Urban household characteristics and dietary diversity: An analysis of food security in Accra, Ghana
TL;DR: There is high dietary diversity in the study communities of Accra but low consumption of foods rich in micronutrient, such as fruits and milk/dairy products.
Abstract: Background:The world’s population is increasingly becoming urbanized. If the current urban growth rate is to continue, new and unprecedented challenges for food security will be inevitable. Dietary...
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TL;DR: Interventions designed to improve food consumption and diversified dietary intake among Indian children need to be universal in their targeting given the overall high prevalence of inadequate dietary diversity and the relatively small differentials by SES.
Abstract: Most interventions to foster child growth and development in India focus on improving food quality and quantity. We aimed to assess the pattern in food consumption and dietary diversity by socioeconomic status (SES) among Indian children. The most recent nationally representative, cross-sectional data from the National Family Health Survey (NFHS-4, 2015–16) was used for analysis of 73,852–74,038 children aged 6–23 months. Consumption of 21 food items, seven food groups, and adequately diversified dietary intake (ADDI) was collected through mother’s 24-h dietary recall. Logistic regression models were conducted to assess the association between household wealth and maternal education with food consumption and ADDI, after controlling for covariates. Overall, the mean dietary diversity score was low (2.26; 95% CI:2.24–2.27) and the prevalence of ADDI was only 23%. Both household wealth and maternal education were significantly associated with ADDI (OR:1.28; 95% CI:1.18–1.38 and OR:1.75; 95% CI:1.63–1.90, respectively), but the SES gradient was not particularly strong. Furthermore, the associations between SES and consumption of individual food items and food groups were not consistent. Maternal education was more strongly associated with consumption of essential food items and all food groups, but household wealth was found to have significant influence on intake of dairy group only. Interventions designed to improve food consumption and diversified dietary intake among Indian children need to be universal in their targeting given the overall high prevalence of inadequate dietary diversity and the relatively small differentials by SES.
58 citations
TL;DR: In this article, the authors correlate neighbourhood food provision with household consumption and poverty in Khayelitsha, South Africa and Ahodwo, Ghana, and find that higher consumption of unhealthy foods suggests that risky food environments and poverty together promote obesogenic diets.
Abstract: In sub-Saharan Africa, urbanisation and food systems change contribute to rapid dietary transitions promoting obesity. It is unclear to what extent these changes are mediated by neighbourhood food environments or other factors. This paper correlates neighbourhood food provision with household consumption and poverty in Khayelitsha, South Africa and Ahodwo, Ghana. Georeferenced survey data of food consumption and provision were classified by obesity risk and protection. Outlets were mapped, and density and distribution correlated with risk classes. In Khayelitsha, 71% of households exceeded dietary obesity risk thresholds while 16% consumed protective diets. Obesogenic profiles were less (26%) and protective more prevalent (23%) in Ahodwo despite greater income poverty in Khayelitsha. Here, income-deprived households consumed significantly (p < 0.005) less obesogenic and protective diets. Small informal food outlets dominated numerically but supermarkets were key household food sources in Khayelitsha. Although density of food provision in Ahodwo was higher (76/km2), Khayelitsha outlets (61/km2) provided greater access to obesogenic (57% Khayelitsha; 39% Ahodwo) and protective (43% Khayelitsha; 16% Ahodwo) foods. Consumption and provision profiles correlate more strongly in Ahodwo than Khayelitsha (rKhayelitsha = 0.624; rAhodwo = 0.862). Higher obesogenic food consumption in Khayelitsha suggests that risky food environments and poverty together promote obesogenic diets.
34 citations
TL;DR: In this paper, the authors examined the diversity and composition of the urban forest and food trees of Accra and shed light on perceptions of urbanites regarding food tree cultivation and availability in the city.
Abstract: Urban and peri-urban forestry has emerged as a complementary measure to contribute towards eliminating urban hunger and improved nutritional security. However, there is scanty knowledge about the composition, diversity, and socioeconomic contributions of urban food trees in African cities. This paper examines the diversity and composition of the urban forest and food trees of Accra and sheds light on perceptions of urbanites regarding food tree cultivation and availability in the city. Using a mixed methods approach, 105 respondents in six neighborhoods of Accra were interviewed while over 200 plots (100-m2 each) were surveyed across five land use types. Twenty-two out of the 70 woody species in Accra have edible parts (leaves, fruits, flowers, etc.). The food-tree abundance in the city is about half of the total number of trees enumerated. The species richness and abundance of the food trees and all trees in the city were significantly different among land use types (p < 0.0001) and neighborhood types (p < 0.0001). The diversity of food-bearing tree species was much higher in the poorer neighborhoods than in the wealthier neighborhoods. Respondents in wealthier neighborhoods indicated that tree and food-tree cover of the city was generally low and showed greater interest in cultivating food (fruit) trees and expanding urban forest cover than poorer neighborhoods. These findings demonstrate the need for urban food policy reforms that integrate urban-grown tree foods in the urban food system/culture.
31 citations
TL;DR: The dominance of studies exploring individual-level factors suggests a need for research to explore how social, physical and macro-level environments drive dietary behaviours of adolescents and adults in urban Africa.
Abstract: Objective: To identify factors influencing dietary behaviours in urban food environments in Africa and identify areas for future research.Design: We systematically reviewed published/grey literature (Protocol CRD4201706893). Findings were compiled into a map using a socio-ecological model on four environmental levels: individual, social, physical and macro.Setting: Urban food environments in Africa.Participants: Studies involving adolescents and adults (11-70 years, male/female).Results: Thirty-nine studies were included (6 adolescent; 15 adolescent/adult combined; 18 adult). Quantitative methods were most common (28 quantitative; 9 qualitative; 2 mixed methods). Studies were from 15 African countries. Seventy-seven factors influencing dietary behaviours were identified, with two-thirds at the individual level (45/77). Factors in the social (11/77), physical (12/77) and macro (9/77) environments were investigated less. Individual level factors that specifically emerged for adolescents included self-esteem, body satisfaction, dieting, spoken language, school attendance, gender, body composition, pubertal development, BMI and fat mass. Studies involving adolescents investigated social environment level factors more, e.g. sharing food with friends. The physical food environment was more commonly explored in adults e.g. convenience/availability of food. Macro-level factors associated with dietary behaviours were: food/drink advertising, religion and food prices. Factors associated with dietary behaviour were broadly similar for men and women.Conclusions: The dominance of studies exploring individual-level factors suggests a need for research to explore how social, physical and macro-level environments drive dietary behaviours of adolescents and adults in urban Africa. More studies are needed for adolescents and men, and studies widening the geographical scope to encompass all African countries.
22 citations
Cites background from "Urban household characteristics and..."
...(53)QN*, Codjoe et al.(33)QN‡ and Cisse-Egbuonye et al....
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...Dietary diversity Codjoe et al.(33)QN‡ Mixed adult and adolescent Household food expenditure (2) Dietary diversity Becquey et al....
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...(32) QN† and Codjoe et al.(33)QN* Female adolescent and adult; Female adolescent and adult; Mixed adult and adolescent Fruit and vegetable intake Landais(44)/Landais et al....
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...Wealth (individual/household) (3) Fruit and vegetable intake Peltzer & Phaswana-Mafuya(52)QN* Mixed adult Dietary diversity Codjoe et al.(33)QN† Mixed adult and adolescent Food choice Agbozo et al....
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...(32) Quantitative, crosssectional Niger Low income Female 15–49 years (adolescent and adult) 3360 Randomly selected household heads in purposive sample Codjoe et al.(33) Cross-sectional Ghana Lower middle income Mixed 15–59 years (adolescent and adult males), 15–49 years (adolescent and adult) 452 households Purposive sampling according to age from a larger data set...
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DOI•
01 Jan 2019TL;DR: This article found that individuals who relocated to urban areas experience a much more pronounced shift away from the consumption of traditional staples, and towards more high-sugar, conveniently consumed and prepared foods.
Abstract: There is rising concern that the ongoing wave of urbanization will have profound effects on eating patterns and increase the risk of nutrition-related non-communicable diseases. Yet, our understanding of urbanization as a driver of food consumption remains limited and primarily based upon research designs that fail to disentangle the effect of living in an urban environment from other socioeconomic disparities. Data from the Tanzania National Panel Survey, which tracked out-migrating respondents, allow us to compare individualsâ dietary patterns before and after they relocated from rural to urban areas and assess whether those changes differ from household members who stayed behind or moved to a different rural area. We find that individuals who relocated to urban areas experience a much more pronounced shift away from the consumption of traditional staples, and towards more high-sugar, conveniently consumed and prepared foods. Contrary to what is often claimed in the literature, living in an urban environment is not found to contribute positively to the intake of protein-rich foods, nor to diet diversity. Though we do not find a strong association with weight gain, these changes in eating patterns represent a clear nutritional concern regarding the potential longer-term impacts of urbanization. Our results however also indicate that the growth of unhealthy food consumption with urbanization is largely linked to rising incomes. As such, health concerns over diets can be expected to spread rapidly to less-urbanized areas as well, as soon as income growth takes off there. Our findings clearly call for more in-depth research that may help to improve health and food and nutrition security as well as correctly predict food demand and adapt trade, agricultural and development policies.
21 citations
Cites background from "Urban household characteristics and..."
...Urban areas typically offer a wider choice of dietary patterns from foreign cultures (Regmi and Dyck, 2001) as they are more likely to carry imported food items (Codjoe et al., 2016)....
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...Codjoe et al. (2016), argue that processed and packaged foods in general are more widely available in urban areas, in part because food-manufacturing sectors are based nearby....
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References
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01 Jan 2004
TL;DR: The main objectives of the MEASURE DHS+ project are to provide decisionmakers in survey countries with information useful for informed policy choices and to develop in participating countries the skills and resources necessary to conduct high-quality demographic and health surveys.
Abstract: The main objectives of the MEASURE DHS+ project are: 1) to provide decisionmakers in survey countries with information useful for informed policy choices, 2) to expand the international population and health database, 3) to advance survey methodology, and 4) to develop in participating countries the skills and resources necessary to conduct high-quality demographic and health surveys.
1,549 citations
"Urban household characteristics and..." refers background in this paper
...This broad criterion, with its greater number of indicator variables, improves the distribution of households, with fewer households being concentrated on certain index scores.(57) All variables included in the index are dichotomized....
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TL;DR: In this paper, a framework for studying the multiple interactions of broadly defined food systems with global environmental change and evaluating the major societal outcomes affected by these interactions: food security, ecosystem services and social welfare is presented.
Abstract: This paper outlines a framework for studying the multiple interactions of broadly defined food systems with global environmental change and evaluating the major societal outcomes affected by these interactions: food security, ecosystem services and social welfare. In building the framework the paper explores and synthesizes disparate literature on food systems food security and global environmental change, bridging social science and natural science perspectives. This collected evidence justifies a representation of food systems, which can be used to identify key processes and determinants of food security in a given place or time, particularly the impacts of environmental change. It also enables analysis of the feedbacks from food system outcomes to drivers of environmental and social change, as well as tradeoffs among the food system outcomes themselves. In food systems these tradeoffs are often between different scales or levels of decision-making or management, so solutions to manage them must be context-specific. With sufficient empirical evidence, the framework could be used to build a database of typologies of food system interactions useful for different management or analytical purposes.
1,048 citations
TL;DR: Improved systems of food production, food distribution and economic access may all contribute to food systems adapted to cope with climate change, but in adopting such changes it will be important to ensure that they contribute to sustainability.
Abstract: Dynamic interactions between and within the biogeophysical and human environments lead to the production, processing, distribution, preparation and consumption of food, resulting in food systems that underpin food security. Food systems encompass food availability (production, distribution and exchange), food access (affordability, allocation and preference) and food utilization (nutritional and societal values and safety), so that food security is, therefore, diminished when food systems are stressed. Such stresses may be induced by a range of factors in addition to climate change and/or other agents of environmental change (e.g. conflict, HIV/AIDS) and may be particularly severe when these factors act in combination. Urbanization and globalization are causing rapid changes to food systems.
Climate change may affect food systems in several ways ranging from direct effects on crop production (e.g. changes in rainfall leading to drought or flooding, or warmer or cooler temperatures leading to changes in the length of growing season), to changes in markets, food prices and supply chain infrastructure. The relative importance of climate change for food security differs between regions. For example, in southern Africa, climate is among the most frequently cited drivers of food insecurity because it acts both as an underlying, ongoing issue and as a short-lived shock. The low ability to cope with shocks and to mitigate long-term stresses means that coping strategies that might be available in other regions are unavailable or inappropriate. In other regions, though, such as parts of the Indo-Gangetic Plain of India, other drivers, such as labour issues and the availability and quality of ground water for irrigation, rank higher than the direct effects of climate change as factors influencing food security.
Because of the multiple socio-economic and bio-physical factors affecting food systems and hence food security, the capacity to adapt food systems to reduce their vulnerability to climate change is not uniform. Improved systems of food production, food distribution and economic access may all contribute to food systems adapted to cope with climate change, but in adopting such changes it will be important to ensure that they contribute to sustainability. Agriculture is a major contributor of the greenhouse gases methane (CH4) and nitrous oxide (N2O), so that regionally derived policies promoting adapted food systems need to mitigate further climate change.
1,022 citations
TL;DR: Evidence from a multicountry analysis suggests that household-level DD diversity is strongly associated with household per capita income and energy availability, suggesting that DD could be a useful indicator of food security.
Abstract: Dietary diversity (DD) is universally recognized as a key component of healthy diets There is still, however, a lack of consensus on how to measure and operationalize DD This article reviews published literature on DD, with a focus on the conceptual and operational issues related to its measurement in developing countries Findings from studies of the association between DD and individual nutrient adequacy, child growth and/or household socioeconomic factors are summarized DD is usually measured using a simple count of foods or food groups over a given reference period, but a number of different groupings, classification systems and reference periods have been used This limits comparability and generalizability of findings The few studies that have validated DD against nutrient adequacy in developing countries confirm the well-documented positive association observed in developed countries A consistent positive association between dietary diversity and child growth is also found in a number of countries Evidence from a multicountry analysis suggests that household-level DD diversity is strongly associated with household per capita income and energy availability, suggesting that DD could be a useful indicator of food security The nutritional contribution of animal foods to nutrient adequacy is indisputable, but the independent role of animal foods relative to overall dietary quality for child growth and nutrition remains poorly understood DD is clearly a promising measurement tool, but additional research is required to improve and harmonize measurement approaches and indicators Validation studies are also needed to test the usefulness of DD indicators for various purposes and in different contexts
828 citations