Do you bring your lunch to work? Or do you usually opt to buy lunch?

Sometimes making your lunch seems like a hassle, so buying a slice of pizza or a sandwich can be an easy solution. But those purchases can add up after a while and have the potential to affect not only your wallet, but your health as well.

A team of Mass General researchers led by Anne Thorndike, MD, MPH, recently published a study in the American Journal of Preventative Medicine that evaluated the association between food purchases at work and overall health and found that healthier purchases were linked to lower prevalence of obesity, hypertension and diabetes.

Anne Thorndike collaborated with the Mass General Department of Nutrition and Food Services to create the traffic-light food labelling program that was implemented in Mass General cafeterias beginning in 2010. The food labelling program, called Choose Well, Eat Well, rates the healthiness of all items for purchase with a green label (choose most often), a yellow label (choose less often) or a red label (choose least often).

Choose Well, Eat Well was created to educate employees and visitors and to encourage healthy choices. Although prior research by Dr. Thorndike and her colleagues demonstrated the program resulted in healthier food purchases, there was no way to evaluate how these choices affected health.

This time around, Thorndike and her team wanted to dig deeper and monitor the food choices made at work to see if they could affect a person’s risk of cardiometabolic disease and impact overall health.

The study involved 602 employees at Mass General who regularly used on site cafeterias with the Choose Well, Eat Well system. Their diets and worksite food purchases were monitored and evaluated over a three month period using a Healthy Purchasing Score, a weighted average using the Choose Well, Eat Well labelling system.

Researchers also measured 24-hour dietary intake using the Healthy Eating Index, BMI, blood pressure and HbA1c to assess diabetic risk for each participant.

After analyzing the results, the team found that the sample of Mass General employees was surprisingly representative of the general population in terms of their diet. About 20% of participants had high blood pressure and almost 30% qualified as prediabetic with an average Healthy Eating Index score of 60 (100 is considered a perfect diet).

Overall, healthier worksite food purchases were associated with lower risk of obesity, high blood pressure and diabetes/prediabetes.

This is not to say that your lunch is the main contributor to the state of your overall health, but evaluating cafeteria purchases did provide researchers with a glimpse into each person’s eating habits, including what they ate outside of work. “There is definitely a relationship between what you’re purchasing at work and your overall dietary intake and health risk factors are,” says Thorndike.

“We can’t say what you eat at work is causing your problems, but it does raise the question: if we intervened in what people are eating at work, could we help to reduce those problems?”

Anne Thorndike, MD, MPH

Her goal for the research is to try to understand more about food choice behaviors and how they affect health outcomes. She believes that behavioral and cognitive factors strongly influence obesity outcomes and her research aims to understand how to address these factors to prevent obesity.

The rates of obesity and diabetes in the US continue to rise despite multiple interventions and campaigns to promote a healthy lifestyle. Most of those interventions focus on weight loss, and sometimes that works, but it often ends with gaining the weight back due to an unsustainable regimen.

Anne Thorndike’s research, however, does not focus on weight loss, but rather preventing weight gain.

“I think that with most of the emphasis on weight loss, many people get stuck. If we could just focus on adults not gaining another pound from here on out, I think we’d be much better off.”

Anne Thorndike, MD, MPH

She is using a population approach to help people make better choices, and the hope is that this system can be scaled up and implemented at other worksites and institutions to reach a much broader population outside Mass General.

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