07764 189516
Blog
Main photo source: https://www.lifestylemedicine.org/What-is-Lifestyle-Medicine

Lifestyle medicine is becoming more prominent.  It’s an approach to medicine which uses lifestyle changes (for example in nutrition, physical activity, sleep, stress management and social support) to prevent, treat and reverse chronic diseases.  

In the UK, GPs Rangan Chatterjee and Ayan Panja are well known to TV viewers for BBC1’s Doctor in the house and Street doctor respectively, both using a lifestyle medicine approach to improving health. Dr Chatterjee’s lifestyle medicine book The Four Pillar Plan topped the book sales charts for weeks when it was launched earlier this year and Dr Aseem Malhotra and Donal O’Neill’s 2017 book The Pioppi Diet – A 21-day lifestyle plan continues to be a best seller. GP Dr Rupy Aujla’s website and accompanying book The Doctor’s Kitchen promotes food as medicine and he has 120,000 followers on Instagram. Every week the media report new research, books and stories about the importance of sleep and physical activity, mindfulness and managing stress on our health and wellbeing. And updates about the gut microbiome’s role in physical and mental health are very exciting. So it appears that the lifestyle medicine approach might be starting to make sense to the public.

But although professional lifestyle medicine associations are established in the UK (British Society of Lifestyle Medicine (BSLM)), Europe and internationally, it looks like GPs and other healthcare professionals are not always supported in their efforts to use a lifestyle approach with their patients.  


At the recent Inspired Medics Lifestyle Medicine Conference in Leeds, I spoke to several GPs who were keen to use a lifestyle medicine approach but were not supported by their GP partners. “It’s not proper medicine” and “you were trained to treat sick people with medication not to advise them on nutrition” were typical admonishments.  This is interesting because the use of nutrition in medicine is not exactly new. Hippocrates is reported to have said, “Let food be thy medicine and medicine be thy food”…


However, as a 2017 BMJ (British Medical Journal) article entitled Students need to understand the role of diet in health promotion and disease prevention pointed out, “The National Institute for Health and Care Excellence guidelines state that a first line intervention for diabetes, obesity, and high cholesterol is to give “lifestyle advice”—but this phrase is so vague that it is left up to doctors and patients to define it and, potentially, ignore it” (my bold text)(1). Supporting this comment, many questions to the panel of speakers at the end of the Inspired Medics conference asked whether a lifestyle approach met NICE guidelines and asked for guidance and evidence to support lifestyle medicine efforts.   One of the speakers, Dr David Unwin, a GP from Merseyside, reminded delegates that NICE recommends that with type 2 diabetes patients, an individualised approach (para 1.3.1) and low glycaemic index sources of carbohydrate (para 1.3.3) should be used – both lifestyle medicine approaches.


Dr Unwin’s presentation outlined how he has worked to improve the health of type 2 diabetes patients in his surgery (not an affluent area) using lifestyle advice, all within the usual 10 minute appointment slot. In fact, not only is patients’ blood sugar successfully managed, around half could be said to be in remission, ie technically no longer diabetic. So successful has this approach been over recent years that his surgery now has the lowest per patient spend on diabetes medication in the area, spending around £40,000 less than the average surgery in the CCG (Fig 1). If this could be replicated by all NHS GP surgeries, it would save the NHS £375m annually on diabetes medication alone – around half of the current total spend(2). But diabetes medication represents only about 6% of the cost of type 2 diabetes(2).  So if type 2 diabetes is being put into remission, the total costs including non-diabetes medication (cardiovascular disease medication constitutes the largest proportion of prescription costs for people with diabetes) as well as spend on short and long term complications will also reduce.


Fig 1: Dr Unwin’s Northwood Surgery diabetes mediation spend compared to other surgeries in the same CCG (reproduced with permission) 

Several conference delegates I spoke to had moved to the private sector, were working part time or had retrained in a lifestyle-related speciality such as functional medicine. They had suffered burn out or had lost their GP mojos through the strain of trying to treat patients within a 10 minute appointment, following protocols that tackled symptoms but not root causes.  Some of the speakers mentioned this, too – that becoming a doctor to help people but never seeming to improve patients’ health was very wearing. Last year, Rangan Chatterjee and Ayan Panja set up Lobe Medical to run Royal College of GPs-accredited lifestyle medicine courses. They have said that course attendees report increased energy and satisfaction at work, partly because they can see they are making a real difference to their patients. We are short of GPs so it makes sense to keep and motivate the ones we have and encourage medical students to take an interest, both in general practice and lifestyle medicine. In fact there is a growing student-led movement to improve nutrition training for medical students. Nutritank was originally set up as a student society by Bristol University medical students to promote awareness of the need for nutrition training for medical students. It has now spread to 15 UK universities plus others in Europe. Bristol and Cambridge universities are reportedly redesigning their student curriculum to increase nutrition tuition.



A parallel education focus is encouraging UK universities to include physical activity science and therapy as part of medical and health-based curricula. A recent report commissioned by Public Health England and Sport England found universities recognised the value of physical activity education for health professionals. Even more important, they seemed keen to make the changes. Report author Ann Gates, of physical activity advocates Exercise Works said, “A qualified doctor, nurse, midwife or allied health professional may see half a million patients during their professional career: this has enormous potential for advocacy and the promotion of physical activity.”   This concept has been given a boost by organisers of the free weekly 5k runs, parkrun, who partnered with the Royal College of GPs to launch parkrun practice earlier this year.  Over 450 GP surgeries have become ‘parkrun practices’, forming close links with their local parkrun. Staff and patients benefit from any or all of the parkrun benefits of walking or running, being outside n a green space, talking to others, volunteering and being part of a community.


Looking in as an interested observer, I perceive a real appetite for lifestyle medicine. It makes so much sense in terms of prevention and treatment.  Just think. Data from Dr Unwin’s patients shows that a low GI diet and lifestyle approach not only improves diabetes symptoms, it also improves liver function, blood pressure and lipid scores.  Other research indicates improvement with mental health, gut and kidney issues and cardiovascular health.  A win for patients, a win for GPs, a win for the NHS and a win for society.


So let’s hope the lifestyle medicine movement continues to grow.


Watch this space!

 

 

 

 

 

References
  1. Womersley K, Ripullone K (2018) Medical schools should be prioritising nutrition and lifestyle education. British journal of sports medicine 52, e6-e6.
  2. Diabetes.co.uk Cost of diabetes in the UK. https://www.diabetes.co.uk/cost-of-diabetes.html (accessed Oct 2018)
0

Blog, News
It’s always nice to win a prize, but when the judges are hugely respected pioneers it is even more special.

So I was bowled when my office cake research won the poster prize at the Inspired Medics lifestyle medicine conference in Leeds last month. The judges were cardiologist Dr Aseem Malhotra and GP and diabetes expert Dr David Unwin  who said they liked the research’s pragmatic, balanced approach to a problem which resulted in realistic conclusions.

The conference itself was superb and there’s a blog on the way about it.
0

Blog
After completing my training, I’m now officially a Public Health Collaboration ambassador. This is an exciting honour and a great opportunity to help a great group of people make a difference to public health… although I know the work won’t provide an easy ride. 

The Public Health Collaboration (PHC) is a charity dedicated to improving public health through diet (its hashtag is #RealFoodRocks). It is tackling the root cause of the UK’s health problems by working to improve the UK’s healthy eating and weight loss guidelines. It also works with GPs, diabetes nurses and other healthcare practitioners to offer more choice to type 2 diabetes sufferers in their treatment, highlighting the NHS-approved availability of a low-carb approach to put diabetes into remission. 

The PHC works closely with diabetes organisation www.diabetes.co.uk to introduce healthcare practitioners to a dietary approach to type 2 diabetes treatment and to provide support with this new protocol. For years, type 2 diabetes has been considered a progressive, irreversible ie terminal condition. But in recent years, thousands have used a low carb/’real food’ approach in combination with other lifestyle changes to put their diabetes into remission or even reverse it completely. Diabetes.co.uk has developed a 10-week low carb eating programme for patients which is approved by the NHS for GPs to prescribe.   It has also received CE Mark approval. At £30 this represents good value compared to the £300 – £375 the NHS currently spends per person on diabetes treatments (and that does not include spend on complications of diabetes which take up around 80% of the total annual diabetes costs of £14bn – 16bn). But this approach is new to the NHS and it will take time for health care providers to be confident to try something different. Recognising this, diabetes.co.uk developed a 30-minute learning module for GPs and other healthcare practitioners which has been approved by the Royal College of GPs.

More alternatives to drug therapy… and more hope
Another dietary lifestyle approach to type 2 diabetes reversal includes the very low calorie diet featured on recent BBC and ITV programmes, based on the DiRECT study. Therefore, alternatives to drug therapy exist for patients, once healthcare practitioners are aware of this. Patients value being given a choice in treatment protocol and, importantly, being given hope that their condition can be either better managed or reversed. 

Type 2 diabetes affects around 6% of the UK population but takes 10% of the NHS budget. With a third of the UK population estimated to have prediabetes, it is obvious that our struggling NHS could not cope if people’s prediabetes progressed to full diabetes. And the issues that lead to prediabetes and type 2 diabetes, also predispose people to other conditions such as obesity, cardio vascular issues, fatty liver disease, kidney problems and some cancers. Increasing evidence suggests that our carbohydrate-heavy diet, particularly in terms of sugars and starchy carbs such as flour, rice, pasta and starchy bread, is a major contributor to the obesity and diabetes crisis which is why the PHC is working to revise lthe UK dietary guidelines.

Exciting times ahead!
0

Blog
What has workplace health and wellbeing got to do with reversing type 2 diabetes? A huge amount and it’s a very exciting opportunity. The problem is, employers are finding it hard to start a much-needed conversation with employees that would help. But there are simple (cheap) solutions.

Last night I sat in Committee Room 11 in the Houses of Parliament and listened to three doctors, a nurse plus two formerly-diabetic patients speak about how type 2 diabetes can be reversed with lifestyle change. The most important lifestyle change revolved around diet. But something they all mentioned was how our obesogenic (obesity-generating) environment makes it difficult to prevent and treat the disease.

Professor Roy Taylor told the All Party Parliamentary Group for Diabetes how patients could get into remission, but struggled to maintain it in our food-obsessed society. He said we must challenge society to change our attitudes to snacking (we are constantly told we must “close the energy gap”), the food environment and the hidden sugar in food. Dr David Unwin said we must do something urgently, and not accept diabetes as inevitable and that changing our food environment would help. Dr Campbell Murdoch, Geoff Whitington and Mark Hancock talked about the need to support patients in a challenging food environment. Geoff, Mark and nurse Catherine Cassell spoke of the hope patients feel when they’re given a chance to come off medication and reverse a disease that is traditionally seen as progressive and terminal.  (It’s not either of those things.)

How can employers help?

Increasingly there are calls for a societal ‘whole systems’ approach to tackle obesity and obesity-related non-communicable diseases (1, 2) such as type 2 diabetes, cancers, non-alcoholic fatty liver disease, cardiovascular disease and chronic respiratory complaints. These are largely preventable and cause the majority of deaths (3). Diabetes costs the NHS is over £1.5m an hour or 10% of the NHS budget for England and Wales which equates to over £25,000 being spent on diabetes every minute (4).

That employers have a role to play, alongside the NHS and politicians, has already been pointed out (5, 6). After all, we spend between half and two thirds of our waking hours at work (7) so the workplace is an important setting for encouraging healthy lifestyles (8-10). Employer organisations, including the Chartered Institute for Personnel & Development (CIPD) and Business in the Community recognise this (11,12) and NICE has guidelines for workplace health provision and leadership and line management responsibility. Professor Cary Cooper, president of the CIPD, said, “It’s the employer’s job to create an environment where employees can make healthy lifestyle choices” (12).

But office cake culture is getting in the way. My research into office cake culture found office cake changes employee eating habits and therefore is likely to undermine health and wellbeing programmes. Many employers invest in health and wellbeing initiatives such as standing desks, healthy canteen offerings, cycle to work schemes and employee assistance programmes. But failing to stem the tide of sugar flooding our workplaces undermines that investment. Having the best wellbeing initiatives but not reducing office cake availability is like going to sea in a ship loaded with all the best safety equipment… but without fixing the leak in the hull.

Last week I discussed this with two groups of employers – a group of doctors and a group of HR and wellbeing professionals. They all helped me realise there is a glitch in my ideas for reducing office cake consumption.

My idea, informed by my research, is that if you start a conversation among employees about office cake, you begin an empowering, employee-led process that would reduce cake consumption, maximise its social benefits and minimise its unhealthy consequences. You would also make it easier for employees to make healthy choices at work and therefore help prevent non-communicable disease.

This idea is based on a key finding from my survey of nearly 1000 UK office workers: 95% thought the ideal frequency for office cake was once a week or less – much less than it is typically available. Therefore, I’ve been reasoning that if people realise they actually agree on how often cake should be available, they would, with support and encouragement, figure out among themselves how to make that happen. The result: healthier, less sugary workplaces without mandated cake bans. Empowered, bought-in employees with agency to influence their workplaces for the good. More awareness of how small changes to an office environment or culture could have a positive impact on our health.

The glitch is that employers are reluctant to start the conversation, even if they recognise the benefits of a less sugary workplace. One senior health and wellbeing executive at a large organisation (a household name) told me the cake table at their office was known as ‘the trough’. Yet with squeezed resources and, until now, little awareness that office cake changes employee eating behaviours, tackling office cake is well down the wellbeing priority list.

Birthdays, meetings, holidays, feeling fed up – there’s always a reason to have cake

Our obesogenic world makes it harder to make healthy food choices at home, when out and about, and at work. The research found it’s becoming the norm to have cake and other treats in the office almost daily for many. Birthdays and other celebrations are the main reason, followed by leftovers from meetings and events. But people also bring goodies back from business trips and holidays (“it’s traditional”) and it’s used to reward (or ‘encourage’ people to do unpopular tasks), and it’s the obvious choice when kind-hearted colleagues fancy a treat and want to share it, or when they’re having a bad day and don’t want to be the only one having a sugary pick-me-up.

Add to this national workplace cake stall our natural propensity to seek out pleasure-giving, dopamine-secreting sugary rewards and we have one explanation for our obesity and diabetes crisis. One of the doctors I talked to said one of the teams in their workplace was staffed by about 16 people all wanting to lose weight. But they had a ‘treat table’. Talk about making it hard for themselves …

Office cake is the now the norm

One reason there is so much office cake around despite 95% thinking once a week is enough, is possibly because we are herd animals and it would take a brave person to risk being ostracised by their herd for suggesting cutting down on cake. So office cake becomes the norm because no one feels comfortable speaking up to challenge it. This is a crying shame if, as the evidence showed, there is consensus around how often to have cake. We are too polite for our own good. Offices are full of people on diets yet survey respondents said cake made it harder to stick to a diet (59%), harder to eat healthily at work (38%) and harder to control bodyweight (35%).

Shouldn’t we be making it easier?

Here’s an example of how a cake conversation does work. Melanie said she’d seen my TEDx talk on the subject and, after outlining the research results to her team, asked whether she should continue to bring a cake to weekly team meetings. They said they’d prefer it if she didn’t because if it was there they would eat it and they were all trying to watch their weight. The TEDx talk triggered a bit of openness by all parties potentially leading to a healthier team. And they could use that new openness to explore other health-related aspects of their workplace environment. A good result coming from a conversation about cake.

There are precedents for starting successful conversations around obesity

Perhaps it is not surprising that HR and wellbeing professionals and even medics feel uncomfortable starting the conversation. No one likes to risk conflict or to upsetting anyone. Overweight and obesity is a taboo subject, and office cake discussions are often emotive. Some managers fear losing a cheap, convenient way to boost morale or say thank you (although there are other ways to do this that don’t involve unhealthy food). Others fear a backlash, should triggering the conversation be misinterpreted as accusing people of being overweight or interfering in matters of personal choice.

Employers are not alone in feeling apprehensive about tackling the obesity taboo. A trial to investigate the effectiveness of brief, opportunistic weight loss conversations by GPs with obese patients reported that GPs were “nervous” about bringing up the subject of obesity. However, 81% of patients found the intervention “both appropriate and helpful” while less than 1% felt it was inappropriate to do so (13).

Similarly, plans to conduct an exploratory survey of obesity in nurses in England (14) were initially met with hesitation by senior personal across the health sector despite their acknowledgement that obesity among nurses was a problem. Fortunately their concerns were overcome and nurses were pleased that someone was trying to help. The Weight Initiative in Nurses (WIN) interim report said: “Almost without exception, the hundreds of nurses who visited our stand at RCN Congress thanked us for taking on this challenge and working with them to help them achieve and maintain a healthy weight” and “The enthusiasm with which WIN has been greeted by obese nurses as well as senior personnel and key stakeholders, and the interest expressed in expanding it beyond England, reaffirms the importance and value of the initiative and is helping to allay concerns about the sensitivities of tackling the problem.” (15).

These are great indications that people want to be helped to tackle their obesity and those in a position to help should not shy away from the challenge.

Time to grasp the nettle

OK, so starting a conversation is challenging, but does that mean it should be avoided? When nearly two thirds of the UK population is overweight or obese (16) and in the UK we spend more on obesity-related illness and diabetes treatment than on the police, judicial system and fire service combined (17), surely we need to grasp the nettle?

As well as societal and moral reasons for employers to engage in making workplaces healthier, employee health impacts the bottom line. Studies found employees who perceive their employers to genuinely care about their health are generally healthier (18.19) and healthy employees are more likely to be happier, more engaged and more productive (20-22).

UK overweight and obesity levels have almost doubled in the last 25 years (23). Type 2 diabetes prevalence has doubled in the last 20 years (4) and this is just the tip of the iceberg with a third of the UK population having pre-diabetes. Why? What has changed in the last few decades to predispose us to such illness? The food environment is one of the culprits, but at least we have a chance to influence the food environment in our workplaces. Tackling office cake really could help us all be healthier and help provide that support and hope everyone spoke about at the Houses of Parliament last night.

Let’s do it!

Eight ideas to make it easier for employers to start a conversation about office cake

  • Create a setting where discussing workplace food is appropriate, even expected eg a health and wellbeing event. Not got one planned? Plan one! Employees who perceive their employer genuinely cares about their health is more likely to be healthy (18,19)
  • Ask your workplace wellbeing champions to watch the TEDx talk then introduce the topic with colleagues. Alternatively, consult them about how best to broach the topic. They have the networks and local knowledge and could suggest appropriate ways to start the conversation. If you don’t have wellbeing champions, consider it. The Royal Society of Public Health runs Workplace Health Champions training plus other relevant qualifications.
  • Start a competition for the most creative, healthy cake alternative. Many people love a bit of team rivalry. Create a gallery of photos of healthy creations in a break out room or kitchen. Why not feature creative cake of the month on your intranet or employee magazine?
  • Ask leaders and managers to identify individuals and teams who might be amenable to/interested in a conversation. Trialling it in one group would provide evidence and generate confidence that a cake conversation has merit.
  • Be confident that initiatives around caring about employee health are appropriate and relevant for employers, and onsite food provision is part of that. Employers should feel confident consulting employees to discuss, survey and learn about employee food needs and preferences in the context of health and safety, improved productivity and wellbeing. All aspects of onsite food provision, cake culture, meeting refreshments, vending and catering for shift workers are relevant topics. The British Dietetic Association’s Work Ready initiative and NICE Workplace Health guidelines both recommend consulting employees and involving them in new initiatives. You could start by consulting on general food provision to start a general food conversation, then introduce a cake conversation at a later date. 
  • When situations have been identified or created where a conversation could be appropriate, share the TEDx talk (11 mins) and ask for reactions. Download the It’s time to rethink office cake research report for background, information and suggestions for ways to reduce cake consumption while retaining opportunities to get together socially at work.
  • If a the water’s been tested and people seem amenable to finding out more, consider conducting a short, anonymous questionnaire among employees to a) get people thinking and talking about it and b) get objective data on the prevailing opinion. Then that data can be shared and form the basis of a conversation.
  • It can start small. It might take months to get a conversation going across the whole company. Don’t be afraid to start small, test the water and work with enthusiasts at first.

Lou Walker is a workplace health and wellbeing consultant, specialising in obesity and office cake culture. She uses talks, training workshops and surveys to help improve workplace environments so that healthy choices become the easy choices. Visit www.louwalker.com to find out about how she can help your workplace become healthier and more productive.


References

  1. House of Commons Health Committee (2018). Childhood obesity: Time for action.
  2. A whole systems approach – Leeds Beckett University
  3. World Health Organisation (2018). Noncommunicable diseases fact sheet. Retrieved 26 June 2018.
  4. Diabetes.co.uk.
  5. Crisp, N. et al (2016). Manifesto for a healthy and health-creating society. The Lancet (388) No 10062, e24-e27
  6. Tackling obesity seriousy: the time has come. The Lancet Public Health (3)
  7. World Health Organisation (2013). Global action plan for the prevention and control of noncommunicable disease 2013-2020.
  8. Black, C (2008). Working for a healthier tomorrow.
  9. Heinen, L., & Darling, H (2009). Addressing obesity in the workplace: The role of employers. The Millbank Quarterly, 87(1).
  10. NiMhurchu, C., Aston, L., Jebb, S. (2010). Effects of worksite health promotion interventions on employee diets: A systematic review. BMC Public Health, 10(1).
  11. Chartered Institute of Personnel & Development (2018). Health and Well-being at Work, 2018
  12. Business in the Community. Workwell Model. Accessed 26 June 2018
  13. Aveyard, P. et al. (2016). Screening and brief intervention for obesity in primary care: a parallel, two-armed, randomised trial.
  14. C3 Collaborating for Health/The Healthy Weight Initiative for Nurses. (WIN.) (2018). Final report.
  15. C3 Collaborating for Health/The Healthy Weight Initiative for Nurses. (WIN.) (2016). Interim report November 2015 – November 2016.
  16. Health Survey for England (2017). Health Survey for England, 2016.
  17. Public Health England (2017). Health matters: obesity and the food environment.
  18. Tabak, R., Hipp, J. A., Marx, C., & Brownson, R. (2015). Workplace social and organizational environments and healthy-weight behaviors. PLoS One, 10(4).
  19. Lemon, S. et al. (2010). Step Ahead: A worksite obesity prevention trial among hospital employees. American Journal of Preventative Medicine, 38(1).
  20. Department for Business Innovation & Skills (2014). Does worker wellbeing affect workplace performance?
  21. National Institute for Health and Care Excellence (2015). Workplace health: management practices.
  22. Millar, M. (2005). Vielife-IHPM health and performance research study
  23. National Statistics/NHS England (2018). Statistics on obesity, physical activity and diet.
1

Blog

It’s Monday morning, you’re sitting at your desk and an email from Fred arrives saying it’s his birthday, he’s brought in cakes, they’re on the table by the photocopier, enjoy!  Next day, Jane brings some baklava back from Istanbul – help yourselves from the usual place. The next morning there are pastries left over from your meeting so you let colleagues know they’re up for grabs in meeting room 1. On Friday it’s the regular last Friday of the month Doughnut Day so everyone congregates at 4pm for a catch up over a doughnut.

This is a familiar pattern for many UK office workers according to new research into office cake culture1. The research surveyed nearly 1000 UK office workers and found that for the vast majority (86%) cake was available at least once or twice a week while for a quarter of respondents cake was available at least three or four times a week. 

Workplace cake culture is a controversial and emotive topic with opinions revolving around its contribution to obesity-related ill health, freedom of choice/nanny state-ism, and its ability to boost morale. The new research cuts through the confusion and helps clarify what’s going on. And yes, office cake may have a role to play in workplace morale.

But don’t rush out to buy celebratory cupcakes just yet… because we need to make sure office cake culture develops in a way that really does boost morale. Unfortunately there is potential for it to do the opposite.

First the bad news

Nearly a third (31%) said they thought office cake had contributed to weight gain, 59% said it made it harder to stick to a diet and 38% said it made it harder to eat healthily in the workplace.  Fundamentally, if cake is there people eat it – getting on for half (41%) said they often or always eat it if it’s available.

We can’t ignore the fact that cakes, pastries or chocolates mean extra sugar and calorie intake and, in a climate where 68% of the UK population is overweight or obese 2 this is not helpful to anyone’s health. One Tesco blueberry muffin (307 calories according to Tesco online grocery) twice a week for 48 weeks a year, is potentially an extra 29,000 calories, and sugary calories at that, which we know is linked to obesity and ill-health 3.  

We spend between a third and two third of our waking hours at work so if our workplace environment is healthy it can play an important role in keeping us healthy. But if our workplace makes it hard to eat healthily, we’re more likely to become unwell.  The new research shows that office cake culture changes employee eating habits, and therefore potentially undermines investment in health and wellbeing initiatives such as healthy options in the canteen and free exercise classes.

Now the good news
 
81% said office cake brings people together and 83% said it cheers everyone up.  In fact research has found that workgroups who eat together tend to have higher co-operation, performance and trust 4,5,6 and eating together is associated with enhanced connection between eating companions 7,8. Certainly, the value of building relationships and cross fertilising ideas through socialising between colleagues is well-established and we all recognise the pleasure and sense of connection we get from eating with friends and family.

As Meik Wiking, CEO of the Happiness Research Institute in Copenhagen, points out, “[Food] feeds our friendships, bolsters our bonds and nourishes our sense of community – and those factors are vital to our happiness. Whether you look at the English word ‘companion’, the Spanish word ‘compañero’ or the French ‘copain’, they all originate from the Latin ‘com’ and ‘panis’ meaning ‘with whom one shares bread’.” 9

But, here’s a question.  If cakes are displayed for long periods for people to help themselves to during the day (as is the case in most workplaces) does that provide sociable morale-boosting effects and companionship? Or does it just promote mindless grazing as people wander past? 62% were distracted by cake to some extent and 68% found it hard to resist even if they were not hungry or had just eaten a meal.  

Some would say people should have better self-control but there’s robust evidence showing why this is not straightforward, but that’s for another blog. For the time being, it helps to understand that when we see something sweet and tasty (or see a picture or even think about it), our brain’s pleasure and reward systems kick in, urging us to seek out that reward. It’s a natural physical response that gets our mouth watering and our stomach juices flowing10,11.  And if we want to rely on willpower, some (not all) researchers maintain12 that is in limited supply so don’t beat yourself up if cakes are still there at tea time and you succumb to a muffin.

So how can we harness the beneficial glow of companionship while minimising the potential health risks? This question is answered by one of the most powerful findings from the new research. When asked what was the ideal frequency for office cake, 95% of respondents said once a week or less. I’ll say that again: once a week or less. Getting on for half (41%) said once a month would be ideal – much less frequent than what most people experience currently.

A great opportunity


This presents a fantastic opportunity to make cake special again; a treat to look forward to.  If 95% of the research respondents thought once a week or less was ideal, there’s a good chance that you and your colleagues feel similarly, whether you think cake is the work of the devil or a delicious way to break up the working day.

All that’s needed is a conversation among colleagues so you can work together create a cake plan that suits you (and your health) most of the time.

Importantly, there is no need for cake to be banned. The research does not suggest this is needed, as long as employees get a chance to discuss and understand what is going on. But what will help is if management instigates, encourages and supports the conversation. Research has found that when employees perceive that their management values employee health, employees tend to be healthier with lower BMI13,14. This encourages a virtuous circle of more healthy behaviours becoming the norm which in turn leads to healthier employees.

So, a happy workplace might involve cake. It should probably involve sociable get togethers. But cake doesn’t make a happy workplace if other factors aren’t right. You might find this diagram, from neuroendocrinologist and obesity expert Dr Robert Lustig, interesting. I’d have thought for a happy workplace, you’d need a range of factors leading to the scenario on the right, rather than a collection of people all independently experiencing the scenario on the left.  After all, it’s probably a happy workplace we’re after rather than a pleasurable workplace.

                                                                               Source:  www.businessinsider.com

 

Start the conversation!

  • A short, confidential survey might be useful to help people say what they really think and help the conversation get started.
  • Decide how often you want to have cake. What will you do if there are three birthdays in one week? What alternatives would work to thank or recognise someone?
  • On cake day, store the cakes out of sight (and therefore out of mind) until cake time, then no one has to rely on willpower to resist them.
  • Consider offering an alternative (fruit the most popular alternative to cake in the survey, followed by ‘cake, but less often’).
  • Enjoy the cake while socialising with colleagues.
  • Then put the cakes away, take them home, decide what to do with any left overs – but don’t leave them lying around.  


This way, office cake becomes a real occasion … not just an every day, run of the mill occurrence that potentially harms health.  Making cake an occasion gets people together to reap the benefits of eating together.  Most importantly, it helps keep the workplace healthier by making the healthy choice the easy choice.

So whether you’re an employee or employer, start a conversation.  What have you got to lose? (Other than the weight, obviously!)

 

References

  1. Walker, L. (2018). It’s time to rethink office cake. louwalker.com
  2. Health Survey for England. (2016). Health Survey for England, 2015.
  3. Scientific Advisory Committee on Nutrition. (2015). Carbohydrates and Health.
  4. Kniffin, K., Wansink, B., Devine, C. & Sobal, J. (2015). Eating together at the firehouse: How workplace commensality relates to the performance of firefighters. Human Performance, 28(4).
  5. Allen-Arave, W., Gurven, M., & Hill, K. (2008). Reciprocal altruism, rather than kin selections, maintains nepotistic food transfers on an Ache reservation. Evolution and Human Behavior, 29(5)
  6. Mameli, M. (2013). Meat made us moral: a hypothesis on the nature and evolution of moral judgement. Biology & Philosophy, 28(6)
  7. Alley, T. (2012). Contaminated and uncontaminated feeding influence perceived intimacy in mixed-sex dyads. Appetite, 58(3)
  8. Kniffin, K., & Wansink, B. (2012). It’s not just lunch: Extra-pair commensality can trigger sexual jealousy. PLoS One, 7(7)
  9. Wiking, M. (2017). The Little Book of Lykke. The Danish search for the world’s happiest people. Pub: Penguin Random House, UK
  10. Ferriday, D & Brunstrom, J. (2011). ‘I just can’t help myself’: Effects of food-cue exposure in overweight and lean individuals. International Journal of Obesity, 35(1)
  11. Ramaekers, M., Boesveldt, S., Lakemond, C., van Boekel, M. & Luning, P. (2014). Odors: Appetizing or satiating? Development of appetite during odor exposure over time. International Journal of Obesity, 38(5)
  12. Hagger, M. S., Wood, C., Stiff, C., & Chatzisarantis, N. L. D. (2010). Ego depletion and the strength model of self-control: A meta-analysis. Psychological Bulletin, 136(4)
  13. Tabak, R., Hipp, J. A., Marx, C., & Brownson, R. (2015). Workplace social and organizational environments and healthy-weight behaviors. PLoS One, 10(4).
  14. Lemon, S. et al. (2010). Step Ahead: A worksite obesity prevention trial among hospital employees. American Journal of Preventative Medicine, 38(1).

 

0

Blog

Public Health England and Business in the Community have launched another excellent toolkit for employers: The physical activity, healthier eating and healthier weight toolkit.

 

The toolkit contains lots of great info and practical suggestions backed up by a rationale for why it makes sense for employers to safeguard and promote employee health and wellbeing.  The investment really does translate into £££ on the bottom line.

 

I am particularly excited that the new toolkit mentions workplace cake culture.  I researched office cake culture for my MSc in Obesity and Weight Management and the results found that office cake culture influences employee eating habits (negatively) and therefore potentially undermines organisations’ ROI on health and wellbeing spend. It is really important that employers recognise that cake culture makes it harder to eat healthily in the workplace and could result in increased employee health risk and lower workforce performance.

The toolkit recommends that employers ‘begin a conversation’ about cake culture. The good news is that my research now provides evidence to support this approach and, furthermore, suggests workplace cake consumption could be reduced in a collaborative way that would not ruffle any feathers. And it’s free.


Promoting healthier choices

The toolkit’s Healthy Eating chapter has a section called Promoting healthier choices which looks at how ‘employers can create a positive environment for food’.  A checklist of positive practices features two points that struck a chord.

 

“Begin a conversation about how special events (birthdays, holidays, anniversaries, promotions) are marked at work. Can ‘cake days’ be shared, or healthier alternatives be provided?”
My survey of almost 1000 UK office workers found that 95% of respondents thought the ideal frequency for office cake was once a week or less. This is less frequent than cake was currently available for the vast majority.  The research also found that fruit was considered the most popular cake alternative while the second most popular was ‘cake, but less often’. So yes, a conversation would help everyone realise having cake once a week or less might be a popular option.

 

“Provide healthier options at meetings and events”. 

In my research, half (50.5%) the respondents thought meeting refreshments were not sufficiently healthy. In addition, the second most common reason for having cakes in the office after celebrations such as birthdays, was meeting left overs.  So potentially we have a double whammy here that increases health risk and employee dissatisfaction, and pushes costs up.  This has to be worth a conversation with employees (and clients?) about either ditching refreshments partially or altogether, or offering healthier alternatives.

I would also add that providing healthier eating choices and opportunity in the workplace is essential but the other crucial part of the formula is to remove the bad stuff. Providing a salad bar and free gym membership is is terrific but the effect is diminished if the rest of the office is a wall-to-wall cake fest. Removing the temptation of unhealthy (and arguably unnecessary) snacks can only enhance a wellbeing offering.  And now we know that 95% think once a week or less is sufficient for office cake, getting agreement from employees to remove most of the cake for most of the time might be easier than many employers believe.

 

Eating together socially can be beneficial

 

The ‘Promoting healthier choices’ section also mentions research which highlights the importance of eating with family, friends and colleagues socially.   Again, my research echoes this. 81% said office cake brings people together and 83% said office cake cheers people up.  Getting together socially at work provides an opportunity for colleagues to network and build relationships which is valuable in any workplace.  Reducing the frequency of office cake could therefore make it more of a special occasion to look forward to, which could enhance its social benefits even further.

 

I think a conversation is a great way to start.  People aren’t daft – once they get talking they’ll sort out the details (eg what to do if there are three birthdays in one week!!!).

 

To get the conversation started, my website offers ideas including a free short questionnaire which can be circulated to find out how people think about cake in a given team, location or organisation.

 

If you would like to know more about the office cake research or how to help make your workplace healthier through briefings, lunch & learn sessions or workshops, get in touch: lou@louwalker.com or visit my website: louwalker.com.


You can also download the research report It’s time to rethink office cake from www.louwalker.com.

0

Blog
Yesterday I gave a TED talk at TEDx University of Chester.

What an honour and what an experience! 

As a graduate of the University of Chester I was invited to speak about the research into office cake culture I conducted as part of my MSc in Obesity & Weight Management. The event’s official theme was ‘Ideas connected’ and talks covered a range of topics including tackling plastic overuse, theatre as a tool in deradicalisation and ‘inventapreneurism’.  But a common theme was that we need to start conversations about difficult situations to help people invest in the solutions.

My talk aimed to help people understand that obesity is more complicated than eating too much and moving too little, and examined the roles of our environment, social influencing and our neurophysiology in causing obesity. The main messages were:  

1. By subtly changing the environments we are in control of, we can make it easier for ourselves to make healthy choices more often, without having to rely on willpower. By making our workplaces less obesogenic we could all make a significant improvement to public health in the UK.
2. We need to start a conversation with colleagues about how often we really want office cake. 95% of office workers thought the ideal frequency for office cake was once a week or less  but this is less than the current availability in most workplaces. People don’t find it easy to speak up when colleagues are apparently enjoying cake (even if they don’t really want it) 
3. Discuss with colleagues how we might get the benefits of getting together socially at work, without cake.  
4. By starting a conversation about something specific like office cake, we can all contribute to tackling the wider obesity problem.

The final call to action was for employers, employees, students and group members to start a conversation about office cake. After all, we have nothing to lose but the weight, and we all have our health to gain.



I will update this blog with a link to the talk on youtube when it is available.
0

Blog

 

I was very excited when the email arrived saying my office cake research had been short-listed for an Inspiring Wellbeing Award. It’s obviously nice that one’s own work has been recognised, but even better when it’s recognised as being potentially useful.  

Inspiring Wellbeing Awards are run in conjunction with the annual Wellbeing Symposium which focuses on wellbeing at work, in the community and for individuals.

The award was presented by Christine Hancock, director of C3 Collaborating for Health, a London-based global charity that addresses risk factors in non-communicable disease.

Said Christine, “C3 was delighted to be asked to help judge the Inspiring Wellbeing Awards. To see Lou’s important research on office cake consumption among the submissions was fantastic. We were so pleased to recommend her for an award and happy to see that colleagues agreed and her research was ‘Highly Commended’ by the panel of judges.” 



Caption: (L-R), Christine Hancock, Lou Walker.

0

Blog
I’m beyond chuffed that my office cake research has been shortlisted for an award.  

The Inspiring Wellbeing Awards are associated with the annual Wellbeing Symposium and recognise efforts to improve wellbeing in the workplace, communities and among individuals. 

Whatever the outcome, it’s exciting that the potential of rethinking workplace cake culture is starting to be recognised. 

You can find out more about the 2018 Wellbeing Symposium here.

0

PREVIOUS POSTSPage 1 of 2NO NEW POSTS