BackgroundAnaemia remains a major cause of morbidity and mortality among women and children worldwide. Because deficiencies in essential micronutrients such as iron, folate and vitamin B12 prior to and during gestation increase a woman's risk of being anaemic, adequate dietary intake of such nutrients is vital during this important phase in life. However, information on the dietary micronutrient intakes of pregnant women in Ghana, particularly of those resident in rural areas is scanty. Thus, this study aimed to assess anaemia prevalence and dietary micronutrient intakes in pregnant women in urban and rural areas in Ghana. MethodsA comparative cross sectional study design involving 379 pregnant women was used to assess the prevalence of anaemia and low intake of dietary nutrients in pregnant women living in rural and urban areas in the Ashanti region of Ghana. Anaemia status and mid upper arm circumference (MUAC) were used as proxy for maternal nutritional status. Haemoglobin measurements were used to determine anaemia prevalence and the dietary diversity of the women were determined with a 24-hour dietary recall and a food frequency questionnaire. ResultsOverall, anaemia was present in 56.5% of the study population. Anaemia prevalence was higher among rural residents than urban dwellers. Majority of the respondents had inadequate intakes of iron, zinc, folate, calcium and vitamin A. The mean dietary diversity score (DDS) of the study population from the first 24-hour recall was 3.81 ± 0.7. Of the 379 women, 28.8% met the minimum dietary diversity for women (MDD-W). The independent PLOS ONE | https://doi.) for researchers who meet the criteria for access to confidential data. predictors of haemoglobin concentration were, gestational age, maternal age and dietary diversity score. Such that respondents with low DDS were more likely to be anaemic than those with high DDS (OR = 1.795, p = 0.022, 95% CI: 1.086 to 2.967). ConclusionsA large percentage of pregnant women still have insufficient dietary intakes of essential nutrients required to support the nutritional demands during pregnancy. Particularly, pregnant women resident in rural areas require interventions such as nutrition education on the selection and preparation of diversified meals to mitigate the effects of undernutrition.Undernutrition prevalence and severity in Ghanaian pregnant women PLOS ONE | https://doi.

In sub-Saharan Africa, urbanisation and food systems change contribute to rapid dietary transitions promoting obesity. It is unclear to what extent these changes are mediated by neighbourhood food environments or other factors. This paper correlates neighbourhood food provision with household consumption and poverty in Khayelitsha, South Africa and Ahodwo, Ghana. Georeferenced survey data of food consumption and provision were classified by obesity risk and protection. Outlets were mapped, and density and distribution correlated with risk classes. In Khayelitsha, 71% of households exceeded dietary obesity risk thresholds while 16% consumed protective diets. Obesogenic profiles were less (26%) and protective more prevalent (23%) in Ahodwo despite greater income poverty in Khayelitsha. Here, income-deprived households consumed significantly (p < 0.005) less obesogenic and protective diets. Small informal food outlets dominated numerically but supermarkets were key household food sources in Khayelitsha. Although density of food provision in Ahodwo was higher (76/km2), Khayelitsha outlets (61/km2) provided greater access to obesogenic (57% Khayelitsha; 39% Ahodwo) and protective (43% Khayelitsha; 16% Ahodwo) foods. Consumption and provision profiles correlate more strongly in Ahodwo than Khayelitsha (rKhayelitsha = 0.624; rAhodwo = 0.862). Higher obesogenic food consumption in Khayelitsha suggests that risky food environments and poverty together promote obesogenic diets.

BackgroundDiet-related noncommunicable diseases represent a major global public health challenge, and require a multisectoral policy response. However, the use of trade policy in this context has met with varied success in the face of strong global trade liberalization agendas. The Government of Ghana has implemented an innovative food standards policy to limit the amount of fat in meat and meat cuts, in response to rising imports of low quality fatty meat cuts. This paper presents an analysis of the policy process and outcomes, as well as contextual factors in policy development, to enable policy learning in other jurisdictions.MethodsWe conducted 28 semi-structured policy analysis interviews with 37 stakeholders at the national and regional level in Ghana, and collated relevant documents. We analysed the data using the health policy analysis triangle and policy theories related to lesson drawing.ResultsThe standards were developed in response to health concerns related to fatty meat (particularly turkey tails), in a context of rising meat imports and a generalised concern about the low quality and high fat content of imported meats. The standards were the result of collaboration between the trade and health sectors. The standards apply to both imported and domestic meat, and were designed to be compliant with Ghana’s multilateral trade commitments. The overall effect of the ban has been to reduce availability of specific ‘low quality’ high-fat meats in the Ghanaian food supply, namely turkey tails and chicken feet.ConclusionsThis study indicates that the use of standards can reduce availability of high-fat meat in a national food supply. The main strength of a standards approach to reducing fatty meat (mainly imported) in the food supply is compliance with global trade law, while the main challenge is effective enforcement. However, the Government of Ghana appears to have developed a functional and flexible application of the policy. Features of this policy approach useful for policy learning include: collaboration at every stage between ministries of trade and health; considerations relating to compliance with international trade law; strategic enforcement of the policy; and the importance of public awareness efforts.

Glycemic index (GI), a measure of blood glucose level as influenced by foods has become a concern due to the increasing cases of diabetes in Ghana. In spite of this, little is known of the GI of commonly consumed carbohydrate‐rich foods of the Ghanaian diet. The GI of five Ghanaian staples: fufu (locally pounded), kenkey (Ga), banku, Tuo Zaafi (TZ), and fufu (Processed powder) were determined in a crossover trial among 10 healthy nondiabetics. Participants were given 50 g portions of pure glucose on two different occasions and subsequently the test foods containing 50 g available carbohydrates. Capillary blood glucose levels of the subjects at fasting and after ingestion of the glucose and test foods were measured within a 2‐hour period. The GI of the test foods were calculated by dividing the incremental area under the glucose response curve (IAUC) of the test food by the IAUC for the reference food and multiplying the result by 100. Processed‐powdered fufu had the least glycemic response (31), followed by Ga kenkey (41) and locally pounded fufu (55), all recording low GI. Tuo Zaafi (68) had a medium GI and banku (73), moderately high GI. Comparison of GI between the foods using ANOVA revealed a significant difference between GIs of locally pounded fufu versus I‐fufu (industrially processed fufu flour) (p = 0.026). This study showed that the five major Ghanaian staples showed low to moderately high GI. These should be considered in recommendations for diabetics.

Background Dietary diversity, a qualitative measure of dietary intake, which reflects the variety of foods consumed has been recommended to assuage nutritional problems related to insufficient micronutrients, and food insecurity. To better understand the underlying factors for poor birth outcomes in Ghana, we assessed factors associated with dietary diversity among rural and urban pregnant adolescents in the Ashanti Region of Ghana. Methods As part of a larger longitudinal cohort of 416 pregnant adolescents, the FAO minimum dietary diversity for women index was used to determine the dietary diversity score (DDS) of the participants from a previous days’ 24-hour dietary recall data. The household hunger scale (HHS) and lived poverty index (LPI) were used to determine hunger and socioeconomic status. Eating behavior and socio-demographic data were gathered using interviewer-administered questionnaires. Results The mean age of the participants was 17.5 (±1.4) years with an MDD-W of 4.4 and 56% recording inadequate MDD score. More rural (63.6%) than urban dwellers (50.6%) had inadequate DDS (p = 0.008). Among all the multiple variables tests of associations on dietary diversity, only hunger status (p = 0.028) and both food aversion and poverty status (p = 0.003) had a significant effect on the adolescents’ dietary diversity. Rural dwelling adolescents (AOR = 1.7, p = 0.035, 95% CI = 1.0–2.6) recorded higher odds for inadequate DD compared with the urban respondents. Pregnant adolescents with severe hunger had higher odds (Unadjusted OR = 1.9, p = 0.053, 95% CI 1.1–3.8) for inadequate dietary diversity compared with those with no hunger. Conclusions Inadequate DD is common among pregnant adolescents in this study and is associated with rural living, food insecurity, poverty, and food craving. Livelihood support for pregnant teenagers and nutrition education are recommended interventions to improve dietary quality and limit the consequences of poor dietary diversity.