The possibility of patient-centered dietetic intervention in the context of health literacy in Hungary

TL;DR

This study explores how health literacy affects the success of dietary interventions in Hungary, finding that low health literacy is a major barrier to effective patient-centered nutrition care.

Contribution

The study provides new insights into the relationship between health literacy and dietary intervention effectiveness in Hungary, emphasizing the need for tailored communication strategies.

Findings

77.4% of respondents had low health literacy, which is linked to higher prevalence of chronic diseases.

Only 20.8% of respondents were aware of the local food-based dietary guidelines (FBDG).

Higher education and younger age correlated with better health literacy and greater likelihood of following medically indicated diets.

Abstract

Non-communicable diseases (NCDs) accounted for 74% of global deaths in 2024, with over 41 million people dying. The WHO has identified reducing behavioral and metabolic risk factors as a priority intervention. In modern healthcare, patient-centered care plays a key role by addressing individual needs, lifestyles, and motivations, thereby enhancing the effectiveness of prevention and behavior change. Food-based dietary guidelines (FBDG), such as Hungary’s OKOSTÁNYÉR®, are vital in prevention and medical nutrition therapy. However, the effectiveness of such dietary interventions largely depends on individuals’ health literacy.

This study aimed to explore the relationship between health literacy, dieting habits, dietary counseling, and awareness of the local FBDG recommendations.

This cross-sectional study was conducted in February 2023 on a representative sample (N = 500) of the adult Hungarian population, using the CAWI method. Data were collected with the validated HLS-EU 47-item questionnaire and additional custom items on health status, dieting, and awareness of the local FBDG. Health literacy indexes were calculated using validated thresholds. Descriptive statistics, chi-square tests, ANOVA, and multivariate regression analyses were applied (p < 0.05).

A total of 77.4% of respondents had low (insufficient or problematic) health literacy. Higher education levels and younger age were significantly associated with better health literacy. Chronic diseases were more prevalent in low health literacy groups. About 32.4% of respondents followed a medically indicated diet, and 36.8% had received dietary counseling. Awareness of the local FBDG was relatively low (20.8%), particularly among men and those with lower education.

Patient-centered care necessitates a high level of health literacy, enabling patients to actively participate in their therapy. Findings of the study highlight that low health literacy in the Hungarian population poses a major challenge to the success of dietary interventions. Targeted health communication strategies and tailored dietetic support are essential to improve the effectiveness of personalized nutrition care, particularly among vulnerable groups with limited health literacy.

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