Policing The Food Environment: Arresting Diet-Related Chronic Diseases In Ghana

The world has become increasingly aware of the importance of non-communicable diseases (NCDs). Hypertension and diabetes have been important on the agenda of clinicians, researchers, and health policymakers. There is an alarming increase in the prevalence of NCDs around the world. The World Health Organization (WHO), in a 2024 report, takes note that globally, NCDs are responsible for 68% of all deaths. In middle- and low-income countries, where Ghana falls, 75% of this mortality emanates from NCDs, as identified by a 2023 study by the WHO. Cardiovascular Diseases (CVDs), diabetes, cancers, and chronic respiratory diseases are the four main contributors to this increasing prevalence. Cardiovascular diseases and diabetes are particularly important in this regard. Diabetes, particularly type-2 diabetes mellitus (DM), and cardiovascular diseases are directly linked to diet choices.

Concerning DM, it has been estimated in a recent report by the International Diabetes Federation, an association with which WHO identifies, that globally, there are 415 million adults between the ages of 20 and 79 years living with DM; this number is projected to hit 642 million, as a 2016 research project WHO discovered. In Ghana, a study by Asamoah-Boahen and his colleagues in 2019 concluded that the overall burden of diabetes stood at 6.46% for persons aged 18 and above.

About CVDs, stroke, heart failure, atrial fibrillation, ischemic heart disease, and rheumatic heart disease are among the leading CVDs that contribute to one-third of all deaths globally, increasing the cost of healthcare. Whilst acknowledging the difficulty of determining the prevalence of CVDs in Ghana, the pooled prevalence stood at 10.34% in a systematic review and meta-analysis study done in 2024 by Doku and colleagues.

Being critical of the food environment by regulating it is a sure way to combat the disturbingly increasing rate of diet-associated chronic diseases. Food environment entails the socio-economic, cultural, political, and material realities that inform how people relate to food systems in terms of how they obtain and consume food.

The realities of the Ghanaian food environment suggest the difficulty with which the diet-related chronic diseases will be dealt with. The economic situation undermines people's choice of healthy diets, as they only consume anything they can afford insofar as they get full. Certain Ghanaian cultural situations prevent people from eating certain kinds of foods even if they have great nutritional value. In some cultures, age is even used to prevent people from consuming foods that are considered healthy. In Ghana’s food environment today, there are numerous unapproved food products that are being sold to consumers. Many packaged foods do not have the requisite labels to guide food choices. Those that have food labels, it is difficult for consumers to understand what the labels are communicating. Furthermore, the social status of people impinges on the ease with which they can obtain healthy foods. The food environment must necessarily be policed in the face of the disturbing prevalence of the diseases in question.

One will realise that there is so much laxity in the food environment. We cannot sit down and watch on as our population becomes morbid every day. In policing the food environment, the policies that shape the food environment must be undertaken with the health of the populace in mind. Policies that discourage the flooding of markets with ultra-processed and sugar-sweetened beverages must be in effect. There must even be an increase in the taxation of these products to discourage their production. Food labels must be made mandatory. Food manufacturers who flout such policies must be punished. The labels must be designed such that they drive healthy food choices easily. The education sector must include lessons on food labels in the curriculum of schools right from the basic level to boost the current appreciation that even the educated have of food labels. The prices of healthy food products, including foods high in fibre and organic foods, must be regulated to enable persons on various levels of the economic ladder to afford them. Cultural beliefs and practices that do not encourage healthy food choices must modified through national laws.

In all these, individuals must be intentional about their personal wellbeing. Make healthy food choices. Stay away from ultra-processed foods. Learn to read food labels before making a purchase. Appreciate your Ghanaian-produced organic foods; the best does not always come from the West. In addition to making healthy food choices, we must take physical exercise seriously. The increasing rate of diet-related chronic diseases can be arrested. It will take intentional policing of the food environment to do this.

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