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Chwyl C, Metzler AL, Nguyen JT, France M, Karbassi N, Turner-McGrievy G, Wright N, Forman EM. "Mindset Matters": Perseverance, a balanced approach and structured support as facilitators of whole foods plant-based adoption. Appetite 2024; 194:107163. [PMID: 38141878 DOI: 10.1016/j.appet.2023.107163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/09/2023] [Accepted: 12/11/2023] [Indexed: 12/25/2023]
Abstract
Whole foods plant-based diets (WFPBD) show potential for preventing and addressing chronic diseases. However, concerns exist about their acceptability and feasibility. Research on firsthand WFPBD adoption experiences is limited but crucial for promoting dietary change. In a 12-week remotely delivered lifestyle modification program using an ad libitum WFPBD, twenty weight-loss seeking adults (ages 18-75) with overweight or obesity completed self-report surveys and semi-structured interviews via Zoom. The study aimed to explore: (1) experiences with WFPBD adoption; (2) factors that helped or hindered adherence; and (3) perceived salient benefits. Interviews were analyzed inductively through a conventional content analysis, and associations between variables examined with correlational analyses. Participants overall reported WFPBD adoption being a positive, new experience, with an equal number (30%) finding it easy/easier than expected as challenging. Key cited challenges included overwhelm, different eating habits in the household, and meal preparation. Key cited facilitators included adopting an incremental approach to dietary change, persisting after setbacks, and having simple go-to meals. Greater self-compassion and family support, and less sabotage from friends and family corresponded to greater dietary change (rs > 0.45, ps < .05). Participants valued accountability, structure, human support, nutrition psychoeducation and recipes in the program. Three categories emerged regarding perceived benefits of following the WFPBD: physical health benefits, improvements to eating habits, and greater perceived control/agency over health. Results indicate that future interventions should include psychological strategies alongside nutrition education to enhance self-efficacy, address household barriers, and combat feelings of overwhelm through sufficient structure, support, and meal preparation guidance. Messaging around WFPBD may benefit from discussing prevailing positive experiences with adoption, common benefits experienced, and options for an incremental approach given that feasibility and acceptability concerns may deter efforts.
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Affiliation(s)
- Christina Chwyl
- Department of Psychological and Brain Sciences, Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, USA.
| | - Abigail L Metzler
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
| | - Jade T Nguyen
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA.
| | - Madelyn France
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
| | - Nikoo Karbassi
- Department of Psychological and Brain Sciences, Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, USA.
| | | | - Nicholas Wright
- Royal New Zealand College of General Practitioners, Gisborne, New Zealand.
| | - Evan M Forman
- Department of Psychological and Brain Sciences, Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, USA.
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Dean E. Academy of Plant-based Physical Therapy: overdue to address a nutrition crisis with a transformative population approach. J Phys Ther Sci 2023; 35:645-658. [PMID: 37670763 PMCID: PMC10475644 DOI: 10.1589/jpts.35.645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 06/09/2023] [Indexed: 09/07/2023] Open
Abstract
This timely evidence synthesis supports the need for an Academy of Plant-based Physical Therapy. Given epidemiological and empirical evidence and the profession's values and practice scope, the time has come for a specialty of plant-based physical therapy based on population health principles. This review connects these factors. Non-communicable diseases (NCDs) are largely nutrition-related resulting from unnatural elements of our diet (i.e., heart disease, several cancers, hypertension, stroke, diabetes, obesity, gastrointestinal diseases, autoimmune diseases, renal disease, and Alzheimer's disease). Most adults, even children, have NCD risk factors or manifestations. Alternatively, plant-based nutrition can prevent, manage, as well as potentially reverse these diseases, as well as augment conventional physical therapy outcomes by reducing inflammation and pain. Proposed competencies for plant-based physical therapists include high-level competency in health and NCD risk assessments/evaluations, to establish population health-informed nutrition needs for maximal health, healing and repair, in turn, function and wellbeing; and assessment of patients' nutrition-related knowledge, beliefs/attitudes, self-efficacy, and readiness-to-change. Population-informed nutritional counseling is initiated as indicated. An Academy of Plant-based Physical Therapy could advance the profession globally at this point in history and also serve as a role model to other health professions through practicing evidence-based, plant-based nutrition built upon population health principles.
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Affiliation(s)
- Elizabeth Dean
- Department of Physical Therapy, Faculty of Medicine,
University of British Columbia: Friedman Bldg, Rm 212 2177 Webrook Mall, Vancouver, BC,
V6T 1Z3, Canada
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Angotti AA, Silva JGSTD, Martins PA. Knowledge of health professionals about vegetarian diets: integrative review. REVISTA CIÊNCIAS EM SAÚDE 2022. [DOI: 10.21876/rcshci.v12i4.1278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objective: To assess studies on the knowledge of health professionals regarding vegetarian diets. Methods: This integrative review was conducted from November to December 2020 and updated in January 2022 in 5 databases and the gray literature. Two investigators performed the article selection. The inclusion criteria were scientific articles with any study design that addressed the intended topic with no date or language limitation. Results: Eleven studies were included. The main common finding was that health professionals, except dietitians, were not satisfied with the available nutritional information in general, not only regarding vegetarian diets. Despite this gap, half of the studies showed a positive view by professionals concerning the vegetarian diet.Conclusions: Many professionals do not feel confident about encouraging a vegetarian diet since they do not know the details of its benefits and risks.
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Jang E, Parsh B. Vegetarian vs. vegan diets. Nursing 2022; 52:10-11. [PMID: 36006743 DOI: 10.1097/01.nurse.0000853992.50898.60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Emily Jang
- Emily Jang is a nurse at the University of California, Davis, Medical Center. Bridget Parsh is a professor at the Sacramento State School of Nursing in Sacramento, Calif. Dr. Parsh is also a member of the Nursing2022 editorial board
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Clark BE, Pope L, Belarmino EH. Perspectives from healthcare professionals on the nutritional adequacy of plant-based dairy alternatives: results of a mixed methods inquiry. BMC Nutr 2022; 8:46. [PMID: 35550654 PMCID: PMC9097167 DOI: 10.1186/s40795-022-00542-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 05/04/2022] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Healthcare professionals are important sources of nutrition and health information for Americans. As plant-based (PB) dairy alternative products increase in popularity, concerns have been raised about their nutritional adequacy, and whether consumers understand nutritional differences to dairy. Healthcare professionals directly advise consumers on dietary choices, therefore we sought to examine their understanding and opinions of PB dairy alternatives. METHODS We analyzed comments submitted to the U.S. Food and Drug Administration (FDA) by health professionals (n = 191) in 2018-2019 in response to a request for public comment on the nutrition of PB dairy alternatives and the use of dairy terms like "milk", "cheese", and "yogurt" on their labels. Survey data from healthcare professionals (n = 417) was collected in 2020-2021. Comments and survey responses to open-ended questions were coded using template analysis and thematically analyzed. Logistic regression models examined perceptions across health professional characteristics for close-ended survey responses. RESULTS Three-fourths of health professionals believe consumers are confused about the nutritional differences between dairy and PB dairy alternatives. Over half (53%) do not believe either product is nutritionally superior to the other. Many believe dairy products have higher nutrient value, but also believe PB dairy alternatives can be part of a healthful diet. Compared to other types of health professionals, dietetics professionals demonstrated a more accurate understanding of the nutritional value of both products and were more likely to believe nutrients like protein (OR 2.02; 95% CI 1.22-3.34, p = 0.006) and vitamin D (OR 2.46; 95% CI 1.48-4.09, p = 0.001) may be nutrients of concern for PB dairy alternative consumers. They were also more likely to believe consumers are confused about these products (OR 3.44; 95% CI 1.65-7.21; p = 0.001). Health professionals who submitted comments to the FDA showed stronger opinions in favor of PB dairy alternatives. CONCLUSIONS Although PB dairy alternatives have nutritional value in certain diets, responses from health professionals suggest that changing their labeling to be different than dairy may reduce confusion. Improved nutrition education among health professionals may also be necessary.
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Affiliation(s)
- Bridget E Clark
- Department of Nutrition and Food Sciences, University of Vermont, 256 Carrigan Wing, 109 Carrigan Drive, Burlington, VT, 05405-0086, USA
| | - Lizzy Pope
- Department of Nutrition and Food Sciences, University of Vermont, 256 Carrigan Wing, 109 Carrigan Drive, Burlington, VT, 05405-0086, USA
| | - Emily H Belarmino
- Department of Nutrition and Food Sciences, University of Vermont, 256 Carrigan Wing, 109 Carrigan Drive, Burlington, VT, 05405-0086, USA.
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Knowledge of Medical Students and Medical Professionals Regarding Nutritional Deficiencies in Patients with Celiac Disease. Nutrients 2021; 13:nu13061771. [PMID: 34067382 PMCID: PMC8224609 DOI: 10.3390/nu13061771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/19/2021] [Accepted: 05/19/2021] [Indexed: 12/11/2022] Open
Abstract
A gluten-free diet provides relief from symptoms for patients with celiac disease, although there is still a risk of nutritional deficiencies. These patients can potentially consume an excessive amount of fat and insufficient amounts of fiber, iron, vitamin D, and calcium. This study aimed to assess the knowledge of medical students and healthcare professionals in Poland regarding nutritional deficiencies and the prevention of such deficiencies in patients with celiac disease who are on a gluten-free diet. Of the 430 survey participants, 46% did not realize the risk of nutritional deficiencies in patients with celiac disease. The knowledge of the participants was lowest regarding the risk of being overweight or obese. Among the healthcare professionals, an acceptable level of correct answers was provided by only 37% of individuals and was highest for the dietitians’ group. Our results demonstrate the need to improve the education of healthcare professionals concerning nutrition in patients with celiac disease.
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