Background: Without proper informational couseling, past studies suggest that patients underestimate the effect of diet in chronic disease progression, specifically in gastrointestinal diseases and type 2 diabetes (T2D). It is unclear, however, the perception of the same patient population on the relative impact that proper diet can play on multiple different diseases. Understanding the complexity of these views and opinions, especially in a rural population, can help identify educational gaps and improve dietary counseling in rural areas. Hypothesis: We hypothesize that a rural patient population will inaccurately estimate the effect of diet on the development of several common diseases, with considerable variation in perceived dietary impact across conditions. Methods: This quantitative, cross-sectional, observational analysis utilized an online survey distributed via a HIPPA compliant platform to adults in rural Georgia. Patient responses were analyzed with descriptive statistics while single-sample t-tests assessed mean perception relative to evidence-based data by condition. Results: Across all 7 chronic diseases studied, patients demonstrated a high perceived impact of diet, with the average patient responses higher than the literature-based value in all instances (Table 2). The highest mean perceived diet based risk was for T2D (74.6%) and Major Cardiovascular Disease (CVD) (70.6%). Compared to evidence-based literature values, the magnitude of overestimation was most pronounced for cardiovascular conditions, with the perceived reduction of about 71% for Major CVD being over three times the literature value of 21% (Figure 1). Conclusions: We attribute both targeted public health messaging and intuitive patient knowledge of diease pathology to the high reported responses for diabetes and major CVD. It is important to note the high prevalence of these conditions in the rural population surveyed, possibly increasing baseline knowledge and awareness. Similarly, the largest perception-evidence gaps for these same diseases may occur because while this cause-and-effect linkage messaging is effective for raising awareness, it often lacks quantitative context on the actual risk reduction. This leads to an oversimplified belief in diet as a near-complete preventive solution, overshadowing the multifactorial nature of these diseases which also require pharmacological and alternative lifestyle interventions.
Miller et al. (Tue,) studied this question.