Evaluation of Salt, Sodium, and Potassium Intake Through Bread Consumption in Chaharmahal and Bakhtiari Province

Document Type: Original Article


1 Deputy of Food and Drug, Shahrekord University of Medical Sciences, Shahrekord, Iran

2 Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran

3 Student of Medical School, Isfahan University of Medical Sciences, Isfahan, Iran


Background and aims: Bread is considered as one of the important sources of sodium in the Iranian diet
and salt is the main source of sodium, which is used to produce bread. The assessment of dietary intake is
a reliable method that shows nutritional problems in the community. Therefore, the purpose of this study
was to evaluate the intake of salt, sodium, and potassium through bread consumption.
Methods: In the present study, 451 samples of different types of bread were tested, sent to the Food
Control Laboratory for health control, and the amount of salt, sodium, and potassium was determined by
potentiometric and flame-photometric methods, respectively. In addition, the amounts of salt, sodium,
and potassium intake were evaluated based on their average concentration in different types of bread
and per capita consumption of bread. Finally, the status of salt, sodium, and potassium intake was
investigated by comparing their recommended daily allowance (RDA) and sodium/potassium ratio and
sodium to caloric intake.
Results: Based on the results, the concentrations of salt, sodium, and potassium were 1.95%, 769%, and
108% (mg per 100 g of bread), respectively. Furthermore, per capita consumption of bread was 320 g/d
and the average intake of salt, sodium, and potassium through bread consumption was 4.03 g, 1588 mg,
and 223 mg/d, respectively. Moreover, 79% of sodium RDA was received through bread consumption.
In these breads, the ratio of sodium to potassium, as well as that of sodium to calorie was 12.07 (mmol/
mmol) and 2 mg/calories, respectively.
Conclusion: In general, the results showed that the intake of sodium and salt by using bread is more than
that of their RDA. Accordingly, the ratio of sodium to potassium and sodium to caloric intake is higher
than the permitted limit in these conditions, which provides the basis for the incidence of cardiovascular
diseases. Therefore, strong monitoring of bread producing units is necessary.


Main Subjects

1. Mente A, O’Donnell MJ, Rangarajan S, McQueen MJ,
Poirier P, Wielgosz A, et al. Association of urinary sodium
and potassium excretion with blood pressure. N Engl J Med.
2014;371(7):601-11. doi: 10.1056/NEJMoa1311989.
2. Mills KT, Chen J, Yang W, Appel LJ, Kusek JW, Alper A,
et al. Sodium excretion and the risk of cardiovascular
disease in patients with chronic kidney disease. Jama. 

2016;315(20):2200-10. doi: 10.1001/jama.2016.4447.
3. World Health Organization (WHO). Guideline: Sodium intake
for adults and children. WHO; 2012.
4. Drewnowski A, Rehm CD, Maillot M, Mendoza A, Monsivais
P. The feasibility of meeting the WHO guidelines for sodium
and potassium: a cross-national comparison study. BMJ Open.
2015;5(3):e006625. doi: 10.1136/bmjopen-2014-006625.
5. Park J, Kwock CK. Sodium intake and prevalence of
hypertension, coronary heart disease, and stroke in Korean
adults. Journal of Ethnic Foods. 2015;2(3):92-6. doi: 10.1016/j.
6. Powles J, Fahimi S, Micha R, Khatibzadeh S, Shi P, Ezzati
M, et al. Global, regional and national sodium intakes
in 1990 and 2010: a systematic analysis of 24 h urinary
sodium excretion and dietary surveys worldwide. BMJ Open.
2013;3(12):e003733. doi: 10.1136/bmjopen-2013-003733.
7. Fulgoni VL, 3rd, Agarwal S, Spence L, Samuel P. Sodium
intake in US ethnic subgroups and potential impact of a new
sodium reduction technology: NHANES Dietary Modeling.
Nutr J. 2014;13(1):120. doi: 10.1186/1475-2891-13-120.
8. Quilez J, Salas-Salvado J. Salt in bread in Europe: potential
benefits of reduction. Nutr Rev. 2012;70(11):666-78. doi:
9. USDA. United State Department of Agriculture and
United State Department of Health and Human Services.
Dietary Guidelines for Americans; 2010. https://www.
10. Charney P. Water, Electrolytes, and Acid-Base Balance. In:
Kathleen M, Escott-Stump, Sylvia. Krause’s Food & Nutrition
Therapy. Canada. Elsevier. 2008. p 170-1.
11. World Health Organization (WHO). Guideline: Potassium
intake for adults and children. 2012. http://www.who.int/
12. World Health Organization (WHO). Global Health
Observatory: Raised Blood Pressure. WHO; 2017. http://www.
13. Heidari K, Ismaili PI. Determination the pattern of bread
consumption in Iran. Business Survey. 2010;40:1-19.
14. Iranian National Standards Organization (INSO). Traditional
breads Specifications and test methods. 3rd ed. Theran, Iran:
INSO; 2014.
15. Shahedi M. The pattern of food production and consumption
- Fifth Conference on Islamic-Iranian model of progress.
16. Silow C, Axel C, Zannini E, Arendt EK. Current status of salt
reduction in bread and bakery products–a review. J Cereal Sci.
2016;72:135-45. doi: 10.1016/j.jcs.2016.10.010.
17. United States Department of Agriculture (USDA). National
Nutrient Database for Standard Reference. United States
Department of Agriculture. Food Composition Databases;
2015. https://ndbnalusdagov/ndb.
18. Castanheira I, Figueiredo C, Andre C, Coelho I, Silva AT, Santiago
S, et al. Sampling of bread for added sodium as determined
by flame photometry. Food Chem. 2009;113(2):621-8. doi:
19. Maalouf J, Cogswell ME, Yuan K, Martin C, Gillespie C,
Ahuja JK, et al. Sodium content of foods contributing to
sodium intake: comparison between selected foods from
the CDC Packaged Food Database and the USDA National
Nutrient Database for Standard Reference. Procedia Food Sci.
2015;4:114-24. doi: 10.1016/j.profoo.2015.06.016.
20. Maghroun M, Sajjadi F, Sarhanghpour MR, Nouri F, Shriatifar
M, Mohammadifard N, et al. Salt and sodium content in
Iranian breads. Hakim Research Journal. 2015;18(3):209-16.
21. Zabihollahi T, Goftari S, Garibi F, Naderi K, Korani A, Danesh
O, et al. Investigation of the amount of sodium bicarbonate
and salt in different types of bread in the bakeries of Kurdistan
Province from 2008 to 2010. Scientific Journal of Kurdistan
University of Medical Sciences. 2013;18(3):39-46. [Persian].
22. Zibaeenezhad M, Hooshangi M, Abtahi F, Heydari ST. A
Study of Salt (Sodium Chloride) Content in Different Bread
Consumed in Shiraz City in Spring/Summer 2009. Iranian
Cardiovascular Research Journal. 2010;4(1):17-21. [Persian].
23. Brinsden HC, He FJ, Jenner KH, Macgregor GA. Surveys
of the salt content in UK bread: progress made and further
reductions possible. BMJ Open. 2013;3(6). doi: 10.1136/