Health literacy, perceived stress, and dietary quality among Danish women with recent gestational diabetes mellitus

OBJECTIVES: Adhering to dietary recommendations after gestational diabetes mellitus (GDM) can mitigate the risk of early-onset type 2 diabetes. Psychosocial aspects, such as health literacy and perceived stress, may affect adherence to these recommendations; yet this remains underexplored in women with recent GDM. This study aimed to examine the association between health literacy and dietary quality 10-14 weeks postpartum and to assess the influence of perceived stress.

STUDY DESIGN: Cross-sectional study.

METHODS: This study used baseline data from the Face-it trial, including 283 Danish women with recent GDM 10-14 weeks postpartum. Dietary quality was measured using the Dietary Quality Score (DQS), health literacy using two domains of the Health Literacy Questionnaire: HLQ-2 (Having sufficient information to manage my health) and HLQ-3 (Actively managing my health), and stress using the Perceived Stress Scale (PSS). Multiple linear regression examined the association between HLQ-2 and DQS, and HLQ-3 and DQS, adjusting for age, education, and country of birth. Additional analyses examined the influence of perceived stress.

RESULTS: Among women with recent GDM, reporting Having sufficient information to manage their health (HLQ-2) and Actively managing their health (HLQ-3) were positively associated with dietary quality, with βadjusted = 0.55 [95 % CI: 0.22-0.87] and βadjusted = 1.12 [95 % CI: 0.84-1.41], respectively. Perceived stress did not affect these associations.

CONCLUSION: Health literacy was positively associated with dietary quality among Danish women with recent GDM. Stress did not affect this association.