Dietary behaviours in the context of nutrition transition: a systematic review and meta-analyses in two African countries
Date
2020-03-11
Journal Title
Journal ISSN
Volume Title
Publisher
Public Health Nutrition
Abstract
Objective: To synthesise evidence of urban dietary behaviours (macronutrients,
types of foods, dietary diversity and dietary practices) in two African countries
in relation to postulated changes in the context of nutrition transition.
Design: Systematic review and meta-analyses, including six online databases and
grey literature, 1971–2018 (Protocol CRD42017067718).
Setting: Urban Ghana and Kenya.
Participants: Population-based studies of healthy adolescents and adults.
Results: The forty-seven included studies encompassed 20 726 individuals plus
6526 households. Macronutrients were within WHO-recommended ranges: mean
energy intake was 1867 kcal/d (95 % CI 1764, 1969) and the proportions of macronutrients
were carbohydrate 61·2 % (58·4, 64·0), fat 25·3 % (22·8, 28·0) and protein
13·7 % (12·3, 15·1). The proportion of population consuming fruit and vegetables
was 51·6 %; unhealthy foods, 29·4 %; and sugar-sweetened beverages (SSBs),
39·9 %. Two-thirds (68·8 %) consumed animal-source proteins. Dietary diversity
scores were within the mid-range. Meal patterns were structured (typically three
meals per day), with evidence lacking on snacking or eating out.
Conclusions: Population-level diets fell within WHO macronutrient recommendations,
were relatively diverse with structured meal patterns, but some indications of
nutrition transition were apparent. The proportion of population consuming fruit
and vegetables was low compared to healthy-eating recommendations, and
consumption of SSBs was widespread. A paucity of evidence from 1971 to 2010
precluded a longitudinal analysis of nutrition transition. Evidence from these
two countries indicates which aspects of dietary behaviours may be contributing
to increasing overweight/obesity, namely a low proportion of population consuming
fruit and vegetables and widespread consumption of SSBs. These are potential
targets for promoting healthier diets
Description
Research Article
Keywords
Dietary behaviours, Macronutrients, Food consumption, Dietary diversity, Dietary practices, Ghana, Kenya