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Why is it important to look after our workforce? 
Unemployment rates are currently at their lowest since 1975, with almost 75% of UK adults in full time employment, that’s 32.6 million people1! The UK government is now placing a high importance on improving the health of the country’s workforce and has released guidance from the National Institute for Health and Care Excellence (NICE)2 and the NHS Five Year Forward View3.  
 
The British Dietetic Association (BDA) has echoed this and made it a priority for 2015-2017 with the creation of their ‘BDA Work Ready Program’3, which aims to benefit both employers and employees by providing dietetic support and expertise to help reduce a wide range of preventable ill health conditions, improve resilience and mental wellbeing. 
Now I’m not suggesting that weight is the only factor affecting health, however much of the research has found links between being overweight or obese with increasing absenteeism and sick leave from work – often due to preventable ‘obesity-related health conditions’ such as musculoskeletal disorders and chronic diseases4. Up to 10% of all sick leave has been attributed to lifestyle behaviours and obesity4, with 25% of the UK working age population having at least one preventable condition e.g. diabetes or heart disease which acts as a barrier to productive employment5. This can be a considerable cost for both individual companies and for the economy as a whole, with NICE estimating the cost of lost productivity due to obesity alone in a company of 1000 employees to be £126,000/year6. Ill health resulting from obesity can also be a precipitating factor in the transition to early retirement, disability pension, social welfare or unemployment4. Obesity, musculoskeletal conditions and depression have been identified as the top three causes of sick leave, all of which can be improved by optimising the nutritional status of our workforce4. Therefore, it makes sense to look at the barriers to good nutritional health and consider some changes/practices that may help overcome these. 
Factors affecting the health of our workforce 
Factors such as working patterns e.g. shift work, working long hours, short, or a lack of structured breaks with limited time to eat, lone working, working in high-pressure environments, having restricted access to healthier food choices, regular travel for work and long periods of sitting can all affect an employee’s ability to make healthy food choices when at work, may lead to increased snacking and disrupt their ‘normal’ meal pattern. 
Eating patterns at work 
Let’s take a closer look at the eating habits of our working population to better understand what choices are being made, and therefore provide insight on what could be targeted. 
 
Research has found that people ‘usually’ eat breakfast at home but 50% of people do ‘sometimes’ eat it outside of the house with rolls/sandwiches, cooked breakfasts and pastries being the top choices7. The important thing here is to encourage regular breakfast consumption, wherever that may be, as a study in nurses found lower stress levels, fewer cognitive mistakes and minor accidents amongst breakfast eaters8, beyond that we could build on that habitual practice of eating breakfast at home. 
 
Almost 40% of workers report bringing a homemade lunch with them 2-5 times/week4 which is positive however it does mean that 60% of people are buying their lunch every day, and therefore relying on work canteens and restaurants. This gives employers a golden opportunity to provide healthy options, and to promote the importance of regular breaks and regular meals as a poll amongst workers found that 62% regularly skipped their lunch break4. 
 
Snacking between meals is a regular part of 97% of adults routines9, therefore provides an excellent opportunity for employers to provide healthy options, to educate employees and increase awareness of what a ‘healthy snack’ might be. A good example here would be the provision of readily available and attractive fruit and vegetable options – a recent 2019 study has found that increasing fruit and vegetable intake, even by one portion/day improves mental health and well-being, therefore having access to more fruit and vegetables at work would benefit not only the physical health but also mental health of the workforce. 
The importance of hydration 
We cannot discuss nutritional well-being without mentioning the importance of hydration. It is well established that adequate hydration is important to maintain focus, concentration and safety, and that dehydration can impact on both physical and mental performance11, having a similar effect on brain structures as mild cognitive impairment12 and contributing to fatigue, headaches and impaired reaction times. One study in drivers found that those who were dehydrated made a similar number of errors as a drunk driver13. Hydration is an important consideration for employers as the work environment can contribute to the risk of dehydration, for example working in a warm environment, needing to wear protective clothing, a lack of breaks to  
obtain fluids, or even a fear of taking toilet breaks as often as may be necessary. One particular workforce group I will quote as an example of this are hospital workers. They are at increased risk of dehydration due to their environment – air conditioning, warm temperatures, long busy shifts, limited breaks and a ban on consuming drinks when face-to-face with patients or relatives4. A 2016 study found that 45% of doctors and nurses were dehydrated by the end of their shift – this significantly impaired their cognition and short-term memory.  
What can employers do? 
Obesity levels are higher amongst workers who frequently eat in the staff canteen15, showing that a person’s surrounding environment has a big influence on the health and nutrition choices they make. Employers need to create an environment which promotes learning and increased awareness, by providing a range of group education sessions, 1:1 consultations, addressing food availability by targeting canteens, vending machines, snack provision, hydration facilities and effect organisational policy changes4. 
 
There are plenty of easy, practical and affordable ways to do this, and a registered Dietitian can guide a workplace through how to do so seamlessly, get in touch here if you’d like to learn more about how I can help you with this. 
 
Cost is always going to be an important factor for any company considering a new intervention or programme – and increasing awareness of, or providing, healthier eating opportunities in the workplace is no exception. It can be difficult to quantify or monetise the benefit of such programmes, however  
employers should be reassured by the BDA findings that such interventions can increase productivity by 1-2%, and by the strong association between obesity 
and increased sick leave4 – therefore promoting healthy weight maintenance amongst employees will reduce absenteeism. Studies have suggested that companies who invest in the health and wellbeing of their workforce have a more positive corporate image, loyal employees and a higher standard of customer service4. 
 
By working with dietitians all workplace health interventions reported some benefits, for example Merseyrail reduced their sickness days from 155 days to 35 days in one year – reducing their cost of sickness by £11,000 in the first year alone, and an airline company achieved a 5% weight loss in men who attended an intervention – maintained at a 2-and-a-half-year follow-up4. So, with strategic implementation of a nutritional care program the benefits can outweigh and cover the costs. 
Conclusion 
In conclusion, employment levels in the UK are currently at the highest they’ve been in over 40 years; however, sickness and absenteeism is a considerable cost for employers. Obesity is one of the top causes of sick leave – most likely due to its associated conditions, therefore optimising nutrition in the workplace needs to be a priority in order to preserve our workforce. In order to succeed, any intervention in the workplace must involve both the individual and the surrounding environment, and employers need to take practical steps to make healthier food choices easier and more attractive to employees. Get in touch here if you’d like to discuss how I can help you improve the health and wellbeing of your workplace. 
 
 
References 
1 UK labour market: February 2019, Office for National Statistics https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/ 
employmentandemployeetypes/bulletins/uklabourmarket/february2019 
#summary-of-latest-labour-market-statistics 
 
2 Workplace policy and management practices to improve the health and wellbeing of employees, NICE 2015 https:// www.nice.org.uk/guidance/ng13. 
 
3 NHS Five Year Forward View, NHS England 2014 http://www.england.nhs.uk/ourwork/futurenhs/ 
 
4 BDA Work Ready Programme: Supporting healthier working lives through dietitian-led wellness initiatives, BDA 2015 https://www.bdaworkready.co.uk... ﷒ 
 
5 Long Term Conditions Compendium of Information: Third Edition, Department of Health 2012 
 
6 NICE (2015) Workplace health: Costs and savings. Available from: http://publication.nice.org.uk... 
 
7 Mintel Breakfast Eating Habits, April 2015 
 
8 Chaplin K and Smith AP Breakfast and snacks: associations with cognitive failures, minor injuries, accidents and stress. Nutrients; 2011 3(5):515-28 
9 Consumer Snacking – UK, Mintel, March 2015 
 
10 Ocean L, Howley P, Ensor J (2019) Lettuce be happy: A longitudinal UK study on the relationship between fruit and vegetable consumption and well-being. Social Science & Medicine; 222:335-345 
 
11 Adan A (2012) Cognitive performance and dehydration. J Am Coll Nutr; 31 (2): 71-78 
 
12 Streitbürger DP, Möller HE, Tittgemeyer M (2012) Investigating structural brain changes of dehydration using voxel-based morphometry. PLoS One; 7(8):e44195 
 
13 Watson P, Whale A, Mears SA et al (2015) Mild hypohydration increases the frequency of driver errors during a prolonged monotonous driving task. Physiology & Behaviour; 147: 313-18 
 
14 El-Sharkawy A, Bragg D, Watson P, Neal K, Sahota O, Maughan R, Lobo D (2016) Hydration amongst nurses and doctors on-call (the HANDS on prospective cohort study). Clinical Nutrition; 35(4):935-942 
 
15 Kjøllesdal MR, Holmboe-Ottesen G, Wandel M (2011) Frequent use of staff canteens is associated with unhealthy dietary habits and obesity in a Norwegian adult population. Public Health Nutr; 14(1):133-41 
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