{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T11:25:37Z","timestamp":1761218737926,"version":"3.43.0"},"reference-count":30,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:00:00Z","timestamp":1750809600000},"content-version":"unspecified","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Plant Based NZ Health Trust","award":["NA"],"award-info":[{"award-number":["NA"]}]},{"name":"Trust Tair\u0101whiti","award":["NA"],"award-info":[{"award-number":["NA"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,5,30]]},"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n<jats:title>Objectives<\/jats:title>\n<jats:p>Investigate the impact of a 10-week whole-food plant-based (WFPB) community programme on weight and type 2 diabetes up to 36\u2009months postintervention.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Design<\/jats:title>\n<jats:p>Randomised waitlist-controlled trial.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Setting<\/jats:title>\n<jats:p>Community-based General Practice clinic classified as \u2018Very Low-Cost Access\u2019 in Gisborne, the main city of the Tair\u0101whiti region of New Zealand.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Participants<\/jats:title>\n<jats:p>\nAdults (n\n<jats:italic>=<\/jats:italic>\n56) aged 30\u201372 years, with obesity (Body Mass Index (BMI) \u226530) and glycated haemoglobin (HbA1c\u226540 mmol\/mol) in the last 6\u2009months. Of the participants, 59% identified as M\u0101ori and 5% as Pasifika.\n<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Intervention<\/jats:title>\n<jats:p>A 10-week programme consisting of 2\u2009hours, two times per week sessions (40 hours total), involving skills-based learning and health education.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Primary and secondary outcome measures<\/jats:title>\n<jats:p>Primary measures were changes in weight, BMI and HbA1c. Secondary measures included changes in cholesterol, waist circumference, exercise levels, plant-based and non-plant-based dietary scores and association with Big Five Inventory personality traits. The primary endpoint was assessed at post-treatment (10 weeks), with follow-up at 6 and 36\u2009months postintervention.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>\n    Differences between the intervention and waitlist control groups at 10 weeks were compared with independent samples t-tests. In intention-to-treat analyses, the intervention group demonstrated significantly greater weight loss of 3.3\u2009kg (95% CI (0.8 to 5.7), p&lt;0.001) and a non-significant trend of 3.2\u2009mmol\/mol HbA1c reduction (CI (\u22120.4 to 6.7), p=0.08). Between-group differences post-treatment were not statistically significant for cholesterol (p=0.69), waist circumference (p=0.16) or activity level (p=0.97). After all participants received the intervention, repeated-measures ANOVAs were used to assess changes over time; significant omnibus effects were followed by paired-sample t-tests comparing baseline with subsequent time points. In this larger intervention group, some significant reductions were observed: weight loss was present post-treatment and sustained at 3\u2009kg at 36-month follow-up (CI (1.2 to 4.7), p&lt;0.001). Waist circumference decreased by 6\u2009cm post-treatment and was sustained. HbA1c dropped by 3.3 mmol\/mol and cholesterol by 0.4 mmol\/L post-treatment, but decreases were not sustained at follow-up time points (HbA1c results were possibly limited by inadequate data capture). Simple linear regression models found that greater dietary adherence related to better outcomes: increased WFPB food intake and decreased non-WFPB intake corresponded with greater weight loss post-treatment (unstandardised regression coefficients=0.3\u20130.4,\n<jats:italic>p<\/jats:italic>\n    values &lt;0.04).\n<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This 10-week WFPB diet community intervention decreased weight, BMI, HbA1c and cholesterol. The intervention produced a weight loss of 5 kg post-treatment, with 3\u2009kg weight loss sustained at 36\u2009months.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Trial registration number<\/jats:title>\n<jats:p>\nThis trial was prospectively registered with the Australian New Zealand Clinical Trials Registry (\n<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/anzctr.org.au\">https:\/\/anzctr.org.au<\/jats:ext-link>\n); ACTRN12617000541303, date of registration 07\/04\/2017.\n<\/jats:p>\n<\/jats:sec>","DOI":"10.1136\/bmjopen-2023-080946","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T11:13:32Z","timestamp":1750936412000},"page":"e080946","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Randomised waitlist-controlled trial of a 10-week community programme using a plant-based diet in a predominantly M\u0101ori population in Tair\u0101whiti (Gisborne)"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4061-558X","authenticated-orcid":false,"given":"Morgen","family":"Smith","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2829-3365","authenticated-orcid":false,"given":"Nicholas","family":"Wright","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6605-3215","authenticated-orcid":false,"given":"Patrick","family":"McHugh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8511-7563","authenticated-orcid":false,"given":"Bruce","family":"Duncan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9257-6650","authenticated-orcid":false,"given":"Christina","family":"Chwyl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,6,25]]},"reference":[{"unstructured":"Ministry of Health NZ: Manat\u016b Hauora . Diabetes. 2018. Available: https:\/\/www.health.govt.nz\/your-health\/conditions-and-treatments\/diseases-and-illnesses\/diabetes","key":"2025062511101650000_15.6.e080946.1"},{"doi-asserted-by":"crossref","unstructured":"Wright NS . Chapter 3. lessons learned from recent clinical trials targeting diets to treat and prevent obesity and diabetes. In: Cheng Z , ed. Food chemistry, function and analysis. Cambridge: Royal Society of Chemistry, 2020: 48\u201370. Available: http:\/\/ebook.rsc.org\/?DOI=10.1039\/9781839160608-00048","key":"2025062511101650000_15.6.e080946.2","DOI":"10.1039\/9781839160608-00048"},{"unstructured":"Ministry of Health NZ . Obesity in 2021\/22: An experimental analysis using data from general practices, 2022. Available: https:\/\/www.health.govt.nz\/statistics-research","key":"2025062511101650000_15.6.e080946.3"},{"unstructured":"Marett A . Obesity and Diabetes in New Zealand. New Zealand Parliament. 2014.","key":"2025062511101650000_15.6.e080946.4"},{"unstructured":"Te T\u0101h\u016b Hauora Health Quality & Safety Commission . Diabetes Atlas 2020, Available: www.hqsc.govt.nz\/our-data\/atlas-of-healthcare-variation\/diabetes\/","key":"2025062511101650000_15.6.e080946.5"},{"unstructured":"Statistics New Zealand . Statistics New Zealand: Gisborne District, Available: https:\/\/tools.summaries.stats.govt.nz\/places\/RC\/gisborne-region","key":"2025062511101650000_15.6.e080946.6"},{"unstructured":"Radio New Zealand . Gisborne housing situation \u201cdire\u201d, says advocate, 2022. Available: https:\/\/www.rnz.co.nz\/news\/national\/464294\/gisborne-housing-situation-dire-says-advocate","key":"2025062511101650000_15.6.e080946.7"},{"unstructured":"Best Practice NZ . Type 2 diabetes management toolbox: from lifestyle to insulin, Available: https:\/\/bpac.org.nz\/2021\/diabetes-management.aspx","key":"2025062511101650000_15.6.e080946.8"},{"key":"2025062511101650000_15.6.e080946.9","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1177\/15598276221087624","article-title":"Dietary Interventions to Treat Type 2 Diabetes in Adults with a Goal of Remission: An Expert Consensus Statement from the American College of Lifestyle Medicine","volume":"16","author":"Rosenfeld","year":"2022","journal-title":"Am J Lifestyle Med"},{"key":"2025062511101650000_15.6.e080946.10","doi-asserted-by":"crossref","first-page":"498","DOI":"10.4158\/EP-2018-0062","article-title":"AACE \/ ACE Consensus Statement Consensus Statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the Comprehensive Type 2 Diabetes Management Algorithm \u2013 2018 Executive Summary","volume":"24","author":"Nadolsky","year":"2018","journal-title":"Endocr Pract"},{"doi-asserted-by":"publisher","key":"2025062511101650000_15.6.e080946.11","DOI":"10.1016\/j.jand.2013.11.001"},{"doi-asserted-by":"publisher","key":"2025062511101650000_15.6.e080946.12","DOI":"10.1016\/j.numecd.2011.07.004"},{"key":"2025062511101650000_15.6.e080946.13","doi-asserted-by":"crossref","DOI":"10.3390\/nu10020189","article-title":"A Plant-Based Dietary Intervention Improves Beta-Cell Function and Insulin Resistance in Overweight Adults: A 16-Week Randomized Clinical Trial","volume":"10","author":"Kahleova","year":"2018","journal-title":"Nutrients"},{"key":"2025062511101650000_15.6.e080946.14","first-page":"623","article-title":"Effects of short-term carbohydrate or fat overfeeding on energy expenditure and plasma leptin concentrations in healthy female subjects","volume":"6","author":"Tappy","year":"2000","journal-title":"Curr Opin Clin Nutr Metab Care"},{"key":"2025062511101650000_15.6.e080946.15","doi-asserted-by":"crossref","first-page":"S53","DOI":"10.1038\/sj.ejcn.1600744","article-title":"De novo lipogenesis in humans: metabolic and regulatory aspects","volume":"53 Suppl 1","author":"Hellerstein","year":"1999","journal-title":"Eur J Clin Nutr"},{"doi-asserted-by":"crossref","unstructured":"Taylor R . 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