Nutrition literacy predicts adherence to healthy/unhealthy diet patterns in adults with a nutrition-related chronic condition

Abstract

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.

Food and nutrition literacy status and its correlates in Iranian senior high-school students

“…However, after controlling for the effect of other possible predictors in multivariate analysis, this association was not significant anymore. The relationship between weight status and FNL has been addressed in a number of studies [12,15,20,30,34,35]; however, the results have not been consistent. In some studies, people with higher BMI have had a lower level of FNL [20,34], while in some others non-significant [12,15,30] or positive [35] association between BMI and FNL has been reported.…”

Food and Nutrition Literacy Status and Its Correlates in Iranian Senior High-School Students

“…However, after controlling for the effect of other possible predictors in multivariate analysis, this association was not signi cant anymore. The relationship between weight status and FNL has been addressed in a number of studies [11,14,19,29,34,35]; however, the results have not been consistent. In some studies, people with higher BMI have had a lower level of FNL [19,34], while in some others non-signi cant [11,14,29] or positive [35] association between BMI and FNL has been reported.…”

Dietary agrobiodiversity for improved nutrition and health outcomes within a transitioning indigenous Solomon Island food system

“…Imported and processed foods can play a role in providing affordable and convenient options for families. Previous studies have documented the links between nutrition knowledge and nutritional literacy with better food choices, healthier diets, and healthy body compositions (Michou et al, 2018;Taylor et al, 2019). Promoting nutrition education, particularly if harnessing traditional knowledge, can help build adaptive capacity towards climate change (Granderson, 2017) and improve the nutrient density of food supplies.…”