; 16:e0244197. [PMID: 33406105 PMCID: PMC7787443 DOI: 10.1371/journal.pone.0244197] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 12/05/2020] [Indexed: 12/01/2022] Open
Abstract
Background This study aimed to develop and validate the Food and Nutrition Literacy Questionnaire for Chinese School-age Children (FNLQ-SC). Methods A comprehensive literature review and qualitative study were initially performed to identify the dimensions and core components of food and nutrition literacy. A cross-sectional survey of 4359 school-age children was conducted, and junior middle school students were used to analyze the reliability and validity of the questionnaire (n = 2452). The reliability of the questionnaire was determined by internal consistency, the construct validity was assessed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and the content validity was assessed by the Pearson correlation coefficient. Results From the literature review and qualitative methods, 19 core components of the FNLQ-SC were developed, including one dimension of food and nutrition knowledge and understanding, and four skill dimensions (ability of access, selection, preparing food and healthy eating). The overall FNLQ-SC questionnaire had acceptable internal consistency (Cronbach’s α = 0.698). The EFA of skill components extracted 5 factors that were included in the conceptual framework in a slightly different model, and the cumulative contribution of variance accounted for 50.60% of the overall variance. The CFA of skill components showed an acceptable fit in general and the root mean square error of approximation (RMSEA) was 0.070 (between 0.50 to 0.80). The communality was greater than 0.20 for all components. The Pearson correlation coefficients between each dimension and the overall questionnaire ranged from 0.370 to 0.877. The average FNLQ-SC score of all 4395 participants was 61.91 ± 9.22, and the score for the knowledge and understanding dimension was higher than that for the skill dimensions. Multiple linear regression analysis indicated that not only social demographic characteristics (being a girl, being an only child, living someplace other than at school, having an urban registered permanent residence status, being from an affluent family, and being cared for by parents/grandparents with a higher education level) but also the home food environment were predictors of food and nutrition literacy in school-age children (R2 = 0.226, F = 81.401, P<0.05). Conclusion The Food and Nutrition Literacy Questionnaire (FNLQ-SC) developed here had good reliability, and it can potentially be a useful instrument for assessing food and nutrition literacy among Chinese school-age children.
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Affiliation(s)
- Tan Liu
- Department of Nutrition and Food Hygiene, Peking University School of Public Health, Beijing, China
| | - Xiao Su
- Department of Nutrition and Food Hygiene, Peking University School of Public Health, Beijing, China
| | - Niuniu Li
- Department of Nutrition and Food Hygiene, Peking University School of Public Health, Beijing, China
| | - Jing Sun
- Department of Nutrition and Food Hygiene, Peking University School of Public Health, Beijing, China
| | - Guansheng Ma
- Department of Nutrition and Food Hygiene, Peking University School of Public Health, Beijing, China
| | - Wenli Zhu
- Department of Nutrition and Food Hygiene, Peking University School of Public Health, Beijing, China
- * E-mail:
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Hamilton-Reeves JM, Johnson CN, Hand LK, Bechtel MD, Robertson HL, Michel C, Metcalf M, Chalise P, Mahan NJ, Mirza M, Lee EK, Sullivan DK, Klemp JR, Befort CA, Parker WP, Gibbs HD, Demark-Wahnefried W, Thrasher JB. Feasibility of a Weight Management Program Tailored for Overweight Men with Localized Prostate Cancer - A Pilot Study. Nutr Cancer 2020; 73:2671-2686. [PMID: 33295204 PMCID: PMC8371995 DOI: 10.1080/01635581.2020.1856890] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 10/21/2020] [Accepted: 11/13/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Overweight men with prostate cancer are more likely to suffer from recurrence and death following prostatectomy compared with healthy weight men. This study tested the feasibility of delivering a comprehensive program to foster weight loss before and weight maintenance after surgery in overweight men with localized prostate cancer. METHODS Twenty overweight men scheduled for prostatectomy elected either the intervention (n = 15) or the nonintervention (n = 5). Anthropometrics, biomarkers, diet quality, nutrition literacy, quality of life, and long-term follow-up were assessed in both groups. RESULTS The intervention led to 5.55 kg of weight loss including 3.88 kg of fat loss from baseline to surgery (mean = 8.3 weeks). The intervention significantly increased fiber, protein, fruit, nut, and vegetable intake; and decreased trans fats intake during weight loss. The intervention significantly reduced insulin, C-peptide, systolic blood pressure, leptin:adiponectin ratio, and visceral adiposity compared to the nonintervention. Post-surgically, weight loss was maintained. Changes in lipid profiles, nutrition literacy, and follow-up were not statistically significant in either group. CONCLUSION Significant weight loss (≥5%) is feasible with a coaching intervention in overweight men preparing for prostatectomy and is associated with favorable cardiometabolic effects. This study is registered under NCT02252484 (www.clinicaltrials.gov).
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Affiliation(s)
- Jill M Hamilton-Reeves
- Department of Urology, University of Kansas Medical Center, Kansas City, Kansas, USA
- Department of Dietetics & Nutrition, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Chelsea N Johnson
- Department of Urology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Lauren K Hand
- Department of Dietetics & Nutrition, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Misty D Bechtel
- Department of Urology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Hilary L Robertson
- Department of Urology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Carrie Michel
- Department of Urology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Meredith Metcalf
- Department of Urology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Prabhakar Chalise
- Department of Biostatistics, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Nicholas J Mahan
- Department of Dietetics & Nutrition, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Moben Mirza
- Department of Urology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Eugene K Lee
- Department of Urology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Debra K Sullivan
- Department of Dietetics & Nutrition, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Jennifer R Klemp
- Breast Cancer Prevention Center, University of Kansas Medical Center, Westwood, Kansas, USA
| | - Christie A Befort
- Department of Preventative Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - William P Parker
- Department of Urology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Heather D Gibbs
- Department of Dietetics & Nutrition, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Wendy Demark-Wahnefried
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - J Brantley Thrasher
- Department of Urology, University of Kansas Medical Center, Kansas City, Kansas, USA
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Michou M, Panagiotakos DB, Lionis C, Costarelli V. Health and nutrition literacy in adults: Links with lifestyle factors and obesity. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2020. [DOI: 10.3233/mnm-200471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Low Health Literacy (HL) and Nutrition Literacy (NL) are associated with serious negative health outcomes. OBJECTIVES: The aim of this study was to investigate certain lifestyle factors and obesity, in relation to HL and NL. METHODS: This cross-sectional study was conducted in the urban area of the Attica region, in Greece. The sample consisted of 1281 individuals, aged ≥18 years. HL, NL sociodemographic characteristics and lifestyle factors (physical activity, smoking status, alcohol consumption,) were assessed. Mann-Whitney U, the Kruskall Wallis, Pearson chi-square tests and multiple linear regression models were used. RESULTS: Linear regression analysis has shown that smoking, alcohol consumption and physical activity, were associated with HL levels (–1.573 points for ex-smokers in comparison to smokers, p = 0.035, –1.349 points for alcohol consumers in comparison to non-consumers, p = 0.006 and 1.544 points for physically active individuals to non-active, p = 0.001). With respect to NL levels, it was also not associated with any of these factors. Obesity was not associated with HL and NL levels. CONCLUSIONS: Certain lifestyle factors, including physical activity, are predicting factors of HL levels, in Greek adults. The results contribute to the understanding of the relationship between lifestyle factors and HL and should be taken into account when HL policies are designed.
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Affiliation(s)
- Maria Michou
- Human Ecology Laboratory, Department of Home Economics and Ecology, Harokopio University, Athens, Greece
| | - Demosthenes B. Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Christos Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Vassiliki Costarelli
- Human Ecology Laboratory, Department of Home Economics and Ecology, Harokopio University, Athens, Greece
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