Sunday, October 19, 2014

Mediterranean Diet and Workplace Health -- Best Practices from the Field

2014 Initiative for Productivity and Health Management Conference at the Harvard School of Public Health

I came back from the Mediterranean Diet and Workplace Health Conference at the Harvard School of Public Health with so many notes, I decided to break them up into two posts. You can read my earlier post about Day 1 where they defined a Mediterranean diet and shared the scientific evidence about the health benefits. Day 2 focused on effective real world initiatives to help people eat a Mediterranean diet. Here’s some of what stood out to me…

Chef Psilakis is a big proponent of teaching kids to cook. That was actually a theme that was thread throughout the two days. Dr. Gianluca Tognon talked about how they improved the diet of school children in Sweden. They empowered children by involving students in the meal planning and offering them choices. They exchanged information by inviting school chefs into the classrooms. And, they evaluated the effects of what they were doing by keeping track of foods that were not well accepted and collecting feedback from students and teachers. He suggested food tastings, having specially themed food days, creating "smarter lunchrooms" by carefully considering food placement and having school gardens as ways to improve dietary habits of children. Dr. Tognon has a free e-book that I look forward to reading. 

UMass shared what they did at the university level and it really didn't sound all that different. Ken Toong the Executive Director did add a mention of "stealth health" for example making sliders with a meat blend that's 30% mushrooms. At UMass they've found a way to make healthy affordable. They have 12% waste and the US average is 40%. He also reported that they consumed 22% less soda from 2013 to 2014. They encourage students to drink water by offering sparkling water and water infused with fruit. (I'm already requesting that we do that in our office.) I loved the UMass tagline -- Come for the food, stay for the education. I sure didn't have lobster when I was in college. 

In general it sounds like it is much easier to get children and college students to make healthy choices than adults. Although the effective strategies for adults were much the same as those used for young people -- samplings, tasting tables, talking with chefs -- with the addition of distributing recipe cards. A few other poignant points:
  • Many people know they should change what they eat and move more, but feel "stuck" and lack the skills to change.
  • Nutritional knowledge is not enough. Culinary literacy is at an all time low. Hands-on training is essential. 
  • Each 30 minute reduction in time spent cooking in the US has been associated with an increase in BMI of 0.5.
This made me recall reading, Trends in US home food preparation and consumption: analysis of national nutrition surveys and time use studies which concluded,
"Across socioeconomic groups, people consume the majority of daily energy from the home food supply, yet only slightly more than half spend any time cooking on a given day. Efforts to boost the healthfulness of the US diet should focus on promoting the preparation of healthy foods at home while incorporating limits on time available for cooking."
I had a chance to observe this first hand when we did our Mediterranean Challenge. Many people really struggled with the cooking. Grocery shopping took a long time because they were looking for items that were unfamiliar to them. The kitchen prep work took a long time because they weren't set up for it and their knife skills weren't good. And, they often picked meals that were too ambitious for a week night because they didn't have enough experience judging what could be prepared quickly. I've been planning to organize a knife skills class and a series of cooking classes at ASHA since I learned this. From what I learned at the conference, I'm on the right track with this idea. 

The experience of Todd LeDuc at the Boston Fire Service affirmed something I believe, money is not the best motivator for improving healthy. They started out with some incentive programs that they later eliminated. He shared an example of a communication that I liked, if you eat x you'll have to run x miles to work it off. How much more useful would that kind of message be than our current food labels?

One of the most exciting presentations was David Eisenberg, MD, he hit on many things that I'd been discussing during the breaks with other attendees. He has a program that teaches physicians too cook -- Health Kitchen, Healthy Lives. You can read about it in this New York Times article. I'm wondering how many of the program objectives we could incorporate in our workplace wellness program. Dr. Eisenberg was the first to mention mindfulness. I emailed him and asked if he'd share his slides. I'll definitely be spending some more time reflecting on what he shared. 

As a Blue Zones fan, I enjoyed hearing from Diane Kochilas. I especially liked her take on seasonal foods, 

"Eating foods in their season, when nature intended, brings anticipation, which in turn teaches us to savor and enjoy the moment, a notion obscured by the 24/7 availability of almost everything in American supermarkets and the erroneous -- and, ultimately, unsustainable -- belief that it's our right to have it all in endless choice."
Chef Michael Psilakis described the Mediterranean as the “have your cake and eat it to diet” and they practiced what they preached.  Breakfast was served both days of the conference – Fage plain greek yogurt, fruit, honey, pistachios and veggie filled filo pastries. Lunch was 90 minutes long. It included chicken, farrow, eggplant, salad and wine (no dessert.) Snacks and appetizers were fruits, roasted vegetables, hummus and more filo pastries. I’ve never eaten so well at a conference and all in the name of health. What’s not to love? They also closed the conference with a Greek Food Expo that gave us a chance to try wines, olive oils and other treats imported from Greece. 

With the focus on diet, I don't want to neglect the fact that activity and sleep were mentioned. I sat next to Voula Manousos, a registered dietitian, and she described our need for sleep in an enlightening way. She suggested you imagine your bedroom with everything pulled out of the closet and drawers heaped in the middle of the floor. While you sleep, everything is neatly put away where you can find it the next day. That's why sleep is such a critical component of memory and recall. On that note, I think I'll say good night. 

I recommend trying the oils from Flying Olive Farms. They're available in Whole Foods in the Raleigh, NC area and I'm begging the Wine Cabinet in Reston, VA to carry them. I loved their balsamic too. 

I recommend the series of Huffington Post articles written by the conference organizers and faculty. 

No comments: