Abstract

BackgroundFood literacy refers to all practicalities associated with healthy eating. Current food literacy tools are limited in practical use in clinical practice. Therefore, an integrated food literacy tool (IFLT) to assess food literacy and to personalize food literacy guidance was developed and validated.MethodsFollowing an iterative process, a food literacy framework was developed and food literacy goals were defined. A corresponding food literacy screener (FLS) to assess food literacy was developed along with an algorithm to provide personalized food literacy guidance based on the food literacy assessment. Content validation of the FLS was assessed by a panel of experts, measuring item and scale content validity index (I/S-CVI) and by the target population in semi structured interviews with 15 adults of reproductive age. Subsequently, an online cross-sectional survey was conducted among 114 adults of reproductive age to evaluate the validity of the FLS. Construct validity was examined against both the validated healthy eating and weight self-efficacy scale and against a food frequency questionnaire assessing healthy eating self-efficacy (HESE) and diet quality, respectively. Reliability was assessed with a two-week test-retest. Pearson correlation tests were conducted.ResultsAn IFLT consisting of a FLS and corresponding algorithm to personalize food literacy guidance by prioritizing food literacy goals was developed. The IFLT includes 24 food literacy goals, addressed by 17 FLS items. Every item received a weighting factor based on theory and expert opinion to prioritize food literacy goals according to personal needs. Content validity revealed that the FLS was rated relevant by experts (S-CVI = 0.93) and well-understood by the target population. The FLS has a good construct validity as it was positively correlated with diet quality (r = 0.536, p < 0.001) and with HESE (r = 0.685, p < 0.001). It also showed a good test-retest reliability (r = 0.721, p < 0.001).ConclusionThe newly developed IFLT is a practically applicable, context specific theory-and expert-based dual purpose tool to assess food literacy and to personalize food literacy guidance by prioritizing individuals' food literacy goals to their needs.

Highlights

  • Food literacy refers to all practicalities associated with healthy eating

  • Regarding domains on food literacy, the Food Literacy (FL) expert panel came to a consensus to focus on planning, selecting, preparing, eating and evaluating information

  • The FL expert panel agreed to the following food literacy definition: “Food literacy is the interrelated combination of knowledge, skills and self-efficacy on food planning, selecting foods, and food preparation, eating and evaluating information about food with the ultimate goal of developing a lifelong healthy, sustainable and gastronomic relationship with food.”

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Summary

Introduction

Food literacy refers to all practicalities associated with healthy eating. Current food literacy tools are limited in practical use in clinical practice. The European Food4me study showed that personalized nutritional advice, via an internet-delivered intervention, produced larger and more appropriate changes in dietary behavior than a conventional approach among European adults [6, 7]. Personalized nutrition (PN) is defined as “individual-specific information founded in evidence-based science to promote dietary behavior change that may result in measurable health benefits.”(3). To the question of “how” to achieve a healthy diet, there is the question of “what (i.e., the content of nutritional advice)” needs to be optimized. Achieving and maintaining a healthy diet comprises more than just an optimal combination of food items. Evidence depicts food literacy as an effective strategy to counter these dietary behavior determinants [9, 10]

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