Food systems thinking unpacked: a scoping review on industrial diets among adolescents in Ghana

Unhealthy diets are among the main risk factors associated with non-communicable diseases (NCDs). In Sub Saharan Africa, NCDs were responsible for 37% of deaths in 2019, rising from 24% in 2000. There is an increasing emphasis on health-harming industrial foods, such as ultra-processed foods (UPFs), in driving the incidence of diet-related NCDs. However, there is a methodological gap in food systems research to adequately account for the processes and actors that shape UPFs consumption across the different domains of the food systems framework and macro-meso-micro levels of analysis. This paper interrogates how the Food Systems Framework for Improved Nutrition (HLPE in Nutrition and food systems. A report by the high level panel of experts on food security and nutrition of the committee on world food security, 2017), considered the dominant framework to analyse nutrition, and language of interdisciplinarity are practised in research with regards to consumption of UPFs among adolescents in Ghana, a population group that is often at the forefront of dramatic shifts in diets and lifestyles. We conducted a scoping review of studies published between 2010 and February 2022, retrieved 25 studies, and mapped the findings against the domains and analysis levels of the Food Systems Framework for Improved Nutrition (HLPE in Nutrition and food systems. A report by the high level panel of experts on food security and nutrition of the committee on world food security, 2017). Our study illustrates that there is a tendency to address unhealthy diets among adolescents in a siloed manner, and as a behavioural and nutritional issue. In most cases, the analyses fail to show how domains of the food systems framework are connected and do not account for linkages across different levels of analysis. Methodologically, there is a quantitative bias. From the policy point of view, there is a disconnect between national food policies and food governance (i.e., trade and regulations) and initiatives and measures specifically targeted at adolescent’s food environments and the drivers of UPFs consumption.