Faith-Based Nutrition Education Interventions for Cardiovascular Risk Reduction in Sub-Saharan Africa: A Narrative Review and Methodological Framework for Church-Engaged Plant-Based Programs in Southwestern Nigeria.

Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide and constitute a rapidly growing public health challenge in Sub-Saharan Africa, particularly in Nigeria. The ongoing nutrition transition from traditional plant-rich diets to energy-dense, ultra-processed foods has contributed substantially to increasing rates of hypertension, obesity, dyslipidaemia, and other cardiometabolic disorders. Although churches constitute influential community institutions capable of promoting healthy lifestyles, faith-based nutrition education interventions remain scarce in Sub-Saharan Africa, with no standardized framework tailored to Christian communities in Southwestern Nigeria. This study systematically reviewed faith-based nutrition education interventions for cardiovascular risk reduction in Sub-Saharan Africa and developed a culturally adapted, biblically aligned methodological framework for church-engaged whole-food, plant-based nutrition education programmes in Southwestern Nigeria. A narrative review design was employed. Literature published between 2010 and 2024 was retrieved from PubMed/MEDLINE, Scopus, Web of Science, Google Scholar, African Journals Online (AJOL), and relevant grey literature sources. Following purposive screening for relevance and methodological quality, 42 studies were synthesized using thematic analysis to examine the effectiveness of existing faith-based interventions, baseline dietary patterns and cardiovascular risk profiles, framework components, and implementation feasibility. The review revealed that 78.5% of faith-based health interventions in Sub-Saharan Africa primarily targeted infectious diseases, while fewer than 5% addressed non-communicable diseases and less than 1% implemented structured nutrition education. Among church congregants in Southwestern Nigeria, hypertension prevalence was estimated at 38.2%, with 71.4% of affected individuals unaware of their condition. Dietary practices were characterized by high consumption of refined carbohydrates and sodium-rich foods, whereas only 14.2% met the World Health Organization recommendation for daily fruit and vegetable intake. Despite prevailing socio-cultural barriers, including perceptions that plant-based diets signify poverty or provide inadequate nutrition, 81.3% of congregants expressed willingness to adopt whole-food, plant-based diets when supported by biblical teachings and pastoral endorsement. The proposed methodological framework integrated biblical principles of health stewardship, socio-behavioural theories, culturally adapted Yoruba plant-based meals, experiential cooking demonstrations, and Lay Health Advisor-led education. Implementation outcomes demonstrated high acceptability (88.4%), operational feasibility (91.7%), and institutional support, with 75.0% of participating churches willing to adopt healthy catering policies. Faith-based institutions represent an underutilized yet highly promising platform for cardiovascular disease prevention in Southwestern Nigeria. Integrating biblical health principles with culturally appropriate whole-food, plant-based nutrition education offers a feasible, acceptable, and sustainable strategy for reducing cardiovascular risk among church congregations. The proposed framework provides a practical model for church-engaged health promotion and may inform future public health interventions and policy development across Sub-Saharan Africa.