Drivers of unhealthy food consumption among adolescents: insights from a study in Sagnarigu Municipality, Ghana

Abstract Background Rising global consumption of ultra-processed, high-fat, and sugary foods, notably in developing countries like Ghana, contributes to escalating adolescent obesity and chronic diseases. Understanding adolescents’ unhealthy food (UF) intake patterns and the factors influencing them is crucial for informing effective, targeted interventions and thus curbing the surge in non-communicable diseases. This study aimed to examine unhealthy food consumption patterns and identify factors associated with their intake among adolescents aged 10 to 19 years in the Sagnarigu Municipality, Ghana. Methods An analytical cross-sectional study involving 425 adolescents aged 10–19 years was conducted. Data were collected using a pretested semi-structured questionnaire, including a food frequency questionnaire and items on socioeconomic and food-environment factors. Descriptive statistics and multilevel logistic regression were performed using SPSS version 26 for analysis. Unhealthy food consumption was assessed using a 12-item food frequency questionnaire (score range: 0–36), with higher scores indicating more frequent consumption. Individual food groups were categorized as rare (never or once/month; score = 0), low (2–3 times/month or once/week; score = 1), moderate (2–4 or 5–6 times/week; score = 2), or high (once or 2–3 times/day; score = 3) consumption. Results The mean age of adolescents was 16.3 ± 2 years, with 87.3% aged 15–19 years. The adolescents had a moderate intake of unhealthy foods, with a high consumption of sugary items. Adolescents going to school with pocket money (AOR: 1.84; 95% CI: 1.04–3.26), having quick access to UF (AOR: 1.99; 95% CI: 1.27–3.10), popularity of UF (AOR: 1.80; 95% CI: 1.04–3.12) and having mothers who were salaried workers (AOR: 1.99; 95% CI: 1.04–3.79) or informally self-employed (AOR: 2.09; 95% CI: 1.17–3.74) significantly increased the odds of UF consumption. In contrast, Mamprusi ethnicity (AOR: 0.29; 95% CI: 0.11–0.78) and a positive perception of the eating environment (AOR: 0.48; 95% CI: 0.31–0.74) were associated with a reduction in UF intake. Conclusions UF consumption was common among Ghanaian adolescents. Household socioeconomic characteristics, particularly maternal employment status, together with school and food-environment factors, were independently associated with higher UF consumption.