1. Presented by
Joycelyn Adinkrah
Faculty of Life Sciences
Assessment of dietary intake and body composition
among first generation
migrant Ghanaians living in London

2.  African and Afro-Caribbean migrants
have a higher prevalence of obesity,
diabetes and hypertension than the
host population.
 Dietary and anthropometric for this population are limited
primarily because of the difficulty of access.
 UK Ghanaians one of the largest ethnic groups now living in
London.
 It is estimated that the majority of first generation West African
migrants in UK are Christian and attend Church.
 The Church has been used successfully in the USA as a setting
to deliver nutrition interventions.
Introduction

3.  This study was designed to characterise the habitual dietary intake
and anthropometry of Ghanaian migrants in London.
 To use anthropometric data to assess prevalence of overweight and
obesity in migrant Ghanaians in London.
 To develop a nutrition education program specific for Ghanaian
migrants in the UK.
 To assess the efficacy of the nutrition education program through the
Black Churches in the UK.
Aims of the study

4.  The study was a cross-sectional study that recruited 18-65 year old
first generation Ghanaian migrants in the UK and Ghana.
 London - known to have a high population of Ghanaian migrants
was used as the catchment area for the study in the UK.
 Four black majority churches in London agreed to participate in the
study and two hundred and twelve volunteers (n=212) were
interviewed face-to-face.
 A sample of eighty (n=80) participants were also recruited from two
local churches in Accra (urban) and Kasoa (rural), Ghana.
Recruitment

5.  Dietary data was collected using a semi-quantitative food
frequency questionnaire (FFQ) which was validated using
repeated 24 hour recalls and 7 day records in a sub-sample
of the population.
 Anthropometric indices of height, weight, waist and hip
circumference was obtained as well as percentage body fat.
 A questionnaire was also developed to collect information on
age, gender, country of birth, marital status, occupation, and
level of education, physical activity, potential confounders
and other relevant lifestyle factors.
Methodology

6.  Three focus group interviews were held with a sample of the
study participants in both London and Ghana to find out their
perceived and ideal body shapes and sizes using the Figure
Rating Scale below.
Focus Groups

7. Sociodemography
 The population sample (n=212) was similar in terms of housing and
employment to that reported in the 2001 census for England.
 About 84% were found to have had either a secondary or tertiary
education.
Dietary Intake
 Validation of the FFQ with repeated multiple 24hr recalls showed
good agreement for energy (r=0.8), protein (r=0.61), fat (r=0.87),
and carbohydrate (r=0.71)
Population characteristics

8. Current study *NDNS (2004) **Afro-Caribbeans in UK
Nutrients Males (n=88) Females (n=124) Males Females Males Females
Energy (kcal) 2290 1852 2313 1632 2166 1853
Protein (g) 83 (14.5%) 71 (15.3%) 88.2 (16.5%) 63.7 (16.6%) 104 (14.6%) 67.7 (14.7%)
Fat (g) 86 (33.9%) 75 (36.5%) 86.5 (35.8%) 61.4 (34.9%) 79.7(31.2%) 66.9 (31.5%)
Carbohydrate (g) 296 (51.6%) 223 (48.2%) 275 (47.7%) 203 (48.5%) 304 (51.2%) 296 (31.5%)
Fibre (g) 18 17 15.2 12.6 24.9 22.4
Vitamin C (mg) 67 79 83.4 81.0
Vitamin E (mg) 10 9 10.6 8.1
Sodium (mg) 3138 2800 3313 2302
Iron (mg) 12 11 13.2 10.6
Vitamin B12 (µg) 6 4 6.5 4.8
Table 1: Dietary intake of Ghanaian migrants in
London
* NDNS National Diet and Nutrition Survey
** Sharma et al, 1998

9. Prevalence of overweight and obesity in
Ghanaian migrants in London

10.  The idea that Ghanaian men preferred women who were overweight was
found not consistent with our findings from focus groups conducted in
Ghana and London.
 For health reasons, first generation Ghanaians wanted to have smaller
body sizes whereas native Ghanaians wanted to be slim to look more
beautiful and also to be accepted in the society.
 The majority of overweight and obese Ghanaian women in London were
receptive to the proposal of a six week nutrition education programme to
be delivered through their Church.
Cultural perceptions on body image

11.  In collaboration with Prof McCarthy’s London Metropolitan weight
management programme a nutrition education program is being
developed specific for UK Ghanaians.
 Topics will include
• Portion sizes, Food labelling
• Getting active, Setting realistic Weight loss goals, Keeping motivated
and Maintaining your weight
• Planning your meals/Shopping, Hunger strategies and Eating out
• Decreasing your Salt/Sodium intake, Fat intake, Alcohol and Drinks and
Hidden calories
 In terms of public health, this will be a useful way to promote weight
loss, modify health behaviours and also serve as a platform to
launch nutrition intervention programs for all West Africans in the
United Kingdom.
Further work

12.  Agyemang, C., Owusu-Dabo, E., de Jonge, A., Martins, D., Ogedgbe, G. & Stronks, K.
(2008). Overweight and obesity among Ghanaian residents in The Netherlands: how
do they weigh against their urban and rural counterparts in Ghana, Public Health
Nutrition, 12(7): 909-916.
 Amoah, A.G. (2003). Obesity in adult residents of Accra, Ghana. Ethn Dis., 13(2 Supp
12):S97–S101.
 Bays, H.E., Bazata, D.D., Fox, K.M., Gandy, S., Gavin, III J.R. and Shield Study
Group. (2009). Perceived body image in men and women with type 2 diabetes
mellitus: correlation of BMI with figure rating scale. Nutr. Journal, 8:57.
 London Health Observatory. (2007). Population Groups- Ethnic Minorities London,
LHO.
 Mackintosh, M. (2005) London – the world in a city: an analysis of 2001 Census
results. Data Management and Analysis Group Briefing 2005/6.
 Office for National Statistics (2002). Census 2001- Ethnicity and Religion in England
and Wales. ONS: London
 Wagner, D.R. & Heyward, V.H. (2000). Measures of body composition in blacks and
whites: a comparative review. American Journal of Clinical Nutrition, 71:1392-1402.
References