How to motivate patients to stick with a healthy diet

Key takeaways:

• Patients often reported concern over nutritional deficiencies and the potential inconvenience of a plant-based diet.
• Tailoring care to individual patients can help encourage them to change their dietary habits.

DENVER — Individualized care can help physicians motivate their patients to choose a healthy plant-based diet, according to presenters at the American College of Lifestyle Medicine’s annual conference.

Despite all of the health benefits plant-based diets provide, most patients “are really reluctant or resistant to be able to change their dietary behaviors or unable to really sustain long-term changes over time,” Matthew J. Landry, PhD, RDN, FAND, FAHA, an assistant professor at the University of California, Irvine, said.

Landry, who presented at the conference with Catherine P. Ward, PhD, RD, a postdoctoral research fellow at Stanford University, discussed some of the reasons he sees pushback in patients who do not want to change their dietary behaviors. One of the biggest challenges he said he sees is the “strong cultural significance meat has in our diets.”

“Oftentimes, people are very attached to the meats that they're consuming, and they feel that to have an entire meal — meat’s got to be on the plate as well,” he said. “But of course, we know that's not the case.”

Other major struggles Landry mentioned were worry that plant-based diets will be inconvenient, worry that they will struggle with preparing unfamiliar foods, food neophobia (being hesitant to try new foods) and concerns regarding nutritional intake.

Patients often worry switching to a plant-based diet might compromise their intake of vitamins, protein, calcium, iron and omega 3, Landry said. Although he conceded this is true to some extent, he added that “this can be really easily overcome” with some simple substitutions.

Aside from just the common choices like using alternatives for burgers rather than red meat, Ward said patients can also swap wheat pasta for a lentil-based option to increase the meal’s protein.

“Some (usually) serving that with, let’s say sausage or meatballs, maybe could leave out the meat and feel like they’re getting an adequate amount of protein from that pasta,” she said.

Ultimately, Ward said, it comes down to knowing what patients like to eat and individualizing recommendations for each person.

“It’s really important to meet the patient where they’re at,” Ward said. “If you have someone eating meat two to three times per day every day, they may not be very receptive to switching to a completely vegan diet, and ... you don’t need to. Even swapping out meat in a few meals is going to be beneficial.”

Landry said that spending the time to speak with patients can also help physicians learn what might motivate them to adhere to plant-based diets more closely.

“Dietary choices and behaviors are complex and determined by a number of individual factors, things like food preference, knowledge, and cultural patterns, or things like social support, and social norms,” Landry said. “All these things, in addition to a person's income and their nutritional environment, influence their ability to be able to go plant based.”

Some patients, he said, may be more inclined to adhere to a plant-based diet because of the environmental benefits, whereas others might be convinced by one of the diet’s other benefits, like its economic sustainability.

“As practitioners it's really important to determine the most fitting source of motivation amongst our patients,” Landry said. “Whether it be health or environmental cost for each individual, we can help tailor the interventions that we have to promote those healthier and sustainable diets.”