Search Results (66)

Background/Objectives: Nutrition in inflammatory bowel disease (IBD) is a central concern for both patients and healthcare professionals, as it plays a key role not only in daily life but also in disease outcomes. The Mediterranean diet represents a healthy dietary pattern that may be suitable in many cases of IBD. Among other factors, health literacy (HL) influences patients’ dietary habits and their ability to follow nutritional recommendations. The aim of this study was to assess HL and dietary patterns in adolescent and pediatric patients with IBD. Methods: We conducted a cross-sectional study that included a total of 99 participants (36 patients with IBD receiving biological therapy recruited from a single center and 63 healthy controls). HL was assessed using the Newest Vital Sign (NVS) tool regardless of disease activity, whereas diet quality was evaluated by the KIDMED questionnaire exclusively in patients in remission. Linear regression models were used to evaluate the effects of sex, age and group (patients vs. control) on NVS and KIDMED scores. Results: Most participants (87.9%) had an adequate HL, which was positively associated with age. While the most harmful dietary habits (such as frequent fast-food consumption) were largely absent in the patient group, KIDMED scores indicated an overall poor diet quality. Conclusions: Although HL increased with age and was generally adequate in this cohort, it did not translate into healthier dietary patterns as measured by the KIDMED score. Further research with larger, more diverse samples is needed to clarify the relationship between HL and dietary adherence in adolescents with IBD. Full article

Background: Chinese school-age students are at a high risk of developing obesity. However, few studies have reported individualized ways to prevent obesity by age, gender, and living regions. Methods: A total of 11,285 students aged 6–18 years were recruited and participated in this cross-sectional study. Questionnaires were used to assess scores of dietary diversity (DDS), physical activity (PA) duration, and nutritional literacy awareness. According to age and gender-specific BMI thresholds, the participants were categorized into normal and participants with obesity groups. Pearson correlation and logistic regression analysis were used to explore the association between nutritional literacy, DDS, PA, and the risk of BMI or obesity. Results: Scores of nutritional literacy were positively associated with Total DDS, Plant DDS, Animal DDS, and PA, and were negatively associated with BMI. High Total DDS (OR = 0.878, p = 0.030), Plant DDS (OR = 0.885, p = 0.027), and PA (OR = 0.869, p = 0.022) were strongly associated with a low risk of obesity. Furthermore, high Total DDS and Plant DDS decreased the risk of obesity only in the high PA group but not in the low PA group. High PA only decreased the risk of obesity in the high Total DDS and high Plant DDS group. Gender-, age-, and living-region-specific associations were also observed. Conclusions: Diverse dietary intakes and physical activity are essential for reducing the risk of obesity in Chinese school-age students. Notably, gender-, age-, and living-region-specific health and nutritional literacy education are required in school-age children to prevent obesity. Full article

Adequate and diverse diets are essential for children’s physical and cognitive development, yet food insecurity and malnutrition continue to threaten this fundamental right, which remains a pressing concern in many resource-poor settings. This study investigated food and nutrition security in Early Childhood Development (ECD) centres in Makhanda, South Africa, through a community-based participatory research approach. Using a mixed-methods approach combining questionnaire interviews, focus group discussions, direct observations, and community asset mapping across eight ECD centres enrolling 307 children aged 0–5 years, the study engaged ECD facilitators and analysed dietary practices across these centres. Results indicated that financial constraints severely affect the quality and diversity of food provided at the centres, thus undermining the ability to provide nutritionally adequate meals. The average amount spent on food per child per month at the centres was R90 ± R25 (South African Rand). Although three meals were generally offered daily, cost-driven dietary substitutions with cheaper, less diverse alternatives, often at the expense of nutritional value, were common. Despite guidance from Department of Health dieticians, financial limitations contributed to suboptimal feeding practices, with diets dominated by grains and starchy foods, with limited access to and rare consumption of protein-rich foods, dairy, and vitamin A-rich fruits and vegetables. ECD facilitators noted insufficient parental contributions and low engagement in supporting centre operations and child nutrition provision, indicating a gap in awareness and limited nutrition knowledge regarding optimal infant and young child feeding (IYCF) practices. The findings emphasise the need for sustainable, multi-level and community-led interventions, including food gardening, creating ECD centre food banks, parental nutrition education programmes, and enhanced financial literacy among ECD facilitators. Strengthening local food systems and establishing collaborative partnerships with communities and policymakers are essential to improve the nutritional environment in ECD settings. Similarly, enhanced government support mechanisms and policy-level reforms are critical to ensure that children in resource-poor areas receive adequate nutrition. Future research should focus on scalable, locally anchored models for sustainable child nutrition interventions that are contextually grounded, community-driven, and should strengthen the resilience of ECD centres in South Africa. Full article

Background/Objectives: Despite the growing awareness of nutrition and the popularity of healthy lifestyles among adolescents, disordered eating behaviors—such as anorexia nervosa, bulimia nervosa, binge eating disorder (BED), and avoidant/restrictive food intake disorder (ARFID)—remain significant public health concerns. ARFID, officially recognized only in 2013, is still poorly understood among youth. This study aimed to assess the relationship between adolescents’ nutritional knowledge, emotional regulation, media influence, and eating behaviors. Methods: A cross-sectional study was conducted in 2024 among 120 students aged 15–17 attending W. Reymont Secondary School No. II in Ostrów Wielkopolski, Poland. Participants completed a custom-designed, paper-based questionnaire consisting of 30 single-choice questions and demographic items. The instrument assessed knowledge of eating disorders, body satisfaction, social media impact, and the emotional determinants of food choices. The tool was developed with expert input but has not undergone formal psychometric validation. While many adolescents demonstrated basic nutritional knowledge—such as awareness of BMI norms and food group distribution—they often failed to apply this knowledge to their dietary behaviors. Results: Significant gender differences were observed: girls were more likely to restrict food intake, report emotional eating, and engage in slimming behaviors, while boys were less emotionally reactive and less influenced by social media. Most participants reported eating one meal daily with family but rarely discussed nutrition at home. Emotional involvement in eating, particularly among girls, emerged as a key factor, more influential than social media in shaping dietary behaviors. Conclusions: The findings highlight a clear gap between nutritional knowledge and actual behavior among adolescents, driven in part by emotional dysregulation and body image concerns. School-based interventions should incorporate not only nutritional education but also emotional regulation strategies and media literacy to effectively support healthy eating behaviors in youth. Full article

Background: This study aims to develop and validate the Nutrition Literacy Questionnaire for Chinese Pre-school Children (NLQ-PSC). Methods: The reliability of the questionnaire was determined by internal consistency, the construct validity was assessed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and the content validity was assessed by the Pearson correlation coefficient. In order to analyze the application of NLQ-PSC, we conducted a cross-sectional study among 790 pre-school children. Results: From the literature review and qualitative methods, NLQ-PSC was developed, including two dimensions of knowledge and four practice dimensions. The NLQ-PSC questionnaire had good reliability and validity. The average NLQ-PSC score of all participants was 64.1 ± 11.0, and we found that older children, girls, and children who had well-educated parents presented higher nutrition literacy. Conclusions: NLQ-PSC has been validated and has shown good reliability and validity, and it could be considered a reliable tool to assess Chinese pre-school children. Full article

Background/Objectives: Recent interest has emerged in novel initiatives that focus on the “whole child” to improve the health and well-being in youth. The purpose of this study was to determine whether a translational health in nutrition and kinesiology (THINK) program addressing physical, psychological, and educational well-being could improve personal health and lifestyle behaviors in youth. Methods: A total of 81 adolescents (44 males, 37 females, 12.50 + 0.62 years) were evaluated at the beginning and end of the spring semester across three different years: 2019, 2021, and 2023. The physical literacy measures included the Physical Activity Enjoyment Scale (PAES) and the Physical Activity Perception Scale (PAPS), along with knowledge-based tests in nutrition and exercise science. Social emotional learning (SEL), STEM education, and nutrition habits were evaluated using standard surveys and questionnaires. The physical evaluations included measures of body composition and physical fitness. Results: At the completion of the spring semester of each year, evaluations were compiled for all three years, with decreases found for % body fat (p < 0.001) and increases found for lean body mass (p < 0.001). The physical fitness components, including muscular strength (p < 0.001), cardiorespiratory fitness (p < 0.001), power (p < 0.001), and flexibility (p < 0.01), all improved. The physical literacy components, including the PACES (p < 0.001), PAPS (p < 0.001), exercise (p < 0.05), and nutrition science knowledge (p < 0.05) results, also improved. There were no significant changes in any other variables. Conclusions: A novel in-school academic curriculum integrating the physical, psychological, and educational well-being of the whole child could lead to improved body composition, physical fitness, and physical literacy. Full article

Background: Health literacy (HL) promotes the achievement of skills and information useful to endorse health. Food Literacy (FL) is a subtype of HL related to the knowledge necessary to achieve a healthy diet. Methods: This pilot study aimed to assess and improve FL of hospital workers through a survey before and after an educational intervention consisting of nutrition courses, infographics, and updates to the canteen service. FL was evaluated with a questionnaire, and Kruskal–Wallis, Friedman and Wilcoxon test was performed to assess group differences. Results: Of 897 participants, 375 (T1) completed both surveys, while 522 completed only T0. A pairwise comparison stratified by role, age and education revealed a significant improvement in FL scores in the T1 group. Improvements were observed in the T1 group, with overall scores rising from 6.2 ± 2.7 to 6.9 ± 2.1 (p-value < 0.001). An upgrade was noted in healthcare workers (T0 = 6.5 ± 2.2 vs. T1 = 7 ± 2, p-value < 0.001), administrative workers (T0 = 5.5 ± 2.5 vs. T1 = 6.2 ± 2.4, p-value = 0.008), all age groups (T0 = 6.3 ± 2.4 vs. T1 = 6.8 ± 2, p-value = 0.03, T0 = 6.2 ± 2.3 vs. T1 = 6.7 ± 2.2, p-value = 0.02, T0 = 6.2 ± 2.3 vs. T1 = 7 ± 2, p-value = 0.003), low and high education (T0 = 5.7 ± 2.3 vs. T1 = 6.6 ± 2.1, p-value < 0.001, T0 = 6.6 ± 2.3 vs. T1 = 7.1 ± 2 p-value = 0.03). Conclusions: Our survey highlights the efficacy of a multifactorial intervention in enhancing FL and proves the importance of food health promotion within workplaces. Full article

Background and Objectives: Most patients with cardiovascular disease have limited health literacy and knowledge. The promotion of knowledge among patients with coronary artery disease is an integral part of health maintenance and the minimisation of secondary cardiac events. The aim of this study was to map the percent proportion of answers and scores obtained from them in the studied domains. Materials and Methods: In this cross-sectional study, a Coronary Artery Disease Education Questionnaire (CADE-Q II) was used to verify knowledge gaps in the five studied domains. In total, 253 patients with coronary artery disease completed the CADE-Q II, which targeted five domains: health status, risk factors, exercise, nutrition and psychosocial risk. Data were collected between June 2021 and November 2024. Results: An analysis of the data found a total mean CADE-Q II score of 61.05 ± 11.42 SD out of 93 points. Our research showed that the total mean score of a group of patients corresponded to an acceptable level of knowledge. Patients in the cohort provided a total of 7843 responses for the five study domains. In total, 46.8% of patients scored all answers correctly in terms of risk factors, 49.0% in terms of nutrition, 53.1% in terms of health status, 64.4% in terms of psychosocial risk, and 65.0% in terms of exercise. Conclusions: The use of the CADE-Q II questionnaire, with its focus on the studied domains, verifies patient knowledge and provides a foundation for education, the provision of effective information and the promotion of secondary prevention knowledge. Full article

Background/Objectives: The transition to university life brings significant social, psychological, and environmental changes, making it a critical period for establishing long-term dietary habits. However, many Mexican university students fail to meet national dietary guidelines, increasing their risk of non-communicable diseases. This study examines the determinants of healthy eating among university students in Oaxaca using a holistic, multi-level approach grounded in the Social Ecological Model (SEM) and Social Cognitive Theory (SCT). Methods: A mixed-methods approach was employed, integrating ethnography with a validated self-report questionnaire completed by 411 students at the Universidad Autónoma Benito Juárez de Oaxaca (UABJO). The ethnographic data included observations, field notes, photographs, informal conversations, and 13 semi-structured interviews. Data triangulation provided a comprehensive understanding of dietary behaviors by capturing both self-reported patterns and real-world eating practices and the food environment, as captured through ethnographic methods. The analysis included descriptive statistics, normality tests, and parametric tests to assess significant differences. Results: The findings revealed a decline in diet quality, characterized by low fruit and vegetable intake, high snack consumption, and irregular meal patterns, particularly among students living independently. Key barriers included academic stress, time constraints, low cooking self-efficacy, limited nutritional knowledge, peer pressure, and negative social norms, which contributed to reliance on convenient, processed foods. The lack of healthy food options on campus and the high perceived cost of nutritious food further led students to prioritize cheap, calorie-dense foods over healthier choices. Conversely, enablers included structured university schedules; peer support; hands-on culinary interventions; and improved access to affordable, healthy food. Conclusions: Addressing these barriers requires multi-level interventions that enhance nutrition literacy, cooking self-efficacy, and peer-led strategies while improving the campus food environment. Future research should explore SCT-based initiatives leveraging social networks and culinary education to foster sustainable dietary behavior change in university settings and assess how these findings can be applied in other socioeconomic and cultural contexts. Full article

Background: Social media platforms have become integral to daily life and increasingly disseminate health, nutrition, and food information. While these platforms can offer evidence-based nutrition education and meal planning guidance, a significant portion of content promotes unrealistic beauty standards and unhealthy weight-loss practices, potentially contributing to disordered eating behaviors. The increasing prevalence of disordered eating, characterized by abnormal eating behaviors and attitudes, has become a global public health concern. This study examines whether social media consumption correlates with disordered eating symptoms in Israeli college students. Methods: A cross-sectional study was conducted among college students at Ashkelon Academic College in Israel. The questionnaire assessed demographics, social media usage (platforms used, frequency, and content followed), body satisfaction, and disordered eating symptoms, measured via the Eating Attitudes Test (EAT-26). Results: The study sample comprised 580 students (73% were female and 27% were male) with a mean age of 27.87 years. Participants predominantly used multiple social media platforms, with a majority following food-, eating-, and health-related content. Despite having a normal BMI, a substantial number of participants reported body dissatisfaction. The results indicated a positive correlation between social media use and disordered eating symptoms. Individuals who frequently engaged with food-related content on social media exhibited higher levels of disordered eating. Moreover, body satisfaction emerged as a significant mediator in the relationship between social media use and disordered eating symptoms. Conclusions: The findings of this study support the growing body of evidence linking social media use to disordered eating behaviors among young adults. Developing targeted interventions that promote media literacy and foster body positivity is essential. Additionally, future research should explore the long-term effects of social media on eating behaviors and the effectiveness of different prevention strategies. Full article

Background: Young women spend 50 min daily on social media (SM); thus, SM platforms are promising for health interventions. This study tested the feasibility and preliminary efficacy of the co-designed SM intervention the Daily Health Coach (DHC). The DHC is a 3-month healthy lifestyles intervention programme, targeting eating, physical activity, and social wellbeing behaviours in women aged 18–24, via the dissemination of health and nutrition content on social media platform Instagram. Methods: The programme was tested using an assessor-blinded, two-arm pilot randomised controlled trial with 46 participants over 12 weeks. Engagement was assessed via SM metrics; acceptability via post-programme questionnaires; and feasibility included retention, randomisation, recruitment, and data collection. Secondary outcomes—dietary quality, physical activity, social influence, disordered eating behaviours, body image, and digital health literacy—were assessed using validated surveys. Analyses included t-tests, chi-squared tests, and linear mixed models. The treatment effects were estimated by testing mean score differences from baseline to 3 months for intention-to-treat populations. Results: The DHC scored 83.6% for programme satisfaction. Over time, a significant decrease in body image disturbance was observed (p = 0.013). A significant group-by-time interaction for digital health literacy (p = 0.002) indicated increased ability to discern evidence-based nutrition information (p = 0.006). The waitlist control group showed increased social influence compared to the intervention group (p = 0.034). No other significant changes were observed. Conclusion: The DHC is a feasible and acceptable method for disseminating nutrition information. Larger studies are needed to determine efficacy. Full article

Background/Objectives: Persons with MS (pwMSs) are often confronted with contradictory dietary advice, which is not always based on sound scientific evidence. This may lead to poor MS-specific nutrition knowledge (MSNK) and food literacy (MSFL). To date, no studies have assessed MSNK and MSFL among pwMSs. Moreover, no validated tools to measure the effects of educational interventions are available. The aim of this study was to develop and validate MS-specific instruments to measure MSNK and MSFL among pwMSs. Methods: Based on a validated food literacy (FL) screener for the general population and prior research about the information needs of pwMSs, we developed 14 MSFL items and 11 MS-specific nutrition knowledge questions. Cognitive debriefing was conducted with 10 pwMSs and resulted in a 12-item MS food literacy questionnaire (MSFLQ) and an 11-item MS nutrition knowledge questionnaire (MSNKQ). After refinement, both questionnaires were pilot tested in an online survey to explore their comprehensibility. The MSNKQ was analyzed descriptively (mean and percentage of correctly answered questions). For MSFLQ item difficulty, the discriminatory power of the items, internal consistency and convergent/divergent validity were assessed. Results: In total, 148 pwMSs (age: 47.1 years (SD = 12.5); 102 women (69%)) completed the online survey. On average, participants answered 3.51/11 MSNK questions correctly (31.9%). The MSFLQ showed good internal consistency (Cronbach’s alpha = 0.85), item difficulty was good and the discriminatory power of the items was satisfactory. Correlations between the MSFLQ and a general food literacy questionnaire was high (r = 0.626, p < 0.001), but only small with the MSNKQ (r = 0.180; p = 0.029), underlining the different constructs. Conclusions: MSNK among pwMSs in Germany is low. The MSNKQ and MSFLQ appear to be suitable instruments to assess MSNK and MSFL and might serve as outcome measures for educational interventions. Full article

Background/Objectives: Caregivers play an important role in supporting care recipients to navigate their health needs, including adherence to dietary recommendations, which are complex and multifaceted. This study aims to (i) describe the nutrition knowledge of caregivers of people with chronic kidney disease (CKD), and (ii) explore caregivers’ perceptions of their role in providing healthy meals and nutrition support for care recipients. Methods: A cross-sectional study design employed a multi-strategy research approach. Caregivers (n = 78) of people with stage 1–5 CKD or post-transplant were recruited from a single centre. Their nutrition knowledge was assessed quantitatively with the revised General Nutrition Knowledge questionnaire. Theory-informed semi-structured interviews of a sub-sample (n = 12) qualitatively explored caregiver perceptions. Results: Most caregivers were female (75.6%) and cared for a male care recipient (87%; aged 74 (66; 80) yrs.). The caregivers (75.6%) provided a meal ≥6 times/week to their care recipient and had moderate nutrition knowledge (66.1 (60.5; 73.9)%). Four themes emerged describing the caregivers’ perceptions of meal provision and nutrition support, including the following: (i) food literacy skills are valued; (ii) social support is important; (iii) caregivers’ sense of social responsibility; and (iv) the management of complex and multifaceted dietary needs. Conclusions: The caregivers had moderate nutrition knowledge; they wanted to provide healthy meals and support to their care recipients to adhere to dietary recommendations. Targeted, co-designed nutrition education programs for caregivers may enhance nutrition care delivery to people with CKD. Full article

Objective: Increasing the awareness of adolescents about hedonic hunger, understanding the difference between homeostatic hunger and hedonic hunger, and adolescents learning to control themselves to stop excessive food consumption are extremely important for a healthy adulthood. The study aimed to evaluate the effects of the multi-strategy nutrition education programs (MSNEP) on hedonic hunger, food addiction, nutrition literacy, and nutritional status in adolescents. Methods: This study was planned using a pre-test and post-test design. The MSNEP was conducted with 132 adolescents (11–15 years; 69 boys, 63 girls) for 4 weeks (45 min–1 h/session). Data were obtained using questionnaires with face-to-face interviews at pre-education (baseline) and post-education (week 4 and week 8). The survey form included sociodemographic information, nine item short version of Children’s Power of Food Scale (C-PFS-9), the Yale Food Addiction Scale for Children 2.0 (YFAS-C 2.0), the Adolescent Nutrition Literacy Scale (ANLS), anthropometric measurements, and 24-hour dietary recall. Results: A decrease in C-PFS-9 total scores was found compared to the baseline (p < 0.001). While the YFAS-C 2.0 score decreased in boys compared to the baseline (p < 0.05), no significant difference was found in girls (p > 0.05). A difference was found in the ANLS scores for girls (p = 0.01), but no difference was found in the scores for boys during the study (p > 0.05). At week 4, the consumption of dairy products, legumes, vegetables and fruits, bread and grains, nuts, and hard-shelled seeds increased compared to the baseline (p < 0.05). Also, daily protein and fiber intake increased (p < 0.05). Accordingly, a higher YFAS-C 2.0 score predicted greater hedonic hunger. A lower ANLS score was a predictor for higher food taste and food available scores. Conclusions: In conclusion, the MSNEP was found to have positive effects on hedonic hunger, food addiction, nutritional literacy, and healthy eating behaviors. The study revealed differences between girls and boys. In order to maintain healthy body weights in adolescents, it is recommended that the MSNEP be provided in schools. Full article

Objectives: Our aim was to study how hemodialysis patients with varying levels of literacy would use a diet and fluid intake monitoring mobile application (DIMA-P) and what would be its impact on their dietary behaviors. Materials and Methods: We developed a mobile application using user-centered methods and informed by the Integrated Theory of Health Behavior Change (ITHBC). Eight hemodialysis patients were recruited to use the application to record and monitor their diet and fluid intakes for a 6-week study. Overall, the participants had low literacy, numeracy, and technical skills. We collected the data on application usage and administered usability and context-of-use questionnaires to gain insights into the participants’ interaction with the application. The participants’ portion estimation skills and dietary self-regulation self-efficacy were assessed using various tests. In addition, interdialytic weight gain data were collected to assess the impact of app usage on the participants’ health outcomes. Results: The application usage patterns varied, with a general trend towards frequent use (n = 5) correlating with engagement in self-monitoring. The participants gave high comprehensibility, user-friendliness, satisfaction, and usefulness ratings, suggesting that the app was well designed and the target users could easily navigate and interact with the features. While the participants improved in estimating portion sizes, the impact on measuring skills was variable. There was also an improvement in the participants’ dietary self-regulation self-efficacy post-study. The interdialytic weight gain trends indicated a slight improvement in fluid and diet management. Conclusion: People with different literacy skills can effectively use icon-based interfaces for portion size estimation and develop personalized usage patterns to self-regulate their fluid and dietary intakes. Moreover, they can experience an enhancement in their dietary self-efficacy skills by using a mobile application aimed at providing nutritional feedback. Furthermore, this research shows that the constructs of the ITHBC are effective in promoting dietary behavior change in a population with varying literacy skills. The target users can benefit from explicitly visualizing the relationship between their health outcomes and the factors influencing those outcomes. These user ambitions could be supported by developing machine learning models. Future research should also focus on enhancing the mechanisms by which technology can further enhance each component of the ITHBC framework. Full article