Eating To Live

Companies are changing their cafeteria menus to offer more healthy items. But getting employees to actually eat them requires some planning and insight.

Wednesday, May 2, 2007
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When it comes to food, it's clear that we Americans have an eating problem. Not only do we eat too much, but we eat too much of the wrong foods, and it shows: Study after study consistently show us to be the fattest people in the world. Worse yet, the rates of obesity among our children continue to climb.

None of this is news. What is news is that more and more companies are stepping forward to declare their own war on fat by offering healthy menu items and information to their employees to encourage them to swear off the burgers, fries and cheese-encrusted nachos in favor of broiled chicken, salads with vinegar dressing and sliced apples instead of ice cream.

Best of all, it works. Just ask Genevieve Ham.

"I've lost 75 pounds in the last three years," she says. "And the healthy eating program here helped me do it."

"Here" is Ham's employer, the Regence Group, a Portland, Ore.-based health insurer where she works as a claims analyst. Not only does the company offer healthy menu items at its three cafeterias, but it also sponsors an annual farmers' market in the parking lot of its main office and provides a "snack attack cart" during the day in which employees can exchange their candy bars, bags of chips and other fat-laden treats for apples, granola bars and other healthy items. The treats are then donated to a local homeless shelter, where the residents have fewer opportunities to enjoy such snacks.

Regence supplements these programs with lots of information. In its cafeterias, signs explain how many calories and grams of fat a typical serving of a burger and fries has compared to, say, a Caesar salad chicken sandwich. "When you go through the cafeteria here and see the information on grams of fat, it makes me more willing to grab the less-fattening items," says Ham. "What I've learned here is that if you know what goes into your meals, you'd be amazed at what you can cut out of your diet."

"Don't Mess With My Food!"

Regence began its healthy eating campaign a year and a half ago, says Denise Johnson, the company's director of human resources.

"We had an obesity issue, smoking issues -- all kinds of health-related challenges facing employees," she says. So the company decided to take action. In addition to offering more healthy menu items, it also offers price differentials that make the cost of a healthy sandwich and a drink substantially less than that of a burger and french fries, says Johnson.

The company worked closely with its cafeteria vendor, Gaithersburg, Md.-based Sodexho USA, on a version of a healthy eating program called Your Health, Your Way that Sodexho recently created for its corporate clients.

One of the key elements of introducing a healthy eating campaign, says Johnson, is that the way in which you do it can mean the difference between success and failure.

"Taking stuff away doesn't necessarily change someone's behavior," she says. "We didn't take the less-healthy items off the menu. We believe employees need to make the choice -- we can educate and incent them, but it's not our job to do it for them."

Anecdotes bear out her claim. Take schools, for example. When the administrators of a high school in Rotherham, England, introduced a new "healthy" menu to the school cafeteria last year, they eliminated pizza, hamburgers and other fattening-but-beloved items.

Many of the students rebelled, refusing to eat the healthy food and instead spending their money on burgers and fries that were passed through the schoolyard fence to students by local mothers dubbed "the meat-pie mums" by the British press.

"It's rubbish," student Andreas Petou told a reporter from the New York Times, referring to the new menu. "We didn't get a choice. [The school] just told us we were having it."

It's one example of an approach that tends to backfire in schools and the workplace, says Anne McBride, a researcher at New York University who studies diet-related issues. "You can't just sort of spring a healthy menu on people without considering where they come from. There's a whole cultural aspect to food. At many companies, 75 percent or more of their employees eat lots of red meat -- you can't just take that away."

"The shorthand for this is 'Don't mess with my food,' " says Lu Ann Heinen, director of the Minneapolis-based Institute on the Cost and Health Effects of Obesity, a nonprofit organization that's part of the National Business Group on Health, a Washington-based consortium of large employers. "The workplace is made up of adults -- no one wants a 'nutrition nanny' at work."

The number of people who actively look for healthy eating options is a small one, she says. "Maybe 10 percent are the so-called 'healthy hunters.' The rest are simply looking for lunch."

Therefore, an overly zealous approach on the part of HR to get employees to eat healthier will likely fizzle, says Heinen. "People will just leave the campus and go to the local fast-food joints if you don't do this right," she says.

She and other experts recommend a more subtle approach, one that is less visible and "below the radar." For starters, companies can work with their food-service vendors to introduce more healthy ingredients into food preparation, cut out fat-heavy ingredients and gradually shrink portion sizes, says Heinlin.

"You want to make the changes invisible," she says. "Work with the food-service vendor to cut out the fat and calories and train the cafeteria staff on portion control. And also -- know your market. I worked with a company once where most of the workers preferred cheese steaks to tuna burgers. They introduced a beefsteak tomato-and-buffalo-mozzarella sandwich and touted it as 'delicious' -- people bought it and they were furious."

A successful healthy eating program is introduced in the same manner in which dieters are encouraged to approach eating -- by taking things in moderation. Healthy items should be introduced slowly and as part of an overall campaign that includes a focus on education, says Andrew Scibelli, manager of employee health and well-being at Florida Power and Light in Juno Beach, Fla.

"When you ram something down someone's throat, they have a tendency to resist," Scibelli says sardonically. "You need to offer choices, communicate and educate people as to why it's important."

Scibelli should know. His company has been offering a healthy eating program to its 12,600 employees at its six on-site cafeterias since 1991.

The company started out by providing a "healthy station" in its cafeterias that offered low-fat menu items. Next it began introducing healthier fare to the other "stations" in its cafeterias -- at the grill station, for example, it began promoting grilled chicken and fish along with the hamburgers that had traditionally been available. Today the company continues to work closely with its food-service vendor, Philadelphia-based Aramark, on creating healthful menus that will appeal to employees.

"If you let employees make the decison, they become better consumers," says Scibelli.

A Culture of Health

FPL's healthy eating program is linked to other efforts to keep its workforce healthy. For example, its on-site medical clinics are staffed with registered dieticians who evaluate and critique the company's cafeteria offerings.

The clinics, which are run by Cleveland-based Whole Health Management Inc., also offer a weight-management program called Steps to Success, which includes physicals, stress tests and regular meetings with dieticians and behaviorialists to help employees devise personal strategies for losing weight and leading healthier lifestyles.

Since the company began tracking the "healthy items" sales in its cafeterias, the average percentage of healthy sales compared to total sales has risen from 28 percent in 2000 to 45 percent today.

Satisfaction surveys conducted every two years reveal that a greater number of FPL employees report that they're feeling healthier, losing weight and exercising more often, says Scibelli.

Statistics bear this out: The percentage of the utility's workforce with a body-mass index of 27 or greater is 41 percent; for the utility industry at large, it's 45 percent. The average blood-pressure readings for the company's employees are also lower than industry norms, he says.

Creating a "culture of health" really does matter when it comes to promoting healthy eating, says Scibelli. "People tend to become what their environment suggests," he says.

At Stamford, Conn.-based Pitney Bowes, the company's healthy-eating campaign is a key part of its Healthcare University program, which aims to encourage employees to lead healthy lifestyles by eating plenty of fruits and vegetables, exercising and avoiding risky behaviors like smoking.

"Our culture is one of prevention," says Brent Pawlecki, the company's associate medical director. "The whole campus has healthy messages, such as 'Take the stairs;' we have fitness centers, on-site medical clinics. One of the things we realized was that people spend so much time at work that we really need to address what they're eating in the cafeteria."

The company has filled its cafeterias with information as well as healthy menu alternatives such as grilled salmon, turkey burgers and vegetable wraps. Signs placed prominently near cash registers advertise the health benefits of fresh fruits and vegetables, while nutritional cards list the amount of fats, carbs and sodium in less-healthy items.

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Pitney Bowes employees might have to work extra hard to escape the company's healthy eating message -- even during meetings, attendees who wish to order snacks and drinks from the company's catering service are offered a "default menu" of bottled waters, diet sodas, fruits and vegetables. Snacks such as popcorn, cookies, doughnuts and non-diet sodas are still available, but employees have to specifically request them, says Pawlecki.

Indeed, meetings featuring calorie-filled meals and snacks can undermine the healthy initiatives being promoted in the corporate cafeteria, says Heinen.

"The dining area might be healthy, but then you go to a lunch meeting and you're trapped in a room with huge croissant sandwiches and cookies the size of your head," she says.

To counter this, Heinen recommends that HR work with its food-service vendor to provide default menus for meetings -- as Pitney Bowes does -- that feature healthy dining options, along with snack options consisting of fruits and vegetables instead of cookies and doughnuts. Attendees will have the option of going with less-healthy fare, but they'll have to make a conscious decision to do so, she says.

Pricing and Promotion

Culture and education aside, when it comes to healthy eating, HR should take some lessons from the fast-food industry, says Heinen. "You need to do promotions to get people to try the healthy food," she says. Just as Wendy's and McDonald's have their dollar-item menus, companies can use competitive pricing and promotion to add an extra bit of luster to their healthy items.

"Offer two-for-one deals," she says. "Offer discounts to get people to try healthy items, or do a frequent-buyer program that gives people a free meal if they buy a certain number of healthy meals. Some companies will ask their vendor to only increase the prices of less-healthy options, so in effect the healthier options are subsidized by the less-healthy foods."

At FPL, employees can get "frequent-buyer" cards that award them a free meal for every 12 healthy meals they order. They also receive coupons they can redeem for prizes after they eat a certain number of healthy meals, says Scibelli. FPL's cafeterias also offer "value meals" consisting of a healthy main course, a salad and a piece of fruit that are priced lower than less-healthy meals.

Pitney Bowes uses the same "default-menu" strategy in its cafeterias as it does with meetings: Sandwiches, for example, are automatically served with carrots and celery on the side instead of the potato chips and a pickle that used to accompany them. Employees can still get the chips and pickle -- but they have to specifically ask for them.

On Fridays, rather than pricing salads by weight, the company charges a single flat price so employees can pile on as many tomatoes, onions and olives (dressings and toppings are excluded from the deal) as they want.

Meanwhile, creamy pies, cakes and other desserts are placed on the bottom shelves to be less visible, while whole fruits and granola are placed on the top shelves, says Pawlecki.

Since its own healthy eating promotion began, sales of healthy menu items at Regence's cafeterias have gone up dramatically, says Johnson. "Last year alone we increased our sales of veggie burgers by three times the previous year's amount," she says. "Our salad bars have seen the most dramatic increase: Sales are up 40 percent to 50 percent over the previous year's."


Size Doesn't Matter

Large companies with full-service cafeterias certainly aren't the only organizations actively promoting healthy eating.

At the Phelps Group, a small advertising and marketing agency in Santa Monica, Calif., the company puts out healthy snacks in its main lobby each day to encourage its 40 employees to interact with one another.

"We encourage our people to exchange ideas face-to-face in an age where it's very easy to just use e-mail for everything," says Judy Lynes, a company vice president. "We put out things like fresh vegetables, rice cakes and fruit bars and just watch the ideas begin to flow."

Companies that lack dining facilities can stock their vending machines with healthy items, says Heinen. "We recommend that your vending machines have a certain percentage of diet, water and fruit drinks, and stock your snack machines with reduced-fat granola bars, sports-nutrition bars, pretzels and nuts and dried fruit," she says.

"Don't eliminate the less-healthy items, but put the healthy items at eye-level and the sugary, salty snacks down below, and work with your vendor to price the healthy items competitively," says Heinen. "Research shows that even a small price differential can make a big difference."

Companies should consider a healthy eating initiative as an investment, not a cost, says Pawlecki.

Genevieve Ham, who chronicled her weight loss on a personal blog, along with a colleague (who lost more than 100 pounds), says her company's healthy eating initiative has given her a new outlook.

"I've been introduced to healthy, delicious food that's simply prepared," she says. "My lifestyle has definitely changed for the better."

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