For busy families, takeout is often the most convenient way to manage dinner. But that convenience may take a toll over time: Meals prepared away from home are often higher in calories and lower in nutrients than home-cooked meals. And too much of it can lead to higher body mass index, cholesterol levels, and blood pressure, all of which increase a person’s risk of obesity and other chronic diseases.
A recent study from the New England Journal of Medicine found that in 10 years, nearly half of Americans will be obese. The alarming statistic, which hit the news just before the holidays, didn’t just raise concerns among public health officials and health care providers; employers around the country likely took notice, too.
The epidemic remains one of the bigger health challenges employers face today. Obesity is not only linked to chronic diseases and poorer overall health, which affect health care costs, but also increased absenteeism and decreased workplace productivity.
Ever on the lookout for ways to improve health through employee wellness programs, employers remain motivated to find ways to help people eat healthier. One tactic is partnering with a community supported agriculture (CSA) program – which cuts out a lot of the legwork by having locally grown food delivered directly to employees at the office.
It’s a fresh approach that Penn researchers have been studying in the health system to gauge just how effective and practical it can be.
“We set out to get people to prepare more home-cooked meals, which tend to be lower in sugar, fat, and sodium than meals eaten away from home,” said the study’s lead investigator, Carolyn C. Cannuscio, ScD, an associate professor of Family Medicine and Community Health at Penn Medicine and director of dissemination at the Penn Center for Public Health Initiatives (CPHI). “And a lot of the produce that people do buy is thrown away because it goes bad. So, we wanted to provide access to fresh food and then encourage people to cook and eat it.”
The team partnered with a regional farm product distributor, Common Market, to deliver free food – including eggs, fruits, and vegetables – every two weeks for four months to Penn employees, all from different departments. In conjunction, they offered the employees cooking education and support, like videos on healthy cooking (which are available online) and communication with the research staff from both CPHI and the Penn Medicine Center for Health Care Innovation.
The program worked: In the randomized study — which included a control group of 30 people who didn’t receive the food, and an intervention group of 30 who did — researchers found that people who received the food ate nearly 30 percent more home-cooked meals. And their fruit and vegetable intake increased, too.
The odds of eating both fruits and vegetables twice a day were nearly four and seven times higher in the intervention group than the control group, respectively.
“People told us that getting subsidized shares allowed them to cook with new and healthy foods without the financial risk,” Cannuscio said. “And then, once they knew they or their families liked the food, they felt more confident going into the grocery store to buy a new kind of squash or new greens, for example.”
The study, published in the American Journal of Health Promotion in December, was also led by Rachel Feuerstein-Simon, a research program manager at CPHI, Roxanne Dupuis, a PhD student at Harvard University, and Ryan Schumacher, an innovation associate at CHCI.
The trial included employees from different incomes, ages, education backgrounds, and races — which suggests the program stands to positively impact a wide range of people in the workplace.
The researchers also found “compelling” evidence that showed how CSAs may potentially help combat food security challenges. Food security means having regular access to enough food. Almost 30 percent of the people who chose to participate reported having experienced low or very low food security before the study started. However, the team found that having access to CSA foods reduced the odds of being food insecure among that group by 90 percent.
“These were our most important findings, and they are not the findings we expected,” Cannuscio said. “This rather low-cost intervention went a very long way to help alleviate this food insecurity in the working adults who participated.”
Cannuscio believes employees across the health system could benefit from an employer-sponsored CSA program, and plans to study different models to better understand the impacts on the workforce and the return on investment, just like any other employee wellness initiative, such as discounted gym memberships. Some CSA models are fully subsidized, while in others, both the employer and employees contribute to the programs.
“I am fascinated by the idea that employers are motivated to keep their workforces healthy,” Cannuscio said. “That’s one of the reasons I am plan to continue to study the issue and to engage the health system in thinking about ways to encourage healthy eating for all, as well as ways to alleviate food insecurity for those who may be experiencing it.”
The NEJM study from December had other grim news: one in four Americans will have severe obesity by 2030. And at the state level, the researchers predicted that nearly 50 percent of the residents in Pennsylvania will be obese by 2030. New Jersey wasn’t far behind with 47 percent, while 53 percent of residents from Delaware were predicted to be obese in 10 years.
Having a workplace CSA is one intervention among many that could help address these rising rates by encouraging healthier dietary practices.
“I think CSAs are one promising way to get people involved and feeling positive about their health and eating fresh foods,” Cannuscio said. “We don’t want to focus on punitive or negative messages about body size or weight because we want to engage people — thinking that if we can change their habits now, down the road we would see likely benefit to their health.”