Introduction: Patients are increasingly recognized as key interest holders in healthcare decision‑making. Integrating patient’s perspective is crucial to patient‑centered, evidence‑based nutrition guideline recommendations.

Objectives: To examine individuals’ willingness to decrease consumption of foods high in saturated fatty acids (SFA) after being informed about the estimated absolute risk reduction (ARR) in myocardial infarction (MI) together with the certainty of the supporting evidence based on a Cochrane systematic review.

Methods: Based on regional samples from seven countries, respondents 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 respondents' willingness to introduce dietary fat changes.

Results: We analyzed 3663 respondents from regions of Brazil, China, Croatia, Canada, Poland, Spain and USA. Overall, 50.2% were willing to reduce their SFA intake. Females (odds ratio, OR=1.51, 95% confidence interval [CI]: 1.29‑1.77), non‑omnivores (OR=1.73, 95%CI: 1.37‑2.19), respondents from Spain, China and Brazil (OR=2.45, 95%CI: 1.83‑3.27; OR=4.36, 95%CI: 3.49–5.45; 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=0.70, 95%CI: 0.51–0.95; OR=0.73, 95%CI: 0.61‑0.87, respectively).

Conclusions: The significant variation in people’s willingness (e.g. gender, education levels, dietary pattern) to reduce their intake of SFA‑rich foods underscores potential importance of incorporating patient preference when developing dietary guideline recommendations, and for promoting individualized evidence‑based care using absolute effects and certainty of evidence.