Lay summary
Hypertension (high blood pressure) is a key contributor to cardiovascular disease and stroke, two leading causes of death in New Zealand. Lifestyle interventions aimed at attenuating hypertension and cardiovascular disease often have poor long-term adherence due to the sheer amount of changes required. This study will examine the impact of changing one significant aspect of diet – the composition of bread – on blood pressure and resulting cardiovascular health. We will investigate three nutritional components that have been shown to influence blood pressure: sodium (salt), nitrate (beetroot) and L-arginine (hazelnuts). This randomised parallel intervention study will have four arms: low sodium bread, beetroot bread, nut bread and a control bread. Participants will be high bread consumers with elevated risk of cardiovascular disease, and at least one metabolic syndrome risk factor. We anticipate that one simple dietary change – an alternate bread recipe – could lower blood pressure and improve cardiovascular health.