If you think about it, a significant amount of our lives is spent at work. We spend 8-10 hours per day, 4-5 days per week, and 40 hours or more working per week. This equates to almost 25% of life being spent at work. With jobs occupying so much of our time, working to improve health in the workplace is an important thing to consider for employers.

Work stress, a form of psychosocial stress, can be a significant concern in the workplace because the HPA-axis (hypothalamic-pituitary-adrenal axis), a system in the body, responds to this type of stress by releasing cortisol. This can elevate daily cortisol levels to higher than usual. It is not suitable for these levels to stay high for an extended period because they can negatively affect health (1,2,3).

In addition to psychosocial stress, the workplace can negatively impact the physical body due to the high amount of hours spent working at a desk.

This article discusses helpful ways employers can promote employee health in the workplace.

(1) DON’T CONTACT EMPLOYEES OUTSIDE OF WORKING HOURS

Adequate and quality sleep is essential for optimal health, but many Americans don’t get the quality sleep they should. Good quality sleep is subjective per person, but the best way to define it is if the individual feels rested upon waking and during the day and doesn’t experience daytime tiredness (4).

One of the vital components of good quality sleep is non-rapid eye movement (REM) sleep, which occurs during deep sleep (5). It is essential to get this deep sleep when dealing with excess stress from work because, during REM, cortisol release from the HPA system is decreased (5).

Normal cortisol levels are elevated in the morning but decrease throughout the day (5). Not enough sleep has been shown to increase evening cortisol levels (5). So if daily levels of cortisol are already high because of work stress, an individual is just doubling down on cortisol levels by not getting enough sleep.

Stress elevates cortisol levels, and sleep deprivation or low quality of sleep increases cortisol, which is bad for health.

Employer Tip: Employers can support employee sleep health by not contacting them outside of working hours. Employers can discuss appropriate times to contact employees or establish concise working hours if they work remotely.

(2) SUPPORT A HEALTHY EATING ENVIRONMENT

One of the last things on our mind at work is focusing on what we are eating; our attention is towards work, and we end up reaching for convenient unhealthy options because our time is limited. With the ever-present increase in diet-related disease numbers, what we eat at work and our eating environment can significantly impact our health.

Employers can support healthy eating environments by understanding perceived barriers by employees to healthy eating in the workplace; some of these reported barriers include affordability, lack of time, and healthy food tasting bland (8). Employees may find more access to hyper-palatable foods in the workplace that are calorie-dense and lacking nutrition quality, which people tend to turn to when trying to cope with stress (7). Having only options of these foods can be detrimental to health because it is easy to overconsume these, leading to weight gain.

Employer Tip: Finding ways to offer affordable healthy food, providing adequate time for employees to have a lunch break, and potentially providing access to tasty healthy food can help promote a healthy eating environment in the workplace.

(3) CREATE ACCESS TO SNACKS THAT FIGHT STRESS IN THE BODY

As we have discussed, chronic stress in the workplace produces daily elevated cortisol levels, which, if continued for an extended time, could increase the risk for various health conditions such as cardiovascular disease, obesity, type 2 diabetes, and metabolic syndrome (2,3).

This prolonged elevation of cortisol in the body can cause stress-related damage to the cells and organelles in the body that have essential functions in supporting metabolism and mental health (9).

An excellent way to help fight the damage that stress is causing to the body is by consuming nutrients that can be protective against this type of damage. These repairing nutrients include vitamin C, zinc, B12, folic acid, omega-3s, and magnesium (9).

Access to foods high in these nutrients around the office could help from the damaging effects of stress.

Some good office snacks high in these nutrients include oranges, hard-boiled eggs, walnuts, cashews, and almonds.

Employer Tip: Try replacing vending machines or chip bowls with these types of snacks in the office.

(4) FORM A WORKPLACE SUPPORT SYSTEM

Prolonged stress from the workplace can increase the risk of job burnout (10). A workplace that fosters a support system in terms of social support from colleagues and supervisors can be preventative against job burnout and help to manage stress (10,11). The best way to define social support is that you gain resources from others to help with your job in the workplace by conversing with each other (11).

Enhancing social support can lead to positive work environments. A study focused on strengthening social support amongst caregivers and house managers working with developmentally disabled patients showed improved working relationships (12). Some support services include skills training, peer support mentoring, group support, and access to helpful resources.

Employer Tip: Ways to socially support employees include peer support, helping them with tasks, creating teams on projects to work together, and providing access to resources to assist in problem-solving.

(5) IMPLEMENT A BREATH WORK BREAK

The stress system in our body is known as our sympathetic nervous system, which activates our fight-or-flight response. As this is a protective mechanism when the body senses immediate danger, triggering the fight-or-flight response for a long time can be detrimental to health.

The parasympathetic nervous system is the opposite, where it is activated during periods of rest, and this state is essential to the body's repair and recovery. Slow breathing, which can occur during meditation, can increase parasympathetic activation. Activating this can be helpful with cortisol because it normalizes stress hormones (13).

A study that focused on incorporating a 15-minute relaxation break during the workday that concentrated on deep breathing techniques for hospital cleaners and bank employees showed a decrease in heart rate, an indicator of parasympathetic activation (14). This study showed that employees were most successful at continuously implementing the daily relaxation meetings when scheduled daily and encouraged by management to attend (14).

Employer Tip: Encouraging a 15-minute deep breathing break during employee workdays can allow them to relax so they can cope better with workplace stressors.

(6) BREAK UP SITTING TIME WITH LIGHT WALKING OR STANDING

A significant component of jobs today consists of desk work. Sitting most of the day at work and coming home to sit the rest of the night can wreak havoc on our health.

The good news is that you don’t have to implement some crazy exercise routine to counteract the negative effects of sitting all day. A study that took individuals with Type 2 Diabetes and implemented different walking and exercise interventions showed beneficial improvements in health by incorporating sitting and standing during their day. The group that replaced 4.7 hours per day with standing and light-intensity walking (totaling 17,502 steps/day) had improved glucose control and insulin sensitivity compared to a group that walked 4823 steps/day and incorporated 1.1 hours of moderate-vigorous intensity cycling (15).

If your employees are walking around for almost 5 hours of their workday, it probably is not the greatest for work productivity. However, incorporating standing desks and promoting light walking throughout the day could be beneficial to health.

Employer Tip: Having walking meetings, utilizing standing desks, and promoting walking during breaks could be various ways to increase physical activity during the workday.

(7) CREATE A DAILY STEP GOAL CHALLENGE FOR THE OFFICE

Another way to combat the lower levels of physical activity that occur with desk jobs is to create a daily step goal challenge in the office. Low physical activity levels can be associated with increased energy intake, increasing the risk of fat gain (16).

A daily step goal is helpful for appetite regulation, decreasing blood pressure, decreasing fasting glucose, decreasing triglycerides, and increasing HDL cholesterol, which all have beneficial effects on health (16,17 ).

Additionally, a step goal of 12,000 with an increased intensity goal (103 steps/min) of three days per week can improve body composition, helping to decrease belly and hip fat (17).

Employer Tip: Create a 30-day steps/day challenge and offer a prize to the winner at the end of 30 days. Bonus: challenge the participants to try and get 103 steps/min for three days per week to increase the intensity.

(8) ERGONOMICS TRAINING FOR EMPLOYEES

Musculoskeletal disorders are skeletal or muscular issues that can limit the body’s normal movement patterns. These disorders are widely reported among desk workers, primarily computer workers (18). The most significant complaints are related to neck, shoulder, and upper limb disorders (18).

If not addressed, this can lead to chronic conditions that could affect employee productivity in the workplace.

Ergonomics training can improve employee body positioning habits while working, decreasing risky positions predisposing them to musculoskeletal issues (18).

Increasing ergonomics awareness has been shown to be beneficial for employees regardless of the method (12). Employers could implement education programs through learning discussions and exercises, lectures, handouts, workshops, or information booklets (12, 18).

Employer Tip: Increase ergonomics information in the workplace. Try holding a workshop, putting up posters, or sending emails about decreasing risky body positioning in the workplace.

(9-10) INCORPORATE AN EXERCISE PROGRAM FOCUSING ON CORE STABILITY AND HIP STRETCHING

The prolonged slumped sitting posture associated with desk work can cause significant discomfort, creating pain in various parts of our body, especially in our low back and hip/buttock area (20).

A contributor to this pain could be instability in our lumbar spine (low back) due to weak core muscles and tight hip muscles (21).

Strengthening the core can contribute to core stability, which helps stabilize the spine and help with low back pain (21). A core strengthening routine focusing on properly training the transverse abdominis, multifidus, diaphragm, and pelvic floor muscles, known as the deep core muscles, has been shown to increase postural stability, a contributor to low back pain (16,20,21, 22,).

When muscles are tight, they shorten, and shortened muscles can create poor biomechanics. Tight hip muscles such as the hamstring can pull on the pelvis, shifting the curve of the lumbar spine (low back) into an incorrect position and creating low back pain (22).

Static stretching, where a stretch is held for a recommended amount of time, can be effective for lengthening hip muscles such as hamstrings, which could aid with decreases in low back pain (16,22).

Employer Tip: Hire a credentialed fitness expert, such as a Certified Personal Trainer, to teach your employees a core strengthening and hip stretching routine to help decrease low back pain, leading to a pain-free work environment.

References:

1. Noushad S, Ahmed S, Ansari B, Mustafa UH, Saleem Y, Hazrat H. Physiological biomarkers of chronic stress: A systematic review. Int J Health Sci (Qassim). 2021 Sep-Oct;15(5):46-59.

2. DeMorrow S. Role of the Hypothalamic-Pituitary-Adrenal Axis in Health and Disease. Int J Mol Sci. 2018 Mar;19(4):986. doi: 10.3390/ijms19040986.

3. Jeong IK. The role of cortisol in the pathogenesis of the metabolic syndrome. Diabetes Metab J. 2012 Jun;36(3):207-10. doi: 10.4093/dmj.2012.36.3.207.

4. Harvey AG, Stinson K, Whitaker KL, Moskovitz D, Virk H. The subjective meaning of sleep quality: a comparison of individuals with and without insomnia. Sleep. 2008 Mar;31(3):383-93. doi: 10.1093/sleep/31.3.383.

5. Van Cauter E, Spiegel K, Tasali E, Leproult R. Metabolic consequences of sleep and sleep loss. Sleep Med. 2008 Sep;9 Suppl 1(0 1):S23-8. doi: 10.1016/S1389-9457(08)70013-3.

6. Scott AJ, Webb TL, Martyn-St James M, Rowse G, Weich S. Improving sleep quality leads to better mental health: A meta-analysis of randomised controlled trials. Sleep Med Rev. 2021 Dec;60:101556. doi: 10.1016/j.smrv.2021.101556.

7. Yau YH, Potenza MN. Stress and eating behaviors. Minerva Endocrinol. 2013 Sep;38(3):255-67. Internet: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4214609/

8. Stern D, Blanco I, Olmos LA, Valdivia JJ, Shrestha A, Mattei J, Spiegelman D. Facilitators and barriers to healthy eating in a worksite cafeteria: a qualitative study. BMC Public Health. 2021 May 22;21(1):973. doi: 10.1186/s12889-021-11004-3.

9. Du J, Zhu M, Bao H, Li B, Dong Y, Xiao C, Zhang GY, Henter I, Rudorfer M, Vitiello B. The Role of Nutrients in Protecting Mitochondrial Function and Neurotransmitter Signaling: Implications for the Treatment of Depression, PTSD, and Suicidal Behaviors. Crit Rev Food Sci Nutr. 2016 Nov 17;56(15):2560-2578. doi: 10.1080/10408398.2013.876960.

10. Velando-Soriano A, Ortega-Campos E, Gómez-Urquiza JL, Ramírez-Baena L, De La Fuente EI, Cañadas-De La Fuente GA. Impact of social support in preventing burnout syndrome in nurses: A systematic review. Jpn J Nurs Sci. 2020 Jan;17(1):e12269. doi: 10.1111/jjns.12269.

11. Aronsson G, Theorell T, Grape T, Hammarström A, Hogstedt C, Marteinsdottir I, Skoog I, Träskman-Bendz L, Hall C. A systematic review including meta-analysis of work environment and burnout symptoms. BMC Public Health. 2017 Mar 16;17(1):264. doi: 10.1186/s12889-017-4153-7.

12. Heaney CA. Enhancing social support at the workplace: assessing the effects of the caregiver support program. Health Educ Q. 1991;18(4):477-94. doi: 10.1177/109019819101800406.

13. Wahbeh H, Goodrich E, Goy E, Oken BS. Mechanistic Pathways of Mindfulness Meditation in Combat Veterans With Posttraumatic Stress Disorder. J Clin Psychol. 2016 Apr;72(4):365-83. doi: 10.1002/jclp.22255.

14. Toivanen H, Lansimies E, Jokela V, Hanninen O. Impact of regular relaxation training on the cardiac autonomic nervous system of hospital cleaners and band employees. Scand J Work Environ Health. 1993 Oct;19(5):319-325. doi:10.5271/sjweh.1468

15. Duvivier BM, Schaper NC, Bremers MA, van Crombrugge G, Menheere PP, Kars M, Savelberg HH. Minimal intensity physical activity (standing and walking) of longer duration improves insulin action and plasma lipids more than shorter periods of moderate to vigorous exercise (cycling) in sedentary subjects when energy expenditure is comparable. PLoS One. 2013;8(2):e55542. doi: 10.1371/journal.pone.0055542.

16. Shook RP, Hand GA, Drenowatz C, et al. Low levels of physical activity are associated with dysregulation of energy intake and fat mass gain over 1 year. AM J Clin Nutr. Nov 2015;102:1332-8. doi: 10.3945/acjn.115.115360

17. Chiang TL, Chen C, Hsu CH, Lin YC, Wu HJ. Is the goal of 12,000 steps per day sufficient for improving body composition and metabolic syndrome? The necessity of combining exercise intensity: a randomized controlled trial. BMC Public Health. 2019 Sep 3;19(1):1215. doi: 10.1186/s12889-019-7554-y.

18. Mahmud N, Kenny DT, Md Zein R, Hassan SN. Ergonomic Training Reduces Musculoskeletal Disorders among Office Workers: Results from the 6-Month Follow-Up. Malays J Med Sci. 2011 Apr;18(2):16-26. Internet: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3216214/

19. Bohr, Paula C. Office Ergonomics Education: A Comparison of Traditional and Participatory Methods. Work. 1 Jan 2002;19(2):185 – 191. Internet: https://content.iospress.com/articles/work/wor00253

20. Baker R, Coenen P, Howie E, Williamson A, Straker L. The Short Term Musculoskeletal and Cognitive Effects of Prolonged Sitting During Office Computer Work. Int J Environ Res Public Health. 2018 Aug;15(8):1678. doi: 10.3390/ijerph15081678.

21. Hsu SL, Oda H, Shirahata S, Watanabe M, Sasaki M. Effects of core strength training on core stability. J Phys Ther Sci. 2018 Aug;30(8):1014-1018. doi: 10.1589/jpts.30.1014.

22. Shamsi M, Mirzaei M, Shahsavari S, Safari A, Saeb M. Modeling the effect of static stretching and strengthening exercise in lengthened position on balance in low back pain subject with shortened hamstring: a randomized controlled clinical trial. BMC Musculoskelet Disord. 2020 Dec;21(1):809. doi: 10.1186/s12891-020-03823-z.

23. Beomryong K, Yim J. Core Stability and Hip Exercises Improve Physical Function and Activity in Patients with Non-Specific Low Back Pain: A Randomized Controlled Trial. Tohoku J. Exp. Med. July 2020;251:193-206. doi: 10.1620/tjem.251.193.