title: Association between health literacy and metabolic syndrome or healthy lifestyle characteristics among community-dwelling Japanese people.
abstract: BACKGROUND
  Few studies have assessed the association between health literacy (HL) and healthy lifestyle characteristics among Japanese people, and reports on the association between HL and prevalence of metabolic syndrome are also scarce.
  
  
  METHODS
  The present cross-sectional study included 1817 (781 men and 1036 women) Japanese individuals who participated in a medical health checkup at Bange Kosei General Hospital and Takada Kosei Hospital in Fukushima, Japan, from April 2013-2014. Information regarding HL and healthy lifestyle characteristics listed in Breslow's seven health practices was collected by self-administered questionnaire.
  
  
  RESULTS
  In multivariate logistic analysis, higher HL (≥14) was positively associated with healthy lifestyle characteristics [odds ratio (OR) = 2.08, 95 % confidence interval (CI) = 1.33-3.23] and inversely associated with prevalence of metabolic syndrome (OR = 0.67, 95 % CI = 0.48-0.95) among men. Among HL items, the ability to make decisions based on health-related information was significantly associated with healthy lifestyle characteristics (OR = 2.04, 95 % CI = 1.34-3.10 for men, OR = 1.38, 95 % CI = 1.30-1.85 for women) and inversely associated with prevalence of metabolic syndrome (OR = 0.62, 95 % CI = 0.44-0.88 for men, OR = 0.68, 95 % CI = 0.49-0.95 for women) in both sexes.
  
  
  CONCLUSIONS
  We found positive associations between HL and healthy lifestyle characteristics and an inverse association with prevalence of metabolic syndrome among men. Our findings also suggest that men and women are likely to engage in health-promoting behaviors and make decisions based on health-related information. These findings highlight the importance of comprehensive assessments, including HL, for health promotion in the community.
authors.affiliation: Department of General Medicine, Juntendo University School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421 Japan.
authors.forename: Hirohide
authors.initials: H
authors.lastname: Yokokawa
authors.affiliation: Department of General Medicine, Juntendo University School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421 Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fukuda
authors.affiliation: Department of Public Health, Juntendo University School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421 Japan.
authors.forename: Motoyuki
authors.initials: M
authors.lastname: Yuasa
authors.affiliation: Division of Health Science Research, Fukushima Welfare Federation of Agricultural Cooperatives, Sakamizu 50, Aizubange Town, Fukushima, 969-6593 Japan ; Department of Tumor and Host Bioscience, Fukushima Medical University School of Medicine, Hikarigaoka 1, Fukushima, 960-1295 Japan.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Sanada
authors.affiliation: Department of General Medicine, Juntendo University School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421 Japan.
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Hisaoka
authors.affiliation: Department of General Medicine, Juntendo University School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421 Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Naito
keywords: Epidemiology; Health Promotion; Health literacy; Lifestyle; Metabolic syndrome