Registered dietitians' perceptions and use of the plant-based recommendations in the 2019 Canada's Food Guide

In 2019, Canada's Food Guide underwent its first transformation in over a decade. The change received considerable attention given the increased focus on plant-based proteins and the decision to eliminate the milk and alternatives food group. Yet little is known about health professionals' views of these updates. In response, the present study examined Canadian dietitians' attitudes and behaviours towards the guide's expanded plant-based recommendations.

A pan-Canadian cross-sectional online survey was administered from January to March 2020 to currently practicing registered dietitians. The study was pre-registered, piloted and received ethical approval. Descriptive and inferential statistics were performed and open-text responses underwent thematic analysis.

In total, 411 dietitians from 10 provinces and various work settings participated. Most dietitians (82.8%) consider the food guide's recommendation to choose protein foods that come from plants more often is evidence-based. Compared to its predecessor, dietitians encourage their patients/clients to choose protein foods that come from plants (p < 0.001) and non-dairy sources of calcium (p < 0.001) significantly more frequently under the new guide. A slight majority of dietitians (57.7%) agree with the decision to omit the standalone milk and alternatives group in favour of bringing dairy into the protein category.

Canadian dietitians generally look favourably upon the new plant-based recommendations and have adjusted their nutrition counselling in response. The findings are considered to be the first to characterise how dietitians view changes to the plant-based content of one of the most recognisable diet-related educational tools in Canada.