Literacy contributes to nutrient intakes among the Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) study participants

Abstract

Background: Low literacy is a common problem in the United States and can be a barrier to following dietary recommendations. Nutrient-based diet quality has been associated with race and education but no prior identified research has evaluated its association with literacy. Purpose:To determine if literacy is a stronger predictor of diet quality than race or education. Methods: The sample consists of 2,067 African American and white, socioeconomically diverse urban adults, aged 30-64 years who participated in the baseline phase of the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) Study. Dietary intake data were obtained from two 24-hour recalls using USDA’s Automated Multiple Pass Method. Diet quality was calculated using a micronutrient composite index of nutrient adequacy ratios (NAR) and a mean adequacy ratio (MAR). Literacy was measured using the Wide Range Achievement Test 3rd edition (WRAT-3) Reading subtest. To assess the relationship of literacy, race and education with diet quality, linear regression analysis was performed using total NAR, MAR and WRAT-3 scores. Results: The mean (±SEM) literacy score for women was 43.3 ±0.4 and for men, 42.9 ±0.5. Mean (±SEM) MAR scores were 77.3 ±0.8 and 82.4 ±0.8, for women and men, respectively. The results of linear regression analyses revealed that both education and literacy, along with sex, predicted diet quality (R2 = 0.13). Race, age and poverty status were found to be nonsignificant. Conclusion: Since both education and literacy are significant, it seems that education may contribute something besides literacy to choosing a healthy diet.