Workplace Dietary Interventions Research Articles

Effectiveness of Workplace-Based Diet and Lifestyle Interventions on Risk Factors in Workers with Metabolic Syndrome: A Systematic Review, Meta-Analysis and Meta-Regression.

Workplace health interventions are essential to improve the health and well-being of workers and promote healthy lifestyle behaviours. We carried out a systematic review, meta-analysis and meta-regression of articles measuring the association between workplace dietary interventions and MetS risk. We recovered potentially eligible studies by searching MEDLINE, the Cochrane Library, Embase, Scopus and Web of Science, using the terms “Metabolic syndrome” and “Occupational Health”. A total of 311 references were retrieved and 13 documents were selected after applying the inclusion and exclusion criteria. Dietary interventions were grouped into six main types: basic education/counselling; specific diet/changes in diet and food intake; behavioural change/coaching; physical exercise; stress management; and internet/social networks. Most programmes included several components. The interventions considered together are beneficial, but the clinical results reflect only a minimal impact on MetS risk. According to the metaregression, the interventions with the greatest impact were those that used coaching techniques and those that promoted physical activity, leading to increased HDL (effect size = 1.58, sig = 0.043; and 2.02, 0.015, respectively) and decreased BMI (effect size = −0.79, sig = −0.009; and −0.77, 0.034, respectively). In contrast, interventions offering information on healthy habits and lifestyle had the contrary effect, leading to increased BMI (effect size = 0.78, sig = 0.006), systolic blood pressure (effect size = 4.85, sig = 0.038) and diastolic blood pressure (effect size = 3.34, sig = 0.001). It is necessary to improve the efficiency of dietary interventions aimed at lowering MetS risk in workers.

Effect of workplace dietary intervention on salt intake and sodium-to-potassium ratio of Japanese employees: A quasi-experimental study.

ObjectivesExcess salt intake is a major risk factor for hypertension and cardiovascular disease. Modifying workplace environments has been recognized to be important for reducing salt intake. However, studies examining the effects of improving the workplace environment regarding salt reduction are limited. This study aimed to evaluate the effects of workplace dietary intervention on employees' salt intake and sodium‐to‐potassium (Na/K) ratio.MethodsA quasi‐experimental study was conducted. Two small business establishments in Saitama Prefecture, Japan, were allocated as the intervention (n = 69) and comparison (n = 68) workplaces, respectively. The 1‐year intervention involving healthy lunch and nutrition education was implemented in the intervention workplace. Spot urine samples, physical assessments, and self‐administered questionnaire data were collected at baseline, 6 months, and 1 year after the start of the intervention. Analysis of covariance was conducted to investigate differences in the salt intake or Na/K ratio between the study workplaces at year 1. Educational status and rotating work schedules were included as covariates.ResultsSalt intake in the intervention workplace decreased significantly from 10.7 to 9.3 g (−1.4 g change; 95% confidence interval [CI]: “−2.4, −0.5”). The adjusted difference in changes in salt intake between workplaces was statistically significant (−3.7 g change; 95% CI: “−5.2, −2.3”). Although no significant change was observed in the Na/K ratio in the intervention workplace (3.37–3.08; −0.29 change; 95% CI: “−0.59, 0.01”), the adjusted difference in changes between the workplaces was statistically significant (−0.60 change; 95% CI: “−1.03, −0.17”).ConclusionsProviding healthy lunch and nutrition education may be effective approaches to reduce employees' salt intake and Na/K ratio.

Dietary Interventions to Promote Healthy Eating among Office Workers: A Literature Review

Our aim is to review published studies on dietary interventions to promote healthy eating habits among office workers. The databases PubMed, EBSCO (MEDLINE, Academic Search Elite, CINAHL Plus, PsycARTICLES, PsycINFO), Cochrane Library, SCOPUS, and Google Scholar were searched between February and April 2019. Initially, 6647 articles were identified, and the final number of articles that met the inclusion criteria was 25. We identified four different types of interventions that included educational and/or environmental components, where environmental components provided healthy food in a work-related context. The interventions at the offices included web-based material, availability of food, provision of information in various ways, and a combination of environmental, educational and theory-based psychological approaches (i.e., multicomponent). The most commonly used designs were web-based and information interventions, respectively, which are the least expensive ways to intervene. The interventions assessed a range of outcomes, but this literature review focused on three, i.e., dietary intake, dietary behavior and health-related outcomes. Although the studies were heterogenous in terms of outcomes, design, number of participants, gender distribution and duration, all studies reported at least one positive effect. Thus, workplace dietary interventions are an unutilized area to positively influence dietary intake and health outcomes among office workers. However, the intervention needs to be tailored to the workplace.

Impact of nutrition interventions and dietary nutrient density on productivity in the workplace.

The global spread of diet-related noncommunicable diseases represents a threat to public health and national economies alike. The elimination of poverty and the eradication of hunger, two key United Nations Sustainable Development Goals, cannot be accomplished without a well-nourished labor force. Easy access to low-cost diets that are energy dense but nutrient poor has resulted in hidden hunger, in which micronutrient deficiencies coexist with obesity or overweight. Workplace interventions in low- and middle-income countries have addressed nutrient adequacy and micronutrient deficiencies, often using fortified foods. Workplace interventions in high-income countries have largely focused on weight loss, smoking cessation, stress reduction, and physical activity. Even though improvement of productivity may have been the ultimate goal, relatively few interventions in high-income countries have explored the likely impact of improved dietary nutrient density on workplace performance. Given that optimal nutrition benefits both physical and mental health, interventions to improve diet quality ought to have a measurable impact on the productivity of the labor force. The present review examines the evidence linking workplace dietary interventions with workplace productivity measures.

The impact of a complex workplace dietary intervention on Irish employees' off-duty dietaryintakes.

A paucity of evidence exists regarding the impact of workplace dietary interventions on employees' off-duty dietary intakes. This study assessed the impact of workplace dietary interventions that included nutrition education and environmental dietary modification both alone and in combination on employees' dietary intakes inside (on-duty) and outside (off-duty) of work. A pre-post study on employees' on and off-duty dietary intakes was undertaken. Data were obtained from a complex workplace dietary intervention study (Food Choice at Work Trial). Four manufacturing workplaces were allocated to: Control (n = 111), nutrition education (n = 226), environmental dietary modification (n = 113) and nutrition education and environmental dietary modification combined (n = 400) (2013-14). Seven- to nine-month follow-up data were obtained for 517 employees (61% response) [Control (n = 67), Education (n = 107), Environment (n = 71) and Combined (n = 272)]. Dietary intakes were measured using 24-h dietary recalls. Differences between on and off-duty mean dietary intakes were compared and regression analyses adjusted for potential confounders. Significant reductions in on-duty intakes of total fat (-14.2 g/day, p = 0.000), saturated fat (-7 g/day, p = 0.000), salt (-1.4 g/day, p = 0.000) and total sugars (-8.9 g/day, p = 0.003) were observed in the Combined and in the Environment [total fat (-11.4 g/d, p = 0.017) and saturated fat (-8.8 g/day, p = 0.000)]. In the Combined, significant changes were also observed in off-duty intakes of total fat (-10.0 g/day, p = 0.001), saturated fat (-4.2 g/day, p = 0.001), salt (-0.7 g/day, p = 0.020) and total sugars (-8.1 g/day, p = 0.020). Food service can have a positive impact in our everyday environments, including inside and outside of work. Dietary interventions combining nutrition education and environmental dietary modification can improve employees' on and off-duty dietary intakes.

The effectiveness of dietary workplace interventions: a systematic review of systematic reviews.

To summarise findings of systematic reviews that distinctively report dietary intervention components and their effects on diet-, health- and economic-related outcomes in the workplace setting. MEDLINE, Embase, CINAHL, Web of Science, Cochrane Library and Google Scholar were searched in December 2014 and the search was updated in August 2017. The search identified 1137 titles, of which nineteen systematic reviews from the initial search and two systematic reviews from the updated search met the inclusion criteria (twenty-one systematic reviews, published in twenty-two papers). Most systematic reviews were of moderate quality and focused on dietary behaviour change outcomes and some health-related biomarkers. Evidence was strongest for interventions to increase fruit and vegetable intake, reduce fat intake, aid weight loss and reduce cholesterol. Few reported workplace-related and evaluation outcomes. These findings suggest that workplace dietary interventions can positively influence diet and health outcomes. Suggestions for effective interventions components have been made.

System-level workplace dietary intervention cost effective

System-level workplace dietary intervention cost effective

Cost-effectiveness of a complex workplace dietary intervention: an economic evaluation of the Food Choice at Work study

ObjectiveTo evaluate the costs, benefits and cost-effectiveness of complex workplace dietary interventions, involving nutrition education and system-level dietary modification, from the perspective of healthcare providers and employers.DesignSingle-study economic evaluation of...

Designing equitable workplace dietary interventions: perceptions of intervention deliverers

BackgroundWorkplaces are a good setting for interventions that aim to support workers in achieving a healthier diet and body weight. However, little is known about the factors that impact on the feasibility and implementation of these interventions, and how these might vary by type of workplace and type of worker. The aim of this study was to explore the views of those involved in commissioning and delivering the Better Health at Work Award, an established and evidence-based workplace health improvement programme.MethodsOne-to-one semi-structured interviews were conducted with 11 individuals in North East England who had some level of responsibility for delivering workplace dietary interventions. Interviews were transcribed verbatim and analysed using thematic framework analysis.ResultsA number of factors were felt to promote the feasibility and implementation of interventions. These included interventions that were cost-neutral (to employee and employer), unstructured, involved colleagues for support, took place at lunchtimes, and were well-advertised and communicated via a variety of media. Offering incentives, not necessarily monetary, was perceived to increase recruitment rates. Factors that militate against feasibility and implementation of interventions included worksites that were large in size and remote, working patterns including shifts and working outside of normal working hours that were not conducive to workers being able to access intervention sessions, workplaces without appropriate provision for healthy food on site, and a lack of support from management.ConclusionsIntervention deliverers perceived that workplace dietary interventions should be equally and easily accessible (in terms of cost and timing of sessions) for all staff, regardless of their job role. Additional effort should be taken to ensure those staff working outside normal working hours, and those working off-site, can easily engage with any intervention, to avoid the risk of intervention-generated inequalities (IGIs).

A cost-analysis of complex workplace nutrition education and environmental dietary modification interventions

BackgroundThe workplace has been identified as a priority setting to positively influence individuals’ dietary behaviours. However, a dearth of evidence exists regarding the costs of implementing and delivering workplace dietary interventions. This study aimed to conduct a cost-analysis of workplace nutrition education and environmental dietary modification interventions from an employer’s perspective.MethodsCost data were obtained from a workplace dietary intervention trial, the Food Choice at Work Study. Micro-costing methods estimated costs associated with implementing and delivering the interventions for 1 year in four multinational manufacturing workplaces in Cork, Ireland. The workplaces were allocated to one of the following groups: control, nutrition education alone, environmental dietary modification alone and nutrition education and environmental dietary modification combined. A total of 850 employees were recruited across the four workplaces. For comparison purposes, total costs were standardised for 500 employees per workplace.ResultsThe combined intervention reported the highest total costs of €31,108. The nutrition education intervention reported total costs of €28,529. Total costs for the environmental dietary modification intervention were €3689. Total costs for the control workplace were zero. The average annual cost per employee was; combined intervention: €62, nutrition education: €57, environmental modification: €7 and control: €0. Nutritionist’s time was the main cost contributor across all interventions, (ranging from 53 to 75% of total costs).ConclusionsWithin multi-component interventions, the relative cost of implementing and delivering nutrition education elements is high compared to environmental modification strategies. A workplace environmental modification strategy added marginal additional cost, relative to the control. Findings will inform employers and public health policy-makers regarding the economic feasibility of implementing and scaling dietary interventions.Trial registrationCurrent Controlled Trials: ISRCTN35108237. Date of registration: The trial was retrospectively registered on 02/07/2013.

The effect of complex workplace dietary interventions on employees' dietary intakes, nutrition knowledge and health status: a cluster controlled trial

BackgroundEvidence on effective workplace dietary interventions is limited. The comparative effectiveness of a workplace environmental dietary modification and an educational intervention both alone and in combination was assessed versus a control workplace on employees' dietary intakes, nutrition knowledge and health status. MethodsIn the Food Choice at Work cluster controlled trial, four large, purposively selected manufacturing workplaces in Ireland were allocated to control (N=111), nutrition education (Education) (N=226), environmental dietary modification (Environment) (N=113) and nutrition education and environmental dietary modification (Combined) (N=400) in 2013. Nutrition education included group presentations, individual consultations and detailed nutrition information. Environmental dietary modification included menu modification, fruit price discounts, strategic positioning of healthier alternatives and portion size control. Data on dietary intakes, nutrition knowledge and health status were obtained at baseline and follow-up at 7–9months. Multivariate analysis of covariance compared changes across the four groups with adjustment for age, gender, educational status and other baseline characteristics. Results: Follow-up data at 7–9months were obtained for 541 employees (64% of 850 recruited) aged 18–64years: control: 70 (63%), Education: 113 (50%), Environment: 74 (65%) and Combined: 284 (71%). There were significant positive changes in intakes of saturated fat (p=0.013), salt (p=0.010) and nutrition knowledge (p=0.034) between baseline and follow-up in the combined intervention versus the control. Small but significant changes in BMI (−1.2kg/m2 (95% CI −2.385, −0.018, p=0.047) were observed in the combined intervention. Effects in the education and environment alone workplaces were smaller and generally non-significant. ConclusionCombining nutrition education and environmental dietary modification may be an effective approach for promoting a healthy diet and weight loss at work.

The effectiveness of workplace dietary interventions: protocol for a systematic review and meta-analysis.

BackgroundThe lack of evidence of the role of workplaces as settings for behaviour change delivery and the failure to recognise and address the complexity of the work environment has been acknowledged. This systematic review and meta-analysis will identify the effectiveness of dietary interventions in the workplace facilitating an understanding of what works, why and how by identifying key components of and examining the theoretical models of behaviour change underpinning successful dietary interventions in the workplace.Methods/designWe will conduct searches in MEDLINE, EMBASE, CINAHL, PsycINFO, CENTRAL and PubMed for studies that assess dietary interventions based within workplace settings in any country, of any length of time or duration of follow-up. We will include all randomised controlled trials (RCTs), non-randomised controlled trials (NRCTs), controlled before-after studies (CBAs) and interrupted time series (ITS) studies with a control group. Risk of bias of included studies will be assessed using a tool adapted from the Cochrane Public Health Review Group’s recommended Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Meta-analysis will be conducted if appropriate, or a narrative synthesis will be conducted following the ESRC Narrative Synthesis Guidance.DiscussionThis paper outlines the study protocol for a systematic review and meta-analysis that will identify, critically appraise, and summarise the relevant evidence on the effectiveness and implications of interventions to promote healthier dietary behaviours in the workplace. This review will give an overview of the evidence and provide a guide for development of interventions promoting dietary behaviour change in workplaces.Systematic review registrationPROSPERO CRD42015015175Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0200-1) contains supplementary material, which is available to authorized users.

OP73 The effect of complex workplace dietary interventions on dietary behaviours, nutrition knowledge and health status: a cluster controlled trial

Background Although the workplace is a potentially important setting to influence dietary behaviours, evidence on effective interventions is limited. The study aim was to assess the comparative effectiveness of a workplace environmental dietary modification intervention and an educational intervention both alone and in combination versus a control workplace on employees’ dietary behaviours, nutrition knowledge and health status. Methods In the Food Choice at Work cluster controlled trial, four large, purposively selected manufacturing workplaces were allocated to A, (Control), B, nutrition education alone (Education), C, environmental dietary modification alone (Environment) and D, nutrition education and environmental dietary modification (Combined intervention). Nutrition education included: group presentations, individual consultations and detailed nutrition information (traffic light menu-labelling, posters and emails). Environmental dietary modification included: menu modification (restriction of fat, saturated fat, sugar and salt), increase in fruit and vegetables, price discounts for fruit, strategic positioning of healthier alternatives and portion size control. Data on dietary intakes (24-hour dietary recalls and food frequency questionnaires), nutrition knowledge (validated questionnaire tool), BMI, waist circumference and blood pressure were obtained at baseline and follow-up at 7–9 months. The Dietary Approaches to Stopping Hypertension (DASH) score was used as a composite measure of diet quality. Analysis of covariance was used to compare changes between baseline and follow-up across the four groups with adjustment for age, gender, educational status and other baseline characteristics. Results At baseline, 850 employees aged 18–64 years were recruited with N (response rate%) in each workplace as follows: A-control: 111(72%), B-Education: 226(71%), C-Environment: 113(91%), D-Combined intervention: 400(61%). Complete follow-up data was obtained for 517 employees (61%). There were significant positive changes in intakes of saturated fat (p = 0.013), salt (p = 0.010) and nutrition knowledge (p = 0.009) between baseline and follow-up in the combined intervention versus the control workplace in the fully adjusted multivariate analysis. Small but significant changes in BMI (–1.4kg/m 2 (95% CI –2.447, –0.346, p = 0.047) were observed in the combined intervention. Changes in the DASH score (p = 0.028) were only significant when adjusted for age and gender. No significant changes in waist circumference and blood pressure were observed. Effects in the education alone and environment alone workplaces were smaller and generally non-significant. Conclusion The ‘Food Choice at Work’ combined intervention represents a potentially viable model that is effective and feasible in a large workplace setting. However, it needs to be fully tested using an optimal randomised controlled trial design and full-scale evaluation to provide robust evidence for policy makers. Current Controlled Trials: ISRCTN35108237.

Nutrition knowledge, diet quality and hypertension in a working population

ObjectiveTo examine if employees with higher nutrition knowledge have better diet quality and lower prevalence of hypertension. MethodCross-sectional baseline data were obtained from the complex workplace dietary intervention trial, the Food Choice at Work Study. Participants included 828 randomly selected employees (18–64years) recruited from four multinational manufacturing workplaces in Ireland, 2013. A validated questionnaire assessed nutrition knowledge. Food Frequency Questionnaires (FFQ) measured diet quality from which a DASH (Dietary Approaches to Stop Hypertension) score was constructed. Standardised digital blood pressure monitors measured hypertension. ResultsNutrition knowledge was positively associated with diet quality after adjustment for age, gender, health status, lifestyle and socio-demographic characteristics. The odds of having a high DASH score (better diet quality) were 6 times higher in the highest nutrition knowledge group compared to the lowest group (OR=5.8, 95% CI 3.5 to 9.6). Employees in the highest nutrition knowledge group were 60% less likely to be hypertensive compared to the lowest group (OR=0.4, 95% CI 0.2 to 0.87). However, multivariate analyses were not consistent with a mediation effect of the DASH score on the association between nutrition knowledge and blood pressure. ConclusionHigher nutrition knowledge is associated with better diet quality and lower blood pressure but the inter-relationships between these variables are complex.

The food choice at work study: effectiveness of complex workplace dietary interventions on dietary behaviours and diet-related disease risk - study protocol for a clustered controlled trial

BackgroundDietary behaviour interventions have the potential to reduce diet-related disease. Ample opportunity exists to implement these interventions in the workplace. The overall aim is to assess the effectiveness and cost-effectiveness of complex dietary interventions focused on environmental dietary modification alone or in combination with nutrition education in large manufacturing workplace settings.Methods/designA clustered controlled trial involving four large multinational manufacturing workplaces in Cork will be conducted. The complex intervention design has been developed using the Medical Research Council’s framework and the National Institute for Health and Clinical Excellence (NICE) guidelines and will be reported using the TREND statement for the transparent reporting of evaluations with non-randomized designs. It will draw on a soft paternalistic “nudge” theoretical perspective. Nutrition education will include three elements: group presentations, individual nutrition consultations and detailed nutrition information. Environmental dietary modification will consist of five elements: (a) restriction of fat, saturated fat, sugar and salt, (b) increase in fibre, fruit and vegetables, (c) price discounts for whole fresh fruit, (d) strategic positioning of healthier alternatives and (e) portion size control. No intervention will be offered in workplace A (control). Workplace B will receive nutrition education. Workplace C will receive nutrition education and environmental dietary modification. Workplace D will receive environmental dietary modification alone. A total of 448 participants aged 18 to 64 years will be selected randomly. All permanent, full-time employees, purchasing at least one main meal in the workplace daily, will be eligible. Changes in dietary behaviours, nutrition knowledge, health status with measurements obtained at baseline and at intervals of 3 to 4 months, 7 to 9 months and 13 to 16 months will be recorded. A process evaluation and cost-effectiveness economic evaluation will be undertaken.DiscussionA 'Food Choice at Work’ toolbox (concise teaching kit to replicate the intervention) will be developed to inform and guide future researchers, workplace stakeholders, policy makers and the food industry.Trial registrationCurrent Controlled Trials, ISRCTN35108237

Healthy eating strategies in the workplace

There is a clear link between dietary behavior and a range of chronic diseases, and overweight and obesity constitute an indirect risk in relation to these diseases. The worksite is a central venue for influencing dietary behavior. The purpose of this paper is to provide an overview of workplace influences on worker dietary patterns. The paper reviews the evidence of the effectiveness of dietary health promotion, and provides a brief overview of appropriate theoretical frameworks to guide intervention design and evaluation. The findings are illustrated through research examples. Through case studies and published research, it is found that workplace dietary interventions are generally effective, especially fruit and vegetable interventions. There is less consistent evidence on the long term effectiveness of workplace weight management interventions, underscoring the need for further research in this area. This paper also reports evidence that changes in the work environment, including through health and safety programs, may contribute to enhancing the effectiveness of workplace health promotion, including dietary interventions. Organizational factors such as work schedule may also influence dietary patterns. The social ecological model, the social contextual model and political process approach are presented as exemplar conceptual models that may be useful when designing or assessing the effects of workplace health promotion. Using the worksite as setting for influencing health by influencing dietary patterns holds considerable promise and may be instrumental in reducing workers' risk of chronic diseases.