Introduction: 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. Objectives: This study aimed to explore the relationship between health literacy, dieting habits, dietary counseling, and awareness of the local FBDG recommendations. Methods: 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). Results: 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. Conclusion: 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.

Introduction: Chronic, non-communicable diseases accounted for 74% of deaths worldwide in 2024, representing a significant social and economic burden. The WHO identifies reducing preventable risk factors as a primary intervention point. Patient-centered care plays a prominent role in modern healthcare, promoting prevention and increasing the effectiveness of lifestyle therapy by taking into account the individual needs, lifestyle, and motivations of patients. Nutritional guidelines play a crucial role in prevention and medical nutrition therapy. However, the effectiveness of personalized dietary care is greatly influenced by the health literacy of the population. Objective: Our research aimed to explore the characteristics that emerge in the interpretation of the OKOSTÁNYÉR ^® nutritional recommendations based on health literacy. Medical nutrition therapy is an important part of lifestyle management for chronic, non-communicable diseases. However, the effectiveness of such interventions is greatly influenced by patients’ health literacy. Our research aimed to explore observable characteristics based on health literacy in the interpretation of the OKOSTÁNYÉR ^® dietary recommendations, with the goal of increasing the effectiveness of dietetic practice. Sample and method: The research was based on a qualitative methodological approach, using focus group interviews. Four online focus group interviews were conducted with 6 participants each (N = 24). 58% of the participants were women (14 people) and 42% were men (10 people); their average age was 50.1 years. A quantitative survey using the HLS-EU47 questionnaire was conducted prior to the selection of participants, during which groups with low and normal health literacy were formed based on internationally validated cut-off scores. The selection of participants was preceded by a quantitative survey, on the basis of which groups with low and normal health literacy were formed. The audio recordings and transcripts of the discussions were analyzed by group and thematic unit, using multi-coded systematic data processing. Coding, analysis, and data visualization were supported by NVivo14 and SmartDraw softwares. Results: Based on the lifestyles, behaviors, and aspirations of individuals with normal and low health literacy, distinctly different character groups can be identified. Higher health literacy is linked to coping strategies that support health maintenance. Awareness of the OKOSTÁNYÉR ^® recommendation is moderate (33.3%), particularly among those with low health literacy (16.6%). Navigating the vast amount of health information available can be challenging, especially for individuals with low health literacy. When it comes to ideal nutritional advice, participants highlighted the importance of reliable sources, however, they primarily rely on the internet and social media for answers to their nutritional questions, only seeking professional help when a health issue has already been established. They assess recommendations based on their personal habits and beliefs, often modifying them accordingly. Conclusion: Low health literacy can pose a significant barrier to effective dietary interventions. In the future, it will be essential to improve health communication, for example, by developing targeted nutritional recommendations and providing guided support to groups with low health literacy, such as developing nutritional competencies and increasing the effectiveness of personalized, patient-centered dietary counselling. Orv Hetil. 2026; 167(24): 952–964.