The Development, Applications, and Future Directions of Nutritional Literacy Scales: A Scoping Review

Nutritional literacy is a core competency for promoting healthy dietary behaviors and preventing nutrition-related chronic diseases. Standardized scales are essential for rigorous measurement and evaluation, yet the field exhibits substantial heterogeneity in concepts and measurement approaches.

We systematically searched five major databases, namely Web of Science, PubMed, Scopus, Embase, and CINAHL, from their inception to October 2025. Evidence was compiled on the conceptual evolution, domain structure, scoring logic, population-specific applicability, and application scenarios of nutritional literacy scales.

A total of 14 nutritional literacy scales developed between 2005 and 2025 were included in the review. The structure and measurement content of these scales have progressively expanded, evolving from an early focus on basic reading and numeracy skills to become multidimensional assessment tools encompassing knowledge, skills, and behavioral practices. The target population has broadened from the general adult population to include multiple special groups, while application regions have extended from high-income Western countries to developing regions, including China and Turkey, and assessment methodologies have progressively shifted from single tests to blended objective-subjective approaches, with most scales demonstrating sound reliability and validity. These instruments are now employed for screening, intervention evaluation, dietary behavior mechanism research, and analysis of chronic disease risk. The reviewed studies indicate that nutritional literacy is generally positively correlated with healthy dietary behaviors, nutrition labeling utilization, and related health outcomes.

Although nutritional literacy scale research has advanced with regard to conceptualization, measurement design, and applications, major gaps remain, including fragmented dimensional structures, insufficient standardization, inadequate cultural adaptation, and limited longitudinal evidence. Future work should prioritize a unified assessment framework, stronger tools for special and vulnerable populations, digital innovations for scalable measurement, and interdisciplinary and cross-national collaboration to enhance quality, practicality, and comparability and to support global nutrition promotion and public health policy.