Higher health literacy score is associated with better healthy eating index in Iranian adults

Mahshid Shahavandi; Parivash Ghorbaninejad; Saba Mohammadpour; Farhang Djafari; Hossein Shahinfar; Fatemeh Sheikhhossein; Kurosh Djafarian; Sakineh Shab-Bidar

doi:10.1016/j.nut.2021.111262

Higher health literacy score is associated with better healthy eating index in Iranian adults

Nutrition. 2021 Oct:90:111262. doi: 10.1016/j.nut.2021.111262. Epub 2021 Apr 8.

Authors

Mahshid Shahavandi¹, Parivash Ghorbaninejad¹, Saba Mohammadpour¹, Farhang Djafari¹, Hossein Shahinfar², Fatemeh Sheikhhossein³, Kurosh Djafarian³, Sakineh Shab-Bidar⁴

Affiliations

¹ Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
² Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
³ Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
⁴ Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran. Electronic address: s_shabbidar@tums.ac.ir.

PMID: 33975063
DOI: 10.1016/j.nut.2021.111262

Abstract

Objective: Although there is some evidence for the importance of health literacy (HL), many health complications and nutrition knowledges such as portion size assessment, knowing the food labels, and choosing the nutrition sources affecting diet quality, data about HL and healthy eating index (HEI) are limited and controversial. The aim of this study was to evaluate the associations between HL and HEI in adults.

Methods: This cross-sectional study included 261 adults 18 to 65 y of age from five districts of Tehran, Iran. HL was estimated using the Health Literacy for Iranian Adult (HELIA) questionnaire. Dietary intake, sociodemographic data, physical activity, and anthropometric measurements were collected using validated questionnaires. Diet quality was assessed based on HEI-2015 scores using data from a food frequency questionnaire.

Results: Despite components of HEI-2015, the association between HEI-2015 and HL tertiles was significant (P of crude model = 0.007) even after adjustment for possible confounders. Multivariate regression showed a positive relationship between HL and HEI-2015 that was significant before (β = 0.12, P = 0.04) and after controlling for the confounding effect in model 1 (β = 0.14, P = 0.03). Additionally, a positive association between physical activity and HL was shown (β = 0.12, P = 0.03) and finally among the HEI components, only saturated fats were significantly related to HL (β = -0.11, P = 0.01).

Conclusion: Findings from the present study confirmed a considerable association between HL and HEI and shows HL levels have an important role in adherence to the Iranian Dietary Guidelines.

Keywords: Diet indexes; Diet quality; Health literacy; Healthy eating index.

MeSH terms

Cross-Sectional Studies
Diet
Diet, Healthy*
Health Literacy*
Iran / epidemiology
Nutrition Policy