A clinical nutritionist's-eye view of Ghana's dietary transition, the foods driving the NCD epidemic, and how to use traditional Ghanaian food culture as medicine.

By Dr. Joseph Ntiamoah (PT)  |  Consultant Physiotherapist & Neurorehabilitation Specialist

The Rehab Haven Rehabilitation Centre  |  Kumasi, Ghana  |  ptntiamoah.com  |  0532767597



When I advise Ghanaian patients on dietary modification for cardiovascular health, I face a tension that many international dietary guidelines do not address: the recommendations I am making need to be achievable within a food culture that is rich, meaningful, and identity-laden in ways that generic nutrition advice completely ignores.

I am not going to recommend that patients eat quinoa or reduce palm oil in favour of olive oil. I am going to recommend that they understand what traditional Ghanaian food culture already knew about health — and why the dietary transition toward ultra-processed urban foods is one of the primary drivers of the chronic disease epidemic Ghana is experiencing.

What the Dietary Transition Looks Like

Ghana's urban dietary landscape has shifted dramatically over the past two decades. Traditional Ghanaian foods — based on whole grains, legumes, fish, vegetables, and freshly prepared plant-based ingredients — were nutritionally dense, fibre-rich, sodium-controlled, and cardiovascular-protective. The urban dietary pattern that has emerged in their place — characterised by ultra-processed convenience foods, seasoning-cube-heavy cooking, sweetened beverages, refined carbohydrates, and deep-fried snacks as daily staples — represents a reversal of almost every nutritional quality that made traditional Ghanaian cuisine protective.

This transition is producing predictable outcomes: rising prevalence of hypertension, dyslipidaemia, type 2 diabetes, and obesity — the risk factor cluster that drives stroke, cardiovascular disease, and chronic kidney disease. The NCD epidemic in Ghana is not primarily a genetic story. It is primarily a dietary and lifestyle story. And it is substantially reversible.

The Specific Problems: A Clinical Breakdown

Sodium: The Seasoning Cube Crisis

Ghana's seasoning cube consumption is one of the most significant drivers of population-level hypertension. A single Maggi or Royco cube contains approximately 1,200mg of sodium — equivalent to 60 percent of the WHO's recommended daily maximum of 2,000mg. Most Ghanaian cooking uses two to four cubes per pot, which is then consumed across multiple servings by multiple family members, including children.

The relationship between sodium intake and blood pressure is direct and dose-dependent: the higher the sodium intake, the higher the blood pressure. Population-level sodium reduction — demonstrated in multiple country-wide interventions — produces measurable reductions in cardiovascular disease and stroke mortality without any other dietary change.

The solution is not to remove flavour from Ghanaian cooking. Traditional Ghanaian cuisine achieved extraordinary flavour complexity without seasoning cubes: fresh tomatoes and peppers, onions, garlic, ginger, dawadawa (locust beans), shrimp powder, garden eggs, and fresh herbs and spices. These ingredients provide flavour, anti-inflammatory compounds, and cardiovascular-protective phytochemicals simultaneously.

Refined Carbohydrates and Blood Glucose

The replacement of traditional complex carbohydrate sources — fermented corn (banku, kenkey), cassava, yam, and plantain — with white bread, white rice as a daily staple, and sugary snacks has dramatically increased the glycaemic load of the average Ghanaian urban diet. High glycaemic load drives post-meal blood glucose spikes, progressive insulin resistance, and eventual type 2 diabetes in susceptible individuals.

The solution: preserve the traditional whole-grain and fermented carbohydrate sources. Kenkey — fermented maize — has a significantly lower glycaemic response than white bread. Whole plantain and yam have a lower glycaemic impact than white rice. Fufu made from cassava and plantain is nutritionally superior to white-bread equivalents. Traditional Ghanaian starchy foods were not the problem — the problem is the replacement of those foods with refined equivalents.

The Hidden Sugar Problem

Sweetened beverages — malt drinks, carbonated sodas, sweetened tea, and juice drinks — have become embedded in Ghanaian social culture as symbols of hospitality and celebration. The sugar content of a typical 330ml malt drink: approximately 35 to 40 grams — 9 teaspoons. The WHO recommendation for added sugar: maximum 25 grams (6 teaspoons) daily for health benefit. Regular consumption of sweetened beverages is a direct driver of obesity, insulin resistance, and type 2 diabetes.

The Traditional Ghanaian Foods That Are Already Medicine

This is the message I want every Ghanaian reader to carry from this post: the most cardiovascular-protective diet available in Ghana is not a foreign dietary import. It is a return to the best of traditional Ghanaian food culture, applied consistently. The following traditional foods represent clinical nutritional interventions:

  • Kontomire (cocoyam leaves) — rich in folate, iron, antioxidants, and anti-inflammatory compounds. Cardiovascular protective.

  • Groundnuts — high in monounsaturated fat (oleic acid), protein, and magnesium. Blood pressure reducing.

  • Beans and cowpeas — soluble fibre reduces LDL cholesterol 5-7%. Blood glucose stabilising. Protein-rich.

  • Fresh fish (tilapia, mackerel, herrings) — omega-3 fatty acids reduce triglycerides and cardiovascular risk.

  • Plantain — complex carbohydrate with resistant starch. Lower glycaemic impact than white rice. Potassium-rich.

  • Tomatoes, peppers, and onions — lycopene, capsaicin, and quercetin — anti-inflammatory and blood pressure modulating.

  • Dawadawa (locust beans) — fermented, umami-rich flavour enhancer that replaces seasoning cubes with no sodium penalty and significant probiotic benefit.

The Practical Prescription

You do not need to overhaul your entire diet to produce meaningful health benefit. The evidence on dietary behaviour change consistently shows that sustainable modification works by adding healthful foods and progressively displacing harmful ones — rather than eliminating foods that carry cultural and emotional meaning.

Start with one change this week: replace one seasoning cube per day with dawadawa, fresh garlic, fresh ginger, and tomatoes. Cook one traditional meal featuring beans, fish, or kontomire. Replace one sweetened beverage with water or unsweetened sobolo (hibiscus drink). These are not sacrifices. They are a return to the food culture that sustained Ghanaian health for generations before the ultra-processed transition.


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About the Author

Dr. Joseph Ntiamoah (PT) is a Consultant Physiotherapist and Neurorehabilitation Specialist and the Founder of The Rehab Haven Rehabilitation Centre, Kumasi, Ghana. He specialises in stroke rehabilitation, neurological rehabilitation, homecare physiotherapy, and preventive health education. He is the author of Stroke Before 50, Exercise as Medicine, and Daily Mobility for Office Workers.

For consultations, home rehabilitation referrals, or corporate wellness enquiries: 0532767597 | ptntiamoah.com