This study assessed the prevalence and compliance of nutrition claims on pre-packaged pita bread.
The prevalence of nutrition and health claims found in this study was much higher than what was reported in many countries such as Canada , UK , Slovenia , Serbia , Ireland , and five more European countries . Moreover, the prevalence was higher than that of a previous study conducted in Lebanon, where among 148 pita bread collected in Mount Lebanon in 2017, 65.5% had at least one claim, 40.5% had a nutrition claim, and 16.9% had a health claim . This showed that the use of nutrition claims has doubled between 2017 and 2018 and the health claims use increased by 1.7 folds. The high variability between the prevalence of claims in these studies could be due to the year when the research was conducted, since the use of these claims and release of pertinent regulations is very recent .
Moreover, this study showed a higher prevalence of claims on functional and unconventional bread as compared to white bread, in accordance with the literature . Thus, in pita bread as well as in other food categories, the higher prevalence of claims is found on products made with functional ingredients like whole grains, oat, quinoa and bran. This can be explained by the fact that consumers who usually buy such products are less price sensitive than other consumers, and are more concerned about the healthiness of products .
Additionally, among nutrition claims, the observed prevalence of nutrient-content claims was higher than what was reported on pre-packed food products in several countries [35, 39,40,41]. The increase in the use of claims in Lebanon, as well as the high prevalence of nutrition claims as compared to health claims observed in all other countries might be explained by the lack of governmental surveillance and improper regulations [7, 42]. In addition, manufacturers might be taking advantage of the use of claims as strong marketing tool considering its effect to influence consumers’ choice, leading to an increase in sales . In fact, in Lebanon, consumers are highly influenced by claims at the point-of-sale, especially in the case of bread, where 49.8% of consumers (n = 400) rely on claims when buying bread .
In line with our results, in Australia, the most common nutrient content claims used on bread were “low in sugar”, followed by “a source of dietary fiber” claim . Similarly, a previous study on pita bread collected between 2017 and 2018 in Mount Lebanon found that the main nutrient claims were mainly related to sugar, salt, and fiber, and that non-addition claims were used on all white bread . In addition, the results of the current study showed that many claims were related to the absence of preservatives which are perceived as an unknown personal and social risk  and are believed to be harmful to health . Therefore, bakeries are stressing on the use of “preservative-free” or “no added preservatives” claims to address the increased consumers’ concern . In fact, based on LIBNOR , the only additives that are allowed in pita bread are the preservatives sodium propionate, and calcium propionate, both of which have antifungal and antimicrobial properties, with no effect on yeast .
In the current study, half of the pita bread samples failed to meet the standard requirements of LIBNOR  and CODEX  which require displaying nutrition facts panels on all pre-packaged foods. Similarly, failure to meet this requirement was observed in Malawi . Nutrition facts are used by some consumers to make product selections that suit their health conditions, thus, they should be displayed on the package . In addition, carrying a nutrition facts panel will give more credibility to the claim and improve the manufacturer’s ability to compete .
Different nutrients were assessed based on the nutrition facts panel. The highest fiber content assigned to the unconventional bread is mainly due to the use of composite flours, and grains like quinoa, oat and wheat bran that are rich in fiber [49,50,51]. Those breads are recommended for consumers seeking to prevent or mitigate certain conditions like cardiovascular diseases (CVDs), diabetes, obesity, constipation and colon cancer [52, 53].
Furthermore, our results regarding the sugar content are in line with other studies reporting lower sugar content in whole grain loaves compared to other loaf breads . Sugar is used in several types of bread, and high levels may be added to white and brown breads as it enhances fermentation, and the sensory characteristics like flavor and color [9, 54, 55]. Regarding sodium assessment, similarly to our results, higher values of sodium in white bread were reported in Lebanon . Likewise, in Australia, white bread was the highest in sodium content as compared to whole grain and gluten-free . As for the protein content, similarly, other studies reported higher concentrations of protein in whole grain breads compared to white bread . The high protein levels recorded in unconventional breads can be the result of using soy flour which contains up to 45% of protein .
In the midst of this high prevalence of nutrition claims, their credibility and compliance with the standards become critical. The results using both, the nutrition facts panels and the nutrient analysis showed low compliance of salt, fiber and sugar claims, in contrast to a high compliance for protein related claims. However, among the minority of compliant claims, the most credible claims were “source of fiber”, “source of protein” and “low in sugar”, which is in line with the literature [9, 13, 57].
In contrast to our results on salt claims, a recent study, analyzing bread samples (n = 48) reported a mean sodium content of 127 mg.100 g−1 in “low-salt” labelled breads, and the absence of sodium in “zero-salt” labelled breads, which indicates the credibility of those claims . However, studies in Slovenia and Australia reported lower compliance of salt claims [9, 10]. Several studies reported In Lebanon, 38.3% and 7% of shoppers examine the sodium content in products in general , and of pita bread respectively . Therefore, such mislabeling can jeopardize people’s health, especially when bread as the main salt contributor in the diet and salt reduction initiatives have been conducted to reduce and prevent NCDs [16, 59].
Similarly, the high prevalence of fraudulent statements related to sugar content might severely affect people with certain medical conditions such as diabetes; especially in Lebanon where the latter ranked fourth among the leading causes of death . Moreover, since bread naturally contains sugar, it is suggested to replace “sugar free” claims by “no-added sugars”. It is practically impossible to differentiate between free and added sugar using chemical analyses. Providing information on intrinsic, and added sugar amounts in the nutrition facts panel, similarly to the approaches followed by the US is recommended.
In Lebanon, fiber claims ranked first among the nutrient content claims people actively look for upon purchasing . However, the high prevalence of fraudulent fiber claims found on bread raises concerns for consumers who are searching to increase their fiber intake due to critical health issues like diverticulosis, constipation or type 2 diabetes . Another impact of this mislabeling is the fact that, bread, with functional ingredients like added fiber, is usually more expensive, accordingly, consumers are paying more for these products.
Protein claims showed a 100% compliance, which can be explained by the proper formulation of those products, that is, the use of high protein components like soy flour, bran, and quinoa as indicated in the ingredients lists.
Among “cholesterol free” claims, 91.7% of claims were accurate. It is important to highlight that the standard recipe adopted by all bakeries in Mount Lebanon relies exclusively on plant based ingredients (flour, salt, yeast, sugar, and water) which are cholesterol free [48, 61]. Thus, although “cholesterol-free” claims on pre-packaged pita bread could be considered credible based on the eligibility criteria, their presence is considered misleading and purely displayed for marketing purposes, as the product will be perceived as a healthier option. In order to be more credible towards consumers, it is suggested to remove “cholesterol-free” claims on pre-packaged pita bread, or replace them by more truthful statements such as “naturally free from cholesterol”.
Like many other low- and middle-income countries, in Lebanon labelling literacy is low. In 2017, Hassan and Dimassi reported that Lebanese shoppers (n = 748) had low knowledge on how to read and use food labels. Therefore, food manufacturers can easily take advantage of consumers’ ignorance. Accordingly, proper regulations in such countries are necessary for consumer protection.
Finally, results of Lebanese bread standards of identity showed poor compliance highlighting the need to reassess crude fiber content by bakeries, as their non-compliance with the standard of identity requires changing the name of the product.
This study has potential limitations, as the reported findings are not representative of all claims on food products, as only one food category was assessed. However, bread was assessed as it is a Lebanese staple food that is likely to have a high prevalence of claims. Therefore, issues reported in this study may occur in other food categories as well. In addition, the bread was only collected from bakeries located in Mount Lebanon and did not cover other governorates. However, most of those bakeries have several branches across Lebanon and sell their products in large supermarkets. Thus, it can be assumed, that the results were enough to highlight the misuse of claims, and the need for control and surveillance.
On the other hand, this study is the first audit conducted on staple food in the country and covering multiple nutrients.