• Étienne Morin, Isabelle Michaud-Létourneau, Yves Couturier, and Mathieu Roy.
• Research Centre on Aging, University of Sherbrooke, Sherbrooke, Quebec, Canada; School of Social Work, Faculty of Arts and Humanities, University of Sherbrooke, Sherbrooke, Quebec, Canada.
• Nutrition. 2019 Oct 1; 66: 54-61.

ObjectivesAn ideal diet to prevent cardiovascular diseases contains an unlimited intake of various plant foods and a reduced intake of animal and highly processed foods. Researchers have reported that nutrition education programs that prioritize whole-plant foods effectively contribute to the prevention of unhealthy cardiovascular outcomes. We examined whether a 12-wk nutrition education program in adults from Montreal (Quebec, Canada) with at least one risk factor of cardiovascular disease was effective in modifying their eating patterns toward including more whole-plant foods. We further evaluated the effects of this program on participants' cardiovascular outcomes and explored determinants influencing food choices toward whole-food, plant-based diets.MethodsA sequential, explanatory, mixed-methods, research design was used. A quantitative step (i.e., single-arm, quasi-experimental trial) preceded participant recruitment for a qualitative phase (i.e., phenomenological study; semistructured interview; thematic analysis). The examined outcomes were changes in cardiovascular risk factors (paired t tests) and determinants of food choice (thematic analysis).ResultsWeight (-10.5 lbs; 95% confidence interval [CI]: -9.0 to -12.0), waist circumference (-7.4 cm; 95% CI: -6.5 to -8.4), total cholesterol (-0.87 mmol/L; 95% CI: -0.57 to -1.17), and low-density lipoprotein cholesterol (-29.7% or -0.84 mmol/L; 95% CI: -0.55 to -1.13) all improved significantly (P ˂ 0.001). Encouraging ad libitum intake of various whole-food plant-based items appealed more to participants than traditional strategies. Altruistic and societal motives, in addition to health, were identified as key determinants of an increased adoption of whole-food plant-based diets.ConclusionsThe whole-food, plant-based nutrition program improves cardiovascular health in adults and features characteristics that may inform future nutrition programs and public health interventions.Copyright © 2019 Elsevier Inc. All rights reserved.

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