FOODLIT-PRO: Food Literacy Domains, Influential Factors and Determinants-A Qualitative Study

Who has a high level of food literacy, and who does not?: a qualitative study of college students in South Korea

BACKGROUND/OBJECTIVES

Unhealthy food choices among young adults are common globally, and the incidence of chronic diseases, such as obesity, is rising. Food literacy (FL) is important for improving and maintaining individual health in a rapidly changing food environment and can form the basis for following a sustainable diet. Therefore, it is essential to improve FL among young adults, particularly college students, who are in the formative years of their lifelong food habits. This study examined the facilitators and barriers of FL and related dietary behavior among college students in South Korea.

SUBJECTS/METHODS

This study recruited 25 college students with different residence types using convenience and snowball sampling. In-person, telephone, and video interviews were conducted from March to November 2021. The interview data were analyzed using framework analysis based on the socio-ecological model.

RESULTS

At the individual level, prior good experiences with food were the most frequently mentioned facilitator. In contrast, the major barriers were a lack of knowledge, financial hardship, irregular schedules, and academic stress. At the interpersonal level, the influences of family and peers, such as early exposure to healthy eating habits and opportunities to have easy accessibility to farms and farming, are major facilitators, but the lack of a sense of community was the major barrier. At the environmental level, the major barriers were unfavorable food environments at home and in neighborhoods, such as the absence of kitchens in housing and large packaging of produce at markets.

CONCLUSIONS

Many factors affected the students' FL and related healthy eating practices. These findings suggest that a campus-based FL program should be developed by reflecting on these facilitators and barriers.

Exploring the Impact of Sociodemographic Characteristics and Health Literacy on Adherence to Dietary Recommendations and Food Literacy

This study investigates food literacy-related abilities and adherence to dietary recommendations in relation to sociodemographic characteristics and health-related features (health literacy, self-rated health and morbidity) in the North-Western region of Romania. This is a secondary analysis of cross-sectional data collected in 2019 from a representative and randomised sample of 1572 individuals. A questionnaire was employed to record participants' sociodemographic characteristics, food-related and health-related features. Most participants were non-adherent to dietary recommendations for fruit and vegetables (83.5%), fish and seafood (61.3%), and water intake (67.9%). However, most participants reported an adequate ability to understand the connection between nutrition and health (89.1%), to distinguish between healthy and less healthy options (84.4%), and to acquire nutrition information (75.6%). Non-adherence to dietary recommendations and low food literacy abilities were more prevalent in disadvantaged groups (older age, rural settings, retirement or social welfare, low educational attainment, formerly married). Health literacy was negatively associated with not adhering to dietary recommendations and poor self-rated food literacy abilities. The study suggests that low socioeconomic status negatively impacts food literacy and adherence to dietary recommendations among Romanian adults. Identifying target populations to improve food-related abilities and health literacy can aid public health services in improving health outcomes.

11- to 13-Year-Old Children's Rejection and Acceptance of Unfamiliar Food: The Role of Food Play and Animalness

Promoting children's healthy food behavior is important in reducing the risk of developing obesity; it is therefore relevant to investigate methods to promote healthy food choices. This study's aim was to investigate differences in rejection-acceptance mechanisms related to unfamiliar foods depending on the inclusion of tactile exercises prior to cooking and food origin. Participant observation was applied in a school setting. Eight fifth and sixth grade classes were recruited from four Danish schools (n = 129). The classes were divided into two groups: animal (AG; quail) and nonanimal (NAG; bladderwrack). AG and NAG were subdivided into two groups: food print (FP) and no food print (NFP). Applied thematic analysis was applied. During preparation/cooking, NFP displayed disgust-related rejection, whereas FP displayed inappropriateness-related rejection. FP exhibited more playful behavior. Inappropriateness and animalness drove AG rejection. NAG rejection was driven by the slimy texture of the food and the perception of it 'not being food'. Acceptance was driven by taste and familiarity. In conclusion, the inclusion of tactile exercises could increase children's exploratory food behavior, and the promotion of children's healthy food behavior should not solely focus on choosing foods deemed safe and familiar, since, despite rejection during cooking, acceptance is ultimately possible.

The Household Food Security and Feeding Pattern of Preschool Children in North-Central Nigeria

Children’s feeding patterns and health outcomes are important determinants of any country’s food and nutrition security status. This study assessed the household food security and feeding patterns of preschoolers in Niger State, Nigeria. A cross-sectional descriptive design and a multi-stage sampling technique were employed to analyze 450 preschool children from selected local government areas. Household food security was measured using the HFIAS nine-item questionnaire, and feeding patterns were evaluated using the qualitative food frequency questionnaire (FFQ). The mean age of the preschoolers was 3.71 ± 0.80 years. A majority (61.30%) of the children consumed cereal-based products, while fruits and vegetables were the least consumed (16.40%). More than half (59.80%) of the preschoolers met their minimum dietary diversity. Almost all (98.80%) of the children were from food-insecure households, with 40.3% being severely food insecure. Parity, religion, and having a breadwinner and source of potable water were significantly associated with the adequacy of minimum dietary diversity (MDD) among the preschoolers (F value = 5.528, p ≤ 0.05). The contribution of poor feeding patterns and household food insecurity to the overall health outcome of preschoolers cannot be overlooked. Hence, nations must prioritize improving the availability, accessibility, and utilization of food to better meet the nutritional needs of preschool children.

The Relationships between Food Literacy, Health Promotion Literacy and Healthy Eating Habits among Young Adults in South Korea

The obesity problem has reached a critical level and is threatening not only personal health but also public health systems around the world. Obesity in young adults is especially rapidly growing and many studies have confirmed that the best prevention is developing healthy eating habits with the improvement of food and health promotion literacy competencies. In this context, this study diagnoses the present levels of food literacy and health promotion literacy among young adults and explores the relationships between both literacies and their healthy eating habits. A total of 325 young adults in South Korea participated in this research, and the results are as follows. First, all food literacy components, which are food and nutrition knowledge, food skills, and resilience, are positively associated with healthy eating habits. Second, health promotion literacy is also positively associated with young adults’ healthy eating habits. Lastly, unlike the primary information sources, gender has a moderating effect on the relationships between both literacies and healthy eating habits. This indicates that the government and educational sectors should propose more policy supports and solid education systems in order to help young adults develop their food and health promotion literacies for overall well-being in the future.

Eating Behaviors and Diet Quality: A National Survey of Australian Young Adults

OBJECTIVE

To investigate associations between eating behavior constructs (social eating, perceived competence, habit automaticity, self-determined motivation) and diet quality among young adults.

DESIGN

Cross-sectional analysis.

PARTICIPANTS

Young adults (n = 1,005; mean age, 21.7 ± 2.0 years; 85% female) enrolled in the Advice, Ideas, and Motivation for My Eating (Aim4Me) study.

MAIN OUTCOME MEASURES

Four eating behavior measures collected via online surveys: Social Eating Scale, Perceived Competence in Healthy Eating Scale, Self-Report Behavioral Automaticity Index, and Regulation of Eating Behaviors scales. Diet quality was assessed using the Australian Recommended Food Score (ARFS) and percentage energy from energy-dense, nutrient-poor (EDNP) foods.

ANALYSIS

Multivariate linear regression investigating associations between eating behavior measures (independent variables) and ARFS and EDNP foods (dependent variables), adjusting for sociodemographic and lifestyle confounders.

RESULTS

Greater perceived competence in healthy eating and behavioral automaticity for consuming healthy foods, limiting EDNP food intake, and higher intrinsic motivation, integrated regulation, and identified regulation of eating behaviors were associated with higher ARFS and lower percentage energy EDNP foods (P < 0.001). Greater self-reported social influence on eating behaviors was associated with higher ARFS (P = 0.01). Higher amotivation was associated with greater % energy from EDNP foods (P < 0.001).

CONCLUSIONS AND IMPLICATIONS

Perceived competence, habit automaticity, and self-determined motivation are determinants of diet quality in young adults. These findings support the development of interventions that promote healthy eating habits by focusing on eating behavior constructs and evaluating their use in improving diet quality.

Effects of University Students’ Perceived Food Literacy on Ecological Eating Behavior towards Sustainability

Due to the COVID-19 pandemic and industrialized food systems, people’s eating behavior has become seriously restricted. Especially, university students have started to overly depend on processed foods and carnivorous diets, and it places a huge burden on society by inducing the deterioration of health and environmental sustainability. Therefore, this study was undertaken to examine the effects of university students’ perceived food literacy on ecological eating behavior towards sustainability. A total of 395 university students in South Korea participated in this research. First, students’ food literacy components, which are reading labels and budgeting, healthy snack styles, healthy food stockpiling and resilience and resistance, exert positive influences on ecological eating behavior; second, the other two components, which are food preparation skills and social and conscious eating, have no positive impact on ecological eating behavior. Finally, the influences of food literacy on ecological behavior are significantly moderated by gender differences. This suggests that strengthening university students’ food literacy through education is necessary to promote ecological eating behaviors and advance the development of sustainable society.

FOODLIT-Trial: Protocol of a Randomised Controlled Digital Intervention to Promote Food Literacy and Sustainability Behaviours in Adults Using the Health Action Process Approach and the Behaviour Change Techniques Taxonomy during the COVID-19 Pandemic

Dietary quality and sustainability are central matters to the international community, emphasised by the burden of the COVID-19 pandemic. To promote healthier and more sustainable food-related practices, the protocol of a web-based intervention to enhance adults' food literacy is presented. The FOODLIT-Trial is a two-arm, parallel, experimental, and single-blinded randomised controlled trial delivered over 11 weeks. Based on the Food Literacy Wheel framework and supported by the Health Action Process Approach (HAPA) and the Behaviour Change Techniques Taxonomy, weekly content with customised behaviour change techniques (experimental group) is hypothesised to be more effective to promote food behaviour change when compared to a single-time and non-customised delivery of food-related international guidelines, with no theoretically informed approaches (comparison group). Primary outcome is food literacy, including food-related knowledge, skills, and behaviours, assessed with the FOODLIT-Tool; a secondary outcome includes psychological mechanisms that efficaciously predict change in participants' food literacy, measured with HAPA-driven items. Enlisted through online sources, participants will be assessed across five time points (baseline, post-intervention, and 3-, 6-, and 9-month follow-ups, i.e., T0-T4). A randomisation check will be conducted, analyses will follow an intention-to-treat approach, and linear two-level models within- (T0-T4) and between-level (nested in participants) will be computed, together with a longitudinal mediation analysis. If effective, the FOODLIT-Trial will provide for a multidimensional and cost-effective intervention to enable healthier and more sustainable food practices over the long term.

Examining Elementary School Children's Knowledge about Food and Nutrition in Southwestern Ontario, Canada

Purpose: Knowledge is fundamental to helping children make nutritional choices that support lifelong healthy behaviours. This study (i) investigates elementary school children's knowledge about food and nutrition and (ii) identifies sociodemographic factors influencing children's reported knowledge.Methods: In 2017-2019, a survey was administered to 2443 students (grades 5-8) at 60 schools across southwestern Ontario, Canada, and a parent survey was used to validate self-reported sociodemographics. Multiple regression was used to analyse children's knowledge scores and related sociodemographic factors. A total knowledge score was calculated by summing correct responses derived from 46 individual questions in the student survey.Results: Mean total knowledge score was 29.2 out of a possible 46 points (63.5% correct). Students demonstrated some knowledge and awareness of strategies to encourage fruit and vegetable consumption, healthy food selection, nutrition, and food preparation skills, although knowledge of food guide recommendations and locally sourced produce were limited. Female sex, family income, and rurality were associated with higher knowledge scores.Conclusions: Results provide insight regarding strengths and gaps in elementary-school children's food and nutrition knowledge. Poor performance of students on specific food guide-related questions suggests that the general guidance of the 2019 Canada's Food Guide might be better understood by children and adolescents.

Food Literacy and Its Associated Factors in Non-Dialysis Patients with Chronic Kidney Disease in China: A Cross-Sectional Study

PURPOSE

Nephrology professionals' understanding of food literacy (FL) and influencing factors is significant for nutrition management, which is key to controlling disease progress among non-dialysis patients with chronic kidney disease (CKD). However, few studies have explored FL in CKD patients. Hence, this study aimed to investigate the level of FL of non-dialysis patients with CKD and to analyze influencing factors in China.

PATIENTS AND METHODS

A total of 203 CKD patients without dialysis were recruited from August to December 2020 to participate in a cross-sectional study. Food literacy was assessed by a modified short food literacy questionnaire for adults. Related influencing factors were measured by the motivation for dietary self-control scale and the satisfaction with dietary behavior scale. Data were also collected regarding patients' health information-seeking behavior (four items), satisfaction and compliance with dietary advice from healthcare professionals (two items), and demographics and clinical diagnoses.

RESULTS

The mean age of patients was 44.5 years (range 18 to 75), and 42.5% were male. Most (50.2%) were in stages 1-2 of CKD. The mean FL score of these patients was 38.75±0.38. The multivariable linear regression analysis shows that secondary educational level (β=0.221, p=0.004), motivation for controlling diet (β=0.198, p=0.003), satisfaction with dietary behaviors (β=0.319, p<0.001), and health information-seeking behavior (β=0.146, p=0.019) were significant influencing factors.

CONCLUSION

Food literacy of Chinese CKD patients without dialysis should be improved. Patients with higher education levels exhibit more active information-seeking behaviors, have greater satisfaction with dietary behaviors, and their motivation for dietary self-control is more likely to be associated with better FL. Healthcare workers should be aware of factors influencing FL and attempt to integrate assessment of FL into routine food-related education for CKD patients.

FOODLIT-tool: Development and validation of the adaptable food literacy tool towards global sustainability within food systems

Facing multiple anthropogenic challenges and considering the current global pandemic, food sustainability is stated as threatened by major intergovernmental agencies. Given the heterogeneity of food systems, the need to enhance food-related behaviours by promoting the acquisition of knowledge and competencies, and the demand to involve stakeholder's diversity, this study aims to develop and validate an instrument that measures food literacy (FL), its determinants and its influential factors in an adult sample. Based on the Food Literacy Wheel (FLW) framework and integrated within the FOODLIT-PRO - Food Literacy Project, this study has three phases and a total of 2406 participants: (1) item development and content validity, (2) instrument development entailing item reduction strategies, factor extraction methodologies (exploratory and confirmatory analyses) and sensitivity testing, with two samples of a total of 1447 adults, and (3) instrument validation encompassing tests of dimensionality (confirmatory factor analysis), reliability (composite reliability) and validity (convergent and discriminant validity), and measure invariance testing, with 959 adults. Concerning statistical and psychometric properties, (1) a pool of 40 items (26 for FL; single items: five for determinants and nine for influential factors) was developed with inductive and deductive methodologies and reflected the FLW, (2) a 5-factor structure was explored, demonstrated acceptable model fit, and good sensitivity indices, and (3) a 5-dimensional reliable structure with 24 items was validated, configural invariance was achieved, and convergent and discriminant validity were significant in most dimensions. The FOODLIT-Tool contributes with an innovative measure of FL in adults that allows for a tailored assessment when approaching food-related issues within global food systems, providing a multidisciplinary tool that can be cross-widely applied to promote food-related behaviour change.

Are We Closer to International Consensus on the Term 'Food Literacy'? A Systematic Scoping Review of Its Use in the Academic Literature (1998-2019)

(1) Background: The term ‘food literacy’ has gained momentum globally; however, a lack of clarity around its definition has resulted in inconsistencies in use of the term. Therefore, the objective was to conduct a systematic scoping review to describe the use, reach, application and definitions of the term ‘food literacy’ over time. (2) Methods: A search was conducted using the PRISMA-ScR guidelines in seven research databases without any date limitations up to 31 December 2019, searching simply for use of the term ‘food literacy’. (3) Results: Five hundred and forty-nine studies were included. The term ‘food literacy’ was used once in 243 articles (44%) and mentioned by researchers working in 41 countries. Original research was the most common article type (n = 429, 78%). Food literacy was published across 72 In Cites disciplines, with 456 (83%) articles from the last 5 years. In articles about food literacy (n = 82, 15%), review articles were twice as prevalent compared to the total number of articles (n = 10, 12% vs. n = 32, 6%). Fifty-one different definitions of food literacy were cited. (4) Conclusions: ‘Food literacy’ has been used frequently and broadly across differing article types and disciplines in academic literature internationally. However, agreement on a standardised definition of food literacy endorsed by a peak international agency is needed in order to progress the field.

The Impact of COVID-19 on Canada's Food Literacy: Results of a Cross-National Survey

Several studies of food literacy emphasise the acquisition of critical knowledge over context. This evaluation looks at how COVID-19 impacted food literacy in a country affected by the global pandemic. To our knowledge, there has been no systematic research that would allow a better understanding of the impact of uncertainty or enhanced perceived risks generated by a global crisis on the prevalence of household food literacy. This study looks at food literacy from a perceptive of how an event that has domesticated many of them can alter knowledge and the relationship people have with food. A cross-national survey including 10,004 Canadians was conducted ten months after the start of the pandemic. Results show that Canadians have learned new recipes. Canadians have also taken up gardening and have relied on several sources to gather information. This study provides some evidence that Canadians have become more food literate because of the COVID-19 pandemic, but less significantly than anticipated. Practical and policy implications are presented as well as some future research directions.

The Nutrition Literacy Assessment Instrument for Italian Subjects, NLit-IT: Exploring Validity and Reliability

The aim of this study was to test validity and reliability of the adapted version of the Nutrition Literacy Assessment Instrument (NLit) for Italian people (NLit-IT). An observational cross-sectional study was conducted, involving a convenience sample of adults (n = 74). To explore the validity of the tool, we considered both diet quality as an outcome of NL, and health literacy (HL) as a construct that presents similarities and differences with NL. Diet quality was measured by adherence to the Mediterranean Diet (Med diet) through the validated Mediterranean Diet Literature-based adherence score (MEDI-Lite). The relationship between NL level and adherence to Med diet was assessed by linear regression analysis and computing correlations between NLit-IT and MEDI-Lite scores (Spearman's Rho). Additionally, we evaluated the correlation between NLit-IT score and the level of HL (Spearman's Rho). Internal consistency and reliability were measured by Cronbach's alpha and intraclass correlation coefficient (ICC) respectively. Internal consistency (ρT = 0.78; 95% CI, 0.69-0.84) and reliability (ICC = 0.68, 95% CI, 0.46-0.85) were confirmed. In addition, NLit-IT total score was correlated with MEDI-Lite score (Rho = 0.25; p-value = 0.031) and multivariate regression analysis confirmed that NL significantly contributed to MEDI-Lite score (R² = 0.13; β = 0.13; p-value = 0.008). There was no significant association between the level of HL and NL. In conclusion, NLit-IT showed validity and reliability as a measure of NL for Italian people.

Nutrition Literacy of Portuguese Adults-A Pilot Study

Nutrition is an essential factor in the prevention and treatment of some chronic diseases. For this reason, the population must know about nutrition, healthy food, and dietetics so that the promotion of healthier eating habits can lead to a consequent decrease in chronic disease incidence. That said, the present study aimed to assess nutrition literacy in the Portuguese population. Three hundred thirty participants aged between 18 and 65 years old were included in an observational, quantitative, and cross-sectional research. After the analysis, it was found that the vast majority of the study population (65.2%) had a good level of nutrition literacy. The participants having upper educational qualifications, following a specific diet, presenting an adequate BMI, having family members trained in the field of nutrition, and those who studied or worked in the field of health sciences reported a higher level of nutrition literacy. In conclusion, it seems to be essential to identify the population groups with the lowest nutrition knowledge so that it would be possible to apply personalized measures and to promote better literacy, reducing the prevalence and incidence of diseases and improving quality of life.

An Evaluation of the COVID-19 Pandemic and Perceived Social Distancing Policies in Relation to Planning, Selecting, and Preparing Healthy Meals: An Observational Study in 38 Countries Worldwide

Objectives

To examine changes in planning, selecting, and preparing healthy foods in relation to personal factors (time, money, stress) and social distancing policies during the COVID-19 crisis.

Methods

Using cross-sectional online surveys collected in 38 countries worldwide in April-June 2020 (N = 37,207, Mage 36.7 SD 14.43, 73.6% women), we compared changes in food literacy behaviors to changes in personal factors and social distancing policies, using hierarchical multiple regression analyses controlling for sociodemographic variables.

Results

Increases in planning (4.7 SD 1.2, 4.9 SD 1.3), selecting (3.8 SD 1.7, 3.8 SD 1.7), and preparing (4.6 SD 1.3, 4.7 SD 1.3) healthy foods were found for women and men, and positively related to perceived time availability among women and stay-at-home policies for planning and preparing in women. Psychological distress was a barrier for women, and an enabler for men. COVID-19 induced financial stress was a barrier depending on various sociodemographic variables (all p < 0.01).

Conclusion

Stay-at-home policies and feelings of having more time during COVID-19 seem to have improved food literacy among women. Stress and other social distancing policies relate to food literacy in more complex ways, highlighting the necessity of a health equity lens.

Food Next Door: From Food Literacy to Citizenship on a College Campus

Industrial agriculture and food corporations have produced an abundance of food that is highly processed, nutritionally poor, and environmentally burdensome. As part of a healthy campus initiative, generated to address these and other food production and consumption dilemmas, a student-run “local and sustainable” food establishment called Food Next Door (FND) was created. This intrinsic case study evaluated food literacy in health science students, faculty, and staff first as a pilot to build the case for FND and further explicated customers’, volunteers’, and leads’ experiences with FND, identifying potential pathways from food literacy to citizenship. Ten returning customers, eight recurring nutrition student volunteers, and three graduate student leads participated in interviews that were analyzed for themes and subthemes. The findings show a progression in themes. Customers’ experiences highlight FND’s fresh, flavorful food, smiling and supportive staff, and personal transformation. Volunteers’ themes identified greater awareness of new foods and plant-based eating, acquiring new knowledge and skills in commercial kitchens, and deepening their connection to food, each other, and to where food comes from. Leads’ themes show opportunities to gain managerial skills, a deeper understanding of food and skills from being immersed in value-based food systems, and confidence in peer teaching. Experiencing and becoming part of the food value chain through FND built food literacy, shifted values, and transformed students into food citizens.

FOODLIT-PRO: conceptual and empirical development of the food literacy wheel

Pursuing food systems' sustainability is crucial. Given the risk constituted by unhealthy diets, scarce research on food-related adjacent fields, and inconsistency across food literacy conceptualizations, this study aims to explore the constructs' definition and develop a conceptual and empirical framework of food literacy. A quantitative approach was taken on previously obtained qualitative outcomes from 30 interviews with experts from food-related fields. Food literacy was defined by a four-dimension model: Cooking Skills, Preserve and Analyse, Choice and Acquisition, Search and Plan. The framework Food Literacy Wheel integrates the construct definition, food literacy determinants (Internal, External) and influential factors (Nutritional, Psychological, Health, Learning Contexts, Policy, Industry, Sustainability, Social and Cultural). Allowing a broader perspective of food literacy within major food systems, this study contributes with new insights for future instruments and interventions, paving the way to develop/implement food literacy-related multi-sectorial and multilevel actions.

School-based interventions for promoting food and nutrition literacy (FNLIT) in elementary school children: a systematic review protocol

BACKGROUND

Food and nutrition literacy is a newly emerged concept to connect food-related knowledge and skills to healthy diets. Its promotion is important to protect children as they eat too many low-nutrient, high-energy foods. Food and nutrition literacy promotion needs multi-dimensional interventions. In the process of developing an intervention to promote food and nutrition literacy, the present review protocol aims to critically examine the evidence in the area of school-based interventions for promoting food and nutrition literacy (FNLIT) in elementary school children.

METHODS

We will search PubMed/MEDLINE, EMBASE, Web of Science, CENTRAL, and ProQuest (from inception onwards). Additional studies will be identified through manual searching of reference lists. Quantitative studies (e.g., randomized controlled trial, quasi-randomized trials, and cluster randomized trials) evaluating the effect of interventions to promote food and nutrition literacy in elementary school children (5-12 years old) will be included. Main outcomes will be food and nutrition literacy at functional, interactive, and critical levels. Secondary outcomes will be dietary intake indicators (e.g., healthy eating index, DDS) and health outcome measures (e.g., reduction in BMI and less weight gain). Two reviewers will independently screen all citations, full-text articles, and abstract data. Potential conflicts will be resolved through discussion. The study methodological quality (or bias) will be appraised using appropriate tools. If feasible, we will conduct random effects meta-analysis. The quality of the included studies will separately evaluate using the validated Quality Assessment Tool for Quantitative Studies, developed by the Effective Public Health Practice Project (EPHPP). Data will be extracted by two reviewers from the identified relevant literature. Standard data synthesis and analysis will be used for the review.

DISCUSSION

This systematic review will summarize the evidence regarding the components, implementation methods, and effectiveness of the interventions of food and nutrition literacy promotion in elementary school children. The results of this review will provide a useful reference for policymakers and curriculum developers to assess education curricula and develop practical learning and teaching strategies to improve students' food and nutrition literacy.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO (CRD42019135118).