Effects of a Low-Cost Evidence-Based Nutrition Program on Obesity in a Worksite Wellness Initiative

Obesity is increasing in epidemic proportions globally, affecting over 650 million adults, and has tripled over the past four decades (World Health Organization [WHO], 2018). In the United States (US) more than one in three adults are obese (Ogden, Carroll, Kit, & Flegal, 2014). Obesity is a preventable risk factor for noncommunicable diseases, including heart disease, type 2 diabetes, and certain cancers (WHO, 2018). There are multifactorial causes of obesity, but a poor diet is a significant contributor to obesity and obesity-related conditions. A healthy diet focused on increased fiber intake is attributed to decreased incidences of obesity and obesity-related chronic diseases such as heart disease and type 2 diabetes (Liu, Wang, & Liu, 2015; Stephen et al., 2017). However, in the US only about ten percent of adults eat the recommended healthy fiber-rich fruits and vegetables for optimum health outcomes (Lee-Kwan et al., 2017). There is evidence to support that medical management is not a substitute for nutritional excellence in obesity treatment and obesity-related causes of chronic diseases. Additionally, obesity-related illnesses cost employers in the United States over $8 billion annually due to lost productivity (Andreyeva, Luedicke, & Wang, 2018). There is a need for feasible, cost-effective worksite interventions to promote healthy eating habits of employees to decrease incidences of obesity, improve health outcomes, and decrease the burden of health care cost to society, and loss of productivity to employers.

Purpose:

The purpose of this presentation is to (a) explore the impact of a novel low-cost evidence-based 8-week nutrition education program on body mass index, health behaviors (fruit, vegetable, and fat intake, and physical activity), emotional eating, and motivators and barriers to health behaviors, and (b) discuss implications for practice and future research.

Methods:

A quasi-experimental, one-group pre-posttest design was used for this study during January to March 2018. Employees of a Southwest Florida Organization were invited by email from the Human Resources Coordinator of the organization to participate in the worksite wellness initiative if they were interested in losing weight and improving eating habits. This program was delivered by an interprofessional team of facilitators, including two advanced practiced registered nurses with doctoral degrees, a registered dietitian, and a nurse practitioner student. The Full Plate Diet (Seale, Sherard, & Fleming, 2010), an established evidence-based nutrition program was used for the intervention. The Full Plate Diet program consisted of eight weekly sessions lasting approximately 60 minutes. The weekly topics included the following: (a) how to eat enough to lose weight, (b) types of fiber-rich foods to help you lose weight, (c) making over meals, (d) it’s more than just food, (e) importance of breakfast for weight loss, (f) smart grocery shopping, (g) eating out, and (h) physical activity to rev up weight loss. Pre-posttest data were collected using a demographic data form, body mass index (BMI) calculated based on measured height and weight, a paper, and pencil survey to determine intake of recommended fruits, vegetables, fats, and physical activity, Motivators and Barriers of Healthy Lifestyle Scale, and emotional eating using the Eating Behavior Patterns Questionnaire.

Results:

A pretest sample of (N = 49) employees participated in this study. The mean age was 51 (SD = 10) years, with a range of 27 to 65 years, the majority were Caucasian (n = 37, 75.5%) and female (n = 45, 91.8%). The pretest BMI mean was 34.5 (SD = 8). There was a significant difference between baseline and post-intervention in BMI (n = 41, p < .05), emotional eating (n = 46, p < .05), fruit intake (n = 45, p < .05) and vegetable intake (n = 46, p < .05), and days of physical activity per week (n = 45, p < .05). No significant differences were found in fat intake, motivators, and barriers after the intervention.

Conclusion:

The Full Plate Diet is a structured, evidence-based low-cost nutrition program that clinicians may implement in a worksite wellness program to decrease incidences of obesity, improve emotional eating, healthy eating habits, and physical activity. Ultimately, a program that decreases obesity may result in decreased obesity-related chronic diseases and the cost of obesity-related loss of productivity to employers. Future randomized control, longitudinal studies should be conducted to determine the sustainability of the outcomes and reduce bias to the study results.