Background Adolescent malnutrition, including stunting, underweight, and micronutrient deficiency, is a major public health concern in Sub-Saharan Africa (SSA). While studies from the global north and Asia have shown that nutrition literacy supports healthier diets, evidence on literacy status and its role on influencing overall diet quality among adolescents and young adults (AYA) in SSA is limited. This study assessed nutrition literacy and its association with diet quality among AYA in rural Uganda.

Method This was a cross-sectional study implemented as part of ARISE-NUTRINT project. Based on Nutbeam’s model of health literacy, the study was conducted among 1206 AYA aged 10–24 years in Mayuge district, Eastern Uganda, selected through stratified random sampling. Using structured questionnaire, the Global Diet Quality Score (GDQS) was adapted to estimate diet quality and Adolescent nutrition literacy scale to assess nutrition literacy status. Logistic regression models were employed to assess the association between nutrition literacy and diet quality, adjusting for socio-demographic characteristics.

Results Among 1206 respondents (51.1% female), 85.9% were still in school, over 62% were from low social economic status households, and only 14% used mobile phones. Low nutrition literacy (49%) was prevalent, many unfamiliar with balanced diet or ignoring dietary advice, although 62% were willing to promote healthy eating. Overall, 12.6% had poor-diet quality based on GDQS, marked by frequent refined grain consumption and low fruits/vegetable intake. Having low nutrition literacy was associated with close to five-fold increase in poor diets (adjusted OR = 4.71, 95% CI: 2.19–10.16) while mobile phone use was associated with better diet quality by 56% (aOR = 0.44, 95% CI: 0.27–0.74).

Conclusion Low nutrition literacy is a significant burden among AYA, and is strongly associated with suboptimal diet quality. Implement targeted interventions for improving nutrition literacy can enhance diet quality among AYA in the study area.

The authors have declared no competing interest.

This study is part of the ARISE-NUTRINT initiative, funded by the European Union; Project: 101095616.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

This study, part of the ARISE-NUTRINT project for the Uganda site, was approved by the Research and Ethics Committee at the School of Public Health, Makerere University (Reference number: SPH-2023-460).

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

The dataset analyzed for the present study is not publicly available due [being kept confidential for other on-going and future analysis] but can be provided by the corresponding author (TB) upon reasonable request.