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Table 1 Objective, key message and learning outcome of EPaL topics

From: School-based intervention to prevent overweight and disordered eating in secondary school Malaysian adolescents: a study protocol

Topics and aims Key message Content
Topic 1
Know Your Body Image and Body Weight Status
 • To promote positive body image.
 • To promote healthy body weight status.
Achieve positive body image and healthy body weight status • Presentation:
 - 5 simple steps to determining body weight status:
  1. Measure weight.
  2. Measure height.
  3. Calculate age in years and months.
  4. Calculate body mass index using the given formula.
  5. Mark the value of BMI and age on the BMI-for-age chart.
 - Things to do after determining your own body weight status.
 - Body image discussion.
  ▪ Effects of negative body image.
  ▪ Definition and effects of positive body image.
• Activities:
 - Measure height and weight; calculate age and BMI; and determine your own body weight status.
 - Compare your own body size perception with actual body weight status and learn about your own body image.
Topic 2
Achieve Healthy Body Weight
 • To identify the concept of energy balance.
 • To describe ways to eat regularly at specified times during the day.
Understand the needs of your own body and achieve energy balance by eating nutritious foods regularly at specified times during the day. • Presentation:
 - Energy balance model.
  ▪ Ways to achieve energy balance in daily life.
 - Recommend walking for 10000 steps a day.
  ▪ Advantages of achieving 10000 steps a day.
  ▪ Type and duration of exercises comparable to walking 10000 steps.
 - Introduce 5 main meals: breakfast, morning snack, lunch, afternoon snack and dinner.
  ▪ Recommended time to consume main meals.
  ▪ Advantages of eating at specified time points.
• Activities:
 - Introduce the pedometer and discuss how to use it.
 - Perform physical activity and read the number of steps counted by the pedometer.
 - Participants share when they usually consume the main meals and peer educators share the recommended time points for main meals during the day.
Topic 3
Follow the Malaysian Food Pyramid
 • To eat in a way that conforms to the concept of SPS (S: seimbang/ balance, P: pelbagai/ variety, S: sederhana/ moderation) and the Malaysian Food Pyramid.
 • To plan daily menus according to the suggested serving size.
Have balance in food, a variety and eat in moderation to stay healthy. • Presentation:
 - Malaysian Food Pyramid: food groups in each level and recommended serving size for each food group.
• Activities:
 - Station game with each station referring to a food group. Interactive activities and hands-on skills related to the respective food group in every station.
 - Menu planning for one day.
Topic 4
Active according to Physical Activity Pyramid
 • To reducing screen-viewing time.
 • To increase daily physical activity following the Physical Activity Pyramid.
Reduce screen time and increase physical activity to be healthy and brilliant adolescents. • Presentation:
 - Physical Activity Pyramid: physical activities of every level and recommended frequencies.
 - Definition and examples of sedentary activities.
 - Screen time to be limited to 2 h daily.
• Activities:
 - Match the physical activity with the frequency in the respective level using an empty Physical Activity Pyramid.
 - Modify a daily activity for a more active lifestyle by cutting screen time and using the extra time to be active.
 - Groups of participants race to perform physical activities shown in the Physical Activity Pyramid upon stepping on the pyramid levels drawn on the floor.
 - Wear pedometer during activities and check the steps count after finishing.
Topic 5
Choose Your Food Wisely
 • To choose healthier foods and beverages by comparing product labels.
 • To order healthier food and beverages when eating out.
Choose healthier foods based on nutrition labels and cooking methods. Healthy food is not only delicious but also good for your health! • Presentation:
 - Food labelling.
  ▪ Information on food labels.
  ▪ Steps to read a food label.
  ▪ Steps to read the nutrition information panel.
  ▪ Ways to compare and purchase foods and beverages based on the information on the labels.
 - Tips for healthy eating when eating out.
• Activities:
 - Comparing foods and beverages by consulting the product label. Choose healthier products to purchase.
 - Order healthier foods and beverages from a restaurant’s menu.
Topic 6
Move Actively Anywhere!
 • To increase physical activity by exercising according to the recommendations of the physical activity pyramid.
 • To do fun exercise.
Be active as much as possible, anywhere! • Presentation:
 - Types of exercises to be performed indoors, especially at home or while sitting.
 - Advantages of a healthy lifestyle.
 - How to warm up before an exercise and cool down afterwards.
• Activities:
 - Groups of students race to do physical activities fixed for every check point provided.
 - Aerobic exercise.
 - Wear pedometer during the activity and check the steps count upon finishing.
Topic 7
Handle Perceptions Wisely, Accept the Uniqueness of Every Individual
 • To identify ways to handle perceptions about one’s own body.
 • To accept the uniqueness and qualities of you and others.
Practice to achieve positive body image:
 i) Handle body perceptions wisely
 ii) Realize the uniqueness of others.
• Presentation:
 - Ways to handle perceptions and dissatisfaction with your own body.
 - Ways to prevent comparing between one’s own body and others’.
• Activities:
 - List your physical characteristics and identify what others like about their bodies and qualities they are not satisfied with (if any).
 - Perform role-play to master ways to respond to statements of dissatisfaction by others.
 - Identify the qualities of a successful person.
 - Identify the similarities among your group members, as well their specific strengths and unique qualities. Share your findings with the other group members.
Topic 8
Happy Practicing EPaL Lifestyle!
 • To identify obstacles and solutions in relation to adopting a healthy lifestyle.
 • To enhance confidence in relation to adopting an EPaL-compliant lifestyle.
Happy practicing of EPaL lifestyle by eating healthy and balanced food, maintain a positive body image and an active lifestyle. • Presentation:
 - Ways to gain confidence to maintain an EPaL lifestyle on the long run.
• Activities:
 - Sharing the changes participants made over the course of this intervention.
 - Sharing the obstacles participants faced when practicing what they learnt in the EPaL programme.
 - In groups, participants recall one health message taken from EPaL and convey it to others.
 - Oath taking to adopt an EPaL-compliant lifestyle.