Table_2_Development of an Aotearoa New Zealand adapted Mediterranean dietary pattern and Kai/food basket for the He Rourou Whai Painga randomised controlled trial.DOCX

BackgroundFollowing a Mediterranean diet (MedDiet) is associated with a lower risk of cardiovascular disease. He Rourou Whai Painga is a dietary intervention trial with behaviour change support that seeks to determine whether a MedDiet pattern can provide equivalent benefits in Aotearoa New Zealand (NZ), a country where cardiovascular disease is a leading cause of death. To do this, the MedDiet needs to be adapted in an acceptable way for NZ, with consideration of the Māori (indigenous) population.
MethodsThe MedDiet was defined using existing MedDiet scoring tools and adapted to the NZ context using local guidelines. The resulting NZ MedDiet pattern was used to develop a kai/food basket, including products from industry partners, for participants in He Rourou Whai Painga. Criteria set for the kai/food basket included providing up to 75% of energy requirements and falling within the Australia/NZ Acceptable Macronutrient Distribution Range to reduce risk of chronic disease. Māori researchers on the team provided support to ensure Mātauranga Māori (Māori knowledge and values) was upheld through this process.
ResultsThe NZ MedDiet pattern criteria was similar to the identified MedDiet scoring tools, with differences in recommendations for dairy, red meat, alcohol and olive oil. The resulting kai/food baskets were estimated to provide on average 73.5% of energy requirements for households, with 36% from fat, 8.6% from saturated fat, 17% protein, and 42% carbohydrate. Forty-two industry partners, including 3 Māori businesses, agreed to provide 22 types of food products towards the total.
ConclusionSmall, feasible changes to the MedDiet can be made to align with the NZ guidelines and food environment. However, this eating pattern still differs from what the population, particularly Māori, are currently consuming. Continued partnership with Māori and additional behavioural support is important to facilitate adherence to this dietary pattern within He Rourou Whai Painga.
Trial registration: https://www.anzctr.org.au/Default.aspx, identifier ACTRN12622000906752 and https://www.isrctn.com/, identifier ISRCTN89011056.

研究背景
遵循地中海饮食（Mediterranean Diet，MedDiet）与更低的心血管疾病发病风险相关。He Rourou Whai Painga是一项附带行为改变支持的饮食干预试验，旨在明确地中海饮食模式能否在奥特罗阿新西兰（Aotearoa New Zealand，简称NZ）——该国心血管疾病为主要致死病因之一——发挥等效的健康获益。为此，需结合本土毛利（Māori）族群的实际情况，以可被当地接受的方式对地中海饮食进行本土化调整。

研究方法
本研究依托现有地中海饮食评分工具定义地中海饮食模式，并结合新西兰当地膳食指南完成本土化适配。基于该本土化后的新西兰地中海饮食模式，本研究为He Rourou Whai Painga试验的受试者开发了包含合作企业产品在内的kai/食品篮（kai为毛利语“食物”之意）。该食品篮的设定标准为：可满足受试者最高75%的每日能量需求，且宏量营养素供能比符合澳大利亚/新西兰可接受宏量营养素分布范围（Acceptable Macronutrient Distribution Range，AMDR），以降低慢性病发病风险。团队中的毛利研究人员提供了全程支持，以确保整个适配过程恪守毛利知识与价值观（Mātauranga Māori）。

研究结果
本土化后的新西兰地中海饮食模式标准与现有地中海饮食评分工具大体一致，但在乳制品、红肉、酒精与橄榄油的推荐摄入量上存在差异。经测算，所开发的食品篮平均可满足家庭73.5%的能量需求，其中脂肪供能占比36%、饱和脂肪供能占比8.6%、蛋白质供能占比17%、碳水化合物供能占比42%。共有包括3家毛利企业在内的42家行业合作方同意提供共计22类食品产品。

研究结论
可通过小幅且可行的调整，使地中海饮食模式适配新西兰的膳食指南与本土食品环境。但该饮食模式仍与新西兰民众，尤其是毛利族群的日常饮食结构存在显著差异。在He Rourou Whai Painga试验中，持续与毛利族群开展合作，并提供额外的行为支持，对提升受试者对该饮食模式的依从性至关重要。

试验注册
试验注册链接：https://www.anzctr.org.au/Default.aspx，注册编号ACTRN12622000906752；https://www.isrctn.com/，注册编号ISRCTN89011056。