Novel insights and practical strategies for health professionals to improve the uptake of plant-based diets in people with chronic kidney disease

There has been a significant shift in dietary guidance in the past 5 years for people with chronic kidney disease. Multiple best practice guidelines in nephrology now include nutritional guidance that recommends the adoption of healthy dietary patterns with an emphasis on whole foods and diets with adequate fruit, vegetables, legumes, nuts, wholegrain bread and cereals, with minimal amounts of processed foods high in salt, sugar, and fat. While there is shortage of enthusiasm, from health professionals to adopt this new approach, there is a clear knowledge gap on how to get people to adopt plant-based diets. This is particularly apparent in settings where renal dietetic services are lacking. This manuscript, cowritten with consumers with lived experience of chronic kidney disease, outlines seven strategies to facilitate the adoption of plant-based diets and draws on evidence from the fields of marketing, implementation science, and behavior change. These strategies include paying attention to language, starting gradually and increasing variety, then transitioning to increasing vegetable portion size, focusing on adequacy, giving explicit guidance on how to reduce meat, remembering neophobia, and emphasizing the importance of individualized advice. Additional strategies from consumers include the need to address consumer fears about the adequacy of nutrient intake, focus on foods to enjoy not nutrients to restrict; provide advice on how to sensibly include favorite foods and make meals flavorsome and finally consider the adoption of plant-based diets as a spectrum to strive towards-with animal foods included at varying levels depending on food preferences, budget, cultural preferences.