Advertisement

Association of Worksite Food Purchases and Employees’ Overall Dietary Quality and Health

      Introduction

      Most Americans spend half their waking hours at work and consume food acquired there. The hypothesis was that the healthfulness of worksite food purchases was associated with employees’ overall diet and health.

      Methods

      Participants were 602 hospital employees who regularly used worksite cafeterias and enrolled in a health promotion study in 2016–2018. All cafeterias used traffic-light labels (green=healthy, yellow=less healthy, red=unhealthy). A Healthy Purchasing Score was calculated for each participant by summing weighted proportions of cafeteria items purchased over a 3-month observation period (red=0, yellow=0.5, green=1; range, 0–1). Healthy Eating Index scores (range, 0–100) were calculated based on two 24-hour dietary recalls. BMI, blood pressure, and HbA1c were measured. Hypertension and prediabetes/diabetes diagnoses were determined by self-reported and clinical data. Regression analyses examined dietary quality and diagnoses by tertile of Healthy Purchasing Score (T1=least healthy purchases, T3=most healthy), adjusting for demographics. All data were collected before the start of the intervention and were analyzed in 2018.

      Results

      Mean age was 43.6 years (SD=12.2), 79% were female, and 81% were white. Mean BMI was 28.3 kg/m2 (SD=6.5); 21% had hypertension, and 27% had prediabetes/diabetes. Mean Healthy Eating Index was 60.4 (SD=12.5); mean Healthy Purchasing Score was 0.66 (SD=0.15). Healthier purchases were associated with healthier Healthy Eating Index scores (T1=55.6, T2=61.0, T3=64.5, p<0.001) and lower obesity prevalence (T1=38%, T2=29%, T3=24%, p<0.001); similar patterns were observed for hypertension and prediabetes/diabetes.

      Conclusions

      Worksite food purchases were associated with overall dietary quality and cardiometabolic risk. Interventions to increase healthfulness of food choices at work may improve employees’ health.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      REFERENCES

        • U.S. Bureau of Labor Statistics
        Economic News Release: American Time Use Survey −2016 Results.
        2016 (Published 2016)
      1. Onufrak SJ, Zaganjor H, Pan L, et al. Foods and beverages obtained at worksites in the United States. J Acad Nutr Diet. In press. Online January 22, 2019. https://doi.org/10.1016/j.jand.2018.11.011.

        • Jackson CL
        • Wee CC
        • Hurtado DA
        • Kawachi I
        Obesity trends by industry of employment in the United States, 2004 to 2011.
        BMC Obes. 2016; 3: 20
        • CDC
        Worker Health Charts: Health Behavior Charts, Behavioral Risk Factor Surveillance System (BRFSS), 2013–2015.
        2018 (Published)
        • Van Nuys K
        • Globe D
        • Ng-Mak D
        • et al.
        The association between employee obesity and employer costs: evidence from a panel of U.S. employers.
        Am J Health Promot. 2014; 28: 277-285
        • Goettler A
        • Grosse A
        • Sonntag D
        Productivity loss due to overweight and obesity: a systematic review of indirect costs.
        BMJ Open. 2017; 7e014632
        • Micha R
        • Penalvo JL
        • Cudhea F
        • et al.
        Association between dietary factors and mortality from heart disease, stroke, and type 2 diabetes in the United States.
        JAMA. 2017; 317: 912-924
        • Sotos-Prieto M
        • Bhupathiraju SN
        • Mattei J
        • et al.
        Association of changes in diet quality with total and cause-specific mortality.
        N Engl J Med. 2017; 377: 143-153
        • Thorndike AN
        • Sonnenberg L
        • Riis J
        • Barraclough S
        • Levy DE
        A 2-phase labeling and choice architecture intervention to improve healthy food and beverage choices.
        Am J Public Health. 2012; 102: 527-533
        • Thorndike AN
        • Riis J
        • Sonnenberg LM
        • Levy DE
        Traffic-light labels and choice architecture: promoting healthy food choices.
        Am J Prev Med. 2014; 46: 143-149
        • Thorndike AN
        • Bright OM
        • Dimond MA
        • Fishman R
        • Levy DE
        Choice architecture to promote fruit and vegetable purchases by families participating in the Special Supplemental Program for Women, Infants, and Children (WIC): randomized corner store pilot study.
        Public Health Nutr. 2017; 20: 1297-1305
        • Onufrak SJ
        • Watson KB
        • Kimmons J
        • et al.
        Worksite food and physical activity environments and wellness supports reported by employed adults in the United States, 2013.
        Am J Health Promot. 2018; 32: 96-105
        • Cawley J
        • Meyerhoefer C
        The medical care costs of obesity: an instrumental variables approach.
        J Health Econ. 2012; 31: 219-230
        • Levy DE
        • Gelsomin ED
        • Rimm EB
        • et al.
        Design of ChooseWell 365: randomized controlled trial of an automated, personalized worksite intervention to promote healthy food choices and prevent weight gain.
        Contemp Clin Trials. 2018; 75: 78-86
        • U.S. Department of Agriculture, HHS
        Dietary Guidelines for Americans 2010.
        7th Edition. U.S. Government Printing Office, Washington, DC2010
        • U.S. Department of Agriculture, HHS
        2015-2020 Dietary Guidelines for Americans.
        8th Edition. U.S. Government Printing Office, Washington, DC2015 (2015)
        • Craig CL
        • Marshall AL
        • Sjostrom M
        • et al.
        International Physical Activity Questionnaire: 12-country reliability and validity.
        Med Sci Sports Exerc. 2003; 35: 1381-1395
        • Hagströmer M
        • Oja P
        • Sjöström M
        The International Physical Activity Questionnaire (IPAQ): a study of concurrent and construct validity.
        Public Health Nutr. 2007; 9: 755-762
        • Division of Cancer Control and Population Sciences Epidemiology and Genomics Research. Program
        ASA24 automated self-administered 24 hour dietary assessment tool.
        2018
        https://epi.grants.cancer.gov/asa24/
        Date accessed: November 30, 2018
        (Published)
        • Frankenfeld CL
        • Poudrier NM
        • Waters NM
        • Gillevet YX
        • Xu Y
        Dietary intake measured from a self-administered, online 24-hour recall system compared with 4-day diet records in an adult U.S. population.
        J Acad Nutr Diet. 2012; 112: 1642-1647
        • Subar AF
        • Kirkpatrick SI
        • Mittl B
        • et al.
        The Automated Self-Administered 24-hour dietary recall (ASA24): a resource for researchers, clinicians, and educators from the National Cancer Institute.
        J Acad Nutr Diet. 2012; 112: 1134-1137
        • Krebs-Smith SM
        • Pannucci TE
        • Subar AF
        • et al.
        Update of the Healthy Eating Index: HEI-2015.
        J Acad Nutr Diet. 2018; 118: 1591-1602
        • Freedman LS
        • Guenther PM
        • Krebs-Smith SM
        • Dodd KW
        • Midthune D
        A population's distribution of Healthy Eating Index-2005 component scores can be estimated when more than one 24-hour recall is available.
        J Nutr. 2010; 140: 1529-1534
        • Reedy J
        • Lerman JL
        • Krebs-Smith SM
        • et al.
        Evaluation of the Healthy Eating Index-2015.
        J Acad Nutr Diet. 2018; 118: 1622-1633
      2. U.S. National Center for Health Statistics. What we eat in America/National Health and Nutrition Examination Survey, 2013-2014: Healthy Eating Index-2015. www.cnpp.usda.gov/healthyeatingindex. Published 2018.

        • Chiuve SE
        • Fung TT
        • Rimm EB
        • et al.
        Alternative dietary indices both strongly predict risk of chronic disease.
        J Nutr. 2012; 142: 1009-1018
      3. Economic News Release: American Time Use Survey  2016 Results. [press release]. U.S. Bureau of Labor Statistics. www.bls.gov/news.release/archives/atus_06272017.pdf. Published June 27, 2017. Accessed March 5, 2019.

        • Levy DE
        • Riis J
        • Sonnenberg LM
        • Barraclough SJ
        • Thorndike AN
        Food choices of minority and low-income employees: a cafeteria intervention.
        Am J Prev Med. 2012; 43: 240-248
        • Baicker K
        • Cutler D
        • Song Z
        Workplace wellness programs can generate savings.
        Health Aff (Millwood). 2010; 29: 304-311
        • Ozminkowski RJ
        • Serxner S
        • Marlo K
        • et al.
        Beyond ROI: using value of investment to measure employee health and wellness.
        Popul Health Manag. 2016; 19: 227-229
        • Pronk NP
        Placing workplace wellness in proper context: value beyond money.
        Prev Chronic Dis. 2014; 11: 140128
        • Miller S
        Employers See Wellness Link to Productivity, Performance.
        Society for Human Resource Management, 2015 (Published)
        • Society for Human Resource Management
        Employee benefits: the evolution of benefits.
        2018 (Published)