Understanding preferences regarding protein-enriched plant-based products of patients with lived experience of (risk of) malnutrition: a grounded theory study

Background/aim
Disease-related malnutrition is common in the Netherlands, and its treatment often involves the use of animal-based protein-enriched products. There is a growing trend and increasing ambition towards a more plant-based diet in the Dutch population and within Dutch healthcare institutions. However, patients may struggle to meet their protein requirements, as the availability of plant-based protein-enriched products remains limited. Patient preferences for such products have not yet been explored. This study aimed to understand patient preferences regarding plant-based protein-enriched products of patients with lived experience of (risk of) malnutrition.

Methods
In this grounded theory study, semi-structured interviews were conducted with patients (≥ 18 years) with recent or current lived experience of (risk of) malnutrition. We systematically analysed the data using open, axial, and selective coding, resulting in themes, using ATLAS.ti and following COREQ guidelines.

Results
Data of 17 out of 18 patients were included in the analysis. Five themes emerged, that addressed product variety, dislikes, health and societal/social considerations, convenience, and packaging. The wish to balance convenience and sustainability gave rise to contradictory product demands. Values of health, sustainability, and animal welfare were similar across participants who were used to eat primarily animal-based and plant-based.

Conclusion
Patients prefer varied, easy-to-eat plant-based products, avoiding strong smells, unhealthy ingredients, and large portions. Emphasizing shared values of health, sustainability, and animal welfare can promote adoption of plant-based options.