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Health Literacy, Nutrition and Public Health
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Health Literacy, Nutrition and Public Health

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (31 October 2021) | Viewed by 47909

Special Issue Editors

Dr. Guglielmo Bonaccorsi

E-Mail Website
Guest Editor
Dipartimento di Scienze della Salute, Università degli Studi di Firenze, 50121 Firenze, Italy
Interests: health literacy; primary health care; food and nutrition sustainability; healthcare for frail social groups (especially for older people)
Special Issues, Collections and Topics in MDPI journals
Dr. Chiara Lorini

E-Mail Website
Guest Editor
Dipartimento di Scienze della Salute, Università degli Studi di Firenze, 50121 Firenze, Italy
Interests: health literacy; epidemiology; determinants of health
Special Issues, Collections and Topics in MDPI journals
Dr. Virginia Vettori

E-Mail Website
Guest Editor
Dipartimento di Scienze della Salute, Università degli Studi di Firenze, 50121 Firenze FI, Italy
Interests: health literacy; nutrition; assessment; food science; preventive medicine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

It is with great pleasure that we announce a Special Issue on Health Literacy, Nutrition and Public Health on IJERPH. In fact, starting from the definition of proximal and distal determinants of health produced by Dalhgren and Withehead in 1991, the strict interconnection between health, nutrition and, more recently, health literacy becomes clear as an individual as well as a diffuse life skill to promote, prevent, and sometimes cure diseases, particularly chronic diseases.

At present, with the epidemiological, nutritional, and demographic transitions in progress, it becomes unavoidable to find other, different public health responses to the health needs of the entire population, from the more to the less deprived people. From this perspective, health literacy—and food and nutrition literacy—is becoming more and more popular both in terms of individual resource and in terms of rethinking public health organizations to counteract the spreading of chronicity, which has completely changed the paradigms of care.

Health literacy is declining in many specific disciplines, among them also food and nutrition. Food and nutrition literacy are becoming potentially powerful arms to strike against obesity, malnutrition, and other nutrition-related diseases, as well as a tool (skill) to make people more empowered towards diet and food behaviors and the impact of food on the environment.

In this SI, we are expecting that the scientific community can discuss the horizons and the present and future solutions that health literacy, in its components devoted to diet, the environment, food security, food safety, and nutrition-related problems, can offer to improve people’ health. Manuscripts regarding primary studies as well as reviews will be welcomed.

Dr. Guglielmo Bonaccorsi
Dr. Chiara Lorini
Dr. Virginia Vettori
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Food literacy
  • Nutrition literacy
  • Measurement tools
  • Health promotion
  • Public health
  • Food safety
  • Food security
  • Food and environment
  • Health literacy
  • Public health nutrition

Related Special Issue

Published Papers (14 papers)

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Research

Jump to: Review, Other

11 pages, 347 KiB  
Article
Health Literacy, Socio-Economic Determinants, and Healthy Behaviours: Results from a Large Representative Sample of Tuscany Region, Italy
by Patrizio Zanobini, Chiara Lorini, Vieri Lastrucci, Valentina Minardi, Valentina Possenti, Maria Masocco, Giorgio Garofalo, Giovanna Mereu and Guglielmo Bonaccorsi
Int. J. Environ. Res. Public Health 2021, 18(23), 12432; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182312432 - 26 Nov 2021
Cited by 17 | Viewed by 2571
Abstract
Background: Health Literacy (HL) is one of the main determinants of health and is crucial for the prevention of noncommunicable diseases, by influencing key health-related behaviours. The aim of the present study was to assess the role of HL and sociodemographic factors in [...] Read more.
Background: Health Literacy (HL) is one of the main determinants of health and is crucial for the prevention of noncommunicable diseases, by influencing key health-related behaviours. The aim of the present study was to assess the role of HL and sociodemographic factors in predicting the adoption of two healthy behaviours—physical activity and fruits and vegetables consumption. Methods: This study was conducted on the Tuscan population subsample of the Italian Behavioral Risk Factor Surveillance System in 2017–2018. HL was assessed using the Italian version of the six-item European Health Literacy Survey Questionnaire (HLS-EU-Q6). Results: About 40% of the 7157 interviewees reported an inadequate or problematic HL level. Female sex, poor financial status, foreign nationality, and low education were associated with a problematic HL level, while an inadequate HL level was associated with being 50–69 years old, low education level, foreign nationality, poor financial status and unemployment or inactive status. Inadequate HL level was a strong predictor of both eating less than three portions of fruits/vegetables per day and not engaging in sufficient PA during leisure times. Conclusions: Our findings showed that an inadequate level of HL could negatively affect physical activity and diet, independently from the other sociodemographic conditions, confirming the role of HL as a relevant social determinant of health. Full article
(This article belongs to the Special Issue Health Literacy, Nutrition and Public Health)
19 pages, 1461 KiB  
Article
Visual Size Matters: The Effect of Product Depiction Size on Calorie Estimates
by Aner Tal, Yaniv Gvili and Moty Amar
Int. J. Environ. Res. Public Health 2021, 18(23), 12392; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182312392 - 25 Nov 2021
Cited by 2 | Viewed by 1885
Abstract
Consumers’ calorie estimates are often biased and inaccurate. Even the presence of relevant nutritional information may not suffice to prevent consumer biases in calorie estimation. The current work demonstrates across two studies that visual cues given by larger product depictions lead to increased [...] Read more.
Consumers’ calorie estimates are often biased and inaccurate. Even the presence of relevant nutritional information may not suffice to prevent consumer biases in calorie estimation. The current work demonstrates across two studies that visual cues given by larger product depictions lead to increased calorie estimates. Further, it demonstrates that these effects occur even when consumers are given, and notice, information about product quantity. The findings thus shed light on a novel biasing effect on consumer calorie evaluation, and, more generally, the findings provide evidence for the importance of visual inputs over textual ones in consumers’ nutritional assessment of food products. In this, the current research provides insights relevant to helping nutritional literacy via awareness of biasing influences on caloric assessment. In the same manner, the research also provides insights that may assist the regulator protecting consumers by highlighting factors biasing nutritional assessment. Full article
(This article belongs to the Special Issue Health Literacy, Nutrition and Public Health)
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12 pages, 316 KiB  
Article
Wanting More, Seeing Less: Hunger Reduces Calorie Evaluations
by Aner Tal
Int. J. Environ. Res. Public Health 2021, 18(23), 12270; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182312270 - 23 Nov 2021
Cited by 3 | Viewed by 1820
Abstract
Calorie estimates play an important role in the regulation of food consumption. Lower calorie estimates contribute to increased consumption, and consequently increase the risk of obesity. The current work presents a novel contribution demonstrating the biasing effect of hunger on calorie evaluations. Study [...] Read more.
Calorie estimates play an important role in the regulation of food consumption. Lower calorie estimates contribute to increased consumption, and consequently increase the risk of obesity. The current work presents a novel contribution demonstrating the biasing effect of hunger on calorie evaluations. Study 1 (N = 70) was a field study, where participants visiting a cafeteria estimated calories in four baked goods, with measures taken of their hunger level and their having had lunch. Study 2 was a lab study, where half of the participants (N = 65) fasted for five hours prior to the study, and then estimated calories in three baked goods. Study 1 found lower calorie estimations by hungry participants (M = 255.52, SD = 112.55) relative to lower hunger participants (M = 311.94, SD = 135.85): F(1, 67) = 6.07, p = 0.02. In study 2, the average estimated calories was lower for fasting participants (M = 253.11, SD = 126.13) than for non-fasting participants (M = 301.75, SD = 145.26). The studies demonstrate that motivations generated by physical state (hunger) alter calorie evaluations. This finding is surprising given that motivation generally leads to estimating more of a desired quantity. The study also presents a novel domain of biases in calorie estimation. This reduction in calorie estimates due to hunger may occur if calories are assessed relative to needs, or serve to allow people to justify increased food consumption. Accounting for such biases, particularly in cases of low nutrition literacy, is important in order to reduce the overeating that may be generated by calorie estimation biases. Full article
(This article belongs to the Special Issue Health Literacy, Nutrition and Public Health)
25 pages, 687 KiB  
Article
The Role of Health Literacy among Outpatient Caregivers during the COVID-19 Pandemic
by Elisabeth Rohwer, Natascha Mojtahedzadeh, Felix Alexander Neumann, Albert Nienhaus, Matthias Augustin, Volker Harth, Birgit-Christiane Zyriax and Stefanie Mache
Int. J. Environ. Res. Public Health 2021, 18(22), 11743; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182211743 - 09 Nov 2021
Cited by 7 | Viewed by 2556
Abstract
Health literacy became an important competence during the COVID-19 pandemic. Despite outpatient caregivers being a particularly vulnerable occupational group, their health literacy has hardly been examined yet, especially during the pandemic. Hence, this study aimed to explore this field and provide first empirical [...] Read more.
Health literacy became an important competence during the COVID-19 pandemic. Despite outpatient caregivers being a particularly vulnerable occupational group, their health literacy has hardly been examined yet, especially during the pandemic. Hence, this study aimed to explore this field and provide first empirical insights. Data were collected based on a cross-sectional online survey among 155 outpatient caregivers. In particular, health literacy (HLS-EU-Q16), diet and physical activity, pandemic-related worries, perceived information sufficiency and stress perception were examined. Descriptive and ordinal logistic regression analyses were run to test explorative assumptions. The majority of outpatient caregivers reported high values of health literacy (69% on a sufficient level). Although no significant associations between health literacy and health behaviours or perceived information sufficiency were found, perceived information sufficiency and perceived stress (OR = 3.194; 95% CI: 1.542–6.614), and pandemic-related worries (OR = 3.073; 95% CI: 1.471–6.421; OR = 4.243; 95% CI: 2.027–8.884) seem to be related. Therefore, dissemination of reliable information and resource-building measures to reduce worries may be important parameters for improving outpatient caregivers’ health. Our results provide first explorative insights, representing a starting point for further research. Considering outpatient caregivers’ mobile work setting, they need to be provided with adequate equipment and comprehensible information to ensure physically and mentally healthy working conditions. Full article
(This article belongs to the Special Issue Health Literacy, Nutrition and Public Health)
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12 pages, 350 KiB  
Article
What Factors Predict the Use of Coercive Food Parenting Practices among Mothers of Young Children? An Examination of Food Literacy, Disordered Eating and Parent Demographics
by Lyza Norton, Joy Parkinson, Neil Harris and Laura M. Hart
Int. J. Environ. Res. Public Health 2021, 18(19), 10538; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910538 - 08 Oct 2021
Cited by 2 | Viewed by 3040
Abstract
Parents have the most significant influence on the development of young children’s eating patterns. Understanding what parental factors best predict specific negative feeding practices is important for designing preventive interventions. We examined the relationship between parents’ use of coercive food parenting practices (pressure [...] Read more.
Parents have the most significant influence on the development of young children’s eating patterns. Understanding what parental factors best predict specific negative feeding practices is important for designing preventive interventions. We examined the relationship between parents’ use of coercive food parenting practices (pressure to eat and restriction) and parents’ disordered eating, food literacy, Body Mass Index (BMI) and socio-economic status (SES). Adult mothers, with a mean age of 33 years, at least one child aged between 6 months and 5 years and living in Australia (n = 819) completed an online questionnaire. Regression models were used to examine predictors of pressure to eat and restriction, respectively. Although the amount of variance accounted for by the models was small, maternal eating disorder symptoms were found to be the most important predictor of coercive food parenting practices. This finding has implications for early nutrition education, which has traditionally focused heavily on nutrition literacy. Parental disordered eating may be a more important preventive target and thus including behavioral strategies for positive feeding practices may better assist mothers in promoting positive eating habits with their children, rather than traditional approaches that aim to increase nutrition literacy. Full article
(This article belongs to the Special Issue Health Literacy, Nutrition and Public Health)
14 pages, 3085 KiB  
Article
Bioinformatics Approach to Mitigate Mislabeling in EU Seafood Market and Protect Consumer Health
by Gabriella Vindigni, Alfredo Pulvirenti, Salvatore Alaimo, Clara Monaco, Daniela Spina and Iuri Peri
Int. J. Environ. Res. Public Health 2021, 18(14), 7497; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18147497 - 14 Jul 2021
Cited by 5 | Viewed by 2467
Abstract
Fisheries products are some of the most traded commodities world-wide and the potential for fraud is a serious concern. Fish fraud represents a threat to human health and poses serious concerns due to the consumption of toxins, highly allergenic species, contaminates or zoonotic [...] Read more.
Fisheries products are some of the most traded commodities world-wide and the potential for fraud is a serious concern. Fish fraud represents a threat to human health and poses serious concerns due to the consumption of toxins, highly allergenic species, contaminates or zoonotic parasites, which may be present in substituted fish. The substitution of more expensive fish by cheaper species, with similar morphological characteristics but different origins, reflects the need for greater transparency and traceability upon which which the security of the entire seafood value-chain depends. Even though EU regulations have made significant progress in consumer information by stringent labelling requirements, fraud is still widespread. Many molecular techniques such as DNA barcoding provide valuable support to enhance the Common Fisheries Policy (CFP) in the protection of consumer interests by unequivocally detecting any kind of fraud. This paper aims to highlight both the engagement of EU fishery policy and the opportunity offered by new biotechnology instruments to mitigate the growing fraud in the globalized fish market and to enforce the food security system to protect consumers’ health. In this paper, after a presentation of EU rules on fish labeling and a general overview on the current state of the global fish market, we discuss the public health implications and the opportunities offered by several techniques based on genetics, reporting a case study to show the efficacy of the DNA barcoding methodology in assessing fish traceability and identification, comparing different species of the Epinephelus genus, Mottled Grouper (Mycteroperca rubra) and Wreckfish (Polyprion americanus), often improperly sold with the commercial name of “grouper”. Full article
(This article belongs to the Special Issue Health Literacy, Nutrition and Public Health)
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14 pages, 327 KiB  
Article
Insights into the Predictors of Attitude toward Entomophagy: The Potential Role of Health Literacy: A Cross-Sectional Study Conducted in a Sample of Students of the University of Florence
by Chiara Lorini, Laura Ricotta, Virginia Vettori, Marco Del Riccio, Massimiliano Alberto Biamonte and Guglielmo Bonaccorsi
Int. J. Environ. Res. Public Health 2021, 18(10), 5306; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18105306 - 17 May 2021
Cited by 10 | Viewed by 2534
Abstract
In Western countries, one of the main barriers to entomophagy is repulsion toward insects. Few studies have investigated the factors that influence attitudes toward entomophagy. Therefore, we conducted a cross-sectional study involving a sample of 248 university students, focusing on disgust and other [...] Read more.
In Western countries, one of the main barriers to entomophagy is repulsion toward insects. Few studies have investigated the factors that influence attitudes toward entomophagy. Therefore, we conducted a cross-sectional study involving a sample of 248 university students, focusing on disgust and other potential attributes that can influence insect consumption, including health literacy. We used a 17-item self-administered questionnaire. Consistent with the literature, two items were chosen as outcome variables to evaluate the predictors of the propensity to consume insects: “Have you ever eaten insects or insect-based products?” and “How disgusting do you find eating insects?” The data analysis shows that having already eaten insects is inversely associated with the level of disgust (OR: 0.1, p < 0.01); and it is positively associated with higher levels of health literacy (OR: 3.66, p > 0.01). Additionally, having some knowledge and information about entomophagy is inversely associated with a higher level of disgust (OR: 0.44, p = 0.03 and OR: 0.25, p = 0.03, respectively), while being female is positively associated with disgust (OR: 3.26, p < 0.01). Our results suggest the potential role of health literacy, in addition to other factors, in influencing the willingness to taste insects. However, further studies involving larger and non-convenience samples are needed to confirm our hypothesis. Full article
(This article belongs to the Special Issue Health Literacy, Nutrition and Public Health)
19 pages, 400 KiB  
Article
The Nutrition Literacy Assessment Instrument for Italian Subjects, NLit-IT: Exploring Validity and Reliability
by Virginia Vettori, Chiara Lorini, Heather D. Gibbs, Francesco Sofi, Vieri Lastrucci, Gino Sartor, Ilaria Fulvi, Duccio Giorgetti, Giuseppe Cavallo and Guglielmo Bonaccorsi
Int. J. Environ. Res. Public Health 2021, 18(7), 3562; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18073562 - 30 Mar 2021
Cited by 8 | Viewed by 3544
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Health Literacy, Nutrition and Public Health)
9 pages, 351 KiB  
Article
Nutrition Literacy of Portuguese Adults—A Pilot Study
by Mónica Monteiro, Tatiana Fontes and Cíntia Ferreira-Pêgo
Int. J. Environ. Res. Public Health 2021, 18(6), 3177; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18063177 - 19 Mar 2021
Cited by 14 | Viewed by 3170
Abstract
Nutrition is an essential factor in the prevention and treatment of some chronic diseases. For this reason, the population must know about nutrition, healthy food, and dietetics so that the promotion of healthier eating habits can lead to a consequent decrease in chronic [...] Read more.
Nutrition is an essential factor in the prevention and treatment of some chronic diseases. For this reason, the population must know about nutrition, healthy food, and dietetics so that the promotion of healthier eating habits can lead to a consequent decrease in chronic disease incidence. That said, the present study aimed to assess nutrition literacy in the Portuguese population. Three hundred thirty participants aged between 18 and 65 years old were included in an observational, quantitative, and cross-sectional research. After the analysis, it was found that the vast majority of the study population (65.2%) had a good level of nutrition literacy. The participants having upper educational qualifications, following a specific diet, presenting an adequate BMI, having family members trained in the field of nutrition, and those who studied or worked in the field of health sciences reported a higher level of nutrition literacy. In conclusion, it seems to be essential to identify the population groups with the lowest nutrition knowledge so that it would be possible to apply personalized measures and to promote better literacy, reducing the prevalence and incidence of diseases and improving quality of life. Full article
(This article belongs to the Special Issue Health Literacy, Nutrition and Public Health)
24 pages, 3493 KiB  
Article
Food Next Door: From Food Literacy to Citizenship on a College Campus
by Nanna Meyer, Mary Ann Kluge, Sean Svette, Alyssa Shrader, Andrea Vanderwoude and Bethany Frieler
Int. J. Environ. Res. Public Health 2021, 18(2), 534; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18020534 - 11 Jan 2021
Cited by 8 | Viewed by 3799
Abstract
Industrial agriculture and food corporations have produced an abundance of food that is highly processed, nutritionally poor, and environmentally burdensome. As part of a healthy campus initiative, generated to address these and other food production and consumption dilemmas, a student-run “local and sustainable” [...] Read more.
Industrial agriculture and food corporations have produced an abundance of food that is highly processed, nutritionally poor, and environmentally burdensome. As part of a healthy campus initiative, generated to address these and other food production and consumption dilemmas, a student-run “local and sustainable” food establishment called Food Next Door (FND) was created. This intrinsic case study evaluated food literacy in health science students, faculty, and staff first as a pilot to build the case for FND and further explicated customers’, volunteers’, and leads’ experiences with FND, identifying potential pathways from food literacy to citizenship. Ten returning customers, eight recurring nutrition student volunteers, and three graduate student leads participated in interviews that were analyzed for themes and subthemes. The findings show a progression in themes. Customers’ experiences highlight FND’s fresh, flavorful food, smiling and supportive staff, and personal transformation. Volunteers’ themes identified greater awareness of new foods and plant-based eating, acquiring new knowledge and skills in commercial kitchens, and deepening their connection to food, each other, and to where food comes from. Leads’ themes show opportunities to gain managerial skills, a deeper understanding of food and skills from being immersed in value-based food systems, and confidence in peer teaching. Experiencing and becoming part of the food value chain through FND built food literacy, shifted values, and transformed students into food citizens. Full article
(This article belongs to the Special Issue Health Literacy, Nutrition and Public Health)
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12 pages, 317 KiB  
Article
Supporting a Healthier Takeaway Meal Choice: Creating a Universal Health Rating for Online Takeaway Fast-Food Outlets
by Louis Goffe, Nadege S. Uwamahoro, Christopher J. Dixon, Alasdair P. Blain, Jona Danielsen, David Kirk and Ashley J. Adamson
Int. J. Environ. Res. Public Health 2020, 17(24), 9260; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17249260 - 11 Dec 2020
Cited by 14 | Viewed by 4400
Abstract
Digital food ordering platforms are used by millions across the world and provide easy access to takeaway fast-food that is broadly, though not exclusively, characterised as energy dense and nutrient poor. Outlets are routinely rated for hygiene, but not for their healthiness. Nutritional [...] Read more.
Digital food ordering platforms are used by millions across the world and provide easy access to takeaway fast-food that is broadly, though not exclusively, characterised as energy dense and nutrient poor. Outlets are routinely rated for hygiene, but not for their healthiness. Nutritional information is mandatory in pre-packaged foods, with many companies voluntarily using traffic light labels to support making healthier choices. We wanted to identify a feasible universal method to objectively score takeaway fast-food outlets listed on Just Eat that could provide users with an accessible rating that can infer an outlet’s ‘healthiness’. Using a sample of takeaway outlets listed on Just Eat, we obtained four complete assessments by nutrition researchers of each outlet’s healthiness to create a cumulative score that ranged from 4 to 12. We then identified and manually extracted nutritional attributes from each outlet’s digital menu, e.g., number of vegetables that have the potential to be numerated. Using generalized linear modelling we identified which attributes were linear predictors of an outlet’s healthiness assessment from nutritional researchers. The availability of water, salad, and the diversity of vegetables were positively associated with academic researchers’ assessment of an outlet’s healthiness, whereas the availability of chips, desserts, and multiple meal sizes were negatively associated. This study shows promise for the feasibility of an objective measure of healthiness that could be applied to all outlet listings on Just Eat and other digital food outlet aggregation platforms. However, further research is required to assess the metric’s validity, its desirability and value to users, and ultimately its potential influence on food choice behaviour. Full article
(This article belongs to the Special Issue Health Literacy, Nutrition and Public Health)
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9 pages, 321 KiB  
Article
Are Health Literacy and Lifestyle of Undergraduates Related to the Educational Field? An Italian Survey
by Francesca Gallè, Patrizia Calella, Christian Napoli, Fabrizio Liguori, Eduardo Alfonso Parisi, Giovanni Battista Orsi, Giorgio Liguori and Giuliana Valerio
Int. J. Environ. Res. Public Health 2020, 17(18), 6654; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17186654 - 12 Sep 2020
Cited by 13 | Viewed by 2380
Abstract
Background: Health literacy (HL) is a fundamental ability to successfully deal with health and illness issues. This study aimed to assess HL among undergraduates from healthcare and non-healthcare degree courses of two Italian universities and the association between their HL, lifestyles, and [...] Read more.
Background: Health literacy (HL) is a fundamental ability to successfully deal with health and illness issues. This study aimed to assess HL among undergraduates from healthcare and non-healthcare degree courses of two Italian universities and the association between their HL, lifestyles, and BMI assumed as health outcome. Methods: The Health Literacy Assessment Tool (HLAT-8) and the Newest Vital Sign (NVS) were used to assess health literacy dimensions. Demographic and anthropometric data, adherence to Mediterranean diet (MD), physical activity levels, and smoking habits were assessed in the enrolled sample to highlight possible associations. Results: A total sample of 806 undergraduates (46% males, mean age 21.01 ± 1.78 years) was recruited. Higher HL scores were found among healthcare rather than non-healthcare students (28.7 ± 4.5 vs. 26.7 ± 4.2 for HLAT-8 and 4.9 ± 1.5 vs. 3.9 ± 1.8 for NVS, p < 0.01). However, healthcare undergraduates were more likely to report unhealthy behaviors. Body Mass Index (BMI) was associated with literacy and numeracy skills only in non-healthcare undergraduates. Significant associations were found between HL scores and adherence to MD in both groups. In the regression analysis, educational field and MD were shown to be predictors of HL scores. Conclusions: Attending a healthcare related degree course was associated with higher HL scores but not with healthy behaviors. This issue should be addressed considering the role that healthcare professionals may have in educating patients towards a healthy lifestyle. Adherence to MD seems to be related to higher HL scores. Full article
(This article belongs to the Special Issue Health Literacy, Nutrition and Public Health)

Review

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21 pages, 1467 KiB  
Review
Towards the Implementation of a Conceptual Framework of Food and Nutrition Literacy: Providing Healthy Eating for the Population
by Virginia Vettori, Chiara Lorini, Chiara Milani and Guglielmo Bonaccorsi
Int. J. Environ. Res. Public Health 2019, 16(24), 5041; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16245041 - 11 Dec 2019
Cited by 52 | Viewed by 8397
Abstract
Existing definitions of food literacy (FL) and nutrition literacy (NL) in particular refer to individual knowledge, motivation, competences, and awareness, which determine the relationship between individuals and food, the food system, and nutrition information. Several authors proposed specific conceptualization of the terms. Nevertheless, [...] Read more.
Existing definitions of food literacy (FL) and nutrition literacy (NL) in particular refer to individual knowledge, motivation, competences, and awareness, which determine the relationship between individuals and food, the food system, and nutrition information. Several authors proposed specific conceptualization of the terms. Nevertheless, the description of analogies and differences between FL and NL is still lacking, as is an integrated framework which highlights the meaning of the concepts. This work aims to describe and discuss evidence provided by the literature in order to develop and propose a comprehensive conceptualization of FL and NL to the scientific community. We systematically reviewed six databases, considering the search terms of FL and NL. We collected the antecedents, components, and consequences of both FL and NL. We underlined and traced similarities of the concepts as well as prerogative features through the content analysis of definitions. We obtained 14 definitions of NL and 12 definitions of FL; 42 papers presented antecedents and 53 papers contained consequences. We observed that NL could be considered a specific form of FL. In addition, we noted that the consequences of NL are included in the subset of the consequences of FL and the conceptual limits of FL correspond to the outcome of healthful diet. We conclude that FL and NL build a multifaceted concept which implies both individual and public perspectives. We propose a conceptualization which could be useful to develop an executive framework aimed at providing healthy eating for the population. Full article
(This article belongs to the Special Issue Health Literacy, Nutrition and Public Health)
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Other

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12 pages, 1223 KiB  
Perspective
A Conceptual Model Map on Health and Nutrition Behavior (CMMHB/NB)
by Kirsten Schlüter, Sandra Vamos, Corinne Wacker and Virginia D. E. Welter
Int. J. Environ. Res. Public Health 2020, 17(21), 7829; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17217829 - 26 Oct 2020
Cited by 7 | Viewed by 3815
Abstract
The Conceptual Model Map (CMM) presented here is intended to show the connections between different theories and constructs in the field of health and nutrition behavior (including literacy models, the knowledge–attitude(s)–practice(s) survey structure (KAP), behavior change theories, and Maslow’s pyramid of needs). The [...] Read more.
The Conceptual Model Map (CMM) presented here is intended to show the connections between different theories and constructs in the field of health and nutrition behavior (including literacy models, the knowledge–attitude(s)–practice(s) survey structure (KAP), behavior change theories, and Maslow’s pyramid of needs). The CMM can be used as a map to locate existing and future studies, to show their range of effect as well as their limitations. In this context, the CMM also reveals reasons for the attitude/intention–behavior gap. Full article
(This article belongs to the Special Issue Health Literacy, Nutrition and Public Health)
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