Associations Between Health Literacy and Dietary Intake: A Cross-sectional Study of Adults With Metabolic Syndrome in Thailand

Background: Health literacy (HL) is an indicator of health outcomes, but its role in dietary intake has received little attention. Excessive dietary intake increases the risk of metabolic syndrome (MetS). Therefore, this study aimed to investigate the HL score, dietary intake, and nutrient intake of participants and the relationship between HL score and dietary intake among adults with MetS in Thailand. Methods: In this cross-sectional study, ۲۵۲۷ adults aged ۱۸–۵۹ years in primary care services, Phetchaburi, Thailand were included in the study using a multistage sampling technique. We determined HL scores using the Health Literacy Questionnaire (HLQ) and dietary intake using a semi-quantitative Food Frequency Questionnaire. We used multiple linear regression analysis to investigate the associations between HL score and dietary intake. Results: HL scores were significantly lower in patients with MetS compared with participants without it (P<۰.۰۵). Participants with MetS had significantly higher calorie and fat intake than participants without it (P<۰.۰۵), and participants with MetS had higher fat and lower carbohydrate intake. The results of multiple linear regression showed a significant negative association between HL score and dietary intake, after controlling for potential confounding variables (ꞵ=−۰.۰۵۳, P<۰.۰۵). Conclusion: Our findings suggest that low HL score is associated with high dietary intake. Therefore, improving HL might play an important role in reducing dietary intake to decrease the risk of MetS.