Characterising "obesogenic" versus "protective" food consumption, and their value chain among Ghanaian households.

Objectives: This paper explores the characteristics of Ghanaian households' consumption of obesogenic versus protective foods, including their retail, distribution, and origin.

Design: A household food consumption survey was conducted using an adapted Prospective Urban and Rural Epidemiology study Food Frequency Questionnaire. Product pathways for selected obesogenic (processed meat, Sugar-Sweetened Beverages, and biscuits) and protective (cooked vegetables, legumes, and fish) foods were traced from retailers through distributors/wholesalers to producers.

Setting: Rural and urban communities in the Ashanti Region and selected retail/wholesale/producers nationwide.

Participants: 612 households, 209 retailers and 185 wholesalers/distributors.

Results: About 20% of households consume Sugar-Sweetened Beverages (SSB) and confectionery weekly, and just 2% consumed processed meat. Of the protective foods, fish had the highest proportion of households consuming weekly (74.5%), followed by cooked vegetables (53.1%) and legumes (22.8%). Frequent SSB consumption is higher in younger (p<0.001), male (p=0.010), urban (p<0.001), and more educated (p<0.001) food purchaser households. Below 10% of households followed the healthiest dietary pattern (high-protective-and-low-obesogenic) but higher in older and more educated food purchaser households. In contrast, most households (about 80%) consumption patterns did not discriminate between obesogenic and protective foods. Generally, characteristics of purchasers from retail/wholesale outlets agree with those of households, where obesogenic foods were retailed to younger, less educated buyers than older, more educated ones. While the protective foods had a strong local producer presence, the obesogenic foods were predominantly imported.

Conclusion: Household consumption and retail/distribution of obesogenic foods are associated with socio-demographic characteristics, but obesogenic foods are almost entirely produced outside Ghana. Policies that regulate importation on health grounds can promote a healthier food environment.