In this research blog, we focus on the workplace as a place to facilitate proper nutrition, identifying evidence-based interventions that promote healthy employee nutrition decisions.

We spoke with nutrition expert Dr. Kristine Madsen, Professor at UC Berkeley’s School of Public Health, who provided insight into consumer habits as part of her research on the Berkeley soda tax. In addition, PhD candidate and author of the forthcoming book The Healthy Office Revolution, Elizabeth Nelson of University of Twente, the Netherlands, shared her research with the Healthy Offices Project.

 

Why care about food in the workplace?
In the 1950s, processed foods and such as hot-dogs, soda, assembly-line hamburgers, and deep-fried potato fries made their debut in society. Now, 70 years later they have become iconic of the Western Diet1, and our health is suffering from these foods which have become deeply engrained in Western culture and have penetrated the workplace. The effects of a processed, Western Diet1 are well-known and include development of chronic diseases and poor cognitive function, which affect productivity, performance, absenteeism, and medical premiums. Luckily, the food issue has the potential to be addressed through changes in office settings.

“What people eat can be medicine or poison, and nutrition is one of the most powerful things you can change to reverse the effects of chronic disease,” explained Dr. Brenda Rea of Loma Linda University in an interview with NPR. For example, there is strong evidence that the Mediterranean2, DASH3, and MIND4 diets reduce the risk of several chronic diseases and help maintain good health. These diets all share a common thread of ”whole,” unprocessed foods which doctors, nutritionists, and researchers agree leads to the best health outcomes. The Mediterranean diet is high in vegetables, legumes, fruits, and whole grains, occasional lean meats and dairy, and low in refined sugars. The DASH diet, an acronym for “dietary approaches to stop hypertension” is low sodium, plain eating rich in fruits and vegetables, and whole, unrefined grains. The MIND diet, standing for the “Mediterranean-DASH Intervention for Neurodegenerative Delay” combines these two diets to encourage brain healthy foods such as leafy green, vegetables, nuts, berries, whole grains, fish, and wine. For these diets, healthy whole foods produce great results.

 

The costs of poor diet

The CDC recently stated that chronic diseases and conditions such as heart disease, stroke, cancer, type 2 diabetes, obesity, and arthritis, are among the most common, costly, and preventable of all health problems. Costs go beyond direct healthcare premiums and payments. For example, in 2012 diagnosed diabetes accounted for $69 billion in decreased productivity–costs associated with people being absent from work, being less productive while at work, or not being able to work at all because of diabetes5. If a poor diet causes or maintains chronic illness in employees and incurs such a financial and human toll at home and at work, it behooves companies to do what they can to address poor diet at least at work.

At Healthy Workplaces we are broadening our focus on food to understand the implications of the connection between food and work to help create specific guidelines organizations can follow for increasing healthy eating at work. Led by Dr. John Swartzberg, Editor in Chief of the Berkeley Wellness Letter and Director of the Joint Medical Program at UC Berkeley, a research team is conducting a literature review on the acute and long-term physiological effects of food in the workplace. For example, the review includes an examination of the role of breakfast in cognition and how this could affect employee productivity and performance.

 

How could the work environment play a role in improving nutrition?

We know that having good eating behaviors are essential to reducing the risk of chronic diseases and promoting productivity, but how can this be addressed through the structure of the work environment? Elizabeth Nelson of the University of Twente notes that long hours of hard work in the office can be very taxing on the body and the brain, and eating caffeine, salt, sugar, and fat can provide temporary relief from our craving for more energy. Yet now that we are aware of the bad effects of these compensatory behaviors on our health and productivity, it is critical for companies to promote healthy eating choices for their employees. Since many employees spend at least half of their waking hours working, the good news is that the workplace can actually play a crucial role in setting healthy dietary habits. Repetition of healthy eating is a possibility at work and is likely to be a key factor of implementing dietary change.

With this in mind, Healthy Workplaces investigated various interventions that a workplace could implement, ranging from a policy level to psychological level. We comment on each intervention and provide evidence for effectiveness.

 

1. Tax
UC Berkeley Professor Dr. Kristine Madsen has proven through research that targeting food policy is an effective strategy to disincentivize purchase of unhealthy foods. Her research on the Berkeley soda tax realized a 21% decrease in consumption of sugar-sweetened beverages in just two years.

How could this policy level strategy be implemented in the workplace? Organizations can change the pricing of foods in their cafeterias to favor healthier options, such as lowering the price of salads, whole grain sandwiches, and fresh fruits, and perhaps increasing the cost of fatty, unhealthy foods. They may find that subsidizing the cost of healthier foods will shift consumption in that direction.

 

2. The influence of “nudges”
In his book Nudge: Improving Decisions about Health, Wealth, and Happiness, Richard Thaler defines a nudge as “any aspect of the choice architecture that alters people’s behavior in a predictable way without forbidding any options or significantly changing their economic incentives.” Thus, choice architecture can be a non-intrusive yet effective way to shift people’s dietary decisions.

For example, consider Google’s work cafeterias where simple and subtle cues prompt people to make better decisions. Candy jars are tall making grabbing candy more difficult, salad is the first thing to see in the cafeteria, plates are smaller, and desserts are marked in red. Additionally, in her Healthy Offices Project, Elizabeth Nelson experienced great success with big jugs of flavored water with orange, cucumber, and apple slices. The colorful and flavorful water “nudged” employees to drink more water, and more importantly, less soda.

 

3. Breaks
Implicit and explicit workplace culture profoundly impacts employee behavior. Although changing deep-rooted work culture is difficult, Elizabeth Nelson reminds us it is important to keep in mind this paradigm: “Taking a lunch break may elicit behavior that might look like a break, but it’s really something much better. Many of us nowadays have a cognitively intense workload, and stepping away from your work allows you to think about and process your work.” Not only this, but other research6 indicates that meal satisfaction is associated with a more positive mood and lower hunger level, as well as feeling less busy and stressed after lunch. Taking breaks could make all the difference in avoiding an afternoon slump in the office.

With this in mind, organizations can promote healthy eating behaviors by encouraging and enforcing meal and rest breaks. This can be done by ensuring that there is a break room, and that meetings do not fill the lunch hour. Workplaces can also schedule social gatherings around meals, signaling that building connections at work is an important part of the work itself.

 

4. Events

Workplace events will be an important opportunity for promoting healthy behaviors. Having events that teach healthy eating behaviors can directly inform healthy eating practices. In addition, the food that is provided at events will be an opportunity to advertise that the organization values the health of its employees. It is also a chance for leadership to demonstrate desired healthy behavior, thereby defining the culture and norms of healthy eating.

Here’s one idea: Create a healthy office cookbook. Compile a booklet of each employee’s favorite healthy dish, and distribute it throughout the office. Or perhaps bring a nutritionist in to a company meeting to present important components of healthy diet and respond to any possible questions. Maybe Friday can become a “free fruit Friday,” to take the emphasis away from treats on Fridays. At breakfast meetings, offer whole food options such as fruit, plain yogurt, hard-boiled eggs, and decaffeinated tea or coffee.

 

5. Resources
Many employees argue that there is simply not enough time to prepare or purchase a nutritious food option. Luckily companies such as Byte, which supplies healthy food in smart vending machines, have popped up. In addition, meal prep companies deliver weekly lunches, which eliminates the time concern. For larger companies, one solution proposed by Elizabeth Nelson is to hire a company chef to cook healthy meals in bulk which may be cheaper than nearby restaurants and save the time of going out and picking up food.

 

What now?
It has become clear that chronic illnesses caused by poor eating habits can be devastating to worker wellbeing and productivity and consequently, very costly to companies. With that said, the solution can be as simple as providing good food, and companies can be the influence that sets dietary trends. In this blog we researched and listed a number of affordable ways to set healthy habits in the workplace, and showed evidence that they are effective.

At Healthy Workplaces we hope that our research can build the ties between food research and the workplace to give companies a clear picture of the best interventions. Our literature review led by John Swartzberg will provide information about breakfast and employee cognition. In addition, we hope that our research with the Transamerica Center for Health Studies on participation in wellness programs for small and medium-sized companies will shed a light on how to successfully change eating habits. Finally, in our graduate student study of the relationship between study environments and their academic success and wellbeing, we hope to understand how the environment including nutritional choices and eating habits influences student health and wellbeing.

The work environment can promote positive behaviors, so why not start with a simple change next week?

 

1Farooqui, Tahira. Farooqui, Aklaq. Neurochemical Effects of Western Diet Consumption on Human Brain.
http://onlinelibrary.wiley.com/doi/10.1002/9781118840634.ch2/summary;jsessionid=681B8907612A1D75C428E2FE2B5C09CD.f04t01. [Accessed 26 February 2017].
2Sofi, Francesco. Adherence to Mediterranean diet and health status: meta-analysis http://www.bmj.com/content/337/bmj.a1344.short. [Accessed 1 March 2017].
3Kwan, Mandy et al. Compliance with the Dietary Approaches to Stop Hypertension (DASH) Diet: A Systematic Review. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0078412. [Accessed 1 March 2017].
4Morris, MC et al. MIND diet slows cognitive decline with aging. https://www.ncbi.nlm.nih.gov/pubmed/26086182. [Accessed 27 February 2017].
5 American Diabetes Association. The Cost of Diabetes. http://www.diabetes.org/advocacy/news-events/cost-of-diabetes.html. [Accessed 1 March 2017].
6Haugaard, P et al. Determinants of meal satisfaction in a workplace environment. http://europepmc.org/abstract/med/27235825 [Accessed 28 February 2017].

 

Primary Author: Pauline Simes
Research Assistant
HealthyWorkplaces
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Isabelle Thibau
Researcher
HealthyWorkplaces
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