BACKGROUND:
Nutrition Health Literacy (NHL) and Self-Perceived Food Literacy (SPFL) are critical determinants of dietary behavior, yet their direct impact on clinical cardiovascular risk is less understood. This study investigated the relationship between these literacy constructs and ASCVD risk scores using the AHA PREVENT calculator.

METHODS:
A cross-sectional study of 139 participants was conducted using the validated Nutrition Health Literacy Scale (NHLS) and the SPFL Short Form. Data included demographics, clinical markers (BMI, BP, comorbidities), and lifestyle habits. Statistical analysis utilized Pearson/Spearman correlations and a Two-Step Cluster Analysis to identify distinct patient personas.

RESULTS:
A strong, highly significant positive correlation was found between NHL and SPFL (r = 0.552, p < 0.001), indicating that nutritional knowledge is robustly associated with healthy eating practices. However, neither NHL (r = 0.046, p = 0.588) nor SPFL (r = 0.008, p = 0.926) demonstrated a significant correlation with ASCVD risk scores. Cluster analysis (N=139, Silhouette = 0.3) revealed four distinct personas: Urban Female Traditionalists (32.4%): Highest rate of inadequate literacy (37.8%). Urban Male High-Risk (29.5%): High education but highest clinical risk (61.0% ASCVD risk 7.5% to <20%) and BMI (27.60). Rural Older Females (23.7%): Lowest BMI but age-driven clinical risk. Rural Active Females (14.4%): Highest physical activity (95%) despite elementary-level formal education.

CONCLUSIONS:
While nutrition literacy is a powerful driver of health behaviors, it does not directly correlate with short-term clinical ASCVD risk in this sample. This suggests a "knowledge-action-clinical gap" where modifiable behaviors may be outweighed by fixed clinical markers (age, BP). Interventions should be cluster-specific, targeting literacy in urban females and clinical risk reduction in urban males regardless of education level.