The nutrition landscape in West Africa has been dominated by the programmes to address
undernutrition. However, with increasing urbanisation, technological developments and
associated change in dietary patterns and physical activity, childhood and adult overweight,
and obesity are becoming more prevalent. There is an evidence of increasing intake of dietary
energy, fat, sugars and protein. There is low consumption of fruit and vegetables universally
in West Africa. Overall, the foods consumed are predominantly traditional with the
component major food groups within recommended levels. Most of the West African countries
are at the early stages of nutrition transition but countries such as Cape Verde, Ghana
and Senegal are at the latter stages. In the major cities of the region, children consume
energy-dense foods such as candies, ice cream and sweetened beverages up to seven times
as frequently as fruit and vegetables. Adult obesity rates have increased by 115 % in
15 years since 2004. In Ghana, the prevalence of overweight/obesity in women has increased
from 12·8 % in 1993 to 29·9 % in 2008. In Accra, overweight/obesity in women has increased
from 62·2 % in 2003 to 64·9 % in 2009. The age-standardised proportion of adults who engage
in adequate levels of physical activity ranges from 46·8 % in Mali to 94·7 % in Benin.
The lingering stunting in children and the rising overweight in adults have resulted to a dual
burden of malnutrition affecting 16·2 % of mother–child pairs in Cotonou. The prevalence
of hypertension has been increased and ranges from 17·6 % in Burkina Faso to 38·7 % in
Cape Verde. The prevalence is higher in the cities: 40·2 % in Ougadougou, 46·0 % in
St Louis and 54·6 % in Accra. The prevalence of diabetes ranges from 2·5 to 7·9 % but
could be as high as 17·9 % in Dakar, Senegal. The consequences of nutrition transition
are not only being felt by the persons in the high socioeconomic class, but also in cities
such as Accra and Ouagadougou, where at least 19 % of adults from the poorest households
are overweight and 19–28 % have hypertension. Concerted national action involving governments,
partners, private sector and civil society is needed to re-orient health systems and
build capacity to address the dual burden of malnutrition, to regulate the food and beverage
industry and to encourage healthy eating throughout the life course