The salt hiding in your bread

A pack of potato chips or a slice of bread. Which one you think has more salt? Experts say it depends. But warns, the answer may surprise you in some cases. Some of the products analysed, the researchers say, were “saltier than seawater” with fingers pointed several times at cereal products likes ‘bread’. Tests conducted earlier in Bahrain by the Nutrition section of the Ministry of Health (MoH) in association with WHO’s Regional Office for the Eastern Mediterranean (EMRO) almost returned similar results.

An EMRO pilot study, which collected twenty samples of bread from bakeries here, found the average salt content as approximately 90,000 ppm- much higher than what WHO recommends. The data available through PubMed Central (PMC) says that there were 8.92 grams of salt in per kilogram of bread here. Salt intake of a person based on a 300 g daily bread intake was found to be 2.7 g. The data also reveals that the daily salt intake per person was a staggering 13.5g, which WHO says is higher than in most other regions in the world.

According to the biomedical and life sciences journal at the US National Institutes of Health’s National Library of Medicine, what made the matter worse here was the higher consumption of bread as a staple food. The study in fact acted as an urgent trigger for Bahrain to jump into action.

The 3-year plan

Sodium is necessary for our normal nerve and muscle function. However, scientists have demonstrated that people who consumed more than 7 grams per day were at higher risk of heart disease and early death than those who consumed 3 to 6 grams daily. It is thus clear why the health ministry here aims to reduce salt content in flatbread or Khubz Arabi to 0.5 per cent in the next three years. In going forward, there can be only 5 grams of salt per kilo of bread.

Measures are also being introduced to reduce trans-fat and oil content in baked goods to 5pc and 2pc, respectively. Bahrain is also implementing a national action plan that sets out different programmes encouraging the population to follow a healthy lifestyle in line with Vision 2030. Objectives include reducing salt in bakery products, enforcing food labelling to include salt content and developing legislation and monitoring its implementation.

NCDs, a concern

In a related study, a global team of researchers, after analysing salt contents in over 2,000 bread varieties sold in around 32 countries, found that more than a third of the loaves exceeds the maximum salt target of 1.13g of salt per 100g. All this tells us why there is a steady increase of non-communicable diseases or NCDs like cardiovascular diseases, hypertension, diabetes and obesity in the region.

However, despite its continued vilification, salt alone is not the villain here. There are other contributing factors too. But for some people, salt turns out to be more sensitive. Nevertheless, researchers agree that most people should aim to eat no more than one teaspoon of salt per day.

The obstacles

Some argue that reducing salt might take away the charm from bread. But that is grossly inaccurate as there is already a broad range of salt levels across similar products in the GCC countries. Jordan and Egypt are producing flatbreads with salt levels as low as 0.4 per cent on a wet basis and without compromising the taste. In the UK, the salt content of processed foods sold in supermarkets was initially reduced by 20-30 per cent over 3 years without affecting consumer preference or sales. It is thus technically feasible and has started here with the government setting a target for salt content in the bread of up to 0.5pc (5.0 g/kg bread). Bahrain has also revised its existing legislation to develop benchmarks for salt content in bread.

In a recent meeting held at Bait Al Tijjar by the Bahrain Chamber of Commerce and Industry (BCCI) in cooperation with the Ministry of Health, these decisions were explained in detail to the bread makers here. The meeting on “measures to reduce salt and trans fat in bakery products” highlighted WHO’s recommendation to reduce salt in food as one of the cost-effective interventions to control and prevent NCDs. Speaking at the event, the Assistant Undersecretary for Public Health of the Ministry of Health Dr Mariam Al Hajri highlighted the need to meet the standards and recommendations of the World Health Organisation (WHO).

In a report by Food Navigator-Asia, Dr Buthaina Ajnan, the head of nutrition and public health consultant at the Ministry of Health, outlined the adverse effects of high salt intake. The practice of putting more salts, sugars and trans-fat in food products had lead to a “noticeable increase in non-communicable chronic diseases,” the report quoted her as saying. “We urgently want to take action to control these diseases by controlling the diet risk factors.” Highlighting reluctance of merchants themselves as the main challenge, Dr Ajnan wanted them to “believe in the benefits of these reductions.”

They have the technology to make the replacements for trans-fats which are there and can be cheap, Dr Anjan told Food navigator. These changes “would not lead to an increase in prices” and in fact would reduce the costs as “fewer artificial ingredients would be used,” she said.

Highest in Tunisia

As per the findings of WHO, the average salt intake of > 12 g/ day per person in the Eastern Mediterranean Region is higher than in most other regions of the world. The highest salt content was found in Tunisia and Kuwait and the lowest in Egypt and Jordan. Salt content per kilogram of bread in Oman was 9.5g, Egypt (4.57g), Kuwait (10.97g), Tunisia (12.41g), Qatar (5.25g), Jordan (4.28g) and Lebanon (5.57g).

The study conducted from 1 November to 15 December 2013 collected one hundred and five bread samples from Bahrain, Egypt, Jordan, Kuwait, Qatar, Oman, Lebanon and Tunisia. The original samples were all flatbread or Khubz Arabi now widely known as pita bread.

WHO recommends

WHO recommends GCC member states to take immediate actions in salt intake to reduce premature mortality from NCDs by 25 per cent by 2025. For this, the WHO recommended a 30pc reduction in salt intake by 2025 with an eventual target of 5 g per day for adults and lower levels for children based on calorie intake. Currently, 39 million people die each year from NCDs, principally, cardiovascular disease (CVD), cancers, chronic respiratory disease, and diabetes.

Researchers say, what people often don’t recognise is the fact that before they “add any salt to their food, they may have actually consumed up to five times this amount without even tasting it”.