Health Behaviors and Diet Quality Among Adults in Southern Togo: A Cross-sectional Study

Objective : To assess the association between selected health behaviors, particularly physical activity, alcohol consumption, and smoking, and dietary quality among adults living in southern Togo. Methods : A cross-sectional study was conducted from September 12 to November 30, 2025, among 1,181 adults, including 990 urban and 191 rural residents. Data were collected using a digital questionnaire administered via the KoboToolbox platform. Diet quality was assessed using a composite score based on the consumption of ten food groups. The score ranged from 3 to 9, with a mean of 7.54 ± 1.12 and a median of 8. Participants were classified as having high diet quality (score ≥ 8) or low diet quality (score < 8). Associations between health behaviors and diet quality were examined using bivariate analyses, Pearson correlations, and multiple linear regression adjusted for key sociodemographic characteristics. Results : A weak but positive association was observed between alcohol consumption and diet quality (r = 0.119; 95% CI: 0.063-0.175; p < 0.001). This association remained significant after adjustment in the multivariate model (β = 0.314; p < 0.001). In contrast, no statistically significant association was found between physical activity and diet quality (r = −0.033; p = 0.256), or between tobacco use and diet quality (r = −0.005; p = 0.853). Conclusion : Among the adults studied in southern Togo, alcohol consumption was weakly associated with better diet quality, whereas physical activity and tobacco use were not significantly associated with the diet quality score. These findings suggest that the health behaviors considered are not necessarily interdependent in this population, and that diet quality may be influenced by other sociodemographic, economic, and cultural determinants. However, the cross-sectional design does not allow for causal inference.