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Cheng J, Levy D, McCurley J, Rimm E, Gelsomin E, Thorndike A. Differential effect by chronic disease risk: A secondary analysis of the ChooseWell 365 randomized controlled trial. Prev Med Rep 2024; 42:102736. [PMID: 38699077 PMCID: PMC11063590 DOI: 10.1016/j.pmedr.2024.102736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 04/17/2024] [Accepted: 04/20/2024] [Indexed: 05/05/2024] Open
Abstract
Objective Whether employees' health status is associated with the effectiveness of workplace health promotion programs is unknown. The objective of this study was to determine if the effect of a workplace healthy eating intervention differed by baseline chronic disease status. Methods This was a secondary analysis of a randomized controlled trial conducted September 2016 to February 2018 among US hospital employees to test the effect of a 12-month behavioral intervention (personalized feedback, peer comparisons, and financial incentives) on diet and weight. Participants were classified as having chronic disease (yes/no) based on self-reported hypertension, hyperlipidemia, heart disease, stroke, pre-diabetes, diabetes, cancer or another serious illness. BMI was measured at study visits and calories purchased were measured from cafeteria sales data over 24 months. Mixed models with random effects assessed heterogeneity of treatment effects by chronic disease. Results Participants (N = 548) were mostly female (79.7 %) and white (81.2 %); 224 (40.9 %) had chronic disease. Among those with chronic disease, intervention participants reduced caloric intake by 74.4 [22.3] kcal more than control, with a smaller difference between intervention and control (-1.9 [18.7] kcal) (three-way p-interaction = 0.02). The effect on BMI for those with chronic disease (0.47 [0.21] kg/m2) indicated weight stability among intervention participants and weight gain among controls while the effect (-0.56 [0.18] kg/m2) for those without chronic disease was the opposite (three-way p-interaction < 0.01). Conclusions Those with chronic diseases had greater reductions in calories purchased and gained less weight. Employers with limited resources for health promotion might consider tailoring programs to employees at highest risk.
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Affiliation(s)
- J. Cheng
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
- Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - D.E. Levy
- Harvard Medical School, Boston, MA, USA
- Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston, MA, USA
| | | | - E.B. Rimm
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - E.D. Gelsomin
- Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - A.N. Thorndike
- Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Bullock SL, Winthrop HM, Hales D, Lin FC, Yang Y, Ammerman AS, Viera AJ. Who chooses "healthy" meals? An analysis of lunchtime meal quality in a workplace cafeteria. BMC Public Health 2024; 24:921. [PMID: 38553694 PMCID: PMC10979548 DOI: 10.1186/s12889-024-18284-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/05/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND The workplace can play an important role in shaping the eating behaviors of U.S. adults. Unfortunately, foods obtained in the workplace tend to be low in nutritional quality. Questions remain about the best way to approach the promotion of healthy food purchases among employees and to what extent health promotion activities should be tailored to the demographic characteristics of the employees. The purpose of this study was to (1) assess the nutritional quality of lunchtime meal purchases by employees in cafeterias of a large organization, (2) examine associations between lunchtime meal quality selection and the demographic characteristics of employees, and (3) determine the healthfulness of foods and beverages offered in the cafeterias of this organization. METHODS A cross-sectional analysis was conducted using secondary data from a food labeling study implemented in three worksite cafeterias. Demographic data was collected via surveys and meal data was collected using a photo capture system for 378 participants. The Healthy Eating Index 2015 (HEI-2015) was used to determine meal quality and a total score for the menu of options available in the cafeterias during the study period. Summary statistics were generated, and the analysis of variance (ANOVA) was used to compare the HEI-2015 scores between groups. RESULTS The mean HEI-2015 total score for the menu items offered (n = 1,229) in the cafeteria during the study period was 63.1 (SD = 1.83). The mean HEI-2015 score for individual lunchtime meal observations (n = 378) was 47.1 (SD = 6.8). In general, HEI-2015 total scores were higher for non-smokers, individuals who self-identified as Asian, had higher physical activity levels, scored higher on numeracy and literacy assessments, and reported higher education levels, incomes, and health status. CONCLUSIONS The overall HEI-2015 scores indicate that the menu of options offered in the cafeterias and individual meal selections did not align with the Dietary Guidelines for Americans, and there were significant associations between average lunchtime meal quality scores and several demographic characteristics. These results suggest that healthy eating promotion activities in workplaces may need to be tailored to the demographic characteristics of the employees, and efforts to improve the food environment in the workplace could improve meal quality for all employees.
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Affiliation(s)
- Sally L Bullock
- Davidson College, PO Box 5000, 209 Ridge Road, Davidson, NC, 28035, USA.
| | - Hilary M Winthrop
- Duke University School of Medicine, 2200 W Main St, Durham, NC, 27705, USA
| | - Derek Hales
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 MLK Jr. Blvd, CB#7426,, Chapel Hill, NC, 27599, USA
| | - Feng-Chang Lin
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, 3101 McGavran-Greenberg Hall, CB #7420,, Chapel Hill, NC, 27599, USA
| | - Yumei Yang
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, 3101 McGavran-Greenberg Hall, CB #7420,, Chapel Hill, NC, 27599, USA
| | - Alice S Ammerman
- Department of Nutrition, Gillings School of Global Public Health, Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, CB# 7426, 1700 MLK Jr. Blvd, Room 239,, Chapel Hill, 27599, USA
| | - Anthony J Viera
- Department of Family Medicine and Community Health, Duke University School of Medicine, 2200 W Main St, Suite 400, Durham, NC, 27705, USA
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Joyce A. A Settings and Systems Approach to Promoting the Health and Wellbeing of People with an Intellectual Disability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:409. [PMID: 38673322 PMCID: PMC11050249 DOI: 10.3390/ijerph21040409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/20/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024]
Abstract
Research has shown that people with an intellectual disability have higher rates of certain preventable health conditions and a higher rate of avoidable mortality relative to the general population. With respect to health behaviours, they also have lower levels of physical activity and poorer nutrition. Despite the increased health needs, this population cohort is less likely to have the opportunity to participate in health promotion programs. The interventions that have been delivered are programmatic and individual in focus and have lacked a broader ecological and settings focus, which makes them very difficult to scale. Health promotion programs designed for the general population, such as lifestyle campaigns, rarely reach people with an intellectual disability. This increases the importance of ensuring that the settings in which they live and engage with are as health promoting as possible. Interventions have been particularly absent in the workplace for people with an intellectual disability. This paper highlights gaps in a settings-and-systems-based approach to promoting the health and wellbeing of people with an intellectual disability, particularly with respect to workplace health promotion. The paper concludes with recommendations for a systems approach that integrates approaches across multiple settings to better promote the health of this population cohort.
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Affiliation(s)
- Andrew Joyce
- Centre for Social Impact, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
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Oostenbach LH, Lamb KE, Crawford D, Timperio A, Thornton LE. Do 20-minute neighbourhoods moderate associations between work and commute hours with food consumption? Public Health Nutr 2023; 26:2026-2035. [PMID: 36987863 PMCID: PMC10564605 DOI: 10.1017/s1368980023000587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 02/07/2023] [Accepted: 03/08/2023] [Indexed: 03/30/2023]
Abstract
OBJECTIVE To examine associations between work and commute hours with food consumption and test whether neighbourhood type (20-minute neighbourhood (20MN)/non-20MN) moderate associations. DESIGN Cross-sectional analysis of the Places and Locations for Activity and Nutrition study (ProjectPLAN). Exposures were work hours (not working (0 h), working up to full-time (1-38 h/week), working overtime (> 38 h/week)), and among those employed, combined weekly work and commute hours (continuous). Outcomes were usual consumption of fruit, vegetables, takeaway food, snacks and soft drinks, and number of discretionary food types (takeaway, snacks and soft drinks) consumed weekly. Generalised linear models were fitted to examine associations between each exposure and outcome. The moderating role of neighbourhood type was examined through interaction terms between each exposure and neighbourhood type (20MN/non-20MN). SETTING Melbourne and Adelaide, Australia, 2018-2019. PARTICIPANTS Adults ≥ 18 years old (n 769). RESULTS Although all confidence intervals contained the null, overall, patterns suggested non-workers and overtime workers have less healthy food behaviours than up-to-full-time workers. Among those employed, analysis of continuous work and commute hours data suggested longer work and commute hours were positively associated with takeaway consumption (OR = 1·014, 95 % CI 0·999, 1·030, P-value = 0·066). Patterns of better behaviours were observed across most outcomes for those in 20MN than non-20MN. However, differences in associations between work and commute hours with food consumption across neighbourhood type were negligible. CONCLUSIONS Longer work and commute hours may induce poorer food behaviours. There was weak evidence to suggest 20MN moderate associations between work and commute hours with food consumption, although behaviours appeared healthier for those in 20MN.
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Affiliation(s)
- Laura Helena Oostenbach
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 1 Gheringhap Street, Geelong3220, Australia
| | - Karen Elaine Lamb
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, Melbourne, Australia
| | - David Crawford
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 1 Gheringhap Street, Geelong3220, Australia
| | - Anna Timperio
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 1 Gheringhap Street, Geelong3220, Australia
| | - Lukar Ezra Thornton
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 1 Gheringhap Street, Geelong3220, Australia
- Department of Marketing, Faculty of Business and Economics, University of Antwerp, Antwerp, Belgium
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Garibay-Lagos CS, Martos-Boira MI, Landeta-Iza E, Contreras-González GB, Wanden-Berghe C, Sanz-Valero J. Occupational Health of Health-Care Workers with Overnutrition: Scoping Review with Meta-Analysis. Nutrients 2023; 15:3416. [PMID: 37571353 PMCID: PMC10421247 DOI: 10.3390/nu15153416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
(1) Objective: To review the scientific literature on the impact of interventions to enhance the occupational health of health-care workers with overnutrition. (2) Methods: Scoping review with meta-analysis. Data were obtained by consulting the following bibliographic databases: MEDLINE (via PubMed), Embase, Cochrane Library, Scopus, Web of Science, Latin American and Caribbean Literature on Health Sciences (LILACS), and Medicina en Español (MEDES). The terms used as descriptors and as text in the title and abstract fields of the records were "health workers", "overnutrition", and "occupational health", using the filters "human", "adult": 19+ years", and "clinical trial". The search update date was January 2023. The documentary quality of the articles was evaluated using the CONSORT questionnaire and the presence of bias was assessed using the Rob 2.0 tool. (3) Results: From the 611 digitally retrieved references, 17 clinical trials were selected after applying the inclusion and exclusion criteria. CONSORT scores ranged from a minimum of 14.6% to a maximum of 91.7%, with a median of 68.8%. According to the SIGN criteria, this review provided "1" evidence with a grade B recommendation. Six different types of intervention were tested, grouped into strategies ranging from a single intervention to a combination of four interventions. The summary effect of the meta-analysis showed significant weight loss, but no association with reduced body mass index. (4) Conclusions: While workplace interventions have been shown to be potentially effective, and strategies using different types of interventions have been proven to be useful in tackling overnutrition, an effective and sustainable solution for changing the behavior of health professionals to tackle overweight and obesity has yet to be identified.
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Affiliation(s)
| | | | | | | | - Carmina Wanden-Berghe
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Health and Biomedical Research Institute of Alicante (ISABIAL), 03010 Alicante, Spain;
| | - Javier Sanz-Valero
- Carlos III Health Institute, National School of Occupational Medicine, 28029 Madrid, Spain
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Jiménez-Mérida MR, Vaquero-Abellán M, Alcaide-Leyva JM, Cantón-Habas V, Raya-Cano E, Romero-Saldaña M. Effectiveness of Multicomponent Interventions and Physical Activity in the Workplace to Reduce Obesity: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2023; 11:healthcare11081160. [PMID: 37107994 PMCID: PMC10137796 DOI: 10.3390/healthcare11081160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/13/2023] [Accepted: 04/16/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Overweight and obesity are public health problems that affects the workplace. This paper aims to analyse the effectiveness of workplace health promotion interventions in reducing Body Mass Index (BMI); Methods: Following PRISMA guidelines, a systematic review was conducted using PubMed, MEDLINE, and SCOPUS databases. The inverse variance statistical method was used for the meta-analysis with a random effects analysis model and standardised means. The results have been represented by Forest Plots and Funnel Plots graphs; Results: The multicomponent approach had the best results for reducing BMI (-0.14 [-0.24, -0.03], 95% CI; p = 0.009) compared to performing physical activity only (-0.09 [-0.39, 0.21], 95% CI; p = 0.56). However, both methods resulted in positive changes in reducing BMI in the general analysis (-0.12 [-0.22, -0.02], 95% CI; p = 0.01). The GRADE evaluation showed low certainty due to the high heterogeneity between interventions (I2 = 59% for overall analysis). CONCLUSIONS The multicomponent approach could be an effective intervention to reduce obesity in the working population. However, workplace health promotion programs must be standardised to conduct quality analyses and highlight their importance to workers' well-being.
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Affiliation(s)
- M Rocío Jiménez-Mérida
- Departamento de Enfermería, Farmacología y Fisioterapia, Facultad de Medicina y Enfermería, Universidad de Córdoba, 14014 Córdoba, Spain
| | - Manuel Vaquero-Abellán
- Departamento de Enfermería, Farmacología y Fisioterapia, Facultad de Medicina y Enfermería, Universidad de Córdoba, 14014 Córdoba, Spain
| | - José M Alcaide-Leyva
- Departamento de Enfermería, Farmacología y Fisioterapia, Facultad de Medicina y Enfermería, Universidad de Córdoba, 14014 Córdoba, Spain
| | - Vanesa Cantón-Habas
- Departamento de Enfermería, Farmacología y Fisioterapia, Facultad de Medicina y Enfermería, Universidad de Córdoba, 14014 Córdoba, Spain
| | - Elena Raya-Cano
- Departamento de Enfermería, Farmacología y Fisioterapia, Facultad de Medicina y Enfermería, Universidad de Córdoba, 14014 Córdoba, Spain
| | - Manuel Romero-Saldaña
- Grupo Asociado de Investigación GA16 Estilos de Vida, Tecnología y Salud, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Departamento de Enfermería, Farmacología y Fisioterapia, Facultad de Medicina y Enfermería, Universidad de Córdoba, 14014 Córdoba, Spain
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7
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Woodside JV, Nugent AP, Moore RE, McKinley MC. Fruit and vegetable consumption as a preventative strategy for non-communicable diseases. Proc Nutr Soc 2023:1-14. [PMID: 36785878 DOI: 10.1017/s0029665123002161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
A high intake of fruit and vegetables (FV) has consistently been associated with a reduced risk of a number of non-communicable diseases. This evidence base is largely from prospective cohort studies, with meta-analyses demonstrating an association between increased FV intake and reduced risk of both CHD and stroke, although the evidence is less certain for cancer and diabetes. Controlled intervention trials examining either clinical or intermediate risk factor endpoints are more scarce. Therefore, evidence that FV consumption reduces the risk of disease is so far largely confined to observational epidemiology, which is hampered by some methodological uncertainties. Although increased FV intake is promoted across all dietary guidelines, national surveys confirm that dietary intakes are suboptimal and are not increasing over time. A range of barriers to increasing FV intake exist, including economic, physical and behavioural barriers that must be considered when exploring potential opportunities to change this, considering the feasibility of different approaches to encourage increased FV consumption. Such interventions must include consideration of context, for example, challenges and uncertainties which exist with the whole food system.
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Affiliation(s)
- J V Woodside
- Centre for Public Health, Institute for Clinical Science A, Queen's University Belfast, Grosvenor Road, Belfast BT12 6BJ, UK
- Institute for Global Food Security, Queen's University Belfast, Belfast, UK
| | - A P Nugent
- Institute for Global Food Security, Queen's University Belfast, Belfast, UK
| | - R E Moore
- Centre for Public Health, Institute for Clinical Science A, Queen's University Belfast, Grosvenor Road, Belfast BT12 6BJ, UK
- Institute for Global Food Security, Queen's University Belfast, Belfast, UK
| | - M C McKinley
- Centre for Public Health, Institute for Clinical Science A, Queen's University Belfast, Grosvenor Road, Belfast BT12 6BJ, UK
- Institute for Global Food Security, Queen's University Belfast, Belfast, UK
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Blaschke S, Schad N, Schnitzius M, Pelster K, Mess F. The Connection between Non-Alcoholic Fatty-Liver Disease, Dietary Behavior, and Food Literacy in German Working Adults. Nutrients 2023; 15:nu15030648. [PMID: 36771354 PMCID: PMC9919132 DOI: 10.3390/nu15030648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/20/2023] [Accepted: 01/25/2023] [Indexed: 02/01/2023] Open
Abstract
(1) Background: German working adults are particularly at risk of non-alcoholic fatty-liver disease (NAFLD), which is connected to increased cardiovascular and overall morbidity and mortality. Dietary behavior (DB) and health knowledge are crucial factors in the conceptual NAFLD model, which can directly influence this disease. These two factors largely align with the concept of food literacy (FL), which deals with proficiency in food-related skills and knowledge to promote healthy DB and prevent NAFLD. However, the potential of FL for NAFLD prevention remains unknown, because FL has not been tested in connection with DB and NAFLD. Therefore, the current study examined the direct and indirect connections between FL, DB, and NAFLD in a mediation model. (2) Methods: A total of 372 working adults (38% female) participated in a cross-sectional study by completing self-report questionnaires on FL and DB. In addition, an independent physician assessed the fatty-liver index (FLI) as an indicator of NAFLD in an occupational health checkup. (3) Results: The mediation model revealed that FL had a direct moderate connection with DB (β = 0.25, p < 0.01), but no direct connection with the FLI (β = -0.05, p = 0.36). However, DB showed a small to moderate connection with the FLI (β = -0.14, p = 0.01), which could indicate the indirect-only mediation of the relationship between FL and NAFLD via DB. (4) Conclusion: These results confirm the value of DB for the prevention of NAFLD. In addition, FL might be a vital component for improving DB and thereby function as a resource in the prevention of NAFLD. However, future longitudinal research is needed to substantiate the value of FL with respect to NAFLD.
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Affiliation(s)
- Simon Blaschke
- Department of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany
- Correspondence:
| | - Nele Schad
- Department of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany
| | - Melina Schnitzius
- Department of Pedagogy and Psychology, University of Cooperative Education, 34225 Baunatal, Germany
| | - Klaus Pelster
- Health Management and Safety—Health Management, Environmental Protection, Siemens AG, 60528 Frankfurt am Main, Germany
| | - Filip Mess
- Department of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany
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Wronska MD, Coffey M, Robins A. Determinants of nutrition practice and food choice in UK construction workers. Health Promot Int 2022; 37:6722664. [PMID: 36166265 DOI: 10.1093/heapro/daac129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The workplace is considered an effective setting for health and wellbeing interventions, including programmes focusing on nutrition, and provides opportunities to tailor programmes to meet the specific needs of industry and employees. This study explored nutrition practices amongst construction workers and managers to inform the design of a nutrition intervention. Five focus groups were conducted on three construction sites: two with managers (n = 11) and three with workers (n = 27). Construction workers and managers identified several unhealthy nutrition-related behaviours, including high consumption of convenient and fast foods, excessive coffee, alcohol, energy drinks and low fruit and vegetable intake. These behaviours were often attributed to high workloads, long working hours and physically demanding jobs. Snacking and skipping meals were repeatedly reported, attributed to short breaks and poor accessibility to food outlets. The nutritional quality of meals differed between individuals (homemade vs fast food), depending on the type of sites (temporary vs permanent) and site location. Nutrition knowledge, establishing routines, meal planning and preparation were recognized as important in sustaining healthy nutrition habits. However, meal preparation depended on the facilities available, which differed between managers and workers, highlighting the complex relationship between the workplace context and eating behaviours. Construction workers were interested in learning about nutrition and improving their eating habits through nutrition intervention. However, they highlighted that better cooking and storage facilities on site, together with fewer job demands and longer break times, would enhance the sustainability of the intervention and their ability to make healthier food choices.
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Affiliation(s)
| | - Margaret Coffey
- School of Health and Society, The University of Salford, Manchester, UK
| | - Anna Robins
- School of Health and Society, The University of Salford, Manchester, UK
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10
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Moretti Anfossi C, Tobar Fredes C, Pérez Rojas F, Cisterna Cid F, Siques Urzúa C, Ross J, Head J, Britton A. Workplace interventions for cardiovascular diseases: protocol of a systematic review and meta-analysis. BMJ Open 2022; 12:e061586. [PMID: 35953246 PMCID: PMC9379504 DOI: 10.1136/bmjopen-2022-061586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Cardiovascular diseases (CVDs) are the number one cause of death globally, impacting on public and private sectors. Current traditional interventions to prevent CVDs are mainly provided in healthcare centres and even when they are effective, they are not enough to reduce the rising prevalence; therefore, additional strategies are needed. Evidence suggests that health interventions in the workplace supply numerous benefits improving cardiovascular risk factor profiles in individuals. Hence, the aim of this systematic review and meta-analysis is to collate the evidence from randomised controlled trials, cluster randomised trials and quasi-experimental studies of workplace interventions to determine their effectiveness in terms of improving cardiovascular risk factors and preventing CVDs. METHODS AND ANALYSIS EMBASE, PsycINFO, PubMed, the Cochrane Central Register of Controlled Trials, LILACS, Scopus, Web of Science, WHO International Clinical Trials Registry Platform, ClinicalTrials.gov and ProQuest Dissertations & Theses Global will be searched to include articles on workplace interventions in adults for CVDs events, cardiometabolic risk factors or behavioural risk factors. The study selection, data extraction, risk of bias and the assessment of the quality of the body of evidence will be conducted by two reviewers working in parallel and disagreements will be resolved by consensus or consultations with a third reviewer. Data synthesis will be done by meta-analysis using random-effects models when possible, otherwise the vote counting method will be applied. Statistical heterogeneity will be assessed by a χ2 test and I2 statistics. The quality of the body of evidence for each outcome will be assessed by applying the Grading of Recommendations, Assessment, Development and Evaluation approach. ETHICS AND DISSEMINATION Ethical approval is not required for this systematic review protocol. The results of the systematic review will be published in a peer-reviewed journal and will be publicly available. PROSPERO REGISTRATION NUMBER CRD42021276161.
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Affiliation(s)
| | - Christian Tobar Fredes
- Facultad de Ciencias de la salud, Universidad San Sebastián-Campus Bellavista, Santiago de Chile, Chile
| | - Felipe Pérez Rojas
- Escuela de Terapia Ocupacional, Universidad Mayor, Sede Temuco, Temuco, Chile
| | | | - Christian Siques Urzúa
- Facultad de Ciencias Médicas, Universidad de Santiago de Chile, Santiago de Chile, Chile
| | - Jamie Ross
- Department of Primary Care and Population Health, University College London Research, London, UK
| | - Jenny Head
- Department of Epidemiology and Public Health, University College London Research, London, UK
| | - Annie Britton
- Department of Epidemiology and Public Health, University College London Research, London, UK
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11
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Oostenbach LH, Lamb KE, Crawford D, Thornton L. Influence of work hours and commute time on food practices: a longitudinal analysis of the Household, Income and Labour Dynamics in Australia Survey. BMJ Open 2022; 12:e056212. [PMID: 35523493 PMCID: PMC9083384 DOI: 10.1136/bmjopen-2021-056212] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Work hours and commute time are key contributors to time scarcity, with potential detrimental implications for healthy eating. This study examined (1) associations between work and commute hours with food practices and (2) within-individual associations between changes in work and commute hours with changes in food practices. DESIGN Longitudinal study SETTING: Australia PARTICIPANTS: Data were from 14 807 respondents in waves 7 (2007), 9 (2009), 13 (2013) and 17 (2017) of the Household, Income and Labour Dynamics in Australia Survey. The sample for this analysis included individuals who were in paid employment in at least one of the four waves. PRIMARY AND SECONDARY OUTCOME MEASURES Outcomes included frequency of out-of-home food purchasing for breakfast, lunch, dinner and all three summed eating occasions, and fruit and vegetables consumption. RESULTS Results indicated the longer individuals spent working and commuting, the more likely they were to purchase out-of-home foods (frequency of total out-of-home food purchasing: incidence rate ratio (IRR)=1.007 (95% CI 1.007 to 1.008)), and the less they consumed fruit and vegetables, although reductions in fruit and vegetables servings were minimal (fruit: β=-0.002 (95% CI -0.003 to -0.001), vegetables: β=-0.002 (95% CI -0.003 to -0.001)). Similar results regarding associations with out-of-home food purchasing were observed when examining within-individual changes (IRR=1.006 (95% CI 1.005 to 1.007)). CONCLUSIONS Results suggest employment-related time demands push towards more frequent out-of-home food purchasing. In the long term, this may have negative health consequences as out-of-home foods tend to be less healthy than home-prepared foods.
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Affiliation(s)
- Laura Helena Oostenbach
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
| | - Karen Elaine Lamb
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - David Crawford
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
| | - Lukar Thornton
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
- Department of Marketing, Faculty of Business and Economics, University of Antwerp, Antwerp, Belgium
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Poirier L, Reznar MM, Wensel CR, Redmond L, Treuth MS, Pardilla M, Swartz J, Gittelsohn J. Process Evaluation and Impact Results of the Worksite Component of a Multilevel, Multicomponent Obesity Prevention Trial in Six Native American Communities. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022. [DOI: 10.1080/19320248.2022.2055988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Lisa Poirier
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Melissa M. Reznar
- Interdisciplinary Health Sciences, Oakland University, Rochester, MI, USA
| | - Caroline R. Wensel
- Cellular and Molecular Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Leslie Redmond
- Dietetics and Nutrition Program, University of Alaska, Anchorage, AK, USA
| | - Margarita S. Treuth
- Department of Kinesiology, University of Maryland Eastern Shore, Princess Anne, MD, USA
| | - Marla Pardilla
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jacqueline Swartz
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Joel Gittelsohn
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Factors Involved in the Food Choices of Diners in a Kibbutz Communal Dining Room Buffet: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031885. [PMID: 35162905 PMCID: PMC8835611 DOI: 10.3390/ijerph19031885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/28/2022] [Accepted: 02/05/2022] [Indexed: 11/19/2022]
Abstract
Improving nutrition improves health outcomes. Eating in a catering system may provide an environment for promoting healthy dietary choices. To map the factors that shape the food choices of diners who routinely eat in catering systems, we collected and analyzed qualitative data about diners’ perceptions of their food choices in communal dining rooms in three kibbutzim in Israel. From May to July 2014, we conducted in-depth, semi-structured, face-to-face interviews with 13 diners who ate at least three lunches per week in the kibbutz’s dining room. Data analysis followed thematic analysis principles. Two categories of themes emerged from the interviews. In the personal context category, the themes identified were eating as a task and attempts to control one’s eating. In the contextual aspects of eating in the catering system category, themes identified were eating in the dining room as a default, the characteristics of the food served, routine, and personal versus public aspects. The sub-theme of the diners’ freedom of choice emerged in the two categories of themes. Diners’ wishes of maintaining their freedom of choice may be an important contribution to the debate of whether catering systems should provide only healthy foods, which may jeopardize diners’ freedom of choice.
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Effects of the nutritional interventions in improving employee’s cardiometabolic risk factors in the workplace: A systematic review. CLINICAL NUTRITION OPEN SCIENCE 2022. [DOI: 10.1016/j.nutos.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Kordsmeyer AC, Efimov I, Lengen JC, Harth V, Mache S. Workplace Health Promotion in German Social Firms-Offers, Needs and Challenges from the Perspectives of Employees, Supervisors and Experts. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:959. [PMID: 35055778 PMCID: PMC8776072 DOI: 10.3390/ijerph19020959] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 01/12/2023]
Abstract
On the general labor market, social firms provide 30-50% of people with different types of disabilities the opportunity to gain employment. However, the topic of workplace health promotion (WHP), needs for improvement and accompanied challenges are neglected in the current research and were the focus of the present study. Therefore, data triangulation was used between July and December 2020 by combining three focus groups with employees (n = 14 employees) with 16 interviews with supervisors from several social firms in Northern Germany (e.g., from catering, cleaning or bicycle repair sectors). 17 semi-structured telephone interviews with experts in the field of WHP or social firms were added. All approaches were audio-taped, transcribed and anonymized. To analyze the data, Mayring's qualitative content analysis was used. The results indicated that several offers for WHP, including sport, nutrition and relaxation, were offered, as well as those on smoking cessation, cooperation with external organizations or training and education offers. Needs for improvement were stated referring to additional sport offers, support for implementing a healthy diet, offers for relaxation, financial incentives or collaborations with external organizations. A low take-up of offers; a lack of resources, structures or management support; compatibility of offers with work time and organization; challenges with available trainings or the consideration of individual needs and capacities were highlighted as challenges. Overall, there is a need for further interventional and longitudinal research on WHP in social firms.
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Affiliation(s)
- Ann-Christin Kordsmeyer
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany; (I.E.); (J.C.L.); (V.H.); (S.M.)
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16
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Systematic review with analysis of bias and quality of interventions in the food environment of the workplace and their impact on the nutritional status of workers. NUTR HOSP 2022; 39:1153-1165. [DOI: 10.20960/nh.04198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Sutherland RL, Jackson JK, Lane C, McCrabb S, Nathan NK, Yoong SL, Lum M, Byaruhanga J, McLaughlin M, Brown A, Milat AJ, Bauman And AE, Wolfenden L. A systematic review of adaptations and effectiveness of scaled-up nutrition interventions. Nutr Rev 2021; 80:962-979. [PMID: 34919715 PMCID: PMC8907487 DOI: 10.1093/nutrit/nuab096] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Context Public health nutrition interventions shown to be effective under optimal research conditions need to be scaled up and implemented in real-world settings. Objectives The primary aim for this review was to assess the effectiveness of scaled-up public health nutrition interventions with proven efficacy, as examined in a randomized controlled trial. Secondary objectives were to: 1) determine if the effect size of scaled-up interventions were comparable to the prescale effect, and; 2) identify any adaptations made during the scale-up process. Data sources Six electronic databases were searched and field experts contacted. Study selection An intervention was considered scaled up if it was delivered on a larger scale than a preceding randomized controlled trial (“prescale”) in which a significant intervention effect (P ≤ 0.05) was reported on a measure of nutrition. Data extraction Two reviewers independently performed screening and data extraction. Effect size differences between prescale and scaled-up interventions were quantified. Adaptations to scale-up studies were coded according to the Adaptome model. Results Ten scaled-up nutrition interventions were identified. The effect size difference between prescale trials and scaled-up studies ranged from –32.2% to 222% (median, 50%). All studies made adaptations between prescale to scaled-up interventions. Conclusion The effects of nutrition interventions implemented at scale typically were half that achieved in prior efficacy trials. Identifying effective scale-up strategies and methods to support retainment of the original prescale effect size is urgently needed to inform public health policy. Systematic Review Registration PROSPERO registration no.CRD42020149267.
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Affiliation(s)
- Rachel L Sutherland
- R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, A.E. Bauman, and L. Wolfenden are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. R.L. Sutherland, C. Lane, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, New South Wales, Australia. S.L. Yoong is with the School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia. A.J. Milat and A.E. Bauman are with the School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Jacklyn K Jackson
- R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, A.E. Bauman, and L. Wolfenden are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. R.L. Sutherland, C. Lane, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, New South Wales, Australia. S.L. Yoong is with the School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia. A.J. Milat and A.E. Bauman are with the School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Cassandra Lane
- R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, A.E. Bauman, and L. Wolfenden are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. R.L. Sutherland, C. Lane, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, New South Wales, Australia. S.L. Yoong is with the School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia. A.J. Milat and A.E. Bauman are with the School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Sam McCrabb
- R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, A.E. Bauman, and L. Wolfenden are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. R.L. Sutherland, C. Lane, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, New South Wales, Australia. S.L. Yoong is with the School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia. A.J. Milat and A.E. Bauman are with the School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Nicole K Nathan
- R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, A.E. Bauman, and L. Wolfenden are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. R.L. Sutherland, C. Lane, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, New South Wales, Australia. S.L. Yoong is with the School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia. A.J. Milat and A.E. Bauman are with the School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Sze Lin Yoong
- R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, A.E. Bauman, and L. Wolfenden are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. R.L. Sutherland, C. Lane, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, New South Wales, Australia. S.L. Yoong is with the School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia. A.J. Milat and A.E. Bauman are with the School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Melanie Lum
- R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, A.E. Bauman, and L. Wolfenden are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. R.L. Sutherland, C. Lane, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, New South Wales, Australia. S.L. Yoong is with the School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia. A.J. Milat and A.E. Bauman are with the School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Judith Byaruhanga
- R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, A.E. Bauman, and L. Wolfenden are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. R.L. Sutherland, C. Lane, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, New South Wales, Australia. S.L. Yoong is with the School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia. A.J. Milat and A.E. Bauman are with the School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Matthew McLaughlin
- R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, A.E. Bauman, and L. Wolfenden are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. R.L. Sutherland, C. Lane, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, New South Wales, Australia. S.L. Yoong is with the School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia. A.J. Milat and A.E. Bauman are with the School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Alison Brown
- R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, A.E. Bauman, and L. Wolfenden are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. R.L. Sutherland, C. Lane, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, New South Wales, Australia. S.L. Yoong is with the School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia. A.J. Milat and A.E. Bauman are with the School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Andrew J Milat
- R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, A.E. Bauman, and L. Wolfenden are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. R.L. Sutherland, C. Lane, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, New South Wales, Australia. S.L. Yoong is with the School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia. A.J. Milat and A.E. Bauman are with the School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Adrian E Bauman And
- R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, A.E. Bauman, and L. Wolfenden are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. R.L. Sutherland, C. Lane, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, New South Wales, Australia. S.L. Yoong is with the School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia. A.J. Milat and A.E. Bauman are with the School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Luke Wolfenden
- R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, A.E. Bauman, and L. Wolfenden are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. R.L. Sutherland, C. Lane, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, New South Wales, Australia. S.L. Yoong is with the School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia. A.J. Milat and A.E. Bauman are with the School of Public Health, University of Sydney, Sydney, New South Wales, Australia
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Panchbhaya A, Baldwin C, Gibson R. Improving the Dietary Intake of Healthcare Workers Through Workplace Dietary Interventions: A Systematic Review and Meta-Analysis. Adv Nutr 2021; 13:S2161-8313(22)00079-5. [PMID: 34591091 PMCID: PMC8970821 DOI: 10.1093/advances/nmab120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The workplace has been identified as a potential location for dietary intervention delivery due to the amount of time spent and the meals eaten in this setting. It is recommended that interventions are tailored to specific occupational groups, and to date, there is limited synthesis of the evidence relating to healthcare workers. This review characterises and evaluates the effectiveness of dietary interventions in healthcare workers to aid the design and implementation of interventions. The MEDLINE database was searched to September 2020. The reference list of an umbrella review was hand searched for additional titles against inclusion criteria. The search included i) population, ii) intervention and iii) work environment. Studies were assessed for risk of bias. Harvest plots and Forest plots were created to display study quality, direction and size of effect of selected primary (energy, fruit and vegetable and fat intake) and secondary outcomes (weight, body mass index, blood pressure and serum cholesterol levels). Thirty-nine articles assessing thirty-four interventions were eligible for inclusion. Intervention types most commonly used were environmental, educational, educational plus behavioural, and behavioural. Due to the heterogeneity in study design and intervention type, results were largely inconclusive. For dietary outcomes, interventions produced small-moderate favorable changes in fruit, vegetable and fat intake. Decreased fat intake was mainly observed in environmental interventions and increases in fruit and vegetable intake were observed when an educational or/and behavioral component was present. Interventions producing weight loss were mostly non-randomised trials involving education and physical activity. Total and low-density lipoprotein cholesterol decreased in interventions involving physical activity. Meta-analyses revealed significant decreases in energy intake, weight, blood pressure, total cholesterol, and LDL cholesterol in non-randomised trials where data were available. Much more research is needed into strategies to promote diet quality improvement in healthcare workers. Statement of significance: It is recommended that workplace dietary interventions are tailored to specific occupational groups. To our knowledge, this is the first review to examine the effects of dietary workplace interventions in healthcare professionals. Small-moderate favourable changes in fruit and vegetable intake can be achieved when an educational or/and behavioural component is included in the intervention. For weight loss, interventions involving nutrition education and physical activity in addition to a dietary component show benefit. In the studies reviewed, a high level of heterogeneity was evident and insufficient information reported to ascertain potential bias.
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Affiliation(s)
- Aasiya Panchbhaya
- Department of Nutritional Sciences, King's College London, London, United Kingdom
| | - Christine Baldwin
- Department of Nutritional Sciences, King's College London, London, United Kingdom
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Palomo-Llinares R, Sánchez-Tormo J, Wanden-Berghe C, Sanz-Valero J. Trends and Seasonality of Information Searches Carried Out through Google on Nutrition and Healthy Diet in Relation to Occupational Health: Infodemiological Study. Nutrients 2021; 13:nu13124300. [PMID: 34959852 PMCID: PMC8708834 DOI: 10.3390/nu13124300] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/19/2021] [Accepted: 11/26/2021] [Indexed: 12/15/2022] Open
Abstract
This study aimed to analyze and relate the population interest through information search trends on Nutrition and Healthy Diet (HD) with the Occupational Health (OH). Ecological and correlational study of the Relative Search Volume (RSV) obtained from Google Trends query, segmented in two searched periods concerning antiquity; date of query: 20 April 2021. The RSV trends for the analyzed three Topics were: Nutrition (R2 = 0.02), HD (R2 = 0.07) and OH (R2 = -0.72). There was a good positive correlation between Nutrition and OH (R = 0.56, p < 0.001) and a moderate one between HD and OH (R = 0.32, p < 0.001). According to seasons, differences were verified between RSV means in the Topics HD (p < 0.01) and OH (p < 0.001). Temporal dependence was demonstrated on Nutrition searches (Augmented Dickey-Fuller = -2.35, p > 0.05). There was only a significant relationship between the RSV Topic HD (p < 0.05) for the Developing and Least Developed countries. The data on the analyzed RSV demonstrated diminishing interest in the search information on HD and OH as well as a clearly positive trend change in recent years for Nutrition. A good positive correlation was observed between the RSV of nutrition and OH whereas the correlation between HD and OH was moderate. There were no milestones found that may report a punctual event leading to the improvement of information searches. Temporal dependence was corroborated in the RSV on Nutrition, but not in the other two Topics. Strangely, only an association was found on HD searches between the Developing and Least Developed Countries. The study of information search trends may provide useful information on the population's interest in the disease data, as well as would gradually allow the analysis of differences in popularity, or interest even between different countries. Thus, this information might be used as a guide for public health approaches regarding nutrition and a healthy diet at work.
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Affiliation(s)
- Ruben Palomo-Llinares
- Department of Public Health and History of Science, School of Medicine, Miguel Hernandez University, 03550 Alicante, Spain;
| | - Julia Sánchez-Tormo
- International Virtual Center for Nutrition Research (CIVIN), 03540 Alicante, Spain;
| | - Carmina Wanden-Berghe
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Health and Biomedical Research Institute of Alicante (ISABIAL), 03010 Alicante, Spain;
| | - Javier Sanz-Valero
- Department of Public Health and History of Science, School of Medicine, Miguel Hernandez University, 03550 Alicante, Spain;
- Carlos III Health Institute, National School of Occupational Medicine, 28029 Madrid, Spain
- Correspondence:
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20
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Melián-Fleitas L, Franco-Pérez Á, Caballero P, Sanz-Lorente M, Wanden-Berghe C, Sanz-Valero J. Influence of Nutrition, Food and Diet-Related Interventions in the Workplace: A Meta-Analysis with Meta-Regression. Nutrients 2021; 13:3945. [PMID: 34836200 PMCID: PMC8622081 DOI: 10.3390/nu13113945] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/28/2021] [Accepted: 11/02/2021] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To review the scientific literature on the influence of verified nutrition, food and diet interventions on occupational health. METHOD This study involved a critical analysis of articles retrieved from MEDLINE (via PubMed), Embase, Cochrane Library, PsycINFO, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature (LILACS) and Medicina en Español (MEDES) using the descriptors "Diet, Food, and Nutrition" and "Occupational Health" and applying the filters "Clinical Trial", "Humans" and "Adult: 19+ years"; the search was conducted on 29 May 2021. RESULTS A total of 401 references were retrieved from the bibliographic databases, with an additional 16 identified through a secondary search; among the studies retrieved, 34 clinical trials were selected after applying the inclusion and exclusion criteria. The interventions were grouped into seven categories: (1) dietary interventions associated with exercise or educational programs; (2) individual environmental interventions or other educational actions; (3) educational interventions oriented toward lifestyle, dietetics, physical activity and stress management; (4) economic incentives; (5) multicomponent interventions (combination of mindfulness, e-coaching and the addition of fruits and vegetables); or dietary interventions (facilitating greater food supply in cafeterias); or interventions focused on physical exercise. CONCLUSIONS Given that most people spend a large part of their time in the workplace and, therefore, eat at least one of their daily meals there, well-planned interventions-preferably including several strategies-have been demonstrated, in general, as useful for combating overweight and obesity. From the meta-regression study, it was observed that the interventions give better results in people who presented high Body Mass Index (BMI) values (obesity). In contrast, intervention 2 (interventions related to workplace environment) would not give the expected results (it would increase the BMI).
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Affiliation(s)
- Liliana Melián-Fleitas
- Nutrition Department, University of Granada, 18012 Granada, Spain;
- Geriatric Service, Insular Hospital, Health Services Management of the Health Area of Lanzarote, 35500 Arrecife, Spain
| | - Álvaro Franco-Pérez
- Playa Blanca Health Center, Health Services Management of the Health Area of Lanzarote, 35580 Playa Blanca, Spain;
| | - Pablo Caballero
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, San Vicente del Raspeig, 03690 Alicante, Spain;
| | - María Sanz-Lorente
- Department of Public Health & History of Science, University Miguel Hernandez, 03550 Alicante, Spain;
- Center of Public Health, Consellería of Universal Health and Public Health, 46940 Manises, Spain
| | - Carmina Wanden-Berghe
- Health and Biomedical Research Institute of Alicante, University General Hospital, 03010 Alicante, Spain;
| | - Javier Sanz-Valero
- Department of Public Health & History of Science, University Miguel Hernandez, 03550 Alicante, Spain;
- National School of Occupational Medicine, Carlos III Health Institute, 28029 Madrid, Spain
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21
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Peñalvo JL, Sagastume D, Mertens E, Uzhova I, Smith J, Wu JHY, Bishop E, Onopa J, Shi P, Micha R, Mozaffarian D. Effectiveness of workplace wellness programmes for dietary habits, overweight, and cardiometabolic health: a systematic review and meta-analysis. LANCET PUBLIC HEALTH 2021; 6:e648-e660. [PMID: 34454642 PMCID: PMC8627548 DOI: 10.1016/s2468-2667(21)00140-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/02/2021] [Accepted: 06/04/2021] [Indexed: 12/17/2022]
Abstract
Background The workplace offers a unique opportunity for effective health
promotion. We aimed to comprehensively study the effectiveness of
multicomponent worksite wellness programmes for improving diet and
cardiometabolic risk factors. Methods We did a systematic literature review and meta-analysis, following
PRISMA guidelines. We searched PubMed-MEDLINE, Embase, the Cochrane Library,
Web of Science, and Education Resources Information Center, from Jan 1,
1990, to June 30, 2020, for studies with controlled evaluation designs that
assessed multicomponent workplace wellness programmes. Investigators
independently appraised the evidence and extracted the data. Outcomes were
dietary factors, anthropometric measures, and cardiometabolic risk factors.
Pooled effects were calculated by inverse-variance random-effects
meta-analysis. Potential sources of heterogeneity and study biases were
evaluated. Findings From 10 169 abstracts reviewed, 121 studies (82 [68%] randomised
controlled trials and 39 [32%] quasi-experimental interventions) met the
eligibility criteria. Most studies were done in North America (57 [47%]),
and Europe, Australia, or New Zealand (36 [30%]). The median number of
participants was 413·0 (IQR 124·0–904·0), and
median duration of intervention was 9·0 months
(4·5–18·0). Workplace wellness programmes improved
fruit and vegetable consumption (0·27 servings per day [95% CI
0·16 to 0·37]), fruit consumption (0·20 servings per
day [0·11 to 0·28]), body-mass index (−0·22
kg/m2 [−0·28 to −0·17]), waist
circumference (−1·47 cm [−1·96 to
−0·98]), systolic blood pressure (−2·03 mm Hg
[−3·16 to −0·89]), and LDL cholesterol
(−5·18 mg/dL [−7·83 to −2·53]),
and to a lesser extent improved total fat intake (−1·18% of
daily energy intake [−1·78 to −0·58]), saturated
fat intake (−0·70% of daily energy [−1·22 to
−0·18]), bodyweight (−0·92 kg
[−1·11 to −0·72]), diastolic blood pressure
(−1·11 mm Hg [−1·78 to −0·44]),
fasting blood glucose (−1·81 mg/dL [−3·33 to
−0·28]), HDL cholesterol (1·11 mg/dL [0·48 to
1·74]), and triglycerides (−5·38 mg/dL
[−9·18 to −1·59]). No significant benefits were
observed for intake of vegetables (0·03 servings per day [95% CI
−0·04 to 0·10]), fibre (0·26 g per day
[−0·15 to 0·67]), polyunsaturated fat
(−0·23% of daily energy [−0·59 to 0·13]),
or for body fat (−0·80% [−1·80 to 0·21]),
waist-to-hip ratio (−0·00 ratio [−0·01 to
0·00]), or lean mass (1·01 kg [−0·82 to
2·83]). Heterogeneity values ranged from 46·9% to
91·5%. Between-study differences in outcomes were not significantly
explained by study design, location, population, or similar factors in
heterogeneity analyses. Interpretation Workplace wellness programmes are associated with improvements in
specific dietary, anthropometric, and cardiometabolic risk indicators. The
heterogeneity identified in study designs and results should be considered
when using these programmes as strategies to improve cardiometabolic
health.
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Affiliation(s)
- José L Peñalvo
- Non-Communicable Diseases Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium; Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
| | - Diana Sagastume
- Non-Communicable Diseases Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Elly Mertens
- Non-Communicable Diseases Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Irina Uzhova
- Department of Health and Nutritional Sciences, Institute of Technology Sligo, Sligo, Ireland
| | - Jessica Smith
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA; Bell Institute of Health and Nutrition, General Mills, Minneapolis, MN, USA
| | - Jason H Y Wu
- George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Eve Bishop
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Jennifer Onopa
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Peilin Shi
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Renata Micha
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA; Department of Food Science and Human Nutrition, University of Thessaly, Thessaly, Greece
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
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22
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Hulls PM, Richmond RC, Martin RM, Chavez-Ugalde Y, de Vocht F. Workplace interventions that aim to improve employee health and well-being in male-dominated industries: a systematic review. Occup Environ Med 2021; 79:77-87. [PMID: 34035181 PMCID: PMC8785069 DOI: 10.1136/oemed-2020-107314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/31/2021] [Accepted: 04/02/2021] [Indexed: 11/17/2022]
Abstract
The published evidence on whether workplace health and well-being interventions are as effective in male-dominated industries compared with mixed-gender environments has not been synthesised. We performed a systematic review of workplace interventions aimed at improving employee health and well-being in male-dominated industries. We searched Web of Knowledge, PubMed, Medline, Cochrane Database and Web of Science for articles describing workplace interventions in male-dominated industries that address employee health and well-being. The primary outcome was to determine the effectiveness of the intervention and the process evaluation (intervention delivery and adherence). To assess the quality of evidence, Cochrane Collaboration’s Risk of Bias Tool was used. Due to the heterogeneity of reported outcomes, meta-analysis was performed for only some outcomes and a narrative synthesis with albatross plots was presented. After full-text screening, 35 studies met the eligibility criteria. Thirty-two studies delivered the intervention face-to-face, while two were delivered via internet and one using postal mail. Intervention adherence ranged from 50% to 97%, dependent on mode of delivery and industry. 17 studies were considered low risk of bias. Albatross plots indicated some evidence of positive associations, particularly for interventions focusing on musculoskeletal disorders. There was little evidence of intervention effect on body mass index and systolic or diastolic blood pressure. Limited to moderate evidence of beneficial effects was found for workplace health and well-being interventions conducted within male-dominated industries. Such interventions in the workplace can be effective, despite a different culture in male-dominated compared with mixed industries, but are dependent on delivery, industry and outcome. CRD42019161283.
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Affiliation(s)
- Paige M Hulls
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK .,MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Rebecca C Richmond
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Richard M Martin
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Yanaina Chavez-Ugalde
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,National Institute for Health Research, School for Public Health Research, Newcastle upon Tyne, UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,National Institute for Health Research, School for Public Health Research, Newcastle upon Tyne, UK.,National Institute for Health Research Collaboration for Leadership, Applied Health Research and Care West (NIHR CLAHRC West), Bristol, UK
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23
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The Mediterranean lifestyle (MEDLIFE) index and metabolic syndrome in a non-Mediterranean working population. Clin Nutr 2021; 40:2494-2503. [PMID: 33932793 DOI: 10.1016/j.clnu.2021.03.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/02/2021] [Accepted: 03/17/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND & AIMS The Mediterranean lifestyle (MEDLIFE), as an overall lifestyle pattern, may be associated with a lower prevalence of metabolic syndrome. We assessed the association of a validated MEDLIFE index with metabolic syndrome and its components in a non-Mediterranean working population. METHODS A cross-sectional analysis was conducted at baseline among 249 US career firefighters in Feeding America's Bravest 2016-2018. The MEDLIFE index consisted of 26 items on food consumption, dietary habits, physical activity, rest, and social interactions that scored 0 or 1 point. Thus, total scores could range from 0 to 26 points. Multivariable logistic regression models were used to determine the associations across tertiles of MEDLIFE adherence with metabolic syndrome and each of its individual components. Multivariable linear models further assessed each component as a continuous outcome. RESULTS The prevalence of metabolic syndrome was 17.7%. Participants with higher MEDLIFE adherence (T3: 11-17 points) had 71% lower odds of having metabolic syndrome compared to those with lower MEDLIFE adherence (T1: 2-7 points) (OR = 0.29; 95%CI: 0.10 to 0.90, p for trend = 0.04). Furthermore, significant inverse associations were found for T3 versus T1 on abdominal obesity (OR = 0.42; 95%CI: 0.18 to 0.99, p for trend = 0.07) and hypertriglyceridemia (OR = 0.24; 95%CI: 0.09 to 0.63, p for trend = 0.002). Significant inverse associations for continuous outcomes included total-cholesterol (total-c), low-density lipoprotein (LDL) cholesterol, and total-c:high-density lipoprotein (HDL) cholesterol (p for trend <0.05). CONCLUSION Higher adherence to traditional Mediterranean lifestyle habits, as measured by a comprehensive MEDLIFE index, was associated with a lower prevalence of metabolic syndrome and a more favorable cardiometabolic profile in a non-Mediterranean working population. Future studies employing the MEDLIFE index in other populations are warranted to support this hypothesis.
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24
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Naicker A, Shrestha A, Joshi C, Willett W, Spiegelman D. Workplace cafeteria and other multicomponent interventions to promote healthy eating among adults: A systematic review. Prev Med Rep 2021; 22:101333. [PMID: 33732606 PMCID: PMC7937753 DOI: 10.1016/j.pmedr.2021.101333] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 01/28/2021] [Accepted: 02/09/2021] [Indexed: 12/18/2022] Open
Abstract
The objective of this review is to evaluate evidence for the effectiveness of workplace cafeteria and other supporting multicomponent interventions to promote healthy eating and reductions in health risks among adults. We conducted an electronic search in EMBASE, CINAHL, EconLit, Ovid, Cochrane, Web of Science and PubMed for English-language articles published from 1985 to July 2019. Studies were original articles reporting the results of workplace cafeteria interventions to promote healthy eating and reduction in health risks. Outcomes were classified as changes in fruit and vegetable intake, health risk indicators, dietary intake, and food sales. Interventions were categorized as interventions targeting food quality or quantity, targeting price, targeting food choice at point of purchase, targeting improved supply, targeting client's information, education or motivation and targeting organization policies. Behavioral change conditions used in interventions were identified using the COM-B system of behavioral change. Results were presented in a narrative summary. A total of 55 studies out of 6285 articles were identified for this review. Several studies used multicomponent interventions and the most featured interventions included interventions targeting food quality or quantity, targeting client's information, education or motivation and targeting food choice at point of purchase. There is evidence that workplace cafeteria and other supporting multicomponent interventions resulted in higher intake of fruit and vegetables, improved dietary intake, improved health outcomes and healthy food sales. The findings of this review have the potential to inform future cafeteria-based and other supporting multicomponent workplace health interventions. The review protocol was not registered in a repository.
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Affiliation(s)
- Ashika Naicker
- Department of Food and Nutrition, Durban University of Technology, Durban, South Africa.,Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA
| | - Archana Shrestha
- Center for Methods on Implementation and Prevention Science (CMIPS) Yale School of Public Health, New Haven, USA
| | | | - Walter Willett
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA
| | - Donna Spiegelman
- Center for Methods on Implementation and Prevention Science (CMIPS) Yale School of Public Health, New Haven, USA
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25
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Madden SK, Cordon EL, Bailey C, Skouteris H, Ahuja K, Hills AP, Hill B. The effect of workplace lifestyle programmes on diet, physical activity, and weight-related outcomes for working women: A systematic review using the TIDieR checklist. Obes Rev 2020; 21:e13027. [PMID: 32803854 DOI: 10.1111/obr.13027] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/19/2020] [Accepted: 03/20/2020] [Indexed: 12/20/2022]
Abstract
Physical activity and healthy diets are essential for the prevention of obesity and chronic disease that disparately impact women compared with men. Given the number of women engaged in the workforce, workplace interventions could improve lifestyle behaviours and health outcomes for women. This systematic review aimed to identify intervention characteristics of lifestyle programmes or organizational policy changes in the workplace associated with improved diet, physical activity, or weight-related outcomes for working women using the template for intervention description and replication (TIDieR) checklist. Seven databases were searched for controlled studies published up to March 2019 that included a workplace diet and/or physical activity intervention. From 5,318 identified records, 20 studies (23 articles and 26 intervention arms) were included. Data were extracted on diet, physical activity, weight-related outcomes, and TIDieR components. Findings indicated that group delivery may improve physical activity outcomes, and a high number of sessions may benefit weight-related outcomes for physical activity interventions. Mixed interventions that included tailoring and input from non-healthcare professionals may also enhance physical activity. In contrast, the role of mixed interventions in improving diet and weight-related outcomes was less clear. Overall, workplace health programmes were effective at improving lifestyle behaviours for working women.
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Affiliation(s)
- Seonad K Madden
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Emma L Cordon
- School of Psychology, Deakin University, Melbourne, Victoria, Australia
| | - Cate Bailey
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Kiran Ahuja
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Briony Hill
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
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26
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Nathan N, Murawski B, Hope K, Young S, Sutherland R, Hodder R, Booth D, Toomey E, Yoong SL, Reilly K, Tzelepis F, Taylor N, Wolfenden L. The Efficacy of Workplace Interventions on Improving the Dietary, Physical Activity and Sleep Behaviours of School and Childcare Staff: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17144998. [PMID: 32664554 PMCID: PMC7400238 DOI: 10.3390/ijerph17144998] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/04/2020] [Accepted: 07/06/2020] [Indexed: 01/07/2023]
Abstract
There is a need for effective interventions that improve the health and wellbeing of school and childcare staff. This review examined the efficacy of workplace interventions to improve the dietary, physical activity and/or sleep behaviours of school and childcare staff. A secondary aim of the review was to assess changes in staff physical/mental health, productivity, and students’ health behaviours. Nine databases were searched for controlled trials including randomised and non-randomised controlled trials and quasi-experimental trials published in English up to October 2019. PRISMA guidelines informed screening and study selection procedures. Data were not suitable for quantitative pooling. Of 12,396 records screened, seven articles (based on six studies) were included. Most studies used multi-component interventions including educational resources, work-based wellness committees and planned group practice (e.g., walking groups). Multiple outcomes were assessed, findings were mixed and on average, there was moderate risk of bias. Between-group differences in dietary and physical activity behaviours (i.e., fruit/vegetable intake, leisure-time physical activity) favoured intervention groups, but were statistically non-significant for most outcomes. Some of the studies also showed differences favouring controls (i.e., nutrient intake, fatty food consumption). Additional robust studies testing the efficacy of workplace interventions to improve the health of educational staff are needed.
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Affiliation(s)
- Nicole Nathan
- Hunter New England Population Health, Hunter New England Area Health Service, Longworth Avenue, Wallsend, NSW 2287, Australia; (S.Y.); (R.S.); (R.H.); (S.L.Y.); (K.R.); (F.T.); (L.W.)
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (B.M.); (K.H.)
- Priority Research Centre for Health Behaviour, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
- Correspondence:
| | - Beatrice Murawski
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (B.M.); (K.H.)
- Priority Research Centre for Health Behaviour, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Kirsty Hope
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (B.M.); (K.H.)
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Sarah Young
- Hunter New England Population Health, Hunter New England Area Health Service, Longworth Avenue, Wallsend, NSW 2287, Australia; (S.Y.); (R.S.); (R.H.); (S.L.Y.); (K.R.); (F.T.); (L.W.)
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Rachel Sutherland
- Hunter New England Population Health, Hunter New England Area Health Service, Longworth Avenue, Wallsend, NSW 2287, Australia; (S.Y.); (R.S.); (R.H.); (S.L.Y.); (K.R.); (F.T.); (L.W.)
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (B.M.); (K.H.)
- Priority Research Centre for Health Behaviour, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Rebecca Hodder
- Hunter New England Population Health, Hunter New England Area Health Service, Longworth Avenue, Wallsend, NSW 2287, Australia; (S.Y.); (R.S.); (R.H.); (S.L.Y.); (K.R.); (F.T.); (L.W.)
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (B.M.); (K.H.)
- Priority Research Centre for Health Behaviour, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Debbie Booth
- University Library, Academic Division, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia;
| | - Elaine Toomey
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland, University Road, Galway H91 TK33, Ireland;
| | - Sze Lin Yoong
- Hunter New England Population Health, Hunter New England Area Health Service, Longworth Avenue, Wallsend, NSW 2287, Australia; (S.Y.); (R.S.); (R.H.); (S.L.Y.); (K.R.); (F.T.); (L.W.)
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (B.M.); (K.H.)
- Priority Research Centre for Health Behaviour, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Kathryn Reilly
- Hunter New England Population Health, Hunter New England Area Health Service, Longworth Avenue, Wallsend, NSW 2287, Australia; (S.Y.); (R.S.); (R.H.); (S.L.Y.); (K.R.); (F.T.); (L.W.)
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (B.M.); (K.H.)
- Priority Research Centre for Health Behaviour, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Flora Tzelepis
- Hunter New England Population Health, Hunter New England Area Health Service, Longworth Avenue, Wallsend, NSW 2287, Australia; (S.Y.); (R.S.); (R.H.); (S.L.Y.); (K.R.); (F.T.); (L.W.)
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (B.M.); (K.H.)
- Priority Research Centre for Health Behaviour, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Natalie Taylor
- Cancer Research Division, Cancer Council New South Wales, 153 Dowling St, Woolloomooloo, NSW 2011, Australia;
- School of Health Sciences, University of Sydney, Camperdown, NSW 2006, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Area Health Service, Longworth Avenue, Wallsend, NSW 2287, Australia; (S.Y.); (R.S.); (R.H.); (S.L.Y.); (K.R.); (F.T.); (L.W.)
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (B.M.); (K.H.)
- Priority Research Centre for Health Behaviour, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
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27
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Raine G, Thomas S, Rodgers M, Wright K, Eastwood A. Workplace-based interventions to promote healthy lifestyles in the NHS workforce: a rapid scoping and evidence map. HEALTH SERVICES AND DELIVERY RESEARCH 2020. [DOI: 10.3310/hsdr08180] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
The health and well-being of staff working in the NHS is a significant issue for UK health care. We sought to identify research relevant to the promotion of healthy lifestyles among NHS staff on behalf of NHS England.
Objectives
To map existing reviews on workplace-based interventions to promote health and well-being, and to assess the scope for further evidence synthesis work.
Design
Rapid and responsive scoping search and evidence map.
Participants
Adult employees in any occupational setting and in any role.
Interventions
Any intervention aimed at promoting or maintaining physical or mental health and well-being. Early intervention initiatives and those addressing violence against staff, workplace bullying or harassment were also included.
Main outcome measures
Any outcome related to the effectiveness, cost-effectiveness or implementation of interventions.
Data sources
A scoping search of nine databases was conducted to identify systematic reviews on health and well-being at work. Searches were limited by publication date (2000 to January/February 2019).
Review methods
The titles and abstracts of over 8241 records were screened and a total of 408 potentially relevant publications were identified. Information on key characteristics were extracted from the titles and abstracts of all potentially relevant publications. Descriptive statistics (counts and percentages) for key characteristics were generated and data from reviews and ‘reviews of reviews’ were used to produce the evidence map.
Results
Evidence related to a broad range of physical and mental health issues was identified across 12 ‘reviews of reviews’ and 312 other reviews, including 16 Cochrane reviews. There also exists National Institute for Health and Care Excellence guidance addressing multiple issues of potential relevance. A large number of reviews focused on mental health, changing lifestyle behaviour, such as physical activity, or on general workplace health/health promotion. Most of the reviews that focused only on health-care staff addressed mental health issues, and stress/burnout in particular.
Limitations
The scoping search process was extensive and clearly effective at identifying relevant publications, but the strategy used may not have identified every potentially relevant review. Owing to the large number of potentially relevant reviews identified from the scoping search, it was necessary to produce the evidence map using information from the titles and abstracts of reviews only.
Conclusions
It is doubtful that further evidence synthesis work at this stage would generate substantial new knowledge, particularly within the context of the NHS Health and Wellbeing Framework[NHS England. Workforce Health and Wellbeing Framework. 2018. URL: www.nhsemployers.org/-/media/Employers/Publications/Health-and-wellbeing/NHS-Workforce-HWB-Framework_updated-July-18.pdf (accessed 10 January 2019)] published in 2018. Additional synthesis work may be useful if it addressed an identifiable need and it was possible to identify one of the following: (1) a specific and focused research question arising from the current evidence map; it may then be appropriate to focus on a smaller number of reviews only, and provide a more thorough and critical assessment of the available evidence; and (2) a specific gap in the literature (i.e. an issue not already addressed by existing reviews or guidance); it may then be possible to undertake further literature searching and conduct a new evidence review.
Funding
This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 18. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Gary Raine
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Sian Thomas
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Mark Rodgers
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Kath Wright
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Alison Eastwood
- Centre for Reviews and Dissemination, University of York, York, UK
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Schliemann D, McKinley MC, Woodside JV. Mixed methods evaluation of an employer-led, free lunch initiative in Northern Ireland. BMC Nutr 2019; 5:60. [PMID: 32153973 PMCID: PMC7050844 DOI: 10.1186/s40795-019-0321-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 11/05/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The objective of this study was to evaluate the acceptance of an employer-led free lunch initiative and its effect on health, diet, and attitudes towards health and diet amongst employees in a small workplace in Northern Ireland. METHODS This was a controlled, employer-led pilot intervention, which was evaluated through a mixed methods approach. RESULTS Seventeen participants from the intervention site and 14 participants from the control site completed all assessments. Post-intervention, there was no difference in change in dietary measures between the sites, except for saturated fat intake during weekdays (IS: - 1.3% of calories, SD: 4.3; CS: 2.8% of calories, SD: 6.6; P-value < 0.05). Qualitative information was summarised to highlight employees' expectations and experiences with the intervention. CONCLUSION This study highlights the challenges that need to be considered when implementing a free lunch initiative for staff.
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Affiliation(s)
- Désirée Schliemann
- 0000 0004 0374 7521grid.4777.3Centre for Public Health, Queen’s University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA UK
| | - Michelle C. McKinley
- 0000 0004 0374 7521grid.4777.3Centre for Public Health, Queen’s University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA UK
| | - Jayne V. Woodside
- 0000 0004 0374 7521grid.4777.3Centre for Public Health, Queen’s University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA UK
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Feuerstein-Simon R, Dupuis R, Schumacher R, Cannuscio CC. A Randomized Trial to Encourage Healthy Eating Through Workplace Delivery of Fresh Food. Am J Health Promot 2019; 34:269-276. [PMID: 31840522 DOI: 10.1177/0890117119890804] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE This study aimed to increase the consumption of home-cooked meals among employees at a large urban worksite through a fully subsidized Community Supported Agriculture (CSA) program. DESIGN Randomized trial. SETTING Worksite in a large northeast city. PARTICIPANTS Employees were recruited through flyers, e-mail listservs, and outreach from departmental administrators (n = 60). INTERVENTION Intervention participants received 8 biweekly fresh food deliveries through a CSA program. They also received cooking education and support. Control participants received usual employee benefits. MEASURES Consumption of meals prepared at home was the primary end point. Increased consumption of fresh fruits and vegetables was the secondary end point, and food insecurity was an exploratory end point. ANALYSIS Poisson regression was used to assess mean differences in weekly consumption of home-cooked meals. To assess differences in fruit and vegetable consumption and food insecurity, binary logistic regression was used to estimate odds ratios. RESULTS Compared to the control group, intervention participants consumed 29% more home-cooked meals per week (P < .01). Fruit and vegetable consumption also increased among intervention participants. The odds of at least twice-daily fruit consumption were 3.8 times higher among intervention participants than among controls, and the odds of at least twice-daily vegetable consumption were 6.2 times higher among intervention participants than among controls. Compared to control participants, intervention participants experienced a statistically significant 89% reduction in the odds of reporting food insecurity at follow-up, when controlling for baseline food insecurity. Participants reported perceived intervention benefits, including the opportunity to experiment with new, healthful foods without financial risk, as well as the social value of sharing recipes, food, and related conversation with colleagues. CONCLUSION The study demonstrated the feasibility and potential positive effects of a subsidized workplace CSA program, augmented with cooking education and support.
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Affiliation(s)
| | - Roxanne Dupuis
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, MA, USA
| | - Ryan Schumacher
- Penn Medicine Center for Health Care Innovation, Philadelphia, PA, USA
| | - Carolyn C Cannuscio
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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30
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Sayón-Orea C, Razquin C, Bulló M, Corella D, Fitó M, Romaguera D, Vioque J, Alonso-Gómez ÁM, Wärnberg J, Martínez JA, Serra-Majem L, Estruch R, Tinahones FJ, Lapetra J, Pintó X, Tur JA, López-Miranda J, Bueno-Cavanillas A, Delgado-Rodríguez M, Matía-Martín P, Daimiel L, Sánchez VM, Vidal J, Vázquez C, Ros E, Ruiz-Canela M, Sorlí JV, Castañer O, Fiol M, Navarrete-Muñoz EM, Arós F, Gómez-Gracia E, Zulet MA, Sánchez-Villegas A, Casas R, Bernal-López R, Santos-Lozano JM, Corbella E, Bouzas C, García-Arellano A, Basora J, Asensio EM, Schröder H, Moñino M, García de la Hera M, Tojal-Sierra L, Toledo E, Díaz-López A, Goday A, Salas-Salvadó J, Martínez-González MA. Effect of a Nutritional and Behavioral Intervention on Energy-Reduced Mediterranean Diet Adherence Among Patients With Metabolic Syndrome: Interim Analysis of the PREDIMED-Plus Randomized Clinical Trial. JAMA 2019; 322:1486-1499. [PMID: 31613346 PMCID: PMC6802271 DOI: 10.1001/jama.2019.14630] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
IMPORTANCE High-quality dietary patterns may help prevent chronic disease, but limited data exist from randomized trials about the effects of nutritional and behavioral interventions on dietary changes. OBJECTIVE To assess the effect of a nutritional and physical activity education program on dietary quality. DESIGN, SETTING, AND PARTICIPANTS Preliminary exploratory interim analysis of an ongoing randomized trial. In 23 research centers in Spain, 6874 men and women aged 55 to 75 years with metabolic syndrome and no cardiovascular disease were enrolled in the trial between September 2013 and December 2016, with final data collection in March 2019. INTERVENTIONS Participants were randomized to an intervention group that encouraged an energy-reduced Mediterranean diet, promoted physical activity, and provided behavioral support (n = 3406) or to a control group that encouraged an energy-unrestricted Mediterranean diet (n = 3468). All participants received allotments of extra-virgin olive oil (1 L/mo) and nuts (125 g/mo) for free. MAIN OUTCOMES AND MEASURES The primary outcome was 12-month change in adherence based on the energy-reduced Mediterranean diet (er-MedDiet) score (range, 0-17; higher scores indicate greater adherence; minimal clinically important difference, 1 point). RESULTS Among 6874 randomized participants (mean [SD] age, 65.0 [4.9] years; 3406 [52%] men), 6583 (96%) completed the 12-month follow-up and were included in the main analysis. The mean (SD) er-MedDiet score was 8.5 (2.6) at baseline and 13.2 (2.7) at 12 months in the intervention group (increase, 4.7 [95% CI, 4.6-4.8]) and 8.6 (2.7) at baseline and 11.1 (2.8) at 12 months in the control group (increase, 2.5 [95% CI, 2.3-2.6]) (between-group difference, 2.2 [95% CI, 2.1-2.4]; P < .001). CONCLUSIONS AND RELEVANCE In this preliminary analysis of an ongoing trial, an intervention that encouraged an energy-reduced Mediterranean diet and physical activity, compared with advice to follow an energy-unrestricted Mediterranean diet, resulted in a significantly greater increase in diet adherence after 12 months. Further evaluation of long-term cardiovascular effects is needed. TRIAL REGISTRATION isrctn.com Identifier: ISRCTN89898870.
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Affiliation(s)
- Carmen Sayón-Orea
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Razquin
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Mónica Bulló
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Dolores Corella
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Montserrat Fitó
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Dora Romaguera
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Jesús Vioque
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Ángel M. Alonso-Gómez
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Julia Wärnberg
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - J. Alfredo Martínez
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Luís Serra-Majem
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Ramón Estruch
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Francisco J. Tinahones
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - José Lapetra
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Xavier Pintó
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Josep A. Tur
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - José López-Miranda
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Aurora Bueno-Cavanillas
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Pilar Matía-Martín
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Lidia Daimiel
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Vicente Martín Sánchez
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Josep Vidal
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Clotilde Vázquez
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Emilio Ros
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Miguel Ruiz-Canela
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - José V. Sorlí
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Olga Castañer
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Miquel Fiol
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Eva M. Navarrete-Muñoz
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Fernando Arós
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Enrique Gómez-Gracia
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - M. Angeles Zulet
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Rosa Casas
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Rosa Bernal-López
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - José M. Santos-Lozano
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Emili Corbella
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Bouzas
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Ana García-Arellano
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Josep Basora
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Eva M. Asensio
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Helmut Schröder
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Manuel Moñino
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Lucas Tojal-Sierra
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Estefanía Toledo
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Andrés Díaz-López
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Albert Goday
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
| | - Jordi Salas-Salvadó
- Centro de Investigación Biomédica en Red (CIBER), Instituto de Salud Carlos III, Madrid, Spain
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