Investigating the impact of Online Grocery Shopping on Blood Pressure in Individuals with Hypertension

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Approximately 4.1 million Australian adults suffer from hypertension, which was estimated to cause 26,000 deaths in Australia in 2017. Excess dietary salt consumption is a leading cause of high blood pressure, and dietary guidelines specifically recommend the avoidance of foods high in salt for blood pressure lowering. Yet, current individual-based education and clinical counselling to reduce salt intakes has shown limited effectiveness, is resource intensive, costly, and has limited reach. Hypertensive patients in Australia currently consume on average ~10g salt per day, nearly twice the World Health Organisation recommended maximum; with most (~80%) dietary salt derived from eating packaged and processed foods. Thus, innovative strategies are urgently needed to help hypertensive patients reduce their dietary salt intake. The overall goal of this research is to determine the effectiveness of a novel, scalable, and sustainable salt reduction intervention (online grocery shopping, OGS) for lowering blood pressure (BP) amongst patients with hypertension. We will do this by conducting a large-scale randomised controlled trial (RCT) using an online grocery shopping intervention designed specifically for Woolworths, Australia’s largest online grocery retailer. The OGS will be provided to the study participants as a web-browser application, such that every time participants purchase groceries online, OGS will provide immediate on-screen, interpretive (i.e. colour-coded symbol) nutrition information and specific suggestions for lower salt alternatives. The personalised approach – consumers can maintain their usual dietary patterns and are guided to choose similar, but lower-salt alternative products – offers flexibility and caters to personal preferences. If this intervention demonstrates even a 2 mmHg BP lowering effect, then it would be meaningful because 2 mmHg lower BP translates into an approximately 10% reduction in premature cardiovascular disease (CVD) amongst hypertensive patients. There is currently no other platform that could improve dietary behaviours more rapidly to reduce BP amongst Australians. The OGS online grocery shopping intervention has the potential to have a major effect on BP control and prevention of CVD in Australia and globally.