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Investigating foods and beverages sold and advertised in deprived urban neighbourhoods in Ghana and Kenya: a cross-sectional study

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posted on 30.10.2020, 09:56 authored by Mark Alan Green, Rebecca PradeillesRebecca Pradeilles, Amos Laar, Hibbah Osei-Kwasi, Nicolas Bricas, Nathaniel Coleman, Senam Klomegah, Milka Njeri Wanjohi, Akua Tandoh, Robert Akparibo, Richmond Nii Okai Aryeetey, Paula GriffithsPaula Griffiths, Elizabeth W Kimani-Murage, Kobby Mensah, Stella Muthuri, Francis Zotor, Michelle Holdsworth
ObjectivesThe aim of this study was to characterise the local foods and beverages sold and advertised in three deprived urban African neighbourhoods.DesignCross-sectional observational study. We undertook an audit of all food outlets (outlet type and food sold) and food advertisements. Descriptive statistics were used to summarise exposures. Latent class analysis was used to explore the interactions between food advertisements, food outlet types and food type availability.SettingThree deprived neighbourhoods in African cities: Jamestown in Accra, Ho Dome in Ho (both Ghana) and Makadara in Nairobi (Kenya).Main outcome measureTypes of foods and beverages sold and/or advertised.ResultsJamestown (80.5%) and Makadara (70.9%) were dominated by informal vendors. There was a wide diversity of foods, with high availability of healthy (eg, staples, vegetables) and unhealthy foods (eg, processed/fried foods, sugar-sweetened beverages). Almost half of all advertisements were for sugar-sweetened beverages (48.3%), with higher exposure to alcohol adverts compared with other items as well (28.5%). We identified five latent classes which demonstrated the clustering of healthier foods in informal outlets, and unhealthy foods in formal outlets.ConclusionOur study presents one of the most detailed geospatial exploration of the urban food environment in Africa. The high exposure of sugar-sweetened beverages and alcohol both available and advertised represent changing urban food environments. The concentration of unhealthy foods and beverages in formal outlets and advertisements of unhealthy products may offer important policy opportunities for regulation and action.


The ‘Dietary Transitions in Ghana’ project was funded by a grant from the Drivers of Food Choice (DFC) Competitive Grants Programme [grant number OPP1110043] which is funded by the Bill and Melinda Gates Foundation and the Department for International Development (DFID), and managed by the University of South Carolina Arnold School of Public Health, USA

The TACLED project was funded by a Global Challenges Research Fund (GCRF) Foundation Award led by the MRC [grant number MR/P025153/1], and supported by AHRC, BBSRC, ESRC and NERC



  • Sport, Exercise and Health Sciences

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This is an Open Access Article. It is published by BMJ Open under the Creative Commons Attribution 4.0 Unported Licence (CC BY). Full details of this licence are available at:

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Dr Rebecca Pradeilles . Deposit date: 29 October 2020

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