Long-term effects of an occupational health guideline on employees’ body weight-related outcomes, cardiovascular disease risk factors, and quality of life: results from a randomized controlled trial

Abstract

Long-term effects of an occupational health guideline on employees' body weight-related outcomes, cardiovascular disease risk factors, and quality of life: results from a randomized controlled trial by Verweij LM, Proper KI, Weel ANH, Hulshof CTJ, van Mechelen W Overweight and obesity prevention efforts are warranted. We evaluated the effectiveness of a occupational health guideline aimed at preventing weight gain. Guideline-based care was not more effective than usual care after 18 months follow-up on body weight-related outcomes, CVD risk factors, or quality of life. Therefore, we cannot recommend implementation of the guideline in its current form. Original article Scand J Work Environ Health. 2013;39(3):284-294. doi:10.5271/sjweh.3341 Long-term effects of an occupational health guideline on employees' body weight-related outcomes, cardiovascular disease risk factors, and quality of life: results from a randomized controlled trial Objective This study aims to evaluate the effectiveness of a draft occupational health guideline, aimed at preventing weight gain, on employees' body weight-related outcomes, cardiovascular disease (CVD) risk factors, and quality of life. AffiliationMethods In a cluster randomized controlled trial including 16 occupational physicians (OP) and 523 employees, guideline-based care was compared to usual care by OP between 2009-2011 in the Netherlands. Guideline-based care consisted of (i) providing advice to employers on how to assess and intervene on the obesogenic work environment, (ii) conducting five face-to-face behavioral change counseling sessions with employees to improve their lifestyles, and (iii) evaluating the outcome and maintaining sections i and ii. Data were collected at baseline and 6, 12, and 18-months follow-up. To evaluate the effects of the intervention, multilevel analyses were performed.Results No significant differences were found between the intervention and control group on waist circumference [β 1.2 cm, 95% confidence interval (95% CI) -0.6-2.9], body weight (β 0.3 kg, 95% CI -1.0-1.6), body mass index (β 0.1 kg/m2, 95% CI -0.3-0.5), systolic blood pressure (β 1.7 mmHG, 95% CI -2.4-5.8), diastolic blood pressure (β 0.3 mmHG, 95% CI -1.0-0.6), cholesterol (β 0 mmol/l, 95% CI -0.2-0.2), or quality of life indicators after 18-months follow-up. Stratified analyses showed an increase in waist circumference among men (β 2.5 cm, 95% CI 0.5-4.5) and obese intervention participants (β 2.7 cm, 95% CI 0.6-4.7) compared to control participants. ConclusionThe draft occupational health guideline was not more effective than usual care. Therefore, the guideline in its current form cannot be recommended for implementation.

Promoting Physical Activity and Healthy Dietary Behavior

“…independently evaluated the methodological quality of the studies by using an existing checklist ( Table 2). [13][14][15][16][17][18][19][20][21][22][23][24][25] Concerning the methodological quality assessment, the authors (L.K. 12 The checklist contains 12 criteria for internal validity that are related to selection bias (2 items), performance bias (3 items), attrition bias (2 items), and detection bias (5 items).…”

“…Most interventions were aimed at men and women with specific risk factors, including unhealthy physical activity and/or dietary behaviors, overweight, high cholesterol levels, high fasting glucose, and large waist circumferences. 23,26 Eight of the 14 studies conducted a randomized controlled trial (RCT), [14][15][16][17]19,21,22,25 4 a controlled trial, 18,20,23,26 and 2 noncontrolled studies. [15][16][17]19 The number of participants ranged from 68 to 1393.…”

“…[15][16][17]19 The number of participants ranged from 68 to 1393. [15][16][17]19,21,22,25 One RCT 14 and three of the four controlled trials 20,23,26 were graded as fair-quality studies. 23,26 Eight of the 14 studies conducted a randomized controlled trial (RCT), [14][15][16][17]19,21,22,25 4 a controlled trial, 18,20,23,26 and 2 noncontrolled studies.…”

“…21,22 The main intervention component used in the included studies was counseling, which was used in 7 of the 10 interventions. 21,22 The main intervention component used in the included studies was counseling, which was used in 7 of the 10 interventions.…”

The obesity epidemic in the occupational health context

“…However, the fact that there is no easy solution is demonstrated by one of the few published randomized controlled studies that examines effects of workplace interventions targeting overweight and obesity. In a controlled trial among Dutch occupational physicians, Verweij et al (21) did not find that an occupational health guideline, including repeated face-to-face counselling sessions to improve lifestyle, was more effective than usual care. The disappointing fact is that, at present, there is no evidence-based recommendable occupational health intervention targeting obesity.…”