Feasibility and Outcome of Reducing Salt in Bread: A Community Trial in Southern Iran

BACKGROUND: Salt is linked to hypertension, stomach cancer, kidney stone, and some other diseases. Given the harmful effect of eating too much salt, which has been reported in recent years more than ever before, culture-bound interventions are emphasized to be designed in Middle Eastern Countries in order to reduce dietary salt.

OBJECTIVES: This research was aimed at studying the feasibility of gradually reducing salt in bread and its effect on blood pressure.

PATIENTS & METHODS: In this community trial, two cities from the southeast of Iran with similar cultural conditions were selected. In addition to the installation of educational banners and door-to-door distribution of pamphlets, salt in bread in one of the cities reduced by 40% over a 4-week period. In the control city, only door-to-door distribution of pamphlets was carried out. Urinary sodium, systolic and diastolic blood pressure, and individuals’ height and weight were measured before and 12 weeks after the intervention.

RESULTS: The average age, weight, and height in the intervention city (n=346) and control city (n=310) were comparable (P>0.05). Perceived harm of salt was similar in both groups (P>0.05). ANCOVA results indicated that salt intake and post-intervention systolic blood pressure had a significantly greater reduction in the intervention group than in the control group (P<0.05).

CONCLUSION: Reduction of salt in bread by 40% was an acceptable intervention to people, which reduced urinary sodium and systolic blood pressure.