<?xml version="1.0" encoding="UTF-8"?><xml><records><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Akosua Pokua Adjei</style></author><author><style face="normal" font="default" size="100%">Gideon Senyo Amevinya</style></author><author><style face="normal" font="default" size="100%">Wilhemina Quarpong</style></author><author><style face="normal" font="default" size="100%">Akua Tandoh</style></author><author><style face="normal" font="default" size="100%">Aryeetey, Richmond</style></author><author><style face="normal" font="default" size="100%">Michelle Holdsworth</style></author><author><style face="normal" font="default" size="100%">Charles Agyemang</style></author><author><style face="normal" font="default" size="100%">Francis Zotor</style></author><author><style face="normal" font="default" size="100%">Matilda E Laar</style></author><author><style face="normal" font="default" size="100%">Kobby Mensah</style></author><author><style face="normal" font="default" size="100%">Phyllis Addo</style></author><author><style face="normal" font="default" size="100%">Dennis Laryea</style></author><author><style face="normal" font="default" size="100%">Gershim Asiki</style></author><author><style face="normal" font="default" size="100%">Daniel Sellen</style></author><author><style face="normal" font="default" size="100%">Stefanie Vandevijvere</style></author><author><style face="normal" font="default" size="100%">Amos Laar</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Availability of healthy and unhealthy foods in modern retail outlets located in selected districts of Greater Accra Region, Ghana.</style></title><secondary-title><style face="normal" font="default" size="100%">Front Public Health</style></secondary-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Consumer Behavior</style></keyword><keyword><style  face="normal" font="default" size="100%">Diet</style></keyword><keyword><style  face="normal" font="default" size="100%">environment</style></keyword><keyword><style  face="normal" font="default" size="100%">Fast Foods</style></keyword><keyword><style  face="normal" font="default" size="100%">Ghana</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2022</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2022</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">10</style></volume><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;&lt;b&gt;BACKGROUND: &lt;/b&gt;Intake of unhealthy foods is linked to the onset of obesity and diet-related non-communicable diseases (NCDs). Availability of unhealthy (nutritionally poor) foods can influence preference, purchasing and consumption of such foods. This study determined the healthiness of foods sold at modern retail outlets- supermarkets and mini-marts in the Greater Accra Region of Ghana.&lt;/p&gt;

&lt;p&gt;&lt;b&gt;METHODS: &lt;/b&gt;All modern retail outlets located in six districts of Greater Accra were eligible. Those &amp;lt; 200 m of floor area and with permanent structures were categorized as mini-marts; and those ≥200 m as supermarkets. Shelf length of all available foods were measured. Healthiness of food was determined using two criteria - the NOVA classification and energy density of foods. Thus, ultra-processed foods or food items with &amp;gt;225 kcal/100 g were classified as unhealthy. The ratio of the area occupied by unhealthy to healthy foods was used to determine the healthiness of modern retail outlets.&lt;/p&gt;

&lt;p&gt;&lt;b&gt;RESULTS: &lt;/b&gt;Of 67 retail outlets assessed, 86.6% were mini-marts. 85.0% of the total SHELF area was occupied by foods categorized as unhealthy (ranging from 9,262 m in Ashiaman Municipality to 41,892 m in Accra Metropolis). Refined grains/grain products were the most available, occupying 30.0% of the total food shelf space, followed by sugar-sweetened beverages (20.1% of total shelf space). The least available food group-unprocessed staples, was found in only one high income district, and occupied 0.1% of the total food shelf space. Retail outlets in two districts did not sell fresh fruits or fresh/unsalted canned vegetables. About two-thirds of food products available ( = 3,952) were ultra-processed. Overall, the ratio of ultra-processed-to-unprocessed foods ranged from 3 to 7 with an average (SD) of 5(2). Thus, for every healthy food, there were five ultra-processed ones in the studied retail outlets.&lt;/p&gt;

&lt;p&gt;&lt;b&gt;CONCLUSION: &lt;/b&gt;This study reveals widespread availability of ultra-processed foods in modern retail outlets within the selected districts. Toward a healthier food retail environment, public health and food regulators, in partnership with other stakeholders need to institute measures that improve availability of healthy foods within supermarkets and mini-marts.&lt;/p&gt;
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