South African Journal of Clinical Nutrition
ISSN: 1607-0658 (Print) 2221-1268 (Online) Journal homepage: https://www.tandfonline.com/loi/ojcn20
Dietary intake as a cardiovascular risk factor: a
cross-sectional study of bank employees in Accra
Ivy Priscilla Frimpong, Matilda Asante & Aloysius Nwabugo Maduforo
To cite this article: Ivy Priscilla Frimpong, Matilda Asante & Aloysius Nwabugo Maduforo (2018):
Dietary intake as a cardiovascular risk factor: a cross-sectional study of bank employees in Accra,
South African Journal of Clinical Nutrition, DOI: 10.1080/16070658.2018.1515394
To link to this article:  https://doi.org/10.1080/16070658.2018.1515394
© 2018 The Author(s). Co-published by NISC
Pty (Ltd) and Informa UK Limited, trading as
Taylor & Francis Group
Published online: 09 Oct 2018.
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South African Journal of Clinical Nutrition 2018; 0(0):1–7
https://doi.org/10.1080/16070658.2018.1515394 SAJCN
ISSN 1607-0658 EISSN 2221-1268
Open Access article distributed under the terms of the © 2018 The Author(s)
Creative Commons License [CC BY-NC 4.0]
http://creativecommons.org/licenses/by-nc/4.0 RESEARCH
Dietary intake as a cardiovascular risk factor: a cross-sectional study of bank
employees in Accra
Ivy Priscilla Frimponga, Matilda Asanteb and Aloysius Nwabugo Maduforoc*
aDiet Therapy Department, 37 Military Hospital, Accra, Ghana
bDepartment of Nutrition and Dietetics, School of Biomedical and Allied Health Sciences, University of Ghana, Legon, Ghana
cDepartment of Nutrition and Dietetics, University of Nigeria, Nsukka, Nigeria
*Corresponding author, email: aloysius.maduforo@unn.edu.ng
Objectives: To determine the dietary and nutrient intakes of bank employees in Accra in relation to recommended dietary intake
for the control of cardiovascular diseases (CVD).
Design: The study was a cross-sectional study.
Methodology: A structured validated questionnaire was used to obtain demographics. A 3-day 24-hour dietary recall and usual
food intake questionnaire were used to obtain information on food intakes and dietary pattern of the respondents. Food
models, household measures and photos of common dishes as well as household cups and measures were used in order to
obtain accurate information regarding the types and quantities of foods and beverages consumed.
Subjects: Convenient sampling was used to select bank branches while simple random sampling by ballot without replacement
was used to select 119 bank employees who consented to participate in the study.
Outcome measures: Data were analysed using Statistical Package for the Social Sciences software. Esha FPro software was used
to analyse food nutrients. The nutrient intakes were compared with a standard dietary guideline for adults.
Results: Findings showed significant (p < 0.05) differences in mean energy intake between males and females. Also, the bank
employees were consuming more fat (32%) compared with the recommended intake. The average intake of dietary sodium
and cholesterol was within the recommended intake levels. All the participants in the study had a mean intake of dietary
potassium, fibre, fruits and vegetables below the recommended levels. The major cooking oils used in meal preparation
were vegetable and palm oil (46%), followed by vegetable oil (31.9%) and palm oil (21.8%).
Conclusions: The study evaluated the dietary intake of bank employees, which is an important risk factor for chronic diseases.
There is a need to develop plans to provide nutrition education and counselling for adequate nutrient intake and prevention of
chronic diseases among bank employees.
Layman’s summary: Obtaining an adequate diet and avoiding overconsumption of food helps to maintain health. Intake of
foods containing high energy and fats without corresponding energy expenditure through physical activity could result in
obesity, heart diseases, diabetes and other health challenges. Inadequate intake of micronutrients as well could result in
deficiency diseases, and depresses the immune system and health of individuals. Bank employees and all other individuals
need to pay attention to what they eat to live a healthy and longer life. Regular physical activity, following the dietary
approaches to avoid hypertension and regular medical check-up are essential for cardiovascular health.
Strong lay message: Inadequate or overconsumption of nutrients can cause chronic heart diseases.
Keywords: dietary intake, macronutrient, micronutrient, fibre, cholesterol, adequacy
Introduction
The disease burden caused by modifiable risk factors is a global such as vitamins, minerals and fibre, which may individually or
problem. It is estimated that modifiable risk factors are respon- in combination provide protection against cardiovascular dis-
sible for about 80% of coronary heart disease and cardiovascular eases and certain cancers.5 It has been reported that consump-
diseases (CVDs).1 Behavioural risk factors of CVDs include tion of green leafy vegetables and vitamin C-rich fruits and
unhealthy diet, physical inactivity, alcohol consumption and vegetables protect against coronary heart disease (CHD).6 The
tobacco use while biological risk factors include raised blood cardioprotection of green leafy vegetables may be due to high
cholesterol, hypertension (raised blood pressure), overweight, levels of antioxidants such as lutein.6,7 Furthermore, studies
obesity and type 2 diabetes.2,3 have shown that lutein protects against progression of athero-
sclerosis by lowering LDL levels in the blood.7
Scientific evidence increasingly supports the view that altera-
tions in diet impact positively and/or negatively on health It has been reported that the banking occupation carries with it
throughout life.4 Most importantly, dietary modification may the risk of unhealthy dietary habits such as snacking on pastries
not only influence present health, but may contribute to an indi- (high in trans fats), eating fast-foods, drinking of soft drinks high
vidual not developing such diseases as CVDs, diabetes and in refined sugar and late-night eating because most employees
cancer in older age. Unhealthy dietary practices such as high return late from work, especially in Ghana.8 The health impli-
consumption of saturated fats, refined carbohydrates as well cation of this dietary habit coupled with the sedentary lifestyle
as low consumption of fruit and vegetables tend to increase imposed on them by the nature of their job may manifest in
the risk of CVD.5 Fruits and vegetables contain many nutrients an individual as high blood pressure, raised blood lipids,
South African Journal of Clinical Nutrition is co-published by NISC (Pty) Ltd, Medpharm Publications, and Informa UK Limited
(trading as the Taylor & Francis Group)
2 South African Journal of Clinical Nutrition 2018; 0(0):1–7
overweight and obesity.5 This had been confirmed from a study Table 1: Distribution of sample from different branches of the bank
in India among bank employees.8 The study in India revealed
that body mass index (BMI), blood pressure, plasma cholesterol Branch Number of workers 80% of workers
and glucose levels were significantly high among bank employ- Branch 1 25 20
ees.8 Bank employees in Ghana are one of the groups of employ- Branch 2 26 21
ees that wake early to go to work and return late to their houses. Branch 3 62 50
Also, most of them sit for long hours attending to customers and Branch 4 34 27
thus have little time for physical activity and sleep, which is a
Branch 5 25 20
CVD risk factor reported in a similar study in India.8 Combi-
nations of these risk factors are likely to have multiple effects Total 163 138
that are capable of accelerating the rate at which the individual Note: Of 138 respondents sampled, only 119 respondents consented to participate
in the study.
develops non-communicable chronic diseases (NCDs) including
CVDs. Most food consumption studies in Ghana focused on
other sectors of the workforce. Bank employees have been a as household cups and measures were used to estimate
neglected group of workers in most nutrition studies because amounts, in order to obtain accurate information regarding
it is believed that they earn a lot of money and can afford to the types and quantities of foods and beverages consumed.
eat whatever they desire. The most common type of malnu- Also, the usual food intake questions (such as types of food
trition in Ghana is undernutrition, thus studies have concen- the respondents usually consume at each mealtime during the
trated on undernutrition studies among children, women and day) were asked to obtain information on the frequency of the
other vulnerable groups. However, this study had to shift its foods reported in the 24-hour dietary recall including fruit and
focus from the usual group for nutrition research to the vegetable consumption. The usual food consumption question
unusual (bank employees). There is an increasing prevalence was designed in the form of 24-hour recall so that each partici-
of NCDs in developing countries.9 Unhealthy diet is one of the pant’s intake was cross-checked with the 24-hour recall reported
CVD risk factors but a dearth of studies on the nutrient intake by the respondents. The foods reported in the three-days24-
of bank employees in Ghana. Hence, the study determined the hour recall was entered into Esha FPro software (ESHA, Salem,
dietary and nutrient intakes of bank employees in Accra in OR, USA). This software uses a food processor analysis tool to
relation to recommended dietary intake for the control of cardi- analyse menus, diets, foods and recipes. The software basically
ovascular diseases, especially the dietary component of Dietary uses the United States Department of Agriculture (USDA)
Approaches to Stop Hypertension (DASH). dietary database as reference, but for some foods that were
local to Ghana not found in the Esha FPro software, the nutrient
Methods composition was added to Esha FPro software using a local food
composition table for Ghana or Food and Agricultural Organiz-
Study design and site description ation food composition table for use in West Africa as
10,11
The study was a cross-sectional study in five branches of a bank reference.
in Accra. The bank had 160 branches and 2 158 staff nationwide.
The five branches in Accra were conveniently sampled based on Data and statistical analysis
the recommendation and consent of the Human Resource Esha FPro software was used for dietary data analysis to deter-
manager for the branches to participate in the study. All the mine the mean nutrient intake by each individual. Statistical ana-
bank branches used in this study were located in the Greater lyses were performed using the Statistical Package for the Social
Accra region of Ghana. Sciences (version 16, SPSS Inc, Chicago, IL, USA) software. Tabu-
lations of frequencies (and percentages) and graphical presenta-
Sampling techniques tions were done using SPSS® (version 16.0). For continuous
Using the Statscalc function of Epi Info™ statistical software variables, the data were checked for normality before analysis.
(CDC, Atlanta, GA, USA), a confidence interval of 95%, esti- An independent samples t-test was used to test the mean differ-
mated prevalence of risk factor of 10% and a worst acceptable ence in nutrient intakes. A two-sample t-test for proportion was
estimate of 5% gave a sample size of 138. Simple random used to test the significant difference between proportions. All
sampling by ballot without replacement was used to select par- statistical tests were conducted as two-sided and declared sig-
ticipants for the study. An estimated 80% (138) of the employ- nificant at p-value < 0.05 or p < 0.01 respectively.
ees were therefore targeted in the five branches. Pregnant and
lactating women were excluded from the study. The summary Ethics
of the distribution of sample from different banks is given The study protocol was reviewed and approved by the College
in Table 1. of Health Sciences Ethical Review Board, University of Ghana
(Ref. no. SAHS/10256520). All participants gave written informed
Dietary assessment consent and procedures were carried out according to the
Information on food intake was collected using a three-day (two approved protocol.
weekdays and one weekend) 24-hour recall method. This
method requires an individual to remember the specific foods Results
and amounts of food they consumed in the past 24 hours.9
With this approach, subjects were asked to provide detailed Nutrient intakes
information on all the foods and beverages consumed including Nutrient intakes were calculated from the three-day 24 hour
cooking methods in the past 24 hours by a registered dietitian recalls.
(the principal investigator) on three different occasions at the
different branches of the bank. During the interview, food Macronutrient intake
models, household measures (commonly used measuring tools There were no significant (p < 0.01) differences between mean
in Ghana households) and photos of common dishes as well intakes of protein, cholesterol and fat between genders. On
Dietary intake as a cardiovascular risk factor 3
the other hand, significantly higher intakes were observed in who consumed an average of 3–4 servings per day were 15.2%
mean intakes of energy (p < 0.01), carbohydrate (p < 0.01), and and 18.3% for males and females, respectively.
dietary fibre (p < 0.01) in men compared with women. A
summary of the findings of macronutrient intake is reported in Similarly, most of the employees (76.9%; n = 80), comprising
Table 2. 83.3% males and 73.1% of females, consumed an average of
1–2 serving of vegetables per day (Figure 1b). The average
Micronutrient intake fruit intake per day for men was significantly higher (p < 0.05)
Table 3 lists the mean daily intake of micronutrients. There were than that for women, whereas average vegetable intake was sig-
no significant differences in the mean daily intake of sodium, nificantly lower (p < 0.05) in men when compared with women.
calcium, magnesium, folate and vitamin C. However, mean Overall, the majority of the study participants had low fruit and
iron intakes were significantly higher (p < 0.05) in men than in vegetable intakes (fruit intake, 89.9%; vegetable intake, 94%)
women. and did not meet the recommended daily intakes of 4–5 ser-
vings a day. These findings are given in Table 4b.
Comparison with population nutrient intake goals
Table 4 (a, b, c) shows comparison of nutrient intake with popu- Dietary fibre and cholesterol intakes
lation nutrient goals,12 which are established recommended Mean dietary fibre intake of the total population was 22.2 g
dietary intake with the aim of preventing or reducing the risk (men; 26.8 g, women; 19.5 g). The mean intake in the total popu-
of diet-related chronic diseases such as CVD. lation was below the recommended nutrient intake of 25–30 g/
day. The majority of employees (89.9%; n = 107) had a dietary
Dietary sodium and potassium fibre intake below the minimum limit of 25 g per day. The
Almost all the participants (99.2%) had a dietary sodium intake mean intake for men was, however, within recommended
within recommended daily intakes (< 2 400 mg). However, intakes of dietary fibre per day. In the total group, mean
dietary potassium intakes in all the participants were below rec- dietary cholesterol intake (177 mg) was found to be less than
ommended population nutrient goals (> 4 700 mg). These find- 300 mg as recommended in the population nutrient goals.
ings are presented in Table 4a. These findings are given in Table 4c.
Fruit and vegetable intake Type of oil used
The frequency of consumption of fruits and vegetables is pre- Figure 2 shows the type of oil most commonly used by the par-
sented in Figure 1 (a and b). In the total population, 78.2% (n = 93) ticipants. The major cooking oils used in meal preparation were
of participants reported daily consumption of fruits. Of this vegetable and palm oil 46% (53.4% females; 34.2% males), fol-
number, 78.8% of males and 78.3% of females reported that lowed by vegetable oil 31.9% (36.3% males; 30.6% females)
they consumed about 1–2 servings of fruit per day. Participants and palm oil 21.8%.
Table 2: Mean daily intake of macronutrients
Reference value using
Variable Male Female All DASH eating plan guideline12
(n = 44) (n = 75) (n = 119)
Energy (Kcal) 2 509 ± 474** 2 117 ± 405 2 262 ± 470
Protein (g) 91.0 ± 21.4 86.1 ± 23.7 81.2 ± 22.9
% of energy intake 14 16.3 14 18% of calories
Total fat (g) 87.2 ± 39.1 77.5 ± 25.5 81.1 ± 31.4
% of energy intake 31 32 32 27% of calories
Cholesterol (mg) 153.7 ± 133.2 191.6 ± 182.4 177.2 ± 165.9
Carbohydrate (g) 350 ± 92.5** 271 ± 71.2 300 ± 88.3
% of energy intake 55 51 53 55% of calories
Dietary fibre (g) 26.8 ± 12.3** 19.5 ± 7.6 22.2 ± 10.2
Notes: Two-sample t-test; data are means ± SD; **p < 0.01 significantly different when compared between genders. DASH = Dietary Approaches to Stop Hypertension.
Table 3: Mean daily intake of micronutrients
Male Female All Reference value using DASH eating plan guideline for a
Item (n = 44) (n = 75) (n = 119) 2 100 Calorie Eating Plan12
Sodium (mg) 749 ± 506 766 ± 621 773 ± 579 2 300 mg
Potassium (mg) 706 ± 547 920 ± 639 841 ± 613 4 700 mg
Calcium (mg) 727 ± 287 695 ± 360 707 ± 334 1 250 mg
Magnesium (mg) 86.3 ± 64.6 88.2 ± 59.7 87.5 ± 61.3 500 mg
Folate (μg) 104.7 ± 76.3 102.5 ± 85.8 103.0 ± 82.2
Vitamin C (mg) 113.2 ± 70.3 120.4 ± 71.8 117.7 ± 70.9
Iron (mg) 27.4 ± 8.4* 24.1 ± 8.7 25.3 ± 8.6
Notes: Two-sample t-test; data are means ± SD; *p < 0.05 significantly different when compared with females. DASH = Dietary Approaches to Stop Hypertension.
4 South African Journal of Clinical Nutrition 2018; 0(0):1–7
Table 4: Comparison with recommended dietary intake
(a)
Reference value using DASH
Factor Male Female All eating plan guideline for a 2 100 Calorie Eating Plan12
(n = 44) (%) (n = 75) (%) (n = 119) (%)
Dietary potassium 4 700 mg/day
Mean intake ± SD 706 ± 547 920 ± 639 841 ± 613
> 4 700 mg (RDI) 0(0) 0(0) 0(0)
< 4 700 mg 44 (100) 75 (100) 119 (100)
Dietary sodium 2 300 mg/day
Mean intake ± SD 749 ± 506 766 ± 621 773 ± 579
< 2 400 mg (RDI) 44 (100) 74 (98.7) 118 (99.2)
> 2 400 mg 0 (0) 1 (1.7) 1 (0.8)
(b)
Reference value using
Male Female All DASH eating plan guideline12
(n = 44) (%) (n = 75) (%) (n = 119) (%)
Fruit serving 4–5 servings/day
Mean serving ± SD 2.57 ± 2.07* 1.85 ± 1.12 2.12 ± 1.57
4–5 servings/day (RDI) 7 (21.2) 5 (9) 12 (12.9)
Below 4–5 servings/day 26 (78.8) 55 (91) 81 (87.1)
Vegetable serving 4–5 servings/day
Mean serving ± SD 1.76 ± 0.86 2.12 ± 0.89* 1.99 ± 0.89
4–5 servings/day (RDI) 2 (4.5) 5 (6.7) 7(6.0)
Below 4–5 servings/day 42 (95.5 70 (93.3) 112 (94.0)
(c)
Reference value using
DASH eating plan guideline for a
Male Female All 2 100 Calorie Eating Plan12
(n = 44) (%) (n = 75) (%) (n = 119) (%)
Dietary fibre 30 mg/day
Mean intake ± SD 26.8 ± 12.3 19.5 ± 7.6 22.2 ± 10.2
25–30 g/day (RDI) 5 (11.4) 7 (9.4) 12 (10.1)
Below 25–30 g/day 39 (88.6) 68 (90.6) 107 (89.9)
Dietary cholesterol 150 mg/day
Mean intake ± SD 153.7 ± 133.2 191.6 ± 182.4 177.2 ± 165.9
< 300 mg (RDI) 39 (88.6) 60 (84.5) 99 (86.1)
≥ 300 mg 5 (11.4) 11 (15.5) 16 (13.9)
Notes: DASH = Dietary Approaches to Stop Hypertension. Recommended dietary intake (RDI) was based on DASH;12 *p < 0.05 significantly different when compared with
women (fruit intake, p = 0.03; vegetable intake, p = 0.03); means and standard deviation for fruit intake are based on participants who consumed them.
Discussion According to the nutrient goals, fats, protein and carbohydrate
The energy-giving food nutrients (carbohydrates, fats and pro- consumption should contribute 15–30%, 10–15% and 55–75%
teins) evaluated in this study perform major functions in the of the total calories per day respectively. The findings of this
body. A positive energy balance leads to overweight and study shows that the bank employees were consuming more
obesity and thus contributes to the morbidity of cardiovascular fat (32%) compared with the WHO’s recommendation of 15–
diseases. Fat especially is being modified in CVD’s as well as the 30% nutrient goals for good health.5 In the DASH guideline, it
total energy intake of individuals.13 Findings of this study is recommended that fat should not exceed 27% of total
showed a significant difference in mean energy intake energy intake per day.12 A high fat intake has detrimental
between males and females. The energy requirement for a effects on health.12 Clinical trials have provided evidence
male is higher due to higher metabolic rate and activity.12 A suggesting that reduction or modification of dietary fat intake
review of the published literature shows that dietary changes reduces the incidence of combined cardiovascular events by
differ according to the population group investigated.7,14,15 16% (rate ratio 0.84; 95% CI 0.72 to 0.99).15 Other studies have
Nevertheless, the percentage contribution of fat (men 31%, also shown that higher fat intakes modify the body’s metabolism
and women 32%) to the total energy in this study was similar in ways that favour fat accumulation.16,17 It has been reported
to intakes among male (33%) and female (35%) Ghanaian that altered diets coupled with diminished physical activity are
migrants reported in Sydney, Australia.14 critical factors contributing to the acceleration of CVD
epidemics.18
In the prevention and control of diet-related chronic disease, it is
recommended that an individual’s nutrient intake should be Dietary cholesterol intakes between men and women in this
within established recommended dietary intake levels.5 study were not significantly different. Generally, the mean
Dietary intake as a cardiovascular risk factor 5
Hypertension is one of the most common CVDs in Ghana.14 It
could precipitate other cardiovascular diseases as well as renal
disease.12
Consumption of dietary iron among the respondents was signifi-
cantly higher in males than in females. However, both genders’
intake of iron was higher than the recommended dietary intake
but did not exceed the upper adult tolerable level of
45 mg/day.12 This could be attributed to the consumption of
meat, fish and poultry, which are rich in iron.12 Adequate
dietary iron intake will ensure prevention of anaemia and
boosts the immune system.12
Micronutrients such as excess intake of sodium and low
potassium intake are strongly related to the risk of developing
CVD.12 Findings of the study showed that the mean intake of
dietary sodium (773 mg) of all the bank employees was
within the recommended intake (< 2 400 mg). Dietary sodium
has long been labelled as a dietary factor in the pathogenesis
of high blood pressure.21 Sodium is positively associated with
blood pressure, therefore the mean intake found in this
study is favourable for health.12 However, these results should
be interpreted with caution since the dietary assessment
method of estimating sodium intake is less reliable as it may
be associated with misreporting and some people cook with
different levels of salt. The software used in analysing the
nutrient composition did not make use of foods cooked in
Figure 1: (a) Distribution of fruit servings per day; (b) distribution of veg- Ghana. Therefore a 24-hour urinary sodium excretion test is a
etable servings per day. better measure for assessing dietary sodium.22 The 24-hour
urinary sodium excretion test was not within the scope of
this study.
All the participants in the study had a dietary potassium intake
(841 mg) below the recommended intake of 4 700 mg of
dietary potassium per day. This may partly be due to the low
intake of fruits and vegetables among the bank employees.
Fruits and vegetables affect cardiovascular risk through their
high potassium levels that serve to modulate blood pressure.23
Potassium has a negative association with blood pressure.24,25
Therefore low intakes of dietary potassium may predispose to
the high prevalence of hypertension.
The majority of the bank employees had a daily intake of fruits
and vegetables below the daily recommended intakes of 4–5
servings a day for each, respectively, in the dietary approaches
to stop hypertension.4,12 The recommendation for fruits and
Figure 2: Most common type of oil used. vegetables was for individuals to eat at least three servings of
fruit and at least four servings of vegetables each day for
intakes were within the recommended daily intake of adults.26 Making a choice from fresh, frozen, dried or canned
< 300 mg a day.4,5 The effect of diet on serum lipids and lipo- forms and a variety of colours and kinds is encouraged. Also,
proteins has been studied extensively in various clinical and intake of dark-green leafy vegetables, orange fruits and veg-
epidemiological trials. Although the dietary content is clearly etables, and cooked dry beans and peas is often rec-
an important determinant, several environmental and meta- ommended.26 It is established that fruits and vegetables
bolic factors intervene to modulate the dietary effect.6 contain many nutrients such as minerals, vitamins, fibre and
However, recent studies indicate that excessive dietary carbo- antioxidants, which may individually or in combination
hydrate intake, especially simple sugars, can promote athero- provide a protective effect against CVD.27 An epidemiological
genic dyslipidaemia.19 In the NHANES III study, higher intakes study has shown that intakes of fruits and vegetables more
of carbohydrates were found to be positively associated with than three times or three servings a day compared with one
serum triglycerides and negatively associated with serum serving a day was significantly associated with a 27% lower inci-
HDL-cholesterol.20 dence of stroke (p < 0.01) and 48% lower stroke mortality (p <
0.05).28 This suggests a strong inverse association between
The micronutrients analysed in this study are essential com- fruit and vegetable intake and the risk of subsequent CVD.28
ponents of the Dietary Approaches to Stop Hypertension Therefore low consumption of fruits and vegetables among
(DASH) diet.12 These micronutrients are also modified in CVDs, the bank employees in this study could increase their risk of
especially sodium, potassium, magnesium and calcium.12 developing morbidity associated with CVD.
6 South African Journal of Clinical Nutrition 2018; 0(0):1–7
The suggested dietary intake (RDI) of fibre was based on WHO/ method used. However, because of the busy life of the group
FAO5 and American Heart Association recommendations.4 The of respondents, weighed food intake measurement was not
mean dietary fibre intake of men in this present study was sig- possible. To determine the actual nutrient composition of
nificantly higher when compared with the mean intake of foods in Accra, a nutrient analysis is required because there is
women. This may be attributed to the higher food requirements no single recipe for foods consumed in Ghana; different house-
of men to meet their energy needs in addition to their higher holds and restaurants have their individual recipes. However, the
consumption of servings of fruits per day. Also, in Ghana, most budget of the study could not support analysing all the foods
of the diets are based on cereals and whole grains, which are identified in the study. Nonetheless, the software ESHA FPro
also a good source of fibre. Dietary fibre intake has been consist- used in the study is a reliable tool that has been used in other
ently associated with a lower risk of CVD.29 In the dietary guide- studies both in Ghana and developed countries.
lines, a daily intake of 25–30 g of dietary fibre was
recommended to prevent diet-related diseases such as CVD.4,5 Ethics approval and consent to participate – The study was
It was found that the majority of the bank employees (89.5%) approved by the Ethical Review Board of the School of Allied
had dietary intakes below the recommended level (25–30 g). Health Sciences (ref SAHS/10256520). Prior to initiating the pro-
Studies have reported that high dietary fibre intake helps to tocols of the study, potential risks were discussed with the
maintain a lower total body fat as it is inversely associated Human Resource Manager of the bank. All participants gave
with body mass index (BMI) and waist–hip ratio (WHR)30 and written informed consent and procedures were carried out
also helps to decrease serum total and low-density lipoprotein according to the approved protocol.
cholesterol concentrations.31
Acknowledgements – The authors would like to thank all the par-
Oils are a good and cheap source of fats in our meals. In Ghana, ticipants who consented to be part of the study, as well as all the
the cheapest source of Vitamin A is palm oil.10,11 Most of the veg- research assistants who helped with the data collection and
etable oils in Ghanaian markets are made from different seeds analysis.
such as safflower seeds, sunflower seeds or groundnuts, while
some are made from palm olein. The oils from tree seeds are a Funding – The study received no external funding or grant.
rich source of monounsaturated fatty acids and essential fatty
acids which confer cardioprotective effects.4,12 Omega-3 fatty
acids provide a cardioprotective effect by reducing the LDL Competing interests – The authors declare that they have no
cholesterol and increasing the HDL cholesterol.12 Vitamin A, competing interests
found in palm oil, boosts the immune system and prevents the
incidence of blindness that results from Vitamin A deficiency.12 ORCID
Oils, however, provide concentrated energy in the form of fats, Matilda Asante http://orcid.org/0000-0003-3488-7087
thus excess consumption of fats could predispose an individual Aloysius Nwabugo Maduforo http://orcid.org/0000-0001-7290-
to fat accumulation, dyslipidaemia, obesity and consequently 5632
CVDs.12 The fat intake of the bank employees in this study
exceeded the recommended levels in the Dietary Approaches References
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to bank employees to ensure a healthy workforce for national intake on risk for coronary heart disease. Ann Intern Med.
development. A more in-depth study using a weighed food 2001;134:1106–14.
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