Has the Reduction of Salt in the Bread’s Composition Played a Role in Reducing Blood Pressure in Morocco?

OBJECTIVES: Overconsumption of sodium can cause several noncommunicable diseases such as hypertension which alone is responsible for 10% of cardiovascular disease. According to the Moroccan Ministry of Health 2018, the prevalence of hypertension in Morocco rose from 33.6% in 2000 to 29.3% in 2018. Bread is the main vehicle of salt for daily food intake in Morocco the objective of this research is the evaluation of the impact of 5 years of awareness campaigns (2011–2016) on the incentive of bakers to reduce the amount of salt used in the preparation of commercial white bread and on improvement of their knowledge and nutritional practices related to salt. METHODS: Knowledge, attitudes and nutritional practices (KAB) on sodium were assessed using a questionnaire during interviews in 2012, 2014 and 2016 with 1218 bakeries in Casablanca, Morocco. The questionnaire covered subjects on diseases linked to overconsumption of salt, the recommended daily intake and their adhesions to gradually reducing salt in the preparation of bread. The amount of sodium chloride in commercial bread was measured by the Mohr titration method. Bread samples were collected and analyzed in 160 bakeries in 2011 and 2016. RESULTS: The KAB survey revealed that in 2016, for bakers, 92.9% knew at least that overconsumption of salt causes blood pressure, 72.8% were engaged or started to reduce the sodium added in the preparation of bread and 98.3% of bakers market around 10% of bread without salt. Analysis of the bread revealed that the added sodium chloride increased from 17.42 ± 1.28 g/kg in 2011 to 13.1 ± 2.24 g/kg in 2016, equivalent to a decrease of 26, 3% over five years (0.94 g per year). The amount of salt measured in 2017–2018 in the bread of 6 Moroccan cities showed an average rate varying between 12.85 and 16.9 g/kg. CONCLUSIONS: This study highlights the effectiveness of awareness campaigns through the CAP to reduce the use of salt in breadmaking. Knowing that the daily consumption of bread in Morocco varied between 360 and 500 g. This 26.3% reduction in salt in bread certainly has a positive impact on CVD protection and would be attributed to the reduction in the prevalence of blood pressure obtained in 2018 among Moroccans. FUNDING SOURCES: University II Hassan Facuty of Sciences Ben M'Sik Casablanca. World Health Organization.