Developing a Conceptual Framework for Food and Nutrition Literacy in Children | BMC Nutrition

The analysis of the data from the two surveys (expert and student survey) was combined into the themes developed in the first survey. In both expert and student studies, food and nutrition literacy has been shown to be highly contextual. The final analysis of data from three sub-surveys resulted in the identification of thirteen components and two main domains of cognitive domain and skill domain are presented in Table 2. More explanations are presented below.

Cognitive domain

Knowledge related to food and nutrition

In the cognitive domain, food and related knowledge was the first concept to develop during continuous data analysis and comparisons. This concept represents the basic knowledge related to food and nutrition that was essential for children based on expert opinion. This concept encompasses four components: knowledge about food and nutrition, knowledge about lifestyle, knowledge about food safety, and knowledge about food and food preparation. One UNICEF nutrition expert describes: “Students from 5^th and 6^th class are expected to be aware and understand basic information about food and nutrition in order to make decisions to improve their diet and to know how proper diet and nutrition play a role in preventing obesity.’

Most experts believe that having a general concept of the basics of nutrition and food balance is more important than more detailed information for this age group. A nutrition expert at the Ministry of Health and Medical Education claims: “I think a 5th grader^th and 6^th class should be familiar with the basics of nutrition, that is, he/she should know about food groups and their nutritional value and he/she should be familiar with a varied, well-balanced diet, students should know what meals are and why and how one must eat food; what are healthy snacks and why should they eat them….“.

Understanding food and nutrition information

Most experts believe that food and nutrition literacy means that students have the ability to apply food and nutrition information to a health situation, which requires understanding and interpreting often complex food and nutrition information.

According to students, the lack of information about food and nutrition in clear and understandable language was a significant barrier to using this information. “Sometimes I don’t understand the nutritional information, so I ask my teacher, but sometimes he can’t explain things clearly or even in terms I know.”(Grade 5 student).

Skill Domain

Functional food and nutrition literacy

Access

According to experts, the ability to search for and identify reliable sources of nutritional information is one of the basic skills needed. Interviews show that most children ask their questions about food and nutrition information from parents, teachers and search the Internet.

Application

Nutritionists stated that in addition to the ability to search for necessary information about food and nutrition, students must apply this information to their lifelong eating behaviors. This concept can be considered both a component and a potential outcome of food and nutrition literacy using both surveys. In relation to food selection skills, one student said: “when I want to buy something, I check production date and expiration date and standard mark. I also check its ingredients“. (5th grade student)

Some of the students mentioned their food preparation skills as; “Scrambled eggs, pasta, omelet and cutlet…” (6th grade student).

Interactive food and nutrition literacy

Interactive skills

According to experts, increased confidence has contributed to new ways of communicating about food and nutrition issues with peers, friends and children, emphasizing the social aspects of food and nutrition literacy. This is what a nutritionist from a research site claims” one should share information about food and nutrition with others because in interactive literacy we would like people to apply information about food and nutrition in their relationships. This relationship can be with a nutritionist, teacher, parents and peers and…”

Emotional skill

The ability to resist cravings and non-nutritious foods and the ability to say “No” to unhealthy eating temptations, which two of the nutritionists in the Ministry of Health and one of the dietitians from the education system identified, conceptualized as an emotional skill included in interactive literacy skills in the field of food and nutrition.

Discussion skills

Among the participants’ statements, the ability to argue and disagree with peers’ and family’s non-nutritive behaviors was one of the skills that was included in this domain.

“One of the other skills is that if the family is unhealthy in their eating behavior, then the person can convince them or be able to self-manage their own diet.” (dietitian from the educational system)

Critical food and nutrition literacy

The main components identified in this dimension are media literacy, food label literacy and decision-making and planning skills.

Media literacy

One of the concepts in the continuous data analysis process was media literacy. Today, we live in an ad-saturated world that encourages the consumption of junk food and promotes unhealthy eating habits. Children as loyal and repeat customers of food marketing are exposed and deceived by these misleading advertisements. According to the experts in our study, developing media literacy in children is a key skill that enables them to evaluate and respond to media advertisements. In our study, most students did not trust the advertisements and some of them believed that they should study the reliability of the advertisements. A 5th grader said: “Ads are not true and most of them are wrong and sell their products. I saw an ad for fruit juice that said the fruit juice was made from real juice, but when I bought it and read the ingredients, it consisted of water, sugar, and flavorings.

Food Label Literacy

In the expert survey, participants referred to the importance of food labelling. They believed this was one of the best ways to deliver nutrition messages at the point of purchase. One of the nutritionists at the Ministry of Health, pointing to the introduction of mandatory traffic lights, stated that “Traffic lights are the first and most important guide where the consumer can communicate with food products through color markers. The traffic light may be more practical for children due to its simplicity.

Decision-making and planning skills in a special situation

Managing money and time to prepare healthy food, making healthy decisions in certain circumstances, and being able to plan for one’s own health, the health of others, and the environment were the components indicated by participants. This component helps the individual minimize the impact of limited resources or other special situations on healthy food choices.

A total of twenty-nine studies were included in the final review. Of these, 21 studies addressed both definitions of food/nutrition literacy and its components [5,6,7,8, 28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44]only three studies defined food/nutrition literacy [45,46,47] and 8 focused on the food/food literacy conceptual framework and its components [7, 8, 30, 31, 36, 38, 47, 48] in youth and adults. The core elements of all food literacy conceptual frameworks include basic nutrition knowledge and skills needed to regulate food intake, meal planning, food selection, and food preparation. Only three conceptual frameworks of food literacy include skills such as sharing information and interacting with others [7, 36, 38, 39]. All definitions of food literacy and half of the definitions of food literacy are based on an existing definition of health literacy [6, 7, 31, 36, 38]. The most emphasized components in ‘food literacy’ were food skills, including management, food preparation and food selection, as well as critical literacy [7, 38, 49, 50]. Slater (2013) introduces food literacy using Nutbeam’s idea of ​​health literacy as a framework for the food and nutrition curriculum in schools [6]. Based on the literature, all definitions of food literacy focus on the cognitive abilities of individuals and strongly emphasize the basic literacy and numeracy skills needed to understand and use nutrition-related information (functional skills). However, none provide a conceptual framework for nutrition literacy. For an overview, see Additional file 2 .

A conceptual framework of food and nutrition literacy in children

Figure 2 shows the final framework developed in two domains of knowledge and skills but five dimensions. Each dimension includes different components presented in Table 2.