The influence of food literacy on eating patterns

Person viewing a nutritional label

The Nutrition Society Paper of the Month for August is from Public Health Nutrition and is entitled ‘Identifying attributes of food literacy: a scoping review‘.

Authors: Elsie Azevedo Perry, Heather Thomas, H Ruby Samra, Shannon Edmonstone, Lyndsay Davidson, Amy Faulkner, Lisa Petermann, Elizabeth Manafò and Sharon I Kirkpatrick.

Food literacy is increasingly recognised as an important influence on eating patterns. However, the absence of a measurement tool makes it challenging for nutrition practitioners to assess the impact of food literacy on eating patterns, as well as to evaluate the outcomes of interventions. To inform a measurement tool, we conducted a scoping review to identify the key attributes of food literacy.

A total of 19 peer-reviewed and 30 grey literature sources were systematically reviewed, leading to the identification of fifteen food literacy attributes falling into five interrelated categories. The Food and Nutrition Knowledge attributes relate to facts and information acquired through experience or education related to foods and nutrition, including the capacity to distinguish between “healthy” and “unhealthy” foods. Attributes within the Food Skills category focus on techniques related to food purchasing, preparation, handling, and storage. The Self-Efficacy and Confidence attributes relate to one’s capacity to perform these skills in varied contexts and situations. The Ecologic attributes capture factors operating beyond the individual (e.g., socio-cultural influences, socio-economic status) and their interactions with food decisions and behaviours. Finally, the single attribute within the Food Decisions category—Dietary Behaviour—pertains to the application of knowledge, information, and skills to make food choices. These attributes are depicted in a proposed conceptual model, which allows visualization of their interconnections and interdependencies.

The appreciation of the interdependent nature of the attributes of food literacy has important implications for strategies to support healthy eating patterns. For example, it is acknowledged that it will be difficult for an individual to achieve food literacy without possessing appropriate knowledge and skills, as well as the ability to apply them. However, in the absence of self-efficacy and confidence and without access to resources for purchasing food, equipment, and supplies for food preparation, neither knowledge nor ability is relevant. As a result, comprehensive approaches aligned with the social determinants of health will be required to impact food literacy and related health outcomes.  Previously, there has been much emphasis on nutrition education. A shift toward a broader food literacy framework that allows appreciation of the complexity of factors influencing dietary behaviors and their interactions may more effectively provide the ‘scaffolding’ needed to navigate the current food system and make healthy food decisions.

Our findings provide a common language to describe food literacy and were used as the groundwork for a subsequent consensus building exercise to refine the attributes. Collectively, this work provides a foundation for the development of a food literacy measurement tool encompassing key indicators of the identified attributes. The capacity to collect robust data on food literacy will provide a means to not only more effectively understand the relevance of food literacy to diet and health and the impact of food literacy-related interventions, but also for advocacy efforts to broaden the focus of public health practice.