Association of health literacy and health consciousness with diet and physical activity

Background

Unhealthy lifestyle is a major determinant of a series of chronic conditions. The drivers of unhealthy behaviour remain poorly understood, hence preventive measures at the population level are largely inadequate. Our study aimed to investigate health literacy (the degree to which people can find, understand, and use health-related information) and health consciousness (an individual’s mindset, awareness, and motivation to improve their health), as determinants of diet and physical activity.

Methods

Cross-sectional study in the general adult population of Greece and Cyprus following proportional quota sampling (2022-2023), comprising 472 participants with complete information on health literacy (HLS-EU-Q16) and health consciousness (HCS-G). Unhealthy diet, defined as low fruit and vegetable intake and physical inactivity, defined as rare or no engagement in any physical activities, were self-reported. Multiple linear regression was used to determine associations between the aforementioned factors, adjusting for sociodemographic covariates.

Results

Health literacy and consciousness were significantly associated with unhealthy diet and physical inactivity. For each standard deviation increase in health literacy the likelihood of low fruit and vegetable intake decreased by 47% (OR 0.53, 95% CI 0.35; 0.79), while for physical inactivity it decreased by 39% (OR 0.61, 95% CI 0.42; 0.82). The corresponding results for health consciousness, were an 80% decrease for low fruit and vegetable intake (OR 0.20, 95% CI 0.12; 0.35), and a 55% decrease for physical inactivity (OR 0.45, 95% CI 0.31; 0.66).

Conclusions

Our results reveal strong inverse associations for both health literacy and consciousness with two major behavioural risk factors for chronic disease, with the latter having a clearly stronger association. Enhancement of health consciousness should be a priority from early on in life, in the battle against unhealthy lifestyles and chronic disease burden.

Key messages

• High health literacy and consciousness are associated with better dietary patterns and higher physical activity among the middle-aged population of Greece and Cyprus

• Enhancement of health literacy and consciousness should be incorporated in public health approaches aiming for lifestyle modification and reduction of chronic disease burden at the population level.