The effect of complex workplace dietary interventions on employees' dietary intakes, nutrition knowledge and health status: a cluster controlled trial.
BACKGROUND
Evidence on effective workplace dietary interventions is limited. The comparative effectiveness of a workplace environmental dietary modification and an educational intervention both alone and in combination was assessed versus a control workplace on employees' dietary intakes, nutrition knowledge and health status.


METHODS
In the Food Choice at Work cluster controlled trial, four large, purposively selected manufacturing workplaces in Ireland were allocated to control (N=111), nutrition education (Education) (N=226), environmental dietary modification (Environment) (N=113) and nutrition education and environmental dietary modification (Combined) (N=400) in 2013. Nutrition education included group presentations, individual consultations and detailed nutrition information. Environmental dietary modification included menu modification, fruit price discounts, strategic positioning of healthier alternatives and portion size control. Data on dietary intakes, nutrition knowledge and health status were obtained at baseline and follow-up at 7-9months. Multivariate analysis of covariance compared changes across the four groups with adjustment for age, gender, educational status and other baseline characteristics.


RESULTS
Follow-up data at 7-9months were obtained for 541 employees (64% of 850 recruited) aged 18-64years: control: 70 (63%), Education: 113 (50%),


ENVIRONMENT
74 (65%) and Combined: 284 (71%). There were significant positive changes in intakes of saturated fat (p=0.013), salt (p=0.010) and nutrition knowledge (p=0.034) between baseline and follow-up in the combined intervention versus the control. Small but significant changes in BMI (-1.2kg/m(2) (95% CI -2.385, -0.018, p=0.047) were observed in the combined intervention. Effects in the education and environment alone workplaces were smaller and generally non-significant.


CONCLUSION
Combining nutrition education and environmental dietary modification may be an effective approach for promoting a healthy diet and weight loss at work.
['Geaney|Fiona|F|', 'Kelly|Clare|C|', 'Di Marrazzo|Jessica Scotto|JS|', 'Harrington|Janas M|JM|', 'Fitzgerald|Anthony P|AP|', 'Greiner|Birgit A|BA|', 'Perry|Ivan J|IJ|']
D002755:Choice Behavior D004032:Diet D005247:Feeding Behavior D006293:Health Promotion D006304:Health Status D006801:Humans D007494:Ireland D009752:Nutritional Status D010353:Patient Education as Topic D017132:Workplace
Workplace Dietary intervention Dietary intakes Nutrition knowledge Health status Nutrition education