Reducing salt content in bread is the essential part of a national strategy for salt reduction with the goal of long-term national general health improvement. In this study we have analysed salt content in three types of bread available in 25 small and five national industrial bakeries in Zagreb, Croatia. Samples of white wheat bread, dark wheat bread, and other types of bread were collected, and the salt content was determined with the Mohr method. Salt content varied widely between bakeries, with an average content of 2.30±0.22 g per 100 g of bread, which is almost twice the threshold content (1.4 %) defined by the Croatian National Regulation on Cereals and Cereal Products. Further efforts are necessary to teach bakers how to reduce salt content without affecting quality or flavour. These should go hand in hand with continuous monitoring of how the legal provisions are implemented.
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1. GBD 2017 Diet Collaborators. Health effects of dietary risks in 195 countries 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2019;393:1958–72. doi: 10.1016/S0140-6736(19)30041-8
2. Thout SR Santos JA McKenzie B Trieu K Johnson C McLean R Arcand J Campbell NRC Webster J. The Science of Salt: Updating the evidence on global estimates of salt intake. J Clin Hypertens (Greenwich) 2019;21:710–21. doi: 10.1111/jch.13546
3. Al Jawaldeh A Rafii B Nasreddine L. Salt intake reduction strategies in the Eastern Mediterranean Region. East Mediterr Health J 2019;24:1172–80. doi: 10.26719/emhj.18.006
4. Appel LJ Lichtenstein AH Callahan EA Sinaiko A Van Horn L Whitsel L. Reducing sodium intake in children: A public health investment. J Clin Hypertens (Greenwich). 2015;17:657–62. doi: 10.1111/jch.12615
5. World Health Organization (WHO). Diet Nutrition and the Prevention of Chronic Diseases. Report of a Joint WHO/FAO Expert Consultation. WHO Technical Report Series no. 916 Geneva 2003 [displayed 20 April 2017]. Available at https://apps.who.int/iris/bitstream/handle/10665/42665/WHO_TRS_916.pdf;jsessionid=F639B3E5A0DDD0C89E60FBF32D5E3936?sequence=1
6. Croatian Institute of Public Health (CIPH). Croatian Health Statistics Yearbook 2017. Zagreb Croatia [displayed 04 December 2018]. Available at https://www.hzjz.hr/en/other-publications/croatian-health-statistics-yearbook-2017/
7. Pucarin Cvetković J. Sol u prehrani - čimbenik rizika od razvoja kroničnih nezaraznih bolesti. [Salt in nutrition - risk factor for the noncommunicable diseases development in Croatian]. In: Šatalić Z editor. [100 (i pokoja više) crtica iz znanosti o prehrani in Croatian]. 1st ed. Croatian Zagreb: Society of Food Technologists Biotechnologists and Nutritionists; 2013. p. 184–5.
8. World Health Organization (WHO). Guideline: Sodium intake for adults and children [displayed 04 November 2018]. Available at http://www.who.int/nutrition/publications/guidelines/sodium_intake_printversion.pdf
9. World Health Organization (WHO). Mapping salt reduction initiatives in the WHO European Region [displayed 14 July 2018]. Available at http://www.euro.who.int/__data/assets/pdf_file/0009/186462/Mapping-salt-reduction-initiatives-in-the-WHO-European-Region.pdf
10. Quilez J Salas-Salvado J. The feasibility and acceptability of reducing salt in partially baked bread: A Spanish case study. Public Health Nutr 2016;19(Suppl 6):983–7. doi: 10.1017/S1368980015000944
11. Perl Pirički A Kenjerić D Mandić ML. Cereals as source of vitamins and minerals In: Ugarčić-Hardi Ž editor. Proceedings of 4th International Congress Flour-Bread’07 6th Croatian Congress of Cereal Technologists; 24–27 October 2007; Opatija Croatia. Osijek: Faculty of Food Technology J.J. Strossmayer University of Osijek; 2008. p. 466–70.
12. Ćurić D Ugarčić Ž Novotni D Koceva Komlenić D Jukić M. [Stanje u mlinskoj pekarskoj i tjesteničarskoj industriji te perspektive razvoja tih vrsta industrije in Croatian]. In: Matić S Tomić F Anić I editors. [Proizvodnja hrane i šumarstvo - temelj razvoja istočne Hrvatske: u povodu 20. obljetnice utemeljenja Znanstvenog vijeća za poljoprivredu i šumarstvo in Croatian]. Zagreb: Croatian Academy of Sciences and Arts; 2013. Book of abstracts p. 30–1.
13. Delaš Aždajić M Delaš I Aždajić S Štimac Grbić D Vahčić N. Udio kuhinjske soli u kruhu Grada Zagreba [Salt content in bread from the city of Zagreb Croatia in Croatian]. Acta Med Croatica 2018;72:133–8.
14. Ugarčić-Hardi Ž Dumančić G Pitlik N Koceva Komlenić D Jukić M Kuleš A Sabo M Hardi J. The salt content in bakery products in Osječko-Baranjska County. In: Ugarčić-Hardi Ž editor. Abstract book of the 5th International Congress and 7th Croatian Congress of Cereal Technologists “Flour - Bread ‘09 “; Osijek Croatia 2009. Osijek: Faculty of Food Technology Osijek; 2009.
15. Đurić J Vitale K Paradinović S Jelaković B. Unos soli i arterijski tlak u općoj populaciji [Salt intake and arterial hypertension in general population in Croatian]. Croat J Food Technol Biotechnol Nutr 2011;6:141–7.
16. Pucarin-Cvetković J Kern J Vuletić S. Regionalne karakteristike prehrane u Hrvatskoj [Regional features of Croatian nutrition in Croatian]. Acta Med Croatica 2010;64:83–7.
17. Nielsen SS. Food Analysis Laboratory Manual. Food Science Texts Series. New York (NY): Springer Science+Business Media; 2010.
18. Pravilnik o žitaricama i proizvodima od žitarica [Ordinance on cereals and cereal products in Croatian]. Narodne novine 81/2016.
19. Silva V Padrão P Novela C Damasceno A Pinho O Moreira P Lunet N. Sodium content of bread from bakeries and traditional markets in Maputo Mozambique. Public Health Nutr 2015;18:610–4. doi: 10.1017/S1368980014000779
20. Saavedra-Garcia L Sosa-Zevallos V Diez-Canseco F Miranda JJ Bernabe-Ortiz A. Reducing salt in bread: a quasi-experimental feasibility study in a bakery in Lima Peru. Public Health Nutr 2016;19:976–82. doi: 10.1017/S1368980015001597
21. Grabež M Rudić Grujić V Petković V. Sodium content and the most important dietary sources of sodium in a sample of student population. Arh Hig Rada Toksikol 2017;68(Suppl 1):22–9.
22. Lazić V. Salt content in white bread in the Republic of Srpska. Scr Med 2017;48:24–9. doi: 10.18575/msrs.sm.s.17.04
23. TNS Opinion & Social. Special Eurobarometer 329/Wave 72.3 Health Determinants [displayed 20 August 2018]. Available at http://ec.europa.eu/commfrontoffice/publicopinion/archives/ebs/ebs_329_sum_en.pdf
24. The Council of the European Union. Action to reduce population salt intake for better health – adoption of the conclusions. OJ (2010/C 305/04). [displayed 20 September 2019]. Available at http://publications.europa.eu/resource/cellar/cf66a644-4ad3-48f6-8ddb-620238428aed.0020.02/DOC_1
25. European Commission (EC). Survey on Members States’ Implementation of the EU Salt Reduction Framework: directorate-general health and consumers [displayed 20 June 2018]. Available at https://ec.europa.eu/health//sites/health/files/nutrition_physical_activity/docs/salt_report1_en.pdf
26. Webster J Trieu K Dunford E Hawkes C. Target salt 2025: a global overview of national programs to encourage the food industry to reduce salt in foods. Nutrients 2014;6:3274–87. doi: 10.3390/nu6083274
27. World Health Organization (WHO). Global Action Plan for the Prevention and Control of NCDs 2013–2020 [displayed 4 November 2018]. Available at https://www.who.int/nmh/events/ncd_action_plan/en/
28. Ministry of Health. Strateški plan za smanjenje prekomjernog unosa kuhinjske soli u RH 2015–2019 [Strategic Plan for Reduction of Salt Intake in Croatian]. [displayed 27 August 2018]. Available at https://www.hzjz.hr/wp-content/uploads/2014/11/Strate%C5%A1ki-plan-za-smanjenje-prekomjernog-unosa-kuhinjske-soli-u-RH-2015.-2019.pdf
29. McLaren L Sumar N Barberio AM Trieu K Lorenzetti DL Tarasuk V Webster J Campbell NR. Population-level interventions in government jurisdictions for dietary sodium reduction. Cochrane Database Syst Rev 2016;9:CD010166. doi: 10.1002/14651858.CD010166.pub2
30. Laatikainen T Pietinen P Valsta L Sundvall J Reinivuo H Tuomilehto J. Sodium in the Finnish diet: 20-year trends in urinary sodium excretion among the adult population. Eur J Clin Nutr 2006;60:965–70. doi: 10.1038/sj.ejcn.1602406
31. Slimani N Deharveng G Southgate DA Biessy C Chajès V van Bakel MM Boutron-Ruault MC McTaggart A Grioni S Verkaik-Kloosterman J Huybrechts I Amiano P Jenab M Vignat J Bouckaert K Casagrande C Ferrari P Zourna P Trichopoulou A Wirfält E Johansson G Rohrmann S Illner AK Barricarte A Rodríguez L Touvier M Niravong M Mulligan A Crowe F Ocké MC van der Schouw YT Bendinelli B Lauria C Brustad M Hjartåker A Tjønneland A Jensen AM Riboli E Bingham S. Contribution of highly industrially processed foods to the nutrient intakes and patterns of middle-aged populations in the European Prospective Investigation into Cancer and Nutrition study. Eur J Clin Nutr 2009;63:S206–25. doi: 10.1038/ejcn.2009.82
32. Moubarac JC Claro RM Baraldi LG Levy RB Martins AP Cannon G Monteiro CA. International differences in cost and consumption of ready-to-consume food and drink products: United Kingdom and Brazil 2008–2009. Glob Public Health 2013;8:845–56. doi:10.1080/17441692.2013.796401
33. Bolhuis DP Temme EH Koeman FT Noort MW Kremer S Janssen AM. A salt reduction of 50% in bread does not decrease bread consumption or increase sodium intake by the choice of sandwich fillings. J Nutr 2011;141:2249–55. doi: 10.3945/jn.111.141366
34. Nghiem N Blakely T Cobiac LJ Cleghorn CL Wilson N. The health gains and cost savings of dietary salt reduction interventions with equity and age distributional aspects. BMC Public Health 2016;16:423. doi: 10.1186/s12889-016-3102-1
35. Ugarčić Hardi Ž Dumančić G Koceva Komlenić D Jukić M. Količina soli u hrvatskim pekarskim proizvodima [Amount of salt in Croatian bakery products in Croatian]. HČJZ 2010;6(21).
36. Ministry of Health Republic of Croatia. Nacionalni program “Živjeti zdravo” 2015 [National Program “Living Healthy” in Croatian] [displayed 25 August 2019]. Available at https://zdravlje.gov.hr/UserDocsImages//Programi%20i%20projekti%20-%20Ostali%20programi//NP%20%C5%BDivjeti%20zdravo.pdf