Skip to main content Accessibility help

Food literacy predictors and associations with physical and emergent literacy in pre-schoolers: results from the Training-to-Health Project

  • Garden Tabacchi (a1), Giuseppe Battaglia (a1), Marianna Alesi (a1), Antonio Paoli (a2), Antonio Palma (a1) and Marianna Bellafiore (a1)...



Food literacy (FL) is a crucial need encompassing basic literacy and fundamental movement skills. The present study aimed to investigate the FL level in pre-schoolers and to evaluate the effect of potential predictors and the associations with gross motor and emergent literacy skills.


Cross-sectional study conducted within the Training-to-Health Project.


Kindergartens (n 21) in the Palermo City Council, Italy.


Pre-school children aged 3–6 years (n 921) followed education sessions on nutritional topics, practical activities and compiled prearranged sheets. FL was assessed by the five-domain toolkit ‘preschool-FLAT’; gross motor and emergent literacy skills were assessed by the Italian version of the gross motor development test and the PRCR-2/2009, respectively. Correlation and regression analyses were performed to assess relationships between FL scores and gender, age, weight, height, BMI, gross motor and emergent literacy skills.


Independent predictors (β, se) of higher FL were female gender (1·06, 0·315, P < 0·01), older age (0·08, 0·019, P < 0·001) and greater height (0·13, 0·03, P < 0·001). The adjusted coefficients were significant for quotient of gross motor development and in particular for the locomotor component (0·03, 0·01, P < 0·01 and 0·16, 0·046, P < 0·001, respectively). Almost all associations with the emergent literacy skills were significant (β = −0·02 to 0·47).


The study suggests that children raised in an environment where both cognitive and motor skills are enhanced can have better chances of increasing FL and success at school. Thus, the need for monitoring FL and its predictors since early age is highlighted.


Corresponding author


Hide All
1. Wardle, J (1995) Parental influences on children’s diets. Proc Nutr Soc 54, 747758.
2. Khambalia, AZ, Dickinson, S, Hardy, LL et al. (2012) A synthesis of existing systematic reviews and meta-analyses of school-based behavioural interventions for controlling and preventing obesity. Obes Rev 13, 214233.
3. Larson, N, Ward, D, Neelon, S et al. (2011) Preventing Obesity Among Preschool Children: How Can Child-Care Settings Promote Healthy Eating and Physical Activity? Research Synthesis. Princeton, NJ: Active Living Research, a National Program of the Robert Wood Johnson Foundation. (accessed August 2019).
4. Story, M, Kaphingst, KM & French, S (2006) The role of schools in obesity prevention. Future Child 16, 109142.
5. Campbell, KJ & Hesketh, KD (2007) Strategies which aim to positively impact on weight, physical activity, diet and sedentary behaviours in children from zero to five years. A systematic review of the literature. Obes Rev 8, 327338.
6. Zarnowiecki, D, Dollman, J & Sinn, N (2011) A tool for assessing healthy food knowledge in 5–6-year-old Australian children. Public Health Nutr 14, 11771183.
7. Cullen, T, Hatch, J, Martin, W et al. (2015) Food literacy: definition and framework for action. Can J Diet Pract Res 76, 140145.
8. Vidgen, HA & Gallegos, D (2014) Defining food literacy and its components. Appetite 76, 5059.
9. Mikkelsen, BE, Rasmussen, VB & Young, I (2005) The role of school food service in promoting healthy eating at school – a perspective from an ad hoc group on nutrition in schools, Council of Europe. Food Serv Technol 5, 715.
10. Fisher, D, McDonald, N & Strickland, J (2001) Early literacy development: a sound practice. Gen Music Today 14, 1520.
11. Geertsen, SS, Thomas, R, Larsen, MN et al. (2016) Motor skills and exercise capacity are associated with objective measures of cognitive functions and academic performance in preadolescent children. PLoS One 11, e0161960.
12. Shanahan, T & Lonigan, CJ (2010) The national early literacy panel: a summary of the process and the report. Educ Res 39, 279285.
13. Piek, JP, Dawson, L, Smith, LM et al. (2008) The role of early fine and gross motor development on later motor and cognitive ability. Hum Mov Sci 27, 668681.
14. Piek, JP, Bradbury, GS, Elsley, SC et al. (2008) Motor coordination and social-emotional behaviour in preschool-aged children. Int J Disabil Dev Educ 55, 143151.
15. Roebers, CM & Kauer, M (2009) Motor and cognitive control in a normative sample of 7-year-olds. Dev Sci 12, 175181.
16. van der Fels, IMJ, te Wierike, SCM, Hartman, E et al. (2015) The relationship between motor skills and cognitive skills in 4–16 year old typically developing children: a systematic review. J Sci Med Sport 18, 697703.
17. Diamond, A (2000) Close interrelation of motor development and cognitive development and of the cerebellum and prefrontal cortex. Child Dev 71, 4456.
18. Grosso, G, Marventano, S, Buscemi, S et al. (2013) Factors associated with adherence to the Mediterranean diet among adolescents living in Sicily, southern Italy. Nutrients 5, 49084923.
19. Fahlman, MM, Dake, JA, McCaughtry, N et al. (2008) A pilot study to examine the effects of a nutrition intervention on nutrition knowledge, behaviors, and efficacy expectations in middle school children. J Sch Health 78, 216222.
20. Hall, E, Chai, W & Albrecht, JA (2016) Relationships between nutrition-related knowledge, self-efficacy, and behavior for fifth grade students attending Title I and non-Title I schools. Appetite 96, 245253.
21. Baskale, H & Bahar, Z (2011) Outcomes of nutrition knowledge and healthy food choices in 5-to 6-year-old children who received a nutrition intervention based on Piaget’s theory. J Spec Pediatr Nurs 16, 263279.
22. Joseph, LS, Gorin, AA, Mobley, SL et al. (2015) Impact of a short-term nutrition education child care pilot intervention on preschool children’s intention to choose healthy snacks and actual snack choices. Child Obes 11, 513520.
23. Sigman-Grant, M, Byington, TA, Lindsay, AR et al. (2014) Preschoolers can distinguish between healthy and unhealthy foods: the all 4 kids study. J Nutr Educ Behav 46, 121127.
24. Gibson, EL, Wardle, J & Watts, CJ (1998) Fruit and vegetable consumption, nutritional knowledge and beliefs in mothers and children. Appetite 31, 205228.
25. Wiseman, N, Harris, N & Downes, M (2017) Validation of an iPad activity to measure preschool children’s food and physical activity knowledge and preferences. Int J Behav Nutr Phys Act 14, 11.
26. Wiseman, N, Harris, N & Lee, P (2016) Lifestyle knowledge and preferences in preschool children: evaluation of the get up and grow healthy lifestyle education programme. Health Educ J 75, 10121024.
27. Wiseman, N & Harris, N (2015) A systematic review of data collection techniques used to measure preschool children’s knowledge of food and nutrition. J Nutr Educ Behav 47, 345353.e1.
28. Perry, EA, Thomas, H, Samra, HR et al. (2017) Identifying attributes of food literacy: a scoping review. Public Health Nutr 20, 24062415.
29. Gibbs, H & Chapman-Novakofski, K (2013) Establishing content validity for the nutrition literacy assessment instrument. Prev Chronic Dis 10, 120267.
30. Rothman, RL, Housam, R, Weiss, H et al. (2006) Patient understanding of food labels. The role of literacy and numeracy. Am J Prev Med 31, 391398.
31. Weiss, BD, Mays, MZ, Martz, W et al. (2005) Quick assessment of literacy in primary care: the newest vital sign. Ann Fam Med 3, 514522.
32. Battaglia, G, Alesi, M, Tabacchi, G et al. (2019) The development of motor and pre-literacy skills by a physical education program in preschool children: a non-randomized pilot trial. Front Psychol 9, 2694.
33. Cole, TJ, Bellizzi, MC, Flegal, KM et al. (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320, 12401243.
34. Ulrich, DA (1985) Test of Gross Motor Development. Austin, TX: PRO-ED.
35. Cornoldi, C, Miato, L, Molin, A et al. (2009) PRCR-2/2009. Prove di Prerequisito per la Diagnosi delle Difficoltà di Lettura e Scrittura. Firenze: Giunti OS.
36. Velardo, S (2015) The nuances of health literacy, nutrition literacy, and food literacy. J Nutr Educ Behav 47, 385389.
37. Krause, C, Sommerhalder, K, Beer-Borst, S et al. (2018) Just a subtle difference? Findings from a systematic review on definitions of nutrition literacy and food literacy. Health Promot Int 33, 378389.
38. Derri, V, Tsapakidou, A, Zachopoulou, E et al. (2001) Complexity of rhythmic ability as measured in preschool children. Percept Mot Skills 92, 777785.
39. Hestbaek, L, Andersen, ST, Skovgaard, T et al. (2017) Influence of motor skills training on children’s development evaluated in the Motor skills in PreSchool (MiPS) study-DK: study protocol for a randomized controlled trial, nested in a cohort study. Trials 18, 400.
40. Hart, KH, Bishop, JA & Truby, H (2002) An investigation into school children’s knowledge and awareness of food and nutrition. J Hum Nutr Diet 15, 129140.
41. Puranik, CS & Lonigan, CJ (2011) From scribbles to scrabble: preschool children’s developing knowledge of written language. Read Writ 24, 567589.
42. Pinto, G, Bigozzi, L, Tarchi, C et al. (2016) Predicting reading, spelling, and mathematical skills: a longitudinal study from kindergarten through first grade. Psychol Rep 118, 413440.
43. Hoyland, A, Dye, L & Lawton, CL (2009) A systematic review of the effect of breakfast on the cognitive performance of children and adolescents. Nutr Res Rev 22, 220243.
44. Ni Mhurchu, C, Turley, M, Gorton, D et al. (2010) Effects of a free school breakfast programme on school attendance, achievement, psychosocial function, and nutrition: a stepped wedge cluster randomised trial. BMC Public Health 10, 738.
45. Hernández-Garbanzo, Y, Brosh, J, Serrano, EL et al. (2013) Psychosocial measures used to assess the effectiveness of school-based nutrition education programs: review and analysis of self-report instruments for children 8 to 12 years old. J Nutr Educ Behav 45, 392403.
46. Vaitkeviciute, R, Ball, LE & Harris, N (2015) The relationship between food literacy and dietary intake in adolescents: a systematic review. Public Health Nutr 18, 649658.
47. Johnson, SB, Riis, JL & Noble, KG (2016) State of the art review: poverty and the developing brain. Pediatrics 137, e20153075.
48. Neumann, MM (2016) A socioeconomic comparison of emergent literacy and home literacy in Australian preschoolers. Eur Early Child Educ Res J 24, 555566.
49. Gillon, GT (2007) Phonological Awareness: From Research to Practice (Challenges in Language and Literacy). New York: Guilford Publications. Inc.


Type Description Title
Supplementary materials

Tabacchi et al. supplementary material
Table S1

 Word (95 KB)
95 KB
Supplementary materials

Tabacchi et al. supplementary material
Table S2

 Word (74 KB)
74 KB
Supplementary materials

Tabacchi et al. supplementary material
Table S3

 Word (106 KB)
106 KB

Food literacy predictors and associations with physical and emergent literacy in pre-schoolers: results from the Training-to-Health Project

  • Garden Tabacchi (a1), Giuseppe Battaglia (a1), Marianna Alesi (a1), Antonio Paoli (a2), Antonio Palma (a1) and Marianna Bellafiore (a1)...


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed