Dr Megan Whelan

British Dietetic Association Work Ready

Nutrition for Women’s Health in the Workplace

Female employment rate is now approximately 70% in the UK

There are specific health conditions which impact many

women during their working lives.

Conditions commonly, or exclusively, associated with women where nutrition can play a role include:

These issues can be overlooked, but have a major impact on women at work

Introduction

– Menopause

– Breast Cancer

– Pregnancy

– Premenstrual syndrome

– Polycystic ovary syndrome

– Eating disorders

Nutrients and lifestyle patterns significant to women’s health

Healthy Eating Guidelines Eatwell Guide

– Eat at least 5 portions of a variety of fruit and vegetables each day

– Choose wholegrain or higher fibre versions of breads, cereals, rice and pasta

– Choose unsaturated oils and use in small amounts

– Choose lower fat dairy and alternatives

– Eat more beans and pulses, 2 portions of sustainably sourced fish per week, one of which is oily, and eat less red and processed meat

– Limit foods that are high in saturated fat, added sugar and salt

– Aim for 6-8 glasses of fluid per day (water, milk, and sugar-free drinks including tea and coffee all count)

Public health England. The Eatwell Guide, 2016

B Vitamins

Why? – Breakdown and release of energy from food

– Maintenance of the nervous system and skin

– Formation red blood cells and haemoglobin

Food sources:

B1 thiamine B2 riboflavin

↓ incidence of premenstrual syndrome (food only, not supplements)

B6 ↓ premenstrual symptoms

B9 folic acid ↓ risk of infant neural tube defect (supplement)

Vitamin D and Calcium Why?

– Vitamin D works together with calcium for healthy bones, muscles and teeth

– Vitamin D helps the absorption of calcium from foods

Sources:

↓ rate of premenstrual syndrome; may help relieve premenstrual pain and migraine

Breast cancer treated with hormone therapy can increase risk for osteoporosis

Loss of oestrogen in menopause increases risk of osteoporosis

Vitamin D Calcium

Low Glycaemic Index What is Glycaemic Index?

– The Glycaemic Index (GI), is a ranking of how quickly carbohydrates make your blood glucose levels rise after eating them

– Low GI foods and drink, which are more slowly digested, will make your blood glucose rise more slowly

Food sources:

↓ inflammation markers associated with reduced premenstrual symptoms

Recommended for impaired glucose tolerance resulting from polycystic ovary syndrome to improve blood sugars and insulin resistance

Alcohol Low risk alcohol guidelines

– To keep health risks from alcohol to a low level it is safest not to regularly drink more than 14 units per week

Alcohol consumption associated with ↑ risk of developing breast cancer

Alcohol consumption in pregnancy may cause foetal harm (foetal alcohol spectrum disorder)

No safe level of alcohol has yet been established for breastfeeding women as it passes into breastmilk

Department of Health. UK Chief Medical Officers’ Low Risk Drinking Guidelines, 2016.

Measure Up

A body mass index (BMI) above the healthy range (25kg/m2) can increase your risk of health problems

Weight management appears to ↓ risk of breast cancer diagnosis and recurrence

Improved levels of insulin and hormones in polycystic ovary syndrome for those with BMI ≥25kg/m2

BMI ≥30kg/m2 strongly associated with more severe premenstrual syndrome symptoms

Overweight/obesity during pregnancy associated with high birth weight and high BMI into adulthood

Low pre-pregnancy weight associated with low birth weight and failure to initiate breastfeeding

Breast feeding

Breastfeed for at least the first 6 months when possible

Some substances consumed by mother can be transferred to baby though breastmilk

– If you choose to drink alcohol, wait up to two hours before breastfeeding

– Caffeine may cause your baby to become irritable if consumed in large amounts

↓ risk of developing breast cancer for mother

↓ risk of infection, diarrhoea and vomiting for infant

↓ risk of type 2 diabetes, obesity and cardiovascular disease in adulthood for infant

Move More

Physical activity guidelines for adults

– 150 minutes of moderate intensity activity in bouts of 10 minutes or

more (30 minutes on at least 5 days of the week); OR

– 75 minutes of vigorous intensity activity spread across the week

– Undertake activity to improve muscle strength on at least 2 days a week

– Minimise the amount of time spent being sedentary (sitting) for extended periods

Low levels of physical activity are associated with ↑ risk of breast cancer

Regular physical activity associated with ↑ quality of life in breast cancer survivors

Department of Health and Social Care. UK physical activity guidelines, 2011

Seek support: Disordered eating • 90% of people diagnosed with bulimia nervosa and anorexia nervosa are

women

• Common eating disorders include:

– Anorexia Nervosa

– Binge eating disorder

– Bulimia Nervosa

– Other specified feeding or eating disorder (OSFED)

• Symptoms may include:

– Weight change

– Increased stress, anxiety, or social withdrawal

– Low self-esteem, mood swings, irritability, or difficulty concentrating

– Very strict eating habits, skipping meals, or over-exercising

Implementation of nutrition interventions in the workplace

The evidence

Limited evidence on nutrition for women’s health in the workplace

Comprehensive workplace wellness programs targeting healthy eating, physical activity and lifestyle behaviour change, have shown significant improvements

Implementation of workplace wellness programs achieve an ROI of 4:1 from healthcare cost-savings, lower absenteesim, improved presenteeism, recruitment and retention

Considerations for the workplace

Information & support Access to healthy food Opportunity

Protect your break Availability, sterility, and temperature of

food storage

Cleanliness of food preparation areas

Information and support

• Provide health and nutrition education materials

– Assessments, brochures, posters, web pages, newsletters,

presentations, workshops, campaigns

• Trusted channel of communication

• Encourage access to screening services and

specialists

Opportunity • Access to drinking water

• Provide healthy food choices at work – Vending

– Canteens

– Catering

– Availability surrounding site location

• Support women to be physically active – Events and opportunities

– Gamification

– Subsidies and incentives

– Adequate shower facilities

– Bike storage availability

Protect your meal break

• A major barrier to food accessibility and positive eating behaviours is poor access to adequate meal breaks

• A recent poll by the BDA found that 62% of employees always or sometimes skip their lunch break

Cleanliness and availability • Adequate storage facilities for number of employees

– Cupboard space

– Fridge space

• Fully-equipped kitchen areas – Food preparation area

– Kettle

– Crockery/cutlery

– Washing up facilities

– Microwave

– Seating/eating area

• Protocols for cleaning frequency and temperature control

Evaluation • How do we know if interventions are effective?

• Measures need to be decided at the planning stage

• Interventions should be evaluated with suitable tools – Valid and reliable

– Low burden to use and analyse

• Ensure the focus is on intended outcomes – Absenteeism and presenteeism

– Recruitment, retention and/or engagement

– Lifestyle behaviours

– Participation

– Satisfaction

– Cost and cost-effectiveness

If a tree falls in a forest…

Take-away message

• Women’s health considerations can often be sensitive topics making it important to reduce stigma, create awareness, and provide support.

• Interventions require a tailored and multi-faceted approach, and employees should be involved in planning and delivery

• Evaluation is key to success!

Acknowledgements

Work Ready Steering Committee

− Alison Clark

− Sue Baic

− Elaine Gardner

− Jo Lewis

− Christina Titlow

workready@bda.uk.combdaworkready.co.uk General Zone 932