Dietary patterns among adults in three low-income urban communities in Accra, Ghana

PLoS One. 2023 Nov 9;18(11):e0293726. doi: 10.1371/journal.pone.0293726. eCollection 2023.

Abstract

Objective: Dietary patterns describe the dietary behaviour and habits of individuals. Unhealthy dietary patterns provide individuals with limited nutrients while increasing the risk of nutrition-related diseases. Unhealthy dietary patterns are high in urban areas, especially among low-income urban residents. This study examined dietary patterns in three low-income urban communities in Accra, Ghana, between 2011 and 2013.

Methods: This study used Wave 2 and 3 data from the Urban Health and Poverty Survey (EDULINK 2011 and 2013). The sample size was 960 in 2011 and 782 in 2013. Dietary pattern was examined using factor analysis and the NOVA food classification system. Summary statistics were computed for sociodemographic characteristics and diet frequency and pattern. Differences in dietary behaviours between 2011 and 2013 were also estimated. Three logistic regression models were computed to determine the predictors of dietary patterns.

Results: The frequency of consumption of animal-source foods (ASF) and fruits was higher in 2013 compared with 2011. The intake of processed culinary ingredients (NOVA Group 2), processed foods (NOVA Group 3) and ultra-processed foods (NOVA Group 4) was higher in 2013 versus 2011. In 2013, 29% consumed ultra-processed foods compared to 21% in 2011. Three dietary patterns (rice-based, snack-based, and staple and stew/soup) were identified. About two out of every five participants consumed the food items in the rice (43%) and staple and sauce patterns (40%). The proportion of participants who consumed the food items in the snack pattern was 35% in 2011 but 41% in 2013. Respondents aged 25-34 and those with higher education often consumed the snack-based and rice-based dietary patterns. In 2013, participants in Ussher Town had a higher probability of consuming food items in the snack pattern than those living in Agbogbloshie.

Conclusions: This study found that between 2011 and 2013, more participants consumed ASFs, fruits, and processed foods. A complex interplay of personal and socio-cultural factors influenced dietary intake. The findings of this study mirror global changes in diet and food systems, with important implications for the primary and secondary prevention of NCDs. Health promotion programs at the community level are needed to address the increasing levels of processed food consumption.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Diet
  • Eating
  • Energy Intake
  • Fast Foods*
  • Food Handling
  • Ghana
  • Humans
  • Nutrition Disorders*
  • Poverty

Grants and funding

Funding sources were jointly from Secretariat of the African Caribbean and Pacific Group of States (ACP) - ACP-EU Cooperation Programme in Higher Education (EDULINK), International Development Research Centre (IDRC) and New York University’s Global Public Health Research Challenge Fund. Sandra Boatemaa Kushitor was supported in part by a travel grant from the Centre for Collaboration in Africa, Stellenbosch University. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.