Editing Human nutrition (section)

=== Nutrition literacy ===
The findings of the 2003 National Assessment of Adult Literacy (NAAL), conducted by the US Department of Education, provide a basis upon which to frame the nutrition literacy problem in the U.S. NAAL introduced the first-ever measure of "the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions"&nbsp;– an objective of Healthy People 2010<ref>Baldi, S. (ED.) et al. (2009). [http://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2009476 Technical Report and Data File User's Manual for the 2003 National Assessment of Adult Literacy (NCES 2009–2047)] {{Webarchive|url=https://web.archive.org/web/20220527011548/https://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2009476 |date=2022-05-27 }}. U.S. Department of Education, National Center for Education Statistics. Washington, DC: U.S. Government Printing Office.</ref> and of which nutrition literacy might be considered an important subset. On a scale of below basic, basic, intermediate and proficient, NAAL found 13 percent of adult Americans have proficient health literacy, 44% have intermediate literacy, 29 percent have basic literacy and 14 percent have below basic health literacy. The study found that health literacy increases with education and people living below the level of poverty have lower health literacy than those above it.

Another study examining the health and nutrition literacy status of residents of the lower [[Mississippi Delta]] found that 52 percent of participants had a high likelihood of limited literacy skills.<ref name="cdc.gov">{{cite journal | vauthors=Zoellner J, Connell C, Bounds W, Crook L, Yadrick K | year=2009 | title=Nutrition Literacy Status and Preferred Nutrition Communications Channels Among Adults in the Lower Mississippi Delta | journal=Preventing Chronic Disease | volume=6 | issue=4 | pages=A128 | url=https://www.cdc.gov/pcd/issues/2009/oct/08_0016.htm | pmid=19755004 | pmc=2774642 | access-date=2020-01-03 | archive-date=2022-08-07 | archive-url=https://web.archive.org/web/20220807213022/https://www.cdc.gov/pcd/issues/2009/oct/08_0016.htm | url-status=live}}</ref> While a precise comparison between the NAAL and Delta studies is difficult, primarily because of [[methodological]] differences, Zoellner et al. suggest that health literacy rates in the Mississippi Delta region are different from the U.S. general population and that they help establish the scope of the problem of health literacy among adults in the Delta region. For example, only 12 percent of study participants identified the [[MyPyramid]] graphic two years after it had been launched by the [[United States Department of Agriculture]] (USDA). The study also found significant relationships between nutrition literacy and income level and nutrition literacy and educational attainment<ref name="cdc.gov" /> further delineating priorities for the region.

These statistics point to the complexities surrounding the lack of health/nutrition literacy and reveal the degree to which they are embedded in the social structure and interconnected with other problems. Among these problems are the lack of information about food choices, a lack of understanding of nutritional information and its application to individual circumstances, limited or difficult access to healthful foods, and a range of cultural influences and [[Socioeconomic status|socioeconomic]] constraints such as low levels of education and high levels of poverty that decrease opportunities for healthful eating and living.

The links between low health literacy and poor health outcomes has been widely documented<ref>Berkman N.D., Sheridan, S.L., Donahue, K.E., Halpern, D.J., Viera, A., Crotty, K., Viswanathan, M. (2011). [https://www.ncbi.nlm.nih.gov/books/NBK82434/ Health and Literacy Intervention Outcomes: an Updated Systematic Review. Evidence Report/Technology Assessment no. 199] {{Webarchive|url=https://web.archive.org/web/20220401064005/https://www.ncbi.nlm.nih.gov/books/NBK82434/ |date=2022-04-01 }}. Prepared by RTI International – University of North Carolina Evidence-based Practice Center. Publication Number 11-E006. Rockville, MD. Agency for Healthcare Research and Quality.</ref> and there is evidence that some interventions to improve health literacy have produced successful results in the primary care setting. More must be done to further our understanding of nutrition literacy specific interventions in non-primary care settings<ref name="cdc.gov" /> in order to achieve better health outcomes.