Relationship between health literacy and nutrition among middle-aged women

Document Type : Original Article


1 Department of Health Education and Health Promotion. School of Public Health. Mashhad University of Medical Sciences . Iran

2 Associate Professor,Social Determinants of Health Research Center, Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Science, Mashhad, Iran

3 Management & Social Determinants of Health Research Center, Dept. of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences , Mashhad, Iran

4 Health Sciences Research Center, Department of Biostatistics and Epidemiology, School of Public Health, Mashhad University of Medical Sciences


Background and Objective: Health literacy refers to the individual's capacity to gain, interpret, understanding basic information and health services for the proper decision-making process. Nutrition behaviors are also health related issues, which are multi-factorial including important health implications. The aim of this study is to determine the relationship between health literacy and nutrition among middle-aged women.
Materials and Methods: This descriptive-analytical study was performed on 600 middle-aged women referring to comprehensive health centers in Dargaz in 2017. The available sampling method and a multi-faceted researcher-made questionnaire were used. Finally, after collecting the questionnaires, the data were analyzed and reported using SPSS-23 software, descriptive and analytical tests and linear regression tests.
Results: The mean and standard deviation of health literacy score was 67.46 ± 16.07. In this study, 16.7%, 27.8% and 55.5% of the subjects had inadequate, border line and adequate health literacy, respectively. According to one-way ANOVA test, there was a significant relationship between health literacy and educational level. The results showed that there was a positive and significant relationship between health literacy and nutrition behaviors.
Conclusion: Based on the findings of the study, increasing the level of health literacy can enhance the nutritional behaviors of people.
Paper Type: Research Article


1. Bohlman LN, Panzer AM, Kindig DA. Health literacy: a prescription to end confusion. Washington (DC):National Academies Press; 2004.
2. Ad Hoc Committee on Health Literacy for theCouncil on Scientific Affairs, American Medical Association. Health literacy: report of the Council on Scientific Affairs. The Journal of American Medical Association 1999; 281: 552-7.
3. Sihota S, Lennard L. Health literacy: being able to make the most of health. London: National Consumer Council; 2004.
4. Reisi M, Mostafavi F, Hasanzade A, G R Sharifirad. The Relationship between Health Literacy, Health Status and Healthy Behaviors among Elderly in Isfahan, Iran. Health Research Journal.2011;7(4).469-480. [Persian]
5. Dunneram Y, Ramasawmy D, Pugo-Gunsam P, Jeewon R. Determinants of eating habits among pre-retired and post-retired Mauritians. Int J Food Sci Nutr. 2013; 2(3):109-15.
6. Matlabi M, Sharifirad G, Mostavafi F, Mohebi S, Azadbakht L. Factors affecting fish consumption based on structures of health education. Journal of Health System Research 2012;8:523-36. [Persian]
7. Salehi L, Eftekhar H, Mohammad K, Tavafian SS, Jazayery A, Montazeri A. Consumption of fruit and vegetables among elderly people: a cross sectional study from Iran. Nutrition Journal 2010; 9: 2. [Persian]
8. Farivar F, Ramin H, Azemati B, Abbaszadeh SH, Keshtkar A, Sheikholeslam R, et al.Comparison of Knowledge, Attitude and Practice of Urban families toward Principles of Applied Nutrition. Iran J Epidemiol 2009; 5(2): 11-18. [Persian]
9. Rekhy R, McConchie R. Promoting consumption of fruit and vegetables for better health. Have campaigns delivered on the goals? Appetite 2014;79:113-23.
10. Flier JS, Morator E, Kasper DL. Harrison's principles of internal medicine. Mc Grow Hill 2010, 1: 422-429.
11. Hommond K, Mahan LA, Escott-Stump S. Krause’s food & nutrition therapy. Elsevier Saunders 2008, 383-410.
12. Tavousi M, Ebadi M, Azin A, Shakerineja GH, Hashemi A, Fattahi A, Montazeri A. Definitions of health literacy: a review of the literature. Journal of the Iranian Institute for Health Sciences. Payesh 2014; 13: 119-124. [Persian]
13. Mohammad Matlabi GS, Firoozeh Mostavafi, Siamak Mohebi, Leila Azadbakht. Factors Affecting Fish Consumption Based on Structures of Health Education. Health System Research. 2012. [Persian]
14. Croll JK, Neamark-Sztainer D, and Story M. Healthy eating: What does it mean to adolescents? J Nutr Educ 2001; 33(4): 193-198.
15. Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. American Journal of Health Promotion. 1997;12(1):38-48.
16. Charkazi A, Fazli L, Alizadeh F, et al. Regular Physical activity Based on transtheoretical Model among Health and Paramedic Schools of Golestan University of Medical Sciences.Iranian Journal of Health Education and Health Promotion. 2014;1(4):57-68.
17. Hekmatpoue Davood OMA, Shamsi Mohsen. Effectiveness of educational program on smoking cessation consistence based on trans-theoretical model. Daneshvar(medicine) shahed University. 2013;20(104):39-59. [Persian]
18. Mohammadi Zeidi Aisa PA. Effect of using the transtheoretical model for breakfast and healthy snacks on education for elementary students in Qazvin. Iranian Journal of Nutrition Sciences & Food Technology. 2013;8(2):201-10. [Persian]
19. Baghaei R, Najarzadeh M, Saei M, Mohamadi N. FUNCTIONAL HEALTH LITERACY IN PREGNANT WOMEN IN HEALTH CENTERS OF URMIA CITY- 2015. The J Urmia Nurs Midwifery Fac.2017;15(5):368-375. [Persian]
20. Khosravi A, Ahmadzadeh Kh, Arastoopoor Sh, Tahmasbi R. Health Literacy Levels of Diabetic Patients Referred to Shiraz Health Centers and Its Effective Factors. Health Inf Manage 2015; 12(2):205. [Persian]
21. Izadirad H, Zareban I. The Relationship of Health Literacy with Health Status, Preventive Behaviors and Health Services Utilization in Baluchistan, Iran. J Educ Community Health. 2016;2(3):43-50. [Persian] DOI: 10.20286/jech-02036
22. Muir KW, Lee PP. Health literacy and ophthalmic patient education. Surv Ophthalmol 2010; 55(5): 454-9.
23. Tehrani BaniHashemi SA, Amirkhani MA, Alavian SM, Asgharifard H, Baradaran H, Barghamdi M, et al.Health literacy and the influencing factors: A study in five provinces of Iran. Trides in Development of Medical Education 2007;4(1): 1-9. [Persian]
24. Javadzade H, Sharifirad Gh, Reisi M, Tavassoli E, Rajati F. [Health Literacy among Adults of Is-fahan, Iran]. Journal of Health System Re-search.2013; 9(5): 540-9. [Persian]
25. Agah B, Aghamolaei T, Alizadeh A, Rafati S, Hossaini F A. Consumption of Fruits and Vegetables based on Constructs of Transtheoretical Model in Women Referred to Health Centers of Bandar Abbas. 3. 2016; 2 (4) :1-13. [Persian]
26. Pirasteh A, Davati A, Jouhari Z, Mohamadi L. Prediction physical activity behavior among Iranian medical college students using the transtheoretical model. Daneshvar.2012;19(100)1-11. [Persian]
27. Ma J, Betts NM, Horacek T Georgiou C, White A, Nitzke S. the importance of decisional balance and self-efficacy in relation to stages of change for fruit and vegetable intakes by young adults. American Journal of Health Promotion.2002;16(3)157-66.
28. Horwath CC, Nigg CR, Motl RW, Wong KT, Dishman RK. Investigating fruit and vegetable consumption using the transtheoretical model. American Journal of health.