Scoping review of diet-related health outcomes and associated risk factors in Ghana

As part of a process to develop food-based dietary guidelines (FBDGs), the national Multi-sectoral Technical Task Team coordinating FBDGs development in Ghana has commissioned a desk review of the nutrition and health situation, and trends for all persons living in Ghana, across the entire life cycle. Using a rapid scoping review method, multiple electronic databases were systematically searched using keywords related to nutrition and health outcomes, as well as potential drivers of nutrition and health in Ghana. The review included evidence from peer-reviewed articles, unpublished manuscripts, dissertations, reports of nationally representative surveys, and other grey literature (reports of nutrition situation evaluations commissioned by international and local agencies), spanning the decade starting from 2010. A total of 48 documents were included in this review: 15 for infants and young children, 14 for adolescents, 19 for adults and women of reproductive age, and five for the elderly. Among children under five, anemia and stunting were the most prevalent nutritionrelated outcomes, 62% and 19%, respectively. Underweight prevalence of 11% was observed among young children; wasting rates have remained below 10%, but registered about 20% prevalence in northern Ghana. Different levels of micronutrient deficiencies, particularly iron deficiency were reported across all age groups. Nutrient deficiency rates were higher among adolescent girls and women of reproductive age. Vitamin A deficiency was also high (21%) among under-fives. Overweight and obesity rates were high among women of reproductive age (40%) and adolescents (11% to 18% between 2013 and 2017), and still increasing. Underweight and overweight coexists among the elderly (50 years and above), at a rate of 10% and 20%, respectively. An increasing prevalence of central adiposity has also been reported among women of reproductive age (high waist circumference of 80.6%) and persons older than 60 years (67% in 2015). Rates of hypertension and cancers have also increased within the study period. Hypertension rates have been increasing with age, particularly among urban dwellers. Majority of persons with hypertension are not receiving treatment . Incidence of breast, cervical, and liver cancers were 20%, 14%, and 12% in 2018. Ghana is experiencing a double burden of malnutrition characterized by co-existing high levels of undernutrition and overnutrition. The national FBDGs for Ghana should prioritize recommendations and actions that address the dual burden of undernutrition and overnutrition.