Abstract
OBJECTIVE: Nutrition literacy is critical for establishing healthy dietary behaviors during childhood, yet research on this topic among primary school students in rapidly urbanizing China remains limited. The aim of this large-scale survey is to assess the current status and identify key influencing factors of nutrition literacy among primary school students in Nanshan District, Shenzhen City. METHODS: A cross-sectional survey was conducted in October 2024 utilizing a cluster random sampling method. A total of 2,423 students from 21 public primary schools participated. Data were collected using the validated "Nutrition Literacy and Dietary Behavior Questionnaire for School-aged Children", which evaluated four dimensions: nutrition knowledge and concepts, food selection, food preparation, and food intake. Statistical analyses included descriptive statistics, correlation analysis, and binary logistic regression. RESULTS: Participants achieved a mean total nutrition literacy score of 69.93 ± 8.75, with 30.38% meeting the criterion for adequate nutrition literacy (score ≥75). Interdimensional analysis revealed statistically significant positive correlations among all four domains (r = 0.198 ~ 0.363, p < 0.001). Multivariable logistic regression identified grade level-representing individual-level factors (Grade 5 vs. Grade 3 OR = 0.626, 95% CI: 0.500-0.783), high household economic status-family-level factors (OR = 1.389, 95% CI: 1.139-1.649), and participation in school activities including nutrition-related activities (OR = 1.346, 95% CI: 1.125-1.611) and regular weight monitoring (OR = 1.346, 95% CI: 1.125-1.611) as key predictors of adequate nutrition literacy. CONCLUSION: Nutrition literacy among primary school students in Nanshan District requires substantial improvement and is influenced by factors at individual, familial, and institutional levels. These findings suggest the necessity of developing a comprehensive, student-centered intervention model that integrates family-school collaboration to effectively enhance nutritional literacy.