Evaluation of adult women's nutrition and health literacy, sustainable and healthy nutrition behaviors and dietary water and carbon footprints

Objective: This study aimed to determine and evaluate the relationship between the sustainable dietary behaviors of adult women, their compliance with the Mediterranean diet, their nutritional and health literacy status, and their dietary water and carbon footprints Method: The study was conducted among 241 adult women aged 18-65 living in Mersin between September 2023 and March 2024. The individuals' general characteristics, dietary habits, anthropometric measurements, food consumption records, sustainable dietary behaviors, nutritional and health literacy, and adherence to the Mediterranean diet were assessed using a survey. Water and carbon footprints were calculated. Results: The mean age of the 241 women who participated in the study was 39.81±13.28 years. The women's mean Mediterranean Diet Adherence Scale (MEDAS) score was 7.81±1.79, the mean Turkey Health Literacy Scale (TSOY-32) score was 35.99±9.34, the mean Self-Perceived Food Literacy Scale (SPFL-Scale) total score was 104.69±13.50, and the mean Sustainable Healthy Eating Behaviors Scale (SHEB-Scale) score was 138.47±31.26. The women's mean water footprint and median carbon footprint values were 2.48±0.93, and 1.89(1.96) (Q1=1.25, Q3=3.21), respectively. A positive correlation was found between women's MEDAS scores and SHEB (r=0.382, p<0.001) and SPFL-Scale (r=0.387, p<0.001) scores. Working women had significantly higher water footprint averages than non-working women (t=2.180, p=0.030). A one-unit increase in SHEB-Scale score was significantly associated with a 1.144-unit increase in SPFL-Scale total score (p<0.001, CI=0.890-1.398) and a 2.992-unit increase in MEDAS score (p=0.002, CI=1.148-4.836). Conclusion: This study found a positive correlation between women's sustainable eating behaviors, their nutritional literacy, and their adherence to the Mediterranean diet. A relationship was found between their sociocultural characteristics, dietary habits, and their water and carbon footprints.