Sophia D. Amenyah

Background: Research shows Black African communities in the UK maintain bicultural dietary patterns combining Westernised and African practices. However, limited research exists on older African adults, who face complex nutrition challenges owing to interacting social and cultural factors affecting health in later life. This study explored factors influencing food choices among older African adults. Methods: Using Photovoice, an innovative community-based participatory research method, 12 purposively sampled participants were given cameras to photograph their thoughts on eating well and older adults’ health. Semi-structured interviews explored the photos, with thematic analysis conducted on photos and transcripts using an inductive approach. Results: Participants averaged 62 ± 5.4 years; 75% were female, 58.3% married, 41.7% lived with family, 50% held postgraduate degrees, and 66.7% were fully employed. Key determinants included social, emotional, cultural, age-related health conditions, knowledge, accessibility, nutrition perceptions, creativity, adaptation, technology use, convenience, cost, and time. Conclusions: This research provides new insights into how older African adults manage the rich, complicated intersection of cultural identity, health needs to support nutrition in ageing. Further research into adaptive strategies, intersectional solutions on culture, health, sociality and technological innovation is warranted to inform culturally tailored age-sensitive interventions for older African adults.

Introduction: Physical inactivity remains a major risk factor for the development of non-communicable diseases. This study investigated physical activity behaviours, as well as barriers, facilitators and preferences that influence participation in a range of community-based physical activity interventions among Ghanaian adults. Methods: Adults living in six regions of Ghana completed a cross-sectional survey. Participants were recruited using a multi-stage sampling technique. Data were collected using a researcher-developed structured questionnaire, administered to participants using Kobo Toolbox, with data reported descriptively and analysed using binary logistic regression. Results: A total of 1122 out of 1164 participants completed the survey (mean age±SD=31.0±12.0; women=621). Overall, 648 (60.1%) participants engaged in ≥150 min of moderate-to-vigorous intensity physical activity (MVPA)/week, while 375 (33.4%) participants completed muscle-strengthening exercises≥twice/week. About a quarter of respondents (n=301, 26.8%) were knowledgeable about the guidelines for physical activity. Six out of ten participants expressed that social media is an effective way to encourage regular physical activity among Ghanaian adults. Over half of the participants (n=624, 55.6%) reported they would take part in physical activity interventions if offered by their place of worship and about half (n=443, 45.6%) indicated they would attend gyms/fitness centres regularly if they were more accessible and affordable in Ghana. Being male (adjusted odds ratios (AOR) 1.92, 95% CI 1.48 to 2.50), having a basic level of education (AOR 2.44, 95% CI 1.29 to 4.63) and being knowledgeable about guidelines for physical activity (AOR 1.86, 95% CI 1.37 to 2.53) were associated with higher odds of engaging in ≥150 min of MVPA per week as per guidance. These findings suggest that social media and faith-based settings may be effective contexts for promoting physical activity in Ghana. Improving accessibility and affordability of gyms/fitness centres may also increase engagement in structured and unstructured physical activity. Conclusion: This study found that a large percentage of participants were not meeting the guidance for daily physical activity. Knowledge about the guidelines for physical activity was very low and concerning. Participants expressed a strong preference for physical activity interventions to be delivered through social media channels, by healthcare professionals and in places of worship. These findings highlight the importance of leveraging these settings for promoting physical activity in Ghana.

Objective: To examine differences in fruit and vegetable intake and food insecurity between Black African and Caribbean and South Asian (Indian, Pakistani and Bangladeshi) ethnic minority groups with a White British/Irish reference population in the UK. This study was part of the TANGERINE project (nuTritional heAlth aNd aGeing in oldER ethnIc miNoritiEs). Design: Longitudinal analysis using multilevel logistic regression from Understanding Society and a cross-sectional comparison with UK Biobank. Setting: Understanding Society waves 2 (2010–2012), 5 (2013–2015), 7 (2015–2017), 9 (2017–2019) 11 (2019–2021) and 13 (2021–2023). UK Biobank baseline data (2006–2010). Participants: Understanding Society: adults aged 16 years and above (approximately 44 000 households). UK Biobank: participants aged 37–73 years (n = 502 412). Results: At wave 2, African, Caribbean, Pakistani and Bangladeshi participants in Understanding Society had lower odds of daily vegetable intake than White British/Irish participants, with Pakistanis showing the lowest intake. These disparities persisted after adjusting for socio-economic position (SEP) at individual and area levels, particularly for Caribbean and Pakistani groups. Indians consistently had higher odds of vegetable intake. Ethnic differences in fruit intake were smaller and largely attenuated by SEP adjustment. Food insecurity was more prevalent in all ethnic minority groups (except Indians) and associated with lower vegetable and fruit intake, though SEP explains more of the ethnic difference. Conclusions: Ethnic differences in fruit and vegetable intake are at least partially explained by SEP, with persistent vegetable consumption disparities after adjustment. Culturally tailored interventions addressing affordability, accessibility and SEP disparities are needed to improve dietary behaviours among minority ethnic groups.

Despite having an increased risk of developing dementia, individuals from minority ethnic communities are largely overlooked by research and dementia services and are less likely to receive timely diagnosis and appropriate support. Culturally specific programmes and policies that promote awareness and engage with minority ethnic communities around brain health and dementia are urgently needed to prevent, diagnose and support people living with dementia. In response to these challenges, we developed and evaluated the Healthy Brain Healthy Life project, a targeted culturally tailored dementia-prevention public engagement project to create dialogue and engage with minority ethnic communities around brain health and dementia. The project involved a series of co-produced, culturally tailored interactive workshops with minority ethnic communities and community organisations in the UK. Outputs, which remain an available resource, included: (a) co-produced culturally tailored information booklet; (b) a recipe book, including six recipes and information on ingredients that support brain health; and (c) digital stories from each workshop, sharing the experiences of participants and highlighting key messages on brain health. This article is a practice case study that describes the co-production process, implementation and evaluation of the workshops. The project achieved national and international impact, creating dialogue around dementia in the workshops, the local community and on social media. Here, we share the learnings from our approach as an example of best-practice in engaging minority ethnic communities to develop knowledge and understanding of this stigmatised condition to inform future research. Our lessons demonstrate the value and impact of co-production and participatory methods embedded in cultural competency to create community discussion around public health agendas and messages.

This scoping review examines the impact of community‐based food interventions on older adults’ health, well‐being, and social connectedness. As the global population ages, these interventions offer promising solutions to address health challenges older adults face, such as malnutrition, social isolation, and chronic diseases. This review finds that community‐based food interventions effectively improve older adults’ dietary quality, physical health, and mental well‐being, with more significant benefits observed when these interventions promote social bonding and foster a sense of community. Key factors contributing to success include combining multiple intervention components, such as nutritional education and physical activity. Offering culturally relevant food; incorporating interactive and sensory activities; embedding staff within interventions; including the involvement of experts; and clear goal‐setting methods, such as SMART goals, are also crucial in driving behavior change and influencing the success of interventions. These elements foster a more personalized and holistic approach to health promotion. However, barriers such as limited time for social interaction, inadequate content delivery, challenges in accessibility and affordability, and limited food variety were identified. The insights from our review are significant for stakeholders integrating community‐based food interventions into local healthcare systems, ultimately supporting healthy aging, improving the quality of life of community‐based older adults, and reducing the burden on healthcare services, with economic benefits.

Background: Life expectancy has increased globally, and, in the UK, however considerable disparities exist in health expectancy particularly for older people from low income and socially deprived backgrounds. While multiple factors contribute to health status in older age, good nutrition and being active socially and physically, remain major determinants of successful ageing. Community-based food models with multigenerational components have been proposed to reduce social isolation and loneliness and have shown potential to enhance health, wellbeing and social connectedness of older people. Objective: The aim of this scoping review is to synthesise the evidence on the impact of community-based food models on health, wellbeing and social connectedness of older people. Methods: This scoping review will be conducted according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR). Systematic literature searches will be conducted in including CINAHL complete, MEDLINE complete, Cochrane Library, PsycInfo and SocINDEX using both key word searches and medical subject headings and Scopus with key terms. Searches will include terms related to older people, communities, community-based activities, food-models, food activities, gardening, cooking classes, lunch clubs and social activities for older people. Studies will be included if they are primary intervention studies using both qualitative and quantitative data collection methods, observational studies without an intervention will be excluded. Results: A narrative review will be produced from the included studies and data synthesis will highlight the interventions strategies that have been successful or unsuccessful and their impact on the health, wellbeing and social connectedness of older people. Conclusion: The findings from this scoping review will identify gaps in the literature and provide novel insights into the development of community-based food models that positively impacts the health, wellbeing and social connectedness of older people.

Background: Obesity and unemployment are complex social and health issues with underlying causes that are interconnected. While a clear link has been established, there is lack of evidence on the underlying causal pathways and how health-related interventions could reduce obesity and unemployment using a holistic approach.Objectives: The aim of this realist synthesis was to identify the common strategies used by health-related interventions to reduce obesity, overweight and unemployment and to determine for whom and under what circumstances these interventions were successful or unsuccessful and why.Methods: A realist synthesis approach was used. Systematic literature searches were conducted in Cochrane library, Medline, SocIndex, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and PsychInfo. The evidence from included studies were synthesised into Context-Mechanism-Outcome configurations (CMOcs) to better understand when and how programmes work, for which participants and to refine the final programme theory.Results: A total of 83 articles met the inclusion criteria. 8 CMOcs elucidating the contexts of the health-related interventions, underlying mechanisms and outcomes were identified. Interventions that were tailored to the target population using multiple strategies, addressing different aspects of individual and external environments led to positive outcomes for reemployment and reduction of obesity.Conclusion: This realist synthesis presents a broad array of contexts, mechanisms underlying the success of health-related interventions to reduce obesity and unemployment. It provides novel insights and key factors that influence the success of such interventions and highlights a need for participatory and holistic approaches to maximise the effectiveness of programmes designed to reduce obesity and unemployment.Trial registration: PROSPERO 2020CRD42020219897.

We previously demonstrated that increased monoclonal antibody productivity in dihydrofolate reductase (DHFR)-amplified CHO cells correlates with phosphorylated transcription factor-cytomegalovirus (CMV) promoter interactions. In this article, we extend the characterization to include CMV promoter methylation and its influence on NFκB and CREB1 transcription factor binding to the CMV promoter in two families of DHFR-amplified CHO cell lines. CMV promoter methylation was determined using bisulfite sequencing. To overcome Sanger-sequencing limitations due to high CG bias and multiple transgenes copies, pyrosequencing was used to determine the frequency of methylated cytosines in regions proximal to and containing the NFκB and CREB1 transcription-factor consensus binding sites. Chromatin immunoprecipitation was performed to interrogate transcription factor–DNA interactions. Antibodies to CREB1 and NFκB were used to immunoprecipitate formaldehyde-crosslinked protein-DNA fractions, followed by reverse transcription quantitative real-time polymerase chain reaction to quantitate the number of copies of CMV-promoter DNA bound to the various transcription factors. The relative unmethylated fraction at the CREB1 and NFκB consensus binding sites determined by pyrosequencing was correlated with transcription factor binding as determined by chromatin immunoprecipitation. Azacytidine treatment reduced methylation in all treated samples, though not at all methylation sites, while increasing transcription. Distinct promoter methylation patterns arise upon clonal selection in different families of cell lines. In both cell line families, increased methylation was observed upon amplification. In one family, the NFκB binding-site methylation was accompanied by increased CREB1 interaction with the promoter. In the other cell line family, lower methylation frequency at the NFκB consensus binding site was accompanied by more NFκB recruitment to the promoter region.