Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
Nutrition. 2021 Oct;90:111262. doi: 10.1016/j.nut.2021.111262. Epub 2021 Apr 8.
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.
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.
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).
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.
尽管有一些证据表明健康素养（HL）的重要性，但许多健康并发症和营养知识，如份量评估、了解食品标签和选择影响饮食质量的营养来源，有关 HL 和健康饮食指数（HEI）的数据有限且存在争议。本研究旨在评估成年人 HL 与 HEI 之间的关系。
本横断面研究纳入了来自伊朗德黑兰五个区的 261 名 18 至 65 岁的成年人。使用伊朗成人健康素养（HELIA）问卷评估 HL。使用经过验证的问卷收集膳食摄入、社会人口统计学数据、身体活动和人体测量数据。使用来自食物频率问卷的数据，根据 HEI-2015 评分评估饮食质量。
尽管 HEI-2015 的组成部分有所不同，但 HEI-2015 与 HL 三分位的关联在调整可能的混杂因素后仍然显著（粗模型 P=0.007）。多元回归显示 HL 与 HEI-2015 之间存在正相关关系，在模型 1 中控制混杂效应之前（β=0.12，P=0.04）和之后均具有统计学意义（β=0.14，P=0.03）。此外，还显示身体活动与 HL 之间存在正相关关系（β=0.12，P=0.03），最后，在 HEI 成分中，只有饱和脂肪与 HL 显著相关（β=-0.11，P=0.01）。
本研究的结果证实了 HL 与 HEI 之间存在相当大的关联，并表明 HL 水平在遵守伊朗饮食指南方面发挥着重要作用。
