Factors associated with nutrition literacy and dietary habits among adolescents in Kota Setar, Kedah

Adolescence is a critical period in human development, characterised by rapid physical, emotional and social changes. Nutrition literacy, which is the ability to access, comprehend, evaluate, and apply nutritional information plays a significant role in shaping dietary habits and, consequently, long-term health outcomes. Adolescents often face challenges with nutrition literacy, struggling to comprehend nutrition information, interpret it accurately, and unable to differentiate reliable sources for making healthy food choices. Therefore, this cross-sectional study aimed to assess nutrition literacy and dietary habits of school-aged adolescents and their associated factors. The study used secondary data from a cross-sectional study conducted between September and November 2023. A total of 408 adolescents aged 14.71 ± 1.08 years old (52.0% males and 48.0% females) were recruited from two randomly selected secondary schools in Kota Setar, Kedah. Parents/caregivers of the adolescents completed a self-administered questionnaire on sociodemographic information and household food security level, while adolescents completed another set of self-administered questionnaires on sociodemographic, nutrition literacy, dietary habits, social support, home food availability, and family meal frequency. Weight and height of the adolescents were obtained from the Standard Kecergasan Fizikal Kebangsaan Untuk Murid Sekolah Malaysia (SEGAK) data, and BMI-for-age z score was calculated and classified using WHO growth reference. Results showed that the mean nutrition literacy score was 68.32 ± 10.65 out of a total score of 110, indicating a moderate level of nutrition literacy among the respondents. The mean dietary habits score was 13.88 ± 4.24 out of a total score of 23, indicating moderate adherence to healthy eating behaviours. The mean BMI-for-age z score of the respondents was -0.08 ± 1.55, with 11.9% classified as overweight and 11.3% as obese, while 7.6% were thin. The mean score for social support was 15.56 ± 3.20, while the mean score for home food availability was 1.09 ± 1.66, ranging from -3 to 5. One third of the respondents (34.1%) reported to have family meal together for three to four times in the previous week, while 19.1% reported to have household food insecurity. Multiple linear regression analysis found that ethnicity (ꞵ = -0.232, p < 0.001), social support (ꞵ = 0.221, p < 0.001), and family meal frequency (ꞵ = 0.136, p = 0.036) were significantly associated with nutrition literacy. Chinese ethnicity was associated with lower nutrition literacy, whereas adolescents with higher social support and more frequent family meals were associated to higher nutrition literacy. On the other hand, social support (ꞵ = 0.205, p < 0.001), home food availability (ꞵ = 0.318, p < 0.001), and nutrition literacy (ꞵ = 0.101, p = 0.031) were significantly associated with dietary habits. Strong social support, greater availability of food at home and higher nutrition literacy were positively associated with healthier dietary habits. In conclusion, social support, home food availability, and family meal frequency are all important factors in shaping adolescents’ nutrition literacy and dietary habits. These findings imply that interventions aimed at improving nutrition literacy and dietary habits should include strengthening social support systems, ensuring the availability of healthy foods at home, and encouraging regular family meals. By addressing these issues, adolescents can develop and maintain healthy eating habits, thereby improving their overall health and well-being.

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