When I began my graduate studies in Clinical Nutrition at New York University in 2000, rates of obesity in the U.S. were on an upward trajectory with no end in sight. The term Metabolic Syndrome (MetS) wasn't yet in the vernacular, however those of us in the nutrition community were about to get familiar with it, and fast. Caused primarily by insufficient exercise and a diet rich in sugar, salt and fat, a MetS diagnosis nearly guarantees a future of diabetes, heart disease and/or stroke.
Fast forward seven years later, my career brought me to the San Francisco Bay Area where I eventually served as a nutrition consultant to employees at a very high-profile Silicon Valley tech company. During my time there, I was surprised at a stunning revelation: for such an educated, seemingly well-informed workforce, rates of MetS were off the charts. My assumptions about this progressive, information seeking, data-driven group -- a population enmeshed in California's yoga, kale and organic food culture -- had been completely defied. If any cohort knew what needed to be done to maximize health and reduce risk for disease, surely it was this one.
Perhaps the most striking characteristic of MetS is the silent way in which it sneaks up on the unsuspecting. These employees felt "just fine," and looked fine, too. The ticking time bomb within their bodies was an unobservable threat. According to the Centers for Disease Control, 1 in 3 people aged 20 years and above has MetS, and most people are unaware if they forgo screening. The good news is that MetS is not a death sentence. In fact, studies show that minor changes to diet along with moderate exercise can prevent and actually reverse it.
These early years were just the beginning of a trend taking shape across corporate America. Bearing a significant burden of the medical insurance costs, loss in productivity and high absenteeism rates associated with treating MetS, companies have become a driving force towards changing the country's health for the better. In 2009, 92 percent of businesses exceeding 200 employees reported offering some degree of wellness programming. This is optimistic, given that the 2013 RAND report findings released earlier this year show minimal financial return on employee wellness investment. According to the same report however, CEOs and executives of companies that have invested in wellness overwhelmingly defend the value of their programs. What this discrepancy tells us is that good health and all its benefits (mood, energy, focus, and general productivity) can't always be measured in dollars. Instead, the true measurement for many companies has been a work-culture shift which has translated into efficiency and innovation. Determining the cost/benefit ratio will continue to be a priority issue for the wellness community who continually seek to prove that treadmills and free oatmeal ought to be as standard to employees as health insurance.
Clearly, best practices have been analyzed and identified; biometric screening, health risk assessments, nutrition, fitness, and stress management programs, financial incentives for healthy behaviors and an onsite fitness center often work together as part of a company's holistic wellness program. Each one of these solutions is important to the program's overall success and can attract and retain good employees, while keeping them healthier, happier and more productive.
In my experience working exclusively in workplace wellness and specifically in my role as National Nutrition Manager at Guckenheimer, I am more convinced than ever that the most important wellness solution is still missing from the larger conversation: the role of the onsite corporate café in healthy outcomes. By making healthier food choices available and engaging workplace conversations about them, there is the subtle yet powerful effect of peer influence which can shift the collective behavior of an entire employee population.
A recent case study with a current client has proven to illustrate this point, and the measurable impact of an integrated food program to employee health and the bottom line.
In 2008, one company recognized they had a significant problem with increasing health care costs, rising insurance rates and decreasing productivity. After company-wide biometric screenings confirmed 29 percent of its population had Metabolic Syndrome, senior executives engaged in leading the overhaul on employee health. They quickly engaged experts to develop a wellness program with incentives, expecting to see significant changes. Instead, they were disheartened with lackluster returns.
After reevaluating their program, executives and experts assessed why their wellness approach wasn't working. The breakfast and lunch offerings sold to employees were more likely to promote disease then prevent it. The café served highly caloric, sodium and fat-rich foods; their dining program was not sufficiently supporting good nutrition or highlighting healthy choices. And the reality was (as it remains for many organizations struggling to get a foothold on the wellness investment return) employees tempted with indulgences like cheeseburgers and hotdogs while they simultaneously participate in their employer-sponsored health challenge, is probably not the most effective strategy for producing positive health outcomes. Consistent messaging will bring credibility to the organization and its wellness initiatives, while offering employees the support and resources they need to be successful.
And this company was successful. After a recalibration of offerings and recognizing the need for a health-focused onsite café, by 2012 Metabolic Syndrome rates finally dropped from a high of 29 percent in 2009 to 18 percent in 2012. In detecting those at highest risk for diabetes, heart disease and stroke early and offering those employees opportunities for prevention, they experienced a $1.5 million reduction in health care spend since the program's inception, translating into a 4:1 return on their wellness investment. Not too shabby.
So what makes the wellness-centric café so integral to a wellness program's success? In many cases, employees may purchase and consume as many as 50 percent of their weekly meals at work. That represents many opportunities over the course of the week to make choices that promote good health. While quitting smoking and spending 45 minutes on the treadmill are extremely positive health behaviors, they may not elicit the same enthusiasm as one might have for an anticipated lunch break. If the food options are good and good for you, employees are likely to seek them out more often, prefer them over off-site lunch locations, and eventually replace old eating habits with newer, healthier ones. Gently nudging healthier options with strategic positioning and pricing subsidies can further promote nutritious choices. And, as more employees engage in the company's wellness program and practice healthy behaviors in the café, other employees begin to take notice.
It's a delicious benefit and one that can lead to a healthier, happier workforce with a significant savings on medical costs. Analysts and industry critics will continue to lump statistics for assessing ROI and bottom line returns for executive decision-makers, but the view from the frontline is already there: with the right ingredients, proof-of-concept has been achieved. Now more than ever, wellness dollars make business sense.