Lifestyle Factors and Diet-Disease-Related Knowledge: A Network Psychometric Analysis of Cardiovascular Health Literacy Among Lebanese Adults

Figures

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  Figure 1. CONSORT-style flow diagram presenting the participant selection process. DDRK, diet-disease-related knowledge (Section 4 of the General Nutrition Knowledge Questionnaire); MEDAS, Mediterranean Diet Adherence Screener; GPAQ, Global Physical Activity Questionnaire.

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  Figure 2. Cardiovascular self-reported biomarker awareness and its associations with cardiovascular literacy and adherence to the Mediterranean diet among participants (n = 406). (A), The stacked bar illustrates the percentage of participants unaware (red) versus those aware (blue) of their individual cardiovascular biomarker values, including glycated hemoglobin (HbA1c), triglycerides (TGs), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and total cholesterol (tCHOL). The composite score captures participants who have at least one biomarker unknown (score ≤ 4, unaware). Conversely, the aware composite group score five exactly. (B), Distribution of the cardiovascular health literacy score (0–5), calculated as the total number of biomarkers known as described in (A). (C) Mean cardiovascular health literacy across DDRK quartiles and AMD levels. DDRK, diet-disease-related knowledge; AMD, adherence to the Mediterranean diet.

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  Figure 3. Regularized EBICglasso network psychometric topology and node centrality profiles across continuous dietary, behavioral, and health literacy domains (n = 406). (A) Estimated Gaussian Graphical Model (GGM) network plot using the EBICglasso estimator. Nodes represent the six continuous variables, and edges represent regularized partial correlation weights (blue lines indicate positive pathways, red lines indicate negative pathways); each edge represents the unique association between two variables after controlling for all other variables in the network, where the regularization process removes weak or spurious associations to prevent false positives. (B) Centrality measures plot demonstrating the relative standardized indices for betweenness, closeness, node strength, and expected influence. (C) Centrality statistics grid detailing the raw values for node strength, betweenness, and closeness across all 2000 bootstrap simulations, establishing high structural stability. DDRK, diet-disease-related knowledge; MEDAS, Mediterranean Diet Adherence Screener; BMI: body mass index (kg/m2); PA, physical activity assessed by MET-min/week (metabolic equivalent minutes per week); CVH literacy,…