Nutrition and food literacy are two important concepts that are often used interchangeably, but they are not synonymous. Nutrition refers to the study of how food affects the body, while food literacy refers to the knowledge, skills, and attitudes necessary to make informed decisions about food and its impact on health. Despite the growing awareness of the importance of food literacy, food illiteracy remains a global issue, affecting people of all ages, backgrounds, and socioeconomic status. Food illiteracy has serious health implications as it contributes to health inequities, particularly among vulnerable populations.
1. Introduction
The world is becoming increasingly complex. It is hard to keep up with everything that is going on in the news, let alone all the information needed to know just to navigate your day-to-day life. Every day, people worldwide feel confused about what to eat for health. People look for science-based information but struggle with the vast amount of information and do not know what to believe. People feel that scientists do not agree with each other and are constantly changing their minds. With so much information about what people should eat and how much exercise they should do each day, it can be difficult for even the most educated people to sort through it all, and this confusion can lead them to make unhealthy choices when they are not aware of what they are doing
[1][2]. In the first part of the research, it was attempted to clarify the differences between nutrition and food literacy, which are often wrongly used as synonyms. It was explored that food illiteracy as a major global issue that leads to poor health outcomes and even death
[3]. Food illiteracy also promotes health inequities, especially if it is combined with other factors such as poverty and a lack of access to fresh foods or proper nutrition education programs
[4]. Food literacy is an important aspect of health literacy because it helps individuals make informed decisions about what they eat and how it affects their health
[2]. In a world where processed and fast foods are often more convenient and accessible than nutritious options
[5], having food literacy can make a big difference in a person’s overall health and well-being. It can also help to prevent chronic health conditions such as obesity, heart disease, and type 2 diabetes, which are often related to poor diet and nutrition
[6].
2. Relationship between Health, Nutrition, and Food Literacy
According to Scopus and Web of Science, nutrition literacy appeared first in the title of a scientific document in 1995 in a study carried out by Sullivan and Gottschall-Pass that was carried out to assess the food label nutrition knowledge of healthy Canadians, i.e., to evaluate their nutrition literacy
[7]. Nutrition literacy continued to be used without a specific definition; it was used under the umbrella of the more general term health literacy. The definition of nutrition literacy evolved from the tripartite model of health literacy developed by Don Nutbeam, who defined it as a set of cognitive and social abilities that affect an individual’s motivation and capacity to access, understand, and manage information that allows the promotion and maintenance of a healthy status. According to this definition, health literacy is more than being able to read package inserts or being successful in appointments and exam schedules, rather it is being able to make informed decisions
[8].
Don Nutbeam
[8] identified three health literacy levels: functional, communicative/interactive, and critical. A functional or basic level of health literacy implies knowing how to read and write, understanding simple health messages, and being able to act according to the health information provided. The functional level highlights the importance of knowing health risks, health services, and a set of healthcare recommendations. This includes understanding the labelling of prescription drugs and the ability to read instructions for taking prescription medication. This information is usually distributed to the public through leaflets as the objective is to obtain global benefits
[8]. The communicative/interactive level involves a more advanced cognitive level and developed skills that allow individuals to seek and use health information to respond to changing needs. At this level, the focus is on improving individual capacities such as lifestyle changes and the effective use of health services. It also involves the ability to discuss information with health professionals to make informed decisions
[8]. For example, it includes understanding a treatment option and how that treatment compares with other options. The most advanced level is critical literacy, which implies an even more advanced cognitive level that allows the individual to critically analyze health information and use the results of their analysis to be alert and thus acquire control over their life events
[8]. However, the definition of these three levels of health literacy has some limitations. They only apply to literate communities and assume that a high level of education corresponds to a high level of health literacy and that this is a prerequisite or guarantee that the person will respond in the desired way, which may not correspond to reality
[9].
Nutrition and food literacy are two linked concepts related to the ability to understand and apply knowledge about food. Understanding the differences between these concepts is crucial. Definitions in the literature are presented in Table 1. Briefly, nutrition literacy (sometimes mentioned as nutritional literacy) has to do with understanding the role of various nutrients in healthy eating, as well as how to read nutrition labels and make healthy food choices. Food literacy focuses more on the social aspects of food: how it is produced, where it comes from, who grows it, and how these things affect the health.
Table 1. Nutrition and food literacy definitions found in the literature.
Nutrition literacy is the level to which people can acquire, process, and comprehend the fundamental nutritional data and services that they need to make correct dietary decisions
[10]. This implies having the knowledge of nutritional principles and the ability to understand, analyze, and use nutritional information; that is, to know the nutrients and their health effects
[11]. It involves an individual’s capacity to acquire, understand, and use nutritional information from several sources
[12]. This includes knowing how foods are digested, their relationship with health, and how to use this information to make healthy choices.
Having nutrition literacy may not be sufficient to achieve the desired well-being and health. It is necessary to have food literacy; that is, to have knowledge, skills, and behaviors that are interrelated and that are necessary to decide, handle, choose, cook, and eat food
[13][14][15]. Food literacy is an individual’s ability to make decisions that lead to better individual health status and lead to a sustainable food system considering all social, environmental, cultural, economic, and political factors
[16]. Krause et al. (2016) defined nutrition literacy as a subfield of food, with both being specific dimensions of health literacy
[17]. According to the researchers, nutrition and food literacy are different but complementary concepts. The main difference lies in the skills needed to be literate in nutrition, food, or health. Thus, nutrition literacy consists of the ability to understand basic nutritional information, which is a requirement for a broader array of skills defined for food literacy. The researchers suggest the use of food literacy instead of nutrition literacy as it is broader and includes the skills necessary for healthy and responsible eating behavior
[17].
Vidgen (2016) identified eight domains of food literacy: (1) access; (2) management and planning; (3) selection; (4) knowledge of food origin; (5) preparation; (6) eating; (7) nutrition; and (8) language
[18]. Truman et al. (2017) expanded the components of the definition of food literacy by considering six core themes: (1) capabilities and behaviors; (2) healthy food and choices; (3) culture; (4) knowledge; (5) emotions; and (6) food systems
[15].
Food literacy measurement involves evaluating the following skills: reading, understanding, and analyzing information; gathering and sharing nutrition and food knowledge; shopping and preparing food; and evaluating the factors that impact their individual food choices and their influence on society
[17].
Vettori et al. (2019) highlight the importance of evaluating the skills needed to access and adhere to a healthy diet when measuring nutrition and food literacy
[19]. A nutrition and food-literate community includes people who eat to ensure their health and well-being while ensuring a sustainable food system. Nutrition and food literacy reflect the individual’s inspiration to adopt suitable behaviors and healthy food choices for oneself, others, and the environment
[19].
Health, food, and nutrition literacy are critical factors that impact every level of prevention in health and disease (
Figure 1). Primary prevention refers to actions taken to prevent the disease onset. Health literacy is essential in promoting healthy lifestyles and behaviors that can prevent chronic diseases. Eating a healthy diet rich in fruits, vegetables, whole grains, and lean proteins can reduce the risk of developing conditions like heart disease, diabetes, and certain types of cancer. Education about the importance of a balanced diet and how to read nutrition labels can also help people make healthier food choices
[20][21]. Secondary prevention refers to actions taken to detect and treat a disease early before it causes significant harm. Food and nutrition literacy is critical in secondary prevention because it enables individuals to make informed decisions about their diet and lifestyle to manage chronic conditions such as high blood pressure, high cholesterol, and diabetes. For example, individuals with food and nutrition literacy may be able to modify their diet to reduce their risk of developing complications from these conditions
[20]. Finally, tertiary prevention focuses on managing the complications and symptoms of chronic diseases. Health literacy is essential in tertiary prevention because it enables individuals to understand their condition and adhere to their treatment plan. Education about how to read food labels, plan meals, and cook healthy foods can help these individuals better manage their condition and prevent complications
[20].
Figure 1. Health, nutrition, and food literacy play a critical role in the prevention and management of diseases across all stages of prevention. The researchers acknowledge NNEdPro for the figure conceptualization.
A comprehensive understanding of nutrition literacy is imperative in today’s complex world. It should not be isolated from the two other critical components of health and food literacy. This integration is of paramount importance in providing individuals with a comprehensive understanding of how their dietary choices affect their overall health and broader societal and economic well-being. Health literacy emphasizes the importance of informed decision making in health matters. Food literacy extends health literacy scope to include the social, cultural, economic, and environmental dimensions of food. This broader understanding of nutrition literacy extends beyond simply acquiring knowledge and interpreting food labels. It serves as a reminder that nutrition literacy encompasses a wider social, cultural, and political context, operating at personal, interpersonal, and societal levels. The inclusion of these elements in nutrition literacy helps individuals make healthier food choices and appreciates the wider implications of their dietary decisions. Therefore, a comprehensive conception of nutrition literacy ought to incorporate crucial components of both health and food literacy to provide individuals with a comprehensive understanding of the significance of nutrition in their lives. It is not simply a matter of knowing what to consume; it also involves understanding the rationale behind its significance and integration into the broader context of health and sustainability. This comprehensive approach has the potential to lead to healthy individuals and a sustainable global community
[12].