Mapping Obesogenic Food Environments in South Africa and Ghana: Correlations and Contradictions

Florian Kroll,Nana Ama Frimpomaa Agyapong,Jean-Claude Moubarac,David Neves,Robert Aidoo,Elizabeth Catherina Swart,Reginald Adjetey Annan,David Sanders,Charles Apprey,Andries Du Toit,Linda Nana Esi Aduku,Anne Marie Thow

doi:10.3390/su11143924

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.

Highlights

Urbanisation, poverty, globalisation, industrialisation, climate change and the emergence of a concentrated corporate food regime [1,2,3] are converging and mutually reinforcing global transitions [4]
This paper explores correlations and linkages between neighbourhood food environments and household food environments, with particular emphasis on the risk they pose for obesity
The second section first presents the diversity of food outlets in the local food environment, maps the aggregate food provision index, juxtaposing this with aggregate food consumption

Summary

Introduction

Urbanisation, poverty, globalisation, industrialisation, climate change and the emergence of a concentrated corporate food regime [1,2,3] are converging and mutually reinforcing global transitions [4]. The United Nations sustainable development goals (UN SDGs 2 and 12) make reference to food security and poverty, they do not recognise the urbanisation of food insecurity nor the dietary transition [5]. This entails increasing consumption of ultra-processed, energy-dense and micronutrient-poor foods, compounded by sedentary lifestyles with reduced physical activity. Rates of obesity and non-communicable diseases (NCDs) are rising rapidly [6,7,8]. Obesity is a major public health concern as it promotes the development of NCDs such as diabetes, hypertension, circulatory disorders and some cancers [12]

Methods

Results

Discussion

Conclusion