Abstract
Background: Obstetricians-gynecologists (OB/GYNs) play a critical role for their pregnant patients during their perinatal period, but research on OB/GYNs knowledge, attitudes, and perceptions regarding plant-based dietary patterns (PBDP) and how this may influence recommendations to patients is lacking. An online cross-sectional survey was conducted to examine OB/GYN’s knowledge, attitudes, and perceptions towards a PBDP. Methods: Postcards were mailed in June 2023 to a convenience sample of 5,000 OB/GYNs across the US using a mailing list provided by the American College of Obstetricians and Gynecologists. Postcards had a brief study description and a QR code that linked to an online survey asking questions about demographics, behavior (e.g., nutritional habits), and other factors that may influence knowledge, attitudes, and perceptions towards a PBDP for their patients. Results: Ninety-six OB/GYNs completed the full questionnaire (~2% response rate). Most (92%) felt that it is within an OB/GYN’s role to incorporate nutrition education and counseling within practice. However, 72% felt inadequately trained to discuss nutrition and diet-related issues with patients. Despite a perceived lack of nutrition training, 86% reported that a PBDP was safe and health-promoting, and 81% reported that a well-planned PBDP could adequately meet all nutritional needs of pregnant and lactating patients. Conclusion: Findings suggest that OB/GYNs are generally knowledgeable about the components and health benefits of a plant-based diets. However, nutrient adequacy misconceptions and lack of sufficient training to discuss nutrition with patients may result in OB/GYNs not recommending PBDPs to patients. These findings underscore the need to enhance OB/GYN graduate medical education and training by integrating education on PBDPs, therefore improving a clinician’s ability to confidently and effectively counsel pregnant persons on this aspect of perinatal care.
Generated Summary
This research article presents the findings of a cross-sectional survey that examined the knowledge, attitudes, and perceptions of obstetrician-gynecologists (OB/GYNs) regarding plant-based dietary patterns (PBDPs). The study employed a convenience sampling method, mailing postcards to a sample of 5,000 OB/GYNs across the United States. The postcards included a brief description of the study and a QR code that linked to an online survey. The survey aimed to assess OB/GYNs’ understanding, beliefs, and practices related to PBDPs, particularly concerning their pregnant patients. The survey instrument included questions about demographics, medical education, personal dietary habits, and knowledge, attitudes, and perceptions related to PBDPs. The researchers intentionally refrained from defining PBDPs to allow participants to express their perceptions without bias. Data analysis was conducted using descriptive statistics to summarize survey responses. The response rate was approximately 2%, with 96 OB/GYNs completing the full questionnaire. The study’s primary goal was to determine how OB/GYNs’ knowledge, attitudes, and perceptions influence their recommendations regarding PBDPs to pregnant patients. This research is significant because OB/GYNs play a critical role in providing dietary advice to pregnant women, and their perspectives can significantly impact patient care and health outcomes. The study seeks to address the lack of research in this area, aiming to provide insights that could inform medical education and improve the quality of nutritional guidance provided to pregnant women.
Key Findings & Statistics
- A total of 96 OB/GYNs completed the full questionnaire (~2% response rate).
- 92% of respondents felt it is within an OB/GYN’s role to incorporate nutrition education and counseling within practice.
- 72% felt inadequately trained to discuss nutrition and diet-related issues with patients.
- 86% reported that a PBDP was safe and health-promoting.
- 81% reported that a well-planned PBDP could adequately meet all nutritional needs of pregnant and lactating patients.
- Of the 5,000 postcard invitations that were sent out, approximately 7% of cards were returned as undeliverable by the postal service.
- 34% of OB/GYNs reported that they sometimes ask patients about their dietary choices, 39% often, and 21% always.
- 62% of OB/GYNs either often or always routinely counsel their patients about their dietary choices.
- 47% strongly disagreed and 44% somewhat disagreed with the statement that recommendations for a pregnant person’s diet are no different than if they were not pregnant.
- 18% of OB/GYNs reported spending no time at all providing nutrition education and counseling about dietary choices.
- 45% spent 1-3 minutes providing nutrition education and counseling.
- 16% believed that educating pregnant patients about a new dietary pattern would take less than 5 minutes, 36% estimated it would take 5-15 minutes, 26% estimated 15-20 minutes, and 22% estimated 30 minutes or more.
- 6% strongly disagreed, 27% somewhat disagreed, 20% neither agreed nor disagreed, 39% somewhat agreed, and 8% strongly agreed to have seen an increase in the number of patients who follow a plant-based dietary pattern.
- 98% of OB/GYNs surveyed correctly identified a vegan and vegetarian dietary pattern.
- 60% of OB/GYNs believed that more should be done to encourage pregnant persons to adopt plant-based dietary patterns.
- 60% felt that pregnant persons who follow a plant-based dietary pattern are healthier than those who do not.
- 92% of OB/GYNs would recommend the Mediterranean diet as appropriate for a pregnant person.
- 78% would recommend a whole-food plant-based dietary pattern.
- 86% of the surveyed OB/GYNs expressed agreement that a plant-based dietary pattern is a safe and health-promoting diet.
- 53% of OB/GYNs strongly agreed or somewhat agreed that a patient following a plant-based dietary pattern would not need to change their diet during pregnancy and lactation.
- 21% of OB/GYNs reported that they tend to recommend blood tests for nutrient inadequacy for patients who follow a plant-based dietary pattern more than for patients who do not.
- 64% reported not recommending any different plan of care for those following a plant-based dietary pattern.
- 7% strongly disagreed, 33% somewhat disagreed with the notion that plant-based dietary patterns are nutritionally adequate, 14% indicated a neutral stance, 25% somewhat agreed and 21% strongly agreed.
- 81% agreed or strongly agreed that if well-planned, a plant-based dietary pattern could adequately meet the nutritional needs of pregnant and lactating persons.
- 48% of OB/GYNs recommending that people following a plant-based diet be concerned about complementary proteins.
- 63% said they were either extremely or somewhat likely to recommend a plant-based dietary pattern to a current or future patient.
Other Important Findings
- The majority of respondents were female (87.5%), non-Hispanic white, and had been in practice for more than 15 years.
- Most respondents (92%) agreed that incorporating nutrition education and counseling was within their role as OB/GYNs.
- A perceived lack of adequate training in nutrition was reported by 72% of respondents.
- 39% of respondents reported receiving zero hours of nutrition-focused continuing medical education.
- When asked about which of 13 popular dietary patterns they would recommend for a pregnant person, the Mediterranean diet was picked by the largest number of OB/GYNs (92%).
- A whole-food plant-based dietary pattern was picked as appropriate by 78% of providers.
- Most OB/GYNs (60%) believed that more should be done to encourage pregnant persons to adopt plant-based dietary patterns.
- Few patients are referred to nutritionists or registered dietitians for additional nutrition education and counseling.
Limitations Noted in the Document
- The survey’s low response rate (approximately 2%) may limit the generalizability of the findings, as it may not fully represent the views and practices of all OB/GYNs.
- The study relied on self-reported data, which is subject to recall bias and social desirability bias.
- The study did not define plant-based dietary patterns, which may have led to varied interpretations among participants.
- The study’s cross-sectional design limits the ability to establish causal relationships.
- The study’s convenience sampling method, using a mailing list from the American College of Obstetricians and Gynecologists, may not fully represent all OB/GYNs.
- The study was conducted in the United States, limiting the generalizability of the findings to other countries or healthcare systems.
Conclusion
The study’s findings underscore the need to enhance medical education and training for OB/GYNs, specifically focusing on plant-based dietary patterns. Despite the general knowledge of the benefits of plant-based diets, misconceptions about nutrient adequacy and a perceived lack of training may hinder OB/GYNs from recommending these diets to their patients. “Findings suggest that OB/GYNs are generally knowledgeable about the components and health benefits of a plant-based diets. However, nutrient adequacy misconceptions and lack of sufficient training to discuss nutrition with patients may result in OB/GYNs not recommending PBDPs to patients.” The study suggests that integrating education on PBDPs into OB/GYN curricula could improve clinicians’ ability to counsel pregnant persons effectively. The study also highlights the potential for OB/GYNs to leverage the expertise of registered dietitians and nutritionists to provide more comprehensive nutritional guidance. “These findings underscore the need to enhance OB/GYN graduate medical education and training by integrating education on PBDPs, therefore improving a clinician’s ability to confidently and effectively counsel pregnant persons on this aspect of perinatal care.” The study’s insights can inform future research, including exploring the role of shared medical appointments and interprofessional collaboration in delivering nutrition education. Future research should explore the relationship between providers’ personal dietary habits and their recommendations to patients. The study encourages further investigation into the knowledge, attitudes, and practices of other medical specialties regarding plant-based diets. “The findings from this survey suggest that OB/GYNs are generally knowledgeable about the components and health benefits of a plant-based diets and view a PBDP as a safe and healthy way of eating for a pregnant person. However, misconceptions about the nutrient adequacy of plant-based diets and lack of sufficient training to discuss nutrition and diet-related issues with patients may result in OB/GYNs not recommending such PBDPs to their patients.”