1. Food and workplace health
Monday 19th May 2014
Food and workplace health
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Lauren Idowu, Cardiff and Vale Public Health Team

2. Eating well
Briefly explain he government’s Eat Well plate and guidelines
Eating a healthy, balanced diet is an essential component of improving and maintaining health and wellbeing. The links between healthy eating and the maintenance of a healthy body weight are well documented in research and literature. Recommended guidelines (1) state that meals should be based around the food groups highlighted in the Eatwell Plate model
UK guidelines also highlight the importance of eating five portions of fruit and vegetables every day (1). Fruit and vegetables are known to provide us with vitamins and minerals that are essential for maintenance and functioning of the human body. Regular fruit and vegetable consumption is also known to reduce the risk of serious disease including heart disease, stroke and some cancers (1).

3. The picture in Cardiff & Vale
In Cardiff and the Vale, the percentage of people eating 5 a day is declining 1
Over half of adults (52%) are overweight or obese 1
Eating 5-a-day could reduce the risk of deaths from chronic diseases such as heart disease, stroke, and cancer by up to 20% 2
Obesity linked with the risk of developing diabetes, coronary heart disease and some cancers
Eating well plays an important part in maintaining good health. The 5-a-day indicator is a proxy measure for a healthy balanced diet and measure of a protective lifestyle factor. It is estimated that eating at least 5 portions of a variety of fruit and vegetables a day could reduce the risk of deaths from chronic diseases such as heart disease, stroke, and cancer by up to 20% i and that increasing fruit and vegetable consumption is the second most important cancer prevention strategy after reducing smoking ii. A balanced diet also helps to reduce fat intake and maintain a healthy weight therefore helping to reduce obesity. Over half the adult population (52%) iii
Levels of obesity are linked with the risk of developing diseases such as diabetes, coronary heart disease and some cancers.
The most disadvantaged communities experience the worst health outcomes.

4. Why?
We’re eating more calories (an increase of 190kcals per capita per day between 1985 and 2002) 3
Increased supply of cheap, palatable, energy dense foods that are much more accessible, convenient and marketed pervasively 4
Less time for meal preparation 3
Food prices increased by 12% ( ) 5 and household incomes have fallen
Eating more calories: In the UK between 60% and 100% of weight gain is attributed to dietary excess rather than lack of physical activity (19). Moreover, in the United Kingdom an increase in national food energy supply of only 63 kcals extra per capita per day was registered from 1970 to 1984, compared with an extra 190 kcals per capita per day between 1985 and This jump towards higher energy intake is due to innovations in food manufacturing and distribution, leading to increased supply of cheap, palatable, energy dense foods that are much more accessible, convenient and marketed pervasively. Healthy food tends to be less convenient, less accessible and more expensive (20).
Less time to cook: Socio-demographic changes, such as urbanization and increased participation by women in the workforce, result in less time for meal preparation.
Energy dense food is cheaper: An increased supply of cheap, palatable, energy dense foods that are much more accessible, convenient and marketed pervasively (ref 20 WHO). Energy dense foods of poor nutritional value are cheaper than more nutritious foods such as fruit and veg.
Lower income households responded by buying cheaper food alternatives. Another study found many families with children and single-parent households are substituting fresh fruit and vegetables with cheaper calorie-dense processed food with high levels of saturated fat and sugar (22). Between 2007 and 2012 food became 30% more expensive and those families with young children spent over 15% less on food. Energy-dense foods of poor nutritional value are cheaper than more nutritious foods such as vegetables and fruit, and relatively poor families with children purchase food primarily to satisfy their hunger (3). WHO document
Food prices: The Defra Family Food Survey indicates that between 2007 and 2011, food prices increased 12% in real terms v.
The recession has seen real household incomes fall; they are now at their lowest level since the second quarter of The cost of food, however, has continued to rise. This has impacted detrimentally on fruit and vegetable consumption and contributed to the growing problem of food poverty in Cardiff and the Vale of Glamorgan. Looking ahead, food prices are expected to continue to increase, while the outlook for earnings is modest.
Low-income households were disproportionately affected, with a 1.6% rise in spending on food compared with a 0.3% rise on average.

5. The impact
Obesity costs the economy around £20 billion per year, taking lost productivity into account 6
Workplace environment might contribute to increased overweight and obesity, but it may also provide opportunities for addressing the problem...
Societal cost = reduced well-being and human lives lost
Financial cost = care and treatment of those with obesity-related diseases.
Workplace cost = decreased worker productivity and increasing the need for support services and disability management
Obesity is associated with substantially increased rates of absenteeism (i.e. more days out of work) and presenteeism (i.e. reduced productivity while at work) [11,13,14]. Obese workers take more sick days, have longer sick leaves and incur greater productivity losses than do non-obese workers. Some analyses estimate that the costs to employers of obesity-related presenteeism are greater than the direct costs of the medical care required by those workers [13].
Obesity costs national economies billions of euros per year, including in lost productivity and sick days. Strategies to address obesity across the social gradient – but especially in low socioeconomic groups – are urgently required to stem these financial losses. WHO report
Moreover, the ‘global tsunami’ of obesity will almost certainly demand increasing commitments from occupational health programmes in coming years. Four related issues deserve attention. First, obesity exacts an enormous societal cost in terms of reduced well-being and human lives lost. Second, huge financial costs result from the care and treatment of those with obesity-related diseases. Third, obesity adversely affects workplace costs by decreasing worker productivity and increasing the need for support services and disability management. Fourth, the work environment might contribute to increased overweight and obesity, but it may also provide opportunities for addressing the problem. Oxford Journals Medicine Occupational Medicine Volume 61, Issue 4 Pp

6. Healthy food environment in the workplace
Improving the food environment e.g. offering healthier food in restaurants and promoting eating well, is one way of contributing to the health of employees, customers and the wider population.
Make the healthy choice the easy choice
An improvement to the food environment (i.e. offering healthier food in our hospital restaurants and promoting eating well) is one way we can contribute to improving the health of the population and prevent future ill health linked to poor diet.
Productivity, absenteeism, presenteeism, overall staff wellbeing
Workplaces are an effective setting to provide targeted health improvement actions and interventions to staff. They offer access to a stable population of adults and provide the opportunity to create environments that invest in long term improvement of staff health and wellbeing.
Organisations have the opportunity to invest in the long term health and wellbeing of their employees by encouraging and supporting healthy eating in the workplace and creating working environments which make the healthy choice the easy choice.
This forum will explore opportunities for workplaces to create healthy environments for staff to make healthy eating choices, by demonstrating available support and examples of best practice for employees to support staff to make healthy eating choices as part of an overall healthy lifestyle.

7. Support and awards Briefly describe schemes available...
Highlight that they can support businesses to make changes to the environment- that will benefit both employees and the customers they serve

8. References
1 –Statistics for Wales (2013). Welsh Health Survey Results 2011 and Department of Health (1998) Nutritional Aspects of the Development of Cancer. London: The Stationery Office. 3 –World Health Organisation (2014 Obesity and inequities Guidance for addressing inequities in overweight and obesity. Copenhagen. 4 - Drewnowski A, Darmon N. Food choices and diet costs: an economic analysis. J Nutr Apr;135(4):900– Department for Environment, Food and Rural Affairs (2012). Family Food London: National Statistics. Accessed: Local Government Association, Public Health England (2013) Social care and obesity. A discussion paper. London: Local Government Association.