Relationship of sustainable and healthy eating behaviors with health literacy, digital healthy diet literacy, and food neophobia among university students: a cross-sectional study

Abstract

Sustainable and healthy eating behaviors play an important role in supporting both individual health and environmental sustainability. This study aimed to examine the relationships of health literacy, digital healthy diet literacy, and food neophobia with sustainable and healthy eating behaviors among university students, and to evaluate the associations of these variables with sustainable and healthy eating behaviors after accounting for sociodemographic, anthropometric, and selected dietary characteristics. This cross-sectional study was conducted with 300 undergraduate students selected via convenience sampling from a single state university in Türkiye between May and July 2022. Sociodemographic, anthropometric, and nutritional characteristics of the participants were assessed. Health literacy, digital healthy eating literacy, food neophobia, and sustainable and healthy eating behaviors were measured using valid and reliable scales. Relationships among variables were examined using Pearson correlation analysis. Factors independently associated with sustainable and healthy eating behaviors were evaluated using hierarchical multiple linear regression analysis. The mean age of the participants was 22.3 ± 3.16 years, and 70.0% were female. The total score for sustainable and healthy eating behaviors was found to be 3.79 ± 1.13. Health literacy was positively correlated with sustainable and healthy eating behaviors ( r  = 0.215; p  < 0.001). Digital healthy diet literacy ( r  = 0.045; p  = 0.435) and food neophobia ( r  = 0.017; p  = 0.767) were not significantly correlated with sustainable and healthy eating behaviors. In the final hierarchical regression model, perceived healthy eating ( β  = 0.310; p  < 0.001) and health literacy ( β  = 0.221; p  < 0.001) were positively associated with sustainable and healthy eating behaviors after accounting for other model variables, while current smoking was negatively associated with sustainable and healthy eating behaviors ( β  = −0.154; p  = 0.009). The final model explained 19.1% of the variance ( R 2  = 0.191). Health literacy was independently associated with sustainable and healthy eating behaviors among university students. However, no significant associations were found between food neophobia and either digital healthy eating literacy or sustainable and healthy eating behaviors. Future longitudinal and intervention studies may clarify the direction of this relationship and the underlying mechanisms.