Table 3.
Secondary studies with cognitive and behavioural interventions included in the umbrella review.
| Author (Year) | Description of the Intervention | Results | Implications |
|---|---|---|---|
| Anderson et al. (2009) [29] | Environmental, educational or behavioural interventions to achieve and/or maintain a healthy body weight | There is evidence of a modest reduction in body weight as a result of workplace health promotion programs aimed at improving nutrition, physical activity or both. Program effects are consistent, with a net loss of 2.8 pounds (95% CI −4.63, −0.96) among workers at 6–12-month follow-up, based on the meta-analysis of nine RCTs. In terms of BMI, a net loss of 0.47 BMI (95% CI −1.02, −0.2) at 6–12 months was observed in six RCTs. | There is strong evidence of a consistent, although small, effect (weight loss), in both men and women. The research quality is lacking and indicates the need and room for more research. |
| Cabrera et al. (2021) [18] | Basic nutrition education and general nutrition counselling, implementation of a specific diet, or dietary changes, motivational changes and/or coaching, physical activity and stress and/or sleep quality management. Most of the interventions studied were partially or fully delivered online using online platforms and/or social media | The effects of nutritional interventions: reduction in waist circumference (−4.9 cm, 95% CI −8.0 to −1.7), systolic blood pressure (−6.5 mmHg, 95% CI −10.7 to −2.3), diastolic blood pressure (−1.9 mmHg, 95% CI −3.6 to −0.2), triglycerides (SMD −0.46, 95% CI −0.88 to −0.04) fasting glucose (SMD −0.68, 95% CI −1.20 to −0.15). | Nutrition interventions in the workplace are beneficial for employees with the metabolic syndrome in terms of preventing the disease and also improving health parameters. Interventions that affect health-related behaviours and attitudes, as well as employee motivation, are the most effective—purely educational interventions are the most common but do not yield the anticipated outcomes. |
| Fitzpatrick-Lewis et al. (2022) [31] | A diabetes prevention program or a program with 3 components of diabetes prevention (nutrition educator/coach, focus on nutrition and increased physical activity) | Participants in diabetes prevention programs were 3.85 times more likely to lose weight ≥ 5% (4 RCTs; RR = 3.85; 95% CI, 1.58 to 9.38; p < 0.05) and had a 9.36-fold greater chance of weight loss ≥ 7% (2 RCTs; RR = 9.36; 95% CI, 2.31 to 37.97; p < 0.05), a significant reduction in BMI was observed (5 RCTs; MD = −0.86; 95% CI, −1.37 to −0.34; p < 0.05). Interventions based on diabetes prevention programs were 2.12 times more effective in increasing physical activity compared to the control group (RR = 2.12; 95% CI, 1.06 to 4.25; p < 0.05). | The quality of these data are low to average. Due to doubts about the quality of the data and its limited availability, further research is needed in this area. |
| Ghobadi et al. (2022) [32] | Nutrition interventions: educational, counseling and environmental | Improvements in lipid indices (HDL, LDL) were observed. Available data say that while dietary interventions are effective in improving the cholesterol profile, they do not affect other variables. | More high-quality primary research is needed to confirm these relationships. |
| Gudzune et al. (2013) [34] | Self-management, dietary, physical activity and/or environmental intervention | There were no statistically significant changes in body weight and BMI in either women or men. However, those in the group with a higher BMI at baseline who received the intervention lost weight, while those in the control group gained weight (a statistically significant relationship). | There is weak to moderate evidence that self-management, dietary, physical activity and/or environmental interventions prevent weight gain in workers. |
| Groeneveld et al. (2010) [33] | Lifestyle or health promotion intervention with emphasis on nutrition and physical activity | There is no evidence that interventions of this type have a positive effect on body weight, blood pressure values, lipid profile or glucose levels. In contrast, there is strong evidence of their effect on fat reduction. | The effectiveness of interventions depends on whether the patients included in the study were at CVD risk or not, with interventions working better for those at risk. |
| Hendren et al. (2017) [19] | Greater availability of fruit and vegetables, subsidies for healthy produce, changing menus/portion sizes, education at point of purchase, combination of education and community intervention | It showed an increase in fruit and vegetables intake which was statistically significant in 13 out of 14 studies (p < 0.05). Only one study showed a statistically significant decrease (p = 0.007). Three studies produced mixed results. One study showed a significant increase in vegetable intake (p = 0.002) but no change in fruit intake (p = 0.78). Another study showed a significant increase in fruit consumption (p = 0.001) but no change in salad sales (p = 0.139). | Environmental interventions conducted at the employee cafeteria/canteen can increase fruit and vegetable consumption, but the lack of consistency in the available literature limits the development of specific recommendations. |
| Lee et al. (2022) [20] | Weight loss interventions carried out using electronic devices such as computers, tablets, smartphones, apps and personal electronic assistants | Video consultations appear to be more effective than face-to-face appointments, while wearable devices (telemedicine devices, smartwatches and smart phones) and apps have proven to be the most effective. | As technology advances, the form of the message has to be updated. Also, these interventions lack a theoretical foundation—indicating the potential for future research. |
| Madden et al. (2020) [35] | Lifestyle programs to improve diet, physical activity and weight-related factors | In mixed activities (diet + physical activity), interventions that were not led by a health worker (possibly a healthcare worker and someone who is not—at the same time) were more effective. Emphasis was placed on how the interventions were delivered and on responding to the needs of female employees. | Proper social support and the right choice of interventions are key to the effectiveness of interventions with female employees. |
| Ni Mhurchu et al. (2010) [36] | A weight loss or healthy eating intervention in the workplace, lasting a minimum of 8 weeks | None of the studies showed measurable effects on presenteeism, productivity and/or health care costs. Overall, the effects of dietary interventions were positive, but the self-reported nature of dietary assessment poses a high risk of error. | Nutrition interventions in the workplace have a positive, though small, effect on employees’ eating habits. |
| Sandercock et al. (2018) [38] | Physical activity and nutrition education | The results of some studies have shown statistically significant changes in body composition (lower BMI, body fat percentage and waist circumference). Even though changes in body composition have been confirmed in other studies, the results are not statistically significant. Six interventions showed no change, and one showed an increase in BMI. | Interventions affect the body composition of the study participants, but the strength of evidence is low. More studies with better endpoint determination are needed—the authors suggest, e.g., BIA. |
CI—confidence interval, p—probability value, RCTSs—randomized controlled trials, BMI—body mass index, SMD—standardized mean difference, RR—relative risk, MD—mean difference, HDL—high-density lipoprotein, LDL—low-density lipoprotein, CVD—cardiovascular disease, BIA—bio-electrical Impedance Analysis.