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Article History

Received: 9 April 2025

Accepted: 17 September 2025

First Online: 14 October 2025

Declarations

:

: The study was conducted in accordance with the Declaration of Helsinki. The study protocol was approved by the Chesapeake Institutional Review Board on February 03, 2021, protocol number Pro00048903. All participants gave written informed consent.

: Dr. Kahleova, Ms. Maracine, Ms. Znayenko-Miller, and Dr. Holubkov received compensation from the Physicians Committee for Responsible Medicine for their work on this study. Drs. Kuo and Herman reported no conflict of interest. Dr. Barnard is an Adjunct Professor of Medicine at the George Washington University School of Medicine. He serves without compensation as president of the Physicians Committee for Responsible Medicine and Barnard Medical Center in Washington, DC, nonprofit organizations providing educational, research, and medical services related to nutrition. He writes books and articles and gives lectures related to nutrition and health and has received royalties and honoraria from these sources.

: Dr. Hana Kahleova is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

: Not applicable.