Relationships of Family food environment with food and nutrition literacy in Chinese school-age children

Abstract Background: Eating behavior is influenced by multiple factors and understanding the interplay of these factors is necessary to promote children’s healthy food choice. This study investigated the relations of family food environment (FFE) with food and nutrition literacy (FNL) in Chinese school-age children.Methods: A total of 605 children aged 7-13 years from Grade 1 to 5, and their caregivers participated in the cross-sectional study in Beijing of China during April 2019. The FFE was assessed by the validated Family Food Environment Questionnaire for Chinese School-age Children (FFEQ-SC). For the children of Grade 3 to 5 (n=260), the FNL, including cognitive and skill domains, was assessed by Food and Nutrition Literacy Questionnaire for Chinese School-age Children (FNLQ-SC). Both FFEQ-SC and FNLQ-SC were developed firstly for Chinese school-age children who had good reliability. The anthropometric data (height and weight) was derived from local health information management system for primary schools.Results: Overall, 68.9% of the children’s families had high level of FFE. The total FNL score of 260 children at Grade 3-5 was 63.2±10.3. Comparison of children’s FNL scores among different levels of FFE showed the children with higher level of FFE, especially higher level of caregiver’s educational degree and FNL, were more likely to have higher FNL scores (P<0.05). The multivariate analysis showed the children’s total FNL score was significantly related with family caregiver (β= -0.123, P=0.04) and caregiver’s nutritional literacy (β= 0.210, P=0.002). Furthermore, the children with higher level of caregiver’s nutritional knowledge were less likely to be overweighted or obesese (OR=0.043, P=0.04).Conclusions: Family food environment, especially caregivers’ FNL, was related with children’s FNL, even the risk of overweight. These findings highlight the importance of targeting nutritional knowledge of family caregivers to facilitate the children’s FNL to maintain good health.