Food and nutrition literacy is an emerging term which is increasingly used in policy and research. Though research in this area is growing, progression is limited by the lack of an accepted method to measure food and nutrition literacy. The aim of this study is to develop a valid and reliable questionnaire to assess food and nutrition literacy in elementary school children in the city of Tehran. The study was conducted in three phases. To develop Food and Nutrition Literacy (FNLIT) questionnaire, a comprehensive literature review and a qualitative study were initially performed to identify food and nutrition literacy dimensions and its components. Content and face validity of the questionnaire were evaluated by an expert panel as well as students. In the second phase, construct validity of the scale was evaluated using Explanatory Factor Analyses (EFA) and Confirmatory Factor Analyses (CFA). In the last phase (confirmatory phase), the final version of the questionnaire was evaluated on 400 students. Findings show Content Validity Ratio (CVR) and Content Validity Index (CVI) of the 62-item questionnaire at acceptable levels of 0.87 and 0.92, respectively. EFA suggested a six-factor construct, namely, understanding food and nutrition information, knowledge, functional, interactive, food choice, and critical. The results of CFA indicated acceptable fit indices for the proposed models. All subscales demonstrated satisfactory internal consistency (Cronbach’s alpha≥0.70), except for critical skill subscale (0.48). The intraclass correlation coefficient (ICC = 0.90, CI: 0.83–0.94) indicated that Food and Nutrition Literacy (FNLIT) scale had satisfactory stability. Each phase of development progressively improved the questionnaire, which resulted in a 46-item (42 likert-type items and 4 true-false items) Food and Nutrition Literacy (FNLIT) scale. The questionnaire measured two domains with 6 subscales, including: 1) cognitive domain: understanding and knowledge; 2) skill domain: functional, food choice, interactive, and critical skills. The developed food and nutrition literacy scale is a valid and reliable instrument to measure food and nutrition literacy in children. This measure lays a solid empirical and theoretical foundation for future research and tailored interventions to promote food and nutrition literacy in this age group.

Objective: This study aims to assess the relationship between Food and Nutrition Literacy (FNLIT) and dietary diversity score (DDS); FNLIT and nutrient adequacy (NAR%, MAR%) in school-age children in Iran. Results: This cross-sectional study was undertaken on 803 primary school students in Tehran, Iran. Socio-economic, as well as three 24-h dietary recalls were collected through interviewing students and their mothers/caregivers. FNLIT was measured by a self-administered locally designed and validated questionnaire. Low level of FFNL was significantly associated with higher odds of low DDS (OR = 2.19, 95% CI 1.32–3.62), the first tertile of fruit diversity score (OR = 3.88, 95% CI 2.14–6.99), and the first tertile of dairy diversity score (OR = 9.60, 95% CI 2.07–44.58). Low level of IFNL was significantly associated with probability of lower meat diversity score (OR = 1.73, 95% CI 1.07–2.81). Low level of FLL was also significantly associated with probability of lower DDS (OR = 1.81, 95% CI 1.11–2.94), dairy diversity score (OR = 2.01, 95% CI 1.02–3.98), and meat diversity score (OR = 2.14, 95% CI 1.32–3.45).Low FNLIT and its subscales were associated with higher odds of low level of NAR of protein, calcium, vitamin B3, B6, B9, as well as the probability of lower level of MAR.

Background: Food and nutrition literacy is a key factor in shaping healthy dietary behaviors and may result in decreasing decrease the prevalence of overweight. Empirical research on food and nutrition literacy and its outcomes is limited, especially among children and adolescents. Thus, this study investigates the link between Food and Nutrition Literacy (FNLIT) with eating behaviors, academic performance, and overweight in 10–12 years old students in Tehran, Iran.Methods: This study was performed through two phases: 1) Proposing a conceptual model of the relationship between FNLIT and its determinants and outcomes, based on the existing evidence and previous models, and 2) Testing the proposed FNLIT model through a cross-sectional study on 803 primary school students (419 boys and 384 girls, from 34 public and 10 private primary schools), aged 10–12 years using structural equation modeling. Demographic, socio-economic, and household food security characteristics were collected by interviewing the students and their mothers/caregivers using a questionnaire. FNLIT was measured by a self-administered, locally designed, and validated questionnaire.Results: The fit indices suggested a reasonably adequate fit of the data to the hypothesized model (χ²/df = 2.03,p < 0.001, goodness of fit index (GFI) = 0.90, adjusted goodness of fit index (AGFI) = 0.88, comparative fit index (CFI) = 0.91, incremental fit index (IFI) = 0.91, root mean square error of approximation (RMSEA) = 0.04, standardized root mean residual (SRMR) = 0.06). SES was directly and positively related to FNLIT and its subscale in students. FNLIT score had a positive direct (non-mediated) relationship with healthy eating behavior and academic performance. This pattern was strongly reversed in unhealthy eating behavior. There was a full mediation relationship between FNLIT and overweight/obesity via healthy eating behaviors. SES predicted academic performance partially through the mediating effect of Food Label Literacy (FLL). The results indicated that despite the direct relationship between SES and academic performance, an indirect but negative relationship existed with food insecurity.The finding also revealed the fully mediating role of Food Choice Literacy (FCL) in the relationship between demographic factors and healthy eating behaviors. Our study also found that Interactive Food and Nutrition Literacy (IFNL) protected unhealthy eating behaviors, and FCL predicted healthy eating behaviors in children.Conclusion: Our study draws attention to FNLIT, especially the skills domain, including IFNL, FCL, and FLL, as the most important determinant of healthy eating behavior, academic performance, and weight status in school-age children reduces social inequalities in children’s development.To ensure an adequate level of FNLIT, educators should assess and plan to enhance food literacy skills in children and adolescents.

Background: Obesity in adolescence is the strongest risk factor for obesity in adulthood. This study aimed to evaluate the effects of a comprehensive lifestyle intervention on different anthropometric indices in 12–16-year-old boy adolescents after 12 Weeks of Intervention. Methods: A total of 96 male adolescents from two schools participated in this study. The schools were randomly assigned to intervention (53 students) and control school (43 students). Height and weight of students were measured and their body mass index (BMI) was calculated. Body fat percent (BF) and body muscle percent (BM) was assessed using a bioimpedance analyzer considering the age, gender, and height of students at baseline and after intervention. The obesity reduction intervention was implemented in the intervention school based on the Ottawa charter for health promotion. Results: Twelve weeks of intervention decreased BF percent in the intervention group in comparison with the control group (decreased by 1.81% in the intervention group and increased by 0.39% in the control group, P < 0.01). However, weight, BMI, and BM did not change significantly. Conclusions: The result of this study showed that a comprehensive lifestyle intervention decreased the body fat percent in obese adolescents, although these changes was not reflected in the BMI. It is possible that BMI is not a good indicator in assessment of the success of obesity management intervention.