Introduction
Why knowing what to eat is not always enough
What is food literacy?
How food literacy relates to dietary choices
Food literacy, cooking skills, and health outcomes
Food literacy and the limits of prevention evidence
Food access, education, and health equity
Digital nutrition education
Can food literacy become part of healthcare?
Conclusions
References
Further reading
What shapes the journey from knowing which foods are healthy to deciding what to put on the table? Research examines how food skills, education, and access influence everyday eating.
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Introduction
Healthy eating advice is widely available, yet knowing what constitutes a healthy diet does not automatically make healthy choices easy. Eating requires people to understand food, plan and prepare meals, judge options, and navigate constraints such as affordability and availability. Food literacy may help connect nutrition knowledge with food decisions.1,3,4
Food literacy includes food knowledge and practical skills used in everyday eating. Nutrition education and healthcare-based approaches may support these abilities, while food-access interventions address material constraints on healthy eating.1,2,6
Why knowing what to eat is not always enough
Nutrition guidance can tell people which foods contribute to a healthy diet, but translating that information into everyday food acquisition, preparation, and consumption is more complicated. Food literacy describes the everyday knowledge, skills, and behaviors needed to navigate the food environment and meet nutrition and health needs.1
Food choices also occur within an environment shaped by availability, accessibility, price, and affordability. An individual may understand healthy eating recommendations but still face practical limitations when attempting to follow them. Research on food insecurity illustrates this problem: limited economic and physical access to safe and nutritious foods can reduce dietary diversity and quality. Food-insecure households may choose cheaper, energy-dense foods instead of fruits, vegetables, meat, and eggs.4
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What is food literacy?
Food literacy is broader than simply knowing about nutrients. Instead, the term describes a wide range of knowledge, behaviors, and skills, including food preparation, cooking, food science, food safety, household food production, and food marketing.
In practical terms, food literacy combines understanding food with the ability to act on that understanding. It can encompass knowledge of foods and dietary recommendations, practical abilities related to food preparation, and the capacity to navigate the food environment.
A commonly cited definition groups these abilities into planning and management, selection, preparation, and eating. For example, planning meals, selecting suitable foods, and preparing them for consumption involve different food-literacy abilities, and their application varies with culture, available time, monetary resources, and the surrounding food environment.1,3
How food literacy relates to dietary choices
Food literacy has been conceptually linked to diet quality, nutrition behaviors, food security, and other food-related outcomes, but the reviewed literature has not established a single standardized pathway from food literacy to dietary behavior. Because questionnaires use similar definitions but differ substantially, researchers need comparable ways to measure food literacy before they can reliably combine findings across studies.1
Cooking is one practical way food knowledge may translate into eating behavior. A scoping review of home-cooking research found that some studies linked home cooking to higher fruit and vegetable intake, better diet quality, and greater adherence to dietary reference intakes, while others found no significant relationship. The review also noted that studies used diet-quality measures, including scores assessing adherence to Mediterranean and Dietary Approaches to Stop Hypertension dietary patterns. These findings indicate that cooking behavior has been studied in relation to several markers of diet quality, but they do not establish that food literacy itself causes adherence to these dietary patterns.3
Food Literacy
Food literacy, cooking skills, and health outcomes
Cooking skills may help people put dietary advice into practice. Culinary medicine is one educational approach that combines meal planning, food preparation, cooking skills, and nutrition counseling. In a scoping review of 24 culinary medicine studies involving medical education, programs generally showed promising improvements in nutrition knowledge, skills, and confidence, with considerable variation in course structure, delivery, setting, and content.2
The culinary medicine review found limited long-term follow-up and considerable methodological variation, meaning improvements in knowledge or confidence do not automatically translate into lasting changes in patient health. Importantly, this review found limited long-term follow-up and considerable methodological variation, meaning that improvements in knowledge or confidence cannot automatically be translated into lasting changes in patient health. These features limit confidence in the findings and their applicability to other settings.2
For home cooking, inconsistent definitions complicate interpretation, as participants may define cooking as preparing meals from basic ingredients or heating ready-made foods. This variation also highlights why cooking skills alone may not translate into healthier meals: nutritional quality depends on the ingredients people choose and the foods available to them.3
Food literacy and the limits of prevention evidence
Nutrition care supports chronic disease prevention and management by improving dietary behavior. Currently, a gap remains between the importance of dietary counseling and healthcare professionals’ confidence in providing it. To address this challenge, researchers have examined hands-on culinary education to strengthen practical nutrition knowledge and counseling competence among medical students.2
The studies discussed here examine different topics, including definitions of food literacy, cooking behavior, and professional training, and do not establish that improving food literacy reduces the incidence of chronic disease. Future longitudinal studies would help determine whether changes in knowledge and skills lead to sustained dietary improvements and better health.1,2,3
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Food access, education, and health equity
Nutrition education alone cannot remove structural barriers to healthy eating. Income and education influence food insecurity, and higher food costs can reduce access to diverse, high-quality foods. Addressing these constraints alongside food literacy recognizes that people’s opportunities to act on dietary advice differ.1,4
The nutritional consequences of restricted access manifest in the relationship between food insecurity and nutrient deficiencies. Specifically, food-insecure individuals face a higher risk of anemia and low ferritin, a marker of iron stores. Although these studies have limitations, including cross-sectional designs, these observations are notable and warrant further investigation.4
Community- and school-based nutrition education may offer broader opportunities to build food knowledge and skills. Accessible, evidence-based public nutrition education appears to help individuals and communities make healthier dietary choices. This can be in the form of community-based programs, nutrition education for teachers, school curricula, and interventions delivered by healthcare workers, particularly in rural and remote settings.5
Digital nutrition education
Online resources and technology-based education can extend nutrition training and support the recommended expansion of evidence-based resources for healthcare professionals and communities. Smart technologies that provide targeted nutrition advice may further support these efforts by tailoring educational content to individual dietary needs and preferences. .5
Some examples include online nutrition-learning modules for healthcare professionals and digital collections of guidance for nutrition interventions. These resources illustrate ways to distribute nutrition education and support clinical practice, though it remains unclear whether digital education improves food literacy or changes food choices.
Professional training resources may inform the advice patients receive, while public-facing resources offer a separate route to nutrition information. The effects of either approach on everyday food decisions require evaluation.5
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Can food literacy become part of healthcare?
Healthcare offers an important setting for practical nutrition education; however, gaps in professional training may limit its delivery. Researchers have identified insufficient and variable nutrition competency among healthcare professionals, prompting calls for standardized, competency-based curricula. Proposed competencies include healthy-diet principles, motivational interviewing, appropriate referral, leadership, and an understanding of how social and cultural factors influence dietary behavior and health.5
Culinary medicine provides one possible model for translating these recommendations into practical education. Some studies in the culinary medicine review compared hands-on learning with lecture-based nutrition teaching, though methodological weaknesses limit conclusions about which approach produces better outcomes. Its relevance to patient care rests on whether clinicians can use their training to provide useful dietary advice.2
At the healthcare-system level, Food Is Medicine programs provide another complementary approach by connecting patients with diet-related chronic disease and food insecurity to healthy foods. Houghtaling and colleagues’ narrative review focused on US programs that screen and refer eligible patients to free or reduced-cost, unprepared foods, often fruits and vegetables. These programs address food access, while their implementation can be limited by funding, staff time, technology, and organizational capacity. The review also cautioned that healthcare-based programs must operate alongside broader efforts to provide lasting, equitable access to nutritious food.6
Future approaches could combine practical food education with clinical nutrition counseling and interventions addressing food access. Evaluation should distinguish the outcomes of each component: patient food-literacy abilities, clinicians’ counseling skills, and access to nutritious food are related but separate measures. The reviewed papers recommend agreed food-literacy indicators, standardized professional curricula, and monitoring of nutrition services to assess progress.1,5,6
Conclusions
Healthy eating requires nutrition knowledge, practical abilities, and access to suitable foods. The reviewed literature describes food literacy as the ability to understand the factors involved in everyday food decisions, while documenting substantial variation in its definition and measurement. Cooking education, professional training, and food-access programs address different parts of this process.1,2,3,6
The question remains whether measurable gains in food literacy translate into lasting improvements in diet and health. Answering it requires consistent assessment and longer follow-up, with attention to the financial, cultural, and practical circumstances in which people make food choices.1,2,3,4
References
- Thompson, C., Adams, J., & Vidgen, H. A. (2021). Are we closer to international consensus on the term “food literacy”? A systematic scoping review of its use in the academic literature (1998–2019). Nutrients 13(6). DOI: 10.3390/nu13062006.
- Tan, J., Atamanchuk, L., Rao, T., et al. (2022). Exploring culinary medicine as a promising method of nutritional education in medical school: A scoping review. BMC Medical Education 22(1). DOI: 10.1186/s12909-022-03449-w.
- Yuan, X., Fujiwara, A., Matsumoto, M., et al. (2022). Definitions and Assessment Methods of ‘Home Cooking’ in Studies with Dietary Variables: A Scoping Review. Nutrients. 14(16). DOI: 10.3390/nu14163344.
- Lopes, S. O., Abrantes, L. C. S., Azevedo, F. M., et al. (2023). Food insecurity and micronutrient deficiency in adults: A systematic review and meta-analysis. Nutrients. 15(5). DOI: 10.3390/nu15051074.
- Lepre, B., Trigueiro, H., Johnsen, J. T., et al. (2022). Global architecture for the nutrition training of health professionals: A scoping review and blueprint for next steps. BMJ Nutrition, Prevention & Health. DOI: 10.1136/bmjnph-2021-000354.
- Houghtaling, B., Short, E., Byker Shanks, C., et al. (2024). Implementation of Food Is Medicine programs in healthcare settings: A narrative review. Journal of General Internal Medicine. 39. 2797–2805. DOI: 10.1007/s11606-024-08768-w.
Further Reading
Last Updated: Nov 5, 2026
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