Lean Beef as Part of a Healthy Meal Plan in Adolescents With Polycystic Ovary Syndrome (PCOS)/Polyendocrine Metabolic Ovarian Syndrome (PMOS)

HbA1c measured as point of care using A1CNow+ point-of-care analyzer, HbA1c will also serve as a safety endpoint.

Derived from a 75g oral glucose tolerance test (OGTT) as a measure of glycemic variability

Drop-out and the reason for drop-out will be recorded, and in both the intervention and usual lifestyle groups will be reported.

Derived from a 75g oral glucose tolerance test (OGTT), measure of insulin sensitivity

Derived from the 75g oral glucose tolerance test (OGTT), measure of insulin sensitivity

Derived from a 75g oral glucose tolerance test (OGTT), measure of insulin sensitivity

Derived from a 75g oral glucose tolerance test (OGTT), as a measure of insulin sensitivity

Derived from blinded Continuous Glucose Monitor (CGM) wear, a measure of glycemic variability

Derived from blinded Continuous Glucose Monitor (CGM) wear, as a metric of glycemic variability

Derived from blinded Continuous Glucose Monitor (CGM) wear, measure of glycemic variability

This will be assessed from 24-hour diet recalls and evaluated via Healthy Eating Index (HEI).

Skin carotenoids will be measured through the Veggie Meter ®, which uses reflection spectroscopy to estimate skin carotenoid levels. Three scans will be taken on your non-dominant ring finger. After each scan, a dial gauge and a score will appear on the screen. A final score, calculated as the average of the three scans, will range from 0 to 800. Higher scores indicate greater fruit and vegetable intake.

This will be measured through an Appetite/Satiety Questionnaire adapted from commonly used appetite assessment methods and previously applied in dietary intervention research. Participants will report their general appetite and satiety experiences using six items assessing hunger frequency, strength of hunger before meals, fullness after eating, desire to eat when food is available, thoughts about food, and satisfaction after eating. Responses are recorded using a 100-mm visual analogue scale implemented as a 0-100 slider (0 = lowest intensity or frequency; 100 = highest intensity or frequency). Participants will be instructed to move the slider to reflect how strongly each statement describes their typical experience. Data collected will be used to evaluate changes in perceived hunger and fullness throughout the intervention.

Type 2 Diabetes is defined as HbA1c >6.5%.

Intake of lean beef, assessed via 24-hour diet recalls

Intake of lean beef, assessed through daily logs of beef intake by providing portion sized objects that align with serving sizes and ask participants to take photos of their meals with the portion estimator, to ensure that both the meal planning is followed and portion sizes are met.

Serum hemoglobin will also be assessed as a metric of compliance.

This will be measured through the Pediatric Quality of Life (PedsQL) questionnaire. It includes 23 questions and is scored by reverse-scoring items and linearly transforming them to a 0-100 scale. Higher scores mean better health-related quality of life.

This will be measured through the Adapted version of the Family Impact Module of the Pediatric Quality of Life (PedsQL). This questionnaire includes 36 questions and includes a 5-point Likert scale (0 to 4), reverse-scored and linearly transformed to a 0-100 scale. Higher scores show better parent health-related quality of life and family functioning with less negative impact.

An exploratory analysis will reveal whether lean beef was directly associated with any change in glycemic outcome over time

An exploratory economic evaluation will estimate household food-related costs associated with participation in the intervention as an ancillary study. Parents or legal guardians will be invited to record and provide receipts for costs related to groceries or food purchased for at-home meal preparation, as well as for meals purchased outside the home, including at restaurants and fast-food venues