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      A Modern Flexitarian Dietary Intervention Incorporating Web-Based Nutrition Education in Healthy Young Adults: Protocol for a Randomized Controlled Trial

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          Abstract

          Background

          The trend of flexitarian eating patterns is on the rise, with young adults among the biggest adopters claiming health and environmental reasons to reduce red meat intake. Nutrient-dense meat and animal products are often the lynchpin of these diets, even when consumed only occasionally and in moderate amounts. Red meat provides forms and concentrations of essential proteins, lipids, and micronutrients that are scarce in exclusively vegetarian regimens.

          Objective

          The aim of this study is to consider the effects of moderate consumption of lean red meat as part of an otherwise vegetarian balanced diet and its impact on biomarkers of sustained health and well-being.

          Methods

          A cohort of healthy, young (20-34 years old, n=80) male and female participants will take part in a 2-arm, parallel randomized controlled trial (RCT) for a duration of 12 weeks, with a 3-month posttrial follow-up. The trial will commence with a 2-week assessment period followed by allocation to the intervention arms. The intervention will include the consumption of red meat or meat alternatives 3 times per week for 10 weeks. Blood samples of the participants will be collected to measure changes in erythrocyte fatty acid distribution, circulating amino acids, neurotransmitters, markers of mineral status, and inflammatory markers. Questionnaires to assess well-being and mental health will be undertaken every 2 weeks. Body composition, physical function, and blood parameters will be assessed at allocation (t 0), week 5 into the intervention (t 5), and post intervention (t 10).

          Results

          The protocol has been developed using the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) checklist and the outcomes will be reported in accordance with the CONSORT (Consolidated Standards of Reporting Trials) guidelines. The trial was approved by the New Zealand Ministry of Health’s Health and Disability Ethics Committees (protocol 20/STH/157). The results of this study will be communicated via publication.

          Conclusions

          To our knowledge, this is the first RCT investigating the overarching health consequences of consuming pasture-fed red meat or no meat as part of a healthy diet.

          Trial Registration

          ClinicalTrials.gov NCT04869163; https://clinicaltrials.gov/ct2/show/NCT04869163

          International Registered Report Identifier (IRRID)

          PRR1-10.2196/30909

          Related collections

          Most cited references43

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          The theory of planned behavior

          Icek Ajzen (1991)
          Organizational Behavior and Human Decision Processes, 50(2), 179-211
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            SPIRIT 2013 statement: defining standard protocol items for clinical trials.

            The protocol of a clinical trial serves as the foundation for study planning, conduct, reporting, and appraisal. However, trial protocols and existing protocol guidelines vary greatly in content and quality. This article describes the systematic development and scope of SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) 2013, a guideline for the minimum content of a clinical trial protocol.The 33-item SPIRIT checklist applies to protocols for all clinical trials and focuses on content rather than format. The checklist recommends a full description of what is planned; it does not prescribe how to design or conduct a trial. By providing guidance for key content, the SPIRIT recommendations aim to facilitate the drafting of high-quality protocols. Adherence to SPIRIT would also enhance the transparency and completeness of trial protocols for the benefit of investigators, trial participants, patients, sponsors, funders, research ethics committees or institutional review boards, peer reviewers, journals, trial registries, policymakers, regulators, and other key stakeholders.
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              The WHO-5 Well-Being Index: a systematic review of the literature.

              The 5-item World Health Organization Well-Being Index (WHO-5) is among the most widely used questionnaires assessing subjective psychological well-being. Since its first publication in 1998, the WHO-5 has been translated into more than 30 languages and has been used in research studies all over the world. We now provide a systematic review of the literature on the WHO-5.
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                Author and article information

                Contributors
                Journal
                JMIR Res Protoc
                JMIR Res Protoc
                ResProt
                JMIR Research Protocols
                JMIR Publications (Toronto, Canada )
                1929-0748
                December 2021
                21 December 2021
                : 10
                : 12
                : e30909
                Affiliations
                [1 ] Discipline of Nutrition Faculty of Medical and Health Science The University of Auckland Auckland New Zealand
                [2 ] AgResearch Ltd Smart Foods Innovation Centre of Excellence Te Ohu Rangahau Kai Palmerston North New Zealand
                [3 ] Department of Psychology University of Otago Dunedin New Zealand
                [4 ] Agency for Science, Technology and Research Singapore Institute for Clinical Sciences Singapore Singapore
                Author notes
                Corresponding Author: Andrea Braakhuis a.braakhuis@ 123456auckland.ac.nz
                Author information
                https://orcid.org/0000-0002-6055-0595
                https://orcid.org/0000-0002-1280-5725
                https://orcid.org/0000-0002-2249-844X
                https://orcid.org/0000-0003-3482-5513
                https://orcid.org/0000-0003-1520-5407
                https://orcid.org/0000-0002-7939-1790
                https://orcid.org/0000-0002-6323-9217
                https://orcid.org/0000-0003-0952-5260
                https://orcid.org/0000-0002-0144-5816
                Article
                v10i12e30909
                10.2196/30909
                8734916
                34931994
                5d41ac55-fc2e-46e6-85e0-ef1c3681af63
                ©Andrea Braakhuis, Nicola Gillies, Anna Worthington, Scott Knowles, Tamlin Conner, Rajshri Roy, Toan Pham, Emma Bermingham, David Cameron-Smith. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 21.12.2021.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on https://www.researchprotocols.org, as well as this copyright and license information must be included.

                History
                : 3 June 2021
                : 30 July 2021
                : 9 September 2021
                : 24 September 2021
                Categories
                Protocol
                Protocol

                protein,meat,vegetarian,eating patterns,diet,nutrition,dietary restrictions,biomarkers,health,well-being,macronutrients,micronutrients

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