Buyinza Thomas, Buzigi Edward, Bukenya Justine, Mbuliro Mary, Kiwanuka Julius, Ndejjo Rawlance, Guwatudde David
Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda.
Department of Community Health and Behavioural Sciences, School of Public Health, Makerere University, Kampala, Uganda.
BMC Public Health. 2025 Jul 3;25(1):2335. doi: 10.1186/s12889-025-23498-2.
Adolescent malnutrition, including stunting, underweight, and micronutrient deficiency, is a major public health concern in Sub-Saharan Africa (SSA). While studies from the global north and Asia have shown that nutrition literacy supports healthier diets, evidence on literacy status and its role in influencing overall diet quality among adolescents and young adults (AYA) in SSA is limited. This study assessed nutrition literacy and its association with diet quality among AYA in rural Uganda.
This cross-sectional study was implemented as part of the ARISE-NUTRINT project. Based on Nutbeam's model of health literacy, the study was conducted among 1206 AYA aged 10-24 years in Mayuge district, Eastern Uganda, selected through stratified random sampling. Using a structured questionnaire, the Global Diet Quality Score (GDQS) was adapted to estimate diet quality, and the Adolescent Nutrition Literacy Scale was used to assess nutrition literacy status. Logistic regression models were employed to assess the association between nutrition literacy and diet quality, adjusting for socio-economic characteristics.
Among 1206 respondents (51.1% female), 85.9% were still in school, over 62% were from low socioeconomic status households, and only 14% used mobile phones. Low nutrition literacy (49%) was prevalent, with many unfamiliar with a balanced diet or ignoring dietary advice, although 62% were willing to promote healthy eating. Overall, 12.6% had poor diet quality based on GDQS, marked by frequent refined grain consumption and low fruit/vegetable intake. Having low nutrition literacy was associated with a close to five-fold increase in poor diets (adjusted OR = 4.71, 95% CI: 2.19-10.16) while mobile phone use was associated with better diet quality by 56% (aOR = 0.44, 95% CI: 0.27-0.74).
Low nutrition literacy is a significant burden among AYA, and is strongly associated with suboptimal diet quality. Implementing targeted interventions to improve nutrition literacy can enhance diet quality among AYA in the study area.
青少年营养不良，包括发育迟缓、体重不足和微量营养素缺乏，是撒哈拉以南非洲（SSA）的一个主要公共卫生问题。虽然来自全球北方和亚洲的研究表明营养素养有助于形成更健康的饮食，但关于SSA青少年和青年（AYA）的素养状况及其在影响总体饮食质量方面的作用的证据有限。本研究评估了乌干达农村地区AYA的营养素养及其与饮食质量的关联。
本横断面研究作为ARISE-NUTRINT项目的一部分实施。基于Nutbeam的健康素养模型，通过分层随机抽样在乌干达东部马尤盖区1206名10 - 24岁的AYA中开展研究。使用结构化问卷，对全球饮食质量评分（GDQS）进行调整以估计饮食质量，并使用青少年营养素养量表评估营养素养状况。采用逻辑回归模型评估营养素养与饮食质量之间的关联，并对社会经济特征进行调整。
在1206名受访者（51.1%为女性）中，85.9%仍在上学，超过62%来自社会经济地位较低的家庭，只有14%使用手机。低营养素养（49%）普遍存在，许多人不熟悉均衡饮食或忽视饮食建议，尽管62%的人愿意推广健康饮食。总体而言，根据GDQS，12.6%的人饮食质量较差，其特征是经常食用精制谷物且水果/蔬菜摄入量低。低营养素养与不良饮食增加近五倍相关（调整后的OR = 4.71，95% CI：2.19 - 10.16），而使用手机与饮食质量提高56%相关（aOR = 0.44，95% CI：0.27 - 0.74）。
低营养素养是AYA中的一个重大负担，并且与次优饮食质量密切相关。实施有针对性的干预措施以提高营养素养可以改善研究地区AYA的饮食质量。
