Business of Well-being

Managing Metabolic Syndrome is a Delicious Boost to ROI

When I made my way west after graduate school and arrived as a nutrition consultant at a high profile Silicon Valley tech company, I was stunned to discover that for such an educated, seemingly well-informed workforce, rates of Metabolic Syndrome (MetS) were off the charts.

My assumptions about this progressive, information seeking, data-driven group-a population enmeshed in California's yoga, kale and organic food culture-had been completely defied. If any cohort knew what needed to be done to maximize health and reduce risk for disease, surely it was this one.

Caused primarily by insufficient exercise and a diet rich in sugar, salt and fat, a Metabolic Syndrome diagnosis nearly guarantees a future of diabetes, heart disease and/or stroke. Perhaps its most striking characteristic is the silent way in which it sneaks up on unsuspecting folks. These employees felt just fine and looked fine, too.

The ticking time bomb within their bodies was an unobservable threat. According to the Centers for Disease Control (CDC), 34 percent of those aged 20 years and above have MetS, and most people are unaware if they forgo screening.1 The good news is that MetS is not a death sentence. In fact, studies show that minor changes to diet along with moderate exercise can prevent and actually reverse it.

Despite increasing awareness of our nation's health problem, obesity, a major driver of MetS has shown no decline. Current NHANES data tells us that there has not been significant change in its prevalence from 2002 - 2003 to 2011 - 2012.2 Unfortunately, government health agencies such as the IOM and CDC have been drastically underfunded, minimizing the scope and scalability of public health programs including those designed to address our nation's weight problem.

And physicians are not well positioned to address the issue either. On average, Americans see their doctors four times per year. These physician contacts are compromised by short visit lengths that can't possibly reinforce the strategies, tools and support individuals need to make lasting lifestyle changes in an impactful way.

However, Corporate America, affected on a daily basis by an unhealthy workforce, has become a driving force in targeting MetS and bears a significant burden of the medical insurance costs, loss in productivity and high absenteeism rates associated with treating the condition.

In 2009, 92 percent of businesses exceeding 200 employees reported offering some degree of wellness programming.3 Clearly, wellness strategies have been identified and analyzed. Biometric screening, nutrition and stress management programs, financial incentives for healthy behaviors and an onsite fitness center often work together as part of a company's holistic wellness program.

Each one of these solutions is important to the program's overall success and can attract and retain good employees, while keeping them healthier, happier and more productive.

I am more convinced than ever that the most important wellness solution, the corporate cafe, is all too commonly missing from the larger conversation. Making healthier food choices enticing and readily available and engaging workplace conversations about them leads to a subtle yet powerful effect of peer influence all of which can shift the collective behavior of an employee population.

One client case-study has proven to illustrate this point, and the measurable impact of an integrated food program to employee health and the bottom line.

Metabolic Syndrome Employer Case Study

Back in 2008, leaders in a Tulsa, Oklahoma-based company recognized they had a significant problem with increasing health care costs, rising insurance rates and decreasing productivity.

After company-wide biometric screenings confirmed 29 percent of its population had Metabolic Syndrome, senior executives engaged in leading the overhaul on employee health. They quickly engaged experts to develop a wellness program with incentives, expecting to see significant changes. Instead, they were disheartened with lackluster returns.

After reevaluating their program, executives and experts assessed why their wellness approach wasn't working. It became clear that their breakfast and lunch offerings sold to employees were more likely to promote disease then prevent it.

The original cafe served highly caloric, sodium and fat-rich foods; their dining program was not sufficiently supporting good nutrition or highlighting healthy choices. And the reality was (as it remains for many organizations struggling to get a foothold on the wellness investment return) employees tempted with indulgences like cheeseburgers and hotdogs while they simultaneously participate in their employer-sponsored health challenge, is probably not the most effective strategy for producing positive health outcomes.

Consistent messaging will bring credibility to the organization and its wellness initiatives, while offering employees the support and resources they need to be successful.

And this company was successful. They participated in an integrated wellness program that included nutrition education, marketing and a recalibration of menu offerings. As a result, MetS rates finally dropped from a high of 29 percent in 2009 to 18 percent in 2012.

In detecting those at highest risk for diabetes, heart disease and stroke early and offering those employees opportunities for prevention, they experienced a $1.5 million reduction in health care spend since the program's inception, translating into a 4:1 return on their wellness investment.

The Case for the Cafe

While prevention and management of chronic disease is a driving force for many organizations like this one, fueling for performance is key, especially for companies among those with a growing population of Millennials.

These younger employees have come to expect a level of quality when it comes to food at work that includes sustainable and responsible ingredient sourcing as well as options that support them in achieving peak performance, so that they may reach their full potential, at work and at home.

So what makes the wellness-centric cafe so integral to a wellness program's success? In many cases, employees may purchase and consume as many as 50 percent of their weekly meals at work. That represents many opportunities over the course of the week to make choices that promote good health and performance.

While quitting smoking and spending 45 minutes on the treadmill are extremely positive health behaviors, they may not elicit the same enthusiasm as one might have for an anticipated lunch break. If the food options are good and good for you, employees are likely to seek them out more often, prefer them over off-site lunch locations, and eventually replace old eating habits with newer, healthier ones.

Gently nudging healthier options with strategic positioning and pricing subsidies can further promote nutritious choices. And, as more employees engage in the company's wellness program and practice healthy behaviors in the cafe, other employees begin to take notice.

It's a delicious benefit and one that can lead to a healthier, happier workforce with a significant savings on medical costs. Analysts and industry critics will continue to lump statistics for assessing ROI and bottom line returns for executive decision-makers, but the view from the frontline is already there: with the right ingredients, proof-of-concept has been achieved.

Now more than ever, wellness dollars make business sense. Determining the cost/benefit ratio will continue to be a priority issue to prove that wellness focused corporate cafes and free oatmeal ought to be as standard to employees as health insurance.


1. Ervin, R. Bethene. (2009). Prevalence of metabolic syndrome among adults 20 years of age and over, by sex, age, race and ethnicity, and body mass index; United States, 2003-2006. CDC Stacks Public Health Publications. Retrieved December 2, 2015.

2. Ogden C, Carroll M, Kit B, Flegal K. Prevalence of Childhood and Adult Obesity in the United States, 2011-2012. JAMA. 2014;311(8):806-814.

3. Mattke, Soeren, Hangsheng Liu, John Caloyeras, Christina Y. Huang, Kristin R. Van Busum, Dmitry Khodyakov and Victoria Shier. Workplace Wellness Programs Study: Final Report. Santa Monica, CA: RAND Corporation, 2013.

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