Conversation aids with absolute estimates and certainty of evidence to elicit people's perspectives on reducing saturated fat intake: a cross‑sectional regional survey in 7 countries.

INTRODUCTION

Patients are increasingly recognized as key interest holders in health care decision‑making. Integrating patient perspective is crucial to patient‑centered, evidence‑based nutrition guideline recommendations.

OBJECTIVES

Our aim was to examine individual willingness to decrease consumption of foods high in saturated fatty acids (SFAs) after being informed about the estimated absolute risk reduction (ARR) of myocardial infarction (MI), together with the certainty of the supporting evidence based on a Cochrane systematic review.

PATIENTS AND

METHODS

Respondents from 7 countries were presented with a conversation aid with the ARR of MI, together with the certainty of evidence, and asked about their willingness to reduce their intake of SFA‑rich foods. Using a multivariable logistic regression model, we explored 12 variables to identify factors underlying respondent willingness to introduce dietary fat changes.

RESULTS

We analyzed 3663 respondents from Brazil, Canada, China, Croatia, Poland, Spain, and the United States. Overall, 50.2% were willing to reduce their SFA intake. Women (odds ratio [OR], 1.51; 95% CI, 1.29-1.77), nonomnivores (OR, 1.73; 95% CI, 1.37-2.19), and respondents from Spain, China, and Brazil (OR, 2.45; 95% CI, 1.83-3.27; OR, 4.36; 95% CI, 3.49-5.45; and OR, 1.31; 95% CI, 1.08-1.58, respectively) showed greater willingness, whereas those from Croatia or holding a university degree showed lower willingness (OR, 0.7; 95% CI, 0.51-0.95; OR, 0.73; 95% CI, 0.61-0.87, respectively).

CONCLUSIONS

The significant variation in people willingness (depending, eg, on sex, education levels, or dietary pattern) to reduce their intake of SFA‑rich foods underscores potential importance of incorporating patient preference when developing dietary guideline recommendations, and of promoting individualized evidence‑based care using absolute effects and certainty of evidence.