Research Square · Oct 19, 2026
Associations Between Dietary Patterns, Lifestyle Factors, and Metabolic Syndrome Components in a Ghanaian Cohort at Baseline of Freeze-Dried Beta Vulgaris (Beetroot) Powder Intervention Study
By Boatemaa E, Larbie C, Tandoh M et al.
Introduction Metabolic syndrome (MetS) is emerging as a significant issue in Sub–Saharan Africa, including Ghana. This is linked to the nutrition transition and changing lifestyle. Objective This study examines the predominant factors contributing to metabolic syndrome at the Abuakwa Polyclinic and Suntreso Government Hospital in the Ashanti Region of Ghana. Method A cross-sectional evaluation of 214 participants was conducted using a standard questionnaire, anthropometric measurements, and biochemical analyses. Inferential analyses were conducted using t-tests, chi-square/Fisher’s exact tests, binomial exact test, Cohen’s kappa, and McNemar’s test. Effect sizes were reported, with significance set at p ˂ 0.05 using Python 3.12 (SciPy 1.12). Dietary patterns were assessed using a 24-hour recall and food frequency questionnaire (FFQ). Principal component analysis (PCA) and Goldberg analysis were used to determine dietary pattern and whether the reported energy intake is physiologically plausible based on the estimated energy requirement. MetS parameters were defined based on IDF and NCEP ATP III criteria. Descriptive statistics, bootstrap validation, prevalence calculation, risk stratification, analysis were employed for this study. Results MetS prevalence was 17.8% and 19.6% based on the IDF and NCEP ATP III criteria respectively, both criteria showed a perfect agreement (κ = 0.877; 95% CI: 0.794–0.961; p < 0.001), whereas 19.6% of the sampled participants have no MetS. Notable gender disparities were observed, with higher MetS prevalence among females than males for IDF and NCEP ATP III (19.4%, 21.1% and 8.8% and 11.8% respectively. Waist circumference and systolic blood pressure were significantly above the clinical threshold (p ˂ 0.001), with a higher prevalence observed among female participants. Majority (76.2%) of the participants had El: BMR ratio above the upper cut-off (2.28) based on the Goldberg analysis with higher prevalence among females (78.7%) than males (68.0%). Five dietary patterns were identified, accounting for 3.130 of eigenvalue and total variance and a Phi coefficience of 0.966. Alcohol consumption was linked to elevated triglycerides (OR: 2.31, 95% CI: 1.32–4.05). The overall significant nutrient imbalances were identified, including very high sodium intake (mean 5723 mg/day), with inadequate calcium (452 mg/day) intake. Conclusion This baseline analysis identifies distinct dietary patterns and a high burden of MetS components among Ghanaian adults. Findings highlight the importance of culturally tailored dietary interventions targeting specific MetS risk factors in transitioning cohorts. Trial registration Pan African Clinical Trial Registry (PACTR) PACTR202512555953324, registered 11th November 2025.