Feasibility of a Culturally Adapted Dietary Weight-Loss Intervention among Ghanaian Migrants in Berlin, Germany: The ADAPT Study

• Main Authors: Stephen Amoah, Ruth Ennin, Karen Sagoe, Astrid Steinbrecher, Tobias Pischon, Frank P. Mockenhaupt, Ina Danquah
• Format: Article
• Language: English
• Published: MDPI AG 2021-01-01
• Series: International Journal of Environmental Research and Public Health
• Subjects: obesity; weight loss; diet; lifestyle; African migrants; Germany
• Online Access: https://www.mdpi.com/1660-4601/18/2/510
• ISSN: 1661-7827; 1660-4601

Background: Dietary weight-loss interventions often fail among migrant populations. We investigated the practicability and acceptability of a culturally adapted dietary weight-loss intervention among Ghanaian migrants in Berlin. Methods: The national guidelines for the treatment of adiposity were adapted to the cultural characteristics of the target population, aiming at weight-loss of ≥2.5 kg in 3 months using food-based dietary recommendations. We invited 93 individuals of Ghanaian descent with overweight or obesity to participate in a 12-weeks intervention. The culturally adapted intervention included a Ghanaian dietician and research team, one session of dietary counselling, three home-based cooking sessions with focus on traditional Ghanaian foods, weekly smart-phone reminders, and monthly monitoring of diet and physical activity. We applied a 7-domains acceptability questionnaire and determined changes in anthropometric measures during clinic-based examinations at baseline and after the intervention. Results: Of the 93 invitees, five participants and four family volunteers completed the study. Reasons for non-participation were changed residence (13%), lack of time to attend examinations (10%), and no interest (9%); 64% did not want to give any reason. The intervention was highly accepted among the participants (mean range: 5.3–6.0 of a 6-points Likert scale). Over the 12 weeks, median weight-loss reached −0.6 kg (range: +0.5, −3.6 kg); the diet was rich in meats but low in convenience foods. The median contribution of fat to daily energy intake was 24% (range: 16–40%). Conclusions: Acceptance of our invitation to the intervention was poor but, once initiated, compliance was good. Assessment centers in the participants’ vicinity and early stakeholder involvement might facilitate improved acceptance of the invitation. A randomized controlled trial is required to determine the actual effects of the intervention.