Sustainable diets and cardiometabolic conditions among Ghanaian adults under transition: findings from the RODAM-Pros...

In sub-Saharan Africa, the burden of cardiometabolic conditions has rapidly emerged. Sustainable diets that are nutritious, environmentally friendly, economically affordable, and socioculturally acceptable may support the prevention of cardiometabolic conditions.

This study aimed to identify associations of optimized sustainable diets with incident general/abdominal obesity, type 2 diabetes mellitus (T2D), and hypertension among Ghanaian adults living in Ghana and Amsterdam.

We used longitudinal data from the Research on Obesity and Diabetes among African Migrants study involving Ghanaian adults (age: 20-82 y). Baseline dietary data were collected using a Ghana-specific food propensity questionnaire. To construct an optimized diet index (ODI, 0-90 points), we used baseline adherence to previously identified site- and sex-specific diets, meeting nutritional adequacy, cultural acceptability, and 50% reductions of greenhouse gas emissions and food costs. Multiple-adjusted logistic regression assessed associations between ODI per 10-point increase and risk of general/abdominal obesity, T2D, and hypertension, reported as odds ratios and 95% confidence intervals (CIs).

In the analytical sample (n = 1499; 66% females; mean age: 47 ± 11 y; mean follow-up time: 7 ± 0.5 y; median ODI = 29 with interquartile range: 23-37), higher ODI scores were related to residence in Ghana, lower total energy intake, older age, and lower educational level. We observed no associations of baseline ODI with incident general obesity, T2D, or hypertension. A 10-point increase in ODI was associated with a 19% higher risk of abdominal obesity (95% CI: 1.00, 1.42; P = 0.049), significantly in rural and urban Ghana.

Overall adherence to the optimized sustainable diet is low in this cohort of Ghanaian adults. Sustainable diets are related to increased risk of abdominal obesity in Ghana. Low variation in the poor adherence may explain the unexpected results.