The Nutrition Literacy Assessment Instrument for Italian Subjects, NLit-IT: Exploring Validity and Reliability

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.

Nutrition Literacy and Healthy Diet: Findings from the Validation of a Short Seniors-Oriented Screening Tool, the Spanish Myths-NL

“…As evidence of convergent validity, the Myths-NL score was the strongest predictor of Mediterranean diet adherence, as previously shown for other NL measurement tools in the literature [2,6,25,40]. The low values in statistical parameters of the regression analyses and the correlation coefficient between Myths-NL and MEDAS tools have been observed previously, suggesting that the association between NL and dietary behavior is weak [6,24].…”

“…Differences between youngest-old (65 and 80 y old) and oldest-old (equal to or more than 80 y old) tested by chi squared or 1 Fisher's exact test, when appropriate. 2 Frequency this source of information was selected. The Myths-NL score for the whole group showed a mean value of 5.8 (SD 2.0), with a range between 0 to 10.…”

“…It is well known that healthy eating behaviors depend on sociodemographic factors, general health status, and psychological/personal characteristics [1]. Nutrition literacy (NL) may be an overlooked contributor [2]. NL refers to the knowledge, skills, and competencies necessary to maintain nutritional health [3].…”

“…On the one hand, there is a paucity of tools specifically designed for the elderly, and none of them is drawn up for Southern Europe [18]. On the other hand, although several questionnaires oriented to the general population have been recently adapted and validated in Mediterranean countries [2,19], those are difficult to administer to older people for whom simplicity and amenity of the format, easiness to understand, or quickness to complete are desirable aspects. Therefore, new, valid instruments for measuring NL targeting seniors living in Southern European countries would be useful as screening tools to help identify people at risk of low NL and to guide professionals on how to address dietary education.…”

Health Literacy, Socio-Economic Determinants, and Healthy Behaviours: Results from a Large Representative Sample of Tuscany Region, Italy

“…Consequently, due to the different definitions and assessment tools used for each concept, it is difficult to compare our results with evidence in the literature. For instance, as reported by Vettori et al [ 53 ], the Italian NL assessment tool (NLit–IT) score is not significantly associated with the score of the Italian version of HLS–EU–Q6.…”