| Objectives To investigate the nutrition literacy level of university students,analyze its influencing factors,and assess the existing problems and weaknesses in nutrition literacy,providing evidence for making targeted intervention on nutrition literacy for university students.Methods A cross-sectional study was conducted from May to June 2021 in Bengbu,China.Study participants were recruited through the stratified cluster sampling.First,two universities(medical and non-medical)were selected using a convenience sampling method.Secondly,eight classes were randomly selected from each year.All students in the classes sampled were used as survey respondents.A self-designed questionnaire was used to investigate the basic profile of university students,and Adult Nutritional Literacy Assessment Scale was used to evaluate the level of nutrition literacy among university students.A total of 2190 participants finished the survey;finally,2133 were analyzed in this study,with a valid response rate of 96.95%.All statistical analyses were performed using SPSS 26.0.Comparison of university students’ nutrition literacy level by age,sex,major,and grade using chi-square test.The factors influencing the level of nutrition literacy among university students were analysed using binary logistic regression to investigate the relationships between the variables.Analysis of the impact of socio-demographic characteristics,parental education,academic status and economic status on nutrition literacy among university students,stratified by major and sex.To evaluate the interaction effects of multiple factors such as socio-demographic characteristics,academic status and economic status of university students on their nutrition literacy.Results Of the 2133 university students in this study,734(34.4%)were men and1399(65.6%)were women;1130(53.0%)were non-medical students and 1003(47.0%)were medical students;595(27.9%)were first-year students,474(22.2%)were second-year students,492(23.1%)were third-year students,and 572(26.8%)were fourth-year students;the average age was 20.9±1.6 years.Of the two domains of nutrition literacy,the cognition domain had higher levels of nutrition literacy than the skill domain.The six dimensions of nutrition literacy are scored in descending order of nutrition knowledge,nutrition understanding,obtaining skills,interactive skills,critical skills,and applying skills.The findings indicate that age,major,grade,BMI,place of origin,only-child status,living arrangement,parent education,acquisition of nutrition education,average grade,and household income were independently associated with nutrition literacy.Students aged 22-27,medical,higher grade,normal BMI,urban,only child,living with both parents,higher parental education,took nutrition courses,better academic score and higher household income had higher levels of nutrition literacy.The results of the multifactorial analysis of the nutrition literacy levels of university students,stratified by major,showed that in the medical group: second and third year students had higher levels of nutrition literacy than first year(OR = 3.24,95% CI: 1.90～5.52),(OR = 1.99,95% CI: 1.17～3.39),urban students had higher levels of nutrition literacy than rural(OR = 1.56,95% CI:1.11～2.21),students with an average score of 80 or above had higher levels of nutrition literacy than those with an average score of 70 or below(OR = 2.34,95% CI:1.44～3.81),and students with a monthly household income of 3000-6000 and 12,000 RMB or more had higher levels of nutrition literacy than those with a monthly household income of less than 3000 RMB(OR = 1.56,95% CI: 1.02～2.39)、(OR =2.03,95% CI: 1.12～3.68).In the non-medical group: Nutrition literacy levels were lower among overweight students than among underweight students(OR = 0.51,95%CI: 0.30～0.88),and higher among students with an average score of 80 or above had higher levels of nutrition literacy than those with an average score of 70 or below(OR= 1.68,95% CI: 1.04～2.70).Students with a monthly household income of 12,000 RMB or more had higher levels of nutrition literacy than those with a monthly household income of less than 3000 RMB(OR = 2.10,95% CI: 1.06～4.17).The results of the multifactorial analysis of nutrition literacy levels among university students,stratified by sex,showed that in the male group: students of urban students had higher levels of nutrition literacy than students of rural students(OR = 1.70,95%CI: 1.17～2.47),students who had attended nutrition courses had higher levels of nutrition literacy than students who had not attended nutrition courses(OR = 2.02,95% CI: 1.36～3.02),and students with an average score of 80 or above had higher levels of nutrition literacy than those with an average score of 70 or below(OR = 1.68,95% CI: 1.00～2.80).In the female group: medical students had higher levels of nutrition literacy than non-medical students(OR = 1.41,95% CI: 1.05～1.88),students who had attended a nutrition course had higher levels of nutrition literacy than those who had not(OR = 1.32,95% CI: 1.02～1.71),and students with an average score of80 or above had higher levels of nutrition literacy than those with an average score of70 or below(OR = 1.93,95% CI: 1.21～3.08)and students with a monthly household income of 12,000 RMB or more had higher levels of nutrition literacy than those with a monthly household income of 3,000 RMB or less(OR = 2.40,95% CI: 1.34～4.29).The results of the multifactorial interaction analysis of nutrition literacy among university students showed that female medical students had higher levels of nutrition literacy compared to male medical students,male non-medical students and female non-medical students(OR = 1.73,95% CI: 1.14～2.62).Medical students who attended nutrition courses had higher levels of nutrition literacy compared to non-medical students who attended nutrition courses,medical students who did not attend nutrition courses,and non-medical students who did not attend nutrition courses(OR = 1.72,95% CI: 1.11～2.65).Compared to only-child students who had a monthly expenditure of 1,000 RMB or less,non-only-child students who had a monthly expenditure of 1,000 RMB or less,non-only-child students who had a monthly expenditure of 1,000-1,500 RMB,non-only-child students who had a monthly expenditure of 1,500-2,000 RMB,and non-only-child students who had a monthly expenditure of more than 2,000 RMB,only-child students who had a monthly expenditure of 1,000-1,500 RMB,1,500-2,000 RMB had higher levels of nutrition literacy(OR = 2.16,95% CI: 1.12～4.14)、(OR = 2.36,95% CI: 1.14～4.91).Conclusion Nutrition literacy among university students was unbalanced and low levels of nutrition literacy in skill domain and their applying skills and critical skills need to be focused on in university education.Nutrition literacy of university students differed in terms of age,major,grade,BMI,place of origin,only-child status,living arrangement,parent education,acquisition of nutrition education,average grade,and household income.These findings suggest that measures should be taken at the individual,school and family levels to improve the nutrition literacy levels of university students. |
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