Nutrition literacy and socio-demographic determinants among Chinese women of childbearing age

TL;DR

This study examines nutrition literacy among Chinese women of childbearing age and finds that socioeconomic factors and health conditions significantly influence their knowledge.

Contribution

The study provides new insights into domain-specific nutrition literacy and its socio-demographic determinants in China.

Findings

Only 33.4% of women met the threshold for adequate nutrition literacy.

Higher education, income, and urban residence were linked to better nutrition literacy.

Critical nutrition literacy was the lowest among the three domains assessed.

Abstract

Nutrition literacy is critical for women of childbearing age because it may shape dietary behaviors before and during pregnancy. Evidence on domain-specific nutrition literacy and associated factors in China remains limited.

A cross-sectional online survey was conducted from August 20, 2024 to March 20, 2025, with dissemination supported by three tertiary hospitals in East, North, and Middle China. Women aged 18–49 years completed an adapted Chinese Nutrition Literacy Questionnaire (CNLQ). Domain and total scores were calculated using the original protocol and transformed to a 0–100 scale, with higher scores indicating higher nutrition literacy. Adequate nutrition literacy was defined as total score ≥80. Psychometric evaluation of the adapted instrument was performed in the full analytic sample. Univariable screening (p < 0.10) was used to select predictors for multivariable linear regression (total score) and multivariable logistic regression (adequacy).

Among 1,764 returned questionnaires, 1,391 were included after exclusions. Mean total nutrition literacy was 74.9 ± 12.8, and 33.4% (n = 465) met the adequacy threshold. Domain scores showed a gradient: functional 77.4 ± 13.4, interactive 75.1 ± 13.8, and critical 69.9 ± 14.2. In adjusted models, higher education, higher income, urban residence, and healthcare background were associated with higher total scores and higher odds of adequacy. Multimorbidity was associated with lower total score (adjusted β = −2.55) and lower odds of adequacy (adjusted OR = 0.62). Women aged 35–49 years had higher total scores (adjusted β = 1.67) and higher odds of adequacy (adjusted OR = 1.43) compared with those aged 18–24 years.

Nutrition literacy among Chinese women of childbearing age is moderate, with critical literacy lowest. Socioeconomic factors, urban residence, healthcare background, and multimorbidity are key correlates, highlighting priorities for targeted interventions that strengthen critical appraisal skills and support women with multimorbidity.

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