Mapping Obesogenic Food Environments in South Africa and Ghana: Correlations and Contradictions
Open accessAbstract
In sub-Saharan Africa, urbanisation and food systems change contribute to rapid dietary transitions promoting obesity. It is unclear to what extent these changes are mediated by neighbourhood food environments or other factors. This paper correlates neighbourhood food provision with household consumption and poverty in Khayelitsha, South Africa and Ahodwo, Ghana. Georeferenced survey data of food consumption and provision were classified by obesity risk and protection. Outlets were mapped, and density and distribution correlated with risk classes. In Khayelitsha, 71% of households exceeded dietary obesity risk thresholds while 16% consumed protective diets. Obesogenic profiles were less (26%) and protective more prevalent (23%) in Ahodwo despite greater income poverty in Khayelitsha. Here, income-deprived households consumed significantly (p < 0.005) less obesogenic and protective diets. Small informal food outlets dominated numerically but supermarkets were key household food sources in Khayelitsha. Although density of food provision in Ahodwo was higher (76/km2), Khayelitsha outlets (61/km2) provided greater access to obesogenic (57% Khayelitsha; 39% Ahodwo) and protective (43% Khayelitsha; 16% Ahodwo) foods. Consumption and provision profiles correlate more strongly in Ahodwo than Khayelitsha (rKhayelitsha = 0.624; rAhodwo = 0.862). Higher obesogenic food consumption in Khayelitsha suggests that risky food environments and poverty together promote obesogenic diets.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Similar trends have unfolded in many countries around the world, including in developing countries such as Brazil and South Africa, although constraints on food environments unfold in unique ways in different contexts.
“Similar trends have unfolded in many countries around the world, including in developing countries such as Brazil and South Africa, although it is important to recognize that the constraints on food envi ronments unfold in unique ways in different contexts (Kroll et al. 2019; Hon ´ orio et al., 2021).”
From Corporate concentration and power matter for agency in food systems (2025) · cites this paper as Kroll et al. 2019
Cites
Mozaffarian, D. (2016) · Circulation · doi:10.1161/circulationaha.115.018585 · Cited by 2,216 · cited 4× · see citing works
“These foods include whole grains, nuts, seeds, and fish high in polyunsaturated fats, as well as yoghurt, vegetables and fruit [51].”
BackgroundInfluentialThe nutrition transition: worldwide obesity dynamics and their determinants
Popkin, B. M., & Gordon-Larsen, P. (2004) · International Journal of Obesity · doi:10.1038/sj.ijo.0802804 · Cited by 1,538 · see citing works
Conceptualizing food systems for global environmental change research
Ericksen, P. J. (2008) · Global Environmental Change · doi:10.1016/j.gloenvcha.2007.09.002 · Cited by 1,486 · cited 2× · see citing works
“Paradigmatic food systems models emphasise the global and national scale [41,42,71], or discuss household food security outcomes while neglecting intermediate scales of analysis [4].”
Backgroundde Souza, R. J., Mente, A., Maroleanu, A., Cozma, A. I., Ha, V., Kishibe, T., Uleryk, E., Budylowski, P., Schünemann, H., Beyene, J., et al. (2015) · BMJ · doi:10.1136/bmj.h3978 · Cited by 1,424 · see citing works
Consumption of ultra-processed foods and obesity in Brazilian adolescents and adults
Louzada, M. L. D. C., Baraldi, L. G., Steele, E. M., Martins, A. P. B., Canella, D. S., Moubarac, J.-C., Levy, R. B., Cannon, G., Afshin, A., Imamura, F., et al. (2015) · Preventive Medicine · doi:10.1016/j.ypmed.2015.07.018 · Cited by 656 · see citing works
Self-citationAnand, S. S., Hawkes, C., de Souza, R. J., Mente, A., Dehghan, M., Nugent, R., Zulyniak, M. A., Weis, T., Bernstein, A. M., Krauss, R. M., et al. (2015) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2015.07.050 · Cited by 507 · cited 2× · see citing works
“These foods can be interpreted as a response to the poverty experienced, as they are typically cheap [9,117,118], and do not require much preparation.”
Background
Flagged first, then by citations
Cited by
Sorted by citations
Ahmed, S. K., & Mohammed, R. A. (2025) · Metabolism Open · doi:10.1016/j.metop.2025.100375 · Cited by 432 · see citing works
Moodie, R., Bennett, E., Kwong, E. J. L., Santos, T. M., Pratiwi, L., Williams, J., & Baker, P. (2021) · International Journal of Health Policy and Management · doi:10.34172/ijhpm.2021.45 · Cited by 130 · see citing works
Westbury, S., Ghosh, I., Jones, H. M., Mensah, D., Samuel, F., Irache, A., Azhar, N., Al-Khudairy, L., Iqbal, R., & Oyebode, O. (2021) · BMJ Global Health · doi:10.1136/bmjgh-2021-006358 · Cited by 107 · see citing works
Corporate concentration and power matter for agency in food systems
Clapp, J., Vriezen, R., Laila, A., Conti, C., Gordon, L., Hicks, C., & Rao, N. (2025) · Food Policy · doi:10.1016/j.foodpol.2025.102897 · Cited by 64 · see citing works
- Authors
- Kroll, F., Swart, E. C., Annan, R. A., Thow, A. M., Neves, D., Apprey, C., Aduku, L. N. E., Agyapong, N. A. F., Moubarac, J.-C., Toit, A. D., Aidoo, R., & Sanders, D.
- Affiliations
- Kwame Nkrumah University of Science and Technology (GH)
- School of Public Health, University of the Western Cape, Cape Town 7535, South Africa
- The University of Sydney (AU)
- Institute for Poverty, Land and Agrarian Studies (ZA)
- Université de Montréal (CA)
- University of the Western Cape (ZA)
- Corresponding author
- Kroll, Florian
- ORCID
- Venue
- Sustainability
- Publisher
- MDPI AG
- Published
- 2019-07-18
- Volume
- 11
- Issue
- 14
- Pages
- 3924
- ISSN
- 2071-1050 (ISSN-L)
- OpenAlex
- W2958061626
- Cited by
- 65
- References
- 6
- Citations by year
- 2026: 7 · 2025: 7 · 2024: 8 · 2023: 6 · 2022: 16 · 2021: 16 · 2020: 4 · 2019: 1
- FWCI
- 8.52
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- Sustainability (publishedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- UWC Research Repository (University of the Western Cape) (submittedVersion)
- Funders
- International Development Research Centre (108425-001)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Health Sciences › Health Professions › General Health Professions › Food Security and Health in Diverse Populations
- Keywords
- nutrition transition, obesity risk, protective diet, food outlet density, food access, income poverty, urbanization, Khayelitsha, sub-Saharan Africa, informal food vendors, supermarkets
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
