An Ontology-Based Serious Game Design for the Development of Nutrition and Food Literacy Skills.

Background: Improving food and nutrition literacy is fundamental to tackling the Middle East and North Africa (MENA) region’s enormous challenges, including malnutrition and food insecurity. To direct initiatives, it is crucial to assess the region’s food and nutrition literacy. Thus, we aimed to review studies on food/nutrition literacy status in the MENA countries and illuminate the region’s research gaps in these areas, in terms of assessment, policy, and program implementation. Methods: PubMed and Google Scholar databases were searched between 18 December and 8 May 2022, to identify relevant articles published up to 2022 in the MENA region. Results: Twelve studies were included in this review. Lebanon, Palestine, and Iran are the only three MENA countries where nutrition and/or food literacy were assessed. People in these countries mostly had inadequate food and/or nutrition literacy levels, especially in the skills rather than the cognitive domain. Food and/or nutrition literacy showed associations with food habits, food-label use, food-consumption patterns, school performance, food security, dietary diversity, and nutrient adequacy. The MENA countries developed no policies or programs to address food and nutrition literacy. Conclusion: This review is a wake-up call for researchers and policymakers to develop a robust approach to combat food and nutrition literacy concerns in the MENA region.

The notion of food or nutrition literacy refers to a person's ability to acquire, understand, and process food and nutrition-related information to make appropriate nutritional decisions.The aim of this study is to present the concepts of nutrition and food literacy, to indicate the methods of their measurement and the factors determining their level, and to determine their importance.The study is based on a selective review of the literature.Food and nutrition literacy is defined as a distinct form of health literacy.The difference between food and nutrition literacy is not clearly defined.Both nutrition and food literacy can be related to the categories of health literacy proposed by Nutbeam, including functional, interactive, and critical categories.However, food literacy appears to be more complex and, as stated by many authors, it corresponds with most of Nutbeam's categories.Nutrition literacy in the literature is generally described as the category of functional literacy.The level of nutrition and food literacy depends on many factors, such as age, gender, and level of education.Several instruments are available to determine the level of food and nutrition literacy.The most popular tools are the Nutrition Literacy Scale (NLS), Nutrition Literacy Assessment Instrument (NLit), Newest Vital Sign (NVS), Electronic Nutrition Literacy Tool (e-NutLit), and Short Food Literacy Questionnaire (SFLQ).Adequate levels of food and nutrition literacy are associated with beneficial dietary choices, which may be important in the prevention of chronic non-communicable diseases.Education and health communication interventions are crucial to improve food and nutrition literacy.

Background A healthy diet is a key factor in people’s long-term health. The nutritional health literacy and food literacy of the population play a crucial role in this. In 2021, comprehensive data on these competences were collected for the first time in Austria. Methods Almost 3,000 people were surveyed online. Nutrition health literacy was assessed with the newly developed Nutrition Health Literacy Scale (NHLS) and food literacy with the Self-Perceived Food Literacy Scale Short-Form (SPFL-SF). Scores and subscores were calculated. Associations between socio-demographic and socio-economic factors and the competences surveyed were assessed using t-tests, variance analysis, correlations, and multivariate regression models. Results In terms of nutritional health literacy, respondents score an average of 60 out of 100 points, with judging (51 points) and applying (60 points) nutritional information being the most difficult. In the area of food literacy, respondents score an average of 62 out of 100 points. The most challenging areas are ‘healthier choices’ (44 points), ‘healthy snacking’ (52 points) and ‘healthy eating in exceptional circumstances’ (54 points). In both areas, men and people with less formal education score lower. In the case of nutritional health literacy, people aged 65 and over have greater difficulties. Conversely, this group performs better in the area of food literacy. Differences by income can only be seen for nutritional health literacy, to the detriment of low-income groups. Conclusions Possible options for action include the provision of quality-assured and target-group-specific information, the implementation of appropriate tools to facilitate the assessment of foods, and measures to strengthen assessment skills, digital health literacy, food and nutrition skills. Key messages • The survey showed that there is potential for improvement in both nutritional health literacy and food literacy. • The biggest challenge is to evaluate and use nutritional information and to stick to a healthy diet without making exceptions.

Stok et al., 2018). Therefore, while the beginning or end points of emerging adulthood can differ in other research contexts, for the purposes of the current dissertation, we will consider emerging adults to be those aged between 18 and 25. The Challenge of Navigating Food Choices in Emerging AdulthoodThe road to adulthood is often described as a winding path marked by newfound independence and autonomy as well as new challenges and responsibilities, making it sometimes difficult to navigate (Arnett, 2014).As emerging adults navigate the complex landscape of adulthood, they have greater autonomy, including Food literacy is often used in the literature alongside related concepts such as health, media, and nutrition literacy (Truman et al., 2020;Velardo, 2015).These interconnected concepts collectively play a crucial role in the promotion of health and well-being, however, each with their own specific focus (Truman et al., 2020).Health literacy, nutrition literacy, and food literacy all describe a spectrum of skills, knowledge, and abilities necessary to make informed and appropriate decisions that enhance one's health (Krause et al., 2018; Truman et al., 2020;Velardo, 2015).While health literacy pertains to the ability to obtain, process, understand, and utilize health information and services to make appropriate health decisions (Murimi, 2013;Nutbeam, 2000), food literacy is considered a distinct form of health literacy that explicitly focuses on health literacy skills within a food-specific context (Velardo, 2015).Nutrition literacy, focusing on the comprehension and utilization of nutrition information for making healthy dietary choices, is often regarded as a subset of food literacy (Krause et al., 2018;Thomas et al., 2019;Vettori et al., 2019).In addition, media literacy is a broader concept aimed at developing critical skills necessary for accessing, interpreting, analyzing, evaluating, and creating messages across various media platforms (Aufderheide, 2018;Livingstone, 2004;Potter, 2010).While media literacy is frequently applied in health contexts to shield individuals from potential negative media effects (Potter, 2010; Truman et al., 2020), it also plays an essential role in the concepts of food and nutrition literacy (Boedt et al., 2021;Fox & Marinescu, 2020).The intersection of media and food/nutrition literacy emphasizes the importance of obtaining and evaluating food-and nutrition-related information and media messages, recognizing how media shape perceptions of food, nutrition, and health, and enabling individuals to make informed dietary decisions based on media content (Boedt et al., 2021;Fox & Marinescu, 2020; Truman et al., 2020).In essence, health, nutrition, media, and food literacy are interconnected pillars that each have a unique focus to collectively empower individuals to be healthier and more informed (Truman et al., 2020).It is worth noting that the relative importance of each type of literacy varies depending on an individual's life stage and the specific situations and challenges they encounter (Barton & Hamilton, 2005).For emerging adults, who often face the responsibility of managing everyday foodrelated matters independently for the first time, food literacy becomes increasingly crucial (Slater et al., 2018).and the specific content of the domains can differ over a person's life course (Cullen et al., 2015; Vidgen, 2016a).First, the competencies related to food literacy may differ depending on one's cultural background, such as socioeconomic status or geographic location.For example, a person with a lower income may need to learn how to stretch their food budget and make nutritious meals with limited resources.In comparison, a person with a higher income may need to learn how to navigate a range of specialty food options.Second, food literacy should be viewed as a "no-end competence," meaning that different competencies or levels are needed during a life course depending on individual or environmental changes (Cullen et

In this paper, preliminary results of the evaluation of a serious game promoting nutrition literacy (NL) and food literacy (FL) are presented. The serious game's effectiveness was evaluated in terms of educational value and user experience through a two-part evaluation strategy. In the first part, a quasi-experimental study was designed to assess the serious game's educational value compared to an alternative intervention based on the study of text-based material. Appropriate questionnaires were delivered prior to, immediately after, and one week after the intervention. In the second part of the evaluation strategy, the user experience was measured by means of the Game Experience Questionnaire (GEQ). Nineteen and 29 participants enrolled in the first and second part of the evaluation, respectively. The results of the study showed that both serious game and control intervention enhance user's NL and FL skills (p-value = 0.002, 0.025 respectively). Comparison between the two groups did not yield significant results (p-value = 0.25). Increased levels of competence, immersion, flow and positive affect were declared in the GEQ demonstrating the attractiveness of the serious game. Moreover, the study revealed an important association between the level of game interaction, as measured by the number of mouse clicks per second, and the user experience. Intermediate levels of mouse interaction indicate lower user engagement.

"Where" and "What" Do Adolescent Athletes Learn When It Comes toFood Literacy Compared With Adolescents that Do Not Play Sports? A Gender-Based Thematic Analysis.

Existing definitions of food literacy (FL) and nutrition literacy (NL) in particular refer to individual knowledge, motivation, competences, and awareness, which determine the relationship between individuals and food, the food system, and nutrition information. Several authors proposed specific conceptualization of the terms. Nevertheless, the description of analogies and differences between FL and NL is still lacking, as is an integrated framework which highlights the meaning of the concepts. This work aims to describe and discuss evidence provided by the literature in order to develop and propose a comprehensive conceptualization of FL and NL to the scientific community. We systematically reviewed six databases, considering the search terms of FL and NL. We collected the antecedents, components, and consequences of both FL and NL. We underlined and traced similarities of the concepts as well as prerogative features through the content analysis of definitions. We obtained 14 definitions of NL and 12 definitions of FL; 42 papers presented antecedents and 53 papers contained consequences. We observed that NL could be considered a specific form of FL. In addition, we noted that the consequences of NL are included in the subset of the consequences of FL and the conceptual limits of FL correspond to the outcome of healthful diet. We conclude that FL and NL build a multifaceted concept which implies both individual and public perspectives. We propose a conceptualization which could be useful to develop an executive framework aimed at providing healthy eating for the population.

BackgroundFood and nutrition literacy is a key factor in shaping healthy dietary behaviors and may result in decreasing decrease the prevalence of overweight. Empirical research on food and nutrition literacy and its outcomes is limited, especially among children and adolescents. Thus, this study investigates the link between Food and Nutrition Literacy (FNLIT) with eating behaviors, academic performance, and overweight in 10–12 years old students in Tehran, Iran.MethodsThis study was performed through two phases: 1) Proposing a conceptual model of the relationship between FNLIT and its determinants and outcomes, based on the existing evidence and previous models, and 2) Testing the proposed FNLIT model through a cross-sectional study on 803 primary school students (419 boys and 384 girls, from 34 public and 10 private primary schools), aged 10–12 years using structural equation modeling. Demographic, socio-economic, and household food security characteristics were collected by interviewing the students and their mothers/caregivers using a questionnaire. FNLIT was measured by a self-administered, locally designed, and validated questionnaire.ResultsThe fit indices suggested a reasonably adequate fit of the data to the hypothesized model (χ2/df = 2.03, p < 0.001, goodness of fit index (GFI) = 0.90, adjusted goodness of fit index (AGFI) = 0.88, comparative fit index (CFI) = 0.91, incremental fit index (IFI) = 0.91, root mean square error of approximation (RMSEA) = 0.04, standardized root mean residual (SRMR) = 0.06). SES was directly and positively related to FNLIT and its subscale in students. FNLIT score had a positive direct (non-mediated) relationship with healthy eating behavior and academic performance. This pattern was strongly reversed in unhealthy eating behavior. There was a full mediation relationship between FNLIT and overweight/obesity via healthy eating behaviors. SES predicted academic performance partially through the mediating effect of Food Label Literacy (FLL). The results indicated that despite the direct relationship between SES and academic performance, an indirect but negative relationship existed with food insecurity.The finding also revealed the fully mediating role of Food Choice Literacy (FCL) in the relationship between demographic factors and healthy eating behaviors. Our study also found that Interactive Food and Nutrition Literacy (IFNL) protected unhealthy eating behaviors, and FCL predicted healthy eating behaviors in children.ConclusionOur study draws attention to FNLIT, especially the skills domain, including IFNL, FCL, and FLL, as the most important determinant of healthy eating behavior, academic performance, and weight status in school-age children reduces social inequalities in children’s development.To ensure an adequate level of FNLIT, educators should assess and plan to enhance food literacy skills in children and adolescents.

AimTo assess food and nutrition literacy status and its determinants among elementary school students in El-Beheira Governorate, Egypt.BackgroundDeveloping strategies to enhance food and nutrition literacy necessitates a deeper understanding of the food and nutrition literacy situation among elementary school students and associated factors.DesignA cross-sectional descriptive research design was adopted.MethodsA final sample of 400 primary school students (aged 6–12 years) at Itay El Barud public elementary schools in El-Beheira Governorate were administered (1) a socio-demographic characteristics and anthropometric measurements questionnaire developed by the researchers, and (2) the Food and Nutrition Literacy Scale. The derived data were analyzed using descriptive and non-parametric tests.ResultsThe majority (61%) of students had low food and nutrition literacy scores. The results have shown that overall socio-demographic variables were significant in predicting understanding food and nutrition information, nutritional health knowledge, interactive functional and nutritional literacy, critical food and nutritional literacy, and food labeling.ConclusionThe study reveals that elementary school students in Egypt have poor knowledge and skills in food and nutrition literacy, largely due to a lack of nutrition education and family awareness. Factors like residential location, income, and education level also contribute to this disparity.Implications for the professionTo improve nutrition literacy among students, a nursing approach involving community stakeholders and school nurses is recommended. This includes integrating nutrition-related topics into the school curriculum, organizing workshops, and conducting age-appropriate health education sessions. Active engagement between community health and school nurses is crucial for raising awareness about healthy nutritional choices.ImpactThese findings hold an important impact on the education system and those designing curricula, emphasizing the need for significant incorporation of knowledge and skills related to food and nutrition within schools.Reporting methodCompliance with the STROBE checklist for cross-sectional studies was maintained throughout the research.Patient or public contributionNo Patient or Public Contribution.

Food literacy (FL) and nutrition literacy (NL) are concepts that can help individuals to navigate the current food environment. Building these skills and knowledge at a young age is important for skill retention, confidence in food practices and supporting lifelong healthy eating habits. The objectives of this systematic review were to: (i) identify existing tools that measure FL and NL among children and/or adolescents and (ii) describe the psychometric properties. A 4-phase protocol was used to systematically retrieve articles. The search was performed in May 2021. Study characteristics and psychometric properties were extracted, and a narrative synthesis was used to summarise findings. Risk of bias was assessed using the COSMIN checklist. Six databases were searched to identify current tools. Children (2-12 years) and adolescents (13-18 years) participated in this study. Twelve tools were identified. Three tools measured FL, 1 tool measured NL, 4 tools measured both FL and NL, and 4 tools measured subareas of NL-more specifically, critical NL, food label and menu board literacy. Most tools were self-reported, developed based on a theoretical framework and assessed some components of validity and/or reliability for a specific age and ethnic group. The majority of tools targeted older children and adolescents (9-18 years of age), and one tool targeted preschoolers (3-6 years of age). Most widely used definitions of FL and NL do not acknowledge life-stage specific criterion. Continued efforts are needed to develop a comprehensive definition and framework of FL and NL appropriate for children, which will help inform future assessment tools.

Food and nutrition literacy is a fundamental and new idiom among health policymakers. Improving children’s food and nutrition literacy is a fundamental task, and it requires detailed planning. The aim of this study is to design, implement, and evaluate a food and nutrition literacy promotion intervention in elementary school children based on the Intervention Mapping model.This is a sequential study to design, implement, and evaluate a food and nutrition literacy promotion intervention in elementary school children aged 10-12 years old in Baneh city (Kurdistan, Iran). The study has three sequential phases, six steps based on the Intervention Mapping model, and four sub-studies.The questionnaire was transformed and culturally adapted since it was previously built for the city of Tehran; the results of a population-based cross-sectional survey indicated that the score for understanding food and nutrition information of a sample of 390 students aged 10-12 was mostly moderate and low (90.3% of participants). Therefore, a qualitative study on how to fix existing barriers, and extract facilitators and the best methods of interventions for promoting food and nutrition literacy of participants was conducted. Finally, an interventional study within six months for two intervention and control groups of elementary children 10-12 years old was carried out.The findings of this research will be used to design interventions and strategies based on needs assessment for improving students’ skills in food and nutrition literacy in all dimensions of food and nutrition literacy.

BackgroundAdolescent nutrition literacy and knowledge are associated with nutrient intake and obesity. With the rising prevalence of obesity in Kuwait, limited studies have assessed nutrition literacy among Kuwaiti adolescents. Therefore, this study aims to assess nutrition literacy among Kuwaiti adolescents and examine factors associated with nutrition literacy, such as body mass index (BMI) and dietary intake.MethodsA school-based cross-sectional study was conducted in public schools across Kuwait, enrolling a convenience sample of 375 adolescents (mean age = 15.6 years, 53.1% female participants). A self-administered questionnaire was used to collect relevant data. The Nutrition Literacy Assessment Instrument (NLit) score was used to assess nutrition knowledge and skills in making food choices.ResultsThe median NLit score among adolescents was 29 (IQR = 6). A large percentage (72.5%) of Kuwaiti adolescents demonstrated adequate overall nutrition literacy and scored adequately in the majority of NLit subscales. However, the majority of adolescents (73.3%) demonstrated inadequate nutrition literacy in understanding food labels. Predictors of NLit included BMI, place of residence, and smoking status. Moreover, the NLit score was negatively associated with the intake of sugar-sweetened beverages.ConclusionThis study’s findings may inform future research aimed at designing effective nutrition literacy interventions to enhance food choices among adolescents in Kuwait. The results of this study may also provide insights for policymakers and public health professionals to tailor food and nutrition programs to address the decline in food literacy skills and combat obesity.

Background:Nutrition literacy (NL) and food literacy (FL) have emerged as key components in the promotion and maintenance of healthy dietary practices. However, a critical appraisal of existing tools is required to advance the operationalization and measurement of these constructs using instruments that demonstrate sound validity and reliability.Methods:Electronic databases were searched in January and July 2016, January 2017, and March 2018 for publications detailing the development and/or testing of NL or FL instruments. Instruments' psychometric properties were assessed using a structured methodological framework. We identified 2,563 new titles and abstracts, and short-listed 524 for full review. The extent to which key domains of NL were included in each measure was examined.Key Results:Thirteen instruments assessing NL underwent full evaluation; seven from the United States, and one each from Australia, Norway, Switzerland, Italy, Hong Kong, and Japan. Measures targeted general Spanish-, Italian-, or Cantonese-speaking adults; primary care patients, parent, and populations with breast cancer. Instruments ranged from 6 to 64 items, and they predominantly assessed functional NL rather than broader domains of NL. Substantial variation in methodological rigor was observed across measures.Discussion:Multidimensional and psychometrically sound measures that capture broader domains of NL and assess FL are needed.Plain Language Summary:This review systemically compiles, and critically appraises 13 existing measures that assess nutrition literacy and food literacy in an adult population. Substantial variation in methodological rigor was found across the measures, and most tools assessed nutrition literacy rather than food literacy. Findings from this current review may be useful to guide development of future measures that comprehensively capture nutrition literacy and food literacy. [HLRP: Health Literacy Research and Practice. 2018;2(3):e134–e160.]

BackgroundFood and nutrition literacy is an emerging term which is increasingly used in policy and research. Though research in this area is growing, progression is limited by the lack of an accepted method to measure food and nutrition literacy. The aim of this study is to develop a valid and reliable questionnaire to assess food and nutrition literacy in elementary school children in the city of Tehran.MethodsThe study was conducted in three phases. To develop Food and Nutrition Literacy (FNLIT) questionnaire, a comprehensive literature review and a qualitative study were initially performed to identify food and nutrition literacy dimensions and its components. Content and face validity of the questionnaire were evaluated by an expert panel as well as students. In the second phase, construct validity of the scale was evaluated using Explanatory Factor Analyses (EFA) and Confirmatory Factor Analyses (CFA). In the last phase (confirmatory phase), the final version of the questionnaire was evaluated on 400 students.ResultsFindings show Content Validity Ratio (CVR) and Content Validity Index (CVI) of the 62-item questionnaire at acceptable levels of 0.87 and 0.92, respectively. EFA suggested a six-factor construct, namely, understanding food and nutrition information, knowledge, functional, interactive, food choice, and critical. The results of CFA indicated acceptable fit indices for the proposed models. All subscales demonstrated satisfactory internal consistency (Cronbach’s alpha≥0.70), except for critical skill subscale (0.48). The intraclass correlation coefficient (ICC = 0.90, CI: 0.83–0.94) indicated that Food and Nutrition Literacy (FNLIT) scale had satisfactory stability. Each phase of development progressively improved the questionnaire, which resulted in a 46-item (42 likert-type items and 4 true-false items) Food and Nutrition Literacy (FNLIT) scale. The questionnaire measured two domains with 6 subscales, including: 1) cognitive domain: understanding and knowledge; 2) skill domain: functional, food choice, interactive, and critical skills.ConclusionThe developed food and nutrition literacy scale is a valid and reliable instrument to measure food and nutrition literacy in children. This measure lays a solid empirical and theoretical foundation for future research and tailored interventions to promote food and nutrition literacy in this age group.

BackgroundFood literacy is capturing the attention worldwide and gaining traction in the Arab countries. Strengthening food and nutrition literacy among Arab teenagers are important promising empowering tools which can protect them from malnutrition. This study aims to assess the nutrition literacy status of adolescents with the food literacy of their parents in 10 Arab countries.MethodsThis cross-sectional study involving a convenient sample of 5,401 adolescent-parent dyads (adolescents: mean age ± SD: 15.9 ± 3.0, females: 46.8%; parents: mean age ± SD: 45.0 ± 9.1, mothers: 67.8%) was launched between 29 April and 6 June 2022 in 10 Arab nations. The Adolescent Nutrition Literacy Scale (ANLS) and the Short Food Literacy Questionnaire (SFLQ) were used to meet the study aims.ResultsMore than one-quarter (28%) of adolescents had poor nutrition literacy, with 60% of their parents being food illiterate. The top three countries with nutritionally” less literate” adolescents were Qatar (44%), Lebanon (37.4%), and Saudi Arabia (34.9%). Adolescents’ age, gender, education level, primary caregivers, employment status, and the inclusion of nutrition education in the schools’ curriculum predicted the nutrition literacy levels of Arab adolescents. Besides, parental weight status, health status, parent’s food literacy level, and the number of children per household were significant determinants too. Adolescents studying at a university and having parents with adequate food literacy had the highest odds of being nutritionally literate (OR = 4.5, CI = 1.8–11.5, p = 0.001, OR = 1.8, CI = 1.6–2.1, p < 0.001, respectively).ConclusionNutrition literacy inadequacy among Arab adolescents is a prioritized challenge to be tackled.