Food and nutrition literacy: a predictor for diet quality and nutrient density among late adolescents.

BACKGROUND: Evidence regarding an individual`s food and nutrition literacy (FNL), and its impact on dietary behaviours, could guide the development of more effective interventions. This study sought to examine the association between FNL and its components with diet quality and nutrient density among Iranian senior highschool students. METHODS: In this cross-sectional study, 755 senior high school students were recruited from high schools in Tehran, Iran. FNL was assessed using the Food and Nutrition Literacy Assessment Tool (FNLAT), a selfadministered questionnaire which has been locally designed and validated. Dietary assessment was performed by obtaining two 24-hour dietary recalls. Healthy Eating Index-2010 (HEI-2010) and nutrient-rich food index 9.3 (NRF9.3) were calculated to evaluate diet quality. Socioeconomic status, anthropometric measures, and the health status of participants were also assessed. RESULTS: Higher FNL score was significantly correlated with higher HEI-2010 (ß = 0.167, p < 0.001) and NRF9.3 (ß = 0.145, p < 0.001) scores. Subgroup analysis indicated that these associations were significant only among males, but not females. Regarding components of FNL, skill dimension of FNL was a stronger predictor for HEI- 2010 (ß = 0.174, p < 0.001) and NRF9.3 (ß = 0.153, p < 0.001) than knowledge (ß = 0.083, p = 0.054 for HEI-2010 and ß = 0.107, p = 0.01 for NRF9.3). CONCLUSIONS: FNL may be a significant predictor of diet quality and nutrient density among late adolescents. To improve the effectiveness of food and nutrition education, emphasis must be placed on skill development.

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

BACKGROUND: Planning interventions to promote food and nutrition literacy (FNL) require a better understanding of the FNL status of the target group and its correlates. AIMS: This study aimed to examine the FNL status and its determinants in Iranian senior high-school students. METHODS: In this cross-sectional study, FNL and its components (food and nutrition knowledge, functional skills, interactive skills, advocacy, critical analysis of information, and food label reading skill) were evaluated by a locally designed and validated, self-administered questionnaire. Besides, socioeconomic, demographic, anthropometric measures, as well as academic performance of 626 senior high-school students were assessed. RESULTS: The mean ± SD of the total FNL score (within potential range of 0 to 100) was 52.1 ± 10.96, which is below the minimum adequate level of 60. The probability of high FNL knowledge score was significantly higher among students who majored in Natural Sciences (OR = 1.73, CI = 1.09-2.75), had better school performance (OR = 1.13, CI = 1.06-1.20) and higher SES score (OR = 1.20, CI = 1.01-1.44). The score for food label reading was significantly lower in girls (OR = 0.45, CI = 0.31-0.67), while those who had a family member with the nutrition-related disease were more likely to have a higher score of food label reading skill (OR = 1.48, CI = 1.01-1.64). CONCLUSION: The level of FNL in senior high-school students in Tehran was relatively low. These findings have key messages for the education system and curriculum designers to have more consideration for food and nutrition-related knowledge and skills in schools.

Development and Validation of Food and Nutrition Literacy Assessment Tool for Iranian High-school Graduates and Youth.

BACKGROUND: Food and nutrition literacy (FNL) is an emerging concept that emphasizes not only on personal knowledge, but food and nutrition skills about. This study aimed to develop and validate a food and nutrition literacy assessment tool (FNLAT) for youth and high-school graduates in Iran. METHODS: The study protocol included the following steps: First, FNL components for Iranian high-school graduates and youth were identified through literature review and interviews with experts. Delphi method was used in order to achieve consensus about FNL components. Then, the questionnaire items were generated, and its content and face validity were assessed. Construct validity of the questionnaire was evaluated through applying principal component analysis (PCA) and confirmatory factor analyses (CFA) in the next step. Finally, reliability of the FNLAT was assessed by calculating Cronbach's Alpha and evaluating test-retest reliability. RESULTS: A 104-item questionnaire was developed. S-CVI was ≥90 which confirmed content validity of the questionnaire. PCA suggested that it was constructed of 6 factors, one in knowledge domain (food and nutrition knowledge) and five in skill domain (functional skills, interactive skills, advocacy, critical analysis of information, and food label reading skills). On the basis of CFA, the fit indices of the model had acceptable fit and confirmed construct validity of the FNLAT (X 2/df = 1.58, RMSEA = 0.041; P = 1.00, RMR = 0.034, GFI = 0.79). The values of Cronbach's Alpha and intraclass correlation coefficient (ICC) confirmed internal consistency and time stability of the FNLAT and its subscales. CONCLUSIONS: The developed FNLAT is a valid and reliable tool to assess FNL in Iranian late adolescents and youth.