Reducing dietary salt consumption in the occupied Palestinian territory: a cross-sectional survey

Abstract

BackgroundThe increasing prevalence of non-communicable diseases in the occupied Palestinan territory accounts for a large part of general mortality. WHO recommends a 30% reduction in mean population intake of salt or sodium as a cost-effective option to decrease the burden of cardiovascular disease. Results of surveys show that salt consumption is 7 g per day in Palestine, almost 50% higher than the recommended daily amount per person. Bread is consumed in large amounts and is an important contributor to salt intake. The aim of this study was to assess the content of salt in the bread sold in the West Bank with the aim of setting a reliable salt reduction target. MethodsIn this cross-sectional study, ad-hoc trained inspectors from the ministry of mealth visited 135 bakeries in all West Bank's Governorates in August, 2015. Data were collected through a structured questionnaire administered to bakers with questions about the amount of salt added to flour during the preparation of 281 bread products. The sample size was calculated for a level of accuracy of 7%. Data were analysed using SPSS 17.0. FindingsThe average amount of salt added to flour during bread preparation was 1·33 g per 100 g of flour (SD 0·62; range 0·00–4·00), corresponding to 1•11 g salt per 100 g bread. InterpretationSalt content in bread sold in the West Bank was highly variable. The salt reduction target for 2016 was set by the Palestine Standard Institute at 1·3 g of salt per 100 gram of flour, with a gradual reduction of 0·1 g of salt per year in the next 3 years to adjust consumers' palates to less salty products. The compliance to the regulation is monitored by the ministry of health and the Palestine food producers association assures full support. According to the available literature, the occupied Palestinian territory is the first Arab country to establish a mandatory programme for salt reduction in foods. FundingThe Italian Cooperation.