Specificity of the Associations between Indices of Cardiovascular Health with Health Literacy and Physical Literacy; A Cross-Sectional Study in Older Adolescents

Background and Objectives: Cardiovascular health status (CVHS) is an important determinant of health, while it is theorized that health literacy (HL) and physical literacy (PL) could be directly related to CVHS. The aim of this study was to evaluate gender-specific associations between PL and HL and indices of CVHS in adolescence. Materials and Methods: The participants were 247 adolescents (177 females) from Split-Dalmatia county in Croatia who were tested on HL, PL, and CVHS (physical activity level (PAL) and lipid profile). The lipid profile included total cholesterol, triglycerides, high-density lipoproteins, non-high-density lipoprotein-cholesterol, and low-density lipoproteins. Gender-stratified multivariate cluster analysis (K-means clustering) was used to group participants into three homogenous groups on the basis of their HL and PL, while differences between clusters in CVHS were evidenced by analysis of the variance and consecutive post-hoc tests. Results: The lipid profile was better in girls with higher HL scores. Additionally, clusters consisting of participants with a better PL were characterized by higher PAL. We have found no evidence that HL is associated with PAL, while PL was not associated with the lipid profile. Conclusions: HL was specifically associated with direct indicators of health status (lipid profile) in girls, while PL was associated with PAL as a particular behavioral health indicator in both genders. The study highlights the necessity of including education of HL and PL in schools.