Salt intake- related knowledge, attitudes, and practices among Jordanian Adults
Publication date: 2023
This study showed that Jordanian adults have limited knowledge around salt intake and their practices of high salt intake are inappropriate. Therefore, it is necessary to take immediate steps to adopt long-term strategies to reduce salt intake among the Jordanian population and lessen the negative impacts on community health.
Estimated 24-Hour urinary sodium and potassium excretion in adults in the Northwest Region of Morocco, 2017
Publication date: 2023
Excessive sodium (Na) and insufficient potassium (K) intake contribute to a high risk of cardiovascular events. Morocco lacks data on actual Na and K intake in adults. We estimated mean Na and K intake in a Moroccan population of adults residing in the Northwest region using 24 h urinary excretion and examined their association with blood pressure (BP). To conclude, Na intake was higher and K intake was lower than WHO recommendations in the study population. There was no association between estimated Na and K intake levels with BP in this population.
Determination of salt content in traditional and industrial Moroccan white bread by inductively coupled plasma mass spectrometry
Publication date: 2022
In Morocco, bread is a major contributor to sodium intake. However, currently, few studies have been carried out to assess the salt content in bread. This study aimed to estimate the sodium and salt content of white bread available in artisanal and industrial bakeries in the twelve regions of Morocco. This study concludes that bread salt content in Morocco exceeds the recommended threshold of the national federation of bakery and pastry and health authorities. Further efforts are necessary to increase knowledge and awareness of bakers and to teach them how to reduce salt content without affecting the flavor and the quality of their products.
Prevalence of iodine deficiency among Moroccan women of reproductive age
Publication date: 2022
Iodine deficiency disorders (IDD) affects nearly 1.9 million people worldwide. Iodine deficiency (ID) remains a public health concern not only for pregnant women, but for women of reproductive age (WRA) as well. This study was planned to evaluate the iodine status and the prevalence of iodine deficiency in a nationally representative sample of Moroccan WRA according to their socio-economic data and living areas. To conclude, ID is still a public health problem in Morocco highlighting the necessity to implement effective national program, including efficient salt iodization, effective nutritional education and awareness, to control iodine deficiency and prevent IDD development.
Salt reduction initiatives in the Eastern Mediterranean Region and evaluation of progress towards the 2025 global target: a systematic review
Publication date: 2021
The World Health Organization has recommended the reduction of salt/sodium intakes as a ‘best buy’, acknowledging it as one of the most cost-effective and feasible approaches to reduce the risk of cardiovascular diseases, stroke, and coronary heart disease. This study aims at identifying national salt reduction initiatives in countries of the Eastern Mediterranean Region and describing their progress towards the global salt reduction target. In conclusion, this study shows that 15 out of 22 countries of the Eastern Mediterranean Region had one or more estimates of salt intake in the population (68%), and that 13 had implemented national salt reduction strategies (59%).
Implementing the national strategy of salt reduction in Morocco: the baker's perspective
Publication date: 2021
Morocco launched a national salt reduction strategy in 2019. The commitment of bakeries is key in the success of this strategy. However, the evaluation of such a commitment is not yet done. This study aims to examine knowledge of bakers about the national strategy of salt reduction and evaluate their commitment in implementing the specific recommendation related to salt reduction in bread. In conclusion, increasing the knowledge of bakers is highly recommended to guarantee their commitment toward contributing to the strategy of reducing salt in bread. Dissemination of messages via TV and radio could be appropria.
A systematic review of salt reduction initiatives around the world: a midterm evaluation of progress towards the 2025 global noncommunicable diseases salt reduction target
Publication date: 2021
In 2013, WHO recommended that all Member States aim to reduce population salt intake by 30% by 2025. The year 2019 represents the midpoint, making it a critical time to assess countries’ progress towards this target. This review aims to identify all national salt reduction initiatives around the world in 2019, and to quantify countries’ progress in achieving the salt reduction target. In summary, there has been an increase in the number of salt reduction initiatives around the world since 2014. More countries are now opting for structural or regulatory approaches. However, efforts must be urgently accelerated and replicated in other countries and more rigorous monitoring and evaluation of strategies is needed to achieve the salt reduction target.
A household-based survey of iodine nutrition in Moroccan children shows iodine sufficiency at the national level but risk of deficient intakes in mountainous areas
Publication date: 2021
Historically, mountainous areas of Morocco have been affected by endemic goiter and severe iodine deficiency. In 1995, Morocco legislated salt iodization to reduce iodine deficiency. There has been no national survey of iodine nutrition in school-age children for nearly 3 decades. This study aims to assess iodine nutrition in a national sample of 6 to 12-year-old children in Morocco by measuring the urinary iodine concentration in spot urine samples to inform the national salt iodization strategy.
Unbalanced intakes of sodium and potassium among Tunisian adults: a cross‐sectional study
Publication date: 2021
The prevention and management of hypertension are associated with a lowering of sodium intake. The present study aimed to evaluate the sodium and potassium intake levels of the Tunisian population through measurement of 24‐hour urinary sodium excretions. This study demonstrates that a high sodium intake and inadequate potassium intake were found among adult populations living in urban cities. According to the WHO, a Tunisian strategy was launched aiming at the reduction of salt intake, and the reduction of sodium content in bread was adopted as the main procedure.
Iodine status in Tunisia two decades after universal salt iodization
Publication date: 2020
The article describes the iodine status and the efforts made to measure it during the last decades in Tunisia. In 2012, over 78% of Tunisian households were using iodized salt, but updated data are needed to ensure sustainability of the 25-year-old salt iodization programme. No concrete actions have been taken since the last iodine survey in 2012. Advocacy on the issue of iodine nutrition should be set as a top priority not only to eradicate iodine deficiency but also to tackle the issue of iodine excess.
Nutritional value of the Middle Eastern diet: analysis of total sugar, salt and iron in Lebanese traditional dishes
Publication date: 2020
The expanding burden of diet-related noncommunicable diseases in the Eastern Mediterranean requires urgent public health vigilance and actions. This study aimed at establishing a database analysis of total sugar, salt and iron content in Lebanese foods, focusing on traditional dishes. This study emphasizes the need for multi-cultural education and awareness on food sources of salt and iron, and the health effects regarding high intake of salt and low intake of iron.
The threshold of salt taste recognition among a sample of Moroccan population
Publication date: 2020
This study aims to determine the threshold of salt taste recognition and to evaluate differences by sex, age and body mass index among a sample of Moroccan population. The present study showed that the average threshold of salt taste recognition is high, and that it is even higher in men compared to women. At a community level, a progressive reduction of salt in food items is recommended. This study provided valuable information to be considered as a baseline for monitoring the population and evaluating the action plan aiming to reduce salt consumption in Morocco.
Trend of Iodine Status in the Eastern Mediterranean Region and Impact of the Universal Salt Iodization Programs: a Narrative Review
Publication date: 2020
This paper aims to evaluate the progress of countries in Eastern Mediterranean Region (EMR) toward the eradication of iodine deficiency disorders (IDD) and recommend operational action to support implementation of the WHO Regional Nutrition Strategy (2020–2030). There has been significant progress in increasing the proportion of dietary salt which is adequately iodized. Many countries have achieved or are now on the threshold of achieving IDD elimination. The WHO in coordination with United Nations Children’s Fund is working with member states to ensure suitability of these achievements.
Assessment of salt concentration in bread commonly consumed in the Eastern Mediterranean Region
Publication date: 2018
Hypertension is the most important cardiovascular risk factor in the WHO Eastern Mediterranean Region. Excessive salt and sodium intake is directly related to hypertension, and its reduction is a priority of WHO. Bread is the leading staple food in the Region; therefore, reducing the amount of salt added to bread could be an effective measure for reducing salt intake. In this study, bread samples were collected, and they were analysed for sodium content using atomic absorption spectroscopy. The mean salt and sodium content in bread for all countries was 7.63 (SD 3.12) and 3.0 (SD 1.23) g/kg, respectively.
Salt intake reduction strategies in the Eastern Mediterranean Region
Publication date: 2018
The World Health Organization has recommended salt reduction as a “best buy”, recognizing it as one of the most cost–effective approaches in preventing noncommunicable diseases and reducing cardiovascular diseases and medical costs. In the context of the global target to reduce salt intake by 30% by 2025, this review presents an up-to-date overview of the current salt reduction initiatives in the Region by highlighting regional and national policies, strategies, and activities that aim at characterizing and/or reducing the intakes of dietary salt.
Policy statement and recommended actions to lower national salt intake and death rates from high blood pressure and stroke in the Eastern Mediterranean Region
Publication date: 2014
This policy statement was published in 2014, aiming to achieve progressive and sustainable reduction in national salt intake in the following 3–4 years by 25% to reduce stroke and heart disease rates within 5 years. It addresses the salt intake in countries of the Eastern Mediterranean Region and suggests several country-level actions for achieving salt reduction in three phases.
How to obtain measures of population-level sodium intake in 24-hour urine samples
Publication date: 2018
There is compelling evidence of the direct relationship between salt consumption and blood pressure. WHO is coordinating initiatives globally to reduce dietary salt intake at the population level. This document provides an essential salt intake measurement tool for countries in the Eastern Mediterranean Region that want to start, contribute to, and share information on dietary salt reduction initiatives. The protocol is primarily intended for principle investigator(s) of studies of salt/sodium, potassium and iodine intake. Parts of the document are also intended for field staff who are conducting the surveys.
Guideline: sodium intake for adults and children
Publication date: 2012
The objective of this guideline is to provide recommendations on the consumption of sodium to reduce noncommunicable diseases (NCDs) in most adults and children. The recommendations in this guideline can be used by policy-makers, technical and programme planners in the government and various organizations involved in the design, implementation and scaling-up of nutrition actions for public health and prevention of NCDs to assess current sodium intake levels relative to a benchmark. If necessary, the recommendations can also be used to develop measures to decrease sodium intake through public health interventions such as food and product labelling, consumer education, and the establishment of food-based dietary guidelines.