To assess the Na content and price of bread available in bakeries in the city of Maputo in 2018 and describe trends since 2012.

Cross-sectional evaluation of bread sold in twenty bakeries in the city of Maputo. Three loaves of white and three loaves of brown bread were collected from each bakery when available, and Na contents were quantified by flame photometry. To assess trends, samples of white bread collected in 2012 and analysed using the same methodology were compared with samples of white bread collected in 2018 from the same bakeries.

City of Maputo, capital of Mozambique.

In 2018, the mean (range) Na content in mg/100 g of white and brown breads were 419·1 (325·4–538·8) and 389·8 (248·0–609·0), respectively. Non-compliance with Na targets in bread according to the South African regulation (<380 mg/100 g) was observed in 70 % of white and 43 % of brown bread samples. A total of twelve bakeries had samples evaluated in both 2012 and 2018; among these, the mean Na content in white bread decreased by just over 10 % – the mean difference (95 % CI) was 46·6 mg/100 g (1·7, 91·5); and there was a significant increase of 3·7–5·4 meticais in the mean price per 100 g of white bread.

The Na content of bread available in bakeries in the city of Maputo decreased in recent years despite the absence of a specific regulation in Mozambique.

To evaluate the nutrient quality of breads and breakfast cereals identified using the wholegrain definition of ≤10:1 carbohydrate:fibre ratio.

Following a cross-sectional study design, nutritional information was systematically gathered from food labels of breads and breakfast cereals that met the ≤10:1 carbohydrate:fibre criterion. The median nutrient content was compared with the UK Food Standards Agency’s nutrient profiling standards and the associations between carbohydrate:fibre ratio and other nutrients were analysed. Subgroup analyses were undertaken for products with and without fruit, nuts and/or seeds.

Products from four major supermarket stores in the UK.

Breads (n 162) and breakfast cereals (n 266).

Breads which met the ≤10:1 criterion typically contained medium fat, low saturated fat, low sugar and medium Na. Breakfast cereals typically contained medium fat, low saturated fat, high sugar and low Na. In both groups, as the carbohydrate:fibre ratio decreased, fat content increased (bread: P=0·029, r=−0·171; breakfast cereal: P=0·033, r=−0·131) and, in breakfast cereals, as the ratio increased, sugar content increased (P<0·0005, r=0·381). Breakfast cereals with fruit, nuts and/or seeds contained, per 100 g, more energy (P=0·002), fat, saturated fat and sugar (all P<0·0005), while seeded breads had more energy, fat and saturated fat (all P<0·0005).

Overall, breads and breakfast cereals meeting the ≤10:1 criterion have good nutritional quality, suggesting that the criterion could be useful in public health and/or food labelling. The utility of applying the ≤10:1 criterion to products containing fruit, nuts and/or seeds is less clear and requires further research.

Americans consume Na in excess of daily recommendations. Most dietary Na comes from packaged foods, and bread is a major contributor. In the UK, national Na reduction strategies contributed to lower Na levels in packaged foods and lower population Na intake. Similar initiatives are emerging in the USA and require surveillance to assess effectiveness. We aimed to examine Na levels in bread products in the USA and compare levels with similar UK products.

Na data for bread products were obtained from the US Label Insight Open Data Initiative (n 4466) and the FoodSwitch UK database (n 1651). Mean, median and range of Na content, and proportion of products meeting Na targets established by the National Salt Reduction Initiative (NSRI) and the UK Department of Health (DH) were calculated overall, by bread type and by country.

Mean (sd) Na content in bread was 455 (170) mg/100 g in the USA and 406 (179) mg/100 g in the UK. In both countries, savoury bread had the highest mean Na (USA=584 mg/100 g, UK=543 mg/100 g) and fruit bread the lowest mean Na (USA=345 mg/100 g, UK=277 mg/100 g). Na content of US bread products was 12 % higher than in the UK, with 21 % of US bread products and 31 % of UK bread products meeting the NSRI and DH targets, respectively.

US bread products have, on average, 12 % more Na than similar products in the UK. Variation in Na content within product categories, and between countries, suggests the feasibility of manufacturing products with lower Na to lower dietary Na intake.

To explore salt content in bread and to evaluate the feasibility of reducing salt contained in ‘pan francés’ bread.

The study had two phases. Phase 1, an exploratory phase, involved the estimation of salt contained in bread as well as a triangle taste test to establish the amount of salt to be reduced in ‘pan francés’ bread without detection by consumers. In Phase 2, a quasi-experimental, pre–post intervention study assessed the effects of the introduction of low-salt bread on bakery sales.

A municipal bakery in Miraflores, Lima, Peru.

Sixty-five clients of the bakery in Phase 1 of the study; sales to usual costumers in Phase 2.

On average, there was 1·25 g of salt per 100 g of bread. Sixty-five consumers were enrolled in the triangle taste test: fifty-four (83·1 %) females, mean age 58·9 (sd 13·7) years. Based on taste, bread samples prepared with salt reductions of 10 % (P=0·82) and 20 % (P=0·37) were not discernible from regular bread. The introduction of bread with 20 % of salt reduction, which contained 1 g of salt per 100 g of bread, did not change sales of ‘pan francés’ (P=0·70) or other types of bread (P=0·36). Results were consistent when using different statistical techniques.

The introduction of bread with a 20 % reduction in salt is feasible without affecting taste or bakery sales. Results suggest that these interventions are easily implementable, with the potential to contribute to larger sodium reduction strategies impacting the population’s cardiovascular health.

Bread is a staple of the Mediterranean diet but contributes substantially to its salt content (19 % in Spain). The objective of the present study was to assess the feasibility and acceptability of salt reduction in partially baked breads, partly replacing salt (NaCl) with a potassium salt, with subsequent follow-up.

During 2013, nine breads already on the market (1·8 % NaCl flour basis) had 0·5 % of NaCl replaced with potassium citrate (27·7 % reduction in sodium) and were commercialized in Spain. Later, breads were baked in bake-off stores and sold ready-to-eat to consumers. This market test was evaluated by comparing the sales between standard- v. reduced-salt breads and the complaints related to flavour attributes. The wholesalers involved in the market test were then surveyed.

Spain.

The market test confirmed good acceptance of the reduced-salt breads, as 2013 sales were 3678 tonnes v. 2012 sales of 3577 tonnes for the same standard breads. No complaints were received. The wholesaler survey showed, in general, little awareness of salt reduction.

It is feasible that potassium citrate can reduce the salt content of bread without negatively affecting sales or complaints. This shows potential for introducing this type of bread on a larger scale.

Bread is the largest contributor of Na to the American diet and excess Na consumption contributes to premature death and disability. We sought to determine the Na level at which consumers could detect a difference between reduced-Na bread and bread with typical Na content, and to determine if consumer sensory acceptability and purchase intent differed between reduced-Na bread and bread with typical Na content.

Difference testing measured ability to detect differences in control bread and reduced-Na bread using two-alternative forced choice testing. Acceptability was measured using a nine-point hedonic scale and purchase intent was measured using a five-point purchase intent scale.

Difference and acceptability testing were conducted in Portland, OR, USA in January 2013.

Eighty-two consumers participated in difference testing and 109 consumers participated in acceptability testing.

Consumers did not detect a difference in saltiness between the control bread and the 10 % reduced-Na bread, but did detect a difference between the control bread and bread reduced in Na content by 20 % and 30 %. Na reductions had no effect on consumer acceptability of sensory characteristics, including overall liking, appearance, aroma, flavour, sweetness, salt level and texture, or purchase intent.

Reducing Na levels by up to 30 % in the sandwich bread tested did not affect consumer liking or purchase intent of the product. These results support national recommendations for small, incremental Na reductions in the food supply over time and assure bread manufacturers that sensory characteristics and consumer purchase intent of their products will be preserved after Na reductions occur.

The Na content of bread is one of the most common targets of initiatives to reduce Na intake worldwide. Assessing the Na content of staple foods is of major relevance in Mozambique, given the high burden of hypertension in this setting. We aimed to estimate the Na content of white bread available in different bakeries and markets in Maputo.

A cross-sectional study of the Na content of white bread available for sale at twenty-five bakeries and markets in Mozambique. Flame photometry was used to quantify the Na content of the bread. The percentage of samples meeting manufacturer Na targets from South Africa and six countries from other regions, selected as benchmarks, was computed.

Maputo, Mozambique.

Three loaves of white bread from each selected bakery/market.

The mean Na content of bread was 450·3 mg/100 g (range: 254·9–638·3 mg/100 g), with no significant differences between bakeries and traditional markets. Most samples (88 %) did not meet the regulation in South Africa (≤380 mg/100 g). When considering the targets from other countries (range: ≤360–550 mg/100 g), the prevalence of non-compliance varied between 8 % and 92 %. There were no significant differences in the price of bread with Na content below and above the targets.

The content of Na in bread varies widely in Mozambique, reaching high values in a high proportion of the bakeries and markets in Maputo. Measures to regulate the Na content in bread may contribute to a reduction in Na intake and improved health at the population level.

The promotion of healthy lifestyles is one of the major goals of governments and international agencies all over the world. Wholegrain cereals are rich in nutrients and many phytochemical compounds, with recognised benefits for health, including dietary fibre, a number of phenolic compounds, lignans, vitamins and minerals and other bioactive components. The aim of the present work is to review the fundamental studies that support the consumption of wholegrain cereals and bread to prevent chronic diseases.

Descriptive review considering human studies.

Subjects included in randomised intervention trials and cohort studies from different countries published up to 2010.

Several studies show consistently that subjects who ingest three or more portions of foods per day based on wholegrain cereals have a 20–30 % lower risk of CVD than subjects who ingest low quantities of cereals. This level of protection is not observed with the ingestion of refined cereals, these being even higher than with the intake of fruit and vegetables. Likewise, high intake of wholegrain cereals and their products, such as whole-wheat bread, is associated with a 20–30 % reduction in the risk of type 2 diabetes. Finally, protection against the risk of colorectal cancer and polyps, other cancers of the digestive tract, cancers related to hormones and pancreatic cancer has been associated with the regular consumption of wholegrain cereals and derived products.

The regular intake of wholegrain cereals can contribute to reduction of risk factors related to non-communicable chronic diseases.