National Food Expenditure Patterns of the Nutrition Transition in Ghana and Differences by Fish and Seafood Diversity.

Background: Diets are changing in low- and middle-income countries in concert with the nutrition transition. National dietary patterns have yet to be established in Ghana, and previous studies present conflicting results on which patterns contain fish and seafood-a highly consumed and diverse food group.

Objectives: We aimed to establish national food expenditure patterns in Ghana and assess their relationships with socioeconomic variables. We further sought to assess differences in these patterns after disaggregating fish and seafood into 10 subgroups.

Methods: We analyzed nationally representative cross-sectional household food expenditure and socioeconomic data from 13,782 households that were collected for 2016-2017 for the seventh round of the Ghana Living Standards Survey. We used principal component analysis to identify food expenditure patterns and multivariable regression models to explore relationships between patterns and household socioeconomic characteristics. We repeated the analysis after disaggregating fish and seafood into 10 subgroups using information on taxonomic population (e.g., species) and ecosystem source (e.g., marine or freshwater).

Results: We found a "traditional" pattern of starchy staples, fruits, vegetables, and fish and seafood, a "processed foods" pattern of refined grains, processed meats, dairy, and sweets, and a "food away from home (FAFH)" pattern of mixed dishes prepared in restaurants. Head of household age, female sex, and households with a pregnant female or children <5 y were positively associated with the "traditional" pattern but negatively associated with the "FAFH" pattern. After disaggregating fish and seafood, we found that freshwater fishes loaded positively in the "traditional" pattern, and sardines, a canned marine fish, loaded positively in the "processed foods" pattern.

Conclusions: The 3 national food expenditure patterns, "traditional," "processed foods," and "FAFH," aligned with the nutrition transition. Disaggregating fish and seafood into subgroups yielded more specific information on the food expenditure patterns to which they belong.