Dietary patterns among adults in sub-Saharan Africa are shaped by food groups and contextual influences: a systematic review.

Nutrition transition in sub-Saharan Africa (SSA) is accompanied by significant changes in dietary intakes. This systematic review reported data-driven dietary patterns (DPs) and their associations with health outcomes and sociodemographic factors among adults in SSA. Observational studies published between January 1990 and December 2024 were retrieved from Web of Science, EMBASE, PubMed, Google Scholar, African Journals Online, Semantic Scholar, and African Index Medicus, between January 29 and 31, 2025. Non-English articles and studies exclusively including diet-modified adults were excluded. Quality of studies was assessed using the NHLBI quality assessment tool. Narrative synthesis of findings from 24 studies out of 2630 retrieved was conducted. Two broad themes of DPs emerged: food group-based (carbohydrate, proteins, fruits/vegetables, assorted foods and snacks/beverages-based patterns) and context-based (traditional, Western, healthy, and transitional-based patterns). Healthy, fruit- and vegetable-based DPs were inversely associated with obesity, hypertension, and diabetes, whereas Western, snack/beverage-, carbohydrate-, fat-, and protein-based patterns were associated with chronic disease outcomes. Traditional DPs were also linked to obesity. Women, younger adults, urban residents, and individuals with higher education showed greater adherence to Western DPs, whereas rural and lower socioeconomic groups adhered more to traditional DPs. The coexistence of traditional and Western DPs, alongside the predominance of individual food groups, highlights an ongoing nutrition transition, increasing vulnerability to noncommunicable diseases in SSA. Underrepresentation of some subregions and countries in the available evidence may limit the generalizability and policy relevance of these findings across SSA. There is, therefore, a need to scale up research on data-driven DPs to inform region-specific nutrition policies and promote healthier dietary intake across SSA.