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Background: Nutrition transition and persistent food insecurity in Ghana are increasingly linked with poor physical and mental health. However, how dietary behaviours shape cardiometabolic outcomes and psychological distress in food-insecure settings remains underexplored.
Objective: This study examines the relationship between dietary patterns, food insecurity, and cardiometabolic risk, as well as the impact of psychological distress in Ghanaian adults, with oral health considered a potential contributing factor.
Methods: This study employed a cross-sectional design, recruiting 100 participants in March 2025. Data on sociodemographic characteristics and dietary patterns were taken using standard questionnaires, while cardiometabolic risk factors were assessed using standard procedures. Mental Health was assessed using Kessler’s Psychological Distress scale, while food security was assessed using the USDA Household Food Security Questionnaire. Dietary patterns were derived from principal component analysis and regression and mediation models were applied.
Key findings: Four distinct dietary patterns were identified: Sweet Tooth, Traditional Ghanaian Staples, Animal-Based Protein, and Street Food. The Sweet Tooth pattern was significantly associated with poorer cardiometabolic health (β = 0.412, p = 0.031), while food insecurity showed a strong positive association with psychological distress (β = 0.594, p < 0.001). The Animal Protein Dominant Pattern was also linked to increased psychological distress (β = 0.174, p = 0.047). Oral health exhibited a marginal association with cardiometabolic health (β = -0.101, p = 0.075) but was not linked to psychological distress. Mediation analysis revealed that the relationship between food insecurity and psychological distress was partially mediated by increased consumption of street foods (β = 0.103, p = 0.014).
Implications: This study highlights the detrimental impact of a sugary, energy-dense dietary pattern on cardiometabolic health and shows food insecurity as a key driver of psychological distress in Ghana..Public health interventions that use an integrated approach targeting food security, promotion of healthy diets, and mental support are essential to address the dual burden of cardiometabolic and psychological disorders in Ghana.
Keywords: Food Security, Dietary Patterns, Mental Health, Cardiometabolic Health