High health literacy is associated with less obesity and lower Framingham risk score: Sub-study of the VGH-HEALTHCARE trial.

Yuan-Lung Cheng,Yaw-Zon Ding,Wan-Leong Chan,Shing-Jong Lin,Ruey-Hsing Chou,Teh-Ling Liou,Yuan-Jen Wang,Hsiu-Chuan Hsu,Hsin-Bang Leu,Ying Liang,Tse-Min Lu,Pai-Feng Hsu,Shao-Sung Huang,Chung-Chi Lin,Jiah-Hwang Shu,Ying-Wen Wang,Yvonne Böttcher

doi:10.1371/journal.pone.0194813

Abstract

BackgroundsLower health literacy (HL) is associated with several cardiovascular disease (CVD) risk factors such as diabetes, hypertension, and metabolic syndrome (MS). The aim of our study was to investigate the association between HL and the Framingham 10-year risk score of CVD.MethodsFrom 2015–2016, 1010 subjects aged 23 to 88 years receiving health check-up in Taipei Veterans General Hospital had complete clinical evaluations and laboratory examinations. Fatty liver was diagnosed by ultrasonography. The short form questionnaire adapted from the Mandarin Health Literacy Scale was used to assess HL. The Framingham risk score was calculated by patient characteristics.ResultsSubjects with higher BMIs were associated with lower HL scores. The proportion of subjects with MS was higher in the lower health literacy score group (≤ 9) at 28.8%; further analysis found that lower HL was significantly associated with MS in women but not in men. The Spearman’s rho demonstrated that the HL score was significantly associated with the BMI-based (rho = -0.11; P < 0.001) or lipid-based (rho = -0.09; P < 0.004) Framingham risk score.ConclusionsHigher HL scores were associated with less CVD risk such as lower BMIs, less MS in women, and less fatty liver disease. Furthermore, HL had an inverse association with the Framingham risk score as expected. Therefore, HL in patients with CVD risk should be improved and considered as an important issue in terms of CVD reduction.

Highlights

Ischemic heart disease and cerebrovascular disease are associated with an increased risk of morbidity and mortality and are the leading cause of death worldwide [1]
Subjects with higher Body mass index (BMI) were associated with lower Health literacy (HL) scores
The proportion of subjects with metabolic syndrome (MS) was higher in the lower health literacy score group ( 9) at 28.8%; further analysis found that lower HL was significantly associated with MS in women but not in men

Summary

Introduction

Ischemic heart disease and cerebrovascular disease are associated with an increased risk of morbidity and mortality and are the leading cause of death worldwide [1]. Recent systematic analysis for the Global Burden of Disease Study revealed age-standardized death rates of ischemic heart disease and cerebrovascular disease decreased 11.6% and 21.0% [1] This showed an improvement in risk reduction, but there is still a great gap in achieving an acceptable result. Health literacy (HL) is the ability to communicate and understand basic health information to make appropriate health decisions concerning health care and disease prevention [3]. It is essential for good health, subjects with inadequate HL are common. Challenges include a lack of familiarity with medical terms, difficulties in interpreting test values, and various educational backgrounds These factors limit improved HL in the general population. Health care providers should be trained to communicate more efficiently with people with low HL to enable them to access health services, understand health-related information, and make informed decisions [3]

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