Abstract

Background The dietary choices we make affect our personal health and have consequences for the environment, both of which have serious implications for the 2030 Sustainable Development Agenda. There is a strong consensus that dietary modifications (including cutting on meat and dairy products) in favour of fruit and vegetables and other plant-based diets would offer dual health and environmental benefits. This is particularly important for Africa where the largest population growth and the most drastic future urbanisation, as well as the largest growth in non-communicable disease deaths are expected to happen in the next few decades amid severe food insecurity issues. Emerging adults are less likely to meet standard healthy diet recommendations. However emerging adulthood presents an opportune period to influence the adoption of healthy lifestyles. Aim The aim of this research was to examine the knowledge, attitudes and behaviour of emerging adults—18 to 25-year olds—about food choices. We were interested in finding out if young adults at the University of Ghana think about health and sustainable development in deciding what food to eat or where to purchase food. The study also sought to map and assess the food retail environment and find out what would support emerging adults to make healthy/sustainable food choices. Methods We asked University of Ghana students what informs their food choices within the University food environment. This was done through focus group discussions with eight groups of university students (aged 18 to 25), and interviews with ten best friend pairs (also university students aged 18 to 25) on the university campus. Food environment mapping and assessment was done using Open Source Mapping tools and a predefined Open Data Kit questionnaire. Using NVivo, the COM-B model to behavioural analysis approach was adopted to analyse the qualitative data. Results Significant gaps in knowledge of dietary guidelines were identified among University students particularly regarding WHO recommended intake for fruit and vegetables. Cost, satiety, convenience and taste were the most important determinants of food choice. While sustainable development was never considered, health and nutrition were only secondary. Healthy eating was interpreted as balanced diet, although students admitted not adhering to balanced meals. Term time food behaviour exhibited by students included breakfast skipping; snacking on pastries and sugar-sweetened beverages (SSBs); low fruit and vegetable intake; late night eating; and eating out. The map of the University food environment showed a limited proportion of food outlets offering healthy food options. Compared to SSBs and pastries, fruit and vegetable outlets were particularly limited and farther from most student accommodation and lecture halls.

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