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Sustainable diets and cardiometabolic conditions among Ghanaian adults under transition: Findings from the RODAM-Pros Cohort Study.

The American journal of clinical nutrition

Authors: Clara Bergmann, Gabriel Kallah-Dagadu, Eva van der Linden, Karlijn A C Meeks, Kerstin Klipstein-Grobusch, Mary Nicolaou, Peter Henneman, Silver Bahendeka, Erik Beune, Charles Agyemang, Ina Danquah

BACKGROUND: In sub-Saharan Africa, the burden of cardiometabolic conditions has rapidly emerged. Sustainable diets that are nutritious, environmentally friendly, economically affordable, and socio-culturally acceptable, may support the prevention of cardiometabolic conditions.

OBJECTIVE: This study aimed at identifying associations of optimized sustainable diets with incident general/abdominal obesity, type 2 diabetes mellitus (T2D), and hypertension among Ghanaian adults living in Ghana and Amsterdam.

METHODS: We used longitudinal data from the Research on Obesity and Diabetes among African Migrants study involving Ghanaian adults (age: 20-82 years). Baseline dietary data was collected using a Ghana-specific food propensity questionnaire. To construct an Optimized Diet Index (ODI, 0-90 score points), we used baseline adherence to previously identified site- and sex-specific diets, meeting nutritional adequacy, cultural acceptability, and 50% reduction of greenhouse gas emissions (GHGEs) and food costs. Multivariable-adjusted logistic regression assessed associations between ODI per 10-point increase and risk of general/abdominal obesity, T2D, and hypertension, reported as odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS: In the analytical sample (n=1,499, women=66%, mean age=47±11 years, mean follow-up time=7±0.5 years, median ODI=29 with interquartile range=23-37), higher ODI scores were related with residence in Ghana, lower total energy intake, older age, and lower educational level. We observed no associations of baseline ODI with incident general obesity, type 2 diabetes or hypertension. A 10-point increase in ODI was associated with a 19% higher risk of abdominal obesity (95% CI: 1.00, 1.42; p=0.049), significantly in rural and urban Ghana.

CONCLUSIONS: Overall adherence to the optimized sustainable diets is low among this cohort of Ghanaian adults. Sustainable diets are related to increased risk of abdominal obesity in the Ghana. Low variation in the poor adherence may explain the unexpected results.

Copyright © 2026 The Author(s). Published by Elsevier Inc. All rights reserved.

PMID: 42580635

Participating cluster members