Reducing red and processed meat is not nutritionally neutral: intended substitution pathways in UK adults

Reducing red and processed meat (RPM) is not nutritionally neutral: health outcomes depend on replacement foods, yet little is known about substitution pathways or who is most at risk of unfavourable substitution. This cross-sectional online survey examined intended substitutions and their psychological, sociodemographic, and socioeconomic correlates among 1,554 UK adults aged 25-65 years. Participants rated how likely they would be to increase consumption across food categories if they reduced RPM. Responses were grouped a priori into nutritionally favourable (e.g. legumes, vegetables, wholegrains, nuts/seeds, soy-based foods) and unfavourable (e.g. refined grains, sweets/desserts, savoury snacks, fried potato products) replacement indices. Multiple regression models tested predictors of each index. Favourable and unfavourable intentions were weakly correlated, suggesting largely independent pathways with distinct correlates. Unfavourable intentions were higher among younger participants, those with lower education and subjective socioeconomic status, and those reporting higher processed meat consumption (R² = 0.10). Favourable intentions were higher among participants with higher education and greater consideration of future consequences (CFC-Future), and lower among those with more positive affective and cognitive evaluations of RPM (R² = 0.36). These cross-sectional, intention-based findings suggest that RPM-reduction strategies may benefit from pairing reduction messages with concrete substitution guidance, particularly for these higher-risk groups. .