Date of Award


Document Type


Degree Name

Master of Science (MS)


Nutrition and Food Sciences

First Advisor

Emily Belarmino


Plant-based (PB) dietary patterns have seen an upsurge in popularity over the past two decades. With this, has come an increase in consumption of PB alternatives to animal food products, including alternatives to dairy. However, because PB dairy alternatives are nutritionally different from dairy, there is concern that consumers of these products may unknowingly fall short on essential nutrients in their diet. Healthcare providers are key sources of nutrition information for U.S. consumers. This work examined U.S. healthcare professionals’ beliefs and recommendations regarding dairy and PB dairy alternatives. Two methods were used: (1) analysis of all public comments submitted the U.S. Food and Drug Administration (FDA) by health professionals (n=191) in response to a request for public comment on the nutrition and use of dairy terms on PB product labels, and (2) a national survey of healthcare professionals’ (n=417) beliefs on the nutrition and labeling of PB dairy alternatives, personal dietary habits, and professional recommendations on dairy and dairy alternatives. Comments and open-ended survey responses were coded in NVivo using a template approach and analyzed by themes. Close-ended survey responses were analyzed in SPSS. Unadjusted and adjusted logistic regression models examined demographic and professional characteristics associated with beliefs about the nutrition, consumer awareness, and labeling of PB dairy alternatives, and examined if personal dietary preference predicted nutrition recommendations on dairy and dairy alternatives.

Three fourths of health professionals who participated in the survey believed consumers are confused about the nutritional differences between dairy and dairy alternatives, yet over half did not consider either product nutritionally superior, and most would recommend both dairy (81%) and dairy alternatives (72%) to their patients. Still, many believed dairy to have higher nutrient value. Health professionals who submitted comments to the FDA showed stronger opinions in favor of PB dairy alternatives, and less than one fourth mentioned concern for consumer confusion. Survey data showed that, compared to other types of health professionals, dietetics professionals demonstrated a more accurate understanding of the nutritional value of both products and were more likely to believe nutrients like protein and vitamin D may be lacking in the diets of those who prefer dairy alternatives. Personal preference for PB milk and PB dietary patterns were associated with greater odds of recommending PB dairy alternatives and lessor odds of recommending dairy to a patient. Improved nutrition training focused on PB nutrition and reducing personal bias in practice may be necessary in certain healthcare disciplines to ensure healthcare providers are equipped to help consumers make informed nutrition decisions. Furthermore, health professionals who participated in the federal rulemaking process may represent over-polarized views on PB dietary patterns.



Number of Pages

109 p.

Included in

Nutrition Commons