Nutrition Literacy Mediates the Relationships between Multi-Level Factors and College Students' Healthy Eating Behavior: Evidence from a Cross-Sectional Study.

Li-Chun Chang,Chia-Kuei Lee,I-Ju Lai,Li-Ling Liao

doi:10.3390/nu13103451

Abstract

College students experience new pressures and choices as they transition to independent living and can easily develop unhealthy eating habits, resulting in obesity and obesity-related chronic diseases in later life. This study aimed to test the hypothesis that nutrition literacy (NL) mediated the relationship between multi-level factors influencing healthy eating behavior identified from the social-ecological model and healthy eating behavior of college students. A four-part questionnaire was completed by 412 participants recruited from six different four-year universities in Taiwan (effective response rate = 85.8%). Data were analyzed using descriptive statistics, an independent samples t-test, hierarchical multiple regression, and mediation analysis. The results indicated that the students’ mean nutrition literacy score was 4.32 (SD = 0.78, range = 1–6). In the social-ecological framework, nutrition literacy significantly predicted healthy eating behavior (β = 0.28, p < 0.001; ΔF = 32.54, p < 0.001; ΔR2 = 0.05) with control variables of background, intrapersonal, interpersonal, environmental, and macrosystem factors. Nutrition literacy mediated the effects of seven factors on healthy eating behavior across four levels. These findings suggested that strengthening influential multi-level factors associated with healthy eating behavior not only enhanced NL, but also improved individuals’ healthy eating behavior.

Highlights

Chronic diseases are a major cause of death in modern society, and some types of chronic diseases are related to overweight and obesity caused by unhealthy dietary patterns [1,2]
The findings of this study suggested that strengthening influential multi-level factors associated with healthy eating behavior enhanced nutrition literacy (NL), and improved individuals’ healthy eating behavior
This study found that college students’ healthy eating behavior was not ideal, which was reported in previous studies [3,4,57]

Summary

Introduction

Chronic diseases are a major cause of death in modern society, and some types of chronic diseases are related to overweight and obesity caused by unhealthy dietary patterns [1,2]. College students are in a period of transition to independent living [3,4], whereby they experience new environments and face new types of pressures [5] They may develop unhealthy eating habits and are more likely to develop obesity and obesity-related diseases in adulthood, which increases the risk of chronic diseases [4,6,7,8,9]. The social-ecological framework was based on the theory of ecosystems (i.e., ecological model) proposed by Bronfenbrenner [10,11] for the study of human development, which emphasized the interaction between humans and their environments This theory posits that the entire ecological system in which growth occurs should be considered when understanding the process of human development. The results revealed that the factors influencing healthy eating in college students included individual factors (e.g., taste preferences, lack of discipline, time, improved food knowledge and education, meal planning, and involvement in food preparation), social networks (e.g., social support from parents and peers), physical environments (e.g., product prices, limited budgets, and the availability and accessibility of healthy and unhealthy foods), and macrosystems [20,21,22,23,24]

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Conclusion