Company TA LIFESTYLE CHALLENGE ANALYSIS 2016

Introduction

After a year’s break, Company TA chose to revert back to focusing employee health on reducing

the risks of diabetes, hypertension, hypercholesterolemia and heart disease, by focusing on

dietary behaviour of employees.

The project was run over a period of 12 weeks, with follow up consultations. All participants

were screened for total cholesterol, blood pressure and had their blood lipids analysed. A total

of 80 employees joined the challenge. Of these, nearly half completed the full 12 weeks of the

challenge, approximately the benchmark for challenges like this. For this report we focus only

on the results of people who completed the challenge.

The results are as follows:

Results

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High BMI Low HDL High LDL HighTriglicerides

Hypertension Highcholesterol

Pre-diabetes Type VHyperlip

High heartrisk ratio

Unidentifiedlipid risk*

2016 Start 70.6% 14.7% 11.8% 64.7% 50.0% 17.6% 47.1% 32.4% 11.8% 64.7%

After 12 weeks 64.7% 5.9% 2.9% 29.4% 35.3% 0.0% 23.5% 23.5% 8.8% 29.4%

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TOTAL SA Lifestyle challenge results

Analysis:

1. 71% initially had a Body Mass Index (BMI) that indicated that they were either overweight

(35.5%) or obese (35.5%). After the initiative, we saw a reduction to 65%, with 35% of

challengers now being overweight and 29% obese. This is a good improvement. Clearly

6% of the challengers managed to reduce their weight to normal levels, while 6% reduced

from being classified as clinically obese, to merely being overweight. This is a good result

in the right direction. As many of the challengers who completed the 12 weeks indicated

that they plan to continue with the eating plans, and so we can expect further

improvements on this measurement. Average BMI of all the challengers was brought

down from 29.2 to 28.2.

2. While 18% tested high for total cholesterol, 82% actually had one- or more problems with

their blood lipids. After completing the challenge, we had no challengers who showed

high total cholesterol, and only 32% of returning challengers now still had problems with

their blood lipids. This is a massive improvement.

3. Of the people with blood lipid problems, 15% had HDL (“good cholesterol”) levels that

were too low. After 12 weeks, only 6% still had this risk. High HDL levels have been

proven to substantially reduce the risk of cardiac events, and go a long way towards

protecting patients from the impacts of high LDL (bad) cholesterol levels.

4. 12% had LDL (“bad cholesterol”) levels that were too high. For the first time in the three

years that the challenge has been run in this format, we have seen substantial

improvements, with only 3% of returning challengers still having high LDL levels.

5. 65% had high triglycerides, the lipid that, in combination with other factors, points to

substantially increased risk of diabetes and heart disease. This percentage was more than

halved to 29%. As triglycerides carry fat in the blood stream, this improvement should

have long lasting effect on heart health, and should lead to future reductions in the LDL’s

as well, a process that takes time. Further improvement can be expected if challengers

keep following the diets.

6. 50% suffered from hypertension, i.e. blood pressure readings that are higher than the

normal range. Again, for the first time in the three challenges, we see a substantial

improvement here, with only 35% of challengers still exhibiting hypertension at the end

of the challenge. It would appear that returning to the current premises have played a

part in the improvement, but also diets that were even more focused on specifically

reducing hypertension, and the general improvement in BMI, have worked together to

bring about this improvement. While not all cases of hypertension can be solved by

dietary adjustments, most respond well to a change in lifestyle as was advocated by this

programme.

7. Adding the risk factors together, 12% of the people tested had a heart attack/stroke risk

ratio > 4, which indicates an elevated risk of heart attacks, stroke and other heart disease.

This percentage improved to 9%. This can be ascribed to a combination of the much

improved HDL, LDL and Triglyceride levels, as well as the reduction in incidences of

hypertension. The potential trauma- and financial savings to Company TA that exist in

reducing these risks is immeasurable.

8. 47% of challengers could be said to be pre-diabetic already with a substantial risk of

developing diabetes in the foreseeable future at the start of the program. The

intervention reduced this number to only 23.5%, an excellent result in such a short

period. Pre-diabetes was reduced by half!

9. Another 18%, while not pre-diabetic yet, have blood lipid profiles that point to them being

well on their way to becoming pre-diabetic. This was halved to 9% at the end of the

challenge.

10. Average body fat % was reduced from 33.5% to 31.7%.

What does this mean?

The risk of heart disease, stroke and/or diabetes to Company TA employees has been reduced

substantially through the intervention of this programme.

Instead of 65% of the employees tested who are at elevated risk, of which 16% was at a serious

risk of developing heart disease, this was reduced to 38%, with only 9% still at serious risk of

developing heart disease.

Continued- and sustained focus on these factors will have long ranging benefits to employees as

well as to Company TA.

How does this compare to previous years?

In most instances, the starting points were very similar for each challenge. We have seen gradual

improvements in HDL levels, with a concomitant reduction in heart risk ratios, both of which are

good indications.

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High BMI Low HDL High LDL HighTriglicerides

Hypertension Highcholesterol

Pre-diabetes Type VHyperlip

High heart riskratio

Unidentifiedlipid risk*

2013 start 74.7% 35.2% 15.4% 65.9% 50.5% 7.7% 56.0% 38.5% 40.7% 71.4%

2014 start 79.1% 18.6% 16.3% 62.8% 58.1% 16.3% 60.5% 44.2% 27.9% 55.8%

2016 Start 70.6% 14.7% 11.8% 64.7% 50.0% 17.6% 47.1% 32.4% 11.8% 64.7%

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TOTAL SA Lifestyle initial comparisons

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High BMI Low HDL High LDL HighTriglicerides

Hypertension Highcholesterol

Pre-diabetes Type VHyperlip

High heart riskratio

Unidentifiedlipid risk*

2013 69.4% 32.3% 21.0% 38.7% 53.2% 8.1% 37.1% 24.2% 25.8% 51.6%

2014 76.7% 20.9% 20.9% 53.5% 55.8% 11.6% 32.6% 20.9% 18.6% 55.8%

2016 64.7% 5.9% 2.9% 29.4% 35.3% 0.0% 23.5% 23.5% 8.8% 29.4%

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TOTAL SA Lifestyle challenge results comparison

We have seen progressively better results over the three years, with 2016 showing the best

improvements. In each of the areas measured, the final results were better than after either of

the previous challenges. With the exception of Type-V hyperlipidaemia risk, all other indicators

are showing excellent trends. It would appear that the cumulative effects of the programmes

over the years, including the raised awareness amongst staff, are starting to pay off. What is

particularly heartening is the fact that Hypertension started showing positive results. Also, the

big reduction in incidence of unidentified diabetic risk points to a much improved position as far

as the health of these employees are concerned.

More research will be done about the impact of dietary behaviour on the incidence of Type-V

hyperlipidaemia, to work towards improving also this incidence in future repetitions of this

programme.

Conclusion and recommendations

Clearly the challenge has made a substantially positive difference to the lives of the challengers.

All of them indicated that they would continue with the change in lifestyle that was provided for

them, and are enthusiastic to repeat this programme should Company TA decide to re-run it

again next year. While a number of challengers have taken part in all three the challenges, every

year brings a substantial number of new challengers, as the word spreads of the beneficial impact

this has on everyday life. If the programme is repeated in future, more and more reliable data

will become available to assist in improving the wellness of Company TA employees.

The enthusiasm from the team was generally high, and a large number indicated that they

realised how easy it is to improve their quality of life and protect their hearts at the same time,

without starving themselves or going overboard with exercise programmes.

How do we achieve a higher return rate? Two possible answer spring to mind:

1. Offer and brand the programme as an initiative rather than a challenge/competition. This

may take the pressure and fear of failure out of the picture, and should result in more

people being comfortable to return for the sake of their own health. As results will not

be shared with anyone, except in a consolidated format such as this, no one need fear

ridicule for possibly not achieving as much as they set out to do.

2. At other companies where we have run similar challenges, the companies had challengers

commit beforehand to repay at least part of the cost of the programme to the company

should they fail to complete the challenge. This has generally resulted in 90% plus return

rates. It also served to eliminate chancers and the people who are simply out to take

anything they perceive to be free.

Motivation was good during the programme, and the three week intervals seem to inspire

challengers who were serious, to perform even better. It is a pity that a large number of

challengers proceeded through most of the programme, and then somehow could not manage

to attend on one of the three days put aside for the final measurements. Judging on interim

results, we might have seen even better final results.

This year we had more patients who did not need to lose weight, but who simply wanted to

maintain, or even gain some weight. It must be noted that, even amongst these, there were still

incidences of prediabetes present that had to be addressed. It is a good sign that employees

seem to realise that this is not primarily about weight loss, but about wellness and a lifestyle

improvement.

Continued improvements could be expected with the continuation of the program.

An added lifestyle recommendation The following scientific article was published in 2016, which may add value to any wellness

program:

Trappe H-J, Voit G: The cardiovascular effect of musical genres—a randomized

controlled study on the effect of compositions by W A Mozart, J Strauss and ABBA.

Dtsch Arztebl Int 2016; 113: 347-52. DOI:10.3238/arztebl.2016.0347

The findings of the experiment conducted in the article showed that listening to classical music

maestros Wolfgang Mozart and Johann Strauss (but not ABBA) for 25 minutes could lower

blood pressure, heart rate and cortisol concentrations in the blood stream. Lowered cortisol levels

have an impact on reducing stress and blood lipid levels.

The music used is listed in Table 2 below.

The recommendation is that employees receive 25 minutes or more of the listed music in daily,

25 minute doses, in addition to paying attention to internal mechanisms such as nutritional and

exercise lifestyle habits.