Replacing meat with alternative plant-based products (RE-MAP): a randomized controlled trial of a multicomponent behavioral intervention to reduce meat consumption.
Bianchi F., Stewart C., Astbury NM., Cook B., Aveyard P., Jebb SA.
BACKGROUND: Reducing meat consumption could protect the environment and human health. OBJECTIVES: We tested the impact of a behavioral intervention to reduce meat consumption. DESIGN: Adult volunteers who regularly consumed meat, were recruited from the general public and randomized 1:1 to an intervention or control condition. The intervention comprised free meat substitutes for four weeks, information about the benefits of eating less meat, success stories, and recipes. The control group received no intervention or advice on dietary change. The primary outcome was daily meat consumption after four weeks, assessed by a 7-day food diary, and repeated after eight weeks as a secondary outcome. Other secondary and exploratory outcomes included the consumption of meat substitutes, cardiovascular risk factors, psychosocial variables related to meat consumption, and the nutritional composition of the diet. We also estimated the intervention's environmental impact. We evaluated the intervention using generalized linear mixed effects models. RESULTS: Between June 2018 and October 2019, 115 participants were randomized. Baseline meat consumption was 134 g/d in the control and 130 g/d in the intervention group. Relative to the control, the intervention reduced meat consumption at 4 weeks by 63 g/d (95%CI: 44, 82, P<0.0001, N = 114) and at eight weeks by 39 g/d (95%CI: 16, 62, P = 0.0009, N = 113), adjusting for sex and baseline consumption. The intervention significantly increased the consumption of meat substitutes without changing the intake of other principal food groups. The intervention increased intentions, positive attitudes, perceived control, and subjective norms of eating a low meat diet and using meat substitutes, and decreased attachment to meat. At 8 weeks, 55% of intervention recipients identified as "meat-eaters" compared to 89% in the control. CONCLUSIONS: A behavioral program involving free meat substitutes can reduce meat intake and change psychosocial constructs consistent with a sustained reduction in meat intake.