Making food-related health taxes palatable in sub-Saharan Africa: lessons from Ghana.

Amidst high burden of infectious diseases, undernutrition and micronutrient deficiencies, non-communicable diseases (NCDs) are predicted to become the leading cause of death in Ghana by 2030. NCDs are driven, to a large extent, by unhealthy food environments. Concerned, the Ghana Ministry of Health (MOH) has since 2012 sought to garner the support of all to address this challenge. We aimed to support the MOH to address the challenge through public health policy measures, but would soon be reminded that longstanding challenges to policy development such as data poverty, and policy inertia needed to be addressed. To do this, the we generated the needed evidence, curated the evidence, and availed the evidence to Ghanaian policymakers, researchers and civil society actors. Thus, we addressed the problem of data poverty using context-relevant research, and policy inertia through advocacy and scholar activism. In this paper, we share how a public interest coalition used context-relevant research, evidence-informed advocacy and scholar activism to valorise and increase demand for healthy food policy (including food-related health taxes) in Ghana.

Anthropometric indices and cardiometabolic risk factors in a Ghanaian adolescent population.

OBJECTIVES: Adolescent overweight and obesity is a public health concern globally, especially in lower- and middle- income countries where there is an additional burden of undernutrition. The prevalence of adolescent overweight/2obesity has increased markedly over the past three decades. The transition in dietary habits coupled with reduced physical activity has been blamed for the increasing trend. Overweight/obesity in adolescence is complicated by cardiometabolic, respiratory, musculoskeletal and psychosocial disorders. Additionally, adolescent obesity is a predictor of future development of type 2 diabetes, cardiovascular diseases and metabolic disorders. The burden of cardiometabolic risk factors associated with adolescent overweight/obesity in Ghana is lacking, the project, therefore, was undertaken to add to the existing knowledge. METHODS: The study was undertaken in adolescent students of a tertiary institution in Ghana. Two hundred and one students consented to participate in the study. Questionnaires on sociodemographic characteristics, dietary and substance abuse habits were self-administered. Blood pressure, height, weight and waist circumference measures were performed and venous blood drawn for the determination of fasting serum total/LDL/HDL cholesterol and triglycerides. Body mass indices were determined as the weight per square of their heights. RESULTS: The prevalence of obesity was determined to be 15.81% generally, 27.71% in the females and 7.08% in the males. Diastolic blood pressure was the only cardiometabolic risk factor significantly associated with obesity in our study. CONCLUSION: Overweight/obesity is common in Ghanaian adolescents, with the prevalence highest in the female population.

Overnutrition and associated factors among adults aged 20 years and above in fishing communities in the urban Cape Coast Metropolis, Ghana.

OBJECTIVE: The study aimed to highlight the determinants of overnutrition (overweight plus obesity) in fishing communities and establish if these were the same as reported elsewhere in Ghana. DESIGN: Cross-sectional study. SETTING: The study was conducted in Idun, Ola and Duakor fishing communities in Cape Coast, Ghana. SUBJECTS: Adults (n 252) aged 20 to 50 years. RESULTS: Results showed that 32 % of participants were overweight/obese (BMI ≥ 25·0 kg/m2). Participants' mean age was 31·7 (sd 1·0) years, they had 13·7 (sd 8·1) mean years of formal education, their median monthly income was $US 7·4 (interquartile range $US 3·3, 20·0) and their median daily energy intake was 7·3 (interquartile range 5·3, 9·8) MJ. Significant associations (P < 0·05) were found between BMI and gender, age, years of education, fat intake and marital status. Females were almost eight times more likely to be overweight/obese than males (adjusted OR = 7·7; 95 % CI 3·6, 16·4). Persons aged ≥40 years were about six times more likely to be overweight/obese than those aged 20-29 years (adjusted OR = 6·1; 95 % CI 2·6, 14·1). Married people were nearly three times more likely to be overweight/obese than singles (adjusted OR = 2·8; 95 % Cl 1·4, 5·7). People with more than 13 years of formal education (adjusted OR = 0·3; 95 % CI 0·1, 0·9) and people with >30 % fat contribution to daily energy intake (adjusted OR = 0·3; 95 % CI 0·1, 0·6) had reduced odds of being overweight/obese. CONCLUSIONS: Overnutrition was prevalent in the fishing communities and associated with factors such as age, gender, marital status, educational status and fat intake.