Association Between Health Literacy and Mediterranean Diet Adherence Among Adult Women in Türkiye

Objective: Health literacy is widely recognized as an important determinant of informed health-related decision-making. However, evidence regarding whether health literacy translates into healthy eating behaviors, particularly adherence to the Mediterranean diet, remains limited. This study aimed to examine the association between health literacy levels and adherence to the Mediterranean diet among adult women living in Türkiye. Methods: This cross-sectional study was conducted with 400 women aged 18 years and older residing in Türkiye. Data were collected using a sociodemographic information form, the Turkish Health Literacy Scale–Short Form, and the Mediterranean Diet Quality Index (KIDMED). Health literacy levels were categorized as inadequate, problematic–limited, adequate, and excellent, while Mediterranean diet adherence was classified as low, moderate, or optimal. Ordinal logistic regression analysis was performed to examine the association between health literacy and adherence to the Mediterranean diet, adjusting for sociodemographic variables (age, education, income, and occupation). Findings: Among the participants, 25.3% had inadequate health literacy, 31.8% had problematic–limited health literacy, 34.0% had adequate health literacy, and 9.0% had excellent health literacy. Mediterranean diet adherence was low in 34.5% of participants, moderate in 52.3%, and optimal in 13.3%. The ordinal logistic regression analysis revealed that, after adjusting for sociodemographic variables, one dimension of health literacy (Cognitive Health Literacy) was significantly associated with Mediterranean diet adherence, whereas no significant association was observed for the other dimension. Conclusion: The findings suggest that certain dimensions of health literacy may be associated with adherence to the Mediterranean diet when sociodemographic factors are taken into account. These results highlight the importance of considering both individual knowledge and contextual factors in understanding dietary behavior. Future research should further explore the role of nutrition-specific literacy and structural determinants in shaping healthy eating practices.