The Feasibility,Acceptability and Impact of a Remotely Delivered Whole-Food Plant-Based Education Program

Abstract

Chronic conditions linked to Western dietary patterns, together with the environmental impacts of high animal product consumption, highlight the need for scalable lifestyle medicine education strategies that support shifts toward plant-based eating. This pilot study examined the feasibility and acceptability of a 5-week, remotely delivered, nutrition-focused lifestyle medicine education program centered on whole-food plant-based eating, and examined changes in dietary intake, knowledge, skills, and perceptions. The pilot program comprised five weekly 90-minute interactive Zoom sessions covering whole-food plant-based principles, health and environmental considerations, and practical strategies for dietary change. Participants completed 24-hour dietary recalls using ASA24-AU and surveys assessing knowledge, skills, and perceptions at baseline and post-intervention. Nine women aged 20 to 61 years completed the pilot program. Acceptability was high (mean rating 4.07/5). Participants reported improvements in whole-food plant-based knowledge, greater confidence in food preparation, and more favorable perceptions of taste, satiety, and convenience. Significant reductions were observed in energy intake, cholesterol, sodium, selenium, vitamin B12, and percent energy from protein. A short-duration online whole-food plant-based education program was feasible, well accepted, and associated with measurable improvements in dietary behaviors and perceptions. Larger studies incorporating clinical outcomes and longer follow-up are warranted to assess long-term effectiveness and sustainability.

Keywords

whole-food plant-based vegan online education remote delivery behavior change

“A high proportion of participants found the program’s mode, duration, and resources helpful in facilitating dietary change.”

Introduction

Conditions such as obesity, type 2 diabetes, and cardiovascular disease are closely linked to Western dietary patterns, which are typically high in energy-dense, nutrient-poor foods.^1–5 These conditions contribute to increased mortality and place a significant burden on healthcare systems.^6–8 Simultaneously, rising affluence urbanization, and changing dietary preferences have driven greater global consumption of animal and dairy products over the past five decades,^9,10 contributing to disproportionately high greenhouse gas emissions compared to plant-based alternatives.^2,6,11

Modeling suggests that widespread adoption of nutritionally adequate vegan diets could prevent up to 8.1 million deaths annually, reduce premature mortality by 22%, and save approximately $1000 billion in healthcare and related costs worldwide.^12,13 Flexitarian diets, predominantly plant-based with modest animal product intake could reduce dietary greenhouse gas emissions by 54% and improve land use efficiency by shifting agricultural production toward food for direct human consumption.^9,12

Within this broader shift toward sustainable eating, whole-food plant-based (WFPB) diets have gained attention for their potential to prevent and manage chronic disease. WFPB diets emphasize minimally processed plant foods such as fruits, vegetables, legumes, wholegrains, nuts, and seeds, while excluding animal products and limiting added fats, salt, and sugar.¹⁴ Evidence suggests that WFPB diets can improve key health markers including body weight, blood pressure, cholesterol, and HbA1c,^14–17 and may even reverse conditions like type 2 diabetes and cardiovascular disease when paired with structured education and clinical support.^15,18,19

Global and national organizations, including the EAT-Lancet Commission and the Australian National Committee for Nutrition, have called for a shift toward more plant-based dietary patterns.^6,20 However, a major barrier to adoption is a lack of knowledge and practical skills.²¹ In-person group education programs that incorporate behavioral change techniques have shown promise in improving diet quality and health outcomes,^14,22 but they are often costly, logistically complex, and inaccessible to individuals facing barriers such as transport, time constraints, or geographic isolation.^23–25

Online nutrition education programs offer a scalable, cost-effective alternative that can overcome many of these barriers.²³ They have demonstrated comparable effectiveness to in-person interventions in improving diet quality and chronic disease biomarkers.²⁶ However, it remains unclear whether this holds true for programs focused specifically on WFPB diets, which often require considerable behavioral change and unlearning of conventional food preparation practices.

Therefore, this pilot study aims to evaluate the feasibility and acceptability of a remotely delivered, 5-week WFPB education program, and to explore preliminary changes in participants’ knowledge, skills, perceptions, and dietary intake. The objectives of this study were to evaluate the feasibility of a remotely delivered whole-food plant-based education program through participant retention, assess its acceptability based on satisfaction with delivery mode, duration, and resources, and examine its impact on participants’ knowledge, skills, perceptions, and dietary intake.

Methods

This pilot study evaluated the feasibility, acceptability, and preliminary dietary impacts of a 5-week, remotely delivered, nutrition-focused lifestyle medicine education program centered on whole-food plant-based eating. The intervention consisted of weekly 90-minute nutrition education sessions held live via the video conferencing platform Zoom.²⁷ Additionally, five one-hour “Question and Answer” optional sessions were available to participants within the five weeks of the program. These sessions provided a space for participants to connect with one another and to ask questions directly to the researchers and dietitians. The Template for Intervention Description and Replication (TIDieR)²⁸ and the Checklist for Reporting Of Survey Studies (CROSS)²⁹ were used to guide study reporting. Study protocols were approved by The University of Wollongong Human Research Ethics Committee (Approval No. 2024/065).

This study recruited participants over 2-weeks through poster advertisements that were displayed at the University of Wollongong, in the local community, through social media platforms (Facebook and Instagram) and existing networks of the research team. To be eligible for the study, participants had to be 18-65 years of age, English speaking, and have access to a phone, tablet, laptop or computer with internet. Participants were excluded from the study if they disclosed currently or previously experiencing an eating disorder or if they were or thought they may have been pregnant. Eligibility for the study was assessed using an 11-item screening questionnaire designed to evaluate alignment with the study’s inclusion and exclusion criteria. Screening question responses were reviewed by two members of the research team, including a medical doctor. Eligible participants were then emailed a consent form, and upon completion, were formally enrolled in the study.

Educational sessions were informed by common enablers and barriers to adopting a plant-based diet, behavioral change techniques and elements of other successful online programs,^22,30,31 as outlined in the program plan in Table 1. The main themes across the five education sessions included ‘what is a WFPB diet, cooking a WFPB meal and simple swaps, health and the environmental benefits of the WFPB diet and overcoming common challenges. These sessions were structured around the four domains of food literacy: plan, manage, select, prepare and eat food to meet needs as described by Vidgen and Gallegos (2014).³²

Table 1.

Program Plan.

Objectives	Desired Behavioral Outcome	Session Components	Session
Build knowledge	Increased WFPB diet knowledge	• Introduction • Outline of WFPB dietary pattern: Including traffic light diet chart • Goal setting • Overview of resources	1
Grow skills	Grow skills to enable transition to greater dietary intake of WFPB foods	• How to create a WFPB meal • How to meal plan • Easy swaps • Creating a healthy environment • Label reading	2
Change perceptions	Change negative perceptions of the protein content, satiety, taste, health and environmental effects of WFPB diet	• Health benefits • Nutrient density • Fiber • Protein	3
		• Environmental benefits • Sustainable food systems • Animal welfare	4
		• Overcoming common challenges • Cheap and quick recipes • Eating out and socially	5

Education sessions were delivered by two student dietitians overseen by two accredited practicing dietitians (APD), one with a specialty in WFPB eating. Nutrition education and counseling were given to support participants in adopting a WFPB diet to include whole grains, legumes, vegetables, fruit and small quantities of nuts and seeds. In addition, participants were encouraged to minimize or exclude animal products such as meat, chicken, fish, milk or eggs and emphasized eating whole unrefined foods with minimal added salt, oil or sugar. A Traffic Light Diet Guide, adapted from previous studies¹⁴ was used to inform recommended dietary intake. Participants were encouraged to eat WFPB foods ad libitum. Resources such as a recipe e-book, shopping list, weekly menu plan, easy swaps, and a “Going plant-based” information sheet were emailed to participants weekly to aid the adoption of the diet and develop food literacy skills.

A baseline survey was conducted online via Qualtrics³³ to collect participant demographics, and baseline knowledge, skills and perceptions of a WFPB diet. After the education program another online survey was used to assess acceptability of the program and its mode, duration and resources as well as knowledge, skills and perceptions of a WFPB diet. Survey questions were adapted from previous studies^31,34 and used a 5-point-Likert scale (1 = strongly dislike, 2 = dislike, 3 = no opinion, 4 = like, 5 = strongly like) along with open text responses. Dietary data was collected via two self-reported 24-hour diet recalls, the first at baseline and the second after the education program using the Automated-Self-Administered 24-Hour-Australian (ASA24AU)³⁵ online dietary assessment tool to determine diet intake. The ASA24AU is an adapted version of the ASA24³⁶ developed using the Automated Multiple Pass Method (AMPM)³⁷ which has been validated against standardized interviewer-administered 24-hour recalls.³⁸

Data analysis was conducted using Jamovi, Version 2.3.42. A Shapiro-Wilk test was conducted on all data to assess normality of distribution. To determine feasibility of the program participant attendance was recorded. Retention rate was deemed to be successful if participants attended ≥3 out of 5 sessions as well as completing both the pre-and-post 24-hour diet recalls and surveys. The education program was considered feasible if there was an 80% retention rate, in alignment with other studies of a similar design.²² To assess acceptability of the program survey data was collected from Qualtrics and analyzed to calculate mean scores for the domains: program, mode, duration and resources. Mean scores for each domain ≥4 was used to establish the acceptability of the program. The impact of the program was evaluated by calculating the mean change in participant knowledge, skills and perceptions from baseline compared to after education using a Wilcoxon signed-rank test. The impact on diet intake was evaluated by collecting dietary data from the ASA24AU tool to calculate nutrient and food group intake at baseline and after education. A Wilcoxon signed-rank test was used to determine changes from baseline compared to after education.

Results

A total of 14 participants (male = 1, females = 13) expressed interest in the study, with 10 participants (females = 10) enrolling in the study, resulting in a 71.4% recruitment rate (Figure 1). One participant withdrew in week 4 of the program due to bereavement. The female cohort was aged between 20 and 61 and had either completed high school (n = 3), a bachelor’s (n = 5), or a master’s degree (n = 1), and had low to medium (n = 3) or medium to high (n = 6) gross household income. Two participants followed specific diets before entering the study, a flexitarian (minimal meat, eggs, dairy) and a pescatarian (includes fish, eggs, and dairy), with all other participants not following any specific diet. Participants were recruited through poster advertisement (1/9), social media (2/9) and existing networks of the research team (6/9) and were attending the sessions from various states within Australia including New South Wales (7/9), South Australia (1/9) and Tasmania (1/9).

Figure 1.

Flow of participants through the WFPB dietary education program study, including recruitment, eligibility, and retention outcomes

Feasibility

The program was found to be feasible with the benchmark retention rate of 80% being achieved. The average attendance rate for the education sessions was 75.6% with attendance as follows: Session 1, 77.8% (7/9), Session 2, 88.9% (8/9), Session 3, 66.7% (6/9), Session 4, 88.9% (8/9), Session 5, 55.6% (5/9). Attendance for the optional Q&A sessions were as follows: Session 1, 44.4% (4/9), Session 2, 22.2% (2/9), following this the Q&A sessions were terminated due to low attendance and disinterest from participants. The majority of participants who did not attend the sessions had pre-emptively communicated their absence due to other commitments including family, work and pre-planned holidays.

Acceptability

All domains assessed were found to be acceptable to participants with an average score of ≥4 as reported in Table 2. Participants rated the overall program with an average score of 4.07/5, the mode of delivery 4.37/5, duration 4.28/5 and resources used in the program 4.50/5. Free text responses on preferred duration of the program participants indicated 5-weeks (n = 3), 8-weeks (n = 3) and 10-weeks (n = 2) would be best. Open text responses also revealed that 78% (7/9) of participants thought one session per week would be best.

Table 2.

Summary of Responses Regarding Program Acceptability.

Question	Average Score (/5)	Participant Responses
Program		Strongly disagree	Disagree	No opinion	Agree	Strongly agree
The program I attended was of high quality	4.44	0	0	0	5	4
I would recommend this program to a friend if they were interested in adopting a WFPBD	4.66	0	0	0	3	6
It is clear to me how the WFPBD education program will help me adopt a WFPBD	4.44	0	0	0	5	4
I am satisfied with the amount of personalized feedback and advice I received with the program	3.88	0	1	2	3	3
I felt supported by the research team during the program	4.44	0	0	1	3	5
		Very Unbeneficial	Unbeneficial	No opinion	Beneficial	Very beneficial
How beneficial did you find the content of session 1, looking at what a WFPBD is?	3.55	0	2	1	5	1
How beneficial did you find the content of session 2, looking at meal planning, easy swaps and label reading?	4	0	1	1	4	3
How beneficial did you find the content of session 3, looking at health benefits, variety and diversity of a WFPBD?	3.77	0	1	1	6	1
How beneficial did you find the content of session 4, looking at environmental benefits and animal welfare?	3.22	1	2	1	4	1
How beneficial did you find the content of session 5, looking at overcoming common challenges of a WFPBD?	3.55	0	2	1	5	1
How beneficial did you find the content of the hot topics (energy density, protein, omega 3, micronutrients of concern)?	4.11	0	1	0	5	3
		Completely unacceptable	Unacceptable	No opinion	Acceptable	Completely acceptable
How acceptable was the WFPED education program	4.77	0	0	0	2	7
Mode		Strongly dislike	Dislike	No opinion	Like	Strongly like
How did you find the experience of meeting online via the Zoom platform?	4.33	0	0	0	6	3
		Very uncomfortable	Uncomfortable	No opinion	Comfortable	Very comfortable
How comfortable did you feel attending online group nutrition education sessions?	4.33	0	0	1	4	4
		Very Unbeneficial	Unbeneficial	No opinion	Beneficial	Very beneficial
Did you find the discussions and interactions beneficial to your experience in the program?	4.44	0	0	0	5	4
Duration		Strongly dislike	Dislike	No opinion	Like	Strongly like
What are your thoughts on the duration (1.5 hours) of the education sessions?	4.33	0	0	1	4	4
What are your thoughts on the duration (5 weeks) of the program	4.22	0	0	0	7	2
Resources
What are your thoughts on the resources (recipes, menu plans, diagrams & suggested documentaries) provided in the program?	4.77	0	0	0	2	7
How much do you agree with the following statements:		Strongly disagree	Disagree	No opinion	Agree	Strongly agree
The resources (recipes, menu plans, diagrams & suggested documentaries) provided help you adopt the WFPBD?	4.22	0	1	0	4	4
Barriers
Did you find it hard to attend both the Tuesday and Thursday sessions	3.88	0	1	1	5	2
Engaging in the WFPBD education program interfered with my other priorities	2.22	2	4	2	1	0
		No effort at all	A little effort	No opinion	A lot of effort	Huge effort
How much effort did it take to attend the weekly education sessions	2.44	2	4	0	3	0

Preliminary Outcomes

The program was associated with improvements in participants knowledge of a WFPB diet from baseline to after education (Table 3). Participants demonstrated greater knowledge of the muscle-related aspects of a WFPB diet, reporting reduced agreement with the belief that they would lose muscle, reduced need for further information, and increased agreement that such a diet can help build or maintain muscle. Other knowledge items, including iron bioavailability, energy and protein adequacy, fiber, vitamins, minerals, and weight management, showed positive shifts but these were not statistically significant. Regarding skills, participants reported reduced uncertainty about preparing plant-based meals, which was statistically supported. Smaller, non-significant improvements were also observed in confidence related to cooking with WFPB foods and finding plant-based options when eating out or shopping at grocery stores (Table 3). However, participants indicated that it would be beneficial to receive more education regarding menu planning (n = 4), overcoming challenges (n = 3) and label reading (n = 2).

Table 3.

Impact of Program on Participant Knowledge, Skills and Perceptions of a WFPB Diet.

Question	Baseline (0 weeks)	After Education (5 weeks)	ChangeMean	95% CILower, Upper
Knowledge
There is not enough iron in plant foods	3 (3-4)	2 (2-2)	−1.00	−2.29, 0.07
I wouldn’t get enough energy or strength	2 (2-4)	2 (1-2)	−1.44	−2.09, 0.09
There is not enough protein in plant foods	2 (2-3)	2 (1-2)	−1.00	−1.53, 0.19
I would lose muscle	2 (2-3)	2 (1-2)	−1.00	−1.12, −0.44*
I would decrease my saturated fat intake	4 (4-5)	4 (4-5)	0.00	−0.38, 0.38
I would eat more fiber	4 (4-4)	4 (4-5)	1.00	−0.21, 0.88
I would get lots of vitamins and minerals	4 (4-4)	4 (4-5)	1.00	−0.05, 0.72
It would help control my weight	4 (4-5)	4 (4-5)	1.00	−0.29, 0.74
Helps build or maintain muscle	3 (3-3)	4 (3-5)	1.50	0.14, 1.42*
I need more information about plant diets	4 (4-5)	2 (2-3)	−2.00	−2.70, −1.08*
Skills
I do not feel confident that I can find plant-based foods when I eat out	3 (2-4)	3 (2-4)	−0.50	−1.10, 0.44
I am not confident that I can buy plant-based foods at the grocery store	2 (2-4)	2 (2-2)	−2.00	−1.23, 0.12
I don’t know how to prepare plant meals	4 (4-4)	2 (2-2)	−2.00	−2.33, −1.00*
I am confident I can cook meals using WFPB foods	4 (4-4)	4 (4-5)	1.00	−0.00, 1.11
Perceived barriers
It would not be tasty enough	2 (2-4)	2 (2-2)	−1.00	−1.53, −0.03*
It would not be filling enough	2 (2-2)	2 (2-2)	−0.50	−1.31, 0.42
I am uncomfortable ordering “special meals”	2 (2-3)	3 (2-4)	1.00	−0.33, 1.00
I don’t want to ask my friends/family to cook a plant-based meal when I visit	4 (4-4)	4 (4-4)	−1.00	−0.74, 0.29
I am concerned I would have to give up my food heritage/culture	2 (2-3)	2 (2-4)	1.00	−1.00, 1.42
It is inconvenient	4 (4-4)	4 (3-4)	−1.00	−1.58, 0.47
There is not enough choice when I eat out	4 (2-4)	4 (2-4)	0.20	−0.44, 1.10
It takes too long to prepare WFPB meals	4 (3-4)	3 (2-3)	−1.00	−1.44, 0.10
It would be too expensive	2 (2-4)	4 (2-3)	−1.50	−1.00, 0.33
I would need to eat such a large quantity of plant foods	3 (3-4)	2 (2-3)	−1.00	−1.75, 0.42
Perceived benefits
I can find good options to eat at restaurants	3 (2-3)	2 (4-5)	−1.00	−0.33, −0.00*
Generally, eating a WFPB diet helps me have a better quality of life	4 (3-4)	4 (4-5)	1.00	0.27, 1.29*
I have plenty of energy on a WFPBD	3 (3-4)	4 (4-5)	1.50	0.14, 1.42*
Plant-based foods increase efficiency of food production	3 (3-4)	4 (4-4)	1.00	0.28, 1.05*
Eating a WFPBD helps the environment	4 (4-4)	4 (4-5)	−0.36	−0.82, 0.60

Note. All questions are assessed on 5-point Likert scale, with 1 = strongly disagree, 2 = disagree, 3 = not sure, 4 = agree, 5 = strongly agree. Baseline and after education displayed as median (25th and 75th percentile) and change calculated used a Wilcoxon signed-rank test and expressed as mean (95% confidence intervals). * Indicates significance (P < 0.05) between baseline and after education.

Participant perceptions regarding taste, satiety, convenience, preparation time, and cost of WFPB eating all improved after education compared to baseline. Key barriers that remained a concern after education included giving up culture/heritage and discomfort ordering “special meals” when eating out. Open text responses highlighted specific barriers to adopting the WFPB diet which included accommodating family or partner preferences (n = 5) and other commitments making it hard to have time to prepare WFPB meals (n = 4). Participants also reported a shift in their perceived benefits of the WFPB diet, describing it as a more efficient way of producing food and one that could improve quality of life.

From baseline to completion of the program participants significantly reduced their consumption of energy (−2150 kJ; 95% CI −4050 to −105), cholesterol (−338 mg; 95% CI −529 to −81.3), sodium (−551 mg; 95% CI −1510 to −0.89), selenium (−52.7 μg; 95% CI −80.1 to −26.0), vitamin B12 (−1.57 μg; 95% CI −3.40 to −0.07), protein (−44.5 g; 95% CI −67.2 to −22.3) and total energy from protein (−3.82%; 95% CI -7.42 to −0.30) as outlined in Table 4.

Table 4.

Change in Nutrient Intake From Baseline to Completion of Education.

Nutrient Component	Baseline (0 weeks)	After Education (5 weeks)	ChangeMean (95% CI)
Energy (kJ)	9670 (7230-10170)	6710 (5610-7740)	−2150 (−4050 to −105)*
% Energy carbohydrate	32.7 (30.8-46.0)	43.6 (37.0-53.2)	6.39 (−3.18 to 18.5)
% Energy protein	23.2 (18.0-24.5)	17.0 (16.0-17.7)	−3.82 (−7.42 to −0.30)*
% Energy fat	37.8 (36.7-41.2)	36.1 (27.3-41.6)	−3.26 (−13.1 to 6.75)
Carbohydrates (g)	189 (169-228)	175 (127-206)	−15.69 (−112 to 100)
Protein (g)	107 (84.1-142)	72.7 (60.2-84.1)	−44.5 (−67.2 to −22.3)*
Total fat (g)	85.5 (71.6-106)	56.4 (48.3-77.3)	−28.0 (−62.8 to 2.17)
Saturated (g)	34.4 (25.2-37.4)	15.3 (9.58-30.1)	−10.3 (−23.5 to 2.42)
Monounsaturated (g)	39.8 (28.7-43.9)	28.7 (24.0-32.8)	−8.59 (−37.1 to 3.63)
Polyunsaturated (g)	15.4 (8.90-20.0)	9.97 (8.29-11.0)	−4.68 (−11.8 to 2.39)
ALA (g)	1.54 (0.99-1.87)	0.77 (0.64-1.23)	−0.59 (−2.02 to 0.14)
EPA (mg)	13.3 (6.73-25.7)	3.66 (1.60-45.8)	−2.16 (−178 to 55.1)
DPA (mg)	48.1 (36.0-60.8)	23.6 (12.1-33.3)	−18.89 (−105 to 14.9)
DHA (mg)	57.3 (27.3-78.3)	6.48 (3.95-19.4)	−28.5 (−232 to 128)
Cholesterol (mg)	440 (296-645)	136 (51.9-191)	−338 (−529 to −81.3)*
Alcohol (g)	0.00 (0.00-0.06)	0.00 (0.00-0.00)	−7.23 (−16.3 to 0.12)
Caffeine (mg)	119 (107-187)	108 (5.55-114)	5.51 (−182 to 125)
Fiber (g)	35.0 (17.4-45.3)	32.4 (23.5-40.1)	−0.39 (−16.6 to 18.1)
Calcium (mg)	793 (697-929)	995 (741-1237)	86.2 (−296 to 359)
Iron (mg)	17.1 (9.54-22.0)	11.0 (334-569)	−3.97 (−12.0 to 7.25)
Magnesium (mg)	478 (334-569)	433 (300-540)	−29.3 (−178 to 132)
Phosphorus (mg)	1600 (1430-1980)	1230 (1160-1460)	−435 (−901 to 27.2)
Potassium (mg)	3350 (2980-4040)	3040 (2930-4170)	−134 (−1750 to 1360)
Sodium (mg)	1940 (1620-2490)	1610 (1510-1860)	−551 (−1510 to −0.89)*
Zinc (mg)	13.4 (9.68-15.9)	9.74 (6.54-12.3)	−2.39 (−10.7 to 0.69)
Selenium (μg)	100 (76.2-128)	47.2 (42.5-56.6)	−52.7 (−80.1 to −26.0)*
Vitamin C (mg)	112 (65.3-190)	141 (79.1-306)	59.6 (−79.4 to 230)
Thiamine (mg)	2.06 (1.31-2.34)	0.85 (0.72-1.28)	−0.80 (−2.05 to 0.06)
Riboflavin (mg)	2.23 (1.89-3.10)	1.97 (1.24-2.10)	−0.73 (−1.57 to 0.09)
Niacin (mg)	31.6 (20.1-35.1)	17.4 (15.2-19.0)	−12.2 (−23.2 to −2.96)*
Vitamin B6 (mg)	1.68 (1.31-2.26)	1.38 (0.10-1.70)	−0.23 (−0.89 to 0.31)
Folate (μg)	506 (410-709)	382 (314-454)	−148 (−329 to 43.6)
Vitamin B12 (μg)	4.06 (3.67-4.44)	2.78 (2.14-4.44)	−1.57 (−3.40 to −0.07)*

Note. Data at baseline and after education expressed as median (25th-75th Percentile) and change calculated using the Wilcoxon signed-rank test (95% Confidence Intervals) due to data being primarily non-parametric. * Indicates significance (P < 0.05) between baseline and after education. Alpha-Linolenic acid (ALA), Eicosapentaenoic acid (EPA), Docosapentaenoic acid (DPA), Docosahexaenoic acid (DHA).

From baseline compared to after education participants increased in median servings of vegetables (+1.93; 95% CI −2.54 to 6.36), fruit (+0.89; 95%CI −0.10 to 1.75) and wholegrains (+0.64; 95% CI −2.56 to 2.22) when compared to baseline (Table 5). Additionally, participants reduced their intake of refined grains (−1.03; 95% CI −3.41 to 1.23), poultry (−1.52; 95%CI -2.77 to −0.31), eggs (−0.32; 95% CI −0.67 to −0.05) and sugars and syrups (−10.39; 95% CI −39.9 to 6.32). Of these changes, only the reductions in poultry and eggs were statistically significant. Food group serving sizes reported in Table 5 are comparable to the Australian Guide to Healthy Eating³⁹ with the exception of Sugars and Syrups being 1g per serving.

Table 5.

Change in food group consumption from baseline to completion of education

Component (serves/day)	Baseline (0 weeks)	After Education (5 weeks)	ChangeMean (95% CI)
Vegetables	4.38 (2.57-7.18)	6.36 (4.90-6.56)	1.93 (−2.54 to 6.36)
Fruit	1.09 (0.17-1.56)	2.08 (1.22-2.50)	0.89 (−0.10 to 1.75)
Wholegrains	1.12 (0.82-2.99)	2.01 (0.54-3.21)	0.64 (−2.56 to 2.22)
Refined grains	3.07 (1.32-4.82)	1.71 (1.34-3.14)	−1.03 (−3.41 to 1.23)
Nuts & seeds	0.37 (0.08-1.00)	0.60 (0.13-1.03)	0.02 (−2.02 to 1.08)
Legumes	0.00 (0.00-0.39)	0.54 (0.00-1.52)	0.07 (−1.29 to 3.82)
Dairy foods	1.19 (0.91-2.00)	1.60 (0.18-2.55)	−0.01 (−0.75 to 0.83)
Red meat	0.02 (0.00-2.43)	0.32 (0.00-1.56)	−0.26 (−2.06 to 0.54)
Poultry	0.00 (0.00-1.56)	0.00 (0.00-0.00)	−1.52 (−2.77 to −0.31)*
Fish & seafood	0.00 (0.00-0.00)	0.00 (0.00-0.00)	0.16 (−0.54 to 0.95)
Eggs	0.32 (0.05-0.67)	0.04 (0.00-0.06)	−0.32 (−0.67 to −0.05)*
Sugars & syrups	20.7 (9.36-24.7)	8.20 (5.09-18.9)	−10.39 (−39.9 to 6.32)
Animal fats^a	0.18 (0.03-0.40)	0.08 (0.03-0.47)	−0.01 (−0.28 to 1.05)
Saturated plant fats^a	0.00 (0.00-0.00)	0.00 (0.00-0.00)	0.00 (−0.00 to 0.00)
Unsaturated plant fats^a	1.86 (0.98-3.11)	1.61 (1.24-2.61)	0.09 (−3.46 to 1.76)

Note. Data at baseline and after education expressed as median (25th-75th percentile) and change calculated using the Wilcoxon signed-rank test (95% confidence intervals) due to data being primarily non-parametric. * indicates significance (P < 0.05) between baseline and after education.

^aDerived from spreads and oils.

Discussion

This pilot study suggests that a remotely delivered WFPB education program is feasible and acceptable and may support changes in dietary behaviors. The program achieved a high retention rate of 90%, with average attendance at 75.6% across the 5 weeks. A high proportion of participants found the program’s mode, duration, and resources helpful in facilitating dietary change. Program facilitators reported confidence in delivering the sessions and found the Zoom platform suitable for online delivery. Following the program, participants demonstrated improved knowledge, skills, and perceptions related to WFPB eating. These changes were reflected in modest, though not statistically significant, increases in vegetable, fruit, and wholegrain consumption, alongside reductions in refined grains and added sugars. This increased consumption of whole-foods, with no kilojoule restriction, was associated with a decreased intake of total energy, protein, cholesterol, iron, B12 and sodium. Despite participants already consuming somewhat adequate diets, including relatively high fiber intake at baseline, the program still resulted in improvements to dietary intake, suggesting that individuals following more typical Western dietary patterns may experience even greater benefits.

Feasibility

The study recruited participants from three Australian states, demonstrating the broad reach of online delivery. A 71.4% recruitment rate was achieved, notably higher than similar studies,^22,40 which reported rates between 19.4% and 27%. This may reflect convenience sampling targeting individuals already interested in WFPB diets. The 80% retention rate aligns with benchmarks from comparable studies, supporting the program’s feasibility.^22,40 Average attendance across five sessions was 75.6%, slightly lower than the 79% reported in the in-person WFPB program by Wright et al. (2017),¹⁴ potentially due to differing participant motivations. Chwyl et al.²² and Lopez et al.⁴¹ also reported higher retention in longer online programs, reinforcing the value of structured support. In contrast, attendance at optional Q&A sessions in this study declined after week two, with only 22% attending later sessions. Participants reported difficulty committing to both components, suggesting that future programs should streamline delivery to a single weekly session of 60-90 minutes to reduce burden and improve feasibility.

Acceptability

This online WFPB education program met the pre-specified benchmark for acceptability, with average participant ratings exceeding four out of five across all evaluated domains: program content (4.07), mode of delivery (4.37), session duration (4.28), and supporting resources (4.50). Participants frequently cited the group discussions, personalized support, and practical resources as the most helpful aspects in facilitating dietary change. These findings align with previous WFPB-focused studies such as Chwyl et al. (2022)²² and Bradley et al. (2019)⁴² both of which reported high acceptability ratings and emphasized the role of behavioral strategies and tailored support in participant engagement. A systematic review by Murimi et al. (2019)⁴³ further supports this, identifying personalized feedback and social support as key contributors to the success of online nutrition interventions. In the present study, although sessions one, three, four and five received slightly lower average ratings than the overall program score, this may reflect variability in topic relevance or delivery and suggests areas for targeted content refinement. Notably, 61 percent of participants reported that it took little to no effort to attend the weekly sessions, suggesting that the online format was compatible with a range of personal schedules and, when paired with interactive and practical elements, can support the successful delivery of real-time, group-based WFPB education.

Impact

Murimi et al. (2019)⁴³ reported in their systematic review that online nutrition education programs are more effective when they focus on specific health behaviors rather than general health information. Consistent with this, the current program aimed to promote knowledge, skills and positive perceptions specifically within the context of a WFPB dietary pattern. Participants demonstrated improvements across all three domains, supporting the program’s potential to foster self-efficacy, improve food literacy and promote long-term dietary adherence. This may be attributed to the program’s intentional alignment of behavioral objectives with educational content, incorporating strategies such as weekly challenges, goal setting, group discussions and interactive polls, which have been shown to support behavior change in WFPB and other dietary interventions.¹⁴

By the end of the program, participants had improved their diet quality, reporting increased consumption of vegetables, fruits, and wholegrains, alongside reduced intake of refined grains and added sugars. These dietary shifts, achieved without any prescribed energy restriction, were associated with reductions in energy, dietary cholesterol, and sodium intake. Participants also decreased their consumption of animal-derived protein sources such as poultry and eggs; however, this was not accompanied by a substantial increase in high-quality plant proteins such as legumes. While the overall dietary changes align with patterns associated with improvements in blood pressure, cholesterol, and HbA1c^44–46 the present study was not designed to assess clinical outcomes. Notably, protein and vitamin B12 intake were also reduced following the intervention. Although median protein intake decreased from 107 g at baseline to 72.7 g after education, this level remained above the Australian and New Zealand Recommended Dietary Intake for adult women aged 19 to 70 years of 46 g/day and for women aged over 70 years of 57 g/day, although individual adequacy cannot be inferred from group level data alone.⁴⁷ Plant-based diets can provide sufficient protein from a range of foods, including legumes, grains, nuts, seeds, and other plant foods,⁴⁷ however, the lack of increased legume intake in this cohort suggests a potential area for improvement in translating plant-based dietary guidance into practice. In contrast, vitamin B12 remains a more important nutritional consideration, as it cannot be reliably obtained from unfortified plant foods,⁴⁸ highlighting the need for future iterations of the program to place greater emphasis on plant protein sources, fortified foods, and appropriate supplementation guidance.

These findings are broadly consistent with previous WFPB interventions that have demonstrated improvements in clinical and dietary outcomes. An 8-week online WFPB intervention⁴¹ similarly reported improvements in diet quality, along with clinically significant reductions in cholesterol and improvements in body composition. The BROAD Study,¹⁴ which delivered an in-person WFPB program, also reported significant improvements in clinical markers, including BMI, total cholesterol and LDL-cholesterol. However, the magnitude of change was greater in the in-person program, with mean reductions in BMI and LDL-cholesterol of 4.3 kg/m² and 0.9 mmol/L, respectively, compared to 0.4 kg/m² and 0.67 mmol/L in the online study by Lopez et al.⁴¹ These differences may reflect the added impact of face-to-face interaction, including structured social accountability, peer connection and greater intensity of support. The current program sought to replicate these attributes within an online format by incorporating real-time group discussions, weekly goal setting and facilitated engagement throughout the sessions. These elements were intended to foster a sense of shared accountability and community, helping to sustain motivation and reinforce behavior change, even in a virtual setting.

These findings suggest that well-designed WFPB education programs may have potential relevance for clinical and community settings, although further research is required. The current program, which includes a complete package of resources and facilitator guidance, could be implemented in clinical or community settings to support meaningful dietary change. More broadly, WFPB dietary interventions have the potential to contribute to public health cost savings. For example, one Australian modeling study estimated that if just five percent of the population met the daily target of 48 grams of wholegrains, healthcare savings of $37.5 million and $35.9 million could be achieved in relation to type 2 diabetes and cardiovascular disease, respectively.⁴⁹ In this context, a cost-effective, scalable and acceptable online WFPB education program may offer value as a preventative strategy that aligns with both health and sustainability goals.

To build on these findings, future research should extend beyond pilot testing to include larger, fully powered studies that collect anthropometric and biochemical measures alongside behavioral outcomes. Online programs such as that by Lopez et al. (2023)⁴¹ have already demonstrated the feasibility of integrating clinical endpoints into remotely delivered nutrition education. Including such measures in future iterations of this program would help determine its effectiveness not only in promoting dietary change, but also in improving markers of metabolic and cardiovascular health. Future studies should also include measures of cost-effectiveness. If proven effective, this model could be scaled nationally to reach a broad range of individuals, including those in rural and remote communities who may face barriers to accessing in-person services.

Whilst this study was found to be feasible and acceptable, with preliminary evidence of change, it was not without limitations. The small sample size (n = 10) limits the generalizability of findings to the broader Australian population. The study cohort also demonstrated a gender imbalance, with all participants identifying as female. This may partially explain the high levels of engagement and willingness to adopt a WFPB diet, as previous research has shown that females are more likely than males to adopt vegetarian or plant-based dietary patterns.⁵⁰ As a result, the study provides limited insight into how male participants may respond to this type of program. Recruitment was conducted via convenience sampling, which may have contributed to the highly motivated nature of the cohort. In addition, dietary data were self-reported, which introduces potential for recall and reporting bias, a known limitation of all dietary assessment methods.⁵¹ Importantly, the absence of a control group limits the ability to attribute observed changes directly to the intervention, and results may reflect reporting bias, regression to the mean, or participant motivation. However, a strength of the study was its structured program design, which was informed by behavior change theory and delivered in real-time, allowing for interactive learning and participant engagement. The use of a validated dietary assessment tool to evaluate changes in intake also strengthens the reliability of the dietary data collected.

This pilot study suggests that online nutrition education may effectively support the adoption of a whole-food plant-based diet by improving participants’ knowledge, skills and perceptions. These changes were associated with measurable improvements in diet quality, including increased intake of whole-plant foods and reduced intake of energy, saturated fat, cholesterol and sodium. Overall, the findings indicate that this model has considerable promise as a practical and accessible approach to supporting dietary change, although further research is needed to evaluate its cost-effectiveness, scalability and public health impact. Building on these findings, future studies should recruit more diverse participants, particularly individuals with chronic conditions such as obesity, type 2 diabetes and cardiovascular disease. Program refinements may include shorter weekly sessions delivered over a longer timeframe, the addition of virtual cooking demonstrations, and enhanced follow-up at three and 12 months to assess sustainability of dietary change. Incorporating anthropometric and biochemical markers alongside dietary outcomes will be important to evaluate the program’s clinical effectiveness.

Footnotes

Acknowledgments

We thank all participants for their time and contribution to this study. We also acknowledge and thank Doctors for Nutrition for providing their online resources, which supported the study’s development and delivery.

ORCID iD

Joel C. Craddock

Ethical Considerations

This study was approved by The University of Wollongong Human Research Ethics Committee (Approval No. 2024/065) on the 7th May 2024.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Declaration of Conflicting Interests

The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: LW serves on the board of Doctors for Nutrition. The organization had no involvement in the study beyond providing publicly available online resources.

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