Nutrition Literacy and Quality of Life of University Students: Evidence from A Cross-Sectional Survey

Document Type : Original Article

Authors

1 Mardin Artuklu University Faculty of Health Sciences Department of Nutrition and Dietetics, Mardin/Türkiye

2 Kırıkkale University, Vocational School of Health Services, First and Emergency Aid Program, Kırıkkale/Türkiye

Abstract

Background and Objective: Nutrition literacy is a concept that improves individuals' diet quality, and quality of life and contributes to enhancing their general health by using and interpreting nutrition-related information correctly. This study purposed to determine the nutritional literacy and quality of life levels of university students and relate them with anthropometric measurements.

Materials and Methods: This is a cross-sectional study and was conducted with 374 university students over the age of 18 at a state university. Nutrition literacy was assessed by using the Evaluation Instrument of Nutrition Literacy on Adults (EINLA), and quality of life was evaluated with the World Health Organization's Quality of Life Questionnaire (Turkish_WHOQOL-BREF). Waist, middle-upper arm, neck circumference, body weight, and height were measured in accordance with appropriate techniques by researchers. Independent t and One-Way ANOVA tests were used to determine differences between two and more than two mean values. Pearson correlation analysis was used to detect relationships between scores of total EINLA, its sections, total Turkish_WHOQOL-BREF and its dimensions, and other variables.

Results: The mean EINLA and WHOQOL-BREF scores of the participants were 25.3±4.7 (borderline) and 54.3±15.1, respectively. While the EINLA score varied according to gender, faculty (health sciences vs others), and degree (1 to 4), the WHOQOL-BREF score varied according to gender and living place (home vs dormitory). EINLA and WHOQOL-BREF scores of BMI (underweight to obese), waist circumference, and neck circumference (normal vs at risk) groups were not different. It was found positive significant relationships between the second section of EINLA (reading comprehension and interpretation) and psychological health, the third section of EINLA (food groups), and social relationships (p<0.05).

Conclusion: Nutrition literacy, anthropometric measurements, and quality of life of university students are affected by a multifactorial situation.

Keywords


Acknowledgements: The authors thank all students to participate in this study and to spend their valuable time.


Availability of data and materials: Data will be available upon request from the corresponding author.


Conflicts of interests: The authors have no conflicts of interest to declare.


Consent for publication: Not applicable.


Ethical approval and consent to participate: The study was conducted with the permission of Mardin Artuklu University Ethics Committee (Date:10.01.2021, Decision no:2022-4). All procedures complied with the principles laid down in the Declaration of Helsinki.


Funding: The authors declared that this study has received no financial support.


Author contributions: Jiyan Aslan Ceylan: The idea/scope, data collection, literature review, manuscript writing. Aylin Bayındır Gümüş: Data analysis and interpretation, literature review, manuscript writing. All authors read the article and approved the final version of the article.

1. Sørensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, et al. Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012;12:1-13.
https://doi.org/10.1186/1471-2458-12-80
PMid:22276600 PMCid:PMC3292515
 
2. Ehmann AT, Groene O, Rieger MA, Siegel A. The relationship between health literacy, quality of life, and subjective health: Results of a cross-sectional study in a rural region in Germany. International Journal of Environmental Research and Public Health. 2020;17(5):1683.
https://doi.org/10.3390/ijerph17051683
PMid:32150820 PMCid:PMC7084276
 
3. Zheng M, Jin H, Shi N, Duan C, Wang D, Yu X, et al. The relationship between health literacy and quality of life: a systematic review and meta-analysis. Health and Quality of Life Outcomes. 2018;16(1):1-10.
https://doi.org/10.1186/s12955-018-1031-7
PMid:30326903 PMCid:PMC6192335
 
4. Arriaga M, Francisco R, Nogueira P, Oliveira J, Silva C, Câmara G, et al. Health literacy in Portugal: results of the health literacy population survey project 2019-2021. International Journal of Environmental Research and Public Health. 2022;19(7):4225.
https://doi.org/10.3390/ijerph19074225
PMid:35409905 PMCid:PMC8998262
 
5. Hirooka N, Kusano T, Kinoshita S, Aoyagi R, Saito K, Nakamoto H. Association between health literacy and purpose in life and life satisfaction among health management specialists: a cross-sectional study. Scientific Reports. 2022;12(1):8310.
https://doi.org/10.1038/s41598-022-11838-w
PMid:35585083 PMCid:PMC9117675
 
6. Taylor MK, Sullivan DK, Ellerbeck EF, Gajewski BJ, Gibbs HD. Nutrition literacy predicts adherence to healthy/unhealthy diet patterns in adults with a nutrition-related chronic condition. Public Health Nutrition. 2019;22(12):2157-69.
https://doi.org/10.1017/S1368980019001289
PMid:31146797 PMCid:PMC6827561
 
7. Velardo S. The nuances of health literacy, nutrition literacy, and food literacy. Journal of Nutrition Education and Behavior. 2015;47 (4):385-9. e1.
https://doi.org/10.1016/j.jneb.2015.04.328
PMid:26026651
 
8. Silk KJ, Sherry J, Winn B, Keesecker N, Horodynski MA, Sayir A. Increasing nutrition literacy: testing the effectiveness of print, web site, and game modalities. Journal of Nutrition Education and Behavior. 2008;40 (1):3-10.
https://doi.org/10.1016/j.jneb.2007.08.012
PMid:18174098
 
9. Nutbeam D. Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promotion International. 2000;15 (3):259-67.
https://doi.org/10.1093/heapro/15.3.259
https://doi.org/10.1093/heapro/15.3.183
 
10. Baş D, Tontaş E, Kavuşan KA, Seçkiner S, Sakar Schoinas E, Kayak S. Relationship between nutritional literacy and quality of life in Turkish adults: a cross-sectional survey. Journal of Health Literacy. 2023.
 
11. Joulaei H, Keshani P, Kaveh MH. Nutrition literacy as a determinant for diet quality amongst young adolescents: a cross sectional study. Progress in Nutrition. 2018;20 (3):455-64.
 
12. Li Z, Zhen T, Zhao Y, Zhang J. Development and assessment of a nutrition literacy scale for patients with end-stage kidney disease undergoing dialysis and its correlation with quality of life. Renal Failure. 2023;45 (1):2162417.
https://doi.org/10.1080/0886022X.2022.2162417
PMid:36632830 PMCid:PMC9848248
 
13. Cesur B, Koçoğlu G, Sümer H. Evaluation instrument of nutrition literacy on adults (EINLA) A validity and reliability study. Integr Food Nutr Metab. 2015;2 (1):127-30.
https://doi.org/10.15761/IFNM.1000114
 
14. Eser E, Fidaner H, Fidaner C, Eser SY, Elbi H, Göker E. WHOQOL-100 ve WHOQOL-BREF'in psikometrik özellikleri. Psikiyatri Psikoloji Psikofarmakoloji (3P) Dergisi. 1999;7 (Suppl 2):23-40.
 
15. Fidaner H, Elbi H, Fidaner C, Eser S, Eser E, Göker E. Measuring quality of life, WHOQOL-100 and WHOQOL-BREF. Psikiyatri Psikoloji Psikofarmakoloji (3P) Dergisi. 1999;7 (2 Suppl.):5-13.
 
16. World Health Organization. Body Mass Index (BMI) Classification 2010 2010 [Available from: https://www.who.int/europe/news-room/fact-sheets/item/a-healthy-lifestyle---who-recommendations.
 
17. World Health Organization. Waist Circumference and Waist-Hip Ratio Report of a WHO Expert Consultation 2008 [Available from: https://apps.who.int/iris/bitstream/handle/10665/44583/9789241501491_eng.pdf.
 
18. Hingorjo MR, Qureshi MA, Mehdi A. Neck circumference as a useful marker of obesity: a comparison with body mass index and waist circumference. JPMA-Journal of the Pakistan Medical Association. 2012;62 (1):36.
 
19. Schober P, Boer C, Schwarte LA. Correlation coefficients: appropriate use and interpretation. Anesthesia & Analgesia. 2018;126(5):1763-8.
https://doi.org/10.1213/ANE.0000000000002864
PMid:29481436
 
20. Vettori V, Lorini C, Milani C, Bonaccorsi G. Towards the implementation of a conceptual framework of food and nutrition literacy: Providing healthy eating for the population. International Journal of Environmental Research and Public Health. 2019;16 (24):5041.
https://doi.org/10.3390/ijerph16245041
PMid:31835678 PMCid:PMC6950737
 
21. Krause C, Sommerhalder K, Beer-Borst S, Abel T. Just a subtle difference? Findings from a systematic review on definitions of nutrition literacy and food literacy. Health Promotion International. 2018;33 (3):378-89.
 
22. Milte CM, Thorpe MG, Crawford D, Ball K, McNaughton SA. Associations of diet quality with health-related quality of life in older Australian men and women. Experimental Gerontology. 2015;64:8-16.
https://doi.org/10.1016/j.exger.2015.01.047
PMid:25639944
 
23. Wu XY, Zhuang LH, Li W, Guo HW, Zhang JH, Zhao YK, et al. The influence of diet quality and dietary behavior on health-related quality of life in the general population of children and adolescents: a systematic review and meta-analysis. Quality of Life Research. 2019;28:1989-2015.
https://doi.org/10.1007/s11136-019-02162-4
PMid:30875010
 
24. Jayasinghe UW, Harris MF, Parker SM, Litt J, Van Driel M, Mazza D, et al. The impact of health literacy and life style risk factors on health-related quality of life of Australian patients. Health and Quality of Life Outcomes. 2016;14:1-13.
https://doi.org/10.1186/s12955-016-0471-1
PMid:27142865 PMCid:PMC4855442
 
25. Nucci D, Manzan E, Tesolin M, Zordan C, Mauro LL, Moretto V, et al. Nutrition literacy assessment in oncology informal caregivers: preliminary data of a cross-sectional study. Population Medicine. 2023;5 (Supplement).
https://doi.org/10.18332/popmed/163855
 
26. Kamarlı Altun H, Suna G, Kürklü NS, Ermumcu MŞK, Ateş Z, Akçınar E, et al. Evaluation of the relationship between nutrition literacy and health literacy in adults. Beslenme ve Diyet Dergisi. 2022;50 (2):30-8.
https://doi.org/10.33076/2022.BDD.1642
 
27. Kalkan I. The impact of nutrition literacy on the food habits among young adults in Turkey. Nutrition Research and Practice. 2019;13 (4):352-7.
https://doi.org/10.4162/nrp.2019.13.4.352
PMid:31388412 PMCid:PMC6669071
 
28. Eroğlu Son N. Association of nutrition literacy level with sociodemographic data: Case of Afyonkarahisar. Medicine Science. 2023;12(1).
https://doi.org/10.5455/medscience.2022.10.218
 
29. Department of Health Human Services Centers for Disease Control Prevention. Body mass index: considerations for practitioners. Centers for Disease Control and Prevention; 2015.
 
30. Al-Jawaldeh A, Abbass MM. Unhealthy dietary habits and obesity: the major risk factors beyond non-communicable diseases in the eastern mediterranean region. Frontiers in Nutrition. 2022;9:817808.
https://doi.org/10.3389/fnut.2022.817808
PMid:35369054 PMCid:PMC8970016
 
31. Saneei P, Esmaillzadeh A, Keshteli AH, Feizi A, Feinle-Bisset C, Adibi P. Patterns of dietary habits in relation to obesity in Iranian adults. European Journal of Nutrition. 2016;55:713-28.
https://doi.org/10.1007/s00394-015-0891-4
PMid:25832491
 
32. Michou M, Panagiotakos DB, Lionis C, Costarelli V. Health and nutrition literacy in adults: Links with lifestyle factors and obesity. Mediterranean Journal of Nutrition and Metabolism. 2020;13 (4):361-70.
https://doi.org/10.3233/MNM-200471
 
33. Demirer B, Yardımcı H. Nutritional literacy levels of university academic and administrative staff: A cross-sectional study from Turkey. Nutrition and Health. 2023:02601060231163922.
https://doi.org/10.1177/02601060231163922
PMid:36916177
 
34. Çıkırıkçı EK, Esin M. Nutrition Literacy of Overweight/Obese and Non-Overweight/Obese Turkish Women and Affecting Factors: Ezgi Hasret Kozan Çıkırıkçı. The European Journal of Public Health. 2022;32 (Suppl 3).
https://doi.org/10.1093/eurpub/ckac131.317
PMCid:PMC9593558
 
35. Li S, Zhu Y, Zeng M, Li Z, Zeng H, Shi Z, et al. Association Between Nutrition Literacy and Overweight/Obesity of Adolescents: A Cross-Sectional Study in Chongqing, China. Frontiers in Nutrition. 2022;9:893267.
https://doi.org/10.3389/fnut.2022.893267
PMid:35634378 PMCid:PMC9134066
 
36. Cunha M, Saboga-Nunes L, Cunha B. Education for health, dietary habits, nutritional status and indicators of metabolic risk. Procedia-Social and Behavioral Sciences. 2017;237:875-81.
https://doi.org/10.1016/j.sbspro.2017.02.186
 
37. Tozetto WR, Leonel LdS, Benedet J, Duca GFD. Quality of life and its relationship with different anthropometric indicators in adults with obesity. Fisioterapia em Movimento. 2021;34.
https://doi.org/10.1590/fm.2021.34102
 
38. Kose B, Yesil E, Turker PF, Ok MA, Bayram S, Beyaz EK, et al. The relationship between quality of life and anthropometric measurements in premenopausal and postmenopausal among turkish women. Progress in Nutrition. 2019;21 (4):776-82.
 
39. Fan Y-J, Feng Y-J, Meng Y, Su Z-Z, Wang P-X. The relationship between anthropometric indicators and health-related quality of life in a community-based adult population: A cross-sectional study in Southern China. Frontiers in Public Health. 2022;10:955615.
https://doi.org/10.3389/fpubh.2022.955615
PMid:36249240 PMCid:PMC9554305
 
40. Chandrasekara R, Jayasinghe M. Nutrition Literacy for Human Health: A Review on Current Global and Sri Lankan Scenario. Vavuniya Journal of Science. 2022;1 (2):27-42.
https://doi.org/10.4038/vjs.v1i2.11
 
41. Güner TA, Günter T. The Effect on the Quality of Life and Metabolic Control of Nutritional Literacy in Individuals with Diabetes Mellitus. Online Türk Sağlık Bilimleri Dergisi. 2022;7 (1):19-26.
https://doi.org/10.26453/otjhs.938705
 
42. Silva AB, Pimenta R. Assessing the relationship between health literacy and quality of life in chronic kidney disease patients. Journal of Health Literacy. 2023;8 (3):22-33.