The mediating role of healthy eating attitudes in the relationship between nutrition literacy and sustainable and healthy eating behaviors among young adults: a cross-sectional study

Abstract

Background This study was conducted to examine the associations of nutrition literacy, healthy eating attitudes, and sustainable and healthy eating behaviors with food insecurity among young adults, and to assess the mediating role of healthy eating attitudes in the relationship between nutrition literacy and sustainable and healthy eating behaviors. Methods This cross-sectional study included 600 young adults aged 18-25 years from Siirt and Gaziantep, T & uuml;rkiye. Data were collected using a sociodemographic form, Turkish Short Nutrition Literacy Scale for Young Adults (S-NutLit-Tr), Attitude Scale for Healthy Nutrition (ASHN), the Sustainable and Healthy Eating Behaviors Scale (SHE Behaviors), and the Food Insecurity Experience Scale (FIES). Group differences, predictors of SHE Behaviors, and the indirect association through healthy eating attitudes were examined using Kruskal-Wallis tests, multiple linear regression, and path analysis, respectively. Results The mean age of the participants was 20.56 +/- 1.87 years, and 50.7% were female. While 50.7% of the participants were food secure, moderate food insecurity was identified in 23.8% and severe food insecurity in 25.5%. Significant differences were observed across FIES groups in total S-NutLit-Tr and ASHN scores (Kruskal-Wallis H(2) = 8.752, p = 0.013; H(2) = 9.088, p = 0.011, respectively), while no significant difference was found in SHE Behaviors score (H(2) = 1.731, p = 0.421). In the multiple linear regression analysis, S-NutLit-Tr score (beta = 0.470, p < 0.001), ASHN score (beta = 0.177, p < 0.001), and sex (beta = 0.083, p = 0.023) were significant predictors of the total SHE Behaviors score. In the indirect-effect model, the total effect of nutrition literacy on sustainable and healthy eating behaviors was significant. Healthy eating attitudes showed a small but statistically significant indirect effect, with an unstandardized coefficient (B) of 0.171 and a 95% confidence interval (CI) from 0.095 to 0.275. This indirect effect accounted for approximately 9% of the total effect. Conclusion Among young adults, nutrition literacy and positive attitudes toward healthy eating are positively associated with sustainable and healthy eating behaviors. Healthy eating attitudes represented a small but statistically significant indirect pathway in this association. These findings suggest that interventions targeting young adults may benefit from addressing both the improvement of nutrition literacy and the strengthening of healthy eating attitudes.