Abstract
Background 
 Non-Communicable Diseases (NCDs) are a leading cause of death globally. NCD mortality attributable to unhealthy food environments (FEs) is significant. Heavy marketing of unhealthy foods is an important contributor to unhealthy FEs.
 Aims 
 We examined the extent of commercial food advertising, messaging, and signage on the campus of Ghana’s oldest and largest university.
 Methods
 We cross-sectionally collected data on all sighted advertisements. Advertisements/signage were categorised as food or non-food adverts, and as healthy or unhealthy (if they were food).
 Results
 Of 503 advertisements recorded, 238 (47.3%) were food ads. Advertised food products were categorised as healthy (38.7%), unhealthy (57.6%), or other/miscellaneous (3.8%). The most advertised food product was sugar-sweetened drinks (37.0%). Different promotional techniques deployed included the use of claim pronouncement, promotional characters, emotional appeal, premium offer, and price promotion.
 Conclusions
 The preponderance of unhealthy food advertising on the campus of Ghana’s largest university has public health implications. Advertising may influence purchasing behaviour and consumption of unhealthy foods. Publicity and advocacy that motivate development of local policies to regulate various food promotion activities within this, and other Ghanaian food environments are urgently needed.
Highlights
The prevalence of non-communicable disease (NCDs), which include type 2 diabetes, hypertension, heart disease and stroke, have reached profound levels and are the leading cause of mortality globally (WHO 2018a)
NCDs are responsible for almost 70% of all deaths, with most deaths occurring in low- and middle-income countries (WHO 2018b)
In Africa, some 39% of adults aged 18 years and over are overweight, and 13% are obese (WHO Regional Office of Africa 2014). This trend is not different from what is observed in children and adolescents in other regions of the world, posing substantial present and future population health risks (Chooi, Ding, and Magkos 2019)
Summary
The prevalence of non-communicable disease (NCDs), which include type 2 diabetes, hypertension, heart disease and stroke, have reached profound levels and are the leading cause of mortality globally (WHO 2018a). In Africa, some 39% of adults aged 18 years and over are overweight, and 13% are obese (WHO Regional Office of Africa 2014) This trend is not different from what is observed in children and adolescents in other regions of the world, posing substantial present and future population health risks (Chooi, Ding, and Magkos 2019). Risk factors such as poor-quality diets have consistently been recognised as important for overweight and obesity (Swinburn et al 2004, Forouzanfar et al 2016). Different promotional techniques deployed included the use of claim pronouncement, promotional characters, emotional appeal, premium offer, and price promotion
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