Abstract
Background: Deaths due to cardiovascular disease are set to rise from 22 million
globally in 2015 to a projected 112 million in 2030. Many dietary modifications have
been shown to be beneficial for the prevention and management of cardiovascular disease
risk. Therefore, many of these dietary changes are recommended by numerous health
organisations to lower cardiovascular disease risk however, only a small percent of the
population make these changes. Previous research has shown that using bread, a staple
in many parts of the world, as a means to changing consumption of certain foods and/or
nutrients is both viable and acceptable. Unfortunately, the majority of these previous
interventions have been of short duration or have not included risk factors for
cardiovascular disease as primary outcomes.
Objective: To investigate the effect of consuming four different types of bread (control
white bread, beetroot-enriched bread, low sodium bread, nut-enriched bread) on markers
of cardiovascular disease over 12 weeks.
Design: A total of 92 participants were recruited from the general public in Dunedin to
take part in this randomised controlled parallel study with four arms: a control bread
(standard white bread), low sodium bread (333 mg sodium per 120 g), a beetroot bread
(1.4 mmol of nitrate per 120 g), and a nut bread (30 g hazelnuts per 120 g). Participants
were randomly allocated to receive one of four breads for 12 weeks. Outcome measures
including body weight, plasma lipids and lipoproteins, blood pressure and pulse wave
velocity were taken at baseline and week 12.
Results: There were no statistically significant differences in change from baseline to
week 12 between groups for any measures of cardiovascular disease or body composition
(all P > 0.05). While there were no statistically significant changes in blood pressure
between groups there were some interesting differences in those participants consuming
the low sodium bread and the beetroot bread compared to baseline (-4.0/-6.0 mmHg in
systolic blood pressure and -2.8/-3.5 mmHg in diastolic blood pressure).
Conclusion: Consuming different breads, enriched with recommended servings of either
beetroot or nuts, or a reduced sodium content, did not significantly affect markers of
cardiovascular disease. While some measures, in particular blood pressure, showed
clinically interesting effects, this was a partial analysis of a study still in recruitment, and
these results should be interpreted with caution.