Review of Ghana’s food environment: Drivers of availability, barriers to healthy food access, and impact of interventions and policies

Food environments exert a significant effect on population dietary choices and health outcomes. Policies that influence the food environment, can have a significant impact on individual and population dietary choices. This rapid review assessed the nature and interaction within the Ghanaian food environment, and the impact that existing school, workplace, and national food policies have on dietary intake and nutritional outcomes. Online databases and university repositories were searched for relevant articles and documents. A total of forty articles and documents were included in the review. Majority of the reviewed papers (85%) used a cross-sectional design. The findings show that traditional outlets (open markets) constitute the main food source among the Ghanaian populace, while convenience stores serve as an important source of processed foods. Prepared local foods are often consumed outside the home and are mainly sourced from street food vendors. Street foods are perceived as less expensive, convenient, and delicious. The food environment was found to influence dietary acquisition, intake, and nutritional outcomes. Although most nutrients provided by the School Feeding Programme (SFP) are below recommended intake standards, the SFP contributes positively to improved diets and nutrition status of school-age children. Children attending SFP-implementing schools experience higher intakes of protein, iron, zinc, calcium, vitamin A, folate, and have higher haemoglobin, and lower prevalence of stunting, underweight, and thinness than children in non-SFP implementing schools. Availability of a private room for breastfeeding mothers improved breastfeeding frequency. Ghana’s fatty meat restriction policy has reduced the availability and sale of fatty meat on the Ghanaian market. Reported drivers and barriers to healthy foods consumption include socio-economic factors, media information, food storage facilities, cultural perception, fruit seasonality, knowledge on the nutrient value of fruits and vegetables, safety profile of fruits and vegetables, and contribution of household production to dietary intake. In conclusion, the food environment review reveals the drivers of availability, barriers to healthy food access, and impact of interventions and policies on the Ghanaian food environment.&nbsp

Review of Ghana’s food environment: Drivers of availability, barriers to healthy food access, and impact of interventions and policies

Food environments exert a significant effect on population dietary choices and health outcomes. Policies that influence the food environment, can have a significant impact on individual and population dietary choices. This rapid review assessed the nature and interaction within the Ghanaian  food environment, and the impact that existing school, workplace, and national food policies have on dietary intake and nutritional outcomes.  Online databases and university repositories were searched for relevant articles and documents. A total of forty articles and documents were  included in the review. Majority of the reviewed papers (85%) used a cross-sectional design. The findings show that traditional outlets (open  markets) constitute the main food source among the Ghanaian populace, while convenience stores serve as an important source of processed  foods. Prepared local foods are often consumed outside the home and are mainly sourced from street food vendors. Street foods are perceived as  less expensive, convenient, and delicious. The food environment was found to influence dietary acquisition, intake, and nutritional outcomes.  Although most nutrients provided by the School Feeding Programme (SFP) are below recommended intake standards, the SFP contributes positively  to improved diets and nutrition status of school-age children. Children attending SFP-implementing schools experience higher intakes of  protein, iron, zinc, calcium, vitamin A, folate, and have higher haemoglobin, and lower prevalence of stunting, underweight, and thinness than  children in non-SFP implementing schools. Availability of a private room for breastfeeding mothers improved breastfeeding frequency. Ghana’s fatty  meat restriction policy has reduced the availability and sale of fatty meat on the Ghanaian market. Reported drivers and barriers to healthy  foods consumption include socio-economic factors, media information, food storage facilities, cultural perception, fruit seasonality, knowledge on  the nutrient value of fruits and vegetables, safety profile of fruits and vegetables, and contribution of household production to dietary intake. In  conclusion, the food environment review reveals the drivers of availability, barriers to healthy food access, and impact of interventions and policies  on the Ghanaian food environment.&nbsp

A review of Ghana’s food system and its implications on sustainability and the development of national food-based dietary guidelines

Food-Based Dietary Guidelines (FBDG) provide culturally-appropriate and actionable recommendations based on which populations can make healthy food choices. Food systems sustainability, from production to consumption, and disposal of food and foodrelated items, should be a critical consideration for developing such guidelines. This rapid review assesses Ghana's food systems to determine the level of sustainability to inform the FBDG recommendations. Peer-reviewed articles, documents and reports of relevance to Ghana were included in this rapid review. A hundred and eight papers, answering different questions on food system sustainability were reviewed. Bread, cereals, fish and indigenous vegetables are the most frequently consumed food groups. Sugar-Sweetened Beverages are the most consumed imported foods. In rural areas, 53% of dietary protein comes from plant sources. Fish is the main the source of animal protein for most Ghanaian households. There is intensive exploitation of marine and fresh water resources. Most livestock are raised by smallholder farmers using freerange system. Poultry is frequently kept on deep litter system and only a few are largescale. Crop production for household consumption and small-scale animal rearing are predominant, especially in Northern Ghana. By weight, fruits and vegetables are the least cultivated and consumed crops at the household level. Wood is the commonest source of fuel for cooking, especially in rural areas. Single use plastic is the most used and preferred material for food packaging. Indiscriminate and poor management of waste and pesticide misuse is commonly reported. The findings suggest the need for promoting production diversification, use of clean fuel and reusable food packaging as part of FBDGs to enhance sustainability of Ghana’s food systems

A review of Ghana’s food system and its implications on sustainability and the development of national food-based dietary guidelines

Food-Based Dietary Guidelines (FBDG) provide culturally-appropriate and actionable recommendations based on which populations can make healthy food choices. Food systems sustainability, from production to consumption, and disposal of food and foodrelated items, should be a critical consideration for developing such guidelines. This rapid review assesses Ghana's food systems to determine the level of sustainability to inform the FBDG recommendations. Peer-reviewed articles, documents and reports of relevance to Ghana were included in this rapid review. A hundred and eight papers, answering different questions on food system sustainability were reviewed. Bread, cereals, fish and indigenous vegetables are the most frequently consumed food groups. Sugar-Sweetened Beverages are the most consumed imported foods. In rural areas, 53% of dietary protein comes from plant sources. Fish is the main the source of animal protein for most Ghanaian households. There is intensive exploitation of marine and fresh water resources. Most livestock are raised by smallholder farmers using freerange system. Poultry is frequently kept on deep litter system and only a few are largescale. Crop production for household consumption and small-scale animal rearing are predominant, especially in Northern Ghana. By weight, fruits and vegetables are the least cultivated and consumed crops at the household level. Wood is the commonest source of fuel for cooking, especially in rural areas. Single use plastic is the most used and preferred material for food packaging. Indiscriminate and poor management of waste and pesticide misuse is commonly reported. The findings suggest the need for promoting production diversification, use of clean fuel and reusable food packaging as part of FBDGs to enhance sustainability of Ghana’s food systems.&nbsp

Strategy Precedes Operational Effectiveness: Aligning High Graduation Rankings With Competitive Graduation Grade Point Averages

Two pivotal and interconnected claims are addressed in this article. First, strategy precedes program effectiveness. Second, graduation rates and rankings are insufficient in any account of academic progress for African American students. In this article, graduation is regarded as the floor and not the ceiling, as it were. The ideal situation in the promotion of strategy is the alignment of high graduation rates or rankings with high graduation cumulative grade point averages. This strategic alignment is precisely what needs to be formulated in the first instance before making judgments about program development and/or operational effectiveness. The work of the Office of African American Affairs of the University of Virginia provides the context for observing trends in academic performance that illustrate the optimal alignment between high graduation rankings and correspondingly high grade point averages

p53 Pro72Arg polymorphism and prostate cancer in men of African descent.

BACKGROUND: p53 is a transcription factor that regulates the cell cycle, DNA repair, and apoptosis. A variant at codon 72, rs1042522, results in altered activities for p53 and is, notably, differentially distributed among different ethnic populations. However, associations of this variant with cancer in men of African descent have not been explored. Herein, we tested the hypothesis that rs1042522 was associated with prostate cancer (PCa) risk. MATERIALS AND METHODS: Genotypes were determined by PCR-RFLP methods in a study population of African descent consisting of 266 PCa patients and 196 male controls. RESULTS: Our results indicate that the p53 polymorphism may be associated with increased risk of PCa. Genotypes were significantly and marginally associated with PCa risk using the dominant and log-additive genetic models (OR=1.53, 95% CI: 1.02-2.29, P=0.04; OR=1.33, 95% CI: 0.99-1.78, P=0.06, respectively). After adjusting for age, the associations with PCa remained, but results were not statistically significant (OR=1.48, 95% CI: 0.95-2.31, P=0.08; OR=1.30, 95% CI: 0.95-1.80, P=0.10, respectively). CONCLUSIONS: The present study demonstrates that population-dependent differences in allele frequencies associated with health disparities provide a valuable framework for the interrogation of complex diseases in all populations. © 2010 Wiley-Liss, Inc

Identification of genetic risk associated with prostate cancer using ancestry informative markers

BACKGROUND: Prostate cancer (PCa) is a common malignancy and a leading cause of cancer death among men in the United States with African-American (AA) men having the highest incidence and mortality rates. Given recent results from admixture mapping and genome-wide association studies for PCa in AA men, it is clear that many risk alleles are enriched in men with West African genetic ancestry.METHODS: A total of 77 ancestry informative markers (AIMs) within surrounding candidate gene regions were genotyped and haplotyped using Pyrosequencing in 358 unrelated men enrolled in a PCa genetic association study at the Howard University Hospital between 2000 and 2004. Sequence analysis of promoter region single-nucleotide polymorphisms (SNPs) to evaluate disruption of transcription factor-binding sites was conducted using in silico methods.RESULTS: Eight AIMs were significantly associated with PCa risk after adjusting for age and West African ancestry. SNP rs1993973 (intervening sequences) had the strongest association with PCa using the log-additive genetic model (P0.002). SNPs rs1561131 (genotypic, P0.007), rs1963562 (dominant, P0.01) and rs615382 (recessive, P0.009) remained highly significant after adjusting for both age and ancestry. We also tested the independent effect of each significantly associated SNP and rs1561131 (P0.04) and rs1963562 (P0.04) remained significantly associated with PCa development. After multiple comparisons testing using the false discovery rate, rs1993973 remained significant. Analysis of the rs156113-, rs1963562-rs615382l and rs1993973-rs585224 haplotypes revealed that the least frequently found haplotypes in this population were significantly associated with a decreased risk of PCa (P0.032 and 0.0017, respectively).CONCLUSIONS: The approach for SNP selection utilized herein showed that AIMs may not only leverage increased linkage disequilibrium in populations to identify risk and protective alleles, but may also be informative in dissecting the biology of PCa and other health disparities. © 2012 Macmillan Publishers Limited All rights reserved