Malloy-Weir L, Cooper M
College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
Bureau of Nutritional Sciences, Health Canada, Ottawa, ON, Canada.
J Hum Nutr Diet. 2017 Jun;30(3):309-325. doi: 10.1111/jhn.12428. Epub 2016 Oct 12.
Low health literacy, literacy and numeracy have been identified as barriers to consumer understanding and the interpretation of nutrition-related information. To inform policy and dietetic practice, we examined the extent, range and nature of research on empirical relationships between health literacy, literacy or numeracy and the understanding and use of nutrition labels.
A scoping review of the literature was conducted. A search of eight databases on 15 April 2014 and 26 May 2016 returned 651 and 173 records, respectively. After de-duplication and two levels of relevance screening, 16 studies were deemed eligible for inclusion in the present review.
The majority of studies were conducted in the USA and focused primarily on the use of back-of-pack nutrition labels. Empirical relationships reported between health literacy and nutrition label use were inconsistent and, in some cases, contradictory. The findings from studies examining empirical relationships between literacy, numeracy and nutrition label use suggest that consumers with lower literacy and numeracy: (i) differ from those with higher levels in some of the judgements that they make about food and (ii) may benefit from interventions designed to improve their understanding and use of nutrition label information. Measurement-related issues were identified, such as a reliance on self-reports of nutrition label use, as well as a lack of independence between some measures of health literacy and nutrition label understanding and use.
The empirical relationships between health literacy, literacy, numeracy and nutrition label understanding and use have not been well-studied. Additional attention is needed regarding the measurement-related issues identified in the present review.
低健康素养、读写能力和算术能力已被确定为阻碍消费者理解和解读营养相关信息的因素。为了为政策制定和饮食实践提供参考，我们研究了关于健康素养、读写能力或算术能力与营养标签理解和使用之间实证关系的研究范围、广度和性质。
对文献进行了范围综述。2014年4月15日和2016年5月26日在八个数据库中进行检索，分别返回651条和173条记录。经过去重和两级相关性筛选后，有16项研究被认为符合纳入本综述的条件。
大多数研究在美国进行，主要关注包装背面营养标签的使用。健康素养与营养标签使用之间报告的实证关系并不一致，在某些情况下甚至相互矛盾。研究读写能力、算术能力与营养标签使用之间实证关系的结果表明，读写能力和算术能力较低的消费者：（i）在对食物的一些判断上与能力较高的消费者不同；（ii）可能受益于旨在提高其对营养标签信息理解和使用的干预措施。确定了与测量相关的问题，例如依赖营养标签使用的自我报告，以及一些健康素养测量与营养标签理解和使用之间缺乏独立性。
健康素养、读写能力、算术能力与营养标签理解和使用之间的实证关系尚未得到充分研究。需要对本综述中确定的与测量相关的问题给予更多关注。
