Food and nutrition literacy as a determinant of health behaviours: Insights from schools in Leiria

Background

The assessment of food and nutrition literacy (FNL) and the understanding of determinants of dietary and lifestyle behaviours are essential to inform health promotion strategies during childhood, a critical period for the establishment of long-term health behaviours.

Methods

This cross-sectional study included 549 students (grades 5–6, aged 9–13 years) from three schools in urban, peri-urban, and rural areas of Leiria, Portugal. Sociodemographic and behavioural data were collected. Validated instruments assessed adherence to the Mediterranean diet (KIDMED) and FNL (E-LAN). Three regressions were computed to examined associations between FNL and (1) adherence to Mediterranean diet (multivariable regression), (2) extracurricular physical activity, and (3) nighttime screen use (logistic regressions). Models were adjusted for sex, age, household income, and maternal education. Regression coefficients (β) and odds ratios (OR) were reported with 95% confidence intervals (CI), with p < 0.05 considered significant.

Results

Higher FNL (E-LAN) was associated with more favorable behaviours. It was positively associated with adherence to the Mediterranean diet (β = 0.13; 95% p < 0.001) and participation in extracurricular sports activities (OR = 1.04; p = 0.001) and inversely associated with nighttime screen use (OR = 0.96; p < 0.001). Female students showed lower adherence to the Mediterranean diet (β = −0.53; p = 0.012) and lower sports participation (OR = 0.41; p < 0.001). Older age was associated with reduced sports participation (OR = 0.69; p = 0.030). Lower maternal education was also associated with reduced participation in sports activities (OR = 0.14, p = 0.003 and OR = 0.29, p = 0.008, up to 9th grade and 12th grade, respectively).

Conclusions

These findings highlight FNL as a key factor associated with dietary and lifestyle behaviours in childhood, supporting its role as a target for health promotion interventions in youth.

Key messages

• Higher FNL is associated with healthier dietary habits, greater physical activity, and lower screen use in children.

• This study highlighted the potential of FNL as a target for public health interventions and policies.