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Better food at work - the Nordic and Baltic experience. Project report and proceedings from Better Food at Work Conference

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Project report and proceedings from Better Food at Work Conference
23rd - 25th September 2009 Tallinn, Estonia
Editors Mia Brandhøj & Bent Egberg Mikkelsen
Published by Centre for Food, People & Design
Aalborg University, 2009
Better food at work
the Nordic and Baltic experience
Better food at work - the Nordic and Baltic experience
Project report and proceedings from Better Food at Work Conference
23rd - 25th September 2009 Tallinn, Estonia
Editors Mia Brandhøj & Bent Egberg Mikkelsen
Published by Research group for Food, People & Design
Aalborg University, 2009
PUBLISHED BY Aalborg University Copenhagen
EDITORS Mia Brandhøj & Bent Egberg Mikkelsen
Project Staff Member Project Manager
Research group for Food People & Design Aalborg University
SUPPORT FROM Nordic Council of Ministers/The NordBalt programme
Øresund Food Network
National Institute for Health Development, Estonia
LAYOUT Aalborg University
Department of Architecture & Design
COPYRIGHT Authors © 2009
ISBN 978-87-92650-00-9
Also available at www.foodandwork.aau.dk
Page 4 of 72
Table of Content
Preface ......................................................................................................................................................................6
Introduction .............................................................................................................................................................7
Mapping of experience .................................................................................................................................7
Conference ...................................................................................................................................................7
Conclusion ....................................................................................................................................................9
Conference proceedings ....................................................................................................................................... 10
Eating at Worksite................................................................................................................................................. 11
What is the Evidence on the Effectiveness of Healthy Eating Interventions at Workplaces? ...................... 11
Glorian Sorensen, ............................................................................................................................................... 11
Worksite Dining as a Collective Good or Individualization of Health - A Danish Perspective ....................... 14
Michael Søgaard Jørgensen ............................................................................................................................... 14
Do Worksite Provided Meals Lead to Healthier Eating? A Finnish Perspective ............................................ 17
Eva Roos............................................................................................................................................................. 17
Company Fruit ....................................................................................................................................................... 18
Healthy Eating at Work - the BAMA way ....................................................................................................... 18
Gunn Helene Arsky ............................................................................................................................................. 18
Food, Health & Irregular Working Hours ............................................................................................................. 20
Food, Health & Shift Work: Nutrition, Shift work and Chronobiology When to Eat? ................................ 20
Maria Lennernäs ................................................................................................................................................ 20
Lots of Food but Poor Meals A Sociological Study of the Worksite as a Meal Arena ................................. 23
Maria Nyberg ..................................................................................................................................................... 23
Successful Physical Activity & Nutrition Intervention at Sea......................................................................... 26
Sonja Sif Jóhannsdóttir, ..................................................................................................................................... 26
Effect of Diet Intervention on Mood, Driving Skills and Cardiovascular Risk Factors among Danish Truck
Drivers ............................................................................................................................................................ 28
Jens Steen Nielsen .............................................................................................................................................. 28
Implementing healthy eating at work in practice ............................................................................................... 31
Coin Offer Meal “Diastole” ............................................................................................................................ 31
Michael Allerup Nielsen ..................................................................................................................................... 31
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New Possibilities in influencing Eating Patterns through Healthier Canteen Take Away ..................................... 33
Gitte Laub Hansen ............................................................................................................................................. 33
Eating Habits in the Baltic States ................................................................................................................... 35
Sirje Potisepp ..................................................................................................................................................... 35
Research on Influencing Worksite Eating ............................................................................................................ 39
Worksite Canteen Availability and Usage among Finnish Employees ........................................................... 39
Susanna Raulio .................................................................................................................................................. 39
Eva Roos, PhD, Docent ....................................................................................................................................... 39
Strategies for Influencing Eating Patterns through the Worksite - A Review ............................................ 41
Signe Poulsen ..................................................................................................................................................... 41
Design Strategy for better Eating Facilities ................................................................................................... 44
Tenna Doktor Olsen, .......................................................................................................................................... 44
Policy Initiatives, Regulations & Recommendations ........................................................................................... 48
Guidelines for the Prevention of Obesity at the Workplace ......................................................................... 48
Dina Zota ........................................................................................................................................................... 48
A Multisectoral Approach is the only Way in Planning and Implementing Policies and Actions towards
Health ............................................................................................................................................................ 50
Sirje Vaask ......................................................................................................................................................... 50
Eating at worksite in the Nordic Countries – From privacy to Collectivity .................................................... 53
Bent Egberg Mikkelsen & Mia Brandhøj............................................................................................................ 53
Appendix 1: Press Coverage ................................................................................................................................. 58
Forskere vil udbrede viden om sunde spisevaner på jobbet ......................................................................... 59
Sund mad spredes mod øst ........................................................................................................................... 60
Sund kantinedrift på danske arbejdspladser - En god forretning.................................................................. 61
Tasakaalustatud lõuna tagab terviseSüdamepäev toob kokku Põhja- ja Baltimaade toitumiseksperdid .... 64
Südamepäev toob kokku Põhja- ja Baltimaade toitumiseksperdid ............................................................... 65
ОБЕД НА РАБОТЕИНВЕСТИЦИЯ В ЗДОРОВЬЕ ......................................................................................... 69
Appendix 2: Summary of Feedback on conference ............................................................................................. 70
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Preface
Food, health and nutrition are topics that increasingly are put on the agenda at workplaces. Policy makers,
politicians, practitioners, corporate actors and health promotion researchers point out the workplace as an
arena where these issues can be shaped.
A Nordic-Baltic partnership has carried out a project on Better Food at Worka project managed by the research
group for Food, People & Design at Aalborg University in cooperation with the Technical University of Denmark,
Øresund Food Network in Denmark & Sweden, and the National Institute for Health Development in Estonia.
The project has received support from the Nordic Council of Ministers/The NordBalt program.
The project has mapped the experiences on food at worksites in the countries and carried out the conference
Better Food at Work - The Nordic Baltic Experiences’ held in Tallinn September 23rd -25th, 2009.
There was a considerable interest in the Better Food at Work conference, indicated from the number of
submitted papers, as well as cross-national press coverage prior to and after the conference. Also, the interest
was reflected by the sixty-five participants and speakers that represented a broad range of researchers, policy
makers and practitioners, gathered from the Nordic and Baltic countries. The outcome of the conference will
be made available through a special issue of the International Journal of Workplace Health Management
published in june 2010, where some of the papers and conference debates will figure as the different
approaches to the field and challenges when working with health and food at work.
The present publication includes a summary of project activities, the submissions from the conference and
press coverage related to the conference. You can explore the website www.foodatwork.aau.dk to download
the presentations from the conference.
As the leader of the project I am grateful for the work and support from a number of individuals. First of all Mia
Brandhøj, Sofie Husby, Anneli Sammel, Piret Potisepp and Sirje Vaask that made the project and the conference
possible through their commitment and hard work. I would also like to thank Michael Søgaard Jørgensen
(Technical University of Denmark), Mie Bendtsen (Øresund Food Network), Tagli Pitsi (National Institute for
Health Development, Estonia), and Morten Strunge Meyer (Danish Cancer Society) for valuable discussions in
the planning process. Especially I would like to thank Monika Pearson (National Food Agency of
Sweden/NordBalt program) for valuable discussion in the initial phase and the Nordic Council of Ministers/The
NordBalt program, Øresund Food Network and National Institute for Health Development in Estonia for their
support.
Bent Egberg Mikkelsen, Project leader
Professor - Research group for Food, People & Design
Aalborg University
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Introduction
Mapping of experience
The first approach to the literature search within Better Food at Work was carried out on the fundamental
basis of the knowledge and results from a previous Danish / Swedish cooperation on “Food at Work around the
Clock. Work Time Meal”. This research is done by researchers and scientist within the field of health,
nutrition, sociology and anthropology at Lund University and the Technical University of Denmark, and
published in 2009 by Øresund Food Network (“Mat på arbetet dygnet runt? Mat Tid Arbete”). In
accordance to the snow ball sampling technique the NordBalt researchers contacted some of the chapter
authors, with references to additional relevant literature and researchers. One of the search criteria was to
mainly include Nordic and Baltic countries and research, in either Scandinavian languages or in English. The
literature search has been collected in a database covering the found literature on food and health promoting
initiatives at worksites, in the Nordic and Baltic countries. A search on other initiatives is included because of
multifactorial intervention practices that include not solely food based interventions; some of the interventions
only include food as a secondary or sub- issue.
The project initially included a mapping of important stakeholders and literature from the Nordic and Baltic
countries. A literature search was performed using a snow ball sampling technique. This technique enabled us
to get in contact with important stakeholders and experts within the field of health promoting initiatives at the
workplace, and at the same time identify important literature. The research was mainly focused on the Nordic
countries, but included significant contributions from other countries as well.
The literature search outcome is structured in the RefWork's software,interested parties can use the URL-link1
Conference
or contact the research group for Food, People & Design at Aalborg University to gain insight and to access the recorded
literature in the shared database. Almost all references are linked to full text PDF files.
The purpose of the Better Food at Work conference was to share experiences and to get a joined
understanding of the future perspectives and challenges related to health at worksites, when implementing
health promotion initiatives focusing specifically on eating. The conference aimed at performing a synthesis of
experiences across the Nordic and Baltic countries in order to be able to perform a literature analysis; identify
evidence based studies; identify best practices; and communicate to authorities, researchers and practitioners.
Bringing the conference participants together gave rise to new and interesting perspectives on the challenges
of an increased number of individuals leading an unhealthy lifestyleindividuals being at worksites, in their
private spheres, and in public foodscapes. It also became clear from the presentations and the debates during
the conference that the Nordic and Baltic countries have different histories and traditions regarding food at
worksites and research in this area.
1 http://www.refworks.com/refshare/?site=041541163664000000/RWWS6A655060/Food%20at%20Work%20NordBalt%20program
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Among the most outstanding issues from the presentations it can be mentioned, that there is evidence proving
how the workplace as an arena for health promotion can have positive health impact. Effects on lifestyle are
documented, in practice i.e. through healthy eating interventions among the employees. Furthermore, it seems
that the traditional method with approaching the individual to work with lifestyle changes no longer is as
applicable, and that there is a greater potential for making changes by focusing on socio-constructive
approaches to large scale numbers of people. Related to this, the social relations and physical contexts should
be taken into account in addition to nutrition and eating.
The conference worked constructively with worksites that traditionally have been difficult to implement health
promotion initiatives at, due to job specific conditions. The presentations included inspiring interventions from
different kinds of worksites that either had irregular working hours or mobile worksites, such as fishermen at
sea; truck drivers; health-care workers, physical versus non-physical work etc. The speakers at the conference
demonstrated best cases and possible strategies to promote health in different worksites settings, with both
traditional and new innovative approaches, such as canteen coin offer; canteen take-away; fruit and vegetable
schemes; and healthy canteen maintenance in general.
The participants discussed that a meal is more than eating, and also include experiences. From these
discussions it was stressed that future implementations should try to involve considerations regarding social
and physical context and that eating is a behaviour influenced by these factors.
Overall, the conference speakers and participants agreed that the process of turning research into policies and
implementing health promotion at worksites in practice is dependent on a determined management and
passionate practitioners to sustain the results in the long run. The outcome of the conference was most
constructive and inspiring for the participants that were rather excited to discuss the presented thesis’s, issues
and challenges in the field of eating at worksites. And in general it became clear to the audience that a multi
factorial way is important in order to promote healthy eating habits at worksites.
The speakers at the conference approached future research areas and examples of these are to gain
knowledge on how changes occur by doing research on the mechanisms and processes within policies,
environment and individuals. It seemed unanswered as well how the work-environment shapes the employees
diet. Also development of strategies to improve social contexts for making changes seemed to be important,
and should of course be studied theoretically as well as in practice. Finally, barriers and facilitators for
dissemination of best practices should be explored to secure future maintenance and sustainability of the
‘healthy eating at work’ initiatives.
The feedback summary from the conference questionnaire evaluation gave the impression that the conference
very much met the participants’ expectations and the majority seemed to have extended their professional
network within the field of health and eating at work across the Nordic and Baltic borders.
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Regarding which presentations the participants found most interesting or gave new knowledge on future
challenges, the evaluation was more varied and dependent on the participant’s interests. There were different
opinions on the number of presentations and professional level of the speakers, which once again underlines
the broad origin of the participants.
Conclusion
From the conference it was obvious that collaboration across the Nordic and Baltic countries is needed and
wanted. The participants expressed interest and motivation in joining forces across Nordic and Baltic borders.
The future challenges lies in identifying the specific subjects for collaboration, searching for funding and placing
responsibility for agreed projects.
Recently an analysis has been made on the existing knowledge on Food at Worksites in Denmark and Sweden
Mat på arbetet dygnet runt?This analysis is a result from cooperation between Danish and Swedish
researchers at University level. Could a similar analysis be performed at a more comprehensive level across all
Nordic and Baltic countries? In that case it would be important to identify specific competencies and look into
the existing knowledge, experiences and best practices.
It is presumed that NordForsk will announce a call for Researcher’s Network with deadline April 2010. The
previous NordForsk program allocated approximately 900.000 NOK for a three year period. It is required that
there are participants from at least three Nordic countries, or alternatively two Nordic and one Baltic country.
It is an obvious opportunity for the Nordic and Baltic competencies to join forces through a NordForsk
Researcher’s Network on “Better Food at Work”.
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Conference proceedings
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Eating at Worksite
What is the Evidence on the Effectiveness of Healthy
Eating Interventions at Workplaces?
Glorian Sorensen, PhD, MPH Harvard School of Public Health and the Dana-Farber Cancer Institute
Boston, Massachusetts, USA
Background
An increasing number of worksites now provide health promotion programs, including interventions for
promoting healthy eating. Workplace research has documented the efficacy of these programs across a wide
array of outcomes. In general, results from randomized studies of workplace health promotions have found
modest yet promising effects. The purpose of this presentation is to put forward the evidence from workplace-
based research on interventions to promote healthy eating at work.
Summary of the Evidence
Workplace intervention research has examined both comprehensive programs and environmental and policy
approaches that aim to increase workers’ dietary patterns. Comprehensive approaches to promote healthy
eating at work often rely on the social ecological framework, and target change at multiple levels of influence,
from changes in individual behaviour to organizational and environmental changes. The workplace research
testing this approach has shown promising results. Studies have pointed to the importance of the use of
participatory strategies designed to assure that programs are responsive to workers’ needs and priorities,
including through employee advisory boards and peer delivered approaches. Dietary patterns are also
influenced by workers’ broader social context, including workplace and family norms, social support, and the
resources available in local neighbourhoods. Recent research has explored the features of the social context
most likely to influence improvement in fruit and vegetable consumption. Tailored interventions provide one
promising avenue for assuring that interventions are responsive to workers’ priorities.
Environmental and policy approaches include changes in the work environment and improved organizational
support. Management commitment may be demonstrated by including worker health as part of the
organization’s mission statement, providing a budget and assigning staff to support the work, and engaging
workers in program planning. Management support is important to reinforce norms supportive of healthful
eating patterns. The evidence also indicates that important environmental influences on dietary patterns
include availability of healthy food options in the workplace, portion sizes available or provided, and food costs.
Some workplaces have linked their efforts to resources in the neighbourhood, such as access to neighbourhood
restaurants and grocery stores.
Recent research has tested interventions aimed at changing multiple risk behaviours, including diet. Evidence
points to the importance of understanding the ways in which changes in one health behaviour may support or
contribute to changes in other health behaviours. Other research has indicated the importance of
simultaneously addressing other workplace factors contributing to worker health, including exposure to
occupational hazards.
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Discussion
Future research is needed to explore further the mechanisms and processes of both organizational and
individual dietary change. It will be important to identify effective ways to offer programs in a range of
workplace settings – from small to large, across different industries, and in different geographic regions.
Research is needed to explore the role of changes in the structure of work, including trends toward downsizing
and mergers, privacy protection of health information, increasing use of technological innovations, and part-
time and contractual work. Increasingly attention is being devoted to understanding effective processes and
strategies for disseminating evidence-based workplace interventions. Therefore, research is needed to explore
barriers to and facilitators of workplace changes as well as willingness to adopt and implement health
promotion programs.
References
Benedict, MA and D. Arterburn. 2008. Worksite-based weight loss programs: A systematic review of recent literature.
Am J Health Promot 22(6): 408-416.
Beresford SA et al. 2001. Seattle 5 a Day worksite program to increase fruit and vegetable consumption. Prev Med. 32:230-
8.
Egerter SM et al. 2008. Work Matters for Health. Robert Wood Johnson Foundation: Commission to Build a Healthier
America. Commissionhealth.org.
French, SA et al. 2001. Pricing and promotion effects on low-fat vending snack purchases: The CHIPS study. Am J Public
Health. 91 (1): 112-117.
Glanz K, Sorensen G and Farmer A. 1996 The health impact of worksite nutrition and cholesterol intervention programs.
Am J Health Promot. 10(6): 453-470.
Groth, MV et al. 2001. Social determinants of dietary habits in Denmark. Eur J Clin Nutr. 55 (11):959-966.
Harnack, LJ and French SA. 2008. Effect of point-of-purchase calorie labeling on restaurant and cafeteria food choices: A
review of the literature. Int J Behav Nutr Phys Act. 5:51.
Hennrikus DJ and Jeffery RW. 1996. Worksite intervention for weight control: a review of the literature. Am J Health
Promot. 10(6):471-98.
Janer G, M Sala, M. Kogevinas. 2002. Health promotion trials and worksites and risk factors for cancer. Scand J Work
Environ Health 28(3):141-157.
Matson Koffman DM, Goetzel RZ, Anwuri VV, Shore KK, Orenstein D, LaPier T. 2005. Heart healthy and stroke free:
successful business strategies to prevent cardiovascular disease. Am J Prev Med. Dec;29(5 Suppl 1):113-21.
Pelletier KR. 2005. A review and analysis of the clinical and cost-effectiveness studies of comprehensive health promotion
and disease management programs at the worksite: update VI 2000-2004. J Occup Environ Med.
Oct;47(10):1051-8.
Proper KI et al. 2004. Costs, benefits and effectiveness of worksite physical activity counseling from the employer's
perspective. Scand J Work Environ Health. Feb;30(1):36-46.
Quintiliani LM, Sattelmair J, and Sorensen G. The Workplace as a setting for interventions to improve diet and promote
physical activity. World Health Organization. 2007.
Available at: http://www.who.int/dietphysicalactivity/workplace/en/index.html
Sorensen G et al. 2007. Tools for health: The efficacy of a tailored intervention targeted for construction laborers. Cancer
Causes Control. 18(1): 51-59.
Sorensen G et al. 2007. The influence of social context on changes in fruit and vegetable consumption: Results of the
Healthy Directions Study. Am J Public Health. 97: 1216-1227.
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Sorensen G et al. 2003. Model for incorporating the social context in behavior interventions: Applications for cancer
prevention for working-class, multi-ethnic populations. Prev Med. 37:188-97.
Sorensen G et al. 2005. Promoting behavior change among working-class, multi-ethnic workers: Results of the Healthy
Directions Small Business Study. Am J Public Health. 95(8): 1389-1395.
Sorensen G, Linnan L and Hunt MK. 2004 Worksite-based research and initiatives to increase fruit and vegetable
consumption. Prev Med. 39 (Suppl 2): S94-S100.
Story, M et al. 2008. Creating healthy food and eating environments: Policy and environmental approaches. Annu. Rev.
Public Health. 29: 253-272.
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Worksite Dining as a Collective Good or Individualization of Health -
A Danish Perspective
Michael Søgaard Jørgensen2
Department of Management Engineering, Technical University of Denmark, 2800 Kgs. Lyngby
, Associate Professor
Bent Egberg Mikkelsen, PhD. Professor
Department of Development and Planning, Aalborg University, 2750 Ballerup, Denmark
Anne-Vibeke Thorsen, PhD. Student
National Food Institute, Technical University of Denmark, 2860 Søborg, Denmark
Abstract
This paper is based on a survey of Danish literature about worksite eating carried out as a part of the project
‘Food at work around the clock?’ by Lunds University and Technical University of Denmark and financed by
Øresund Food Network. The focus has especially been on the relations between work and diet and the
experiences with promotion of healthier eating through intervention projects at worksites.
The overall results of the survey show that there does not exist much Danish research about the influence of
work and the work environment on eating habits, including worksite eating. The few analyses that have been
conducted show that negative and long-term stress, where the employee lacks influence and control on his
own work, may cause health problems and changes in body weight, so that slim persons become slimmer and
the obese become more obese.
A small interview survey shows that the type and the organization of work influence how worksite eating is
organized. Especially in the service sector, it is difficult for all employees to eat at the same time. Their eating
schedule is negotiated among the employees according to the needs of the individual employee.
An area with Danish research is the influence of the worksite eating on work and work environment. The
survey showed social inequalities in relation to health, like in many other countries. A national dietary survey
has shown that persons with long education eat healthier and are more interested in healthy food. Research
also shows a correlation between diet and other aspects of life style: if a person has health dietary habits it is
more likely that the person also has a high level of physical activity, does not smoke and does not have a high
consumption of alcohol.
An increasing number of Danish worksites have some sort of health promotion activities, including some kind
of healthier food, like providing free water, healthier meal options, bread with high fibre content, fruit supply
scheme etc. A national survey of these activities is carried out bi-annually. The recent survey shows that 60% of
the worksites have some variety of food supply for its employees. For example, 33% of the worksites have a
food scheme like a canteen and 48% have a fruit scheme. The surveys show big inequalities with respect to
2 Corresponding author: E-mail: msj@man.dtu.dk
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health promotion at the worksites in relation to branch and geographic regions. Within the finance sector, 53%
of the worksites have a food supply scheme, while only 30% within the construction sector has some kind of
food supply to its employees.
Big worksites are more likely to have a canteen than small worksites. A survey indicates that worksites with
more than 50 employees are more likely to have a canteen. The canteens are typically small. Around 75% of
the canteens have less than five employees. Of the canteens, 25% are outsourced, while 75% are run by the
worksite. A recent survey shows that more and more canteens serve food from a buffet and not from a
counter.
A substantial part of the Danish experience within worksite eating is based on worksite intervention projects
aiming at making the food supply healthier. These interventions have achieved bigger awareness about health
food and also an average increase in the consumption of fruit and vegetables. How this differs among the
individual employees is unknown.
The long term embedding of these activities has up till now only been analysed to a limited extent. The
analyses seem to show that employee participation in the planning and implementation of the scheme and a
scheme based on voluntary initiatives make employees assess the scheme as a positive initiative. The
organizational and economic conditions of the worksite seem to influence the long-term embedding of
healthier eating initiatives. For instance, outsourcing of the canteen may make it difficult to sustain results
obtained before the outsourcing.
The government initiatives around healthier worksite eating have, up till now, focused on developing policy
documents, printed materials for inspiration, guidelines, training, and funding of intervention projects. Most
government initiatives have involved a number of different stakeholders in a kind of partnership. The
stakeholders include government authorities and agencies, research institutes, health organizations and trade
unions. A recent initiative focuses on food and diet policies at worksites. All government worksites at the state
level should, before the end of 2008, develop a food and diet policy. The experiences so far from other areas,
like public green procurement, indicate that a policy in itself may not change the practice of an organization.
The experiences so far seem not to have focused on the relations between work, work environment and
health. Thereby the food interventions may cause a more individualistic approach to health at worksites,
compared to the more collective and interest-based approach which characterizes the safety work and the
safety organization of public and private worksites. A small international study conducted in relation to the
Danish and Swedish survey of food at work show some, although limited, experiences in other countries with
integration of concerns about work environment as part of health promotion activities.
Future Danish activities within health promotion, including healthier worksite eating, should integrate a focus
on work environment in order to combine an individualistic approach with a collective and interest-based
approach to health and the role of the worksite. Work environment research indicates that more problems at
Page 16 of 72
the workplace are managed within the human resource (HR) field rather than in the work environment field,
which could imply a more individualistic approach to worksite health and health in general, where life style is
seen as a free and individual choice.
References
Jørgensen, M.S.; Lagnevik, M.; Lindén, A-L.; Mikkelsen, B.E.; Nyberg, M.; Thorsen, A.V.: Mat på arbetet dygnet runt?
Arbete Tid Måltid. (In Danish and Swedish) (Food at work around the clock. Work time meal), Øresund
Food Network, 2009 (Danish and international part)
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Do Worksite Provided Meals Lead to Healthier Eating?
A Finnish Perspective
Eva Roos, PhD, Docent
Folkhälsan Research Center & Department of Public Health, University of Helsinki, Finland
Susanna Raulio, MSc. (Food Sc.)
The National Institute for Health and Welfare, Helsinki, Finland
Ritva Prättälä, PhD, Docent, Senior Researcher
Folkhälsan Research Center & Department of Public Health, University of Helsinki, Finland
Introduction
Eating outside of the home is increasing in the West, partly because more women are joining the workforce
resulting in less time for food preparation in the home. Therefore, meals provided at worksites can be a useful
tool for improving health among its employees. The objectives of this presentation are to (a) describe the use
of worksite canteens and its determinants in the Finnish population; (b) illustrate the association of healthy
lunch eating patterns among employees; and (c) reflect on whether worksite provided meals lead to healthier
eating.
Methods
The results presented are mainly based on basic reports and published studies relating to worksite catering
services conducted in Finland.
Results
Nationally representative health monitoring surveys show that the use of catering services is common in
Finland. Of all employees, 30% eat from worksite canteens daily, while 30% of men and 45% of women eat
packed lunches. Some evidence exists on the contribution of catering services to food habits and nutrition in
the population. Cross-sectional population surveys suggest that the use of catering services is associated with
more healthy food habits; those eating lunch from worksite canteens tend to make food choices closer to
nutrition recommendations when compared to those not using catering services.
Discussion
Evidence exists on the contribution of catering services to healthy food habits in the Finnish population. In
order to verify the role of catering services, more scientific research with prospective and intervention designs
will be needed.
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Company Fruit
Healthy Eating at Work - the BAMA way
Gunn Helene Arsky, Nutritionist M.Sc
BAMA JobFrukkt, Norway
Background
The intake of fruits and vegetables in Norway is less than half the recommended amount just over 300 grams
per person per day. At the same time we see an increasing tendency towards overweight and obesity in all age
groups. A healthy diet as well as a focus on physical activity is important to curb this development.
BAMA is Norway’s largest fruit and vegetable importer, purveyor and wholesaler with 60% of the market share.
Its vision is to make Norwegian consumers healthier by making available the best quality and freshest fruits
and vegetables for a positive health impact. Hence, its focus on healthy eating in the work place plays a central
part, in achieving both its vision and goal.
Case description
BAMA has two major target areas when it comes to healthy eating at work.
The first is Jobbfrukt (Jobfruit), the result of collaboration between BAMA and a nationwide network of
Norwegian companies, both private and public, employing people with various physical or mental disabilities.
The companies have training programs for their employees, ensuring a meaningful workday as well as safe,
hygienic and well presented products. Jobbfrukt.no distributes fruit baskets to these Norwegian companies
throughout the year on a subscription basis.
The second target area is BAMA Pluss Bedrift (BAMA Plus Workplace), a part of BAMA’s Plus strategy, whose
aim is to ensure healthy food choices in the sports arenas around Norway. The Pluss Bedrift concept consists
of coolers and salad bars in strategic spots in office canteens and offices. For a very low cost, the salad bars
ensure healthy lunch options while the coolers offer healthy snacks, smoothies, overtime meals and ready-to-
heat takeaway dishes, to bring home after a long day at work; All for a very low cost. Pluss Bedrift also includes
offers easy-to-do physical activities to the employees, such as morning walks followed by communal breakfast,
short jogging trips and weekend trips with focus on physical activity. The program started in 2006 in BAMA.
Today 40 of BAMA’s offices offer Pluss Bedrift to its employees. The concept has also been introduced, with
great success, in the Norwegian Football Association’s offices in Oslo.
Aim
For both target areas the aim is to increase the intake of fruits and vegetables at work and create new and
healthier eating habits which will influence employees’ food choices outside work as well.
Findings
The increased offer of healthy options is a welcome addition to the workplace. Readily available fruits and
vegetables make it easier for the employees to fulfil the recommendation of eating five portions of fruits and
vegetables a day. Consumption of fruit and vegetables also increases wellbeing, and findings suggest that
companies offering fruits and vegetables register fewer sick absences among the employees.
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Discussion
There is an increasing need for various healthy alternatives during work hours concerning both food choices
and easy physical activities. BAMA offers two alternatives, and will continue to develop these in accordance
with the overall health status in the Norwegian society and the needs expressed by its customers.
Page 20 of 72
Food, Health & Irregular Working Hours
Food, Health & Shift Work: Nutrition, Shift work and Chronobiology When to Eat?
Maria Lennernäs, PhD Nutrition, Professor in Food and Meal Science with Special Emphasis on Behavioural Science
Kristianstad University College, Sweden
maria.lennernas@hkr.se
Introduction
More and more businesses operate outside “standard” or daytime hours. This 24-hour society is driven by
commercial competitiveness and consumer demand; and governments, too, seem to encourage flexible
working policies. Non permanent daytime workers operate in process industries, transport and communication
sectors, social service, bars and restaurants, public media, entertainment etc. In this abstract, the term “shift
work” includes traditional shift work (alternation between morning and afternoon shifts, or between morning,
evening and night shifts), irregular work hours, night work, work that occurs during early morning and/or late
evening.
Health and Safety
Shift work affects social and biological rhythms. This, in turn, has an impact on social life and on timing of
eating and sleeping in relation to the circadian rhythms generated from the inherent biological clock. Shift work
is a behaviour associated with gastrointestinal complaints, fatigue and depression as well as impaired safety at
work. It is considered a risk factor for the metabolic syndrome, including obesity, insulin resistance and altered
lipid profiles and is associated with type-2-diabetes and cardiovascular disease. Shift work and fatigue probably
have an impact on physical activity and energy balance. Sleep deprivation is associated with increased appetite
(ghrelin increases), decreased satiety (leptin decreases), obesity and insulin resistance due to endocrine
responses correlated to disrupted circadian rhythms.
Circadian Rhythms
Circadian rhythms have evolved to help all living organisms to anticipate and adapt to circadian (“about a day”
or about 24-hours) seasonal, and annual variations in light, darkness, climate and temperature, availability of
food etc. Human circadian rhythms are generated within the Suprachiasmatic Nucleus (SCN), or “Master Clock”
in the brain. The SCN is located in the Hypothalamus, the area from which internal energy supply, hunger,
thirst, libido sleep and other vital functions are controlled. Bright light is the main stimulus that “sets” the
internal clock that, in the “free-running condition,” might vary between 23-28 hours. Time zone-transitions,
shift work, times for eating and sleep as well as physical exercise stabilize or desynchronize circadian rhythms.
Food intake in human beings is regulated by energy balance and modified by circadian rhythms in anabolic and
catabolic hormones, hunger, appetite and satiety. Eating against the clock is “confusing” for the brain and leads
to a conflicting situation since human beings are diurnal (day active) and thus constituted for nocturnal sleep,
restoration and fasting.
Page 21 of 72
Circadian rhythms are influenced by ageing (younger are more evening oriented, elderly more morning
oriented), environmental and genetic factors. Thus, individuals range from being larks (best performance in
early morning) to owls (evening types).
Assessing Eating Behaviour of Shift Workers
A comprehensive knowledge about eating behaviour in shift workers includes data collection about their
average intake (across a work cycle) of energy and nutrients. Furthermore, analysis needs to take into account
the temporal distribution of energy and nutrients and the frequency and quality of eating events. Between
groups comparisons are done between workers having permanent morning-, afternoon- or night shifts, or
rotating shift-schedules, and their daytime controls. Within group comparisons are done between 24 hour
working days (including various shifts) and days off, or between time segments, to evaluate how much of total
intakes are being consumed during each work shift respectively. Thus, to design a dietary survey in shift
workers is complicated. As a screening method, anthropometric measurements combined with a cost-effective
method for food-based classification of eating events based on what was consumed (not amounts) and time of
day is recommended.
Eating Habits of Shift Workers
Past research shows that it is the timing of the meals, rather than the energy intake and macronutrient
composition, that is affected by shift work. Observational and experimental studies show an association
between nocturnal eating and metabolic abnormalities. Subjects adopt different coping strategies to night
work ranging between fasting and eating energy dense snacks or sweets to fight tiredness. Chrono-biological,
social and environmental factors affect eating in shift workers. Psychobiological studies have shown that night
eating improves acute well being but impairs health in the long run. Nocturnal intake of carbohydrates is
associated with a higher degree of sleepiness.
Summary and Future Research
Intervention studies are needed to find a successful solution to lower social costs and to improve health, safety
and well being in shift workers. Such interventions must include recommendations with regard to meal
frequency, meal timing and meal composition. To be successful, it is necessary to take into account individual
(circadian rhythms, food preferences), structural (work schedule, food availability, meal pauses) and social
(family, networks) barriers.
References
Atkinson, G., S. Fullick, et al. (2008). "Exercise, Energy Balance and the Shift Worker." Sports Medicine 38(8): 671-685.
Holmbäck, U., A. Forslund, et al. (2002). "Metabolic responses to nocturnal eating in men are affected by sources of
dietary energy." Journal of Nutrition 132(7): 1892-1899.
Kreier, F., A. Kalsbeek, et al. (2007). ""Diabetes of the elderly" and type 2 diabetes in younger patients: Possible role of the
biological clock." Experimental Gerontology
Proceedings of the eighth international symposium on the neurobiology and neuroendocrinology of aging 42(1-2): 22-27.
Lowden, A., U. Holmbäck, et al. (2004). "Performance and sleepiness during a 24 h wake in constant conditions are
affected by diet." Biological Psychology 65(3): 251-263.
Page 22 of 72
Lennernäs, M. A.-C., T. Åkerstedt, et al. (1994). "Nocturnal eating and serum cholesterol in three-shift workers." Scan J W
Enwiron Health 20: 366-71.
Lennernäs, M., T. Åkerstedt, et al. (1995). "Work shift related dietary intake in day- and shiftworkers." Appetite 25: 253-
65.
Lennernäs, M. and I. Andersson (1999). "Food Based Classification of Eating Episodes (FBCE)." Appetite 32: 53-65.
Lennernäs , M. (2004). Eating pattern. Nordic Nutrition Recommendations. Copenhagen, Nordic Council of Ministers.
Ruud, M. and F. Kreier (2006). "The metabolic syndrome: A brain disease?" Neuro-endocrinology Briefing:26.
Spiegel, K., R. Leproult, et al. (1999). "Impact of sleep debt on metabolic and endocrine function." The Lancet 354(9188):
1435-1439.
Strubbe, J. H. and G. van Dijk (2002). "The temporal organization of ingestive behaviour and its interaction with regulation
of energy balance." Neuroscience and Biobehavioral Reviews 26: 485-498.
Page 23 of 72
Lots of Food but Poor Meals A Sociological Study of the Worksite as a Meal Arena
Maria Nyberg, PhD
Department of Sociology, Lund University, Sweden
Introduction
Many people spend hours in their workplace every week, which makes it not only a work place but also a place
for social interaction, eating and drinking. Food and drink play a central role in providing nutrition and energy
so that individuals can continue working, and also help to create a welcome break in the daily routine.
Therefore, food and drink also have an important social dimension in the workplace, and mark a division
between work-time and break-time. Although many people eat and drink at work on a regular basis, studies
focusing on the meal as a separate concept from the food eaten, are rare in a workplace context. The meal is
understood to be something more than just the food consumed. Previous research into meals from a social
science perspective have primarily focused on the home and the family in defining, analysing and
understanding the meal, its social settings and relations (see e.g. Bugge & Almås 2006; DeVault 1991; Douglas
1975; Ekström 1990). At work, the meal is surrounded by other circumstances when it comes to time, place and
social relations, as well as the food itself, which are all important aspects in understanding the conditions for
the meal.
In today’s society an increasing number of people in different occupational groups are working irregular hours,
creating conditions for meals compared with those only working during the day. It is no longer only within
traditional industrial shift-work that people have irregular working hours or where work is scheduled during
evenings and nights. An increasing number of people within the service and transport sectors are also working
both during the day, evenings and nights. Bus-drivers (Lindén et al. 2005) and lorry-drivers (Wirfält 1997) and
staff in supermarkets and boutiques are examples of these round-the-clock employees. Hospitals are another
example of non-stop workplaces. The objective of this dissertation study was to increase the understanding for
the conditions for meals at work (see Nyberg 2009). The impact of the work organization and the structure of
time, as well as how social relations are handled and food supply taken care of, are all important aspects to
acknowledge in understanding the conditions for meals at work. A previous study, where a residential home
for care of the elderly and a bus company participated, also have contributed important insights in trying to
understand food habits at work (Lindén et al. 2005). This has been important and significant knowledge in
continuing the study of how people reason and value food and meals at their workplace. To achieve this
study’s objective, different meal actors in the workplaces were of interest, consisting of the employees,
management and representatives for the food provision system in the workplaces, and how they reasoned
about, communicated around and valued food and meals in their workplace.
Page 24 of 72
Methods
The methods for gathering empirical material for the analysis were participant observations, semi-structured
interviews and a questionnaire at one industrial company consisting of two production units that produced
components for medical technology, and two wards in a public hospital. In order to get an overview of the
physical and social structure of the respective workplaces, a number of observations were initially conducted.
By obtaining information about working tasks, routines and time schedules, as well as about food habits at
work and at home, the subsequent interviews were facilitated. A total number of 29 male and female
employees from different occupational groups, working conditions and ethnic backgrounds were interviewed.
In addition to these methods, a questionnaire was used in order to obtain an overview of the workplaces as a
whole. Additionally, twelve interviews were also conducted with representatives from the management and
the food suppliers in the workplaces.
Results
The study raises important questions about the preconditions for having meals at work, where the importance
for companies to increase productivity, save money and rationalise time often leaves no considerations for the
meal and its “ingredients”. The results of the study can be summarized in the following statements: The meal
should take no time, the meal should take no place and the meal should cost no money. The meal is often
rationalized away and as time mainly is valued as a quantitative instrument by the management, the subjective
dimension of time, as an important aspect of the meal experience, is not noticed. The time ingredient of the
meal is central, as is the importance of the room (see e.g. King et al. 2004, 2007; Meiselman 2000) and the
place for the meal. In this study it became obvious that the place for having a meal among the employees was
not always prioritised by the management. Many workplaces only have minor rooms for the employees to eat
their food brought from home or bought outside the workplace. Furthermore, the often crowded staff rooms
at the hospital wards in the study impacted not only what was eaten, for example cold food instead of hot, but
also the duration of the break and how the food was experienced. The idea that the meal should cost no
money was expressed by the management and the food supply actors in the study, as well as by many of the
employees. Having a staff restaurant of their own, with a variety of dishes and extended opening hours that fits
different working hours, may be considered unprofitable and expensive for the workplace management. Due
to organisational- and time restrictions, the lack of space to eat, but also critical opinions about the food being
served, many employees were not interested in spending a lot of money on the food eaten at work. Especially
for the women, the family and the meals eaten at home were also important in understanding the value of the
meal at work.
Discussion
The meal as defined and discussed in this study is vulnerable when considered in a working context and in
relation to how different actors reason about and value food, as well as time and space for the meal to take
place. Due to health considerations it is essential to consider these questions in today´s working life. What will
be the consequences when the workplaces only offer people the possibility to eat, and where the meal and its
important “ingredients” are rationalized away, or when it is only possible for a few to actually have meals at
work that not only taste good but are also allowed to take time and be enjoyed in a comfortable atmosphere
Page 25 of 72
together with other people? In focusing on health promotion at workplaces, the importance of the meal has
seldom been acknowledged in Sweden. The study highlights the importance of including the meal and its
ingredients at workplaces in order to improve health among different occupational groups as well as among
people working both regular and irregular working hours. The meal is something we eat, we experience, we
prioritise and value, create in a social context and give time and space. According to this wide definition, the
meal may be achieved at work, but the way the work is organised, time is planned, health is considered, food is
reasoned about and social relations are valued at work as well as at home, are important in understanding the
conditions for the meal and its limitations at work.
References
Bugge, A. & Almås, R. (2006). Domestic dinner. Representations and practices of a proper meal among young suburban
mothers. Journal of consumer culture, vol. 6: 2, ss. 203-228.
DeVault, M. (1991). Feeding the family. The social organization of caring as gendered work. Chicago: The University of
Chicago Press.
Douglas, M. (1975). Deciphering a meal. I Douglas, M. (red.). Implicit meanings. Essays in Anthropology. London:
Routledge. S 249- 275.
Ekström, M. (1990). Kost, klass och kön. Doktorsavhandling. Umeå: Sociologiska institutionen, Umeå Universitet.
King, S.C., Weber, A.J., Meiselman, H.L. & Lv, N. (2004). The effect of meal situation, social interaction, physical
environment and choice on food acceptability. Food Quality and Preference, vol. 15, ss. 645-653.
King, S.C., Meiselman, H.L., Hottenstein, A.W., Work, T.M. & Cronk, V. (2007). The effects of contextual variables on food
acceptability: A confirmatory study. Food Quality and Preference, vol. 18, ss. 58-65.
Lindén, A-L., Lagnevik, M., Sjöberg, K., Svederberg, E., Jönsson, H. & Nyberg, M. (2005). Mat, hälsa och oregelbundna
arbetstider. Research report in Sociology, 2005:1. Lund: Sociologiska Institutionen, Lunds Universitet.
Meiselman, H.L., Johnson, J.L., Reeve, W. & Crouch, J.E. (2000c). Demonstration of the influence of the eating
environment on food acceptance. Appetite, vol. 35, ss. 231-37.
Nyberg, M. (2009). Mycket mat, men lite måltider. En studie av arbetsplatsen som måltidsarena. Doktorsavhandling. Lund:
Sociologiska Institutionen, Lunds Universitet.
Wirfält, E. (1997). Maten en transportsträcka. En kvalitativ studie av Yrkesförares matvanor under arbetspassen. Rapport
9. Uppsala: Livsmedelsverket.
Page 26 of 72
Successful Physical Activity & Nutrition Intervention at Sea
Sonja Sif Jóhannsdóttir, Master in Health and Physical Activity,
Anna Sigríður Ólafsdóttir & Erlingur Johannsson.
Centre for Research in Sport and Health Sciences, School of Education
University of Iceland, Iceland.
Introduction
Icelandic sea crew members working on fish-processing trawlers lead a potentially unhealthy lifestyle. Staying
at sea for a month at time gives few opportunities for regular exercise, and being sleep-deprived and away
from home easily leads to limited and unhealthy dietary choices.
Objectives
In this study, a physical activity and nutrition intervention was undertaken to increase awareness and facilitate
a healthier lifestyle among sea crew members.
Methods
Body composition, health parameters, fitness, physical activity level and food choices were investigated among
62 sea crew members (intervention group (IG), n=31; control group (CG), n=31) before and after a six-months
lifestyle intervention. The main focus in the IG was to increase physical activity and promote healthier food
choices. Physical fitness was estimated by a maximal cycle ergometer test and physical activity was measured
by questionnaires (min/week). Questionnaires were used to assess food choices and health related quality of
life. To aid better food choices the cooks were assisted in changing cooking methods and increasing the variety
of food available at sea.
Results
The average age of the crew members was 41.7±10.8 years and there was no age difference between the
groups. After the intervention period (IP) the average bodyweight decreased by 3.5±2.7 kg in IG, compared to
the CG that gained weight by 0.6±1.8 kg (p<0.001). The waist circumference and body fat percentage
decreased significantly in the IG (-4.1±2.5 cm, p=0.001 and -1.8%, p=0.001 respectively). The IG increased their
physical activity level by 233%, but in the CG only by 13.5%. The physical fitness increased by 14.3% in the IG,
but no difference was obtained in the CG after the IP (p<0.001) (Table 1). HDL-cholesterol increased by 11.4%
in the IG (p<0.001) after IP, compared with a 6.1% decrease in the CG (p<0.05). There were no significant
changes in LDL-cholesterol, but triglycerides decreased by 18.6% (p<0.01) in the IG (Table 2). IG also lowered
their diastolic blood pressure by 3.3 mmHg (p<0.05). No positive changes in blood parameters or blood
pressure occurred in the CG after IP (Table 2). Positive changes in the factors associated with health related
quality of life were only found in the IG after the IP. These were decreased depression, decreased pain and
increased fitness by self-evaluation (p<0.05). Positive changes in food choice were only noticable in the IG.
After the IP they ate fresh vegetables and unsweetened breakfast cereals more often and less frequently
consumed sweet cakes and biscuits. They also less frequently drank carbonated beverages and fruit drinks with
added sugar (p<0.05).
Page 27 of 72
Table 1. Characteristics of the study subjects, weight, BMI, waist circumference (WC), fatness, fitness and
physical activity (PA).
All (n=60) IG (n=31) CG (n=29)
Test I Test II Test I Test II Test I Test II
Weight (kg)
87.8 (17.4)
85.9 (17.3)*
89.0 (11.6)
85.5 (10.7)#
86.6 (21.8)
87.2 (22.2)
BMI (kg/m2)
27.2 (5.3)
26.8 (5.2)#
27.1 (3.1)
26.2 (2.9)#
27.1 (6.8)
27.3 (6.7)
WC (cm)
96.3 (13.2)
94.8 (13.0)#
97.3 (8.9)
93.2 (7.8)#
95.4 (16.5)
96.3 (16.5)
Fitness (w/kg)
2.61 (0.5)
2.79 (0.6)#
2.58 (0.4)
2.95 (0.5)#
2.64 (0.5)
2.61 (0.6)
PA(min/week)
56.3 (69.4)
109.4 (85.5)
38.6 (43.6)
128 (74.4)#
76.8 (77.2)
87.2 (93.4)
Fat (%)
23.8 (7.6)
22.8 (7.1)#
24.6 (5.6)
22.8 (5.2)#
22.9 (9.3)
22.9 (8.8)
Mean + SD, range. *=p<0,05 #=p<0,01
Table 2. Blood parameters.
ALL (n=60) IG (n=31) CG (n=29)
Test I Test II Test I Test II Test I Test II
5.04 (0.8) 4.99 (0.7) 5.10 (5.0) 4.93 (5.2) 4.99 (9.3) 5.04 (8.8)
1.44 (0.2) 1.48 (0.4) 1.40 (0.2) 1.56 (0.4)# 1.47 (0.3) 1.38 (0.3)*
3.12 (0.9) 3.06 (0.8) 3.17 (0.8) 2.97 (0.8) 3.07 (0.9) 3.16 (0.9)
1.06 (0.4) 1.01 (0.5) 1.13 (0.4) 0.92 (0.4)# 0.97 (0.4) 1.11 (0.6)
5.15 (0.4) 5.07 (0.4) 5.14 (0.3) 5.07 (0.4) 5.16 (0.5) 5.07 (0.5)
Mean + SD, range. *=p<0,05 #=p<0,01
Conclusion
The primary aim of the intervention was to improve the overall lifestyle of the sea crew members by
emphasizing the importance of physical activity and healthy diet. The results show the advantage of a work-
place intervention among men working and living under potentially unhealthy conditions. Healthier lifestyles
leading to better health among sea crew members is valuable for their personal well-being and is a good
investment for their employers.
Page 28 of 72
Effect of Diet Intervention on Mood, Driving Skills and Cardiovascular Risk Factors
among Danish Truck Drivers
Jens Steen Nielsen, PhD
Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense
Mette-Marie Linding
Be-you healthcare A/S, Grindsted, Denmark
Background
The number of fatal accidents involving trucks are twofold per driven km when compared with small cars (1).
Furthermore, 50 % of all accidents occur on freeways and highways (1). While technical defects may cause
accidents, most accidents are due to factors such as stress, fatigue, and health problems among truck drivers
(5). It is generally accepted that administration of few meals with high carbohydrate content elicit fatigue and
reduces the general health status, and that these factors are improved by increasing the meal frequency and
reducing the amount of carbohydrates consumed (4).
Truck drivers are known to have irregular meal rhythms and to consume a high amount of carbohydrates (2). If
the driver’s meal frequency could be increased and the carbohydrate consumption reduced, it may result in
lessened fatigue and improve the health status. Which in turn, would decrease the number of accidents.
However, the effect of increased meal frequency on driving skills is unknown.
Aim
The aim of the present study is to investigate the effect of increased meal frequency on the general health
status and driving skills among truck drivers.
Hypothesis
The hypothesis is that increased meal frequency will improve mental and physical conditions which, in turn,
would improve driving skills leading to decreased risk and number of accidents.
Methods
Fifteen skilled truck drivers were informed of the project and the risks involved before obtaining their written
informed consent to participate. All procedures were carried out according to Danish law. Subjects were
randomly assigned to either a diet intervention (DI, n=10) or a control group (CG, n=5). The DI group were
provided with five meals a day over a twelve days period. The diet administered to the DI group was balanced
for fat, protein and carbohydrate according to national Danish guidelines, and energy was adjusted to
individual needs within the first two days. All in the DI group were given a 45-min. instruction on what and
where to eat and a 24-h food hotline was open for calls. The CG were left to their normal habits and given
neither instructions nor hotline access. Both groups were tested and retested prior and post the twelve days.
During each test, blood was sampled and used to determine the lipid profile, glycogen content, and
glycosylated hemoglobin (HbA1c). Additionally, Profile Of Mood States (POMS) were measured (3). Driving skills
were assessed using a validated standardized driving situation in an advanced truck simulator that all drivers
were familiarized with. The finger reaction time was measured using a Good Response from Metitur (Findland).
Page 29 of 72
All parameters were measured in a fast (12 h) and feed state (1.5 h after a standardized meal), except HbA1c
that was measured in the fast state.
Results
The average blood glucose in both the DI group and CG was 4.9 ± 0.1 (mean ± SEM) in the fast state, which
value increased by 7 ± 3 % 1.5 h after a standardized meal. The meal did not affect driving skills when
measured in the truck simulator and finger reaction time when measured using the Good Response timer.
Following the twelve days of diet intervention weight, body fat content, and
BMI significantly reduced in the DI group, while only a small reduction in
body fat content was observed in the CG. Furthermore, the blood glucose
concentration over time measured as the amount of HbA1c was significantly
reduced in the DI group whereas it remained unchanged in the CG (Fig. 1).
The diet intervention significantly shifted the blood lipid profile to a more
healthy direction as indicated by the significant reduction in the total and LDL
cholesterol in the blood.
The summed T-score from the POMS test showed that subjects in the DI
group felt less “anger”, while the subjects in the CG felt more “confused
following the twelve days of intervention. Furthermore, following
intervention, the speed of finger moving, evaluated using the Good Response
machine was significantly reduced in the DI group when compared to prior
intervention but was unchanged in the CG. Most interestingly, driving skills improved following diet
intervention. The improved driving skills were seen as a faster response and reduced total reaction time in the
DI group post vs. prior intervention, whereas it was unchanged in
the CG (Fig. 2). Moreover, the total reaction time was significantly
lower in the DI group than in the CG when compared post the
intervention period.
Discussion and conclusion
The main finding in the present study is that twelve days with
regular healthy meals improves reaction time and driving skill
among skilled truck drivers when compared to matched controls.
This is likely to have a huge impact on a driver’s ability to avoid
accidents during working hours, especially in the difficult post prandial
period where fatigue normal occurs. In the present study the
optimized meals improved the general mental and physical health
status of the drivers. This is likely to reduce healthcare costs and
improve quality of life for the individual driver. In conclusion the
present study shows that simple diet intervention improves driving
skills and the mental and physical health state of skilled truck drivers.
This is likely to reduce the risk of accidents during driving.
Figure 1. The amount of glycosylated
hemoglobin (HbA1c
) prior and post a
12
day period in subjects that were
subjected to Diet intervention (DI) or
placed in a control group (CG).
*significantly different from prior
p<0.05.
Figure 2. Data from the test of driving skill
showing the response distance, i.e
the
distance from an
obstruction appears until
the foot is lifted from the gas pedal.
Furthermore, the movement distance, i.e.
the distance from
the gas pedal is lifted and
until the breaks are on. Data are shown prior
and post the 12 day period for the
DI group
and CG. * significantly different from prior
test § significantly different from CG in same
situation. p<0.05
Page 30 of 72
References
1 Kines P. Lastbiluheld - en dybdeanalyse af 21 uheld. 2001. Technical University of Denmark, Department of Civil
Engineering. Annual report year: 2001.
2 Linding MM. Trafiksikkerhed og Kost. 2005. http://tsu.dk/, Transportsektorens Uddannelsesfond.
3 McNair DM, Lorr M, and Droppleman LF. Educational and Industrial Testing Service, Manual for the Profile of Mood
States. San Diego, CA: 1971,
4 O'Keefe JH, Gheewala NM, and O'Keefe JO. Dietary strategies for improving post-prandial glucose, lipids, inflammation,
and cardiovascular health. J Am Coll Cardiol 51: 249-255, 2008.
5 Taylor AH and Dorn L. Stress, fatigue, health, and risk of road traffic accidents among professional drivers: the
contribution of physical inactivity. Annu Rev Public Health 27: 371-391, 2006.
Page 31 of 72
Implementing healthy eating at work in practice
Coin Offer Meal “Diastole”
Michael Allerup Nielsen, Canteen Manager
Staff Canteen, Herlev University Hospital, Copenhagen
Background
The Herlev University Hospital (HUH), to a greater extent than previously, takes responsibility for its
employees’ health when they are at work. Along with other health promotion initiatives for its employees,
HUH requested the staff canteen to take more responsibility for the nutrition value of the food served, focusing
on a fatE% of a maximum of 30E% and with restrictions on the availability of sugary and fatty products; in
practice by taking sodas, juices, cakes and full-cream milk off the shelves. The other health promotion
initiatives were the introduction of the no smoking policy, corporate fitness programmes, fruit schemes, health
week etc.
The Projects Objective
To ensure that a balance nutritional meal would be available for those who patronize it, working with Bojesen
ApS, HUH developed the following criteria for its staff canteen:
Salads and sandwiches are available in several variations.
Make available a hot meal, good quality freshly baked bread and different fruits and vegetables.
The availability of various beverages, such as fresh cold water, organic buttermilk, semi-skimmed and
low-fat milk.
The employee should be able to purchase a meal that constitutes a complete lunch, no matter how the
individual assembles the items from the different groups of available food. The objective here is to
have a nutritionally balanced meal without the individual having to spend too much worrying about it.
Taste is an important factor to eat more fresh vegetables with homemade dressings. Therefore, the
dressings should consist of ingredients put together with quality and creativity in mind.
A quick lunch to ensure that employees do not waste time in queues. Instead get a quick service and
enjoy their lunch break.
Coin offer - the success of which depends on pricing. The employees should be able to purchase a
complete and healthy lunch for 20DKR (Danish coin ≈ 2, 6 €).
Attention should be paid to the hygienic aspect of the food by restricting the number who comes into
contact with a food item. Over the counter food to be packed in environmentally friendly wrapping
that is easy to eat from directly.
Nutritional labeling be easy to understand, making it easy to choose.
In general, the objective is that the workplace be able to serve its employees healthy tasty meals that are
hygienically prepared and cooked with fresh ingredients.
Page 32 of 72
Results
More satisfied customers based on oral feedback. (A Satisfaction Survey will be carried through in
October 2009)
Positive dialogue with the employees, with feedback and constructive criticism;
Raised customer base by 80%;
More care assistants patronizing the staff canteen;
Higher professional competency among the canteen staff, along with the use of fresh ingredients and
focus on taste;
Less usage of tableware resulting in less washing; and
Environmentally friendly packaging.
Page 33 of 72
New Possibilities in influencing Eating Patterns through
Healthier Canteen Take Away
Gitte Laub Hansen, PhD.
Department of Prevention and Documentation, Danish Cancer Society
Anne Dahl Lassen, PhD. Student
Department of Nutrition, National Food Institute, Technical University of Denmark
Sanne Poulsen & Lotte Ernst
Department of Prevention and Documentation, Danish Cancer Society
Introduction
This strategic research network focuses on a new, innovative and health promoting workers’ benefit called
‘Canteen take away’. Canteen take away is ready-to-heat-meals and meal-elements freshly prepared in
workplace canteens for the employees to take home at subsidized or market prices. Canteen take away
reduces the time needed for shopping, prep-work, cooking and cleaning at home and is expected to improve
the nutritional quality of the diet of employees and their families.
This strategic network will conduct multi-level intervention/action research over a 3-year period. The network
includes three research institutions and many relevant and powerful public, private and civil organizations. The
partners will conduct this research in real life situations to provide evidence for the efficiency of the canteen
take away concept. The research will be conducted in close dialogue with Danish workplaces to ensure
maximum practical and strategic relevance and feedback, and to facilitate future implementation of results of
the project. It is our hypothesis that health promotion activities such as Canteen take away can relatively
quickly and cost-effectively lead to healthier eating habits among employees and their families, especially in
lower socioeconomic groups.
The aim of this part of the study was to evaluate the impact of the canteen take away program on the dietary
habits of employers.
Methods
We conducted a six week diet intervention to study the impact of Canteen take away meals on the dietary
quality of a sample of employees in a Danish white collar worksite. 27 employees (14 women and 13 men) from
the enterprise, ATP-huset, participated in the study. The employees participated in two 24 h recalls on days
when they had their usual evening meals and on two days when they included Canteen take away. The
nutritional quality of the diet was evaluated on parameters of total energy (kJ), protein (g) total fat (g),
saturated fat (g), carbohydrate (g), added sugar (g) dietary fibre (g), alcohol (g), fruit and vegetables (g). The
data were described with cross classification and analysed with respectively paired t-test and Wilcoxon signed
rank tests.
Results
The diet of the participants contained significantly less total energy, total fat, saturated fat, carbohydrate and
significantly more fruits and vegetables on days when the employers consumed Canteen take away meals
compared to days, when they consumed their usual evening meals. The diet of a sub sample of the employees
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with the shortest education contained significantly more fruit and vegetables on days where Canteen take
away meals were included compared to when usual evening meals were included. The influence of the Canteen
take away meals on the nutritional quality of the evening meals has not yet been analyzed.
This study indicates that it is possible to improve the nutritional quality of the diet of employees when they
consume Canteen take away meals.
Discussion
This study was conducted in a highly motivated employer environment, with predominantly white collar
workers, who pose positive attitudes towards healthy eating. The worksite has a long history of working with
health promotion as well as canteen take away. Furthermore, the company aspires to be awarded for their
health promoting activities.
It is interesting to investigate whether it is possible to implement Canteen take away in a blue collar worksite.
This autumn we are conducting an intervention study in a private blue collar worksite in the municipality of
Copenhagen. This is at a relatively small worksite with less than 200 workers working shift. We have recorded
their dietary habits (24 h recalls among more than 50 employees), before the intervention in May and June and
are now repeating the 24 h recall among the workers participating in the intervention. In this study, we also
intend to evaluate the motives and incentives for the employees to use Canteen take away as well as their
perception of the Canteen take away meals and the influence it imposes on their everyday lives in the family.
Further, we will study what will ensure the success of a Canteen take away program in a blue collar worksite.
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Eating Habits in the Baltic States
Sirje PotiseppDirector
Association of the Estonian Food Industry
Tagli Pitsi Nutrition expert
National Institute for Health Development
Introduction
In 2007, at the request of the Association of the Estonian Food Industry, Faktum & Ariko conducted a survey
into the eating habits in the Baltic States. The aim of this survey was to compare the general eating habits of
the residents on both weekdays and weekends in the three Baltic States. The survey revealed that Estonians
are the most urban (i.e. modern) consumers, since the breakfasts are more varied; significantly more fruit juice
and milk is consumed; the main meal of the day is eaten outside home; a much broader selection of
ingredients are used in preparing evening meals, including semi-processed and ready-to-eat meals; elderly
follow nutritional recommendations and value their time; and the populations are eating more healthy, using
more rapeseed and olive oil and showing a preference for fish.
Methods
The survey was conducted simultaneously in the three countries between 1 and 28 October 2007 using the
telephone questionnaire method. The sample for the survey was random, with 500 (or slightly more)
consumers between the ages of 15 and 74 in all three countries surveyed. Although those who took part in the
survey were representatives of various nationalities, they will hereafter be referred to as Estonians, Latvians
and Lithuanians. The survey was designed to identify the times at which people eat, which meal qualified as
their main meal and the places they eat on weekdays and weekends; the food and drinks people primarily
consume at different meal times; the food they eat as snacks between meals; and sources of information in
shaping nutritional habits.
Results
The total number of people surveyed was 501 in Estonia, 507 in Latvia and 529 in Lithuania, of whom 5354%
were men and 4647% women. Of the three age groups surveyed (15–34, 3554 and 5574) there were more
respondents from the first two groups in all three countries: 37%, 36% and 28%, respectively, in Estonia; 38%,
35% and 28% in Latvia; and 38%, 37% and 25% in Lithuania. The majority of respondents had secondary or
tertiary education or vocational secondary education. More respondents were married or in a relationship
(60% in Estonia and Latvia and 58% in Lithuania) than single. Roughly half of those surveyed in all three
countries were the main shoppers in their families. Similarly, approximately half of the respondents were
salaried employees: primarily skilled workers, specialists, managers and personal or customer service officers.
37% of those surveyed in Estonia, 33% in Latvia and 40% in Lithuania had families including children under the
age of 16.
Breakfast is eaten in all three countries in much the same way at home, although there are certain differences
in people’s choice of food. The breakfasts that Estonians eat are somewhat more varied than those of their
Page 36 of 72
neighbours. 73% of Estonians, 70% of Latvians and 73% of Lithuanians eat breakfast before 10.00 am on
working days.
The main meal of the day in all three countries is taken between 12.00 pm and 2.00 pm on working days,
although Estonians and Latvians also tend to have main meals between 6.00 pm and 8.00 pm, especially those
with children. The majority of respondents in all countries tend to eat between 6.00 pm and 8.00 pm on
weekends and days off, although lunch remains the main meal of the day and is usually eaten between 12.00
pm and 4.00 pm.
The biggest differences in the main meal on working days emerge in the choice of location: 44% of Estonians
eat their main meal at home, while 36% eat theirs at their work place or school, and 10% eat food they have
taken with them from home. The same figures for Latvia are 47%, 19% and 21% and for Lithuania 61%, 8% and
24%. On the other hand, Estonians tend to eat out on weekends and days off less frequently than Latvians and
Lithuanians.
The most common component of the main meal in all three countries is meat (89% in Estonia, 80% in Latvia
and 87% in Lithuania), while 64% of Estonians, 36% of Latvians and 47% of Lithuanians nominated fish as the
main component. Vegetables and salad formed the most common component of the main meals of 85% of
Estonians, 77% of Latvians and 71% of Lithuanians. Estonians also consume more grain products as part of their
main meal than their neighbours (41% of respondents), as well as dairy products (33%), sausage products
(28%) and ice cream or other dessert items (23%). However, Estonians also represented the smallest
proportion of consumers of fruit (23% of respondents). Estonians prefer milk or fruit juice as their drink (42%
and 41% of respondents, respectively), while Latvians and Lithuanians prefer tea (37% and 47%, respectively).
The proportion of beer and wine drinkers was also slightly higher among Estonians.
Water or mineral water is the most popular drink between meals in all three countries (70% of in Estonia, 61%
in Latvia and 63% in Lithuania). In second place in Latvia and Lithuania is tea (32% and 33% of respondents,
respectively), while in Estonia second place is given to fruit juice (31%). 22% of Estonian respondents drink tea
between meals, and 16% drink coffee. Soft drinks (including sodas, colas and kvass) are only notably popular in
Latvia (13% of respondents compared to just 7% in Estonia and Lithuania). At the same time, more Estonians
drink milk or beer between meals (5% of respondents each).
Estonians eat a warm meal at home in the evening with slightly less frequency than Latvians or Lithuanians.
61% of Estonians, 73% of Latvians and 71% of Lithuanians eat a warm meal at home in the evening every day.
The most important factors in what people make for their warm meals in all three countries were personal
taste preferences and what is healthy. The third most important factor for Estonians and Lithuanians was the
speed at which the meal can be prepared, while for Latvians the third most important aspect is the quality of
the food. Compared to their neighbours, Estonians also place greater emphasis on variety.
Estonia is characterised by the fact that it is the country in which the fewest people snack between meals.
Page 37 of 72
Discussion
The proportion of breakfast eaters among Estonians is comparable to the figures obtained in the course of the
2008 Health Behaviour among Estonian Adult Population (HBEAP) survey, which showed that 75.9% of
respondents almost always eat breakfast and that just 8.6% of respondents never do. Comparing the foods
eaten for breakfast, Estonians prefer black bread, sausage products and ham and white bread, and porridge is
also popular. Latvians, on the other hand, prefer to put cheese and spreads on their bread in place of meat,
while cheese curd products are eaten in Latvia more than in the other two countries. Lithuanians also prefer
cheeses and spreads, but they favour white bread over black bread. The most popular drinks are coffee and
tea, with Estonians drinking more coffee and Lithuanians drinking more tea. In terms of other drinks, Estonians
consumer more fruit juice and milk than their neighbours.
Comparing the places in which people eat their main meal on weekdays, it can be seen that Estonians are much
more urbanised than their neighbours, eating outside of the home more, while Lithuanians tend to eat at home
the most. It can also be seen from the people’s choice of food that a lot of meat is eaten in all three countries.
The survey shows that a lot of fish is also consumed, as is partially confirmed by the HBEAP, although the
Health Behaviour in School-aged Children (HBSC) study conducted among students revealed that as much as
54.7% of students eat fish less than once a week or do not eat fish at all. According to the HBEAP, around half
of all Estonians eat fish once or twice a week (51.1% of respondents), while around a quarter do not eat fish at
all (24.9%).
Although this survey has shown that quite a lot of vegetables are consumed, other studies have confirmed that
the majority of Estonians do not eat the recommended five daily portions of fruit and vegetables. The results of
the HBSC survey of Estonian school children between the ages of 11 and 15 show that only 36% of students eat
fruit and vegetables every day. The majority of students eat fruit and vegetables between two and four times
per week. According to the HBEAP, 38.6% of respondents eat between 200 and 399 grams of fruit per day and
36.2% of respondents eat between 200 and 399 grams of vegetables per day; less than 200 grams of fruit and
vegetables is consumed by 30.6% and 37.4% of respondents each day, respectively.
The way in which Estonians prepare their evening meals differs from the way in which Latvians and Lithuanians
prepare theirs: they use fewer fresh and raw ingredients and more semi-processed products, and also heat up
ready-to-eat meals. Whereas in terms of such products Estonians prefer meat patties and meat balls, fish
products and sausage products, Lithuanians have a clear preference for sausage products. Latvians, meanwhile,
eat dumplings. Frozen vegetables and pre-prepared salads are consumed slightly more by Estonians than by
their neighbours.
Based on the figures obtained in this survey, Estonian students eat fewer sweets and drink less soft drinks than
their Latvian and Lithuanian counterparts. 34% of students consume such drinks and sweets on a daily basis.
Compared to their neighbours, Estonians eat less fruit and vegetables, dairy products and fish as light meals or
snacks. The main snacks eaten between meals in Latvia are confectionery products, sandwiches and junk food.
Dairy products, meat and fish products are the main snacks eaten between meals in Lithuania.
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This survey has shown that the lunch choice made by Estonians is probably influenced by what is offered in
their work places, as many Estonians eat lunch outside of the home. By increasing the amount of fruit and
vegetables and fish offered in eateries it may be possible to persuade people to consume them more. Sufficient
consumption of both food groups is important for the prevention of cardiovascular diseases. Unfortunately,
Estonia is at the forefront of the occurrence of the latter.
References
1 Association of the Estonian Food Industry. Eating habits in the Baltic States. Tallinn, October 2007.
2 Tekkel, M., Veideman, T., Rahu, M. Health Behaviour among Estonian Adult Population, 2008. National Institute for
Health Development. Tallinn, 2009
3 Aasvee, K., Poolakese, A., Minossenko, A., Kurbatova, A. Health Behaviour in School-Aged Children Study 2005/2006.
National Institute for Health Development. Tallinn, 2007
4 Regulation no. 89 of the Government of the Republic of 14 February 2005. National Strategy for the Prevention of
Cardiovascular Diseases 20052020. Tallinn, 2005.
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Research on Influencing Worksite Eating
Worksite Canteen Availability and Usage among Finnish Employees
Susanna Raulio, MSc. (Food Sc.)
The National Institute for Health and Welfare, Helsinki, Finland
Eva Roos, PhD, Docent
Folkhälsan Research Center & Department of Public Health, University of Helsinki, Finland
Ritva Prättälä, PhD, Docent, Senior Researcher
Folkhälsan Research Center & Department of Public Health, University of Helsinki, Finland
Introduction
In Finland, lunch is the most important meal of the day, both as a main energy source and as the most
frequently eaten meal by the population [1, 2]. On workdays lunch is mainly eaten from worksite canteens [2-
4] or, especially among women, as a packed meal in the workplace’s break rooms [2, 5]. Worksite canteens
could be a useful setting for improving employees’ diets by offering servings that are balanced according to
dietary guidelines [6]; moreover, food provided at worksite canteens could serve as a model for an optimal diet
[7]. Well-planned catering services at workplaces could therefore have a major effect on the nutrition and well-
being of its employees as well as on public health [8].
Our aim was to study the availability of canteens according to employee’s socio-demographic factors and
characteristics of her/his workplace. A further aim was to study the association between socio-economic
factors and use of worksite canteens among those who have the option to use a canteen.
Methods
The study material was the data of the Health Behaviour and Health among Finnish Adult Population survey [9].
This data have been collected, annually, since 1978 by the National Institute for Health and Welfare (formerly
KTL). The annual sample size of the study has been 5,000 and the response rate has varied from 60% to 86%. In
this study we used data from 2005-2007, and employed Finns, aged 25 to 64 years, from all possible types of
workplaces (except for farmers). Altogether 2659 men and 2926 women were included in the analysis.
Sociodemographic and work-related differences on the availability of worksite canteens, canteen usage, and in
the use of packed lunches were analyzed by logistic regression models. All models were fitted separately to
males and females, since it has been observed that practices and attitudes toward food are gender specific [10,
11]. The overall effect with age was added first, followed by education, place of residence, marital status,
number of children, socioeconomic status, size of the workplace, and the degree of physical burden of the
respondent’s job. Results of the model were adjusted only for age and ‘fully’ adjusted models are presented in
odds ratios (OR) and 95% confidence intervals (CI). All analyses were carried out in a cross-sectional design.
Results
Worksite canteens are mostly available to well-educated white-collar workers in large workplaces in the
capital area. The most unsatisfactory situation is among men working physically demanding jobs in small
Page 40 of 72
workplaces and private enterprises. However, even when there is a canteen, less-educated female unskilled
blue-collar workers eat packed lunches instead of eating from the canteen.
Discussion
There is an obvious lack of worksite canteens among less-educated male workers who are in physically
demanding jobs. These men are typically construction workers or lorry drivers who have mobile work and tight
schedules. Eating at canteen is not an option for them and they mostly eating packed lunches during working
hours [12, 13]. Efforts should be made to improve the possibilities for them to have lunch from canteens or
restaurants offering healthy, nutritious lunches among these employees.
Also barriers for canteen use should be studied among those female workers who have opportunity to use
canteen, but still doesn’t do so. Price of the food has earlier been mentioned as a reason to eat packed lunches
instead of using canteen [14].
To improve the nutrition of these two groups, attention should be paid to the nutritional quality of the packed
lunches eaten at work.
References
1. Männistö S, Ovaskainen M-L and Valsta Lt. The National Findiet 2002 Study Helsinki: Publications of the National Public
Health Institute (KTL) B3/2003, 2003.
2. Paturi M, Tapanainen H, Reinivuo H and Pietinen P. The National FINDIET 2007 Survey Helsinki: Publications of the
National Public Health Institute (KTL) B23/2008, 2008.
3. Raulio S, Roos E, Rahkonen O and Prättälä R. Twenty-year trends of workplace lunches in Finland. Food Service
Technology. 2005;5:57-66.
4. Laitinen J. Eating during working hours among young adults [in Finnish]. Työ ja ihminen. 2000;14:49-67.
5. Raulio S, Roos E, Mukala K and Prättälä R. Can working conditions explain differences in eating patterns during working
hours? Public Health Nutrition. 2007;11:258-270.
6. National Nutrition Council. Finnish Nutrition Recommendations [In Finnish] Helsinki: Edita Publishing Oy, 2005.
7. Mäkelä J. "You should eat more salad" nutrition recommendations and women's views of healthy eating in Helsinki
metropolitan area [Abstract in English] Journal of Social Medicine. 1996;33:17-23.
8. Wanjek C. Food at Work: Workplace solutions for malnutrition, obesity and chronic diseases Geneva: International
Labour Organization (ILO), 2005.
9. Helakorpi S, Prättälä R and Uutela A. Health Behaviour and Health among the Finnish Adult Population, Spring 2007
Helsinki: Publications of the National Public Health Institute B6/2008, 2008.
10. Turrell G. Determinants of gender differences in dietary behavior. Nutrition Research. 1997;17:1105-1120.
11. Roos E, Lahelma E, Virtanen M, Prättälä R and Pietinen P. Gender, socioeconomic status and family status as
determinants of food behaviour. Soc Sci Med. 1998;46:1519-1529.
12. Jack FR, Piacentini MG and Schroder MJ. Perception and role of fruit in the workday diets of Scottish lorry drivers.
Appetite. 1998;30:139-149.
13. Uusitalo H, Prättälä R and Uutela A. Type of work, social orientation, and meals at work [in Finnish, abstract in English].
Journal of Social Medicine. 1996;33:25-31.
14. de Almeida MD, Graca P, Afonso C, Kearney JM and Gibney MJ. Healthy eating in European elderly: concepts, barriers
and benefits. J Nutr Health Aging. 2001;5:217-219.
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Strategies for Influencing Eating Patterns through the Worksite - A Review
Signe Poulsen, PhD student
DTU Management Engineering, Technical University of Denmark
Introduction
During the past 10-20 years there has been an increase in interventions related to health at worksites
(Sorensen, Linnan & Hunt 2004). The workplace, as a setting, is believed to be an important area to include in
health promotion since most adults spends a significant amount of time in the workplace every day. An
ongoing research project in Denmark uses the worksite setting to promote healthy eating to its employees and
their families. The Canteen Take Away (CTA) project involves companies that sell healthy takeaway food to
their employees, with the intention that they bring it home to their families. Some of the characteristics of the
CTA project are that it involves the family and it is an attempt to comply with the busy schedules of the
employees. The aim of this review is to make an explorative review and to investigate whether there have been
other projects like the CTA project. Further, it researches the field of healthy eating initiatives to establish
potential pitfalls and advantages of the different types of initiatives.
Methods
An online literature search of different relevant databases was conducted. Primary databases used were Web
of Science and DADS (Digital Article Database Service).
A search strategy with the following words was set up before the search was performed. Some of the keywords
in the search strategy were: worksite, workplace and healthy eating (table 1).
From reading the title and the abstract of the articles it
was assessed whether they were relevant with regard to
the initial scope. A snowball sampling was used to ensure
that as many relevant articles as possible were included.
The references from the selected studies were screened
for other relevant studies.
The main focus was healthy eating initiatives. To get as many different aspects of this area as possible, it was
decided to include as many different approaches as possible. To be included were articles and reviews
concerning fruit and vegetable consumption initiatives, worksite health promotion programs and change of
food choice.
Results
In this review it has not been possible to identify health initiatives which are comparable to the CTA project.
There are several aspects which seem to be of great importance when establishing healthy eating initiatives.
These are: participation, organizational support, the social context, the influence of peers, different worksite
characteristics and environmental changes.
Table 1
Page 42 of 72
The use of employee participation both in the planning of the intervention and during the intervention can be
beneficial; this was found both in a fruit and vegetable intervention (Sorensen, Linnan & Hunt 2004) and at
blue-collar worksites (Lassen et al. 2007).
It is stated that organizational support influences the success of interventions, especially when the
interventions are fairly comprehensive (Sorensen, Linnan & Hunt 2004). Another aspect which is highly relevant
is the worksite characteristics. It is found that at blue collar worksites, factors such as size of the worksite and
whether there is a cafeteria at the worksite plays a role in interventions (Lassen et al. 2007). An additional
characteristic mentioned is the organizational structure which is found to influence workplace health
promotion (Harden et al. 1999). Sorensen and colleagues suggest that future programs take the development
of worksites into consideration. Several people do not go to the office every day, e.g. sales personnel, and they
should also be included in healthy eating initiatives (Sorensen, Linnan & Hunt 2004).
The social context includes factors from inside the workplace and outside the worksite. These factors are the
local society and the employees’ families, which seem to have a great influence (Sorensen, Linnan & Hunt
2004). Furthermore, the use of peers in nutrition education at worksites has not been thoroughly researched
(Buttriss et al. 2004). One study has shown an increase in fruit and vegetable consumption as a result of peer-
led nutrition education amongst lower socio-economic employees in the US.
A recent review of health promotion schemes at worksites shows that changes in the worksite environment are
not often used (Engbers et al. 2005). Though a number of worksites that have used changes in the worksite
environment are limited, it would suggest that it was not possible to make conclusions with regard to how
modifications in the environment effect healthy eating. Engbers and colleagues found that using i.e. food
labelling and placement of food has an effect on the diet.
Discussion
A limitation to this review is the literature search. Since it was only performed in English it is possible that the
search did not include all relevant publications. There could be relevant material written in other languages
which were not found. Furthermore, the search was mainly focused on scientific articles because of the choice
of databases; this could have excluded some relevant grey literature. This could be significant because it was
not possible to find publications about research projects similar to the CTA project.
Given that it was not possible to find results from intervention studies comparable to the CTA project, it could
also imply that the CTA project is a new way of thinking interventions. When establishing a CTA scheme it is not
only the employees who are targeted but also the employees’ families who are affected by the initiative. The
integration of the family in this complies with the importance of including the families in interventions, as
found in the review.
Through the review it is clear that there is a connection between food and health aspects at the worksites,
though it has not been possible to find initiatives that also include the aspect of work into the intervention.
Page 43 of 72
This could partly be due to limitations in the literature search or it could be that this aspect is yet to be included
in healthy eating initiatives at worksites. One study showed that combining health promotion with
occupational health and safety initiatives has a greater effect compared to health promotion initiatives (Hunt
et al. 2005). This is presumably because the OHS hazards are regarded as more serious by the employees and
that this is an area in which the management is more involved.
References
Buttriss, J., Stanner, S., McKevith, B., Nugent, A.P., Kelly, C., Phillips, F. & Theobald, H.E. 2004, "Successful ways to modify
food choice: lessons from the literature", Nutrition Bulletin, vol. 29, no. 4, pp. 333-343.
Engbers, L.H., van Poppel, M.N.M., Paw, M.J.M.C.A. & van Mechelen, W. 2005, "Worksite health promotion programs with
environmental changes - A systematic review", American Journal of Preventive Medicine, vol. 29, no. 1, pp. 61-70.
Harden, A., Peersman, G., Oliver, S., Mauthner, M. & Oakley, A. 1999, "Original Papers - A systematic review of the
effectiveness of health promotion interventions in the workplace", Occupational Medicine, vol. 49, no. 8, pp. 540.
Hunt, M.K., Lederman, R., Stoddard, A.M., LaMontagne, A.D., McLellan, D., Combe, C., Barbeau, E. & Sorensen, G. 2005,
"Process Evaluation of an Integrated Health Promotion/Occupational Health Model in WellWorks-2", Health
Education & Behavior, vol. 32, no. 1, pp. 10-26.
Lassen, A., Bruselius-Jensen, M., Sommer, H.M., Thorsen, A.V. & Trolle, E. 2007, Factors influencing participation rates and
employees' attitudes toward promoting healthy eating at blue-collar worksites.
Sorensen, G., Linnan, L. & Hunt, M.K. 2004, "Worksite-based research and initiatives to increase fruit and vegetable
consumption", Preventive medicine, vol. 39, pp. 94-100.
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Design Strategy for better Eating Facilities
On-going research on the importance of design in meal experiences
Tenna Doktor Olsen, PhD student
Department of Architecture & Design, Aalborg University
Poul Henning Kirkegaard, PhD, Associate Professor
Department of Civil Engineering, Aalborg University
Anna Marie Fisker, PhD, Associate Professor
Department of Architecture & Design, Aalborg University
Introduction
The workplace plays a great part in the consumption of daily meals among adults, and it is commonly known
that better food and intentional awareness on the wellbeing of employees can improve their efficiency and
quality of work effort. Catering services and kitchen industries delivering daily meals for employees, as well as
workplaces wishing to take on an increasing health responsibility, are therefore becoming extremely interested
in food- and health related research. Most contemporary research on improved food at workplaces, however,
often specify only the direct importance of exercise, easy access to fruits and vegetables, as well as proper
amounts of healthy foods during meals. [5] The same research rarely discusses the significance of spatial
settings and aesthetic environments encompassing the consumption of meals. Nor does it consider the design,
brand or experience related impacts, on food.
A study of the contemporary research on meal science revealed a common lack of interest in design and
experience related aspects of eating foods and their inherited sense of wellbeing. Existing literature and
research in this area is furthermore full of contrasting theories, myths and contradictions, and lacks a thorough
understanding of the interplay between food science, consumer experiences and integrated design. [1] This,
despite researchers like Meiselman, Wansink and Gustafsson, who have for years implied the perceptive
importance of physical environments surrounding meals. [2-4] This poster presents the research carried out
with the master thesis; “Millennium Triclinium Staging Figgjo Meal Experiences”, and initiates a theoretical
discussion on how design and food are related. As well as presenting the specific proposal for a design strategy
to actively improve wellbeing among employees, by means of designing better settings around meal
experiences at workplaces.
Methods
The research is based on a theoretical study taking its point of departure in an interdisciplinary approach
combining the evidence based food- and consumer science of Meiselman with phenomenological and semiotic
theories on perception and language of space experienced through bodily encounters and form as signs,
developed by Merleau-Ponty, Eco and Barthes. [6-9] With this, it was investigated how spatial settings impact
on public restaurant meals, and discussed how design could be used to stage future meal experiences.
Furthermore, a general holistic approach was chosen, unfolding cultural, sociological and aesthetic impacts of
Page 45 of 72
architectural design on meal experiences through an elaborate study on Roman historical settings’ staging of
meal experiences, by significant use of interior design and performative presentations of food.
Results
The study revealed that, in the past, grand Roman banquets utilized the performative element of theatre to
create multi-sensuous meal experiences, engaging the entire body and all its sense modalities. Held together
with the theories of food and consumer science, phenomenology and semiotics, the element of eating proved
to be an extended experience depending as much on visual, audio, tactile and kinetic experiences, as gustatory
and olfactory stimuli, not only from the specific food items, but from the entire surroundings. Consequently,
concluding that we ascribe significance to spaces and objects we encounter whether it being buildings,
tableware or food - and does so on behalf of the bodily and sensuous contact, together with our inherited
social and cultural norms and values. Design- as the design of dining environments, the spatial settings, room
interior, furniture, decoration, tableware and presentation of the food - is not just matters of physical form,
but sensuous phenomena involving as much the engagement and understanding of society and life, as the
behaviour of man. Design becomes intentional – it becomes staging, and it is in this act that design defines the
frames of our lives and directly relates to our sense of being-in-the-world and our sense of wellbeing. [1] This is
not something new in the perspective of phenomenology. But, in the perspective of meals at workplaces,
design strategies as means of staging food become important.
Based on the understanding of design as sensuous phenomena, a specific design strategy outlining five focal
design points, Context, Narrative, Scale, Detail and Experience and seven specific design parameters,
Movement, Touch, Scent, Sound, Sight, Taste and Surprise, were developed as practical guiding means to
architecturally enhance meal experiences when developing future eating facilities.
Discussion
With form as means of staging human being design becomes an essential aspect of “taste” when we evaluate
the quality of meals and food at workplaces. The theoretical study proved that the sense of “self” is
strengthened by design allowing us to engage fully in the mental dimensions of dreams, imagination and
desire, and whereas food is a latent mean of expressing hidden dreams and desires, design relate, mediate and
project those meanings directly through form. Hence, the design and form of objects communicate severe
cultural and sociological meanings and thereby highly affect the expectations and levels of satisfaction from
eating. [1] Design should therefore be carefully considered when dealing with food experiences in future
workplaces, as possible means to improve the experience, satisfaction and wellbeing of employees.
The proposed design strategy obtain these careful considerations and utilizes the act of physical contact and
the psychological- and social ability of core senses like touch, taste, vision, sound, surprise and scent to
establish mutual bonds between users, form and food. The orchestration of space, form and sensations
through choice of materials, light, movements, elements of surprise, unexpected interaction, and mediation
allow for a slow travel and exploration of taste. There is, however, a tendency towards contemporary design of
eating facilities moving away from the bodily related qualities. Instead aesthetic focus has moved toward
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mediated space and advanced technologies as eye-catching means to visually draw attention, lacking bodily
abilities to fully address and engage sensuously with the mind. [1] It seems that some of the qualities in the
performed gesamtkunstwerk applied food, art and design throughout history, and argued for with the
proposed design strategy, have been lost. That gastronomy and food science, by dismissing design and
neglecting the importance of architectural detailing, to some extent, has lost the sense of staging meal
experiences?
Many of the aspects defining the meal experience, as well as design, are intangible phenomenological matters.
Neither food science nor architectural theory today reveals the full extent of this. By working with design
relative to food, I have challenged knowledge on meal experiences, combined theory and practice and let the
“taste for space and form” give the necessary power to explore food. I did so with the strong persuasion of
opening perhaps just a small door towards a future interest in research across design and food; but also with
the strong interest in investigating how interrelated scales of design and food can be utilized to create
sensuous experiences around eating, and thereby initiate social relations and wellbeing among eaters, for
instance, at workplaces?
Since not every one of us is a chef, most of us, however, still arrange food on our individual plates daily;
intuitively arranging the different food elements in a certain order and in relation to each other. With this act
we are all designing “foodscapes” relating the comprehension of design as staging with food and tableware.
Food experiences whether in the public restaurant, at home or at work are, as such, not just a matter of
getting the appropriate amount of nutritional food and vitamins, and being satiated physiologically. But as
much about social satisfaction and enrolling oneself in a community, showing or articulating a sense of
belonging through food choices. Likewise design both as a single object and as a presentation and serving of
food - cannot and is not experienced as mere physical shape, but must be understood as part of a greater
intention and architectural significance; expressed through the staging and articulation of spatial settings,
interior and detailing around food.
The lesson to be learned from this is that form and design engages with the body. It is encountered,
approached, moved through and related directly to our behaviour and being-in-the-world, creating a sense of
comfort and pleasure. Through careful consideration on architectural form and choreographed movements
interacting with space, furniture, tableware and food, form in general develops a primordial sense of belonging
and can actively improve the sense of wellbeing also at work.
References
1 Olsen, T.D. (2008): “Millennium Triclinium Staging Figgjo Meal Experiences”, Master Thesis, Department of
Architecture & Design, Aalborg University
2 King SC., Weber AJ. , Meiselman HL. (2004): “The effect of meal situation, social interaction, physical environment and
choice on food acceptability”, Food Quality and Preference, 15, pp. 51-65
3 Gustafsson IB. (2004): “Culinary arts and meal science, a new scientific research discipline”, Food Service Technology, 4,
pp. 9-20
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4 Sobal J., Wansink B. (2007): “Kitchenscapes, Tablescapes, Platescapes and Foodscapes Influences of microscale built
environments on food intake”, Environment and Behavior, 39, pp. 124-142
5 Ministeriet for Familie- og Forbrugeranliggender, Fagligt Fælles Forbund 3F (2005): ”Idémappe, Mad på Arbejde”
6 Barthes, R. (1996): ”Mytologier”, Gyldendal
7 Eco, U. (1968): ”Funktionen og Tegnet” In: Bek, L., Oxvig, H. (1999): Rumanalyser. Fonden til udgivelse af
arkitekturtidsskriftet B, Århus C, pp.293-335
8 Merleau-Ponty, M. (1994): ”Kroppens Fænomenologi”, Det lille Forlag, Frederiksberg, 1. Udg., 3. Oplag
9 Meiselman, H.L. (2000): ”Dimensions of the meal”, Aspen Publishers, Maryland
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Policy Initiatives, Regulations & Recommendations
Guidelines for the Prevention of Obesity at the Workplace
Dina Zota, MSc.; Karnaki, P; Veloudaki, A; Linos, A
Institute of Preventive Medicine, Environmental and Occupational Health
PROLEPSIS, Greece
Background
The Guidelines for the Prevention of Obesity at the Workplace - GPOW was a 2-year project implemented
under the DG - SANCO 2003-2008 Public Health Program co-funded by the European Commission. Identifying
the obesogenic nature of different workplaces and providing guidelines for the prevention of obesity at the
workplace were its main goals. Overweight and obesity are increasing at an alarming rate in Europe with
obesity rates ranging from 10% to 27% in men and up to 38% in women. Individual life-style choices alone
cannot account for these high rates, while environments, such as the workplace through its obesogenic nature,
play an important role in determining obesity outcomes. Thus, the GPOW project approached the workplace
from a dual perspective: a) Workplaces present an ideal setting and provide unique opportunities to address
factors which contribute to obesity, such as unhealthy diet and inadequate physical activity, because it
provides access to large populations, and b) Modern workplaces have become increasingly obesogenic,
because of both the changing nature of work and the working conditions, such as long working hours.
Description of policy initiative
GPOW conducted an in depth exploration of how work and work conditions influence weight outcomes among
employees through original research and extensive analysis of existing data. Activities that have been
evaluated and resulted in measurable success are recommended as best practices, taking into consideration
the general principles of good workplace health promotion practices and offering a comprehensive account of
the most successful and promising counter obesity actions. The project, hence, provides a valuable framework
to stakeholders for the design and implementation of effective Workplace Health Promotion Programs (WHPP).
The end product of the project is a set of evidence-based guidelines for the prevention of obesity at the
workplace, which is a useful instrument for employers and employees as it:
Outlines the most prevalent obesogenic factors per work sector affecting or leading to obesity
Outlines the most effective interventions for the prevention of obesity at the workplace
Provides practical recommendations on specific evidence-based strategies per workplace sector
Outlines the stages of workplace health promotion planning, implementation and evaluation.
Expected outcome
The GPOW is expected to raise awareness on the obesogenic nature of different work sectors among all
interested parties. In addition, the project and the produced guidelines are expected to have a positive impact
in promoting the implementation of interventions for the prevention of obesity at the workplace.
Implementing diet and physical activity interventions have the potential for improving the health status of
workers, contributing to a positive and caring image of the company, improving staff morale, reducing the staff
turnover and absenteeism, enhancing productivity, reducing sick leave and workers’ compensation and
disability payments. By focusing on interventions in the workplace, the GPOW can influence the health
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behaviour of large proportions of the population, resulting in a positive impact on the social and environmental
factors that shape lifestyle choices.
Discussion
Modern workplaces have become increasingly obesogenic, with the following factors considered important in
influencing obesity outcomes among employees: workplace environmental factors (lack of facilities for storing
food and onsite healthy food options), occupational stress, long working hours, continuous sedentary work,
and other environmental and organizational factors (e.g. night shifts, lack of management commitment to
promoting health). The in depth evaluation of existing interventions revealed several recommendations
concerning successful obesity prevention activities at the workplace, including conducting needs assessments,
changing behaviors which influence weight outcomes, implementing both physical activity and nutrition
methods aimed at behavioral change, including environmental and organizational change, carrying out most of
the planned intervention during work hours, extending the intervention period over one year, allowing
participants to self monitor their progress, emphasizing employee participation, using simple language, visuals,
etc., establishing incentives for both employees and employers, and conducting continuous evaluation. A
healthy, motivated and well qualified workforce is fundamental to the future social and economic wellbeing of
the European Union. There is a growing body of evidence that improvements in workplace health can be key
ingredients to business efficiency and competitiveness.
References
Berghöfer A, Pischon T, Reinhold T, Apovian CM, Sharma AM, and Willich SN (2008). Obesity prevalence from a European
perspective: a systematic review. BMC Public Health. 8:200.Egger, G.J., Vogels, N., Westerterp, K.R. (2001).
Estimating historical changes in physical activity levels. Med J Aust, 175 : 635636
Hellerstedt WL, & Jeffery RW (1997). The effects of a telephone-based intervention on weight loss. Am J Health
Promotion, 11(3):177-82.
Kouvonen A, Kivimäki M, Cox SJ, Cox T and Vahtera J (2005). Relationship between work stress and body mass index
among 45,810 female and male employees. Psychosomatic medicine. 67: 577-83.
Lallukka T, Laaksonen M, Martikainen P, Sarlio-Lähteenkorva S and Lahelma E (2005). Psychosocial working conditions and
weight gain among employees. Int J Obes. 29: 909-15.
Nakamura, K., Shimai, S., Kikuchi, S., Takahashi, H., Tanaka, M., Nakano, S., Motohashi, Y., Nakadaira, H., & Yamamoto, M.
(1998). Increases in body mass index and waist circumference as outcomes of working overtime. Occupational
Medicine, 48: 169-173.
Mummery, W.K., Schofield, G.M., Steele, R., Eakin, E.G., & Brown, W.J. (2005). Occupational sitting time and overweight
and obesity in Australian workers. American Journal of Prevtive Medicine, 29: 9197.
Niedhammer, I., Goldberg, M., & Leclerc, A. (1998). Psychological factors at work and subsequent depressive symptoms in
the Gazel cohort. Scandinavian Journal of the Work Environment and Health, 24: 197-205.
Schneider, S., & Becker, S. (2005). Prevalence of Physical Activity among the Working Population and Correlation with
Work-Related Factors: Results from the First German National Health Survey. Journal of Occupational Health, 47:
414-423.
Wamala, S.P., Mittleman, M.A., Horsten, M., Schenck-Gustafsson, K., Orth-Gomér, K. (1997). Job stress and the
occupational gradient in coronary heart disease risk in women: the Stockholm Female Coronary Risk Study. Soc
Sci Med, 51: 4819.
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A Multisectoral Approach is the only Way in Planning and Implementing Policies
and Actions towards Health
Sirje Vaask PhD., Anneli Sammel, Tagli Pitsi PhD.
National Institute for Health Development
Background
Cardiovascular diseases (CVD) are the main reason for early loss of work capacity (at an age below 65) and
death in Estonia. Estonia is a leader in CVD mortality in Europe and the world. There has been no significant
change for the better over the past 20 years. Systematic health promotion activities were launched in Estonia
in 1996. Many campaigns and actions promoting the consumption of fruits and vegetables, rye bread and
products with a low fat and salt content targeted at young people and adults have been carried out since then.
Although a number of positive changes have occurred in the nutrition behaviour of the Estonian population
over the past decade, the Estonian diet is still poorly balanced to a large extent, especially from the aspect of
cardiovascular health.
Activities in the area of disease prevention and health promotion have been a central concern in Estonia over
recent years and significant progress has been made in the development of public health strategies, including
prevention strategies for cardiovascular disease and health, delivered at both population and individual levels.
Description of policy initiative
Specific public health programs implemented before 2005 were mainly vertical programs where the
responsibility was in the hands of a single ministry. Since 2005 the planning process has changed and actions
planned in the broad consultation process with different ministries and stakeholders. The result was formalized
as an intersectorial public health strategy. The last two and newly developed national strategies in Estonia are
the Estonian National Strategy for the Prevention of CVD 2005-2020 and the Estonian Health Strategy for 2009-
2020. The first strategy focuses on five major areas: physical activity, nutrition, smoking, health care services,
and dissemination of information and securing local capacity. The Estonian Health Strategy is a main national
public health policy document approved in 2008 and all other public health strategies (including Estonian
National Strategy for the Prevention of CVD) have been integrated into it. The Estonian Health Strategy has
been divided into five wider sections: social inclusion and equal opportunities; development of health of youth
and children; healthy environment; healthy lifestyle and development of healthcare systems. The Estonian
Health Strategy incorporates all strategy documents in the country that deal with or affect human health in any
way.
The development of the Network for Workplace Health Promotion is one of the actions carried out within the
above mentioned strategies. Information is not enough to improve eating habits; people must be given the
practical opportunity for healthy nutrition. Changes in the environment (such as changing the composition of
food in catering establishments) are considered to be one of the most effective activities and to yield the
quickest results.
The implementation of the CVD prevention strategy is managed and coordinated by the Strategy Council set up
in the Ministry of Social Affairs, which includes representatives of relevant ministries and other institutions,
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including non-profit organizations and professional associations. The strategy also introduced county based
health councils, which are responsible for the management and coordination of the implementation of the
Strategy at local level. Since 2006, every county government has a health promotion specialists attached to it.
Their responsibilities are to initiate, coordinate and evaluate local activities, and help local municipalities to
plan and implement health supporting policies.
Expected or obtained outcome
The main purposes of the above mentioned strategies are to increase the duration of a healthy life by reducing
preterm mortality and reduced occurrence of illnesses. The health strategy as a frame allows coordinating the
work done in the whole country in the field of public health via one policy document, and there exists one
management structure for all public health strategies. County Health Councils have been working in all county
government since 2005, consisting of representatives from County offices, local governments, and stakeholder
groups (educators, general practitioners etc). The work of the public health specialist and Council is funded
mainly by the central government. National interventions are planned and managed by the National Institute
of Health Development; local/regional actions are planned and managed by the County Councils. To plan and
implement actions via County Health Councils decentralize public health activities and allow for being flexible
with local needs. The expected outcome is to have a sustainable network for health promotion and thereby
implement national and regional actions in close coordination.
The Network of Health Promoting Workplaces is still coordinated at a national level by the Estonian Institute
for Health Development and with the cooperation of the regional councils it has great potential but is still quite
weak. There have been important changes politicians, other ministries and communities have shown
initiative and interest to integrate public health actions to the political programs at national and local levels:
health promotion has been moved from the traditional “health” sector. The results of the CVD Prevention
Strategy have shown that there have been remarkable positive changes in CVD mortality and morbidity in
Estonia, especially among the working-age population. Still, the mortality rate is considerably higher among
non-Estonians, men, and people with lower education and income status (including unemployed). This calls for
directing health promotion activities towards these target groups.
Discussion
The cooperation between County Councils and local enterprises is still not sufficient and this is an area that
requires improvement on the CVD prevention strategy. Health impact assessment is not being systematically
applied in Estonia today neither in the national nor at municipality level. The social determinants of health and
health inequalities are still not sufficiently incorporated into planning and strategies. Since then there has been
no clear evidence that the positive change in CVD mortality and morbidity in Estonia, due to the
implementation of the strategy and its management structure. In the long run, such organization at the county
level should become a permanent structure and form the basis for all public health programs.
Page 52 of 72
References
Brunner E, Cohen D, Toon L. Cost effectiveness of cardiovascular disease prevention strategies: a perspective on EU food
based dietary guidelines. Public Health Nutr. 2001 Apr;4(2B):711-5. Review.
Estonian Centre for Health Promotion and Education. Kasmel, A., Laasner, A., Lipand, A., Tamm, K., Vaask S. Kümme aastat
tervisedendust Eestis 2003/Ten years of Health Promotion in Estonia. Estonian Centre for Health Promotion and
Education. 2003.
National Strategy for Prevention of Cardiovascular Diseases 20052020 http://www.tai.ee/failid/HeartStrategy.pdf
Roos 2001 - Roos, G., Johansson, L., Kasmel, A., Klumbiene, J. and Prattala, R. Disparities in vegetable and fruit
consumption: European cases from the north to the south. Public Health Nutr 2001;4:35-43.
Similä M et al. The NORBAGREEN 2002 study Consumption of vegetables, potatoes, fruit, bread and fish in the Nordic
and Baltic countries. TemaNord 2003:556. ISBN 92-893-0952-0. Nordic Council of Ministers, Copenhagen 2003.
World Health Organization. Robertson, A., Tirado, C., Lobstein, T., Jermini, M., Knai C., Jensen J. H., Ferro-Luzzi, A. and
James W.P.T. Food and health in Europe: a new basis for action. WHO Regional Publications, European Series,
2004 No. 96.
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Eating at worksite in the Nordic Countries
From privacy to Collectivity
Bent Egberg Mikkelsen, PhD, Professor & Mia Brandhøj, Project Staff Member
Research group for Food, People & Design, Aalborg University, Denmark
Introduction
A large proportion of citizens in the Nordic countries do not eat in accordance with the official
recommendations. Only few meet the recommended intake of fat and sugar, intake of fruits and vegetables is
below recommendations, and many have a low intake of fish and whole-grain cereals (Nordic Council of
Ministers, 2006). Unhealthy eating patterns contribute to the growing prevalence of obesity and other lifestyle
related disorders. Where this has traditionally been considered as a private matter and the responsibility of the
individual, there is now a growing awareness and increasing interest for taking collective action in the
promotion of health.
As a result workplaces increasingly engage in initiatives aimed at promoting healthy lifestyle in order to protect
the health of their employees and the workplace seems to emerge as a potential promising setting for health
promotion (WHO, 1986). A considerable part of the adult population nowadays eats one or more of the daily
meals at worksite and this seem to have been driving a new interest in the settings based approach to health
promotion in particular in the Nordic countries. Studies on worksite health promotion interventions has shown
a positive return on investments (Trogdon et al, 2009) and increased productivity (Mills et al, 2007).
The call for healthier eating patterns seems to be mirrored by a growing interest from workplaces in staging
and shaping the eating environment at worksite. As a result food and meals at work seems to have moved to
the front stage in the modern workplace and this interest is reflected in interest from authorities and health
promoting NGO’s. Food at Work has become an issue and as such it has become an object of governance and
despite cultural differences this governance seems to have interesting similarities in the Nordic countries. The
current paper forms a part of the project Better food work Nordic and Baltic experiences that have been
initiated by Nordic Council of Ministers and aims at giving an overview of the emerging issue of food at work in
a Nordic context.
Purpose
The purpose of this paper is to give an account on the way that food at work over the past decades has become
an issue and as such the object of governance in the Nordic countries. Governance in this context is as the
actions taken by a broad range of stakeholders involved in the field and include among others workplaces,
NGO’s, public authorities and research institutions.
Method
The existing literature on research, practice and policies on the topic of eating at worksite in the Nordic
Countries has been reviewed. The main part of the literature originates from Denmark and Sweden and was
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identified in the Øresund Food Network project on food at work and has been published in the knowledge
survey publication ‘Mat på arbetet dygnet runt? Mat Tid - Arbete’, (Food at work around the clock. Work
time meal). Reports on eating at worksite from the other Nordic countries as well as from the Baltic countries
are infrequent. As a starting point a search for literature was performed regarding technical and scientific
literature. The literature was identified through a modified snowball sampling technique. In the snowball
sampling technique knowledgeable study subjects are contacted and these in turn recruit future subjects from
among their network. Through this technique the subjects identified evidence on projects, grey literature and
policy initiatives that could inform this paper.
Origin of worksite eating
The increased focus on eating at worksite was originally a reaction on the changes in work conditions in
industrialised countries. Worksite meal developed when more people became occupied in factories and had to
do irregular working hours with shift work. The impact the irregular working hours has on the body functions;
metabolic disruptions; was the foundation of making recommendations and research for eating at worksite.
Thus the approach to eating at worksite was focused on the science of the body and its’ functions, rather than
on the mind and the possible consequences food policies could have on the employees. Along with a more
diverse interpretation and definition of health, the focus was assembled in a biological - psychological and
social understanding, both in policies and practice. However focus has changed in the 90’s and carried through
the 21st century to involve more social aspects as well as experiences and enjoyment related to the aspects of
eating an eating together with colleagues.
The food as experience and source of enjoyment plays an increasing role in the workplaces attempts to stage
the food in canteens and dining facilities. Workplaces increasingly tend to use eating facilities and healthy food
opportunities as corporate branding both directed to the public and as a strategy to recruit and retain
employees, especially in knowledge-intensive enterprises and worksites. This means that there do not seem to
be a best way of organising food at work; the workplaces seem to strive for uniqueness when they invent their
particular way of providing meals for the employees.
At the same time the growing rates of overweight and obesity, and the concerns regarding the risk of
unfavourable consequence on the performance and long term health of the employees, has had a significant
effect over the past decades on workplaces’ interest in the issue of eating at work.
Despite the similarities in the development of eating at worksite it is important to note that the food culture in
the Nordic countries is different. This can be seen most significantly in Denmark and Sweden. In Sweden there
is a tradition of two hot meals a day and thus also a longer tradition for worksite provided meals where as in
Denmark the tradition for bringing a homemade cold lunch still plays a significant role although many
workplaces has taken over the responsibility for food and meals.
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Structure of eating at work
Workplaces are very different in terms of eating environment as well as in terms of working conditions offered
to the employees (Thorsen et al., 2009). The structural conditions for food at the workplace is dependent on
parameters such as gender distribution and educational background of the employees, type of work, working
hours and location of work tasks. The working conditions are not the only factors deciding what is eaten at
work. The eating habits seem to be passed on from the personal life and social class to the worksite eating. And
the other way around the conditions of the work reflects the base of the employees’ health.
This means that blue colour workers seems to have far less opportunities of making healthy choices at work
than white colour workers. This is an important challenge for all involved in food and nutrition interventions at
worksite and there is a great potential in making interventions within these types of worksites. A number of
parameters seems to influence the usage of worksite canteens as well as the nutritional quality of foods
consumed. These parameters include the accessibility of fruit and vegetables, prices of meals, way of serving
buffet vs. counter or fixed portions, local food policies and/or restrictions, duration of lunch break, pressure of
working tasks as well as type, taste and quality of the food served.
Health as a driver of worksite eating
The emerging governance of food at work has been especially significant in the case of fruit and vegetable
promoting initiatives. Examples include “6 om dagen”, ”Jobfrukkt”, ”Mødefrugt”, “Firmafrugt” and other fruit
and vegetable initiatives that has helped workplaces to organize their provision of healthy food options. Food
and nutrition guidelines and policies have been a preferred instrument in many workplaces.
Also diploma and certification schemes for canteens are common and used in several countries where task
forces of nutritional experts are responsible for setting criteria and guidelines of how to produce and serve
healthy meals. Canteen take-away is the most recent health promotion strategy in the field. The aspects of
canteen take-away is wider than the nutritional health aspects, the fundamental idea is also to secure the
work-life balance by helping the employees in their daily life, to avoid the stress it is to work full time and
having a successful and healthy private life.
Conclusion
Despite the cultural differences among the Nordic countries there seems to be a general increasing interest
from a number of different stakeholders in redesigning food at worksite. These include workplaces, public
authorities, research institutions, trade unions and NGO’s. The driving factors for this redesign seem to include
a number of factors. Increasing prevalence of obesity and overweight seems to be important. But also the
influence food intake has on work performance and well being seem to be important driver. In addition many
workplaces put effort into staging food as a part of the experience of going to work and this seems to play an
important role.
In general the fact that food became an issue at the workplace, and as a result of the object of governing
attempts (governance), not only comes from the workplaces, but from a broad range of stakeholders. As a
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result the responsibility for food, nutrition and health seems to have been shifting from a private matter to
collective matter. Public health strategies in the Nordic countries (Nordic Council of Ministers, 2006) for as well
as Corporate Social Responsibility strategies have fuelled this development and the research interest in the
field has grown meanwhile.
Discussion
The paper shows that in contrast to healthy eating promotion interventions at school, worksite interventions in
the Nordic countries are rarely evaluated. Thus one of the challenges is to generate scientific research
providing specific knowledge on the evidence of health interventions at worksite. Especially there is a need to
demonstrate whether interventions affect the employees positively in relation to food choices, health,
absence, performance etc.
The paper also shows that there is a lack of sharing knowledge and experiences among practitioners, as well as
among policy makers and among food and nutrition scientists. To secure a more goal-oriented approach more
research is needed, to prove which initiatives makes positive or negative results for the employee as well as for
the workplace, orientated towards physical conditions, social cohesion of eating and psychological aspects of
health at work and workplace environment. For example through measuring consumed vegetables and fruits
before, during and after a workplace intervention, and meanwhile gain access to more qualitative data of the
employees job satisfaction, life status, sphere and work-life-balance.
References
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Arbete Tid Måltid, Oresund Food Network, 2009.
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worksite - developing and disseminating new tools to ensure nutritional quality of the meals, 2009 [Abstract].
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vegetables: Results from the danish ‘6 a day’ work-site canteen model study. Public Health Nutrition, 7(2), 263270.
Lassen, A., Bruselius-Jensen, M., Mølgaard, H., Thorsen A.V., Trolle, E. Factors influencing participation rates and
employees’ attitudes toward promoting healthy eating at blue-collar worksites. Oxford University Press, 22 no.5
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Work Productivity. American Journal of Health Promotion. 22(1), 45-53.
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Quality of Life through Diet and Physical Activity. (http://www.norden.org/da/publikationer/publikationer/2006-
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Page 58 of 72
Appendix 1: Press Coverage
Print from www.idag.dk - Industriens Dagblad
Forskere vil udbrede viden om sunde spisevaner påjobbet
23. september 2009 kl. 13:00 / Indland
Virksomhederne stå r på spring for at hjæ lpe
deres ansatte til sundere spisevaner, og forskere
og politikere vil hellere end gerne hjæ lpe. Det
viser forhå ndsinteressen for denne uges
nordisk-baltiske konference "Better food at
Work", som læ gger op til at dele gode erfaringer
påtvæ rs af landegræ nser og sociale skel.
Konferencen bliver holdt i Tallinn i Estland, og den er
arrangeret af Aalborg Universitet i samarbejde med
det Estiske Institut for Sundhedsudvikling, Ø resund
Food Network og det sundheds-fremmende
Nordbalt-program under Nordisk Ministerrå d. Det
nordisk-baltiske samarbejde giver en unik mulighed
for at udveksle erfaringer om mad på arbejdspladser
på tvæ rs af græ nserne, og i den sammenhæng er
lande i Norden klare forbilleder.
- For 10 å r siden blev mad til medarbejderne
betragtet som et rent drifts-anliggende, som man
kunne sæ tte "nogen" til at sø rge for. Nu er det i nogle
typer virksomheder blevet et strategisk anliggende,
som direktionen går op i. Sverige og Danmark har fø rertrøjen på , og vi håber, at gode nordiske vaner med fokus på sunde
medarbejdere og sund mad kan sprede sig ø stpå , forklarer professor Bent Egberg Mikkelsen fra Aalborg Universitets Institut
for Samfundsudvikling og Planlægning.
Sund branding
Firmabetalte frugt-ordninger og lignende tiltag er efter hans mening gode eksempler på , at virksomhederne kan gavne
folkesundheden og egne interesser på samme tid. Sunde medarbejdere er gode medarbejdere, og samtidig er madordningerne
med til at pleje firmaernes image.
- Vi oplever i øjeblikket en stæ rkt stigende interesse for emnet, fordi arbejdsgiverne bruger mad og må ltidspolitik og sund mad
i kantinen som en form for branding. De sender et signal om, at de ikke er som alle andre, og de bruger det både til
rekruttering og til fastholdelse af medarbejdere, siger Bent Egberg Mikkelsen.
Social slagside
Indtil videre er det dog isæ r teknologifirmaer, banker, forsikringsselskaber og andre vidensbaserede virksomheder, som
sætter kosten højt på personaleafdelingernes prioriteringsliste. Derfor bliver en af udfordringerne at få de gode eksempler til at
sprede sig til brancher med anderledes traditioner.
- Det er fint, at vidensvirksomhederne gø r en stor indsats og er meget motiverede. Men hvis der skal væ re social balance,
skal vi have andre typer arbejdspladser med, og der kan det offentlige hjælpe tingene i gang med sæ rlige udviklingspuljer.
Samtidig kan vi som forskere producere viden om, hvad der gø r en forskel, og
demonstrere fornuftige lø sninger, som også kan bruges af medarbejdere, der er på farten eller har skæve arbejdstider,
fortæ ller Bent Egberg Mikkelsen.
En del af forskerne gransker konsekvenserne af, at arbejdspladserne begynder at involvere sig i noget, som traditionelt har
væ ret et individuelt anliggende. Selv om det sker med de bedste intentioner, er det vigtigt at forstå medarbejdernes reaktioner
og forbehold.
- Det er ikke uproblematisk, nå r virksomheder krydser græ nsen mellem arbejdsliv og privatliv. Så det er et forskningsbehov
at afdæ kke, hvad virksomhederne kan gø re, og hvordan de kan gø re det påen ordentlig må de, mener Bent Egberg Mikkelsen.
Alle de nordiske og baltiske lande er repræ senteret på konferencen, som derfor også kommer vidt omkring med bidrag fra
Danmark, Sverige, Norge, Finland, Island, Estland Litauen og Letland. Desuden giver konferencens hovedtaler, den
amerikanske professor Glorian Sorensen fra Harvard School of Public Health, et bud på om de sunde madinitiativer på
arbejdspladserne rent faktisk kan må les på individets sundhed.
Konferencen begynder onsdag aften og fortsæ tter til og med fredag.
mola
Af Anders Kanberg, Torsdag den 24. september 2009, 10:55
Virksomhederne står på spring for at hjælpe deres ansatte til sundere spisevaner, og forskere og politikere vil hellere
end gerne hjælpe.
Det viser forhåndsinteressen for denne uges nordisk-baltiske konference ”Better food at Work”, som lægger op til at
dele gode erfaringer på tværs af landegrænser og sociale skel. Konferencen bliver holdt i Tallinn i Estland, og den er
arrangeret af Aalborg Universitet i samarbejde med det Estiske Institut for Sundhedsudvikling, Øresund Food
Network og det sundheds-fremmende Nordbalt-program under Nordisk Ministerråd.
- For 10 år siden blev mad til medarbejderne betragtet som et rent drifts-anliggende, som man kunne sætte ”nogen”
til at sørge for. Nu er det i nogle typer virksomheder blevet et strategisk anliggende, som direktionen går op i.
Sverige og Danmark har førertrøjen på, og vi håber, at gode nordiske vaner med fokus på sunde medarbejdere og
sund mad kan sprede sig østpå, forklarer professor Bent Egberg Mikkelsen fra Aalborg Universitets Institut for
Samfundsudvikling og Planlægning.
Sund branding
Firmabetalte frugt-ordninger og lignende tiltag er efter hans mening gode eksempler på, at virksomhederne kan
gavne folkesundheden og egne interesser på samme tid. Sunde medarbejdere er gode medarbejdere, og samtidig er
madordningerne med til at pleje firmaernes image.
- Vi oplever i øjeblikket en stærkt stigende interesse for emnet, fordi arbejdsgiverne bruger mad og måltidspolitik og
sund mad i kantinen som en form for branding. De sender et signal om, at de ikke er som alle andre, og de bruger
det både til rekruttering og til fastholdelse af medarbejdere, siger Bent Egberg Mikkelsen.
Social slagside
Indtil videre er det dog især teknologifirmaer, banker, forsikringsselskaber og andre vidensbaserede virksomheder,
som sætter kosten højt på personaleafdelingernes prioriteringsliste. Derfor bliver en af udfordringerne at få de gode
eksempler til at sprede sig til brancher med anderledes traditioner.
- Det er fint, at vidensvirksomhederne gør en stor indsats og er meget motiverede. Men hvis der skal være social
balance, skal vi have andre typer arbejdspladser med, og der kan det offentlige hjælpe tingene i gang med særlige
udviklingspuljer. Samtidig kan vi som forskere producere viden om, hvad der gør en forskel, og demonstrere
fornuftige løsninger, som også kan bruges af medarbejdere, der er på farten eller har skæve arbejdstider, fortæller
Bent Egberg Mikkelsen.
Sund mad spredes mod øst http://www.erhvervsbladet.dk/node/1078052/prin
t
1 af 1 01-12-2009 14:24
Sund kantinedrift på danske arbejdspladser
- En god forretning
Projektmedarbejder Mia Brandhøj
Researchgroup for Food, People & Design, Aalborg Universitet - Campus Ballerup
Sundhedsfremme på arbejdspladsen virker
Arbejdet med sund og bedre mad på
arbejdspladser har en positiv effekt, og virker
sundhedsfremmende blandt medarbejderne.
Arbejdspladsen og bespisningen på arbejdspladser
spiller en afgørende rolle, som arena for
sundhedsfremmende initiativer målrettet
medarbejderne.
Forskning viser at der kan opnås gode og
vedvarende resultater, når sundhedsfremme
implementeres gennem politiker og brede
indsatser, mod store grupper som f.eks.
medarbejdere på arbejdspladser. Resultaterne ved
ændringer med fokus på den enkelte medarbejder,
har i ringere grad længerevarende succes, her
tænkes bl.a. på det der praktiseres med
sundhedssamtaler, kostvejledning mm.
En generel sundhedspolitisk indsats, har større
effekt fordi det sunde/usunde valg, først og
fremmest beror på tilgængeligheden af
sunde/usunde fødevarer på arbejdspladsen, f.eks. i
kantinen og generelt i mad- og målitdskulturen.
Dette forhold kan reguleres ved at fjerne usunde
produkter, og øge tilgængeligheden af sunde.
En indsats i medarbejderkantinen fokuseret på
sundere mad er en vigtig del af den generelle
sundhedspolitik på den enkelte arbejdsplads.
Sundhedspolitikker bør udarbejdes i samarbejde
mellem praktikere og ledelse, uanset om der er tale
om kommunale indsatser eller initiativer på den
enkelte arbejdsplads.
I efteråret 2009 afholdtes konferencen “Better
Food at Work” i Tallinn, se www.foodandwork.net
Formålet var at dele viden og erfaringer indenfor
området ’Bedre mad på arbejdspladsen’. Der blev
drøftet sund og bedre mad samt fremvist
præsentationer fra praktikere, beslutningstagere
og forskere indenfor emnet. Formålet var at nærme
sig en fælles forståelse af behovet, samt for
ændringer af metoder i teori og i praksis.
Der blev debatteret fremtidige muligheder og
udfordringer, i sammenhæng med den øgede
forekomst af usund livsstil i de vestlige lande.
Konferencen understregede at madkulturen og
måltidsmiljøet på arbejdspladsen er afgørende for
den enkeltes muligheder for at vælge sundt, og
dermed et vigtigt led i at fremme medarbejdernes
sundhed.
’Best Practice’ fra Herlev Hospital
Køkkenchef Michael Allerup Nielsen fra Herlev
Hospital fremlagde på konferencen visionerne for
den store indsats i medarbejderkantinen på Herlev
Hospital. Her har de arbejdet med at skabe nem,
sund og billig kantinemad for personalet.
Som en del af nye og fremtidige behov inddrager
de nye tiltag klimavenlighed og problemstillinger i
sammenhæng med bl.a. spild.
Generelt vil klima som del af kantine profilen spille
en vigtigere rolle, som følge af klimadebatten, og
kundernes efterspørgsel på klimaansvarlighed.
Sunde tiltag i medarbejder kantinen
En vigtig faktor i medarbejderkantinen på Herlev
Hospital har været at øge udbuddet af sunde
fødevarer, samt reducere udbuddet af usunde.
Blandt andet blev fjernet fede og sukkerholdige
produkter fra kantinens sortiment, såsom
sodavand, juice, kager og sødmælk.
Den øvrige indsats blev i praksis etableret i henhold
til næringsstofanbefalingerne. Kantinen på Herlev
Hospital tjekker jævnligt det næringsmæssige
indhold i maden og opskrifterne, og arbejder
fortsat på at gøre ændringerne til nye vaner i den
daglige drift. De har yderligere overvejet at arbejde
mere med ernærings-mærkning af energiindhold
og energifordeling, så medarbejderne nemt kan
overskue hvilke produkter der er rigtige for dem.
Der bliver i kantinens daglige drift og visioner lagt
en stor arbejdsindsats i at gøre det sunde valg til
det nemme valg. Dette gøres i praksis ved at sikre
et stort udbud af sunde salater, sandwiches med
frisk brød samt en daglig sund varm ret.
I hele udbuddet er der fokus på anvendelse af frugt
og grønt, høj råvarekvalitet, sammensætning der
giver masser af smag, økologiske mejeriprodukter
med lav fedtprocent, tilgængelighed af frisk koldt
vand mm. Disse tiltag stemmer godt overens med
fødevarestyrelsens anbefalinger for sund
kantinedrift, der bygger på 4 generelle anbefalinger
og 8 konkrete målsætninger, der kan indarbejdes i
menuplanen.
Et sundt udbud kan tage udgangspunkt i de 8
kostråd (kostkompasset), og inddrage frugt og
grønt, fisk, lavt fedtindhold, spar på salt og sukker,
fuldkorn og sluk tørsten i vand udbud bør baseres
på de 8 kostråd: (Læs mere på www.altomkost.dk
under fanen ’Mad på arbejde’).
Sund kantine en God Forretning
Der er et stort og afgørende potentiale i at arbejde
sundhedsfremmende med bespisningen af
arbejdspladsernes medarbejdere, både for
sundhedseffekten, kantinedriften, kundesuccesen
og omsætningen ved omstilling til sund drift.
De ændrede kantinestrategier har øget antallet af
kunder med ca. 80%, samt bidraget til at øge de
faglige kompetencer blandt køkkenpersonalet på
Herlev Hospital.
Herlev Hospital var blot en af ’best practice’
historierne fra konferencen, blandt øvrige
Anbefalinger for sund kantinedrift
- Et sundt udbud
- Indretning af kantinen
- Økologi
- Involvering af flere parter
Kilde: Fødevarestyrelsen alt om kost.
Mulige klimaovervejelser i kantinedrift
- Valg af råvarer
- Økologi
- Valg af leverandør
- Lokale råvarer (transport)
- Tilberedningsmetoder (genopvarmning)
- Opbevaring (nedkøling, nedfrysning)
- Emballage
- Spild
- Affaldssortering
Læs mere og få inspiration i Fødevareministeriets
Klimakogebog - Klima på Bordet
kantinetiltag kan nævnes ’Kantine Takeaway’ som
et bud på mulighederne for sundere mad for
medarbejderne.
(Læs mere på www.kantinetakeaway.dk)
Ildsjæle søges
Det kan være en krævende omvæltning at skulle
kortlægge og implementere nye visioner for den
mad der serveres på de danske arbejdspladser.
Men det kan gøre en sundhedsmæssig forskel!
En af konklusionerne fra ’Better Food at Work’
konferencen er at vedvarende sundhedsfremme på
arbejdspladser, kræver passionerede praktikere til
den daglige drift. Der er brug for ildsjæle med vilje
til at implementere og arbejde kontinuerligt med
udviklingen af sundheds- og kostpolitikker i praksis.
Det er ikke kantinen alene der har ansvar for de
sundhedsfremmende initiativer, men sund
kantinedrift og sund mad er en vigtig og solid del af
de generelle sundhedsfremmende strategier
arbejdspladserne kan arbejde med, for at øge
medarbejderes sundhed.
postimees 23. september 2009
toimetaja rain uusen, tel 666 2194, rain.uusen@postimees.ee
- 
20
16363
Haigekassa infotuba
tööpäeviti 8.30 - 16.30
www.haigekassa.ee
16363
«Meeste tervis on tõesti kehv. Vana juurdunud
stereotüüp, et mees peab olema tugev, pärsib
õigeaegset abi otsimist.»
Meestearst Margus Punab online-inter vjuus Postimees.ee lugejatele
SIRJE VAASK
Eesti Haigekassa
TAGLI PITSI
Tervise Arengu Instituut
Eestis on südame- ja veresoon-
konnahaigused varase, noore-
malt kui 65-aastaselt töövõi-
me kaotamise ja surma pea-
põhjusteks. Südame- vere-
soonkonnahaigustesse sure-
muselt oleme juhtpositsioonil
nii Euroopas kui ka kogu maa-
ilmas.
Euroopas seostatakse ligi-
kaudu kolmandikku tööealise
elanikkonna südame-veresoon-
konnahaigustest kehva ja tasa-
kaalustamata toitumisega. See
põhjustab ligi 5% kõigist töö-
võimetuse ja vaegurluse tõttu
kaotatud eluaastatest Euroopa
Liidus.
Täiendavalt lisanduvad üle-
kaalust ja vähesest kehalisest
aktiivsusest tingituna kaotatud
eluaastad.
Ehkki Eesti inimeste toitu-
misharjumused on iseseisvus-
aastatega oluliselt paranenud,
ei saa praegusi toitumisharju-
musi samuti tervislikeks pida-
da ning seda just südametervi-
se seisukohast. Soovitatavast
vähem süüakse Eestis puu- ja
köögivilju, rukkileiba ja kala
ning vajalikust enam on toi-
dus rasva ja soola, ka liialda-
takse maiustuste ja lihatoode-
tega.
Ülemaailmset südamepäe-
va tähistatakse igal aastal sep-
tembri lõpus. Inimeste tervis
mõjutab märkimisväärselt nen-
de võimet igapäevaelus toime
tulla, samuti ka sotsiaalset ja
majanduslikku panust riigi
ülesehitamisel ning riigi üldist
edu. Sellest lähtuvalt ongi tä-
navuse südamepäeva motoks
«Tööta südamega» ehk «Work
with heart».
Lõuna tööl
Südamepäeva tähistamiseks
toimub Eestis homme ja üle-
homme, 24. ja 25. septembril
rahvusvaheline konverents
«Better food at work – the Nor-
dic & Baltic experience» («Pa-
rem toit töökohal – Põhja- ja
Baltimaade kogemused»), mis
keskendub edukatele projekti-
dele Põhjamaades.
Töötav inimene sööb vä-
hemalt ühe oma päevasest toi-
dukorrast töökohal, mistõttu
on selle toidu koostis oluline
inimeste tasakaalustatud toi-
tumise ja hea tervise tagami-
seks.
Põhjamaades on läbi vii-
dud mitmeid pikaajalisi uuri-
musi ja programme, saamaks
teada, kas töökohal pakutav
toit võib mõjutada inimeste
töövõimet ja tervist. Baltimaa-
des on töökohale suunatud
tervise edendamise program-
midega alustatud alles viimas-
tel aastatel.
Rahvusvaheline konve-
rents töökohtade toitlustami-
sest on üheks esimeseks teetä-
hiseks sellesuunaliste tegevus-
te kavandamisel ka Eestis.
Konvrentsist oodatakse osa
võtma üle 60 asjatundja ja eks-
perdi.
Üheks heaks ja tulemusli-
kuks näiteks on laialdaselt levi-
nud praktika pakkuda tööko-
hal aastaringselt oma töötaja-
tele värsket puuvilja. Ka sule-
tud keskkonnas, näiteks kala-
laevadel, on võimalusi paran-
dada oma töötajate liikumist ja
toitumist. Oluline seos valitseb
ka toitumise ja elukeskkonna
kujunduse vahel. Einestamise
keskkond, lauanõud ja toidu
välimus on eelduseks, et tekita-
da inimeses heaolutunne. See
teadmine ei ole uudne, ent töö-
koha toitlustamise arendamise
kontekstis on ruumi ja olusti-
ku kujundamine määrav, et
ühised tervislikud eined saak-
sid organisatsiooni kultuuri
osaks.
Eestlane lõunatab väljas
Eesti Toiduliidu tellimusel teh-
tud uurimuse alusel erinevad
ka toitumisharjumused Balti
riigiti. Näiteks sööb enamus
eestlasi oma lõunat kodunt väl-
jas, aga enamus leedulasi eelis-
tab lõunat süüa koduses kesk-
konnas. Kahjuks on kiire elu-
tempo mõjutanud ka eestlaste
harjumusi väljaspool tööaega –
ka õhtusöögiks kasutavad eest-
lased oma lõunanaabritest
enam poolfabrikaate ja valmis-
toite. Lätlased ja leedulased
seevastu valmistavad õhtusöö-
gi ise, kasutades eestlastest
enam värskeid tooteid. Seetõt-
tu on ka eestlaste toidus vähem
puu- ja köögivilju ning kala.
Näiteks Taanis osutus edu-
kaks aga projekt „Canteen take
away“, mille raames on toidu-
tootjad koostanud tasakaalusta-
tud einekomplektid, mida kiire
ajagraafikuga töötajad ja nende
pered võivad osta ja kasutada.
Häid tulemusi on andnud ka
toitude toitaineline märgistami-
ne ja asjakohane paigutamine
töökoha kohvikus.
Ka igal Eesti inimesel peaks
olema võimalus elada tervist
toetavas keskkonnas ja võima-
lus teha tervislikke valikuid.
Harjumusi saab kujundada
Põhjamaad on suutnud edukalt
käima panna programmid ka
neile töötajatele, kel ei ole või-
malik töökoha läheduses söök-
las einestada (näiteks ehitajad,
pikamaaautojuhid, kalurid).
Tehtud muudatused ja te-
gevused töötajate eluviisi pa-
randamiseks on avaldanud mõ-
ju ka töötajate tervisenäitajate-
le – mis omakorda tähendab ka
kasu tööandjale.
Töökohal pakutava toidu
kaudu on võimalik tõenduspõ-
hiselt kujundada inimeste toi-
tumisharjumusi ning vähenda-
da seeläbi meeste ja naiste ris-
ki haigestuda kroonilisse hai-
gusesse juba tööealises eas.
Kvaliteetne lõunasöök ei ole
kulu, vaid investeering oma
tervisesse!
Tasakaalustatud lõuna tagab tervise
Tänavune ülemaailmne südamepäev keskendub
teadmisele, et oma töötajaid positiivsele
tervisekäitumisele julgustavad tööandjad
annavad olulise panuse vähendamaks
haigestumist südamehaigustesse ja insulti.
 
Kuidas saab tööandja toetada töötajate tervislikumaid
valikuid?
Liikumine:
• Loo võimalused jalgratta parkimiseks.
• Toeta spordiklubides osalemist.
• Korralda ja toeta sportlikke üritusi.
• Julgusta töötajaid end pauside ajal liigutama.
Muuda infomaterjalid terviseriskidest ja nende en-
netamisest kättesaadavaks.
Ter visli k toitumine:
• Varusta kontor/töökoht puhta joogiveega.
Tee koostööd et tevõttes asuva toitlustajaga (uuri me -
nüü tervislikkust ja tee vajadusel muudatused, et
pakutav toit oleks tervislik.)
Loo võimalused kaasa võetud toidu soojendami-
seks.
Tööalased suhted ja koostöö:
Anna töötajale selged ja arusaadavad juhised ning
eeskirjad, näiteks ametijuhendid, töökorraldused,
head tavad jms.
• Taga sõbraliku ja toetava kollektiivi areng.
Võimalda paindlikku ja peresõbralikku töögraafi-
kut.
Mida saab töötaja teha selleks, et olla terve?
• Söö igaev vähemalt viis portsjonit puu- ja köögi-
vilju. Tee tervislikke valikuid oma töökoha toiduko-
has või võta söök kodust kaasa.
Kasuta iga võimalust liikumiseks. Kasuta lifti ase-
mel treppe, mine pausi ajal jalutama, ühistranspor-
ti kasutades tule paar peatust varem maha ja jaluta
tööle.
Kasuta vähem soola ja väldi valmistoite, mis sisal-
davad sageli liialt soola ja rasva.
• Loobu suitsetamisest.
• Tea oma tervisenäitajaid. Lase mõõta oma vererõh-
ku ning kolesterooli ja veresuhkru taset,öümber-
mõõtu ja kehamassiindeksit. Olles teadlik riskidest,
oled motiveeritum oma eluviise tervislikumaks muut-
ma.
Ter v is e e dendamiseks tö ökohal:
Looge töörühm töötajatest, keda tervise teema hu-
vitab, jagage ülesanded ja valige eestvedaja.
Uurige teistelt töötajatelt nende eluviiside kohta ja
pange kirja nende ootused ja soovid.
Koostage töötajate tervise arendamise tegevuska-
va, planeerige selle jaoks vahendid ja võimalused.
Mõelge, kuidas võiksite tulemusi mõõta ja kuidas
tagada hästi käivitunud tegevuste jätkusuutlikkus.
sige nõu tervist edendavate töökohtade võrgus-
tikult või vaadake www.terviseinfo.ee
:  ,   
Ter v is t
edendavate
töökohtade
võrgustik
toimib ka Eestis
KÜLLI LUUK
Tervise Arengu Instituut
Tervist toetavateks tegevusteks
töökohal on näiteks tubakava-
ba töökeskkonna loomine, ter-
visliku toitlustamise korralda-
mine, liikumisharrastuste toe-
tamine, tööga seotud stressi
maandamine, perekeskse polii-
tika elluviimine töökohal või
töötajate terviseteadlikkuse pa-
randamine.
Nii paraneb ettevõtte sise-
selt ka töökeskkond, mille tule-
musena esineb vähem tööstres-
si ja tööga seotud õnnetusi või
tervisehäireid. Kasvab ka tööta-
jate motivatsioon ja rahulolu
tööga, mistõttu töötajad puu-
duvad vähem töölt.
Eeskujulikud ettevõtted
Eesti Tervist Edendavate Töö-
kohtade võrgustik (TET) loodi
2005. aastal 20 ettevõtte baasil
ning selle tegevust koordinee-
rib Tervise Arengu Instituut.
Võrgustikku on algusest pea-
le kuulunud näiteks Tallinna
Vesi AS, Ida-Tallinna Keskhaig-
la, Politseiamet, Tallinna Kau-
bamaja, BLRT Grupp AS, SEB ja
Coca-Cola HBC Eesti AS, kes on
oma töötajate tervise alases te-
gevuses eeskujuks ka teistele.
Tervist edendavate töökoh-
tade võrgustiku liikmete hulk
Eestis on viimasel paaril aastal
jõudsalt kasvanud. Tänaseks
kuulub liikmeskonda juba sada-
kond organisatsiooni. Üle poo-
le liikmeskonnast moodustavad
suurettevõtted saja ja enama
töötajaga.
Kogemuste vahetamine
Võrgustik korraldab oma liik-
metele ka mitmeid koolitusi
ning nõustamisprogramme,
koondades erinevate ettevõtete
ja asutuste spetsialiste koge-
muste jagamiseks. TET-võrgus-
tikku toetab Euroopa Sotsiaal-
fond.
Alates 2006. aastast kuulub
TET üle-euroopalisse tervist
edendavate töökohtade võrgus-
tikku European Network for
Workplace Health Promotion
(www.enwhp.org).
TET motoks on «Terves or-
ganisatsioonis terved tööta-
jad», mis tähendab, et lisaks
ohutu töökeskkonna loomise
ja töötervishoiu nõuete täitmi-
sele tegeletakse võrgustikku
kuuluvates ettevõtetes ka töö-
tajate tervise hoidmise ja aren-
damisega.
Lõunaooteks planeeritud rammusad saiakesed tasub asendada puu- või köögiviljadega. Skandinaavia-
maades võib mitmeski ettevõttes kohata värskeid puuvilju aastaringselt. Foto: CORBIS/Scanpix
http://www.mu.ee/Default2.aspx?ArticleID=f9c00154-9431-4cd9-b6a0-6fea63a1be90
Südamepäev toob kokku Põhja- ja Baltimaade
toitumiseksperdid
Maris Jakobson, Tervise Arengu Instituut
23.09.2009 13:42
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Sel pühapäeval tähistatakse maailma südamepäeva, mille tänavune tunnuslause on „Work with
heart“ (Tööta s
üdamega). Tervise Arengu Instituut (TAI) tähistab südamepäeva rahvusvahelise
konverentsiga töökohtade toitlustamisest.
Konverentsil „Better food at work - the Nordic & Baltic experience“ (Parem toit töökohal
Põhjamaade ja Baltimaade kogemused) tutvustatakse Põhjamaades läbi viidud teaduslikke uuringuid
ja programme ning parimaid praktikaid sellest, kuidas töökohal pakutav toit mõjutab inimeste tervist
ning töövõimet. Käesolev konverents on üheks esimeseks teetähiseks sellesuunaliste tegevuste
kavandamiseks ka Eestis.
Konverents peetakse 24. ja 25. septembril Meriton Grand Hotel Tallinnas. Konverentsi peaesineja on
dr Glorian Sorensen Ameerika Ühendriikidest Harvard School of Public Health’ist. Kokku saab kahe
päeva jooksul kuulata üle 20 ettekande.
ETTEKANNETE KOKKUVÕTTED
I päev
Key note speech: What is the evidence on the effectiveness of healthy eating interventions at
workplaces? Dr. Glorian Sorensen, Harvard School of Public Health, USA
Ettekande eesmärk on esitada tõendusmaterjale uuringutest, mis puudutavad töökohtades läbi viidud
üritusi tervisliku toitumise edendamiseks. Selle toob kuulajateni konverentsi peaesineja Glorian
Sorensen. Oma ettekandes väidab ta, et töökohtade uurimisel on ilmnenud, et tervise edendamine
on tõhus siis, kui töötajad kaasatakse nii kavandamisse kui ka elluviimisse. Oluline on töötajate
vajaduste ja prioriteetidega arvestamine. Uuringu tulemusena jõuti järeldusele, et toitumist mõjutab
inimese laiem sotsiaalne taust, sealhulgas töökohal ja perekonnas kehtivad normid, ühiskonna toetus
ja kohaliku kogukonna käsutuses olevad ressursid. Hiljutised uuringud on näidanud, et just
sotsiaalsed tegurid on kõige tõenäolisemalt mõjutanud inimeste suuremat puu- ja köögiviljade
tarbimist.
Keskkonnaalased ja poliitilised lähenemisviisid hõlmavad muutusi töökeskkonnas ning suuremat
organisatsioonipoolset toetust. Juhtkonna pühendumust võib näidata kas või see, kui töötaja tervise
edendamine on organisatsiooni üks eesmärke, kusjuures selle eesmärgi saavutamise saavutamisse
kaasatakse ka töötajaid ise. Keskkonnaaspektide hulgas tõstetakse esile näiteks tervisliku toidu
kättesaadavust töökohas, aga ka selle maksumust. Samuti hõlmavad need võimalust süüa töökoha
lähedal.
Sorensen tõdeb, et vaja on täiendavaid uuringuid, et selgitada välja, kuidas toitumine nii
individuaalsel kui ka organisatsiooni tasandil muutub. On vaja kindlaks teha tõhusad võimalused,
kuidas pakkuda välja programme erinevat liiki töökohtadele (väikestest kuni suurteni, eri
tööstusharudes, eri geograafilistes piirkondades). Samuti tuleb uurida, millised takistavad ja
soodustavad tegurid valitsevad töökohtades ning milline on valmidus selliste tervist toetavate
programmide kasutamiseks.
Toitumine töökohtadel
2. Worksite dinning as a collective good, or individualisation of health? A Danish Perspective by:
Michael Søgaard Jørgensen, Technical University of Denmark, Denmark
Ettekanne võtab kokku Taani ülikoolide ülevaate nende kirjanduses ilmunud uuringutest toitumise
kohta töökohal. Uuringus keskendutakse peamiselt seoste leidmisele töö ja toitumise vahel ning
püütakse välja selgitada, milliseid kogemusi on erinevate toimingute kaudu saadud tervisliku
toitumise edendamisel töökohas. Ettekandes antakse ülevaade Taanis toimunud toitumisalastest
üritustest töökohtades, selgitatakse söömisvõimalusi tööl. Tõdetakse, et töö, töökeskkonna, tervise
ja toitumise vaheliste seoste leidmisele ei ole pööratud piisavalt tähelepanu.
3. Does worksite provided meals lead to healthier eating? A Finnish Perspective by: Dr. Eva Ross,
Public Health Research Forum, Finland
Ettekanne põhineb Soomes seni avaldatud uurimistöödel, mis käsitlevad söömisvõimalusi töökohas.
Soomes sööb 30% töötajatest iga päev töökoha sööklas, 30% meestest ja 45% naistest võtavad
toidu kodust kaasa. Uuringud näitavad, et töökoha sööklas einestamist võib seostada tervislikumate
toitumisharjumustega.
Toit, tervis ja ebaregulaarsed söömisajad
4. Nutrition, shift work and chronobiology when to eat?
Professor Maria Lennernäs, University of Kristiansstad, Sweden
Ettekanne annab ülevaate vahetustega töötavate inimeste toitumise iseärasustest. Üha enam
ettevõtteid töötab paindliku töögraafiku järgi ja see toob paljude inimeste jaoks kaasa vahetustega
töö, tihti ka öises vahetuses. Uurimuses tõdetakse, et vahetustega töö mõjutab inimeste sotsiaalset
ja bioloogilist elurütmi ning see omakoda avaldab mõju nende seltsielule, söögi- ja uneaegadele.
Vahetustega tööd seostatakse sageli mao- ja soolevaevustega, väsimuse ning depressiooniga.
Samuti on see riskitegur, mida seostatakse ülekaalulisuse, südame-veresoonkonna haiguste, 2. tüüpi
diabeedi ja mitmete teiste haigustega. Uuringus tõdetakse, et täiendavalt on vaja uurida võimalusi
vahetustega töötavate inimeste tervise, ohutuse ja heaolu suurendamiseks.
5. Lots of food but poor meals a study of the worksite as a meal arena.
PhD Maria Nyberg, University Lund, Sweden
Ettekanne annab ülevaate Rootsis läbi viidud uuringust töökohal toitumisest. Uuringu vältel toimusid
erinevad vaatlused, intervjuud ja küsitlused, hinnati erinevaid toidu mõjutajaid töökohal: töötajad
ise, juhtkond, toidu pakkuja ning nende suhtumine toitu töökohal. Uuring toimus ühes
tootmisettevõttes, mis koosneb kahest meditsiinitehnoloogia tarvikuid tootvast üksusest ja kahest
haiglapalatist. Uuringu tulemused näitasid, et sageli ei huvitanud juhtkonda, kus töötajad lõunatasid,
lisaks ei olnud selleks ka eriti palju aega. Paljudes töökohtades olid söömiseks ette nähtud vaid
väikesed ruumid, kus töötajad said süüa toitu, mis oli ostetud väljaspool töökohta või kodust kaasa
võetud. Uuringu läbiviijad tõdesid, et töökohtadel tuleb nii töötajaid endid kui ka juhtkonda rohkem
teavitada sellest, et söömine peab olema meeldiv kogemus, mitte ainult kõhutäide, ning seetõttu on
selleks vaja meeldivat ümbrust ja aega toidu nautimiseks.
6. Successful intervention with physical activity and nutrition at sea.
Sonja Sif Jóhannsdóttir, Anna Sigríður Ólafsdóttir & Erlingur Johannsson,
Centre for Research in Sport and Health Sciences, School of Education, University of Iceland
Ettekanne keskendub Islandi kalatraaleritel töötavate inimeste toitumisharjumustele ja
sportimisvõimalustele. Antakse ülevaade tervisenäitajatest enne ja pärast 6 kuud kestnud tervislike
eluviiside propageerimist ning tõdetakse, et need on paranenud. Uuringus osalejatel täheldati
järgmisi muutusi: nende kehakaal ja keha rasvaprotsent langesid, suurenes kehaline aktiivsus ja
tõusis „hea“ kolesterooli tase. Täheldati ka seda, et uuritavad kannatasid vähem depressiooni all ja et
nende toitumine muutus tervislikumaks.
7. Coin offer Meal “Diastole”, Healthy eating at healthcare institutions.
Michael Allerup Nielsen, Catering Manager, Herlev University Hospital, Foodservice Unit, Denmark
Ettekanne tutvustab Taani Herlevi Ülikooli haigla tegevust oma sööklas pakutava toidu tervislikumaks
muutmisel. Nii näiteks peab sööklast saama korraliku tervisliku lõunasöögi ühe mündi eest
(väärtusega 20 Taani krooni). Alati peab saadaval olema erinevaid puu- ja köögivilju ning leiba,
samuti tuleb pakkuda rikkalikku joogivalikut. Töötajatel peab olema võimalik saada toit kätte kiiresti,
et neil jääks rohkem aega selle nautimiseks.
8. New possibilities in influencing eating patterns through healthier canteen take away.
Dr. Gitte Laub Hansen - The Canteen Take Away Partnership, Danish Cancer Society, Denmark
Ettekanne tutvustab Taanis läbi viidud uudse lähenemisega projekti „Canteen take away“, kus
töökoht pakkus töötajatele võimalust osta töölt sooja toitu koju kaasa subsideeritud või madalama
hinnaga. Selline toidutootjate koostatud tasakaalustatud einekomplekt vähendab ühelt poolt
töötajate poodlemisele ja kodus toidu valmistamisele kuluvat aega, kuid teiselt poolt parandab nii
töötajate endi kui ka kogu pere toitumise kvaliteeti. Uuringu tulemused näitasid, et neil päevil, mil
töötajad sõid kodus töölt kaasaostetud toitu, oli toidu energiasisaldus oluliselt väiksem, samuti
sisaldas toit vähem rasva ja süsivesikuid ning rohkem puu- ja köögivilju
9. Eating Habits in the Baltic States
Nutrition expert Tagli Pitsi, National Institute of Health Development, Estonia & Sirje Potisepp,
Director Association of the Estonian Food Industry
Ettekandes tutvustatakse Eesti Toiduliidu tellitud kolme Balti riigi toitumisharjumuste uuringu
tulemusi. Näiteks sööb enamik eestlasi oma lõunat kodunt väljas, aga enamik leedulasi eelistab
lõunat süüa koduses keskkonnas. Kahjuks on kiire elutempo mõjutanud ka eestlaste harjumusi
väljaspool tööaega. Ka õhtusöögiks kasutavad eestlased oma lõunanaabritest enam poolfabrikaate ja
valmistoite. Lätlased ja leedulased seevastu valmistavad õhtusöögi ise, kasutades eestlastest enam
värskeid tooteid. Seetõttu sisaldab eestlaste toit ka vähem puu- ja köögivilju ning kala.
Uurimused
10. Worksite Canteen Availability & Usage Among Finnish Employees.
Susanna Raulio, Eva Ross & Ritva Prättälä, National Institute for Health and Welfare, Finland
Ettekanne käsitleb Soome töötajate võimalusi süüa lõunat töökoha sööklas ja mil määral seda
võimalust kasutatakse. Ettekandes antakse ülevaade sellest, kuivõrd need võimalused ja nende
kasutamine on seotud töötajate sotsiaalsete, demograafiliste ja tööalaste tingimustega.Uuringu
tulemused näitasid, et töökohas on söökla kasutamise võimalus tavaliselt olemas kõrgema
haridustasemega kvalifitseeritud töötajatel, kes töötavad suuremates ettevõtetes ja asutustes. Kõige
halvem on olukord meeste seas, kes teevad rasket füüsilist tööd väikestes asutustes või
eraettevõtetes. Täheldati ka seda, et söökla olemasolu korral on madalama haridustasemega füüsilist
tööd tegevatel naistel pigem tavaks oma toit kaasa võtta, kui sööklasse sööma minna. Eeltoodud
rühmade toitumise kvaliteeti aitaks see, kui tööandja korraldaks oma töötajatele eelpakitud lõuna
saatmise, mille koostis vastab üldtunnustatud soovitustele.
11. Strategy for influencing eating patterns through the worksite.
PhD student Signe Poulsen, Aalborg University, Denmark
Ettekandes käsitletakse tervist edendavat tegevust töökohal. Et inimesed veedavad tööl väga suure
osa oma päevast, on töökohal oluline osa nii töötajate kui nende perekondade tervislike
toitumisharjumuste arendamisel. Uuringus otsiti vastust küsimusele, kas on läbi viidud projektiga
“Canteen Take Away” analoogseid projekte. Selleks uuriti erinevaid võtmesõnu kasutades erinevaid
andmebaase ning jõuti tõdemuseni, et võrreldavaid projekte ei ole varem olnud. Uuringu tulemused
näitasid, et töökohas tervislike toitumisharjumiste arendamisel võib kasu olla töötajate kaasamisest
nii planeerimise kui ka elluviimise etappi. Samuti leiti, et sellise tegevuse edukust mõjutab ettevõtte
või organisatsiooni toetus. Tõdeti ka, et sotsiaalsetel teguritel, näiteks kohalikul kogukonnal ja
töötajate perekondadel on samuti suur mõju.
12. Designing food spaces for better meal experiences at worksites.
M.Sc. Tenna Doktor Olsen, Aalborg University, Denmark
Ettekanne käsitleb ruumilise ja esteetilise keskkonna mõju toidu tarbimisele. Kuigi toitlustajad ja
tööandjad tunnevad järjest rohkem huvi toidu ja tervisega seotud teemade vastu, ei ole ruumilist ja
esteetilist aspekti, samuti toidu serveerimise või toiduga seotud kogemuste osa eriti põhjalikult
uuritud. Uuringu tulemusel tõsteti ruumilisel ja esteetilisel tasapinnal esile viis peamist aspekti ning
seitse parameetrit, mida on võimalik kasutada praktiliste suunistena, et parandada tulevikus
söögikohtade kavandamisel nende arhitektuurilist ja esteetilist poolt. Uuringus jõutakse järeldusele,
et vorm ja kujundus mõjutavad meie käitumist ning meie maailmatunnetust, sest loovad mugavuse-
ja heaolutunde ka töökohas.
II päev
Konverentsi teisel päeval räägitakse enam ka poliitikatest ja lahendustest, mis aitavad ennetada
ülekaalu ja tasakaalustamata toitumist töökohal.
Better food at work in a European perspective - Guidelines for the Prevention of Obesity at the
Workplace.
Dina Zota, Pania Karnaki, Afroditi Veloudaki, Athena Linos, Institute of Preventive Medicine,
Environmental and Occupational Health, Prolepsis, Greece
Ettekandes toovad Kreeka ennetava meditsiini instituudi eksperdid näite Euroopa Komisjoni poolt
rahastatud projektist, mis analüüsis tänapäeval muutunud töö iseloomu ja töökohtade mõju inimeste
eluviisile, eelkõige kehakaalule. Eluviisi ja kehakaalu mõjutab töökoha ümbruskond ( kaupluste
olemasolu toidu ostmiseks või tervislike valikute kättesaadavus töökoha kohvikus), tööstress, pikad
töötunnid, istuv töö, öötöö jne. Kui tööandja hoolitseb oma töötajate võimaluste eest tervislikult
toituda ja kehaliselt liikuda, aitab see kaasa ka firma positiivse maine kujunemisele nii oma töötajate
hulgas kui väljapoole kollektiivi, see vähendab töötajate voolavust ning töölt ärajäämist haigestumise
tõttu või muudel põhjustel. Üha enam uurimusi annab tõendust, et töötajate tervise edendamine on
võti ka äri edukusele ja firma kompetentsivõimele.
A multisectorial approach to planning implementation of policies and actions towards health at
workplace.
Triinu Täht, Tagli Pitsi, Sirje Vaask, Anneli Sammel
Ettekandes räägitakse Eesti kogemustest poliitilise raamistiku loomisel rahva tervise arendamisel ja
südame- veresoonkonnahaiguste ennetamisel. Sotsiaalministeerium annab ülevaate riiklike
tervisestrateegiate kujunemisloost, kuidas südame- veresoonkonna haiguste ennetamise strateegia
2005 -2020 ning rahvastiku tervise arengukava 2009-2020 valmisid väga paljude erinevate osapoole
koostööna ning ka nende elluviimine ei ole vaid Sotsiaalministeeriumi haldusala asutuste kanda. Ka
tervist edendavate töökohtade võrgustiku tegevus Eestis toimub eeltoodud strateegiate meetmete
raames. Strateegiad näevad ette ka tervise edendamise spetsialisti ametikoha maakondades, ning
maakondadesse loodi tervisenõukogud, kelle ülesandeks on viia strateegiat ellu kohalikul tasandil.
Maakonna tervisenõukogud ei ole siiani väga aktiivselt teinud koostööd kohalike ettevõtetega selle
oleks tuleviku arengupotentsiaali. Ehkki Eestis on juba näha positiivne trend haigestumuse ja
suremuse vähenemisel, ei ole siiani piisavalt tegeletud tervisealase ebavõrdsuse vähendamisega.
Suurema tervisetulemi saavutamine oleks võimalik just haavatavate rühmade (mittekindlustatud,
madala sissetulekuga pered) kaasamisega tervist edendavatesse tegevustesse.
Ежегодно в конце сентября по всему миру
отмечается День сердца. В этом году лозунг
Дня сердца – «Работай с сердцем». Идея
состоит в том, что работодатели, которые
создают на своих предприятиях здорову