Adaptation of the E-HEALTHY nutrition literacy (E-HDL) questionnaire into Turkish and determining the relationship between E-HDL levels and nutritional parameters of adult individuals before and during the COVİD-19 pandemic

This study aimed to evaluate the nutritional status of adults, to determine their food choices and habits, nutritional knowledge levels, attitudes towards healthy eating, level of healthy eating obsession during the Covid-19 pandemic and to determine the effect of the pandemic on the electronic healthy nutrition literacy levels of this population. In order to determine the electronic healthy nutrition literacy levels of individuals, validity and reliability studies were performed for the Turkish version of the e-Healthy Nutrition Literacy (e-HDL) Questionnaire. The study was conducted on 158 adult individuals with a mean age of 41.32±12.52 years, who followed a social media page that shares content related to healthy nutrition, between January and March 2022, using online methods. In the study general information questionnaire, one-day food consumption record, Nutrition Knowledge Level for Adults (YETBİD) scale, Attitude Scale for Healthy Nutrition (ASHN) and ORTO-15 test were applied once, the e-HDL scale was applied to individuals twice, before (retrospectively) and during the pandemic, using online methods. It has been observed that the e-HDL questionnaire, which consists of 15 items, is gathered under five factors, as in the original. The factor load of the items in each dimension was found over 0.40 and the percentage of total variance explanation was found 73.5%. When the correlation between the e-HDL questionnaire score and its sub-dimensions is examined, scores of all sub-dimensions were moderate positively correlated with the total score of the e-HDL questionnaire (p=0.000). In the reliability analysis of the e-HDL questionnaire, Cronbach's Alpha Internal Consistency Coefficient was found as 0.77, and the sub-dimensions coefficient was found as 0.80, 0.68, 0.89, 0.85 and 0.88, respectively. The correlation coefficient of the test and retest scores of the e-HDL questionnaire was determined as 0.98 (p=0.000). These results show that the Turkish version of the e-HDL questionnaire is a valid and reliable tool for measuring the electronic healthy nutrition literacy levels of individuals. The intake of thiamine, niacin, potassium, calcium, zinc, iron and selenium micronutrients of the individuals was below the Turkey's Dietary Guidelines (TUBER) 2015 reference value. All participants were found to have changed their food selection and/or eating habits during the Covid-19 pandemic (p<0.05). However, it has been determined that the number of individuals who have the habit of eating fast food/ordered food during the Covid-19 pandemic has decreased compared to the pre-Covid-19 pandemic (p<0.05). During the Covid-19 pandemic, the majority of the participants reported that they did not tend to smoke or drink alcohol more, while their physical activity levels decreased. It was determined that the intake of vitamins D and C, and zinc and magnesium supplements of the participants increased statistically significantly during the Covid-19 pandemic (p<0.05). There is a weak but positive correlation between YETBİD scores (p<0.05) and ASHN scores (p<0.05) with e-HDL questionnaire scores and a weak but negative correlation between ORTO-15 scores (p>0.05) with e-HDL questionnaire scores. While the mean scores of the e-HDL questionnaire before the Covid-19 pandemic was 34.0±7.36 points, the mean scores of the e-HDL questionnaire increased to 37.6±7.85 points during the Covid-19 pandemic (p<0.05). Keywords: Nutrition literacy, Covid-19, nutritional status, healthy eating obsession, e-Healthy Nutrition Literacy.