Association Between Nutrition Literacy and Diet Quality Among Adolescents and Young Adults in the Rural District of Mayuge, Eastern Uganda

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Abstract
Background: Adolescent malnutrition, including stunting, underweight, and micronutrient deficiency, is a major public health concern in Sub-Saharan Africa (SSA). While studies from the global north and Asia have shown that nutrition literacy supports healthier diets, evidence on literacy status and its role on influencing overall diet quality among adolescents and young adults (AYA) in SSA is limited. This study assessed nutrition literacy and its association with diet quality among AYA in rural Uganda. Method: This was a cross-sectional study implemented as part of ARISE-NUTRINT project. Based on Nutbeam’s model of health literacy, the study was conducted among 1206 AYA aged 10–24 years in Mayuge district, Eastern Uganda, selected through stratified random sampling. Using structured questionnaire, the Global Diet Quality Score (GDQS) was adapted to estimate diet quality and Adolescent nutrition literacy scale to assess nutrition literacy status. Logistic regression models were employed to assess the association between nutrition literacy and diet quality, adjusting for socio-demographic characteristics. Results: Among 1206 respondents (51.1% female), 85.9% were still in school, over 62% were from low social economic status households, and only 14% used mobile phones. Low nutrition literacy (49%) was prevalent, many unfamiliar with balanced diet or ignoring dietary advice, although 62% were willing to promote healthy eating. Overall, 12.6% had poor-diet quality based on GDQS, marked by frequent refined grain consumption and low fruits/vegetable intake. Having low nutrition literacy was associated with close to five-fold increase in poor diets (adjusted OR = 4.71, 95% CI: 2.19–10.16) while mobile phone use was associated with better diet quality by 56% (aOR = 0.44, 95% CI: 0.27–0.74). Conclusion: Low nutrition literacy is a significant burden among AYA, and is strongly associated with suboptimal diet quality. Implement targeted interventions for improving nutrition literacy can enhance diet quality among AYA in the study area.
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