The relationship between digital healthy diet literacy, physical activity, and health literacy: a community-based...

Health literacy and digital healthy diet literacy are increasingly recognized as important determinants of health behaviors. However, the relationship between these literacy domains and physical activity remains complex and not fully understood. This study aimed to examine the interrelationships between health literacy, digital healthy diet literacy, and physical activity levels in a community-based adult population.

This cross-sectional, community-based study included 1,047 adults aged 18-65 years recruited from three districts with different socioeconomic characteristics in Istanbul, Türkiye. Health literacy was assessed using the Health Literacy Scale-Short Form (HLS-SF), digital healthy diet literacy using the Digital Healthy Diet Literacy Scale (DHDLS), and physical activity levels using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). Correlation analyses, group comparisons, and binary logistic regression were conducted to examine associations between variables.

The median HLS-SF score was 20.83 (range: 0-50), indicating limited health literacy, while the median DHDLS score was 29.17 (range: 0-50). Nearly half of the participants (46.6%) had low physical activity levels. A moderate positive correlation was found between health literacy and digital healthy diet literacy (r = 0.488, p < 0.001). Health literacy and digital healthy diet literacy scores were positively correlated with age and body mass index. However, higher health literacy was associated with a lower likelihood of engaging in moderate-to-high physical activity (OR = 0.970, p < 0.001). Male gender, district of residence, family history of obesity, and prior physical activity counseling were positively associated with achieving moderate-to-high physical activity levels.

This study demonstrates that while health literacy and digital healthy diet literacy are correlated, higher health literacy does not necessarily translate into higher physical activity levels. Physical activity appears to be more influenced by environmental, social, and structural factors than by individual knowledge alone. Public health interventions should move beyond information-based approaches and adopt multicomponent strategies that address contextual barriers to behavior change.