Lipidemia Clinical Trial
Official title:
Impact of Reducing Dietary Intake of Red and Processed Meat Intake on Fasting Lipemia in Healthy Participants
Excessive meat consumption, particularly of red and processed meat, is associated with increased risk of developing a range of chronic diseases. Meat production also significantly contributes to the production of global greenhouse gasses (GHG). Given the predicted global increase in the human population, coupled with the rise in demand for meat within emerging economies, it has been suggested that strategies to alter dietary patterns and reduce meat intake should be devised. With the provision of appropriate non- or reduced-meat alternatives, this study aims to investigate whether free living subjects can significantly reduce their meat intake, and whether such dietary changes positively impact on a range of health measures
In UK adults, meat provides approximately 40% of the average daily protein intake and makes a
significant contribution to intake of thiamin, niacin, vitamin B12, iron, zinc, potassium,
and phosphorus. However, excessive consumption, particularly of red and processed meat, is
associated with increased risk of developing a range of chronic diseases, including
cardiovascular disease (CVD), obesity, type 2 diabetes and some cancers. Meat production
significantly contributes to the production of greenhouse gasses (GHG) and hence global
warming. Given the predicted global increase in the human population, coupled with the rise
in demand for meat within emerging economies, it has been suggested that concerted efforts
should be made to alter dietary patterns and reduce meat intake. Moreover, a number of
reports have suggested that replacing meat with non-meat protein-rich products has health
benefits. Such products tend to be inherently lower in total and saturated fat and, higher in
fibre and as such, could also be cardioprotective.
The aim of this trial will be to investigate whether, with appropriate non/reduced-meat
alternatives and motivational support, free living subjects can significantly reduce their
meat intake and whether such dietary changes positively impact on a range of cardiovascular
risk factors.
Trial design; A non-randomised, single group study design, with an initial control period
will be used.
Participants; Forty healthy men and women will be recruited from the general population of
Nottinghamshire, UK. All participants will attend the David Greenfield Human Physiology Unit
(Queen's Medical Centre, Nottingham, UK) for an initial medical screening visit to confirm
health status. In addition, blood pressure (BP) will be measured at the left upper arm (after
lying semi-supine for 5min) using automated oscillometry, and body mass index (BMI) will be
calculated from measured height and weight. If participants are suitable to take part with
regards to their health questionnaire and BMI measures, a venous blood sample will then be
taken to assess full blood count, urea, and electrolytes. Those taking lipid-lowering
medication, or who report using nutritional strategies to lower their cholesterol, will be
excluded. Participants will be accepted onto the trial if they report habitual consumption of
4-5 portions of red and/or processed meat per week (with 3-4 of these being consumed as main
meals), they do not have food allergies related to soya or mycoprotein, and do not
demonstrate any clinically significant abnormalities on screening.
Study Protocol; After recruitment, participants will be asked to record all food intake
(including snacks and drinks) in a diet diary, for 4 days (3x week or work days, and 1x
weekend or rest day) prior to assessment visit 1, for baseline assessment of macronutrient
and energy intake. Individuals will be asked to complete further 4-day diet diaries in the
week before assessment visits 2,3 and 4 (weeks 4, 10, and 16), to assess any changes in
macronutrient or energy intake and meat consumption which may have occurred as a consequence
of the intervention. Household measures will be used to estimate portion size, and diaries
will be analysed using a food composition database. To calculate habitual diet composition, a
mean daily intake will obtained from all 4 days of each recording period, and these data will
be combined to produce group means.
Assessment visits will take place in the morning after the individual has fasted from
midnight the night before. Initially, measurement of body mass will be made to the nearest
0.1kg using a Seca 882 Digital Scale, and waist and hip circumference will be assessed (with
the participant standing) mid-way between the lowest rib and the iliac crest, and at the
greater trochanters, respectively. Participants will then be asked to rest, semi-supine, on a
couch for >5min before having their resting BP measured, and estimation of body composition
made using bioelectrical impedance. A 5ml fasting blood sample will be taken for
determination of serum insulin, total cholesterol, high density lipoprotein cholesterol
(HDL), low density lipoprotein cholesterol (LDL), triacyl glycerides (TAG) and whole blood
glucose. In a subset of the cohort (n=26, 13 Male:13 Female), flow mediated dilatation (FMD)
will also be measured on the laboratory visits when fasted, after resting semi-supine for 1
and 2 hours.
Intervention; After visit 1 (week 0) assessment, participants will be asked not to make any
changes to their lifestyle and to continue their habitual diet until visit 2 (week 4) when a
second assessment will be made ('control' period). The 12 week 'intervention' period will
begin on the day after the second study visit. Participants will be given information
regarding how meat intake can safely be reduced in their diet, including a recipe book
containing ideas for meals using meat analogues and other protein sources. A range of frozen
meat-free (soya or mycoprotein 'mince', mycoprotein sausages, meatballs and 'steak strips')
and reduced meat products (pork sausages, beef meatballs, beef mince and beef burgers made
with 50% meat and 50% soya or mycoprotein) are available for the participants to use to aid
this reduction in red meat intake. In addition, a range of dried beans (red kidney, haricot,
black turtle), pulses (chick peas, green and red lentils) and grains (quinoa) will also be
offered. Weekly telephone contact with the study participants will be maintained over the
intervention period to improve compliance, to identify any problems and to arrange further
food deliveries.
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