Voluntary Food Reformulation Initiatives Failed to Reduce the Salt Content of Artisanal Breads in Greece

Reducing salt in bread is considered a straightforward, cost-effective public health intervention and is implemented in several countries, either voluntarily or through legislation. A Memorandum of Understanding (MoU) was signed in Greece in 2016, setting a voluntary maximum salt content of 1.2% in artisanal bread. This study aimed to evaluate the effectiveness of the MoU and assessed the potential impact of reducing salt in bread on overall salt intake, using the MoU target and the relevant WHO global sodium benchmark.

Artisanal bread samples (n = 253) randomly collected from different parts of Greece in 2024 were analyzed for salt content and compared with samples collected in 2012 (n = 220). Salt intake from bread was estimated using data from the Hellenic National Nutrition and Health Survey (HNNHS), and modeling scenarios were conducted.

The MoU and related voluntary awareness activities were ineffective as a strategy to reduce salt in bread. The mean salt content in bread in 2024 was 1.41 (0.30)%, representing a 6.8% increase compared to 1.32 (0.31)% in 2012. Only 19.4% of samples in 2024 contained ≤1.2% salt, compared to 31.8% in 2012. Full MoU compliance would enable an additional 3.1% of Greek bread consumers, currently exceeding 5 g in their daily salt intake from foods alone, to reduce their intake to below 5 g. This would rise to 6.2% if the WHO sodium benchmark was implemented.

A mandatory salt limit, aligned with the WHO global benchmark, is urgently needed to support national reformulation strategies. This work can contribute to European and international discussions on food reformulation.