Characterizing diet quality indicators and their demographic determinants among adults: a population-based study in Northern Ghana

Paula Malebna KobilaMusah Abdul-SamedSeidu RahamaAfia Aboabea Apau-TeteBruce Ayabilla AbugriBright Yammaha AmoorePatience K GaaVictor Mogre^*

• University for Development Studies, Tamale, Ghana

Objectives: Unhealthy eating patterns increase the risk of noncommunicable diseases (NCD) like type 2 diabetes, heart disease, and cancer. A healthy diet should provide energy and nutrients for growth, maintenance, activity, and infection prevention. Global indicators include dietary diversity score, following recommended food groups, and NCD-protective consumption. We assessed dietary patterns and associated demographic factors among adult Ghanaians from northern Ghana using indicators aligned with global recommendations for healthy eating.Methods: A cross-sectional design was employed, utilizing a diet quality questionnaire to evaluate five indicators: Food Group Diversity Score (FGDS), All-5 recommended food groups, NCD-protect scores, NCD-risk scores, and global dietary recommendations (GDR) scores. Data analysis incorporated Spearman's rho, Mann-Whitney, Kruskal-Wallis tests, and multiple linear regression to explore associations.Results: A total of 842 participants were recruited. In which 96.4% consumed starchy staples, over 90% ate vegetables, and 70% included fruits in their diet. Mean (SD) scores for FGDS, NCD-protect, WHO all-five food groups, NCD-risk, and GDR were 6.02, 4.22, 2.89, 4.23, and 10.33, respectively. A moderately positive correlation was observed between NCD-protect scores and FGDS (r = 0.763, p= 0.001), as well as with WHO all-five groups (r= 0.688, p<0.001).Higher education was the strongest predictor of better diet quality-those with secondary education ate more protective foods, had greater dietary diversity, and better WHOrecommended food adherence-while Mole-Dagbani/Gonja ethnicity was consistently associated with poorer diet quality; married/cohabiting status modestly increased both protective and risk food consumption, and each additional year of age slightly reduced NCD-risk food intake.Consumption of staple foods was widespread. Vegetables were consumed frequently, but not fruits. Diets were only moderately diverse, and dietary patterns reflecting NCD risk factors were prevalent. Dietary patterns reflecting NCD risk factors were widespread.Ethnicity, marital status, and employment status significantly predicted diet quality indicators, informing future dietary guidelines.