The role of anxiety in the association between nutrition literacy and health-related quality of life among college students

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Abstract

The health-related quality of life (HRQOL) of college students is not promising and needs to be improved through effective interventions. This study aimed to investigate the associations of nutrition literacy (NL) with HRQOL and anxiety among college students, and to identify the role of anxiety in the relationship between NL and HRQOL. The cross-sectional survey was conducted via the “Wenjuanxing” platform from September to November 2023. The Food and Nutrition Literacy Questionnaire (FNLQ), the Generalized Anxiety Disorder (GAD-7) diagnostic tool and the SF-12 scale were used to assess NL, anxiety, and HRQOL, respectively. Logistic regression models, mediation analysis, additive and multiplicative interaction analyses were used. 2066 college students participated in the analysis. After adjusting for potential confounders, we found that college students with higher NL had higher HRQOL (OR = 2.52, 95% CI: 2.09–3.03, p < 0.001) and a lower risk of anxiety (OR = 0.53, 95% CI: 0.39–0.73, p < 0.001). Additionally, anxious college students had lower HRQOL (OR = 0.16, 95% CI: 0.11–0.24, p < 0.001). Furthermore, mediation analysis confirmed that anxiety was a partial mediator of the relationship between NL and HRQOL (β = 0.600, 95% CI: 0.406–0.779/0.430–0.818). Significant additive interactions were found between NL and Anxiety (RERI = 6.96, 95% CI: 2.74–11.17; AP = 0.51, 95% CI: 0.37–0.64; SI = 2.21, 95% CI: 1.58–3.07). Higher levels of NL are associated with better HRQOL and lower anxiety among college students. Additionally, anxiety partially mediated the relationship between NL and HRQOL. Furthermore, there is a synergy between NL and anxiety.

Supplementary Information

The online version contains supplementary material available at 10.1038/s41598-024-76361-6.

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Most cited references 34

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A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity.

J. Ware, M Kosinski, S Keller (1996)

Regression methods were used to select and score 12 items from the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) to reproduce the Physical Component Summary and Mental Component Summary scales in the general US population (n=2,333). The resulting 12-item short-form (SF-12) achieved multiple R squares of 0.911 and 0.918 in predictions of the SF-36 Physical Component Summary and SF-36 Mental Component Summary scores, respectively. Scoring algorithms from the general population used to score 12-item versions of the two components (Physical Components Summary and Mental Component Summary) achieved R squares of 0.905 with the SF-36 Physical Component Summary and 0.938 with SF-36 Mental Component Summary when cross-validated in the Medical Outcomes Study. Test-retest (2-week)correlations of 0.89 and 0.76 were observed for the 12-item Physical Component Summary and the 12-item Mental Component Summary, respectively, in the general US population (n=232). Twenty cross-sectional and longitudinal tests of empirical validity previously published for the 36-item short-form scales and summary measures were replicated for the 12-item Physical Component Summary and the 12-item Mental Component Summary, including comparisons between patient groups known to differ or to change in terms of the presence and seriousness of physical and mental conditions, acute symptoms, age and aging, self-reported 1-year changes in health, and recovery for depression. In 14 validity tests involving physical criteria, relative validity estimates for the 12-item Physical Component Summary ranged from 0.43 to 0.93 (median=0.67) in comparison with the best 36-item short-form scale. Relative validity estimates for the 12-item Mental Component Summary in 6 tests involving mental criteria ranged from 0.60 to 107 (median=0.97) in relation to the best 36-item short-form scale. Average scores for the 2 summary measures, and those for most scales in the 8-scale profile based on the 12-item short-form, closely mirrored those for the 36-item short-form, although standard errors were nearly always larger for the 12-item short-form.

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The Microbiota-Gut-Brain Axis

John F. Cryan, Kenneth J. O'Riordan, Caitlin S M Cowan … (2019)

The importance of the gut-brain axis in maintaining homeostasis has long been appreciated. However, the past 15 yr have seen the emergence of the microbiota (the trillions of microorganisms within and on our bodies) as one of the key regulators of gut-brain function and has led to the appreciation of the importance of a distinct microbiota-gut-brain axis. This axis is gaining ever more traction in fields investigating the biological and physiological basis of psychiatric, neurodevelopmental, age-related, and neurodegenerative disorders. The microbiota and the brain communicate with each other via various routes including the immune system, tryptophan metabolism, the vagus nerve and the enteric nervous system, involving microbial metabolites such as short-chain fatty acids, branched chain amino acids, and peptidoglycans. Many factors can influence microbiota composition in early life, including infection, mode of birth delivery, use of antibiotic medications, the nature of nutritional provision, environmental stressors, and host genetics. At the other extreme of life, microbial diversity diminishes with aging. Stress, in particular, can significantly impact the microbiota-gut-brain axis at all stages of life. Much recent work has implicated the gut microbiota in many conditions including autism, anxiety, obesity, schizophrenia, Parkinson’s disease, and Alzheimer’s disease. Animal models have been paramount in linking the regulation of fundamental neural processes, such as neurogenesis and myelination, to microbiome activation of microglia. Moreover, translational human studies are ongoing and will greatly enhance the field. Future studies will focus on understanding the mechanisms underlying the microbiota-gut-brain axis and attempt to elucidate microbial-based intervention and therapeutic strategies for neuropsychiatric disorders.

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Is Open Access

Mental health problems and social media exposure during COVID-19 outbreak

Junling Gao, Pinpin Zheng, Yingnan Jia … (2020)

Huge citizens expose to social media during a novel coronavirus disease (COVID-19) outbroke in Wuhan, China. We assess the prevalence of mental health problems and examine their association with social media exposure. A cross-sectional study among Chinese citizens aged≥18 years old was conducted during Jan 31 to Feb 2, 2020. Online survey was used to do rapid assessment. Total of 4872 participants from 31 provinces and autonomous regions were involved in the current study. Besides demographics and social media exposure (SME), depression was assessed by The Chinese version of WHO-Five Well-Being Index (WHO-5) and anxiety was assessed by Chinese version of generalized anxiety disorder scale (GAD-7). multivariable logistic regressions were used to identify associations between social media exposure with mental health problems after controlling for covariates. The prevalence of depression, anxiety and combination of depression and anxiety (CDA) was 48.3% (95%CI: 46.9%-49.7%), 22.6% (95%CI: 21.4%-23.8%) and 19.4% (95%CI: 18.3%-20.6%) during COVID-19 outbroke in Wuhan, China. More than 80% (95%CI:80.9%-83.1%) of participants reported frequently exposed to social media. After controlling for covariates, frequently SME was positively associated with high odds of anxiety (OR = 1.72, 95%CI: 1.31–2.26) and CDA (OR = 1.91, 95%CI: 1.52–2.41) compared with less SME. Our findings show there are high prevalence of mental health problems, which positively associated with frequently SME during the COVID-19 outbreak. These findings implicated the government need pay more attention to mental health problems, especially depression and anxiety among general population and combating with “infodemic” while combating during public health emergency.

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Author and article information

Contributors

Jun Liu: liujun_zmc@sina.com

Yan Xie: xie814yan@zmu.edu.cn

Journal

Journal ID (nlm-ta): Sci Rep

Journal ID (iso-abbrev): Sci Rep

Title: Scientific Reports

Publisher: Nature Publishing Group UK (London )

ISSN (Electronic): 2045-2322

Publication date (Electronic): 19 October 2024

Publication date PMC-release: 19 October 2024

Publication date Collection: 2024

Volume: 14

Electronic Location Identifier: 24618

Affiliations

[1 ]School of Public Health, Zunyi Medical University, ( https://ror.org/00g5b0g93) No.6 Xuefu Xilu, Zunyi, 563006 PR China

[2 ]The First Clinical Institute, Zunyi Medical University, ( https://ror.org/00g5b0g93) No.6 Xuefu Xilu, Zunyi, 563006 PR China

[3 ]GRID grid.495267.b, ISNI 0000 0004 8343 6722, Nursing specialty of Xi’an Peihua College, ; Xi’an, China

[4 ]Key Laboratory of Maternal & Child Health and Exposure Science of Guizhou Higher Education Institutes, School of Public Health, Zunyi Medical University, ( https://ror.org/00g5b0g93) No.6 Xuefu Xilu, Zunyi, 563006 PR China

Article

Publisher ID: 76361

DOI: 10.1038/s41598-024-76361-6

PMC ID: 11490534

PubMed ID: 39427070

SO-VID: 75800a66-48c7-4f01-9d07-3f63ab75ef83

License:

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

History

Date received : 15 July 2024

Date accepted : 14 October 2024

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100013254, National College Students Innovation and Entrepreneurship Training Program;

Award ID: ZYDC202401134

Funded by: Project of Humanities and Social Sciences of Colleges and universities of Guizhou Provincial Department of Education

Award ID: 23RWJD177

Funded by: Guizhou province General Higher Education Young Science and Technology Talent Development Project

Award ID: QJHkyZ[2022]275 No.

Funded by: Guizhou Provincial Education Reform Project

Award ID: YJSJGKT(2021)031

Award ID: SJJG2022-02-166

Funded by: Science & Technology Program of Guizhou Province

Award ID: QKHHBZ[2020]3002

Funded by: City School Joint Foundation Project

Award ID: QKH-PTRC[2020]-018 & ZYKH-HZ-Z[2021]292

Funded by: Start-up Foundation for Doctors of Zunyi Medical University

Award ID: QKH-PTRC[2019]-032

Funded by: Nature Science Foundation of Guizhou Provincial

Award ID: QKH-J[2022]YB612

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ScienceOpen disciplines: Uncategorized

Keywords: nutrition literacy,health-related quality of life,anxiety disorders,mediating effect,interacting effect,nutrition,public health,quality of life,anxiety

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ScienceOpen disciplines: Uncategorized

Keywords: nutrition literacy, health-related quality of life, anxiety disorders, mediating effect, interacting effect, nutrition, public health, quality of life, anxiety

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The role of anxiety in the association between nutrition literacy and health-related quality of life among college students

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Supplementary Information

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Chinese Journal of School Health

Most cited references 34

A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity.

The Microbiota-Gut-Brain Axis

Mental health problems and social media exposure during COVID-19 outbreak

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