{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T10:55:10Z","timestamp":1775472910933,"version":"3.50.1"},"reference-count":60,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T00:00:00Z","timestamp":1760918400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"crossref","award":["RS-2023-00280503"],"award-info":[{"award-number":["RS-2023-00280503"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Unhealthy diets are major contributors to obesity and chronic diseases. In 2023, 50.7% of Chinese adults were overweight or obese, underscoring the need to strengthen healthy-eating intentions. Methods: We analysed a cross-sectional online survey of 1145 adults (18\u201364 years) from Henan and Shandong. Moderation was tested using multiple linear regression with mean-centred interaction terms between each Theory of Planned Behaviour (TPB) construct (attitude, subjective norms, and perceived behavioural control [PBC]) and each food-literacy component (production, choices, preparation and cooking, intake, disposal). Models were adjusted for age, occupation, marital status, alcohol use, physician-diagnosed chronic disease, and living with family. To address multicollinearity, we performed a ridge-regression robustness check (L2-regularised linear model; \u03bb = 0.02 selected by 10-fold cross-validation; CV-RMSE = 0.483; CV-R2 = 0.631). We report B, SE, \u03b2, p-values, and R2\/adjusted R2. Results: The overall food-literacy score did not significantly moderate the associations between attitude, subjective norms, or PBC and healthy-eating intention (p = 0.328, 0.671, 0.985). In component-wise analyses, only intake (intake) significantly moderated the PBC\u2013intention association (B = 0.002, SE = 0.001, t = 2.497, p = 0.013); in the ridge model, the effect remained positive (\u03b2 = 0.182; \u03bb = 0.02). PBC (\u03b2 = 0.459) and subjective norms (\u03b2 = 0.169) were the strongest main-effect predictors. The best-fitting model explained R2 = 0.663 of the variance in intention (adjusted R2 = 0.663). Conclusions: Among adults in Henan and Shandong, the intake component of food literacy strengthened the association between PBC and healthy-eating intention, whereas overall food literacy showed no general moderating effect. Interventions should prioritise intake-related skills (e.g., portion planning, lower-sodium choices and nutrition label use) to enhance perceived behavioural control and, in turn, intention. Given the cross-sectional design, causal inference is limited; longitudinal, capability-building evaluations are warranted.<\/jats:p>","DOI":"10.3390\/nu17203295","type":"journal-article","created":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:44:10Z","timestamp":1760957050000},"page":"3295","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Impact of Chinese Adult\u2019s Food Literacy on Healthy Eating Intentions Based on the Planned Behaviour Theory"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8986-8377","authenticated-orcid":false,"given":"Yingying","family":"Li","sequence":"first","affiliation":[{"name":"Department of Foodservice Management and Nutrition, Graduate School, Sangmyung University, Seoul 03016, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4003-1293","authenticated-orcid":false,"given":"Ji-Yun","family":"Hwang","sequence":"additional","affiliation":[{"name":"Major of Foodservice Management and Nutrition, Sangmyung University, Seoul 03016, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,20]]},"reference":[{"key":"ref_1","unstructured":"Ministry of Agriculture and Rural Affairs of the People\u2019s Republic of China (2020). China Agricultural Outlook Report (2020\u20132029), China Agricultural Press."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e72978","DOI":"10.2196\/72978","article-title":"Dietary Risk Factors and Associated Disease Burden Among Chinese Adults Aged 25 Years and Older: Systematic Analysis of the Global Burden of Disease Study 2021","volume":"11","author":"Xin","year":"2025","journal-title":"JMIR Public Health Surveill."},{"key":"ref_3","unstructured":"National Center for Cardiovascular Diseases, and The Writing Committee of the Report on Cardiovascular Health and Diseases in China (2024). Report on Cardiovascular Health and Diseases in China 2023: An Updated Summary. Biomed. Environ. Sci., 37, 949\u2013992."},{"key":"ref_4","unstructured":"International Diabetes Federation (2025). IDF Diabetes Atlas, IDF. [11th ed.]. Available online: https:\/\/diabetesatlas.org\/."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1056\/NEJMoa1501451","article-title":"Fresh Fruit intake and Major Cardiovascular Disease in China","volume":"374","author":"Du","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1476","DOI":"10.1093\/jn\/nxac041","article-title":"Coarse Grain intake and Risk of Cardiometabolic Diseases: A Prospective Cohort Study of Chinese Adults","volume":"152","author":"Yang","year":"2022","journal-title":"J. Nutr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.ajcnut.2023.09.005","article-title":"Estimation of 24-Hour Urinary Sodium and Potassium Excretion among Chinese Adults: A Cross-Sectional Study from the China National Nutrition Survey","volume":"119","author":"Liu","year":"2024","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_8","unstructured":"Chinese Nutrition Society (2022). Dietary Guidelines for Chinese Residents, People\u2019s Medical Publishing House."},{"key":"ref_9","unstructured":"Bureau of Disease Prevention and Control, and National Health Commission (2021). Report on Nutrition and Chronic Disease Status of Chinese Residents (2020), People\u2019s Medical Publishing House."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e1089","DOI":"10.1016\/S2468-2667(24)00250-0","article-title":"Diabetes in China Part 1: Epidemiology and Risk Factors","volume":"9","author":"Xu","year":"2024","journal-title":"Lancet Public Health"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e70012","DOI":"10.1111\/1753-0407.70012","article-title":"National Burden and Risk Factors of Diabetes Mellitus in China from 1990 to 2021: Results from the Global Burden of Disease Study 2021","volume":"16","author":"Deng","year":"2024","journal-title":"J. Diabetes"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"494","DOI":"10.2337\/dc17-1852","article-title":"Associations of General and Central Adiposity with Incident Diabetes in Chinese Men and Women","volume":"41","author":"Bragg","year":"2018","journal-title":"Diabetes Care"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/S2213-8587(19)30425-5","article-title":"Association of Insulin Resistance and \u03b2-Cell Dysfunction with Incident Diabetes Among Adults in China: A Nationwide, Population-Based, Prospective Cohort Study","volume":"8","author":"Wang","year":"2020","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_14","unstructured":"China Internet Network Information Center (2024, October 12). The 53rd Statistical Report on China\u2019s Internet Development. Available online: https:\/\/www.cnnic.net.cn\/n4\/2024\/0322\/c88-10964.html."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.appet.2014.01.010","article-title":"Defining food literacy and its components","volume":"76","author":"Vidgen","year":"2014","journal-title":"Appetite"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Li, Z., Xu, Y., Liu, Z., Ma, Y., Guo, Y., Wang, D., Yu, W., Zhao, R., Yuan, Q., and Xu, M. (2024). Status and associated factors of food and nutrition literacy among young adults aged 15\u201344\u2009years in Shenzhen City, China. Front. Public Health, 11.","DOI":"10.3389\/fpubh.2023.1329241"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1177\/1090198118775485","article-title":"Identifying food literacy educational opportunities for youth","volume":"45","author":"Amin","year":"2018","journal-title":"Health Educ. Behav."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Amouzandeh, C., Fingland, D., and Vidgen, H.A. (2019). A scoping review of the validity, reliability and conceptual alignment of food literacy measures for adults. Nutrients, 11.","DOI":"10.3390\/nu11040801"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1093\/nutrit\/nuad072","article-title":"Development of food literacy in children and adolescents: Implications for the design of strategies to promote healthier and more sustainable diets","volume":"82","author":"Ares","year":"2024","journal-title":"Nutr. Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2406","DOI":"10.1017\/S1368980017001276","article-title":"Identifying attributes of food literacy: A scoping review","volume":"20","author":"Perry","year":"2017","journal-title":"Public Health Nutr."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Begley, A., Paynter, E., and Dhaliwal, S.S. (2018). Evaluation tool development for food literacy programs. Nutrients, 10.","DOI":"10.3390\/nu10111617"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1509\/jppm.30.1.5","article-title":"From nutrients to nurturance: A conceptual introduction to food well-being","volume":"30","author":"Block","year":"2011","journal-title":"J. Public Policy Mark."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"140","DOI":"10.3148\/cjdpr-2015-010","article-title":"Food literacy Definition and framework for action","volume":"76","author":"Cullen","year":"2015","journal-title":"Can. J. Diet. Pract. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/j.appet.2017.08.039","article-title":"A short food literacy questionnaire (SFLQ) for adults: Findings from a Swiss validation study","volume":"120","author":"Sommerhalder","year":"2018","journal-title":"Appetite"},{"key":"ref_25","first-page":"8","article-title":"Toward a common understanding of food literacy: A pedagogical framework","volume":"8","author":"Hernandez","year":"2021","journal-title":"Can. Food Stud."},{"key":"ref_26","first-page":"378","article-title":"Just a subtle difference? Findings from a systematic review on definitions of nutrition literacy and food literacy","volume":"33","author":"Krause","year":"2018","journal-title":"Health Promot. Int."},{"key":"ref_27","first-page":"99","article-title":"Sustainability of well-being through literacy: The effects of food literacy on sustainability of well-being","volume":"8","author":"Palumbo","year":"2016","journal-title":"Agric. Agric. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Rosas, R., Pimenta, F., Leal, I., and Schwarzer, R. (2019). FOODLIT-PRO: Food literacy domains, influential factors, and determinants\u2014A qualitative study. Nutrients, 12.","DOI":"10.3390\/nu12010088"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1111\/ijcs.12471","article-title":"Food literacy competencies: A conceptual framework for youth transitioning to adulthood","volume":"42","author":"Slater","year":"2018","journal-title":"Int. J. Consum. Stud."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/j.jand.2018.10.015","article-title":"Complexities in conceptualizing and measuring food literacy","volume":"119","author":"Thomas","year":"2019","journal-title":"J. Acad. Nutr. Diet."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1968","DOI":"10.1017\/S1368980021004560","article-title":"Progressing the development of a food literacy questionnaire using cognitive interviews","volume":"25","author":"Thompson","year":"2021","journal-title":"Public Health Nutr."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/j.appet.2017.05.007","article-title":"Defining food literacy: A scoping review","volume":"116","author":"Truman","year":"2017","journal-title":"Appetite"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1017\/S1368980014000962","article-title":"The relationship between food literacy and dietary intake in adolescents: A systematic review","volume":"18","author":"Vaitkeviciute","year":"2015","journal-title":"Public Health Nutr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.jneb.2015.04.328","article-title":"The nuances of health literacy, nutrition literacy, and food literacy","volume":"47","author":"Velardo","year":"2015","journal-title":"J. Nutr. Educ. Behav."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Vettori, V., Lorini, C., Milani, C., and Bonaccorsi, G. (2019). Towards the implementation of a conceptual framework of food and nutrition literacy: Providing healthy eating for the population. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16245041"},{"key":"ref_36","first-page":"e134","article-title":"Measuring nutrition and food literacy in adults: A systematic review and appraisal of existing measurement tools","volume":"2","author":"Yuen","year":"2018","journal-title":"Health Lit. Res. Pract."},{"key":"ref_37","unstructured":"Lee, J., Kim, E., Shin, M., Park, D., and Choi, M. (2021). Food Literacy for Sustainable Eating Habits, National Institute of Agricultural Sciences, Department of Agro-Food Resources, Division of Food and Nutrition."},{"key":"ref_38","unstructured":"Kuhl, J., and Beckmann, J. (1985). From intentions to actions: A theory of planned behavior. Action-Control: From Cognition to Behavior, Springer."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/0749-5978(91)90020-T","article-title":"The theory of planned behavior","volume":"50","author":"Ajzen","year":"1991","journal-title":"Organ. Behav. Hum. Decis. Process."},{"key":"ref_40","first-page":"121","article-title":"Consumer attitudes and behavior: The theory of planned behavior applied to food intake decisions","volume":"70","author":"Ajzen","year":"2015","journal-title":"Ital. Rev. Agric. Econ."},{"key":"ref_41","first-page":"315","article-title":"A review of the theory of planned behavior","volume":"16","author":"Duan","year":"2008","journal-title":"Adv. Psychol. Sci."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e13059","DOI":"10.1111\/ijcs.13059","article-title":"Secondhand intake: A systematic literature review and future research agenda","volume":"48","author":"Gilal","year":"2024","journal-title":"Int. J. Consum. Stud."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1080\/01973533.2011.568834","article-title":"Knowledge and the prediction of behavior: The role of information accuracy in the theory of planned behavior","volume":"33","author":"Ajzen","year":"2011","journal-title":"Basic Appl. Soc. Psychol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1007\/BF01024160","article-title":"Understanding of consumer behaviour as a prerequisite for environmental protection","volume":"18","year":"1995","journal-title":"J. Consum. Policy"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1111\/ijcs.12741","article-title":"To Read or Not to Read: An Extension of the Theory of Planned Behaviour to Food Label Use","volume":"46","author":"Tian","year":"2022","journal-title":"Int. J. Consum. Stud."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"67","DOI":"10.4163\/jnh.2021.54.1.67","article-title":"Factors related to the intention of healthy eating behaviors based on the theory of planned behavior: Focused on adults residing in Beijing, China","volume":"54","author":"Liu","year":"2021","journal-title":"J. Nutr. Health"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"188","DOI":"10.4163\/jnh.2022.55.1.188","article-title":"Factors related to the short-term and long-term intentions of healthy eating among Chinese adults living in Shanghai and parts of Anhui Province of China using the theory of planned behavior","volume":"55","author":"Liu","year":"2022","journal-title":"J. Nutr. Health"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"112","DOI":"10.4163\/jnh.2023.56.1.112","article-title":"Healthy eating-out options are related to healthy eating intention in adults residing in Daqing(China)","volume":"56","author":"Ma","year":"2023","journal-title":"J. Nutr. Health"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Ma, X., Lee, S., and Hwang, J.-Y. (2025). Exploring the Role of Intrinsic Motivation in Healthy Eating Intentions: An Extension of the Theory of Planned Behavior in Chinese Adults. Nutrients, 17.","DOI":"10.3390\/nu17122007"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1108\/09654281311293600","article-title":"Using theory of planned behavior to predict healthy eating among Danish adolescents","volume":"113","author":"Chan","year":"2012","journal-title":"Health Educ."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"115","DOI":"10.5993\/AJHB.33.2.1","article-title":"Intention for healthy eating among Southern Appalachian teens","volume":"33","author":"Wu","year":"2009","journal-title":"Am. J. Health Behav."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Park, D., Park, Y.K., Park, C.Y., Choi, M.K., and Shin, M.J. (2020). Development of a comprehensive food literacy measurement tool integrating the food system and sustainability. Nutrients, 12.","DOI":"10.3390\/nu12113300"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"566","DOI":"10.4162\/nrp.2025.19.4.566","article-title":"How food literacy levels shape healthy eating intentions: A cross-sectional study of adults in Shandong Province, China, using the theory of planned behavior","volume":"19","author":"Xu","year":"2025","journal-title":"Nutr. Res. Pract."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Fishbein, M., and Ajzen, I. (2010). Predicting and Changing Behavior: The Reasoned Action Approach, Psychology Press\/Taylor & Francis.","DOI":"10.4324\/9780203838020"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1348\/014466601164939","article-title":"Efficacy of the Theory of Planned Behaviour: A meta-analytic review","volume":"40","author":"Armitage","year":"2001","journal-title":"Br. J. Soc. Psychol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1080\/17437199.2010.521684","article-title":"Prospective prediction of health-related behaviours using the Theory of Planned Behaviour: A meta-analysis","volume":"5","author":"McEachan","year":"2011","journal-title":"Health Psychol. Rev."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1017\/S1368980014001943","article-title":"Is cooking at home associated with better diet quality?","volume":"18","author":"Wolfson","year":"2015","journal-title":"Public Health Nutr."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"2384","DOI":"10.1017\/S1368980019003549","article-title":"More frequent cooking at home is associated with higher Healthy Eating Index-2015 score","volume":"23","author":"Wolfson","year":"2020","journal-title":"Public Health Nutr."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1016\/j.jada.2011.08.047","article-title":"Nutrition label use mediates the relationship between attitudes and diet quality","volume":"112","author":"Graham","year":"2012","journal-title":"J. Acad. Nutr. Diet."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/nure.12000","article-title":"Effects of front-of-package and shelf nutrition labelling on consumers","volume":"71","author":"Hersey","year":"2013","journal-title":"Nutr. Rev."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/20\/3295\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T04:37:24Z","timestamp":1761107844000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/20\/3295"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,20]]},"references-count":60,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["nu17203295"],"URL":"https:\/\/doi.org\/10.3390\/nu17203295","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,20]]}}}