He Rourou Whai Painga, an Aotearoa New Zealand dietary pattern for metabolic health and whānau wellbeing: protocol for a randomized controlled trial

Fiona E Lithander; Amber Parry Strong; Andrea Braakhuis; Anna Worthington; Meika Foster; Anna Rolleston; Cheryl Davies; Jane Mullaney; Cecilia Ross; Denise Conroy; Troy L Merry; Richard Gearry; Mark Weatherall; Jeremy D Krebs

doi:10.3389/fnut.2023.1298743

He Rourou Whai Painga, an Aotearoa New Zealand dietary pattern for metabolic health and whānau wellbeing: protocol for a randomized controlled trial

Front Nutr. 2023 Dec 11:10:1298743. doi: 10.3389/fnut.2023.1298743. eCollection 2023.

Authors

Fiona E Lithander^{1

2

3}, Amber Parry Strong^{3

4}, Andrea Braakhuis², Anna Worthington², Meika Foster⁵, Anna Rolleston⁶, Cheryl Davies⁷, Jane Mullaney¹, Cecilia Ross⁴, Denise Conroy^{1

8}, Troy L Merry^{2

9}, Richard Gearry¹⁰, Mark Weatherall¹¹, Jeremy D Krebs^{4

11}

Affiliations

¹ New Zealand National Science Challenge High Value Nutrition, Liggins Institute, University of Auckland, Auckland, New Zealand.
² Discipline of Nutrition, School of Medical Sciences, The University of Auckland, Auckland, New Zealand.
³ The Liggins Institute, The University of Auckland, Auckland, New Zealand.
⁴ Centre for Endocrine, Diabetes and Obesity Research, Te Whatu Ora New Zealand Capital, Coast and Hutt Valley, Wellington, New Zealand.
⁵ Edible Research Ltd., Christchurch, New Zealand.
⁶ Centre for Health, Manawa Ora Centre, Tauranga, New Zealand.
⁷ Tū Kotahi Māori Asthma and Research Trust, Kōkiri Marae, Lower Hutt, New Zealand.
⁸ The New Zealand Institute for Plant & Food Research Ltd., Auckland, New Zealand.
⁹ Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, Auckland, New Zealand.
¹⁰ Department of Medicine, University of Otago, Christchurch, New Zealand.
¹¹ Department of Medicine, University of Otago, Wellington, New Zealand.

Abstract

Background: Cardiometabolic diseases are highly prevalent in Aotearoa New Zealand. Dietary intake is a modifiable risk factor for such diseases and certain dietary patterns, specifically the Mediterranean diet (MedDiet), are associated with improved metabolic health. This study aims to test whether an intervention including a Mediterranean dietary pattern incorporating high quality New Zealand foods (NZMedDiet pattern) and behavior change science can improve the metabolic health of participants and their household/whānau.

Methods and analysis: This is a multi-center, three-stage trial with two parallel group superiority randomized controlled trials (RCTs), and a longitudinal cohort study embedded within the trial design. The first RCT (RCT 1) is a comparison of the NZMedDiet pattern compared to usual diet for 12 weeks. The Behavior Change Wheel was used to select and implement strategies to support participant adherence to the NZMedDiet, such as web-based nutrition education on healthy shopping and cooking. The second (RCT 2) compares online social support to no online social support for 12 weeks, administered to participants immediately following RCT 1. The third stage is a longitudinal cohort study where all participants are followed from the beginning of their start of the active intervention for 12 months in total. The primary outcome measure for each stage is the metabolic syndrome severity score (MetSSS). The duration of enrolment is 12-15 months. The total recruitment target is 200 index participants and their household/whānau members who participate with them, and the primary analyses will be intention to treat on index participants.

Discussion: The trial will test whether the NZMedDiet pattern and behavior change support improves the cardiometabolic health of people in Aotearoa New Zealand.

Clinical trial registration: https://www.anzctr.org.au/Default.aspx, identifier ACTRN12622000906752 and https://www.isrctn.com/, identifier ISRCTN89011056 (Spirit 2).

Keywords: behavior change support; cardiometabolic; dietary pattern; household/family intervention; mediterranean diet; metabolic syndrome; metabolic syndrome severity score.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by High Value Nutrition National Science Challenge Funding through the NZ MBIE.