Evaluating health-related values and preferences about reducing foods high in saturated fat: a pooled analysis from 7 countries

Oral
2024 Prague [Global Evidence Summit]
Alonso-Coello P1, Bała M2, Castro Reyes B3, Cruz Lopes L4, de Souza Serio dos Santos D5, Franka Žuljević M6, Ge L7, Ghosh N8, Gillespie-Friesen J9, Guyatt G10, Johnston B11, Majdak K2, Maraj M2, Philipe Nagem L4, Poklepović-Peričić T6, Pons Boyero C1, Prokop-Dorner A2, Thabane L10, Theodoro H12, Valli C13, Wang Q7, Warzecha S2, Zajac J2, Zawisza K2
1Iberoamerican Cochrane Centre, Biomedical Research Institute San Pau (IIB Sant Pau), Barcelona, Spain
2Jagiellonian University Medical College, Poland, Kraków, Poland
3Hospital Clìnic del Maresmena, Barcelona, Spain
4University of Sorocaba, São Paulo, Brazil
5Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
6University of Split School of Medicine, Split, Croatia
7Lanzhou University, Lanzhou, China
8Texas A&M University, College Station, Texas, USA
9Dalhousie University, Halifax, Nova Scotia, Canada
10McMaster University, Hamilton, ON, Canada
11Dalhousie University, Halifax, Nova Scotia, Canada; Texas A&M University, College Station, Texas, USA
12University of South of Caxias, Brazil
13Avedis Donabedian Research Institute, Universidad Autónoma de Barcelona, Barcelona, Spain

Background:

Little is known about the public’s values and preferences related to dietary fat intake, particularly with respect to the current evidence on association between saturated fat (SF) and health outcomes. The study is a part of NutriRECS Collaboration and will inform public health nutrition guidelines on SF.

Objectives:

To investigate values and preferences related to reducing foods high in SF in response to evidence-based information about the effect of such change on cardiovascular health risk—myocardial infarction (MI) as an outcome.

Methods:

The cross-sectional study was conducted in Brazil, Canada, China, Croatia, Poland, Spain, and the United States. Using a common questionnaire, we gathered information on demographic characteristics of the respondents, their lifestyle, and medical history. We stratified participants into 1 of 4 baseline cardiovascular (CV) risk categories. Based on a high-quality Cochrane 2020 systematic review and meta-analysis, the respondents were presented with infographics on absolute risk reduction (ARR) of MI if they reduced their SF intake—for participants with low CV risk, it was 2 fewer MI cases per 1000 people; for moderate, 7 fewer; for high, 18 fewer; and for very high, 24 fewer MI cases. The certainty of the presented evidence was low. Participants were asked how likely, given this potential reduction, they were to reduce their SF intake.

Results:

Over 50% of respondents were willing to reduce their SF intake when they learned about the low-certainty evidence and the relatively small ARR of MI. Women were more willing to reduce their SF intake (β = -0.53, P < 0.001), as were people with nonomnivore dietary pattern (β = 0.22, P = 0.02) and a recent history of a low-fat diet (β = 0.88, P < 0.001). In contrast, those with a history of high-fat diet were less willing (β = -0.44, P < 0.001). There were no associations between the 4 CV risk groups and level of willingness.

Conclusions:

Any prior experience of changing one's diet may increase cognitive and behavioral flexibility; however, strong convictions about SF could stay in conflict with dietary recommendations and interfere with the process of dietary change. Identifying individual attitudes towards fats and evidence-based information could enhance guidelines implementation process.