{
  "abstract": "Introduction Phthalates and bisphenols, chemicals commonly used in the production of plastic products, exhibit endocrine disrupting properties linked to obesity and systemic inflammation. Given the ubiquitous use of plastic chemicals, their adverse impact on human health is of great importance. In this protocol, we describe a randomised controlled trial aimed at testing whether minimising exposure to plastics and plastic-associated chemicals (PACs) in community-dwelling adults with cardiometabolic risk factors can reduce urinary excretion of PACs and improve cardiometabolic health.Methods and analysis The study will recruit (n=60) community-dwelling adults (18–60 years) with cardiometabolic risk factors, characterised by a body mass index of ≥30 kg/m 2 and waist circumference of ≥88 cm in women and ≥102 cm in men. Participants will be randomised to a control (n=30) or an intervention group (n=30) receiving a 4-week diet and lifestyle modification designed to reduce plastic exposure, which includes the replacement of all food, kitchen utensils and equipment, personal care and cleaning products. The primary outcome is a reduction in urinary excretion of bisphenols after the 4-week intervention compared with the control arm. The secondary outcomes are the reduction in urinary excretion of low and high molecular weight phthalates. Finally, tertiary outcomes investigate improvements to cardiometabolic biomarkers, body composition, waist circumference and blood pressure. Participants will self-collect urine, stool and nasal lavage samples a day before beginning the intervention and at the end of each week. Fasting blood samples and health assessments will be collected during clinic visits: at baseline, mid-point and a day after the intervention period. Urinary PAC excretion and cardiometabolic health outcomes will be compared between the intervention and control groups.Ethics and dissemination The PERTH Trial has ethics approval from the University of Western Australia Human Research Ethics Committee; 2021-ET001118. Results will be submitted for publication in peer-reviewed journals and presented at conferences.Trial registration number NCT06571994.",
  "authors": [
    {
      "affiliations": [
        "School of Biomedical Sciences, The University of Western Australia, Nedlands, Western Australia, Australia"
      ],
      "name": "Andrew Lucas"
    },
    {
      "affiliations": [
        "Medical School, The University of Western Australia, Nedlands, Western Australia, Australia",
        "Children’s Diabetes Centre, The Kids Research Institute Australia, Nedlands, Western Australia, Australia"
      ],
      "name": "Amelia Harray"
    },
    {
      "affiliations": [
        "Medical School, The University of Western Australia, Nedlands, Western Australia, Australia"
      ],
      "name": "Lelinh Duong"
    },
    {
      "affiliations": [
        "Medical School, The University of Western Australia, Nedlands, Western Australia, Australia"
      ],
      "name": "Susan Herrmann"
    },
    {
      "affiliations": [
        "Centre for Applied Statistics, The University of Western Australia, Perth, Western Australia, Australia"
      ],
      "name": "Philip Vlaskovsky"
    },
    {
      "affiliations": [
        "Centre for Applied Statistics, The University of Western Australia, Perth, Western Australia, Australia"
      ],
      "name": "Michelle Trevenen"
    },
    {
      "affiliations": [
        "Medical School, The University of Western Australia, Nedlands, Western Australia, Australia"
      ],
      "name": "Dick Chan"
    },
    {
      "affiliations": [
        "Medical School, The University of Western Australia, Nedlands, Western Australia, Australia"
      ],
      "name": "Hannah Papendorf"
    },
    {
      "affiliations": [
        "Medical School, The University of Western Australia, Nedlands, Western Australia, Australia"
      ],
      "name": "Tony Smith"
    },
    {
      "affiliations": [
        "Department of Biochemistry and Pharmacology, The University of Melbourne, Parkville, Victoria, Australia"
      ],
      "name": "Lilith Flint"
    },
    {
      "affiliations": [
        "Medical School, The University of Western Australia, Nedlands, Western Australia, Australia"
      ],
      "name": "Alex Liu"
    },
    {
      "affiliations": [
        "School of Human Sciences, The University of Western Australia, Perth, Western Australia, Australia",
        "Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Western Australia, Australia",
        "Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA"
      ],
      "name": "Silvana Gaudieri"
    },
    {
      "affiliations": [
        "Minderoo Centre – Plastics and Human Health, The University of Queensland, Woolloongabba, Queensland, Australia",
        "Queensland Alliance of Environmental Health Sciences, The University of Queensland, Woolloongabba, Queensland, Australia"
      ],
      "name": "Xianyu Wang"
    },
    {
      "affiliations": [
        "Minderoo Centre – Plastics and Human Health, The University of Queensland, Woolloongabba, Queensland, Australia",
        "Queensland Alliance of Environmental Health Sciences, The University of Queensland, Woolloongabba, Queensland, Australia"
      ],
      "name": "Jochen F Mueller"
    },
    {
      "affiliations": [
        "Minderoo Centre – Plastics and Human Health, The University of Queensland, Woolloongabba, Queensland, Australia",
        "Queensland Alliance of Environmental Health Sciences, The University of Queensland, Woolloongabba, Queensland, Australia"
      ],
      "name": "Kevin V Thomas"
    },
    {
      "affiliations": [
        "Centre for Applied Statistics, The University of Western Australia, Perth, Western Australia, Australia",
        "School of Population and Global Health, The University of Western Australia, Nedlands, Western Australia, Australia"
      ],
      "name": "Kevin Murray"
    },
    {
      "affiliations": [
        "Minderoo Foundation, Perth, Western Australia, Australia"
      ],
      "name": "Christos Symeonides"
    },
    {
      "affiliations": [
        "Minderoo Foundation, Perth, Western Australia, Australia",
        "School of Biological Sciences, The University of Western Australia, Nedlands, Western Australia, Australia"
      ],
      "name": "Sarah Dunlop"
    },
    {
      "affiliations": [
        "Medical School, The University of Western Australia, Nedlands, Western Australia, Australia",
        "Lipid Disorders Clinic, Department of Cardiology and Internal Medicine, Royal Perth Hospital, Perth, Western Australia, Australia"
      ],
      "name": "Gerald Watts"
    },
    {
      "affiliations": [
        "Medical School, The University of Western Australia, Nedlands, Western Australia, Australia",
        "Department of Immunology, PathWest Laboratory Medicine WA, Nedlands, Western Australia, Australia",
        "Department of Immunology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia",
        "Department of Immunology, Perth Children’s Hospital, Nedlands, Western Australia, Australia"
      ],
      "name": "Michaela Lucas"
    }
  ],
  "title": "Randomised controlled trial of a low plastic diet and lifestyle intervention for adults with cardiometabolic risk factors: the Plastic Exposure Reduction Transforms Health (PERTH) trial – a protocol",
  "uid": "50061e6b-db3b-540d-9002-7cab1fef2424"
}