Development and validation of a comprehensive food literacy questionnaire for adolescents integrating knowledge, skills, and environmental influences.

BACKGROUND/OBJECTIVESMost child and adolescent food literacy measurement tools focus on nutrition and food safety. However, the importance of aspects related to the food system such as food distribution and food waste and their effects on environmental sustainability is growing. We therefore developed and validated a two-dimensional tool for children (8–12 years old) and adolescents (13–18 years old) that can comprehensively measure food literacy. The association of food literacy with diet quality and self-reported health was assessed.SUBJECTS/METHODSFirst, we developed a food literacy conceptual framework that contains food system and literacy dimensions through a literature review, focus group interviews, and expert review. After a face validity study, we conducted the main survey (n = 200) to validate the questionnaire. Construct validity and reliability were assessed using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and Cronbach's alpha.RESULTSAs a result of the Delphi study, content validity was confirmed for the remaining 30 items after two items were excluded (content validity ratio = 0.86). Eleven items were excluded from the EFA results, while the CFA results indicated appropriate fit indices for the proposed model (comparative fit index = 0.904, root mean square error of approximation = 0.068). The final food literacy questionnaire consisted of 19 questions and comprised 5 factors: production, distribution, selection, preparation and cooking, and intake. Food literacy was positively associated with diet quality, as assessed by the Nutrition Quotient score, in both children and adolescents and with self-reported health in adolescents.CONCLUSIONSBased on this integrated conceptual framework, a two-dimensional 19-item food literacy measurement tool was developed and verified for practical use to improve the diet quality and food-related environmental sustainability awareness of children and adolescents.

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.

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

Food waste is a global hindrance to sustainable food systems. In Indonesia, a lot of food suitable for consumption is wasted annually. In 2023, Banyumas Regency was dominated by the most significant portion of food waste, with a daily volume of 541.80 tons. Food waste comes from hotels, restaurants, and trade sectors, such as food court areas. Therefore, this study aims to analyze factors influencing consumers' food waste behavior at food courts in Banyumas Regency. The method used was quantitative, with 410 respondents, and this research employed structural equation modeling-partial least squares (SEM-PLS). The factors influencing food waste generation include food choice, food literacy, social influence and normative behavior, food ordering routine, intention to reduce food waste, and food waste behavior. The results show that food choice and food literacy have a significant relationship with intention to reduce food waste (IR), and IR has a significant relationship with food waste behavior (FWB). The result also shows that IR mediates the relationship between Food choice (FC) and FWB, and IR mediates the relationship between food literacy (FL) and FWB. Food choice and literacy play a significant role in shaping the intention to reduce food waste. This contributes to the literature on avoiding food waste behavior by emphasizing the importance of cognitive (food knowledge) and affective (food preferences) influences on changing more sustainable consumption behavior. The food court manager can develop visual campaigns in the area, train consumers, and provide flexible food portions that suit customer needs to minimize food waste.

Analogous to health literacy, food literacy can be defined as a set of cognitive and social skills associated with the ability to acquire and understand information about food and nutrition to make appropriate nutritional decisions. In the literature, several terms such as food, nutrition, or nutritional literacy are used in parallel, differing in some aspects of their meaning. Food literacy is an important measure of the effectiveness of nutritional education interventions and appropriate instruments for its measurement should be available in every society. The aim of this study was the assessment of the validity and testing of a proposed model of the Short Food Literacy Questionnaire (SFLQ) culturally adapted into Polish. The analysis was performed on data from an online survey in a representative sample of 1286 adult internet users. Exploratory (EFA) and confirmatory factor (CFA) analyses were performed on two different subsets obtained through random splitting of the initial dataset. The Polish version of the SFLQ had good internal consistency (Cronbach’s α 0.841; Guttman split-half coefficient was 0.812). The EFA revealed that the tool had a three-factor latent structure. The distinguished dimensions were ‘information accessing’, ‘knowledge’, and ‘information appraisal’. The subscales also showed acceptable internal consistency based on the values of the Cronbach’s α coefficients (ranging from 0.768 to 0.845). The CFA confirmed a good fit of the three-factor model with at least five indexes achieving acceptable levels (CFI = 0.972, GFI = 0.963, AGFI = 0.940, NFI = 0.959, and RMSEA = 0.059). The validation of the Polish version of the SFLQ revealed, contrary to earlier reports, not a single but a three-factor structure of the instrument. The SFLQ will be an important tool for the assessment of the effectiveness of educational interventions and population studies analyzing the determinants of food literacy in Poland.

BackgroundFood literacy has emerged as an essential determinant of dietary behavior, encompassing the skills needed to access, understand, evaluate, and apply food- and nutrition-related information in daily life. Evidence examining food literacy and its relationship with healthy food choices among adults in Saudi Arabia remains limited.ObjectivesThis study aimed to assess food literacy levels and healthy food-choice priorities among adults living in Saudi Arabia and to examine the association among food literacy, food-quality priorities, and sociodemographic factors.MethodsA cross-sectional study was conducted using a survey that included sociodemographic variables, a validated food quality questionnaire assessing food choice priorities, and the Short Food Literacy Questionnaire (SFLQ). Descriptive statistics were used to summarize participant characteristics. Associations between food literacy, food choice priorities, and sociodemographic factors were examined using chi-square tests, Pearson correlation, and multivariable binary logistic regression analyses.ResultsA total of 901 adults participated in the study. Higher food literacy was significantly associated with greater prioritization of health-related food attributes. Women and older adults demonstrated higher food literacy, whereas healthy food-choice priorities did not differ significantly by gender. Participants residing in the Western and Northern regions had higher odds of adequate food literacy than those in the Central region. Respondents with education up to high school were more likely to have adequate to excellent food literacy than those with higher education, while household income was not significantly associated with either food literacy or food choice priorities. Retired participants demonstrated healthier food-choice priorities than other employment groups.ConclusionFood literacy is associated with healthier food choice priorities among adults in Saudi Arabia and varies across sociodemographic and regional groups. However, higher food literacy does not consistently translate into more nutritious choices, underscoring the influence of environmental and structural factors. Skill-based, contextually tailored food literacy interventions may support healthier dietary behaviors and help reduce diet-related health disparities.

PurposeThe purpose of this paper is to explore the associations between food literacy, consumer profiling and purchasing behaviour in a sample of Italian consumers.Design/methodology/approachParticipants (N = 194) completed an online survey including personal data, two questionnaires on purchase behaviour and food consumption, the General Trust Scale (GTS), a questionnaire assessing individual chronotype and two scales about food literacy: one investigating nutritional knowledge (short food literacy questionnaire, SFLQ) and the other focussing on procedural skills (self-perceived food literacy scale, SPFL). Associations between food literacy, consumer profiling and purchase behaviour were analysed with linear regression models.FindingsParticipants with specific education in nutrition reported higher scores in food literacy. The final score of food literacy was predicted by a greater attention to nutritional content and nutritional properties of products. Women paid more attention to nutritional properties than men, and they obtained higher scores in SFLQ. Evening types obtained lower scores in SFPL compared to intermediate and morning chronotypes. Body mass index (BMI) was negatively correlated to SPFL score, while it was associated with the easy availability of a product, so that obese (BMI ≥ 30) subjects considered the easy availability of a product more important compared to non-obese ones (BMI < 30).Originality/valueThis study investigates the influence of personal and psychometric variables of consumer profiling on food literacy and consequently on purchase behaviour, paving the way for implementing healthier food consumption policies. These findings reinforce the primacy of specific education in building healthy eating habits.

Practice problem: The increase in preventable chronic diseases is associated with food illiteracy, which arises from a lack of understanding of nutritional value and dietary guidelines (Silva et al., 2023). PICOT: (P) In adult primary care patients aged 30-75 years, (I) does the implementation of evidence-based food literacy program (C) compared to standard practice (O) improve food literacy (T) in eight weeks? Evidence: Using a validated food literacy questionnaire effectively measures improvements in food literacy. Customized programs that fill knowledge gaps are essential for enhancing overall food literacy. Intervention: Customized educational tools were provided to participants based on their knowledge gaps on food literacy encompassing ultra-processed food consumption, portion sizes, nutritional labels and general nutrition understanding. A validated food literacy questionnaire was used to compare improvement in scores pre and post intervention over the course of eight weeks. Outcome: The intervention did not yield statistically significant results; however, it demonstrated clinical significance, with 50% of participants improved their food literacy scores post-intervention. Additionally, 75% reported better food choices, increased intake of nutrient dense foods, reduced consumption of ultra-processed foods, and greater awareness of nutrition labels. Conclusion: Food literacy is increasingly recognized as crucial for improving health outcomes in primary care, particularly in the management of chronic conditions. Customized educational tools are crucial for bridging knowledge gaps and enhancing overall food literacy.

Commentary - Food for thought on food environments in Canada.

When students enter university, they suffer adaptations, including, usually, greater autonomy and responsibility for the choices they make. Therefore, it is crucial that they are well informed so as to make healthier food choices. The aim of this study was to determine whether sociodemographic characteristics, academic performance and lifestyle (tobacco and alcohol consumption) interfere with food literacy in university students. A quantitative, analytical, descriptive, transversal and correlational study was carried out, using quantitative data obtained through a questionnaire survey applied to a sample of 924 university students in Portugal. Food literacy was assessed through a scale of 27 items, distributed in three dimensions: D1-Literacy about food nutritional value and composition, D2-Literacy about labelling and food choice and D3-Literacy about healthy eating practices. Results showed no differences in food literacy according to sex or age. However, food literacy varied significantly with nationality, either globally (p = 0.006) or in the different dimensions evaluated (p-values of 0.005, 0.027 and 0.012 for D1, D2 and D3, respectively). In terms of academic achievement, the results showed no significant differences according to self-reported academic performance or even to the average classification obtained in the course. Regarding lifestyle variables, it was observed that alcohol consumption or smoking are not associated with food literacy, that is, food literacy does not vary significantly with these two lifestyle variables. In conclusion, food literacy in general and the dimensions evaluated are essentially constant among university students in Portugal, only varying for students from abroad. These results help to better perceive the food literacy levels for the population under study, university students, and that can be a valuable tool to better increase food literacy at these institutions as a way to better prepare for a healthier life and proper food habits that can enhance health in the long term.

The concept of food literacy is evolving and expanding, increasing the need for a comprehensive measurement tool for food literacy. This study aimed to develop a validated food literacy questionnaire based on an expanded conceptual framework for food literacy. A literature review of existing frameworks and questionnaires for food literacy and focus group interviews (n = 12) were conducted to develop a conceptual framework and candidate questions. A Delphi study (n = 15) and pilot survey (n = 10) to test the preliminary questionnaire’s content and face validity were conducted, which were followed by the main survey (n = 200). Construct validity and reliability were assessed using exploratory factor analysis (EFA) and Cronbach’s alpha, respectively. Criterion validity was assessed by comparing food literacy scores with food knowledge scores (FN-score) and nutrient quotient scores (NQ-score). By integrating and revising the six existing conceptual frameworks and focus group interview results, we proposed a two-dimensional conceptual framework comprising a literacy dimension and a food system dimension. After reviewing 560 items and categorizing them into 18 domains (3 in the literacy dimension × 6 in the food system dimension), 32 questions were selected. As a result of the Delphi study, two items were deleted, and content validity was confirmed for the remaining 30 items (content validity ratio (CVR) = 0.92). Ten items were revised during the face validation process, and five items were excluded as a result of the EFA. The final food literacy questionnaire comprised 25 questions related to five factors: production, selection, preparation and cooking, intake, and disposal. Food literacy scores were positively associated with FN- and NQ-scores, confirming the reliability and criterion validity of the final questionnaire. The two-dimensional food literacy conceptual framework developed in this study systematically encompasses complex food literacy concepts by adding a food systems dimension (production, selection, preparation and cooking, intake, and disposal domain) to the existing literacy dimension (functional, interactive, and critical literacy domain). Based on this integrated conceptual framework, a 25-item food literacy questionnaire was developed and validated for practical use.

Avoidant/Restrictive Food Intake Disorder (ARFID) is a newly described eating disorder. Adequate levels of food literacy allow individuals to have adequate food choices. This study aimed to assess the prevalence of ARFID and the level of food literacy in patients with inflammatory bowel disease (IBD) and to analyse the correlation between ARFID and food literacy. This cross-sectional study screened for ARFID and assessed food literacy levels in patients with IBD attending four tertiary hospitals in China. ARFID risk was measured using the Nine Item Avoidant/Restrictive Food Intake Disorder Screen (NIAS).Food literacy was assessed using the Food Literacy Evaluation Questionnaire (Chinese version, FLEQ-Ch).The relationship between individual NIAS scores and food literacy variables was analysed to assess which food literacy aspect is positively or negatively associated with NIAS scores. Stepwise linear regression analysis was performed to identify the possible predictors of NIAS scores in patients with IBD. A total of 372 IBD subjects completed the NIAS and FLEQ-Ch. The overall mean NIAS scores for the IBD cohort was 28.16 ± 8.03 (p < 0.01), and of the 372 participants, 123 (32.5%) had positive ARFID risk scores (≥ 10 NIAS-picky eating, ≥ 9 NIAS-poor appetite, and ≥ 10 NIAS-fear of negative consequences).The NIAS scores were inversely associated with food literacy levels (β = - 0.299; p < 0.01).Disease phenotype, disease activity, and food literacy in patients with IBD provided valuable predictive insights for avoiding positive outcomes in ARFID. This study shows that the risk of ARFID in the cohort of patients with IBD is associated with their inadequate food literacy levels. Therefore, this study supports the notion that patients with IBD should be assessed for food literacy regardless of whether they are currently diagnosed with ARFID. Specifically, for early identification of those at risk for ARFID in IBD, disease phenotype, disease activity, and food literacy should be routinely considered in clinical practice.The food literacy awareness of patients must be investigated and improved to predict the risk occurrence of ARFID and encourage healthy eating behaviour.

Food literacy includes the knowledge, skills and behaviours young people use to plan, manage, select, prepare and eat foods to meet their needs. As described in the previous chapter, food literacy typically develops in the home; but, schools have an important role because they are a setting that allows programmes to reach and influence a large number of people. This is particularly important when home environments do not support healthy eating. Food and nutrition is typically included in school curricula around the world, but the extent to which hands-on food skills are present varies. Hands-on programmes are more likely to be present in middle school years rather than for younger children. In secondary schools, food literacy is generally developed through hands-on practical skills programmes, usually in Home Economics classes. A well-designed healthy eating skills-based programme needs to include a range of declarative (knowledge) and procedural (hands-on) skills that will enable young people to develop the food skills they need to be able to live healthy independent lives. This chapter outlines and explains these essential skills and how they can be incorporated strategically and easily into a school programme. Suggestions are made on how these food skills could be measured. A tool for measuring these skills, in the form of a food literacy skills checklist, is outlined for teachers and facilitators of such programmes. This chapter aims to describe food literacy in an educational context byfirstly reviewing current definitions and how they apply in an educational setting. Next, an overview of relevant models with particular attention to those applicable in an educational setting is presented. Finally, a sample of a generic food literacy measure and checklist based on and underpinned by a model (the Food Literacy Model) is described. The Food Literacy Measure and Food Literacy Checklist include sample activities designed for teachers to use in upper primary and junior secondary schools. Further, a sample of a pre-and post-evaluation series of questions based on the the Food Literacy Model is provided.

Food literacy can encourage adolescents to develop healthy dietary patterns. This study examined home economics teachers' (HET) perspectives of the importance, curriculum, self-efficacy, and food environments regarding food literacy in secondary schools in Australia. A 20-item cross-sectional survey was completed by 205 HETs. The survey focused on the importance of aspects of food literacy, HETs' self-efficacy, and attitudes toward food literacy and schools' food environments. Data were analyzed descriptively, and associations between participants' demographic characteristics and perceptions were investigated by chi-square analyses. HETs rated aspects of food literacy including preparing and cooking food, knowing about healthy foods and food safety and hygiene practices as very important. They indicated animal welfare, where food comes from, and plan and manage time for food shopping to be the least important aspects of food literacy. HETs reported that students' involvement in food literacy activities resulted in healthier diets and improved food practices, but the schools' food environments are not comprehensively supportive of food literacy. HETs report that food literacy is very important for adolescents to learn. The focus is more on microaspects in comparison to macroaspects of food literacy. Schools' food environments are ideally positioned to shape dietary intake of adolescents but their potential is not being realized.

Background: Food literacy is an essential aspect of modern education, nourishing students with the knowledge and necessary skills to make informed, healthy, and sustainable food choices. Building upon the validated research conducted in Portugal concerning the nutritional knowledge level of Portuguese students, our objective was to provide a similar survey instrument to Romanian students to assess their level of food literacy. Methods: The data was collected, based on a pilot study, from 120 Romanian students who completed an online questionnaire. The questionnaire covered anthropometrics, physical activity, diet, food literacy knowledge, and behavior. Food literacy was classified into three distinct sections: literacy about healthy eating patterns, literacy about labeling and food choices, and literacy about nutritional value and composition. Results: Students who possessed the most elevated food literacy were also the ones with a high academic performance. Weight issues affected 45% of students, with a significant 12.7% having eating disorders. We found no association between food literacy, BMI, and age. Conclusions: Our pilot study could lay the foundation for similar studies for our country on a larger scale, with the aim of developing further educational curricula and community programs regarding nutrition, striving towards a healthier future.