Food and nutrition literacy and proactive health behavior among patients with gastric ulcer: a profile analysis of nutrition awareness and a cross-sectional mediation comparison.

OBJECTIVE

This study aimed to explore, from both variable-centered and person-centered perspectives, the relationships among food and nutrition literacy, nutrition awareness, and proactive health behavior in patients with gastric ulcer, as well as the cross-sectional mediating role of nutrition awareness. Furthermore, this study sought to identify the latent classes of food and nutrition literacy and examine their differences in nutrition awareness and proactive health behavior.

METHODS

A cross-sectional study design was adopted. From March to April 2026, convenience sampling was used to recruit 418 patients with gastric ulcer from the gastroenterology outpatient and inpatient departments of two tertiary Grade A hospitals in Zhejiang Province, China.

RESULTS

Food and nutrition literacy, nutrition awareness, and proactive health behavior were significantly and positively correlated with one another. Further analysis showed that food and nutrition literacy was significantly and positively associated with both nutrition awareness and proactive health behavior. Bootstrap analysis indicated that nutrition awareness played a significant cross-sectional partial mediating role between food and nutrition literacy and proactive health behavior. Latent profile analysis showed that four latent classes were identified and labeled as the low food and nutrition literacy group, relatively low food and nutrition literacy group, relatively high food and nutrition literacy group, and high food and nutrition literacy group. Analysis of variance showed significant differences in nutrition awareness and proactive health behavior among different latent classes of food and nutrition literacy.

CONCLUSION

In the long-term management of gastric ulcer, it is necessary to develop a stratified intervention model based on the improvement of food and nutrition literacy, with the strengthening of nutrition awareness as a key psychological pathway and latent class identification as the basis. This may provide theoretical evidence and practical references for precision nutrition education, psychological and behavioral interventions, and long-term self-management among patients.