Review of Ghana’s food environment: Drivers of availability, barriers to healthy food access, and impact of interventions and policies

Food environments exert a significant effect on population dietary choices and health outcomes. Policies that influence the food environment, can have a significant impact on individual and population dietary choices. This rapid review assessed the nature and interaction within the Ghanaian  food environment, and the impact that existing school, workplace, and national food policies have on dietary intake and nutritional outcomes.  Online databases and university repositories were searched for relevant articles and documents. A total of forty articles and documents were  included in the review. Majority of the reviewed papers (85%) used a cross-sectional design. The findings show that traditional outlets (open  markets) constitute the main food source among the Ghanaian populace, while convenience stores serve as an important source of processed  foods. Prepared local foods are often consumed outside the home and are mainly sourced from street food vendors. Street foods are perceived as  less expensive, convenient, and delicious. The food environment was found to influence dietary acquisition, intake, and nutritional outcomes.  Although most nutrients provided by the School Feeding Programme (SFP) are below recommended intake standards, the SFP contributes positively  to improved diets and nutrition status of school-age children. Children attending SFP-implementing schools experience higher intakes of  protein, iron, zinc, calcium, vitamin A, folate, and have higher haemoglobin, and lower prevalence of stunting, underweight, and thinness than  children in non-SFP implementing schools. Availability of a private room for breastfeeding mothers improved breastfeeding frequency. Ghana’s fatty  meat restriction policy has reduced the availability and sale of fatty meat on the Ghanaian market. Reported drivers and barriers to healthy  foods consumption include socio-economic factors, media information, food storage facilities, cultural perception, fruit seasonality, knowledge on  the nutrient value of fruits and vegetables, safety profile of fruits and vegetables, and contribution of household production to dietary intake. In  conclusion, the food environment review reveals the drivers of availability, barriers to healthy food access, and impact of interventions and policies  on the Ghanaian food environment.&nbsp

Review of Ghana’s food environment: Drivers of availability, barriers to healthy food access, and impact of interventions and policies

Food environments exert a significant effect on population dietary choices and health outcomes. Policies that influence the food environment, can have a significant impact on individual and population dietary choices. This rapid review assessed the nature and interaction within the Ghanaian food environment, and the impact that existing school, workplace, and national food policies have on dietary intake and nutritional outcomes. Online databases and university repositories were searched for relevant articles and documents. A total of forty articles and documents were included in the review. Majority of the reviewed papers (85%) used a cross-sectional design. The findings show that traditional outlets (open markets) constitute the main food source among the Ghanaian populace, while convenience stores serve as an important source of processed foods. Prepared local foods are often consumed outside the home and are mainly sourced from street food vendors. Street foods are perceived as less expensive, convenient, and delicious. The food environment was found to influence dietary acquisition, intake, and nutritional outcomes. Although most nutrients provided by the School Feeding Programme (SFP) are below recommended intake standards, the SFP contributes positively to improved diets and nutrition status of school-age children. Children attending SFP-implementing schools experience higher intakes of protein, iron, zinc, calcium, vitamin A, folate, and have higher haemoglobin, and lower prevalence of stunting, underweight, and thinness than children in non-SFP implementing schools. Availability of a private room for breastfeeding mothers improved breastfeeding frequency. Ghana’s fatty meat restriction policy has reduced the availability and sale of fatty meat on the Ghanaian market. Reported drivers and barriers to healthy foods consumption include socio-economic factors, media information, food storage facilities, cultural perception, fruit seasonality, knowledge on the nutrient value of fruits and vegetables, safety profile of fruits and vegetables, and contribution of household production to dietary intake. In conclusion, the food environment review reveals the drivers of availability, barriers to healthy food access, and impact of interventions and policies on the Ghanaian food environment.&nbsp

A review of Ghana’s food system and its implications on sustainability and the development of national food-based dietary guidelines

Food-Based Dietary Guidelines (FBDG) provide culturally-appropriate and actionable recommendations based on which populations can make healthy food choices. Food systems sustainability, from production to consumption, and disposal of food and foodrelated items, should be a critical consideration for developing such guidelines. This rapid review assesses Ghana's food systems to determine the level of sustainability to inform the FBDG recommendations. Peer-reviewed articles, documents and reports of relevance to Ghana were included in this rapid review. A hundred and eight papers, answering different questions on food system sustainability were reviewed. Bread, cereals, fish and indigenous vegetables are the most frequently consumed food groups. Sugar-Sweetened Beverages are the most consumed imported foods. In rural areas, 53% of dietary protein comes from plant sources. Fish is the main the source of animal protein for most Ghanaian households. There is intensive exploitation of marine and fresh water resources. Most livestock are raised by smallholder farmers using freerange system. Poultry is frequently kept on deep litter system and only a few are largescale. Crop production for household consumption and small-scale animal rearing are predominant, especially in Northern Ghana. By weight, fruits and vegetables are the least cultivated and consumed crops at the household level. Wood is the commonest source of fuel for cooking, especially in rural areas. Single use plastic is the most used and preferred material for food packaging. Indiscriminate and poor management of waste and pesticide misuse is commonly reported. The findings suggest the need for promoting production diversification, use of clean fuel and reusable food packaging as part of FBDGs to enhance sustainability of Ghana’s food systems.&nbsp

A review of Ghana’s food system and its implications on sustainability and the development of national food-based dietary guidelines

Food-Based Dietary Guidelines (FBDG) provide culturally-appropriate and actionable recommendations based on which populations can make healthy food choices. Food systems sustainability, from production to consumption, and disposal of food and foodrelated items, should be a critical consideration for developing such guidelines. This rapid review assesses Ghana's food systems to determine the level of sustainability to inform the FBDG recommendations. Peer-reviewed articles, documents and reports of relevance to Ghana were included in this rapid review. A hundred and eight papers, answering different questions on food system sustainability were reviewed. Bread, cereals, fish and indigenous vegetables are the most frequently consumed food groups. Sugar-Sweetened Beverages are the most consumed imported foods. In rural areas, 53% of dietary protein comes from plant sources. Fish is the main the source of animal protein for most Ghanaian households. There is intensive exploitation of marine and fresh water resources. Most livestock are raised by smallholder farmers using freerange system. Poultry is frequently kept on deep litter system and only a few are largescale. Crop production for household consumption and small-scale animal rearing are predominant, especially in Northern Ghana. By weight, fruits and vegetables are the least cultivated and consumed crops at the household level. Wood is the commonest source of fuel for cooking, especially in rural areas. Single use plastic is the most used and preferred material for food packaging. Indiscriminate and poor management of waste and pesticide misuse is commonly reported. The findings suggest the need for promoting production diversification, use of clean fuel and reusable food packaging as part of FBDGs to enhance sustainability of Ghana’s food systems

Strategy Precedes Operational Effectiveness: Aligning High Graduation Rankings With Competitive Graduation Grade Point Averages

Two pivotal and interconnected claims are addressed in this article. First, strategy precedes program effectiveness. Second, graduation rates and rankings are insufficient in any account of academic progress for African American students. In this article, graduation is regarded as the floor and not the ceiling, as it were. The ideal situation in the promotion of strategy is the alignment of high graduation rates or rankings with high graduation cumulative grade point averages. This strategic alignment is precisely what needs to be formulated in the first instance before making judgments about program development and/or operational effectiveness. The work of the Office of African American Affairs of the University of Virginia provides the context for observing trends in academic performance that illustrate the optimal alignment between high graduation rankings and correspondingly high grade point averages

Predictors of hypertension among diabetic patients in the Ejisu Municipality of Ghana

<p><strong>Introduction: </strong>The co-existence of hypertension with diabetes mellitus among diabetic patients is a setback to public health. About 40–75% of diabetic patients present with hypertension. The co-existence of hypertension and diabetes can accelerate complications such as stroke, myocardial infarction, nephropathy, and mortality. Available data indicate the devastating effects of hypertension and diabetes on individuals, families, and the economy as catastrophic. Therefore, knowing the predictors of hypertension among diabetic patients would inform the lifestyle and management of the two conditions.</p> <p><strong>Objective:</strong> The study focused on predictors of hypertension among diabetic patients in the Ejisu Municipality of Ghana.</p> <p><strong>Methods: </strong>The study employed a quantitative approach with a sample size of 120. Data were collected on sociodemographic characteristics, family history, 24-hour dietary recall, blood pressure, fasting blood glucose, glycated haemoglobin, total lipid profile, and anthropometrics. Data were analyzed using SPSS version 27.</p> <p><strong>Results:</strong> Out of 120 respondents, 85% were females with 77.5% above 50 years of age. A majority (66.7%) had a family history of diabetes with 76.7% having hypertension as a comorbidity. Fasting blood glucose was found to be 8.519 times more likely to present with hypertension. Systolic blood pressure, carbohydrate, and sodium intakes were 6.1%, 2.9%, and 0.1% respectively. However, diabetic patients with high HbA1c were 97% less likely not to present with hypertension.</p> <p><strong>Conclusion:</strong> Hypertension was found to be the most common comorbidity among diabetic patients in Ghana. Glycaemic control, systolic blood pressure, and dietary factors specifically carbohydrate and sodium intake were significant predictors of hypertension among the study participants.</p><p>Funding provided by: Kwame Nkrumah University of Science and Technology<br>Crossref Funder Registry ID: https://ror.org/00cb23x68<br>Award Number: VC/OGR/15</p><p>Questionnaires made up of socio-demographic characteristics, 24-hour dietary recall, and anthropometric and blood pressure measurements were administered to patients. Again, the study also took the biochemical parameters of the participants.</p&gt

Predictors of hypertension among diabetic patients in the Ejisu Municipality of Ghana

<p><strong>Introduction: </strong>The co-existence of hypertension with diabetes mellitus among diabetic patients is a setback to public health. About 40–75% of diabetic patients present with hypertension. The co-existence of hypertension and diabetes can accelerate complications such as stroke, myocardial infarction, nephropathy, and mortality. Available data indicate the devastating effects of hypertension and diabetes on individuals, families, and the economy as catastrophic. Therefore, knowing the predictors of hypertension among diabetic patients would inform the lifestyle and management of the two conditions.</p> <p><strong>Objective:</strong> The study focused on predictors of hypertension among diabetic patients in the Ejisu Municipality of Ghana.</p> <p><strong>Methods: </strong>The study employed a quantitative approach with a sample size of 120. Data were collected on sociodemographic characteristics, family history, 24-hour dietary recall, blood pressure, fasting blood glucose, glycated haemoglobin, total lipid profile, and anthropometrics. Data were analyzed using SPSS version 27.</p> <p><strong>Results:</strong> Out of 120 respondents, 85% were females with 77.5% above 50 years of age. A majority (66.7%) had a family history of diabetes with 76.7% having hypertension as a comorbidity. Fasting blood glucose was found to be 8.519 times more likely to present with hypertension. Systolic blood pressure, carbohydrate, and sodium intakes were 6.1%, 2.9%, and 0.1% respectively. However, diabetic patients with high HbA1c were 97% less likely not to present with hypertension.</p> <p><strong>Conclusion:</strong> Hypertension was found to be the most common comorbidity among diabetic patients in Ghana. Glycaemic control, systolic blood pressure, and dietary factors specifically carbohydrate and sodium intake were significant predictors of hypertension among the study participants.</p><p>Funding provided by: Kwame Nkrumah University of Science and Technology<br>Crossref Funder Registry ID: https://ror.org/00cb23x68<br>Award Number: VC/OGR/15</p><p>Questionnaires made up of socio-demographic characteristics, 24-hour dietary recall, and anthropometric and blood pressure measurements were administered to patients. Again, the study also took the biochemical parameters of the participants.</p&gt