Objective
To describe the relationship between adherence to distinct dietary patterns and nutrition literacy.
Design
We identified distinct dietary patterns using principal covariates regression (PCovR) and principal components analysis (PCA) from the Diet History Questionnaire (DHQ) II. Nutrition literacy was assessed using the Nutrition Literacy Assessment Instrument (NLit). Cross-sectional relationships between dietary pattern adherence and global and domain-specific NLit scores were tested by multiple linear regression. Mean differences in diet pattern adherence among three pre-defined nutrition literacy performance categories were tested by ANOVA.
Setting
Metropolitan Kansas City
Participants
Adults (n=386) with at least one of four diet-related diseases.
Results
Three diet patterns of interest were derived; a PCovR prudent pattern and PCA-derived Western and Mediterranean patterns. After controlling for age, sex, BMI, race, household income, education level, and diabetes status, PCovR prudent pattern adherence positively related to global NLit scores (p<0.001, β=0.36), indicating more intake of prudent diet foods with improved nutrition literacy. Validating the PCovR findings, PCA Western pattern adherence inversely related to global NLit (p=0.003, β=−0.13) while PCA Mediterranean pattern positively related to global NLit (p=0.02, β=0.12). Using predefined cut points, those with poor nutrition literacy consumed more food associated with the Western diet (fried food, sugar sweetened beverages, red meat, and processed food) while those with good nutrition literacy consumed more food associated with prudent and Mediterranean diets (vegetables, olive oil, and nuts).
Conclusion
Nutrition literacy predicted adherence to healthy/unhealthy diet patterns. These findings warrant future research to determine if improving nutrition literacy effectively improves eating patterns.