Association between diet-related knowledge, attitudes, behaviors, and self-rated health in Chinese adult residents: a population-based study

Abstract

Background: Diet-related knowledge, attitudes, and behaviors (KABs) are important for building healthier dietary patterns. We conducted this study to (a) investigate diet conditions of Chinese adult residents from the perspective of knowledge, attitudes, and behaviors, and (b) assess the association between diet-related KABs and self-rated health. Methods: We analyzed the 2015 China Health and Nutrition Survey (CHNS) data. Individuals aged 18 years and older were included as study subjects (n = 12,814), assessing their diet-related knowledge, attitudes, behaviors, and self-rated health. Comparison of diet-related KABs in urban and rural residents was conducted using chi-square test. Ordinal logistic regression analysis was adopted to examine the association between diet-related KABs and self-rated health. Results: The proportion of knowing about the Chinese Food Pagoda (CFP) or the Dietary Guidelines for Chinese Residents (DGCR) was 27.1%. 34.3% of the participants were assessed as having adequate dietary knowledge literacy. 24.3% reported a positive attitude towards healthy eating. 27.6 and 65.9% of the participants reported proactively looking for nutrition knowledge and preferring eating fruits & vegetables, respectively. Chi-square test indicated that rural people experienced poorer diet-related knowledge, attitudes, and behaviors than urban residents (all p-values < 0.01). Regression analysis revealed that participants who knew about CFP/DGCR (OR = 1.11, 95% CI = 1.08-1.15), had adequate dietary knowledge literacy (OR = 1.12, 95% CI = 1.10-1.15), held positive attitude towards healthy eating (OR = 1.14, 95% CI = 1.09-1.19), proactively looked for nutrition knowledge (OR = 1.11, 95% CI = 1.08-1.15), and preferred eating fruits & vegetables (OR = 1.09, 95% CI = 1.07-1.12) had significantly better self-rated health. Conclusions: Chinese adult residents experienced poor diet-related knowledge, attitudes, and behaviors. Rural people had significantly worse diet conditions than urban residents. Better diet-related knowledge, attitudes, and behaviors were associated with higher self-rated health in Chinese adult residents.

Association of a Single-Item Self-Rated Diet Construct With Diet Quality Measured With the Alternate Healthy Eating Index

“…While most component scores trended in the hypothesized direction, the only significant association with SRD was noted for fruit. In general, fruit and vegetables have been correlated with perceptions of healthfulness ( 46 – 49 ) and self-rated eating habits ( 33 ). A previous study in this same cohort showed that individuals consuming local fruit and vegetable more frequently (vs. never or rarely) had higher overall diet quality ( 50 ).…”

The Impact of Dietary Knowledge on Health: Evidence from the China Health and Nutrition Survey

“…Previous medical studies demonstrated that smoking and alcohol consumption adversely affect health and induce chronic diseases [ 45 , 46 , 47 ]. However, several studies identified that the self-rated health conditions of smokers and drinkers tend to be biased upwards [ 11 , 48 ]. There are two possible explanations: one is that those who are addicted to smoking and alcohol consumption generally believe that their health is better and that smoking and alcohol consumption have a less negative impact on their health [ 49 ]; the other is that smoking and alcohol consumption may relieve psychological pressure and make people happy [ 50 ], leading to a better self-evaluation of health status.…”

“…De Vriendt et al [ 8 ], Petrovici and Ritson [ 25 ] find that an individual’s level of nutrition knowledge mainly depends on his/her education, age, and occupation. Some scholars argue that more knowledge of diet usually leads to better health [ 11 , 26 ]. However, there are also studies suggesting that dietary knowledge is not translated into healthier food choices [ 27 ], and so has no positive impacts on health [ 28 , 29 ].…”

“…Studies examining how dietary knowledge affects public health in China are sparse. Yang et al [ 11 ] find dietary knowledge leads to better self-rated health of Chinese adults based on the 2015 China Health and Nutrition Survey (CHNS) data. Since China is a vast country with a huge population, it is of importance to investigate the heterogeneous impacts of dietary knowledge on health across different groups of people.…”

Do Physical Activity-Related Knowledge, Attitudes, and Behaviors Play a Role in the Elderly's Mental Health? A Cross-Sectional Study from the China Health and Nutrition Survey

“…Doyle et al [11] have emphasized the importance of improving PA-related knowledge and strengthening the awareness of PA's bene ts for mental health. In our previous study [12], we indicated the possibility that behavioral intervention from the perspective of knowledge, attitudes, and behaviors could help improve individual health. Thus, assessing PA-related knowledge, attitudes, and behaviors might be of vital importance in elderly health promotion in China.…”