Type II diabetes and dietary preferences in a rapidly urbanizing region of West Africa

Urban centers in Sub-Saharan Africa are especially impacted by the dual burden of infectious and non-communicable disease (NCD), including a rise in type II diabetes mellitus (T2DM) prevalence. In fact, T2DM recently registered as a top ten leading cause of death in rapidly urbanizing Kumasi, Ghana. To develop effective intervention programs, the World Health Organization recommends more research to better understand the relationship between food consumption and the escalation of NCDs. This study aims: to inform health interventions on food preferences, knowledge, attitudes and behaviors (KABs) to improve self-management of T2DM in the Kumasi region; and to identify areas for future research targeting T2DM prevention among younger generations.

In this qualitative study, focus groups and semi-structured, individual interviews were used to assess food preferences and KABs of patients with T2DM as well as caregivers responsible for food preparation. Additionally, hospital-based health talks were observed, a dietician was interviewed, and educational documents were collected. Themes were identified and coded using Nvivo10 software.

Findings suggest that messages regarding sweetened foods, fats, use of seasonings and meal timing are followed. However, some 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.

Recommendations include the following: messaging on portion sizes and certain foods should be more consistent; local vegetable consumption should be promoted; and a research-informed, T2DM prevention campaign should be developed specifically for younger generations.