Dietary Patterns as Characterized by Food Processing Levels and Their Association with the Health Outcomes of Rural Women in East Africa

Abstract

Overweight and obesity are rapidly rising in Sub-Saharan Africa including in rural areas. However, most studies focus on urban centers, and have attributed this epidemic to the consumption of processed foods without their clear characterization. This study investigated food intake patterns defined by food processing levels and their association with overweight/obesity in rural areas. Four 24-h dietary recalls, anthropometric measurements, and socio-demographic characteristics were collected from 1152 women in Kenya, Tanzania, and Uganda. The PCA method was used to extract patterns characterized by food processing levels. The association between patterns and overweight/obesity was ascertained with regression models. The overweight/obesity rate was 47%, 42%, 26%, and 38% in Kenya, Tanzania, Uganda, and East Africa (as pooled data), respectively. Several patterns were identified, yet a “plant-based pattern” largely characterized by unprocessed and minimally processed foods and a “purchase pattern” mainly distinguished by highly processed foods were dominant. The “plant-based pattern” was inversely or not associated with overweight/obesity, while the “purchase pattern” had a positive association or no association. A clear distinction on processed foods as healthy and unhealthy should be made based on their nutrient provision to avoid their mischaracterization as unhealthy. Policies to reverse consumption of unhealthy processed foods while promoting healthy ones should be pursued.

Are processed fruits and vegetables able to reduce diet costs and address micronutrient deficiencies? Evidence from rural Tanzania

“…This affirms that the possibilities of processed FV not only lower postharvest losses but also contribute to improving the nutritional status of individuals who otherwise would have been malnourished. There have been concerns about processed foods, and indeed some processed foods have been widely documented to have direct linkages with adverse health outcomes such as obesity and other non-communicable diseases, including in sub-Saharan Africa (14,(35)(36)(37) . Therefore, it is vital to make clear distinctions between processed foods such that consumers can make healthy choices.…”

“…Also, appropriate channels for transferring these processing innovations to communities where these foods are produced should be developed. This would help farmers/households and small and medium enterprises (SME) process their FV to attract extra income (14) . Second, interventions such as subsidies must be provided to SME that engage in FV processing to make processed FV cheaper for the poor (14) .…”

“…Overall, 300 households were sampled per study area. A detailed description of the design for Tanzania, including the inclusion and exclusion criteria for compiling household lists, has been published elsewhere (14) .…”

“…This, among others, is because the benefits of processed foods, especially the nutritious ones, have not been communicated clearly and consistently to consumers to overcome the negative messaging (7,13) . Indeed, not all processed foods contribute to adverse health outcomes, including overweight and obesity (14) , and as such, a distinction on them should be unambiguous. Dwyer et al (15) espoused that processed foods can provide critical micronutrients otherwise unavailable in diets.…”

Demand for Processed Indigenous Fruit and Vegetable Products – Insights from East Africa

“…The purchase pattern stands for highly processed foods, including ultra-processed foods and ultra-processed foods away from home. The authors find a positive association of the purchase pattern with overweight and obesity in Kenya and Tanzania, albeit not in Uganda (Sarfo, Pawelzik, and Keding 2021). The findings highlight the importance of considering the health aspects of processed foods.…”