Effectiveness of workplace wellness programmes for dietary habits, overweight, and cardiometabolic health: a systematic review and meta-analysis

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. FindingsFrom 10 169 abstracts reviewed, 121 studies (82 [68%] randomised controlled trials and 39 [32%] quasiexperimental 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%. Betweenstudy 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.

Influence of Nutrition, Food and Diet-Related Interventions in the Workplace: A Meta-Analysis with Meta-Regression

“…In line with what was stated by Peñalvo et al [78], it is important to highlight the generally short/moderate duration (between 6 months and 1 year) of the vast majority of workplace health interventions and programs, as well as the limited evaluation of the sustainability of the change in habits after the end of the program, which may raise doubts about the long-term effectiveness of these interventions. However, in relation to the failure of interventions focused on overweight and obese patients carried out in the workplace, Park and King [72] argue that there is evidence indicating that the duration of the intervention is a determining factor, with short-term programs (less than 6 months) being more effective than long-term programs.…”

“…Most of the identified studies came from high-income countries, mainly the United States, where the problem of obesity and overweight has become a heavy burden in economic and health terms for the state and companies [7]. In this sense, and as indicated by Peñalvo et al [78], occupational health programs and their evaluation are scarce in other geographic and socioeconomic contexts (a single study from India included in the review) where non-communicable diseases are increasing rapidly.…”

Co-Creating an Occupational Health Intervention within the Construction Industry in Sweden: Stakeholder Perceptions of the Process and Output

“…Second, our results imply that allowing influence over both the content and the process seemed to have enhanced the implementation. The need to identify efficient strategies to support the implementation of workplace interventions is stressed [ 22 , 41 ]. However, explicit implementation strategies are often left out when planning and evaluating participatory work environment interventions [ 24 ].…”

Semmelweis Caring University Model Program Based on the Development of a Center of Preventive Services: Health for All Employees at a University Occupational Setting

“…Monitoring and to define effectiveness of a workplace health promotion/disease prevention program is an essential requirement, although evaluation methods derived for and applied within the field of health promotion at different (especially occupational) settings have often fallen short of the ideal. In the most recent systematic review and meta-analysis carried out by Peñalvo et al ( 33 ) could extract sufficient information to calculate pooled estimates for 20 different outcomes, of which 13 were found positively affected by workplace health promotion/disease prevention programmes, and could demonstrate beneficial effects on dietary factors, body anthropometrics, and cardiometabolic risk. These outcome indicators will be evaluated regularly every 5 years.…”