Skip to main content
Top
Published in: BMC Public Health 1/2014

Open Access 01-12-2014 | Research article

Type 2 diabetes in a rapidly urbanizing region of Ghana, West Africa: a qualitative study of dietary preferences, knowledge and practices

Authors: Megan L Doherty, Ellis Owusu-Dabo, Osei Sarfo Kantanka, Rickie O Brawer, James D Plumb

Published in: BMC Public Health | Issue 1/2014

Login to get access

Abstract

Background

Urban centers in Sub-Saharan Africa, such as Kumasi, Ghana, are especially impacted by the dual burden of infectious and non-communicable disease (NCD), including a rise in type 2 diabetes mellitus (T2DM) prevalence. To develop effective intervention programs, the World Health Organization recommends more research to better understand the relationship between food consumption and the escalation of non-communicable disease such as T2DM. This study provides qualitative information about current food knowledge, attitudes and practices among T2DM patients and their caregivers in the region of Kumasi, Ghana.

Methods

In this qualitative study, three focus groups discussions of 30 persons total and 10 individual interviews were used to assess food preferences, knowledge, attitudes and practices of patients with T2DM as well as caregivers responsible for food preparation. Participants included both urban and rural dwellers. Hospital-based health talks were observed, a dietician was interviewed, and educational documents were collected. Themes were identified and coded using Nvivo10 software.

Results

Findings suggest that messages regarding sweetened foods, fats, use of seasonings and meal timing are followed. However, confusion exists regarding the impact of fruits, food portioning, plantains and processed foods on health outcomes for diabetic patients. Results also revealed a problem-solving approach to increasing vegetable consumption, and a concern about unhealthy food preferences among younger generations.

Conclusions

Education about the impact of commonly available carbohydrates on blood sugar should be emphasized; messaging on portion sizes and certain foods should be more consistent; the economic benefits of local vegetable consumption should be promoted; and a research-informed, T2DM prevention campaign should be developed specifically for younger generations.
Appendix
Available only for authorised users
Literature
2.
go back to reference World Health Organization: Global Status Report on Non-Communicable Diseases: 2010. 2011, Geneva: World Health Organisation World Health Organization: Global Status Report on Non-Communicable Diseases: 2010. 2011, Geneva: World Health Organisation
3.
go back to reference International Diabetes Federation: Implementation of the United Nations Resolution on Diabetes in Africa. (No. 61/225). 2008, Brussels: International Diabetes Federation International Diabetes Federation: Implementation of the United Nations Resolution on Diabetes in Africa. (No. 61/225). 2008, Brussels: International Diabetes Federation
4.
go back to reference United Nations Population Fund: State of World Population 2007: Unleashing the Potential of Urban Growth. 2007, New York: Martin G United Nations Population Fund: State of World Population 2007: Unleashing the Potential of Urban Growth. 2007, New York: Martin G
5.
go back to reference Patel RB, Burke TF: Urbanization-an emerging humanitarian disaster. N Engl J Med. 2009, 361 (8): 741-743.CrossRefPubMed Patel RB, Burke TF: Urbanization-an emerging humanitarian disaster. N Engl J Med. 2009, 361 (8): 741-743.CrossRefPubMed
6.
go back to reference Sobngwi E, Mauvais-Jarvis F, Vexiau P, Mbanya J, Gautier J: Diabetes in Africans. Diabetes Metab. 2001, 27: 628-634.PubMed Sobngwi E, Mauvais-Jarvis F, Vexiau P, Mbanya J, Gautier J: Diabetes in Africans. Diabetes Metab. 2001, 27: 628-634.PubMed
7.
go back to reference Amuna P, Zotor FB: Epidemiological and nutrition transition in developing countries: impact on human health and development. Proc Nutr Soc. 2008, 67 (1): 82-90. 15–18 August 2006; Legon, GhanaCrossRefPubMed Amuna P, Zotor FB: Epidemiological and nutrition transition in developing countries: impact on human health and development. Proc Nutr Soc. 2008, 67 (1): 82-90. 15–18 August 2006; Legon, GhanaCrossRefPubMed
8.
9.
go back to reference World Health Organization: Diet, nutrition and the prevention of chronic diseases: report of a joint WHO/FAO expert consultation (Vol. 916). 2003, Geneva: Diamond Pocket Books (P) Ltd World Health Organization: Diet, nutrition and the prevention of chronic diseases: report of a joint WHO/FAO expert consultation (Vol. 916). 2003, Geneva: Diamond Pocket Books (P) Ltd
10.
go back to reference Dodu SRA, de Heer N: A diabetes case-finding survey in Ho, Ghana. Ghana Med J. 1964, 3: 75- Dodu SRA, de Heer N: A diabetes case-finding survey in Ho, Ghana. Ghana Med J. 1964, 3: 75-
11.
go back to reference Amoah AGB, Owusu SK, Adjei S: Diabetes in Ghana: a community based prevalence study in Greater Accra. Diabetes Res Clin Pract. 2002, 56 (3): 197-205.CrossRefPubMed Amoah AGB, Owusu SK, Adjei S: Diabetes in Ghana: a community based prevalence study in Greater Accra. Diabetes Res Clin Pract. 2002, 56 (3): 197-205.CrossRefPubMed
12.
go back to reference Shaw JE, Sicree RA, Zimmet PZ: Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010, 87 (1): 4-14.CrossRefPubMed Shaw JE, Sicree RA, Zimmet PZ: Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010, 87 (1): 4-14.CrossRefPubMed
13.
go back to reference Potts D: The slowing of Sub-Saharan Africa’s Urbanization: evidence and implications for Urban Livelihoods. Environ Urban. 2009, 21 (1): 253-259.CrossRef Potts D: The slowing of Sub-Saharan Africa’s Urbanization: evidence and implications for Urban Livelihoods. Environ Urban. 2009, 21 (1): 253-259.CrossRef
14.
go back to reference Ghana Health Service: Regional Health Directorate, Ashanti Region: Annual Report. 2005, Ghana: Ashanti Region Ghana Health Service: Regional Health Directorate, Ashanti Region: Annual Report. 2005, Ghana: Ashanti Region
15.
go back to reference Amidu N, Owiredu W, Mireku E, Agyemang C: Metabolic syndrome among garage workers in the automobile industry in Kumasi, Ghana. J Medical and Biomedical Sciences. 2012, 1 (3): 29-36. Amidu N, Owiredu W, Mireku E, Agyemang C: Metabolic syndrome among garage workers in the automobile industry in Kumasi, Ghana. J Medical and Biomedical Sciences. 2012, 1 (3): 29-36.
16.
go back to reference Cook-Huynh M, Ansong D, Steckelberg RC, Boakye I, Seligman K, Appiah L, Kumar N, Amuasi JH: Prevalence of hypertension and diabetes mellitus in adults from a rural community in Ghana. Ethn Dis. 2012, 22 (3): 347-352.PubMed Cook-Huynh M, Ansong D, Steckelberg RC, Boakye I, Seligman K, Appiah L, Kumar N, Amuasi JH: Prevalence of hypertension and diabetes mellitus in adults from a rural community in Ghana. Ethn Dis. 2012, 22 (3): 347-352.PubMed
18.
go back to reference Clark JP: How to Peer Review a Qualitative Manuscript. Peer Review in Health Sciences. Second edition. Edited by: Godlee F, Jefferson T. 2003, London: BMJ Books, 219-235. Clark JP: How to Peer Review a Qualitative Manuscript. Peer Review in Health Sciences. Second edition. Edited by: Godlee F, Jefferson T. 2003, London: BMJ Books, 219-235.
19.
go back to reference Glanz K, Rimer BK, Viswanath V: Health Behavior and Health Education: Theory, Research, and Practice. 2008, New Jersey: John Wiley & Sons Glanz K, Rimer BK, Viswanath V: Health Behavior and Health Education: Theory, Research, and Practice. 2008, New Jersey: John Wiley & Sons
20.
go back to reference Aikins ADG: Living with Diabetes in Rural and Urban Ghana: a critical social psychological examination of illness action and scope for intervention. J Health Psychol. 2003, 8 (5): 557-572.CrossRefPubMed Aikins ADG: Living with Diabetes in Rural and Urban Ghana: a critical social psychological examination of illness action and scope for intervention. J Health Psychol. 2003, 8 (5): 557-572.CrossRefPubMed
21.
go back to reference Uchenna O, Ijeoma E, Pauline E, Sylvester O: Contributory factors to diabetes dietary regimen non adherence in adults with diabetes. World Academic of Science, Engineering and Technology. 2010, 69: 734-741. Uchenna O, Ijeoma E, Pauline E, Sylvester O: Contributory factors to diabetes dietary regimen non adherence in adults with diabetes. World Academic of Science, Engineering and Technology. 2010, 69: 734-741.
22.
go back to reference Quaye W, Gyasi O, Larweh P, Johnson PT, Obeng-Aseidu P: The extent of marketability and consumer preferences for traditional leafy vegetables; a case study at selected markets in Ghana. Int J Consum Stud. 2009, 33 (3): 244-249.CrossRef Quaye W, Gyasi O, Larweh P, Johnson PT, Obeng-Aseidu P: The extent of marketability and consumer preferences for traditional leafy vegetables; a case study at selected markets in Ghana. Int J Consum Stud. 2009, 33 (3): 244-249.CrossRef
23.
go back to reference Shodehinde SA, Oboh G: In vitro antioxidant activities and inhibitory effects of aqueous extracts of unripe plantain pulp (musa paradisiaca) on enzymes linked with Type 2 diabetes and hypertension. J Toxicol Environ Health Sci. 2012, 4 (4): 65-75. Shodehinde SA, Oboh G: In vitro antioxidant activities and inhibitory effects of aqueous extracts of unripe plantain pulp (musa paradisiaca) on enzymes linked with Type 2 diabetes and hypertension. J Toxicol Environ Health Sci. 2012, 4 (4): 65-75.
24.
go back to reference Ayodele OH, Erema V: Glycemic indices of processed unripe plantain (musa paradisiaca) meals. Afr J Food Sci. 2010, 4 (8): 514-521. Ayodele OH, Erema V: Glycemic indices of processed unripe plantain (musa paradisiaca) meals. Afr J Food Sci. 2010, 4 (8): 514-521.
25.
go back to reference Eleazu CO, Okafor PN, Amajor J, Awa E, Ikpeama A, Eleazu KC: Chemical composition, antioxidant activity, functional properties and inhibitory action of unripe plantain (M. Paradisiacae) flour. Afr J Biotechnol. 2011, 10 (74): 16948-16952.CrossRef Eleazu CO, Okafor PN, Amajor J, Awa E, Ikpeama A, Eleazu KC: Chemical composition, antioxidant activity, functional properties and inhibitory action of unripe plantain (M. Paradisiacae) flour. Afr J Biotechnol. 2011, 10 (74): 16948-16952.CrossRef
26.
go back to reference Slabber M: Complexities of consumer understanding of the Glycaemic index concept and practical guidelines for incorporation in diets. South Afri J Clinical Nutrition. 2007, 18 (3): 252-257. Slabber M: Complexities of consumer understanding of the Glycaemic index concept and practical guidelines for incorporation in diets. South Afri J Clinical Nutrition. 2007, 18 (3): 252-257.
27.
go back to reference Doku D, Koivusilta L, Raisamo S, Rimpelä A: Socio-economic differences in adolescents’ breakfast eating, fruit and vegetable consumption and physical activity in Ghana. Public Health Nutr. 2013, 16 (05): 864-872.CrossRefPubMed Doku D, Koivusilta L, Raisamo S, Rimpelä A: Socio-economic differences in adolescents’ breakfast eating, fruit and vegetable consumption and physical activity in Ghana. Public Health Nutr. 2013, 16 (05): 864-872.CrossRefPubMed
Metadata
Title
Type 2 diabetes in a rapidly urbanizing region of Ghana, West Africa: a qualitative study of dietary preferences, knowledge and practices
Authors
Megan L Doherty
Ellis Owusu-Dabo
Osei Sarfo Kantanka
Rickie O Brawer
James D Plumb
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2014
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-14-1069

Other articles of this Issue 1/2014

BMC Public Health 1/2014 Go to the issue