Fitbug - Company Health Report

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1 Fitbug - Company Health Report Prepared for COMPANY ABC October 2008 For more information, please contact Jen Spencer on or in association with

2 Contents Introduction Health Profile Overview Part 1 Fitbug Lab Results Health Risk Factors Definition of Medical Ranges Body Composition Body Mass Index Blood Pressure Resting Heart Rate Part 2 Activity Reports Definition of Activity ranges Group Activity Report Activity report by gender Activity report by department Member logging in report Member usage report

3 Health Profile Overview Thank you for choosing Fitbug as your partner in increasing staff wellness. To your staff, Fitbug provides an online health and well-being coach that motivates them to achieve exercise and nutrition targets and gives them specific information on the latest trends in health and fitness. To you, the employer, Fitbug is a partner in monitoring and improving the health of your staff. The use of Fitbug demonstrates your commitment to your people, thus making it easier to recruit, retain and motivate your staff. This report was compiled using data from the Fitbug Lab combined with employee activity and usage for the duration of the trial. We have compared baseline results from the kiosk test to a second test taken at the end of the trial. The data comparison report is based on the 99 employees who took both tests. The Department of Health recommends that all adults should walk 10,000 steps per day (roughly 3-4 miles or 7km) in order to maintain good health. According to the BBC, adults in the UK take an average 3-4,000 steps per day demonstrating a specific need for programmes and incentives which encourage increases in physical activity.

4 Definition of Health Metric Ranges

5 Body Fat Percentage Overall The body fat percentage measures the percentage of body weight which is composed of fat. The healthy level of body fat will depend on your age and sex women naturally have a higher percentage of body fat than men At the start of the pilot almost 80% of employees had a higher than desirable level of body fat. As can be seen from the final test, there has been a significant reduction in levels of body fat over the pilot and the number of employees with a high level of body fat has dropped by 13%. This is an extremely positive outcome due to the relationship between body fat and risk from chronic disease, particularly in those who store adipose tissue centrally A reduction in body fat can be achieved by reducing energy in (calories) and increasing energy out (physical activity). Increasing activity levels will also help to preserve and increase lean muscle tissue improving overall body composition. In relation to energy in, the Fitbug nutrition pages are designed to educate individuals about the nutrients which make up the largest proportions of their diet and the areas in which they can make changes to improve the overall composition of their diet. Encouraging engagement in diet is important in order to achieve the maximum benefits from the Fitbug programme. Eight percent of employees have body fat percentage that fall under the healthy range. Those who are naturally lean and healthy probably don t need to worry but those who have been actively trying to lose weight should be encouraged to maintain weight by eating a well balanced diet to ensure they obtain all the nutrients they require.

6 Body Fat Percentage Gender Breakdown Male Over the pilot duration there has been a significant reduction (17%) in the number of male participants with a higher than desirable level of body fat indicating an overall improvement in body composition. Female participants showed more moderate progress with 5% reduction in those with a high level of body fat. Positively, a further 3% moved from the under healthy range to the recommended healthy range. Female Since women naturally have a higher percentage of body fat, a lower percentage of lean muscle tissue (impacting on their ability to burn calories) and a lesser capacity to increase lean muscle, reductions in body fat will be slower than those observed in men Continued reductions in body fat should be encouraged to improve overall body composition and reduce the risks associated with a high level of body fat.

7 Body Mass Index Overall Being overweight or obese carries significant health risks such as increased risk of heart disease, stroke, type 2 diabetes, increased blood pressure and some cancers; therefore, it is important to keep one s weight within the healthy range. BMI or body mass index uses individuals height and weight to determine whether their weight is within the healthy range. BMI (Av.) At the start of the pilot, 62% of all employees were categorised as overweight or obese. In the final test we see this has reduced to 60%, but with an 8% increase in the number of participants classed as obese. However, since this has been observed alongside reductions in body fat it reflects an overall increase in lean muscle tissue. Certainly one of the limitations of BMI is its inability to discriminate between lean and fat mass and using BMI alongside other measures (such as body fat and waist circumference) is necessary to gain a more accurate picture of body composition Overall, the decrease in body fat coupled with the slight increase in average BMI is a positive trend in terms of body composition and as a whole, mean BMI has increased by just 0.1 unit reflecting just marginal increases in weight. Employees should be encouraged to maintain and continue these changes with this trend to burn more fat, gain more lean mass, and lose overall weight. Whilst gains in lean tissue are of benefit, future efforts should concentrate on reducing calorie intake to support weight loss efforts alongside continued increases in activity levels. 29

8 Body Mass Index Gender Breakdown Male Rates of overweight and obesity are fairly similar between male and female employees and as seen in the overall results there has been a increase in the number of both males and females in the obese category once again this can be explained by an increase in lean tissue as indicated by the drop in body fat percentage. To encourage further reductions in body fat and body weight future initiatives should focus on the importance of diet in weight management and should emphasise reductions in the consumption of energy dense foods to support weight loss. Female Whilst BMI is a useful measure of obesity it should be assessed in conjunction with other measures to appreciate changes in body composition particularly in weight loss programmes which encompass exercise as increases in fat free mass can negate weight loss from reductions in body fat

9 Blood Pressure Overall The Blood Pressure Association states that high blood pressure affects over 16 million people in the UK. The higher your blood pressure, the greater your risk of stroke, heart attack and heart failure. It is thought that of the people in the population with high blood pressure, only about half have this diagnosed, and only half of these are properly treated. Early and appropriate treatment will be valuable in reducing the risk of heart disease and stroke in the working population At the start of the pilot 46% of employees had a blood pressure reading which fell into the hypertensive range. At the end of the pilot we see the number of employees falling within the hypertensive category has dropped by 25%, from 46% to 21%. This an extremely positive change which will confer significant benefit to health research shows that even modest reductions in blood pressure substantially reduce cardiovascular risk. 18 Future initiatives should focus on the impact of activity and a diet on blood pressure since 42% of employees blood pressure levels still exceed the optimal range. Although a single measurement is not sufficient to diagnose hypertension, it is advisable that these employees are encouraged to monitor their blood pressure to track consistent high readings which may require medical attention and to encourage positive lifestyle changes which will help to reduce their readings. 21 Since the relationship between blood pressure and cardiovascular risk is strong and graded even within what is considered the normal range, all employees could further benefit from lifestyle changes which will help to reduce their blood pressure Increasing activity levels, reaching a healthy weight, increasing fruit and vegetable consumption and reducing salt intake are the key lifestyle modifications promoted by Fitbug which will have a positive impact on blood pressure. 21

10 Blood Pressure Gender Breakdown Male At the start of the pilot over 40% of male employees and over 50% of female employees had a blood pressure reading which fell into the hypertensive range. At the end of the pilot we see there have been significant reductions in the percentage of both male and female employees with hypertensive readings with a 21% and 32% reduction respectively. Female Future initiatives should focus on those employees whose blood pressure still falls within the hypertensive range whilst supporting continuing reductions in all employees since even those who fall within the normal range can benefit from lowering their blood pressure. Employees should be encouraged to monitor their blood pressure regularly and know their numbers to promote health awareness and support healthy behaviours. Regular monitoring will also help to demonstrate the positive benefits of increased activity and dietary modification. 7 5

11 Resting Heart Rate Overall Resting heart rate measures the number of times the heart beats per minute when the body is at rest. Resting heart rate is used as a measure of overall fitness a low resting heart rate indicates a high level of fitness because the heart becomes more efficient with repeated exercise At the start of the pilot around 40% of employees had an elevated resting heart rate. As can be seen from the results of the final test there has been a slight increase in the number of employees with an elevated heart rate, and a drop in those falling into the athletic range. However, since we have observed an overall reduction in blood pressure it is likely that the changes seen are due to external factors - whilst heart rate can be an effective parameter with which to assess fitness there are many factors (such as caffeine and stress) which can produce variations. Indeed it is recognised that day to day variability in heart rate is up to 40% and in addition, anxiety caused by testing itself can cause tachycardia. In addition we see that overall, the average increase has been very slight less than 2bpm. Repeated tests can reduce variability and encouraging employees to avoid caffeine and take a 5 minute rest period prior to testing can improve the reliability and usefulness of this measure. RHR (Av.) Continuing to promote moderate intensity activity such as walking will improve resting heart rate and regular testing will increase awareness and allow employees to track improvements

12 Resting Heart Rate Gender Breakdown Male At the start of the pilot over one third of female employees and around 40% of male employees had a resting heart rate above the optimal level As seen with the overall test results we see that both groups have shown an increase in the percentage of those falling into the elevated range. Female However, as previously discussed this is likely to be as a result of external influences, particularly since substantial reductions in blood pressure have been observed. Continued monitoring of RHR will provide a more accurate and long-term picture of changes encouraging employees to avoid stimulants and to relax prior to testing will help to improve reliability, and as they become more familiar with the procedure, associated anxiety will decrease

13 Definition of Activity metric ranges

14 Activity Data Fantasy footfall competition *graph is by calendar week Race to Paris Employee activity started at an average of about 8,000 steps at the start of the trial. However, this is likely to be an overestimation of true activity levels since members often walk more in the first week (despite Fitbug telling members to do as little as possible!) as they quickly become engaged in the programme and want to make changes to their activity levels. What is apparent from the data is that interventions throughout the programme were correlated with increases in activity levels demonstrating the importance of competition and reward. More significantly we notice that the greater the value of the reward, the higher the engagement and increase in activity. Positively, members have continued to use the Bug after the trial ended (wk33)

15 Activity Data - from baseline week Fantasy footfall competition Fantasy footfall competition Race to Paris Race to Paris The first graph (left, above) shows average steps of the entire group from baseline week (week 1) to the end of the trial. As we see there is a natural increase in the first few weeks of membership when engagement and interest in the programme are high. An intervention in the second month helped to re-engage the initial buzz and at the mid point of the trial (week 18) there is an increase in activity of approximately 20%. At the end of the trial we seen there has been a 35% increase in activity from baseline to final week an extremely positive outcome with an average increase of almost 3,000 steps. This demonstrates a steady but significant increase with peaks and troughs as observed in our average member. The second graph (left, below) tracks a sample of 30 people who were consistent users throughout the entire pilot. Once again a steady improvement in activity is observed with an overall increase of 22% from week 1 to the end of trial. *selected 30

16 Activity Data Fantasy footfall competition Fantasy footfall competition Race to Paris Race to Paris Employees falling into the sedentary category showed a significant and steady improvement from the beginning to just beyond the midpoint of the trial where average steps had increase by almost 3,000 per day. Following this midpoint there was a decline in activity and it is clear that engagement was reduced at this point. However, the ability of an intervention to re-engage employees was proved towards the end of the trial with the Race to Paris challenge where we see a significant spike in activity to almost 10,000 steps a huge improvement for employees whose average steps were just over 4,000 at the start of the programme. Those in the low active category showed increases at the start of the programme which tailored off but were picked up by the midpoint. As observed in the sedentary group there was a decline around week 20 which was quickly followed by a large increase in activity as a result of the Race to Paris challenge.

17 Activity Data Fantasy footfall competition Fantasy footfall competition Race to Paris Race to Paris Those in the somewhat active and active groups showed peaks and troughs in activity throughout the pilot. Although there were increases in activity as a result of the fantasy footfall and Race to Paris challenge these were not as great as those seen in the sedentary and low active groups due to the higher level of activity sustained throughout. It is expected that increases in activity in those individuals who are already active will be less pronounced as the capacity to increase steps as a result of reasonable changes to lifestyle is smaller. It is important to encourage those who are already active to maintain their activity levels but also to now focus on improving other areas of health such as diet which also contributes to overall risk.

18 Activity Data Fantasy footfall competition Race to Paris Employees in the highly active group were doing over 14,000 steps per day from week 1. Like all members, they have displayed natural peaks and troughs throughout the trial but its unrealistic to expect significant increases in this group as they are already highly active. With this group its important to focus on the impact of other lifestyle factors such as diet and stress. It s important to recognise that activity is only one half of the overall energy balance.

19 Activity Data by Department A B C D D E F G I

20 Members data sent report Member usage was predictably high when Fitbug first launched. As the initial excitement faded, usage dropped but then became sustained which is in line with our expectations. An average of 40% of all members continued to upload throughout the trial. Unfortunately there were technical problems with the kiosk at the end and therefore usage dropped off.

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