Over-consumption of sodium is closely linked to hypertension, stroke and other cardiovascular diseases (CVD). According to the Moroccan Ministry of Health 2019, the prevalence of hypertension in Morocco decreased from 33.6% in 2000 to 29.3% in 2017. Bread is one of the most important sources of sodium in several countries, including Morocco.

This study aims to assess the impact of 5years of awareness campaigns (2011–2016) in reducing the quantity of sodium chloride used in preparing commercial white bread, and in improving nutritional knowledge and practices related to sodium.

Nutritional knowledge, attitudes and practices (KAP) about sodium were assessed using a questionnaire in interviews in 2012, 2014 and 2016 with 1218bakeries in Casablanca, Morocco. The questionnaire covered topics on the consequences of sodium over-consumption and recommended daily intake. The quantity of sodium chloride in commercial bread was measured by Mohr's titration method. Bread samples were collected and analyzed from 160bakeries in 2011 and 2016.

The KAP survey revealed that in 2016 for bakers that 92.9% knew at least that over consumption of salt causes blood pressure, 72.8% were committed or started reducing added sodium in bread preparation and 98.3% of bakers market bread without salt. Analysis of bread revealed that added sodium chloride decreased from 17.42±1.28g/kg in 2011 to 13.1±2.24g/kg in 2016, which is equivalent to a decrease of 26.3% on five years (0.94g per year). The quantity of salt measured on 2017–2018 in the bread of 6 Moroccan cities showed an average rate varying between 12.85 and 16.9g/kg.

This study highlights the effectiveness of awareness campaigns through the KAP for reducing the use of salt in bread-making. Knowing that the daily consumption of bread in Morocco varied between 360 and 500g, this reduction of 26.3% of the salt in the bread certainly has a very positive impact on the CVD protection.