Evaluation of the relationship between health literacy and body mass index, blood pressure and healthy lifestyle behaviors in adult population; GLM mediation model analysis
Mehmet Enes Gökler1, Furkan Akyüz1, Hacer Demirköse2, Hamit Harun Bağcı31Department of Public Health, Faculty Of Medicine Ankara Yıldırım Beyazıt University Ankara, Turkey2Department of Infectious Diseases and Early Warning Republic of Turkey Ministry of Health, General Directorate of Public Health Ankara, Turkey
3Republic of Türkiye Ministry of Health, General Directorate of Administrative Services Ankara, Turkey
INTRODUCTION: This study examines the relationship between health literacy (HL) and body mass index (BMI), blood pressure, and healthy lifestyle behaviors in 526 adults attending primary care centers. Mediation analysis was used to assess both direct and indirect effects of HL on these outcomes.
METHODS: HL was measured using the Turkey Health Literacy Scale-32 (THLS-32). Independent variables included demographic characteristics, BMI, blood pressure, dietary habits, physical activity, and scores from the Healthy Lifestyle Behaviors Scale-II (HLSBS). Chi-squared tests were applied for categorical variables, Student’s t tests for parametric data, and Mann-Whitney U tests for non-parametric data. GLM mediation analysis conducted in JAMOVI examined the role of HL in BMI, body fat, and mean arterial pressure (MAP), with p<0.05 considered statistically significant.
RESULTS: Among 526 participants, 40.7% were overweight, and 27.8% were obese, while 48.1% had sufficient-perfect HL. Individuals with inadequate-limited HL had higher BMI and blood pressure and lower engagement in healthy behaviors. GLM analysis showed HL was significantly and directly associated with BMI, fat mass, and MAP (β = −0.195, −0.139, and −0.146, respectively; all p < 0.001). However, healthy lifestyle behaviors did not mediate these associations.
DISCUSSION AND CONCLUSION: HL was independently associated with BMI, fat mass, and blood pressure, although the tested behavioral mediators did not explain this relationship. Health literacy plays a key role in health promotion. Health professionals should emphasize HL to improve lifestyle behaviors and reduce risks of obesity and hypertension. Practical strategies include HL-tailored patient education, simplified prescriptions, HL screening in routine care, individualized counseling, and community programs.
Keywords: Obesity, health literacy, healthy lifestyle behaviors, mediation model analysis
Makale Dili: İngilizce