The Effectiveness of The 10 on 10 Program Mohd Azemir Bin Mustafa Health Education Division Ministry of Health Malaysia Msc Health Education, Universiti Kebangsaan Malaysia Msc Sports Science, Universiti Teknologi MARA BA Hons (Sports Science), Universiti Teknologi MARA Health Education Division Ministry of Health Malaysia
Prevalence of obesity & overweight ≥ 18 years old (NHMS 1996, 2006, 2011, 2015)
“ A reasonable timeline for 5% to 10% weight loss is 3 to 6 months with a safe weight loss of ½ to 1kg per week ” Page 24
10 on 10 - Systematic exercise intervention program lasts for 10 weeks aim to achieve 10 kg weight loss among overweight and obese participants in Health Promotion Centre for Community (PPKK) - Combine elements of “ Practise & Compete ” involving evaluation, training with and without trainer - Complete module with schedule and microcycle every weeks - Nutrition lecture given on the first week of intervention and weekly nutritional diary monitored each weeks
PPKK Management Meeting No. 1/2015 in Penang had decided 4 PPKK initiated Program 10 on 10 in 2015 PPKK Seberang PPKK Kertih Jaya Penang Terengganu PPKK Masjid PPKK Bangi Tanah Selangor Melaka
2016 2016 PPKK Seberang Jaya PPKK Teluk Datok PPKK Sabak Bernam PPKK Masjid Tanah PPKK Kota Setar PPKK Purun PPKK Kuala Sawah PPKK Bangi PPKK Sungai Dua
9 participants achieved reduction of 10 kg in 10 weeks 2015 2015 Champion 15 kg in PPKK Seberang Jaya First Runner Up 14.8 kg in PPKK Seberang Jaya > 10 kg 6 peoples (4 men, 2 women) 10 kg 3 peoples (1 man, 2 women) > 7 kg 9 peoples > 5kg 3 peoples > 3 kg 9 peoples < 3 kg 18 peoples Total 48 peoples
15 participants achieved reduction of 10 kg in 10 weeks 2016 2016 Champion 17.8 kg in PPKK Seberang Jaya 1st Runner Up 17.6 kg in PPKK Seberang Jaya 2 nd Runner Up 17.5 kg in PPKK Masjid Tanah > 10 kg 15 peoples 6-9 kg 30 peoples < 5kg 55 peoples Static 3 peoples Increased 4 peoples Total 107 peoples
Research study PPKK Seberang Jaya, Penang “ Only 12.5 % participants achieve targeted weight reduction ” (10 on 10 Program Report 2015) Vanhees et al. (2005) Wing et al. (2011) Physical fitness lead to Although with 5% weight health benefits and reduction, it will enhance important to be measured health benefits related with in order to evaluate the blood pressure, cholesterol effectiveness of level and blood glucose intervention
Justification Avoid misunderstanding of the Support and common perception that weight optimise 10 on reduction is the only important 10 Program plan indicator to be monitored in of action in weight reduction program future
General Objective To identify the effectiveness of 10 on 10 Program on weight reduction, physical fitness, cardiovascular risk factors, and physical activity among overweight and obese participants
Specific Objective 1) To identify weight reduction before and Paired Samples t Test after intervention 2) To identify physical fitness before and after Paired Samples t Test intervention 3) To identify cardiovascular risk factors Paired Samples t Test & Wilcoxon before and after intervention Signed Rank Test 4) To identify physical activity before and after Paired Samples t Test intervention 5) To identify correlation between physical Spearman Correlation fitness changes and cardiovascular risk factors changes
Importance Identify other measurement beside weight reduction Addition to the literature review Improve effectiveness of the intervention Confirmed relationship between variables in conceptual framework Find solution to the problem
METH THODO ODOLOGY OGY
Study Technique - Pre & Post Study Location – Health Promotion Centre for Community (PPKK) Seberang Jaya, Penang Sampling – Universal Sampling Sample - 10 on 10 Program Participants Data Collection Period – 12 weeks (23rd July 2016 – 14th October 2016)
Participant Recruitment 1) Open to all 3) Not having any 5) Not pregnant Malaysian citizens physical injury age 25-40 years 6) Not have health old 4) Not involve in problems other exercise 2) BMI 25 ≥ program
Inclusion & Exclusion Criteria Exclusion Inclusion 1. Voluntarily join this 1. Having heart problem program 2. Refuse to engaged in 2. Completed 10 pre and post test weeks intervention
Data Collection Flow Chart • Briefing and Preliminary 1 • Pre-test (Fill up IPAQ-M form, Anthropometry & Physical Fitness tests) 2 • Pre-test (Fasting Blood Sugar & Fasting Serum Lipids ) 3 • Intervention (Preparation, Transition & Specific) 4 • Post-test (Fill up IPAQ-M form, Anthropometry & Physical Fitness tests) 5 • Post-test (Fasting Blood Sugar & Fasting Serum Lipids) 6
Intervention Week 1 – Aerobic Interval & Peripheral Heart Action
Week 2 – Aerobic interval & pre-exhaustion compound set
Week 3 – Fartleks & post-exhaustion compound set
Week 4 – Cross fit & circuit training
Week 5 – Fartleks & pre-exhaustion superset
Week 6 – Crossfit & antagonist superset
Week 7 – Cardio & post-exhaustion superset combination
Week 8 – Hiking in Bukit Cherok Tok Kun (Cross fit, antagonist superset & maximum repetition )
Week 9 – Combination of cardio & load, aerobic continuous & triset
Week 10 – Fast & slow cross fit & antagonist superset & triset
FIN INDING DING
Sociodemography Gender Race 1 Malay 2 5 Chinese Indian 7 9 Male Female
WEIGHT HT REDUCT UCTION ION
Weight Reduction (kg) 102 100.4 100 98 93.2 96 94 92 90 7.2 kg reduction 88 Mean Before Mean After - Successful weight reduction depending on the commitment of the participants (Garner & Wooley, 1991)
PHY HYSIC ICAL AL FITNESS TNESS
1) BODY Body Fat Percentage (%) COMPOSITION 39.9 37.3 40 39 38 37 36 Daniels et al. (2014) – Body fat percentage is an Mean Before Mean After important factor in determining the cardiovascular risk factors
Shuttle Run/VO2max 2) CARDIOVASCULAR ENDURANCE (ml/kg/min) 20.2 19.3 20.5 20 19.5 19 18.5 Mean Before Mean After Miller (2002) – Reduce risk of having an obesity and obesity related problems
3) MUSCULAR Sit Up Test (Repetition/Minute) STRENGTH & ENDURANCE 18 10 20 15 10 5 0 Mean Before Mean After
3) MUSCULAR STRENGTH Plank Test (Second) & ENDURANCE 42.8 20.4 60 40 20 0 Miller (2002) – Enable to maintain good body posture, Mean Before Mean After protecting joints and doing daily chores effectively
Sit & Reach Test (cm) 4) FLEXIBILITY 43.1 27.6 50 40 30 20 10 Chan et al. (2011) – Without good flexibility, the 0 Mean Before Mean After body will not have maximum strength and endurance
Suni et al. (2006) – Physical fitness enhance health potential for weight reduction’s program participants due to physical activity and exercise intervention
CARDIOVA VASCULAR LAR RISK FACTOR TORS
Waist Circumference (cm) 109.9 99.8 110 105 100 95 90 Mean Before Mean After 1) Janssen et al. (2004) – Individual with fat around waist have high risk to get cardiovascular diseases and diabetes
Body Mass Index (kg/m2) 37.6 38 37 35.2 36 35 34 Dudina et al. (2011) – Those with BMI > 25 are related with Mean Before Mean After deaths because of cardiovascular disease
Blood Pressure (mmHg) 127.8 117.9 130 125 120 115 110 Mean Before Mean After Kannel (1996) – Reduction of blood pressure decreasing in linear fashion (direct) with body weight reduction
Gordon et al. (2008) – Inverse Fasting Blood Sugar & Fasting Serum Lipids (mmol/L) relationship between HDL & 7.27 CHD: Increasing 0.026 mmol 8 HDL = Decreasing 2-3 % risk of CHD Nordestgaard & Varbo 7 5.89 (2014) – Adding too 4.9 5.22 6 much chalories; > risk of hypertriglyceridemia 5 3.34 3.19 Qazi & Malik (2013) – BG 4 reduction decreasing CVD risks 1.65 1.11 3 1.34 1.13 2 1 TC 0 HDL LDL BG TG Mean Before Mean After
PHYSICAL AL ACTIVI VITY
Physical Activity IPAQ-M QUESTIONNAIRE (MET-minutes/weeks) 2826.9 731.5 3000 2000 1000 0 Shepard (1995) – Other than healthy diet, Mean Before Mean After active in doing physical activity and exercise can decrease body weight in a long term
RELATIO IONSH NSHIP IP BETWEEN EEN CHANGES GES IN WEIG IGHT HT REDUCT CTIO ION N AND CHANGES GES IN CARDIOV IOVASC ASCUL ULAR AR RISK K FACTOR ORS
Spearman Correlation Variables Value p Value p Value p ∆ WC ∆ VO2max ∆ Body Weight ∆ BG 0.625 0.930 0.485 ∆ TC 0.278 0.784 0.016* (r =0.68) ∆ HDL 0.718 0.770 0.57 ∆ LDL 0.219 0.322 0.08 ∆ TG 0.752 0.346 0.346
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