Nyarko and Bartelmeß Globalization and Health (2024) 20:22 https://doi.org/10.1186/s12992-024-01027-x RESEARCH Drivers of consumer food choices of multinational corporations’ products over local foods in Ghana: a maximum difference scaling study Eric Nyarko1 and Tina Bartelmeß2* Abstract Introduction The fundamental transformation of food systems and retail environments in low-income countries is influencing consumers’ food choices and dietary habits in unfavourable directions through the consumption of highly processed, energy-dense foods, predominantly manufactured by multinational food corporations. This study aims to identify the principal factors driving consumers’ preference for multinational foods over local foods in the urban Accra region of Ghana. Method This cross-sectional survey involving a random sample of 200 consumers conducted in March/April 2023 using interviewer-administered questionnaires employed a maximum difference scaling approach to investigate the drivers of urban Ghanaian consumer food choices for multinational food corporations’ products over local foods. The maximum difference scaling modelling analysis utilized in this study identifies the primary drivers of multinational food corporations’ product preferences and the associated trade-offs. Result The study discovered that food quality and safe packaging, perceived healthiness, taste and flavour, and nutri- tional value were the most significant factors driving consumer preference for multinational food corporations’ products over local foods in Ghana. The criterion food quality and safe packaging had the significantly highest utility than all other attributes in terms of consumer preference for products/meals from multinational food corporations over local foods. Conclusion The results of this study provide significant contributions to the existing body of research, as previous studies have not identified these factors as primary drivers of multinational food products. Public health authorities and nutritionists can use the study’s findings to implement targeted quality assurance measures in local markets and to address the drivers in health education campaigns. Keywords Nutrition transition, Multinational food corporations, Supermarkets, Fast-food, Consumer preferences, Ghana Open Access © The Author(s) 2024. 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The Creative Commons Public Domain Dedication waiver (http://creativecom- mons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Globalization and Health *Correspondence: Tina Bartelmeß tina.bartelmess@uni-bayreuth.de Full list of author information is available at the end of the article http://orcid.org/0000-0003-2848-584X http://creativecommons.org/licenses/by/4.0/ http://creativecommons.org/publicdomain/zero/1.0/ http://creativecommons.org/publicdomain/zero/1.0/ http://crossmark.crossref.org/dialog/?doi=10.1186/s12992-024-01027-x&domain=pdf Page 2 of 16Nyarko and Bartelmeß Globalization and Health (2024) 20:22 Introduction The impact of multinational food corporations in emerg- ing economies on the nutrition transition [1, 2], has been a long-standing public health concern [3]. Multinational food corporations such as fast-food restaurants, manu- facturing and processing corporations and retailers increasingly dominate global trade and investment and are progressively penetrating markets in low-income countries [4, 5]. Various supply chain processes facili- tate the expansion of multinational corporations to low- income countries, including trade liberalization, market concentration in the food system, and foreign direct investment (FDI) [6–8]. FDI serves as a mechanism through which corporations can enter the markets of Global South countries and acts as a stimulus for the glo- balization of the highly processed food industry and the economic development of a country [6]. However, FDIs predominantly occur in the context of food processing and enable the globalization of the highly processed food industry and the production and distribution of such foods in these markets, which pose significant challenges to public health nutrition [1, 6, 9]. It is argued that this profound change in food systems in low-income coun- tries is influencing consumers’ food choices and dietary habits in an undesirable direction of consuming highly processed, energy-dense foods [1, 5, 10]. These develop- ments are accelerating the so-called nutrition transition [1], which leads to an increase in the double burden of malnutrition, a growing public health problem in sub- Saharan African countries [9]. Considerable research efforts have been dedicated to elucidating the unfavourable health outcomes linked to the increasing availability and accessibility of highly processed food and beverages in low-income countries [2]. The causal association between the consumption of highly processed foods and non-communicable diseases (NCDs), such as type 2 diabetes, obesity, and coronary heart disease, has been well-established. Unhealthy die- tary habits are a significant global risk factor for NCDs, and enhanced public health nutrition measures can aid in preventing and addressing unhealthy dietary habits in populations [11, 12]. Consequently, improving popula- tion nutrition and food environments has emerged as a crucial public health priority [13]. In addition to chang- ing conditions, public health approaches have largely centred on altering individual behaviours [14]. Sophis- ticated research is needed to identify the drivers of consumer choice for global food products in emerging economies and to examine how they interact with chang- ing food environments [12, 15]. To date, scholarly research has given relatively less attention to examining the perspective of consumers and demand-side factors in low-income countries regarding global food products [15, 16]. Previous research has pri- marily focused on the supply-side processes and their connections to the nutrition transition [17]. Scholars have tacitly assumed that the proliferation of multina- tional food corporations in emerging economies, along with associated marketing efforts, not only alters the food environment and the availability of food products but also shapes food preferences and fosters the appeal of global food products [17, 18]. The spread of global food products in emerging economies is presumed to result in a gradual change in local food culture, by transferring tastes, preferences, and habits from highly developed countries to low-income countries, particularly through advertising and promotion [17, 19]. Nonetheless, the socio-cultural and nutritional contexts of a country, as well as the socio-economic characteristics of consum- ers, influence the degree of acceptance of global food products and the motives underlying consumer choices. Prior research on the consumer acceptance of multi- national corporations’ food products in low-income countries has predominantly suggested that these prod- ucts are valued for their symbolic and status-enhancing properties, as well as their perceived foreignness or non- localness, which are considered prestigious and cosmo- politan, implying a social signalling effect [18]. However, at the time of these studies, research on nutrition and consumption patterns in low-income countries was pri- marily concerned not only with the malnutrition of low- income groups, but also with the slightly aspirational middle class, with their purchasing power and their pur- ported aspiration for a Western lifestyle [2]. In the mean- time, the middle class in Sub-Saharan African countries has gradually increased, and due to economic growth, improved living standards, urbanization, and progres- sive cultural globalization [12], it can be assumed that, in addition to the global appeal of multinational corpora- tions’ food products, other drivers for their consumption have become increasingly important. This study investigates the drivers of urban Ghanaian consumer food choices of multinational food corpora- tions’ products over local foods using a maximum differ- ence scaling approach to identify current key drivers. The study’s results can be used to formulate recommenda- tions for public health nutrition policy makers to support healthy food choices in Ghana. Impact of multinational food corporations on consumer food choices in Ghana Multinational food corporations and health impacts on Ghanaian consumers At the global level, changes in the supply chain con- trol have led to the concentration of multinational food and beverage manufacturers, retailers, and fast-food Page 3 of 16Nyarko and Bartelmeß Globalization and Health (2024) 20:22 takeaways in the food sector, which has increased the availability of highly processed, packaged, and unhealthy foods and beverages. This phenomenon has been linked to the rising prevalence of overweight and obesity, par- ticularly in urban areas, of emerging economies [20, 21]. In Ghana, a prominent emerging economy in sub-Saha- ran Africa, foreign direct investment in highly processed foods has primarily led to breweries and distilleries, sugar and confectionery as well as soft drinks being more widely available. In addition, the retail sector and the density of franchise fast food restaurants have also increased [22]. No specific data is available for Ghana, but an overall comparison of African regions shows that most FDI flows have been to West Africa, partly because Guinness Ghana owned by Diageo invested substantially in Ghana in the early 2000s [23]. In Ghana there has been a correlation between economic growth and a decrease in undernutrition over the past decade, although signifi- cant disparities persist between rural and urban popu- lations and between the northern and southern regions [12]. However, in the southern region and urban areas in particular, the escalating issue of health risks associ- ated with the rise of overweight and obesity has become a cause for concern [15]. According to the Global Nutri- tion Report [24], the prevalence of overweight in Ghana among women and men in 2019 was 43.3% and 23.9%, respectively, and the prevalence of obesity was 19.3% and 5.6%, respectively. The Ghanaian food environment is gradually chang- ing, with multinational food corporations offering an increasing number of products and meals, especially in urban areas [12, 21]. In Ghana, prominent multinational corporations in the food processing and beverage sector include Nestlé, Danone, Guinness Breweries and Coca Cola Bottling Company. Major supermarket chains oper- ating in the country include Shoprite Holdings, Melcom Group, PICK ’N PAY, and SPAR. Fast food companies with branches in Ghana include Kentucky Fried Chicken, Burger King, and Pizza Hut. As a result of the presence of multinational corporations in the Ghanaian market, the consumption of traditional foods is reportedly declining [25], as has been observed in other Global South coun- tries [10]. The shift from urban markets selling fresh pro- duce to commercially prepared and processed foods is seemingly contributing to the trend towards processed and imported foods in urban diets, as it is assumed that dietary preferences are changing and access to nutrient- rich foods is restricted by the built environment [12, 15]. Studies in Sub-Saharan Africa including Ghana show that the rapid spread of supermarkets has fundamentally altered the local food retail environment and has nega- tively affected customers’ nutritional outcomes [26–28]. Survey and panel data analyses reveal that customers who shop at supermarkets are more likely to consume highly processed foods, have lower intake of unprocessed foods, higher total energy consumption, and a greater likelihood of having an increased Body Mass Index (BMI) or being overweight or obese [26, 29, 30]. Furthermore, multina- tional fast-food production and consumption are experi- encing a significant upsurge in Ghana through franchise models, leading to social differentiation through patterns of consumption, as well as the increased intake of highly processed foods in the rising urban middle class [31]. Food consumption trends and drivers in Ghana Recent research highlights the rapid increase in the total amount of food demanded in West Africa due to popu- lation growth and rising per capita income. Convenience foods, which are quick and easy to prepare and consume, are increasingly in demand across all income groups and countries in the region, particularly among urban popu- lations, where limited time has been identified as a driver of consumption.[32]. In addition, while price remains a significant factor, consumers are also considering differ- entiated quality attributes, such as cleanliness, shelf life, cooking time, freshness, nutritional content, packag- ing, labelling, and presentation, as well as general con- cerns about the quality and health of food [32]. However, the studies show diverse developments and variations between the drivers for the consumption of multinational and local foods. While previous studies have shown that Ghanaians value traditional food variety in their daily diets, consist- ing of local staples accompanied by seasonal vegetables and fruits prepared as soup or stew [15], processed and packaged foods are now ubiquitous in all households, including flavour cubes, canned tomatoes, imported rice, bread, canned or powdered milk, tea, Milo, sunflower oil, and canned fish or meat [15]. One reason identified for buying industrially processed foods was to bridge seasonal gaps in the availability of nutritious foods [15]. However, the increasing consumption of highly pro- cessed foods, such as bouillon cubes, when fresh food is unavailable poses challenges to the public health nutri- tion system and the local markets. It has been shown, that consumers primarily choose brands from multina- tional corporations based on taste, previous experiences, and expiry date, while perceptions of the nutritional quality of food are still largely based on traditional con- cepts of health and well-being. Food was described as "nutritious" if they give strength, energy, build the body, or build blood [15]. A cross-sectional survey conducted in Ghana revealed that despite having good general knowledge about tra- ditional foods, consumers have limited knowledge regarding their nutritional composition [25]. Lower Page 4 of 16Nyarko and Bartelmeß Globalization and Health (2024) 20:22 consumption of traditional foods was found to be poten- tially driven by convenience, economic status, and safety concerns associated with traditional foods. In contrast to multinationals’ food products, consumers in Ghana are concerned about the generally unhygienic conditions under which food is prepared and sold in local markets, as this can lead to food-borne diseases such as cholera, typhoid, food poisoning, diarrhoea, avian influenza and swine fever [30]. Ghanaian consumers are concerned about the safety of food sold in local markets and fear it could harm their health. Consumers are most concerned about the use of pesticides in vegetables, artificial fla- vours and colours, bacterial contamination and harmful substances from plastic packaging [30, 31]. Demographic factors such as age and education did not significantly relate to specific attitudes, knowledge, and consump- tion towards local foods [25]. However, another study focused on consumer preferences of local chicken versus imported chicken found that the quality of the chicken in terms of freshness and taste, as well as ethnocentrism in favour of domestic production, can positively influence the consumption of local products [33]. Overall, there is limited research on the drivers behind the consumption of multinational corporation food products in Ghana. While some studies have focused on specific product categories, retail outlets or fast-food settings, there is a lack of sophisticated research that includes other factors that may influence the overall pref- erence and desirability of these products. Methodology Study setting The present study employed a maximum difference scal- ing experiment to investigate consumer preferences for multinational food corporations’ products over local foods in the Greater Accra Region of Ghana, which is the most populous and urbanized among the 16 administra- tive regions of Ghana. The region encompasses an area of approximately 3,245 square kilometres and has an esti- mated population of 5,446,237, with an urban population increase of about 37.7% between the years 2010 and 2021 [34]. Given that the Greater Accra Region serves as the political capital of Ghana, it is a major economic hub that heavily influences consumer behaviour in terms of multi- national food corporations’ products[35]. Study design and data collection To conduct this study, we surveyed 200 consumers within the Greater Accra Region (Accra) over a period of three weeks in March/April 2023 using paper–pencil ques- tionnaires. We utilized a random sampling technique to obtain the data collected through interviewer-adminis- tered questionnaire. This method aid the respondents in understanding the questions and writing out their responses. However, self-administration of the question- naire was allowed upon request by some respondents to minimize potential interviewer bias. Respondents were approached at multinational supermarkets and inter- national fast-food restaurants such as Shoprite Hold- ings Ltd, Barcelos Ghana, PICK ‘N PAY, Burger King, Massmart, Chicken Inn, SPAR, Kentucky Fried Chicken, Melcom Group, Pizza Hut, and Pizza Inn. Prior to data collection, permission to collect data was obtained in the form of written consent from the respondents after duly explaining to them the purpose of the study. Respondents were informed that their participation was voluntary, and they were at liberty to decide whether to participate or not in the study. The survey questionnaire consisted of two sections. The first section, Section A, gathered socio-demographic characteristics of the respondents as well as reasons that inform consumers’ decision to select or choose products and/or meals from international food corporations and fast-food restaurant chains. The second section, Section B, focused on factors that influence consumers’ choice of multinational food corporations’ products over local foods. Prior to the main survey, a pilot study was con- ducted to identify possible challenges and problems dur- ing data collection, assess respondents’ understanding of the various factors, manage the length of the question- naire and respondents’ reasons or basis for indicating their preferences. Adjustments were made to the ques- tionnaire to address the respondents’ issues and enhance comprehension while reducing information overload and cognitive burden [36]. The sample for this study consisted of 200 respond- ents who completed the survey. It is worth noting that the sample size exceeded the minimum sample size sug- gested by [36] for the number of choice scenarios pre- sented in the questionnaire. According to their proposed sample size calculation, approximately 77 respondents were needed to accurately estimate preference weights. However, the obtained sample size was about two times larger than the minimum required. Therefore, all 200 respondents were included in the final analysis as there were no missing responses. Experimental design Maximum difference scaling is a state-of-the-art approach for conducting consumer experiments [37]. Interest in using this method is growing in diverse areas [38] such as health [39–41], and environmental sustain- ability [42]. Researchers have discussed the potential for wider application of such experiments in food-related consumer research [43–45]. In this experimental design, each respondent is asked to select the most-preferred Page 5 of 16Nyarko and Bartelmeß Globalization and Health (2024) 20:22 attribute and the least-preferred attribute from at least three profiles in a given choice set [46]. One of the main benefits of maximum difference scaling is its capacity to estimate the relative importance of all attributes on a common scale. Unlike traditional rating scale surveys, maximum difference scaling involves greater involve- ment and cognitive effort, which may help consumers focus when completing the choice task [47]. The appeal of maximum difference scaling relative to discrete choice experiments [48] has also been highlighted [43, 49]. To identify potential factors that could inform consum- ers’ routine decision to choose multinational food corpo- rations’ products over local foods, an extensive literature review was conducted [15, 50–54], along with expert consultation involving food actors. Subsequently, a focus group discussion was conducted with 10 food actors and 30 potential consumers of multinational food corpora- tions’ and international fast-food restaurant products. The initial list of potential factors was narrowed down to 16 plausible attributes, which are presented in Table 1. To ensure manageable and comprehensible choice sets for the respondents, 20 choice sets were created using a balanced incomplete block design [55]. The balanced incomplete block design employed for k attributes is denoted as (b, r, v, �) where b is the number of choice sets (blocks), r is the repetition per level, v is the number of items in each choice set (block size) and � is the pair fre- quency. For example, the design noted as 20, 5, 4, 1 for 16 attributes has 20 choice sets, each attribute appears 5 times across all choice sets, each choice set contains four attributes, and each attribute appears once with each other. The 20 choice sets generated from the balanced incomplete block design contain four attributes per set. This approach mitigated the issue of cognitive overload and minimized the potential cognitive burden that may be induced by presenting too many attributes within each choice set [36, 56]. During the survey, each partici- pant was presented with the 20 choice sets, with each set comprising four attributes, as depicted in Fig. 1. The respondents were required to express their preferences by selecting the "best" (most important) reason (attrib- ute) and the "worst" (least important) attribute while con- sidering purchasing a multinational food corporations’ product over local food (when there is a means or an option to eat local food) related to the situation described in Fig.  1. The situation was defined to standardize the reasons for considering purchasing a multinational food corporation’s product over local food and to avoid con- fusion with special situations where people might think about directly comparing preferences for multinational food corporations’ products to local foods as frequently encountered in discrete choice experiments [48], where respondents have to compare product descriptions and select one alternative in a choice set. Empirical strategy/ Data analysis In a maximum difference scaling experiment, profiles are evaluated using a random utility framework [57, 58]. The Table 1 Attributes considered in the maximum difference scaling experiment questionnaire Attributes Explanation Nutrition content/ nutritional value perceived ratio of carbohydrates, fats, proteins, and energy of a food Image/ desirability subjectively perceived image of a food as a representation of global lifestyles, foreignness, or non-localness, which is seen as prestigious and cosmopolitan High in fibre and roughage portion of plant foods, such as whole grains, nuts, seeds, legumes, fruits, and vegetables, present in a food Taste/ flavour expected or previously experienced taste of a food Less preparation time of a meal convenience of ready meals/take-away food that can be prepared in 5 to 15 min Familiarity of a meal frequency of consumption of a meal, with a threshold of at least once a week Healthiness subjectively perceived healthiness of a food Social (family/friends eat) socialization into, and cultural norms around, eating habits, including the diet consumed within the family or by friends Food quality/packaging subjective perception of the quality of the ingredients used in the food/meal. Multinational food is perceived as safer than conventional food (sold on the open market) and well packaged/covered Availability ready-to-eat meals are readily present at fast-food franchises and restaurants for purchase Accessibility convenience of not having to travel long distances to obtain the food Affordability consumer’s ability to afford the cost of the food/meal Convenience convenience of ready-to-eat meals that can be bought in food franchises and restaurants close to where the consumer lives/works or can be ordered without walking (i.e., in a sedentary lifestyle) Aroma/smell favor sensation or reflection of the sense of taste associated with the food/meal Texture characteristics of a meal that can be felt with the fingers, tongue, palate, or teeth Visual aesthetic pleasing appearance of a meal Page 6 of 16Nyarko and Bartelmeß Globalization and Health (2024) 20:22 choice frequencies for best and worst options in a choice set are used to compare the relative importance of different attributes. The Maximum difference model estimates the underlying utility of each choice. To formalize this model, we denote � with |�| ≥ 3 as the finite set of potentially available options from a choice set and let ψ(�) denote the statistical experimental design, that is, the set of (sub)sets of choice options that occur in this study. For any set Y ∈ ψ(�),Y ⊆ � with |Y | ≥ 3 , let PY (i) and PY ( j ) denote the probability that respondents select a pair of items i and j from set Y , where i is selected as the best and j is selected as the worst, and the difference in util- ity between the two items is the maximum among all utility differences. Here PY ( i, j ) is the probability that the item i is selected as the best and item j = i is selected as the worst. By assuming that there is a scale µ such that for all i ∈ Y ∈ ψ(�), where the value µ(i) for an item i is inter- preted as the utility for that option, the best choice model can be formulated as The parallel worst choice model can be reformulated as follows if we assume that there is a scale v such that for all j ∈ Y ∈ ψ(�), If both the corresponding choice probabilities on best and worst item satisfy all distinct pairs i, j ∈ Y ∈ ψ(�), then and we obtain (1.1)PY (i) = eµ(i) ∑ Z∈Y eµ(z) (1.2)PY ( j ) = ev(j) ∑ Z∈Y ev(z) P{i,j}(i)=P{i,j} ( j ) , (1.3)PY ( j ) = e−µ(i) ∑ Z∈Y e−µ(z) Assume that the choice probabilities satisfy the corre- sponding best and worst model, and that the utility of a choice alternative in the selection of a best option is the negative of the utility of that option in the selection of a worst option, and this utility-scale µ is such that for all i, j ∈ Y ∈ ψ(�),i = j, where µ(i) is the systematic component of the utility of item i, which is assumed to be µ(i) = βiXi , where βi is a preference coefficient to be estimated and Xi is a dummy variable taking the value 1 if item i is included in a choice set, and 0 otherwise. In this study, consumers indepen- dently select the attributes related to multinational food corporations’ products/meals they like and dislike the most when compared to local meals. We fitted the maximum difference model to our data using JMP Pro Version 16.0. Statistical significance was measured at p-values of less than 0.001, 0.01, and 0.05. In the absence of p-values, statistical significance was meas- ured at 95% confidence intervals (CIs) greater than or less than zero. A significant positive/negative preference coefficient indicates a high/low preference for a specific attribute. The sign of the preference coefficient indicates whether the plausible attribute has a positive or negative effect on utility. We compared the relative importance of the different attributes across attributes given the utility estimates (preference coefficients). Results Sample characteristics Table  2 presents the demographic characteristics of the respondents as well as their frequency of consumption of products from multinational food corporations. The study comprised 200 participants with a median age of 26.5 years (interquartile range (IQR): 22–32 years). Most of the respondents were female (53%), unmarried (70.5%), childless (66.5%), and held a bachelor’s degree (38%). These findings mirror the expected composition of the (1.4)PY i, j = e[µ(i)−µ(j)] {p,q}∈Y e[µ(p)−µ(q)] , Fig. 1 A sample completed maximum difference scaling experiment choice set as presented to respondents Page 7 of 16Nyarko and Bartelmeß Globalization and Health (2024) 20:22 study population, as the Greater Accra region is known to have a distinct age distribution, with a higher propor- tion of young adults (aged 15–35 years) and a lower total fertility rate (2.2%) compared to other regions in Ghana [34]. Among the respondents, 38.5% reported frequently consuming products or meals from multinational food corporations or fast-food chains during the daytime, with 32.5% reporting occasional consumption, 16% report- ing habitual consumption, 12.5% reporting infrequent consumption, and only 0.5% reporting never consuming such products. Respondents aged 15–29 years, females, unmarried individuals, childless individuals, and those with a bachelor’s degree reported higher rates of frequent consumption, with 25.5%, 21%, 29.5%, 28%, and 16% of respondents in these respective categories reporting fre- quent consumption of multinational food corporation products or meals. Sample preference estimation The results of the maximum difference model (Likeli- hood Ratio (LR) test statistic = 1203.665, p < 0.0001) demonstrated significant differences in preferences for the various attributes (Table  3). The estimated prefer- ence coefficients exhibited the expected sign within the 95% CIs. Each attribute was statistically significant (i.e., 95% CIs did not contain zero or were greater or less than zero); however, there was considerable overlap in the 95% CIs, indicating that certain attributes were not statisti- cally different from each other. We interpret these results with respect to the model specification, beginning with the observation that the reference level was the attribute variable visual aesthetic. Preference coefficients for the attribute variables, such as aroma/smell, availability, food quality/packaging, healthiness, image/desirability, less preparation time of a meal, nutrition content/nutritional value, social (family/friends eat), taste/flavour, and tex- ture, were mostly significant, indicating their influence on consumers’ choice decisions. Specifically, the positive signs of the preference coefficients for attributes such as aroma/smell, food quality/packaging, healthiness, nutri- tion content/nutritional value, and taste/flavour indicated that consumers were more likely to choose products from multinational corporations over local foods. Con- versely, negative signs for attributes such as availability, image/desirability, less preparation time of a meal, social (family/friends eat), and texture indicated disutility for choosing multinational corporations’ products over local foods. This suggests that consumers tended to weigh the Table 2 Sample characteristics and frequency of consumption of products from international food corporations * IQR interquartile range Variable Category Respondents (n = 200) Number of respondents by frequency of products/meals consumption Always Often Sometimes Rarely Never Age (years) median (IQR*) 26.5 (22–32) Age (years) 15 – 29 126 (63.0%) 18 (9.0%) 51 (25.5%) 44 (22.0%) 13 (6.5%) 0 (0.0%) 30 – 49 67 (33.5%) 14 (7.0%) 23 (11.5%) 19 (9.5%) 10 (5.0%) 1 (0.5%) 50 + 7 (3.5%) 0 (0.0%) 3 (1.5%) 2 (1.0%) 2 (1.0%) 0 (0.0%) Gender Male 93 (46.5%) 21 (10.5%) 34 (17.0%) 23 (11.5%) 14 (7.0%) 1 (0.5%) Female 106 (53.0%) 11 (5.5%) 42 (21.0%) 42 (21.0%) 11 (5.5%) 0 (0.0%) Diverse 1 (0.5%) 0 (0.0%) 1 (0.5%) 0 (0.0%) 0 (0.0%) 0 (0.0%) Educational level completed Primary or less 19 (9.5%) 6 (3.0%) 3 (1.5%) 5 (2.5%) 4 (2.0%) 1 (0.5%) Secondary School/SHS/SSS 57 (28.5%) 8 (4.0%) 22 (11.0%) 21 (10.5%) 6 (3.0%) 0 (0.0%) Diploma/HND 19 (9.5%) 3 (1.5%) 8 (4.0%) 7 (3.5%) 1 (0.5%) 0 (0.0%) Bachelors 76 (38.0%) 8 (4.0%) 32 (16.0%) 24 (12.0%) 12 (6.0%) 0 (0.0%) Masters 19 (9.5%) 6 (3.0%) 8 (4.0%) 5 (2.5%) 0 (0.0%) 0 (0.0%) Ph.D./DrPH 10 (5.0%) 1 (0.5%) 4 (2.0%) 3 (1.5%) 2 (1.0%) 0 (0.0%) Marital status Single 141 (70.5%) 25 (12.5%) 59 (29.5%) 44 (22.0%) 13 (6.5%) 0 (0.0%) Married 46 (23.0%) 5 (2.5%) 15 (7.5%) 17 (8.5%) 8 (4.0%) 1 (0.5%) Divorced 8 (4.0%) 2 (1.0%) 1 (0.5%) 4 (2.0%) 1 (0.5%) 0 (0.0%) Widowed 5 (2.5%) 0 (0.0%) 2 (1.0%) 0 (0.0%) 3 (1.5%) 0 (0.0%) Number of children None 133 (66.5%) 20 (10.0%) 56 (28.0%) 44 (22.0%) 13 (6.5%) 0 (0.0%) 1 child 34 (17.0%) 5 (2.5%) 15 (7.5%) 11 (5.5%) 3 (1.5%) 0 (0.0%) 2–3 children 27 (13.5%) 4 (2.0%) 6 (3.0%) 10 (5.0%) 6 (3.0%) 1 (0.5%) More than 3 children 6 (3.0%) 3 (1.5%) 0 (0.0%) 0 (0.0%) 3 (1.5%) 0 (0.0%) Page 8 of 16Nyarko and Bartelmeß Globalization and Health (2024) 20:22 attributes of availability, image/desirability, less prepara- tion time of a meal, social (family/friends eat), and tex- ture against each other when selecting multinational food corporations’ products/meals. To facilitate interpretation of the relative importance of each plausible attribute to consumers based on the mag- nitude of the preference coefficients, we have arranged the attributes in Fig.  2 in accordance with the marginal Table 3 Maximum difference model estimates of attributes that contribute to consumers choice of multinational corporations’ products over local foods * SE standard error, L-R likelihood ratio, AIC Akaike information criteria, BIC Bayesian information criteria, DF degree of freedom Attribute Estimate SE* Lower 95% Upper 95% Accessibility -0.0325 0.0442 -0.1192 0.0541 Affordability 0.0559 0.0439 -0.0300 0.1420 Aroma/smell 0.1089 0.0440 0.0226 0.1954 Availability -0.1866 0.0440 -0.2730 -0.1003 Convenience 0.0060 0.0441 -0.0804 0.0925 Familiarity of a meal -0.0616 0.0440 -0.1480 0.0245 Food quality/packaging 0.8053 0.0471 0.7134 0.8983 Healthiness 0.5995 0.0457 0.5102 0.6896 High in fibre and roughage -0.0314 0.0436 -0.1169 0.0540 Image/desirability -0.3284 0.0444 -0.4157 -0.2416 Less preparation time of a meal -0.2328 0.0442 -0.3196 -0.1463 Nutrition content/ nutritional value 0.4076 0.0447 0.3201 0.4957 Social (family/friends eat) -0.2734 0.0441 -0.3602 -0.1871 Taste/flavor 0.4918 0.0450 0.4037 0.5805 Texture -0.8255 0.0470 -0.9184 -0.7337 Model fits L-R* test statistic 1203.66 AIC* 18,258.42 BIC* 18,352.37 DF* 15 P-Value < 0.0001 Number of observations 16,000 Fig. 2 Marginal utility estimates and marginal probability of attributes that contribute to consumers choice of multinational corporations’ food products over local meals Page 9 of 16Nyarko and Bartelmeß Globalization and Health (2024) 20:22 utility estimates (MUE) and their corresponding mar- ginal probability (MP) values. MUE represents the perceived importance of the matching level of the effect. Larger values imply that the level of the effect is of greater importance. MP represents the estimated probability that a consumer expresses a preference for the matching effect over all other effects. Our analysis revealed that food quality/packaging was the most important attribute (MUE: 0.8053; MP: 0.1286; 95% confidence interval [CI]: 0.7134, 0.8983), followed by healthiness (MUE: 0.5996; MP: 0.1047; 95% CI: 0.5102, 0.6896), taste/flavour (MUE: 0.4918; MP: 0.0940; 95% CI: 0.4037, 0.5805), nutrition content/nutritional value (MUE: 0.4077; MP: 0.0864; 95% CI: 0.3201, 0.4957), and aroma/smell (MUE: 0.1090; MP: 0.0641; 95% CI: 0.0226, 0.1954). However, we also observed negative rela- tive importance for some attributes, such as availability (MUE: -0.187; MP: 0.0477; 95% CI: -0.2730, -0.1003), less preparation time of a meal (MUE: -0.233; MP: 0.0455; 95% CI: -0.3196, -0.1463), social (family/friends eat) (MUE: -0.273; MP: 0.0437; 95% CI: -0.3602, -0.1871), and image/desirability (MUE: -0.328; MP: 0.0414; 95% CI: -0.4157, -0.2416). Finally, texture was found to be the least important attribute (MUE: -0.826; MP: 0.0252; 95% CI: -0.9184, -0.7337). Additionally, Table  4 provides a comparison of the greatest utility difference (GUD) among the preference weights for the attributes. GUD is defined as the maxi- mum change in utility that can be achieved from an attribute, based on the plausible attributes included in the maximum difference experiment. Our results show that food quality/packaging had significantly the highest utility (GUD: 1.63088; p = 5e-113) compared to all other attributes related to consumers’ preferences for multi- national food corporations’ products/meals over local foods. Healthiness also had a significantly higher utility (GUD: 1.42512; p = 4.1e-91) but did not differ signifi- cantly from the taste/flavour attribute (p = 0.10109). The taste/flavour attribute had the next highest utility (GUD: 1.31736; p = 8.3e-80), followed by the nutrition content/ nutritional value attribute (GUD: 1.23321; p = 3.4e-71), though it did not differ significantly from the taste/fla- vour attribute (p = 0.1957). The aroma/smell attribute had a lower but still significant utility (GUD: 0.93449; p = 1.7e-43), though it did not differ significantly from the convenience attribute (p = 0.10964). In our study, we found that the affordability attribute had a positive utility value, indicating that it is a desir- able attribute for consumers (GUD: 0.88151; p = 4.3e-39). However, this attribute did not significantly differ from other attributes such as high fibre and roughage, famili- arity of a meal, convenience, and aroma/smell. When affordability was made available concurrently with other attributes, such as food quality/packaging, healthiness, nutrition content/nutritional value, and taste/flavour, consumers tended to trade it off (GUDs ranging from -0.3517 to -0.7494; ps < 0.05), suggesting that affordabil- ity may not be the deciding factor in their meal choices. Similarly, the convenience attribute had a significant pos- itive utility value (GUD: 0.83257; p = 1.6e-35), but it did not differ significantly from the high fibre and roughage and familiarity of a meal attributes. When convenience was made available concurrently with other attributes such as food quality/packaging, healthiness, nutrition content/nutritional value, and taste/flavour, consum- ers tended to trade it off (GUDs ranging from -0.4016 to -0.7993; ps < 0.05). Overall, our findings suggest that con- sumers prioritize attributes such as food quality/packag- ing, healthiness, nutrition content/nutritional value, and taste/flavour over affordability and convenience when selecting international meal or food products over local options. We also observed significant differences for the attrib- ute variable high in fibre and roughage (DUE: 0.79409; p = 2.2e-32). However, when made available concurrently with the nutrition content/nutritional value attribute (GUD: -0.4391; p = 1.4e-11) and the taste/flavour attrib- ute (GUD: -0.5233; p = 19.9e-16), it will be traded off. Similarly, the accessibility attribute was significantly dif- ferent (GUD: 0.79298; p = 3.9e-32), but it will be traded off when made available concurrently with the aroma/ smell attribute (GUD: -0.1415; p = 0.02891), healthi- ness (GUD: -0.6321; p = 9.2e-22), food quality/packaging (GUD: -0.8379; p = 1.4e-35), nutrition content/nutritional value (GUD: -0.4402; p = 1.5e-11) as well as taste/flavour (GUD: -0.5244; p = 31.1e-15). These findings suggest that the high in fibre and roughage attribute and the accessi- bility attribute are not as important as the other attrib- utes when making food choices. The study found that the attribute variable "famili- arity of a meal" had a significant positive utility value (GUD: 0.76385; p = 6.6e-30), but it did not differ signifi- cantly from the attribute "high in fibre and roughage" (p = 0.63583) or "availability" (GUD: 0.63892; p = 1.2e- 21), which did not differ significantly from the attribute "less preparation time of a meal" (p = 0.47014) or "social (family/friends eat)" (p = 0.17776). However, when made available concurrently with other attributes, familiar- ity of a meal was traded-off for food quality/packaging (GUD: -0.867; p = 5.3e-38), healthiness (GUD: -0.6613; p = 1.3e-23), nutrition content/nutritional value (GUD: -0.4694; p = 5.1e-13), and taste/flavour (GUD: -0.5535; p = 1.8e-17). Similarly, "less preparation time of a meal" had a significant utility value (GUD: 0.59271; p = 8.6e-19), but it did not differ significantly from the "social (fam- ily/friends eat)" attribute (p = 0.52704). However, when Page 10 of 16Nyarko and Bartelmeß Globalization and Health (2024) 20:22 Ta bl e 4 Pr ef er en ce s w he n tw o at tr ib ut es th at c on tr ib ut e to c on su m er s ch oi ce o f m ul tin at io na l f oo d co rp or at io ns ’ p ro du ct s or m ea ls a re m ad e av ai la bl e co nc ur re nt ly D iff er en ce (R ow - Co lu m n) St an da rd Er ro r o f D iff er en ce W al d p- Va lu e A cc es si bi lit y A ffo rd ab ili ty A ro m a/ sm el l Av ai la bi lit y Co nv en ie nc e Fa m ili ar it y of a m ea l Fo od qu al it y/ pa ck ag in g H ea lth in es s H ig h in fib re a nd ro ug ha ge Im ag e/ de si ra bi lit y Le ss pr ep ar at io n tim e of a m ea l N ut ri tio n co nt en t/ nu tr iti on al va lu e So ci al (f am ily / fr ie nd s ea t) Ta st e/ fla vo r Te xt ur e Vi su al ae st he tic A cc es si - bi lit y 0 -0 .0 88 5 -0 .1 41 5 0. 15 40 5 -0 .0 38 6 0. 02 91 2 -0 .8 37 9 -0 .6 32 1 -0 .0 01 1 0. 29 59 4 0. 20 02 6 -0 .4 40 2 0. 24 09 5 -0 .5 24 4 0. 79 29 8 0. 47 02 8 0 0. 06 41 8 0. 06 47 5 0. 06 47 7 0. 06 45 4 0. 06 42 6 0. 06 66 5 0. 06 55 7 0. 06 39 8 0. 06 47 6 0. 06 46 7 0. 06 50 2 0. 06 43 8 0. 06 51 3 0. 06 66 0. 06 51 4 0. 16 78 8 0. 02 89 1 0. 01 74 4 0. 54 99 1 0. 65 04 4 1. 4e -3 5 9. 2e -2 2 0. 98 61 5 5. 03 e- 6 0. 00 19 7 1. 5e -1 1 0. 00 01 8 1. 1e -1 5 3. 9e -3 2 6. 2e -1 3 A ffo rd - ab ili ty 0. 08 85 3 0 -0 .0 53 0. 24 25 8 0. 04 99 4 0. 11 76 5 -0 .7 49 4 -0 .5 43 6 0. 08 74 2 0. 38 44 7 0. 28 87 9 -0 .3 51 7 0. 32 94 8 -0 .4 35 9 0. 88 15 1 0. 55 88 1 0. 06 41 8 0 0. 06 41 4 0. 06 40 4 0. 06 42 2 0. 06 40 5 0. 06 67 0. 06 56 8 0. 06 37 4 0. 06 41 5 0. 06 42 7 0. 06 50 6 0. 06 42 3 0. 06 52 3 0. 06 66 7 0. 06 45 4 0. 16 78 8 0. 40 88 2 0. 00 01 5 0. 43 68 4 0. 06 63 1 7. 4e -2 9 1. 7e -1 6 0. 17 03 2 2. 23 e- 9 7. 22 e- 6 6. 84 e- 8 3. 04 e- 7 2. 7e -1 1 4. 3e -3 9 6. 8e -1 8 A ro m a/ sm el l 0. 14 15 1 0. 05 29 8 0 0. 29 55 7 0. 10 29 2 0. 17 06 4 -0 .6 96 4 -0 .4 90 6 0. 14 04 0. 43 74 6 0. 34 17 7 -0 .2 98 7 0. 38 24 6 -0 .3 82 9 0. 93 44 9 0. 61 17 9 0. 06 47 5 0. 06 41 4 0 0. 06 43 1 0. 06 43 2 0. 06 43 7 0. 06 67 6 0. 06 53 8 0. 06 37 3 0. 06 45 2 0. 06 44 2 0. 06 46 8 0. 06 42 7 0. 06 52 3 0. 06 67 6 0. 06 50 3 0. 02 89 1 0. 40 88 2 4. 44 e- 6 0. 10 96 4 0. 00 80 6 3. 7e -2 5 7. 6e -1 4 0. 02 76 4 1. 4e -1 1 1. 19 e- 7 3. 99 e- 6 2. 9e -9 4. 73 e- 9 1. 7e -4 3 8. 4e -2 1 A va ila bi lit y -0 .1 54 1 -0 .2 42 6 -0 .2 95 6 0 -0 .1 92 6 -0 .1 24 9 -0 .9 92 -0 .7 86 2 -0 .1 55 2 0. 14 18 9 0. 04 62 1 -0 .5 94 3 0. 08 68 9 -0 .6 78 4 0. 63 89 2 0. 31 62 2 0. 06 47 7 0. 06 40 4 0. 06 43 1 0 0. 06 42 7 0. 06 41 0. 06 68 6 0. 06 57 7 0. 06 39 1 0. 06 43 9 0. 06 39 7 0. 06 50 7 0. 06 44 6 0. 06 52 9 0. 06 64 7 0. 06 47 4 0. 01 74 4 0. 00 01 5 4. 44 e- 6 0. 00 27 4 0. 05 13 5 1. 7e -4 8 2. 2e -3 2 0. 01 52 4 0. 02 76 0. 47 01 4 1e -1 9 0. 17 77 6 5. 7e -2 5 1. 2e -2 1 1. 08 e- 6 Co nv en i- en ce 0. 03 85 9 -0 .0 49 9 -0 .1 02 9 0. 19 26 5 0 0. 06 77 2 -0 .7 99 3 -0 .5 93 6 0. 03 74 8 0. 33 45 4 0. 23 88 5 -0 .4 01 6 0. 27 95 4 -0 .4 85 8 0. 83 15 7 0. 50 88 7 0. 06 45 4 0. 06 42 2 0. 06 43 2 0. 06 42 7 0 0. 06 44 8 0. 06 71 4 0. 06 62 4 0. 06 38 9 0. 06 45 5 0. 06 43 9 0. 06 47 7 0. 06 43 4 0. 06 50 4 0. 06 61 9 0. 06 49 4 0. 54 99 1 0. 43 68 4 0. 10 96 4 0. 00 27 4 0. 29 37 3. 9e -3 2 4. 8e -1 9 0. 55 74 3 2. 3e -7 0. 00 02 1 6. 2e -1 0 1. 43 e- 5 9. 9e -1 4 1. 6e -3 5 5. 9e -1 5 Fa m ili ar ity of a m ea l -0 .0 29 1 -0 .1 17 7 -0 .1 70 6 0. 12 49 3 -0 .0 67 7 0 -0 .8 67 -0 .6 61 3 -0 .0 30 2 0. 26 68 2 0. 17 11 4 -0 .4 69 4 0. 21 18 2 -0 .5 53 5 0. 76 38 5 0. 44 11 5 0. 06 42 6 0. 06 40 5 0. 06 43 7 0. 06 41 0. 06 44 8 0 0. 06 65 7 0. 06 55 9 0. 06 38 4 0. 06 49 7 0. 06 45 2 0. 06 47 7 0. 06 44 4 0. 06 48 0. 06 66 9 0. 06 48 0. 65 04 4 0. 06 63 1 0. 00 80 6 0. 05 13 5 0. 29 37 5. 3e -3 8 1. 3e -2 3 0. 63 58 3 0. 00 00 4 0. 00 80 2 5. 1e -1 3 0. 00 10 2 1. 8e -1 7 6. 6e -3 0 1. 1e -1 1 Fo od q ua l- ity /p ac ka g- in g 0. 83 79 0. 74 93 7 0. 69 63 9 0. 99 19 6 0. 79 93 1 0. 86 70 2 0 0. 20 57 5 0. 83 67 9 1. 13 38 4 1. 03 81 6 0. 39 76 6 1. 07 88 5 0. 31 35 1 1. 63 08 8 1. 30 81 8 0. 06 66 5 0. 06 67 0. 06 67 6 0. 06 68 6 0. 06 71 4 0. 06 65 7 0 0. 06 69 4 0. 06 66 0. 06 74 7 0. 06 70 4 0. 06 65 7 0. 06 70 7 0. 06 67 9 0. 06 98 9 0. 06 79 8 1. 4e -3 5 7. 4e -2 9 3. 7e -2 5 1. 7e -4 8 3. 9e -3 2 5. 3e -3 8 0. 00 21 3 1. 5e -3 5 2. 7e -6 1 1. 4e -5 2 2. 52 e- 9 1. 9e -5 6 2. 77 e- 6 5e -1 13 5. 5e -7 9 H ea lth in es s 0. 63 21 5 0. 54 36 2 0. 49 06 4 0. 78 62 0. 59 35 6 0. 66 12 7 -0 .2 05 8 0 0. 63 10 4 0. 92 80 9 0. 83 24 1 0. 19 19 1 0. 87 31 0. 10 77 6 1. 42 51 2 1. 10 24 3 0. 06 55 7 0. 06 56 8 0. 06 53 8 0. 06 57 7 0. 06 62 4 0. 06 55 9 0. 06 69 4 0 0. 06 54 4 0. 06 61 9 0. 06 58 9 0. 06 55 5 0. 06 59 9 0. 06 57 1 0. 06 86 0. 06 67 6 9. 2e -2 2 1. 7e -1 6 7. 6e -1 4 2. 2e -3 2 4. 8e -1 9 1. 3e -2 3 0. 00 21 3 9. 1e -2 2 1. 2e -4 3 6. 8e -3 6 0. 00 34 3 3. 9e -3 9 0. 10 10 9 4. 1e -9 1 2. 6e -5 9 H ig h in fi br e an d ro ug h- ag e 0. 00 11 1 -0 .0 87 4 -0 .1 40 4 0. 15 51 6 -0 .0 37 5 0. 03 02 3 -0 .8 36 8 -0 .6 31 0 0. 29 70 5 0. 20 13 7 -0 .4 39 1 0. 24 20 6 -0 .5 23 3 0. 79 40 9 0. 47 13 9 0. 06 39 8 0. 06 37 4 0. 06 37 3 0. 06 39 1 0. 06 38 9 0. 06 38 4 0. 06 66 0. 06 54 4 0 0. 06 41 9 0. 06 38 4 0. 06 47 5 0. 06 37 2 0. 06 49 1 0. 06 64 2 0. 06 46 8 0. 98 61 5 0. 17 03 2 0. 02 76 4 0. 01 52 4 0. 55 74 3 0. 63 58 3 1. 5e -3 5 9. 1e -2 2 3. 81 e- 6 0. 00 16 2 1. 4e -1 1 0. 00 01 5 9. 9e -1 6 2. 2e -3 2 3. 8e -1 3 Im ag e/ de si ra bi lit y -0 .2 95 9 -0 .3 84 5 -0 .4 37 5 -0 .1 41 9 -0 .3 34 5 -0 .2 66 8 -1 .1 33 8 -0 .9 28 1 -0 .2 97 1 0 -0 .0 95 7 -0 .7 36 2 -0 .0 55 -0 .8 20 3 0. 49 70 3 0. 17 43 3 0. 06 47 6 0. 06 41 5 0. 06 45 2 0. 06 43 9 0. 06 45 5 0. 06 49 7 0. 06 74 7 0. 06 61 9 0. 06 41 9 0 0. 06 44 7 0. 06 53 7 0. 06 45 8 0. 06 55 9 0. 06 63 9 0. 06 49 8 5. 03 e- 6 2. 23 e- 9 1. 4e -1 1 0. 02 76 2. 3e -7 0. 00 00 4 2. 7e -6 1 1. 2e -4 3 3. 81 e- 6 0. 13 78 5 5. 6e -2 9 0. 39 45 3 3. 1e -3 5 8. 7e -1 4 0. 00 73 3 Page 11 of 16Nyarko and Bartelmeß Globalization and Health (2024) 20:22 Ta bl e 4 (c on tin ue d) D iff er en ce (R ow - Co lu m n) St an da rd Er ro r o f D iff er en ce W al d p- Va lu e A cc es si bi lit y A ffo rd ab ili ty A ro m a/ sm el l Av ai la bi lit y Co nv en ie nc e Fa m ili ar it y of a m ea l Fo od qu al it y/ pa ck ag in g H ea lth in es s H ig h in fib re a nd ro ug ha ge Im ag e/ de si ra bi lit y Le ss pr ep ar at io n tim e of a m ea l N ut ri tio n co nt en t/ nu tr iti on al va lu e So ci al (f am ily / fr ie nd s ea t) Ta st e/ fla vo r Te xt ur e Vi su al ae st he tic Le ss p re pa - ra tio n tim e of a m ea l -0 .2 00 3 -0 .2 88 8 -0 .3 41 8 -0 .0 46 2 -0 .2 38 9 -0 .1 71 1 -1 .0 38 2 -0 .8 32 4 -0 .2 01 4 0. 09 56 8 0 -0 .6 40 5 0. 04 06 9 -0 .7 24 6 0. 59 27 1 0. 27 00 2 0. 06 46 7 0. 06 42 7 0. 06 44 2 0. 06 39 7 0. 06 43 9 0. 06 45 2 0. 06 70 4 0. 06 58 9 0. 06 38 4 0. 06 44 7 0 0. 06 51 9 0. 06 43 2 0. 06 54 3 0. 06 66 3 0. 06 51 2 0. 00 19 7 7. 22 e- 6 1. 19 e- 7 0. 47 01 4 0. 00 02 1 0. 00 80 2 1. 4e -5 2 6. 8e -3 6 0. 00 16 2 0. 13 78 5 1. 6e -2 2 0. 52 70 4 4. 2e -2 8 8. 6e -1 9 3. 45 e- 5 N ut rit io n co nt en t/ nu tr iti on al va lu e 0. 44 02 4 0. 35 17 1 0. 29 87 2 0. 59 42 9 0. 40 16 4 0. 46 93 6 -0 .3 97 7 -0 .1 91 9 0. 43 91 3 0. 73 61 8 0. 64 05 0 0. 68 11 8 -0 .0 84 1 1. 23 32 1 0. 91 05 1 0. 06 50 2 0. 06 50 6 0. 06 46 8 0. 06 50 7 0. 06 47 7 0. 06 47 7 0. 06 65 7 0. 06 55 5 0. 06 47 5 0. 06 53 7 0. 06 51 9 0 0. 06 51 6 0. 06 50 2 0. 06 77 5 0. 06 58 7 1. 5e -1 1 6. 84 e- 8 3. 99 e- 6 1e -1 9 6. 2e -1 0 5. 1e -1 3 2. 52 e- 9 0. 00 34 3 1. 4e -1 1 5. 6e -2 9 1. 6e -2 2 3e -2 5 0. 19 57 3. 4e -7 1 1. 7e -4 2 So ci al (fa m ily / fri en ds ea t) -0 .2 40 9 -0 .3 29 5 -0 .3 82 5 -0 .0 86 9 -0 .2 79 5 -0 .2 11 8 -1 .0 78 8 -0 .8 73 1 -0 .2 42 1 0. 05 5 -0 .0 40 7 -0 .6 81 2 0 -0 .7 65 3 0. 55 20 3 0. 22 93 3 0. 06 43 8 0. 06 42 3 0. 06 42 7 0. 06 44 6 0. 06 43 4 0. 06 44 4 0. 06 70 7 0. 06 59 9 0. 06 37 2 0. 06 45 8 0. 06 43 2 0. 06 51 6 0 0. 06 53 6 0. 06 63 9 0. 06 48 6 0. 00 01 8 3. 04 e- 7 2. 9e -9 0. 17 77 6 1. 43 e- 5 0. 00 10 2 1. 9e -5 6 3. 9e -3 9 0. 00 01 5 0. 39 45 3 0. 52 70 4 3e -2 5 3. 7e -3 1 1. 2e -1 6 0. 00 04 1 Ta st e/ fla vo r 0. 52 43 9 0. 43 58 6 0. 38 28 7 0. 67 84 4 0. 48 57 9 0. 55 35 1 -0 .3 13 5 -0 .1 07 8 0. 52 32 8 0. 82 03 3 0. 72 46 5 0. 08 41 5 0. 76 53 3 0 1. 31 73 6 0. 99 46 6 0. 06 51 3 0. 06 52 3 0. 06 52 3 0. 06 52 9 0. 06 50 4 0. 06 48 0. 06 67 9 0. 06 57 1 0. 06 49 1 0. 06 55 9 0. 06 54 3 0. 06 50 2 0. 06 53 6 0 0. 06 80 8 0. 06 61 4 1. 1e -1 5 2. 7e -1 1 4. 73 e- 9 5. 7e -2 5 9. 9e -1 4 1. 8e -1 7 2. 77 e- 6 0. 10 10 9 9. 9e -1 6 3. 1e -3 5 4. 2e -2 8 0. 19 57 3. 7e -3 1 8. 3e -8 0 9. 1e -5 0 Te xt ur e -0 .7 93 -0 .8 81 5 -0 .9 34 5 -0 .6 38 9 -0 .8 31 6 -0 .7 63 9 -1 .6 30 9 -1 .4 25 1 -0 .7 94 1 -0 .4 97 -0 .5 92 7 -1 .2 33 2 -0 .5 52 -1 .3 17 4 0 -0 .3 22 7 0. 06 66 0. 06 66 7 0. 06 67 6 0. 06 64 7 0. 06 61 9 0. 06 66 9 0. 06 98 9 0. 06 86 0. 06 64 2 0. 06 63 9 0. 06 66 3 0. 06 77 5 0. 06 63 9 0. 06 80 8 0 0. 06 67 3. 9e -3 2 4. 3e -3 9 1. 7e -4 3 1. 2e -2 1 1. 6e -3 5 6. 6e -3 0 5e -1 13 4. 1e -9 1 2. 2e -3 2 8. 7e -1 4 8. 6e -1 9 3. 4e -7 1 1. 2e -1 6 8. 3e -8 0 1. 36 e- 6 Vi su al ae st he tic -0 .4 70 3 -0 .5 58 8 -0 .6 11 8 -0 .3 16 2 -0 .5 08 9 -0 .4 41 2 -1 .3 08 2 -1 .1 02 4 -0 .4 71 4 -0 .1 74 3 -0 .2 7 -0 .9 10 5 -0 .2 29 3 -0 .9 94 7 0. 32 27 0 0. 06 51 4 0. 06 45 4 0. 06 50 3 0. 06 47 4 0. 06 49 4 0. 06 48 0. 06 79 8 0. 06 67 6 0. 06 46 8 0. 06 49 8 0. 06 51 2 0. 06 58 7 0. 06 48 6 0. 06 61 4 0. 06 67 0 6. 2e -1 3 6. 8e -1 8 8. 4e -2 1 1. 08 e- 6 5. 9e -1 5 1. 1e -1 1 5. 5e -7 9 2. 6e -5 9 3. 8e -1 3 0. 00 73 3 3. 45 e- 5 1. 7e -4 2 0. 00 04 1 9. 1e -5 0 1. 36 e- 6 Page 12 of 16Nyarko and Bartelmeß Globalization and Health (2024) 20:22 made available concurrently with other attributes, "less preparation time of a meal" was traded-off for nutrition content/nutritional value (GUD: -0.6405; p = 1.6e-22) and taste/flavour (GUD: -0.7246; p = 34.2e-28). Finally, the attribute variable "social (family/friends eat)" had a significant positive utility value (GUD: 0.55203; p = 91.2e- 16), but it was traded-off for taste/flavour (GUD: -0.7653; p = 63.7e-31) when made available concurrently with this attribute. The attribute variable "image/desirability" was found to have a significantly lower utility (GUD: 0.49703; p = 8.7e-14) than all other attributes related to multi- national food corporations’ products/meals preference over local foods. However, this attribute did not differ significantly from the attributes of "less preparation time of a meal" (p = 0.13785) and "social (family/friends eat)" (p = 0.39453). These results suggest that although "image/ desirability" can influence consumers’ food choices, it is less valued than other attributes. It is noteworthy that the "image/desirability" attribute will be traded off when made available concurrently with "nutrition content/ nutritional value" (GUD: -0.7362; p = 5.6e-29) and "taste/ flavour" (GUD: -0.8203; p = 3.1e-35). Thus, consumers are likely to base their food choices on nutrition content/ nutritional value and taste/flavour rather than the image/ desirability of the meals/products. Discussion The present study aimed to investigate the key factors that influence the food choices of urban Ghanaian con- sumers regarding multinational food corporations’ prod- ucts over local foods. The findings revealed that food quality and safe packaging, perceived healthiness, taste and flavour, as well as nutritional value, were the main drivers of consumer preferences for multinational food products. Of these factors, food quality and safe packag- ing emerged as the criterion with the highest utility, sug- gesting that it is a significant aspect of consumer food choice decisions. This finding is notable because pre- vious research has not identified this criterion as a pri- mary driver of consumer preference. Previous studies have mostly focused on either the supermarket [26, 29] or local market context [25] and have not compared the preferences for multinational food products over local foods when there is an option to eat local foods. By pos- ing this question, the study sheds light on the substitu- tive links between traditional and imported multinational foods and dishes, which are becoming increasingly sali- ent in the Ghanaian food landscape. Studies investigating the preference for consuming local food have found that concerns about quality, safety, and health are important factors in consumers’ decision to refrain from consum- ing locally produced and distributed food [25, 50]. This suggests that concerns about food safety, combined with the availability and affordability of industrially produced food, may lead consumers to view multinational corpora- tions as offering safer substitutes to local food supplies. However, anxiety over contamination and foodborne ill- ness underscores the need for reliable policies and food controls for both local and imported food products [50]. In addition, public authorities and public health nutri- tionists should invest in accompanying education cam- paigns on a broader understanding of quality, so that food safety does not become the sole criterion for con- sumer food choice decisions. Such campaigns could help prevent the consumption of multinational, highly pro- cessed foods from being seen as the default choice. The results of the present study underscore the impor- tance of perceived health and nutritional value as signifi- cant factors driving the preference of multinational food corporations’ products over local foods among urban Ghanaian consumers. This observation aligns with pre- vious research in other countries of the Global South that highlight how health claims, labelling, and market- ing play a crucial role in shaping consumers’ perceptions of the health value of industrially produced foods [32]. Moreover, traditional foods in Ghana are often endowed with cultural meanings related to health, such as build- ing the body, energy, and blood [15], which further high- lights the importance of perceived healthiness in food choices. However, while multinational corporations often aggressively market their products, promoting supposed knowledge about their health value, local foods are gen- erally less well-known in terms of their nutritional values [25]. This knowledge gap suggests that there is a need to provide more nutrition education to consumers to make them aware of the benefits of consuming local healthy foods. Public health nutritionists and policymakers could help to promote the consumption of local foods by pro- viding more nutrition education and increasing aware- ness about the nutritional values of traditional foods. This approach could encourage more conscious consumption choices and promote a shift towards healthier and more sustainable food choices in urban Ghanaian settings. The findings of this study reveal that a significant pro- portion of the Ghanaian urban population studied fre- quently or occasionally consume food or dishes from multinational companies, with younger, educated, single, and childless females being the predominant consum- ers. These findings partly align with previous studies that have identified regular supermarket shoppers as being economically better off with secondary or tertiary educa- tion, but contrast with previous socio-economic charac- teristics such as married individuals and those living in larger households [28]. Our results therefore also sug- gests that lack of time to prepare fresh food is one of the Page 13 of 16Nyarko and Bartelmeß Globalization and Health (2024) 20:22 main reasons for consuming food from MNCs in the city of Accra, as it is readily available, affordable, and conveni- ent for this group [32]. It can be inferred that the popu- lation under study not only acquires highly processed food items, such as Maggi cubes, canned, or powdered milk, from outlets that distribute products of multina- tional corporations to compensate for seasonal gaps in locally available nutrient-rich food [15], but also increas- ingly consumes convenience food and ready-to-eat meals owing to time constraints. The escalating consumption of highly processed and pre-packaged foods in urbanized regions of emerging economies has been associated with adverse health and environmental impacts [15, 27] neces- sitating the involvement of government and other private sector stakeholders to address public health, nutrition, and sustainability issues. This obligation may involve implementing general awareness campaigns to promote healthy and sustainable diets, as well as targeted policy measures, such as incentives to incorporate more nutri- tious food items and meals into the product portfolio or developing effective waste management systems [12]. The previously prevalent assumption that multinational products are sought after for their symbolic value, which is based on their foreignness or non-localness, and per- ceived as prestigious and cosmopolitan [17, 18] cannot be fully supported by the results of this study. However, it should be noted that taste/flavour was also found to be a significant criterion for the consumption of food from multinational corporations. Taste is not only an indi- vidual experience and sensorially determined but also socially constructed [59]. Therefore, from an anthropo- logical perspective on taste, it is plausible that taste, as an expression of socio-cultural change, may contribute to the preference for multinational food. In conclusion, the present study suggests that consum- ers tend to favour multinational foods over local foods when food quality and safety, health and nutritional value, and taste attributes are addressed. It is recom- mended that targeted public health campaigns be imple- mented to raise awareness of the negative health impacts associated with the consumption of highly processed multinational foods. Additionally, education campaigns aimed at promoting informed and conscious food choices could contribute to a cultural shift towards a more com- prehensive perception of food quality. These measures could potentially counteract the increasing trend of con- suming highly processed foods in emerging countries. The findings and recommendations of this study may potentially be applicable to other urban contexts in sub- Saharan African countries where the dominance of mul- tinational food products and outlets is similarly high, and urban food environments have undergone similar devel- opments in recent decades [21]. Enlightening consumers and fostering a countermovement to corporate norm- setting regarding societal perceptions of nutritious and safe foods in these emerging markets are of paramount importance to promote conscious food consumption. Given the rapid growth and market power of multina- tional food corporations in countries of the Global South [9], this represents a potential point of intervention that can be addressed early on through national public health nutrition campaigns. Such campaigns can help proac- tively mitigate the negative health implications associated with high consumption of these products and contrib- ute to addressing the effects of globalization processes in food supply on population health [22]. The present study has some limitations that should be acknowledged. Firstly, due to the design of the survey and the complexity of the questionnaire, the study did not undertake a detailed differentiation by product cat- egories and outlets, such as supermarkets and fast-food chain restaurants. Therefore, the study cannot draw definitive conclusions about which products or outlets the respondents referred to in their answers. Future stud- ies are required to conduct more differentiated analy- ses of the preferences of specific products against the background of their national or seasonal availability to provide a more detailed picture of consumer behaviour. Additionally, the study did not consider the availability of local substitutes for imported products, which may be a crucial factor influencing consumer preferences. Secondly, since preferences are heterogeneous among consumers, the study only identified one main consumer segment. Further research should aim to identify addi- tional consumer segments and distinguish them based on their preferences for the identified attributes. In addition, a comparison between rural and urban consumer groups would be of interest to explore potential differences in the drivers of preference for local vs. multinational foods, considering socio-economic characteristics as well. The study only investigates specific attributes and does not cover other important attributes such as price, shelf life, and freshness, among others. This may lead to biased util- ity estimates. Future studies should include these attributes to address excluded attribute biases. Though the results can potentially be applied to other regions due to the prob- ability sampling technique employed, the geographical area covered is limited. Additionally, the study relied on consumer reports, and their integrity could not be veri- fied. Further study should incorporate reveal preference data. Though self-administration of the questionnaire was allowed upon request, interview-administered survey may lead to potential interviewer bias. Though the maximum difference scaling is a theory-driven and a cutting-edge sur- vey-based method for conducting consumer studies where there is a greater involvement and the amount of cognitive Page 14 of 16Nyarko and Bartelmeß Globalization and Health (2024) 20:22 effort required may help consumers to focus when asked to complete a best–worst task, there may be an issue of force- choice set. Finally, the study was conducted exclusively in urban hotspots in Accra, which are close to business cen- tres and universities. Therefore, the sample may be biased in terms of educational attainment, and further studies should collect data in other locations, including rural areas, to gain a broader understanding of consumer behaviour. Conclusions In conclusion, the study provides important insights into the factors that drive consumer preferences for multina- tional and local foods in urban Accra. While the preference for multinational foods is mainly determined by the per- ceived quality and safety of packaging, healthiness, nutri- tional value, and taste, the findings also suggest that targeted measures could be taken to promote the consumption of local food. These could include establishing quality control systems in local production facilities and distribution out- lets, promoting healthy eating campaigns, and encouraging multinational corporations to support waste management systems and offer more health-promoting product ranges. Additionally, consumer awareness campaigns could be implemented to raise awareness of the health risks associ- ated with highly processed food, the nutritional values of local and industrial food, and a comprehensive understand- ing of food quality. By targeting the relevant attributes that determine preferences, these campaigns could successfully promote the consumption of local products and reduce the consumption of highly processed multinational products, ultimately improving public health, nutrition, and sustain- ability impacts in emerging economies. Abbreviations BMI Body Mass Index CIs Confidence intervals FDI Foreign direct investment GUD Greatest utility difference IQR Interquartile range LR Likelihood ratio MP Marginal probability MUE Marginal utility estimates NCDs Con-communicable diseases Acknowledgements This study was undertaken as part of a short-term research stay of Dr Eric Nyarko granted under the Humboldt Initiative of the University of Bayreuth. We are grateful for support for this activity from the Bayreuth Humboldt centre and the German Research Association (DFG). Authors’ contributions Conceptualization: TB and EN; Methodology, Investigation, Formal Analysis: EN; Writing Original Draft and Review and Editing: TB and EN. Funding Open Access funding enabled and organized by Projekt DEAL. Funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) – 491183248. Funded by the Open Access Publishing Fund of the University of Bayreuth. Availability of data and materials The datasets used and analysed during the current study are available from the corresponding author on reasonable request. Declarations Ethics approval and consent to participate All methods were carried out in accordance with relevant guidelines and reg- ulations. Ethical clearance was obtained from the University of Ghana College of Basic and Applied Sciences Ethical and Protocol Review Committee (Refer- ence No: ECBAS 006/22–23). Permission to collect data was obtained in the form of written consent from the respondents after duly explaining to them the purpose of the study. Respondents were informed that their participation was voluntary, and they were at liberty to decide whether to participate or not in the study. Moreover, because of the risk associated with the study due to the COVID-19 outbreak, face masks were worn, and the researchers provided hand-cleansing sanitizers and soaps together with water before interacting with the study participants. Thus, all the COVID-19 preventive protocols were followed during each personal interaction session and data collection session. Consent for publication Not applicable. Competing interests No conflicts to report. 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Publisher’s Note Springer Nature remains neutral with regard to jurisdictional claims in pub- lished maps and institutional affiliations. https://doi.org/10.3945/ajcn.114.096776 https://doi.org/10.3945/ajcn.114.096776 https://doi.org/10.1016/j.foodqual.2020.104171 https://doi.org/10.1016/j.foodqual.2020.104171 https://doi.org/10.1093/advances/nmy116 https://doi.org/10.1007/s10551-006-9112-7 https://doi.org/10.1002/hec.1587 https://doi.org/10.4337/9781781003152.00014 https://doi.org/10.1186/2044-7248-4-6 Drivers of consumer food choices of multinational corporations’ products over local foods in Ghana: a maximum difference scaling study Abstract Introduction Method Result Conclusion Introduction Impact of multinational food corporations on consumer food choices in Ghana Multinational food corporations and health impacts on Ghanaian consumers Food consumption trends and drivers in Ghana Methodology Study setting Study design and data collection Experimental design Empirical strategy Data analysis Results Sample characteristics Sample preference estimation Discussion Conclusions Acknowledgements References