A Qualitative Study of Rural Plant-Based Eaters' Knowledge and Practices for Nutritional Adequacy

(1) Background: Healthful plant-based diets, especially those rich in minimally processed plant-based foods such as fruits, vegetables, and whole grains, have been associated with a lower risk of diet-related chronic disease. However, individuals who limit or avoid animal products may be at risk of nutrient deficiencies, especially related to Vitamin B12, Vitamin D, omega-3 fatty acids, calcium, iron, iodine, zinc, and protein. Such deficiencies can result in both short- and long-term health challenges. We used qualitative methods to explore plant-based eaters' knowledge and awareness of these eight nutrients of concern in diets that limit or exclude animal-source foods. (2) Methods: We conducted interviews with 28 rural flexitarian, pescatarian, vegan, or vegetarian adults in Vermont, USA. (3) Results: The participants positively viewed the healthfulness of plant-based diets, but many recognized limitations to accessing Vitamin B12, Vitamin D, and omega-3 fatty acids. They shared the strategies used to meet their needs including eating a varied diet, seeking out specific foods, and taking dietary supplements. Analyses identified gaps in the participants' knowledge related to nutrient bioavailability, food sources of specific nutrients, and the importance of zinc and iodine. Vegans-the highest-risk group-generally presented as the most knowledgeable. The participants noted a lack of local plant-based nutrition expertise. (4) Conclusions: Addressing the identified knowledge gaps and challenges to dietary adequacy, especially among those who limit, but do not fully omit, animal-source foods, may support plant-based nutrition.