Mapping food and nutrition literacy in non-communicable disease contexts: A scoping review

Abstract

Objectives

Food and nutrition literacy (FNL), the ability to access, understand, evaluate, and apply nutrition information, is increasingly recognized as a critical determinant of dietary behavior and chronic disease outcomes. This scoping review aimed to synthesize global evidence on the prevalence, measurement approaches, and clinical and behavioral correlates of FNL among adults living with non-communicable diseases (NCDs), and to clarify its relevance for clinical care and public health practice.

Material and methods

Following the PRISMA-ScR guidelines, PubMed, Scopus, Web of Science, and Google Scholar were systematically searched for peer-reviewed studies up to October 30, 2025. Eligible studies assessed functional, interactive, or critical FNL in adults with NCDs. Data were extracted on study characteristics, FNL measurement, and associations with behavioral or clinical outcomes. Two researchers independently performed searches of electronic databases, study selection, and data extraction, with discrepancies resolved by consensus or a third reviewer.

Results

Thirteen studies, covering 5004 participants across diverse settings, were included. FNL levels were generally suboptimal, with pronounced deficits in label interpretation, portion control, meal planning, and critical appraisal. Higher FNL was consistently associated with healthier dietary behaviors, improved self-management, and better cardiometabolic indicators. Functional literacy supported adherence to evidence-based diets, while interactive and critical literacy enhanced patient-provider communication and resilience against misleading nutrition information.

Conclusion

FNL is a modifiable, clinically actionable determinant of chronic disease management. Integrating FNL assessment and education into care pathways can empower patients, strengthen long-term adherence, and support population-level NCD prevention.