Relationship between health literacy, fruit and vegetable consumption, and dietary supplement use among Korean adults

Objectives: This study examined the relationship between health literacy (HL) and combined patterns of fruit and vegetable (FV) intake as well as dietary supplement (DS) use. Methods: This study comprised 5,120 adults who participated in the 2023 Korea National Health and Nutrition Examination Survey. Participants were categorized into four groups based on whether they met FV intake recommendation (≥ 500g/day) and used DS. The groups were as follows: FV&DS (meeting FV intake recommendation and using DS); FV-only (only meeting FV intake recommendation); DS-only (only using DS); and None (neither meeting FV intake recommendation nor using DS). Multinomial logistic regression analyses were performed to examine the association between HL and the four FV-DS groups. Results: The proportion of meeting FV intake did not differ significantly according to HL level. The proportion of DS users was highest in the high HL group (72.8%) and lowest in the low HL group (62.5%) ( p<0.001). Multinomial logistic regression revealed that individuals with moderate or high HL had significantly higher odds of belonging to the FV&DS or DS-only groups than to the None group. Furthermore, HL was not significantly associated with being in the FV-only group. Conclusion: Higher HL was positively associated with a greater likelihood of relying on DS use over FV intake. This suggests a need for deliberate efforts to effectively communicate evidence-based information about FV intake and DS use.