Nutrition Promotion In The Workplace
By: Nancy Bevilacqua
More and more scientific research shows that workplace nutrition programs can reduce employee healthcare costs, disability, and turnover. Nancy Bevilacqua, of York Region Health Services, looks at how to establish a program in a workplace.
When you ask employees about their major health concerns, not surprisingly, healthy eating seems to be at the top of the list. Nourishing food and good nutrition are vital to an employee’s overall health and well-being. Workplaces are an ideal setting for promoting healthy eating, as they provide a captive audience and a variety of opportunities to influence and support employee food choices.
It is quite common for employees to eat one or more meals and snacks at work. Eating habits are influenced not only by individual choice, but also by an individual’s surroundings and conditions at work. For this reason, successful workplace nutrition programming must go beyond educational activities that solely target individuals and must be comprehensive and include strategies that also address the physical environment of the workplace, the food choices available, and the supports that positively influence employee eating habits.
Employers can be instrumental in promoting nutrition to employees in a variety of ways. Here are some health promotion strategies and ideas on how they can be applied to make your workplace nutrition program a success:
- Awareness raising and education – These activities give employees the information they need to make healthy food choices. This can be accomplished by:
- Holding health fairs or interactive display booths with pamphlets and recipes which promote healthy eating
- Providing articles in company newsletters or by email about the benefits of healthy eating
- Providing nutrition ‘Lunch-and-Learn’ sessions or cooking demonstrations
- Skill building – These activities teach people how to get actively involved in changing their eating behaviour. Try:
- Teaching employees about setting realistic goals to improve their eating habits
- Engaging them in regular challenges, such as a healthy lunch challenge or a vegetable and fruit challenge
- Co-ordinating monthly potluck lunches where employees are asked to prepare heart-healthy recipes
- Environmental support – These are the workplace surroundings and conditions that foster and support healthy eating. For example:
- Ensure that there are healthy food and beverage choices being offered on a daily basis in the cafeteria and in vending machines and that there is a good balance between these and other choices
- Provide a variety of vegetables and fruits at a nominal price
- Provide employees with a refrigerator, microwave, and toaster oven to encourage them to bring their own food
- Policy Development – these are specific policy guidelines that support healthy eating in the workplace environment. You may want to ensure that:
- Workplace fundraising does not rely on the sale of less nutritious food choices
- Healthy food and beverage choices are offered for business meetings, functions, or events where food is served
- Healthy food and beverage choices in the cafeteria and vending machines are available at a lower or comparable price to other choices
- Employee medical insurance packages cover nutrition counselling by a registered dietitian
The last point is an important one to consider given the scarce availability of outpatient counselling services by registered dietitians through the healthcare system. Over the last decade, many services in hospitals have been discontinued leaving private practice consulting dietitians as one of the few alternatives for nutrition counselling. The disadvantage to this is that often people are required to pay out-of-pocket, unless the employee’s workplace medical insurance package covers the cost for such services.
Interestingly, surveys indicate that a large majority of the ‘standard eight’ services that are provided through insurance packages do not include the services of a registered dietitian. This may be related to the misconception that these services are covered through OHIP. In addition, many of the services that are covered in the ‘standard eight’ are not by regulated health professions. In the province of Ontario, for example, there are 21 health regulatory colleges that regulate health professionals. These colleges were established by a law called the Regulated Health Professions Act and protect consumers’ right to highquality, safe, effective, and ethical healthcare. The College of Dietitians of Ontario regulates registered dietitians. More information on regulated health professions can be found at www.itsnotagame.ca.
Workplaces should also consider covering services in medical insurance packages that have proven to be cost-effective. There is accumulating scientific research that demonstrates that interventions by registered dietitians can be instrumental in reducing employee healthcare costs, disability, and turnover. These interventions may also enhance the company’s image, improve employee productivity, and aid in recruiting new employees. One Torontobased employee with registered dietitian coverage on her health plan sums it up this way: “The help of a dietitian enabled me to sustain my weight loss and achieve better overall health. I now have the confidence and skills required for a lifetime of healthy eating,” says Michelle Bardeau. “With the pressures of work and home, it’s hard enough to maintain a healthy lifestyle. The fact that I can see a dietitian under my health plan makes it that much easier to do, and anything that takes the guesswork out of nutrition is helpful. It also makes me feel like my workplace is making my health a priority and that is important to me.”
To see data on cost-effectiveness of registered dietitians, go to www.dietitians.ca, click on Resources Centre, then Resource Inventory and search using keyword ‘costeffectiveness.’ You will see the results of a research review of literature that demonstrates the cost-effectiveness of nutrition intervention by registered dietitians.
Cutting From Plans
Although the trend in the industry for health and benefits spending is more at cutting from plans, administrators should consider cost savings that registered dietitian services can contribute. Medications are at the top of the list of insurance spending. The costs of cholesterol-lowering medications – along with those used to treat hypertension, diabetes, and heart disease – are sky high.
In research published in the Journal of the American Dietetic Association in 1998, scientists investigated whether nutrition counselling provided by registered dietitians could lead to both better cholesterol readings and financial outcomes in a group of 43 men with elevated blood cholesterol and triglyceride readings. Not only did they improve their blood cholesterol profiles – lower levels of LDL (the bad) cholesterol and triglycerides and higher amounts of HDL (the ‘good’) cholesterol – but they also lowered their weight significantly. The annual cost-savings related to cholesterollowering medications were more than US$600 dollars per patient.
In another study, published in the Journal of the American Dietetic Association, researchers conducted a six-month trial to evaluate the cost effectiveness of different treatments on a group of patients, aged 20 to 65 years, with elevated blood cholesterol readings. The subjects were randomly assigned to receive nutrition counselling by registered dietitians or what’s termed ‘usual care’ by physicians. Those who received the nutrition counselling had significantly lower levels of total and LDL cholesterol at three and six months compared to those who received usual care. And when the scientists assessed the difference in price for the services provided by the dietitians versus physicians, the costeffectiveness ratio was $36 per one per cent decrease in cholesterol. The counselling also resulted in healthier food choices, improved activity, weight, and patient satisfaction outcomes.
At little or no cost to workplaces, it makes total sense for every workplace to promote healthy eating through workplace wellness programs and to provide support for access to registered dietitians by including this service in employee medical insurance packages. Your workplace will demonstrate that it has a vested interest in the health and well-being of its employees.
Many public health departments offer professional nutrition programs free-ofcharge. Contact your local public health department for further information on the services they provide. Employees that have coverage for registered dietitian services should be directed to www.dietitians. ca to use the ‘find a dietitian in your area’ search tool.
Nancy Bevilacqua is public health nutritionist and registered dietitian at York Region Health Services. Rosie Schwartz, a consulting dietitian, contributed to the article.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -