Document Type : Original Article

Authors

1 Research Center for Nursing and Midwifery Care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

2 Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran, Department of Community Health Nursing, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran

3 Non‑Communicable Diseases Research Center, Rafsanjan University of Medical Sciences Rafsanjan, Iran, Social Determinants of Health Research Centre, Rafsanjan University of Medical Sciences, Rafsanjan, Iran

4 Department of Nursing, Faculty Member of Zahedan University of Medical Sciences, Zahedan, Iran

5 Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran

Abstract

BACKGROUND: Obesity and overweight in children and adolescents have become a global problem
in recent years. Adolescence increases the likelihood of obesity in adulthood and associated illnesses.
Nowadays, health literacy is one of the greatest determinants of the health. This study was conducted
to evaluate the correlation between body mass index (BMI) and health literacy in high school students.
MATERIALS AND METHODS: In this descriptive‑analytical study, 430 high school students were
enrolled in a multi‑stage random method in Yazd city in the center of Iran. The data were collected
through The Health Literacy Measure for Adolescents and calculate BMI with measurement of
height and weight of adolescents. The data were then analyzed using SPSS 25 and descriptive and
inferential statistics (Chi‑square and multivariate regression).
RESULTS: The results showed that the mean score of BMI (21.76 ± 3.76) was in a normal range.
The score of health literacy was at the borderline level (58.44 ± 13.79). BMI was not significantly
correlated with health literacy (P = 0.09). BMI was significantly different in terms of age, high school
grade, school type, and health status. School type and health status predict 37% of the variance of
BMI (R2 = 37%) and the best predictor was health status (P < 0.05).
CONCLUSIONS: The results of the present study showed that BMI was not correlated with health
literacy and student health literacy was at the borderline level. It is necessary to carry out further
studies on the causes and facilitators and the barriers to increasing health literacy. Furthermore,
educational interventions are needed to prevent the increase of BMI in adolescents and identify
determining factors.

Keywords

1. Haththotuwa RN, Wijeyaratne CN, Senarath U, Mahmood T,
Arulkumaran S. Worldwide epidemic of obesity. In Obesity:
A Ticking Time Bomb for Reproductive Health. Oxford: Elsevier
2013; pp. 3–11.
2. Sinelnikova EM, Dvoretskova TV, Kagan ZS. Intermediate
plateaux in kinetics of the reaction catalyzed by biodegradative
L‑threonine dehydratase from Escherichia coli. Biokhimiia
1975;40:645‑51.
3. Mistry SK, Puthussery S. Risk factors of overweight and obesity in
childhood and adolescence in South Asian countries: A systematic
review of the evidence. Public Health 2015;129:200‑9.
4. Reade AE, Gregory KF. High‑temperature production of
protein‑enriched feed from cassava by fungi. Appl Microbiol
1975;30:897‑904.
5. Cunha M, Gaspar R, Fonseca S, Almeida D, Silva M, Nunes L.
Implications of literacy for health for body mass index. Aten
Primaria 2014;46 Suppl 5:180‑6.
6. Skinner AC, RavanbakhtSN, SkeltonJA, PerrinEM, ArmstrongSC.
Prevalence of obesity and severe obesity in US children, 1999‑2016.
Pediatrics 2018;141 (3): e20173459.
7. Djalalinia S, Kelishadi R, Qorbani M, Peykari N, Kasaeian A,
Nasli‑Esfahani E, et al. A systematic review on the prevalence of
overweight and obesity, in Iranian children and adolescents. Iran
J Pediatr 2016;26:e2599.
8. Sharif I, Blank AE. Relationship between child health literacy and
body mass index in overweight children. Patient Educ Couns
2010;79:43‑8.
9. Moghaddam R, Mokhtari Lakeh N, Rahebi SM, Kazemnezhad
Leili E. Health literacy and its relationship with body mass index.
J Holistic Nurs Midwifery 2019;29:8‑14.
10. Karimi N, Saadat‑Gharin S, Tol A, Sadeghi R, Yaseri M,
Mohebbi B. A problem‑based learning health literacy intervention
program on improving health‑promoting behaviors among girl
students. J Educ Health Promot 2019;8:251.
11. Schulz PJ, Nakamoto K. Health literacy and patient empowerment
in health communication: the importance of separating conjoined
twins. Patient Educ Couns 2013;90:4‑11.
12. Karimi S, Keyvanara M, Hosseini M, Jazi MJ, Khorasani E. The
relationship between health literacy with health status and
healthcare utilization in 18‑64 years old people in Isfahan. J Educ
Health Promot 2014;3:75.
13. Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K.
Low health literacy and health outcomes: An updated systematic
review. Ann Intern Med 2011;155:97‑107.
14. Liao LL, Shih SF, Osborne RH, Liu CH. Health literacy and the
determinants of obesity: A population‑based survey of sixth grade
school children in Taiwan. BMC Public Health 2016;16:280.
15. Tavousi M, Ebadi M, Fattahi E, Jahangiry L., Hashemi A,
Hashemiparast M, et al. Health literacy measures: A systematic
review of the literature. Payesh 2015;14:485. Retrieved
from: http://payeshjournal.ir/article‑1‑230‑en.html
16. Saeedy Golluche F, Jalili Z, Tavakoli R. The study of relationship
between health literacy and nutritional practice in high school
adolescents in Tehran. Iran J Health Educ Health Promot
2017;5:224‑30.
17. Santoro K, Speedling C. The case for investing in youth health
literacy: One step on the path to achieving health equity for
adolescents. NIHCM Issue Brief 2011; October, 1‑15. Retrieved
from http://www.NIHCM.org..
18. Story M, Kaphingst KM, French S. The role of schools in obesity
prevention. Future Child 2006;16:109‑42.
19. Salari N, Farokhzadian J, Abazari F. Comparing health promotion
behaviors of male and female high school students in Southeast
of Iran. Int J Adolesc Med Health 2017;32:1.
20. Sheikhbardsiri H, Mousavi SH, Doustmohammadi MM,
Karimi M, Salahi S. The effect of educational workshop on
emergency department nurses’ self‑efficacy in patient training.
J Educ Health Promot 2019;8:136.
21. Bahramian M, Najimi A, Omid A. Association between health
literacy with knowledge, attitude, and performance of health‑care
providers in applying health literacy education strategies for
health education delivery. J Educ Health Promot 2020;9:10.
22. Allender J, Rector C, Rector C, Warner K. Community & Public
Health Nursing: Promoting the Public’s Health Eighth, North
American Edition. Eight Edit. Wolters Kluwer | Lippincott
Williams & Wilkins; 2014.
23. Sheikhbardsiri H, Sheikhasadi H, Mahani SA, Mohamadi MM.
Emotional intelligence and learning strategies of postgraduate
students at Kerman University of Medical Sciences in the
southeast of Iran. J Educ Health Promot 2020;9:66.
24. Ghanbari S, Ramezankhani A, Montazeri A, Mehrabi Y. Health
literacy measure for adolescents (HELMA): Development and psychometric properties. PLoS One 2016;11:e0149202.
25. Lam LT, Yang L. Is low health literacy associated with overweight
and obesity in adolescents: An epidemiology study in a
12‑16 years old population, Nanning, China, 2012. Arch Public
Health 2014;72:11.
26. Kooshyar H, ShoorvaziM, DalirZ, HosseiniM. Health literacy and
its relationship with medical adherence and health‑related quality
of life in diabetic community‑residing elderly. J Mazandaran
Unive Med Sci 2014;23:134‑43.
27. Lima AS, Pitangui AC, Gomes MR, Mola R, Araújo RC. Risky
sexual behaviors and their association with overweight and
obesity among adolescent students: A cross‑sectional study.
Einstein (Sao Paulo) 2019;17:eAO4782.
28. Aghamolaei T, Hosseini Z, Hosseini F, Ghanbarne Jad A. The
relationship between health literacy and health promoting
behaviors in students. J Prev Med 2016;3:36‑43.
29. Linnebur LA, Linnebur SA. Self‑Administered assessment of
health literacy in adolescents using the newest vital sign. Health
Promot Pract 2018;19:119‑24.
30. Uysal N, Ceylan E, Koç A. Health literacy level and influencing
factors in university students. Health Soc Care Community
2020;28:505‑11.