Perspectives of Urban Ghanaian Adolescents on Healthy Eating Habits

Abstract

Abstract Objectives Adolescents are vulnerable to diet-related health risks as they experience major life changes alongside food environment changes. In Ghana, non-communicable diseases (NCDs) are rising, and there is a need to understand what, how and why adolescents eat the way they do. This study explored perspectives of adolescents about healthy and unhealthy eating and relationships to portion sizes. Methods The Measurement, Evaluation, Accountability, and Leadership Support for NCDs (MEALS4NCDs) Project is measuring the nature and extent of unhealthy food marketing to support public sector actions to create healthier food environments for Ghanaian children. In July-August 2020, 48 interviews with students (14–17 years old) in six districts across the Greater Accra Region were conducted in schools. Interviews were done in English, audio recorded, and transcribed verbatim. Transcripts were coded with NVivo12 using a thematic analysis. Results All students demonstrated basic nutrition knowledge and conceptualized healthy eating as “not eating too much”, “a balanced diet,” “not eating late,” and “not eating cold foods.” Connections between NCDs and consumption of foods high in fat, sugar, and salt were rarely made. All students consumed items contrary to what was described as a healthy diet. Students expressed food safety as indicative of healthy food, emphasizing food prepared in a “hygienic environment by a hygienic person,” “a hot temperature,” and “covered.” Participants did not understand portion sizes beyond “too much of anything is bad” and most stated contexts where they would consume smaller or larger portion sizes, such as around strangers (less) or unsure of next meal (more). Participants admitted that peer pressure and food advertising claims informed their food choices and showed minimal knowledge of marketing tactics. Students voiced their limited agency in food choice decisions, citing financial and cultural constraints. Conclusions Students had some nutrition knowledge but limited agency to apply it in daily food choices. Interventions should include educating students and parents on diet-related NCDs and deceptive marketing tactics that promote unhealthy foods. Funding Sources International Development Research Centre's Food, Environment & Health Programme, IDRC-Canada. Office of the Vice President for Research, University of South Carolina.