Effectiveness of workplace wellness programmes for dietary habits, overweight, and cardiometabolic health: a systematic review and meta-analysis.
Effectiveness of workplace wellness programmes for dietary habits, overweight, and cardiometabolic health: a systematic review and meta-analysis.
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DOI：
10.1016/s2468-2667(21)00140-7
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发表时间：
2021-09
期刊：
影响因子：
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通讯作者：
Mozaffarian D
中科院分区：
文献类型：
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作者：
Peñalvo JL;Sagastume D;Mertens E;Uzhova I;Smith J;Wu JHY;Bishop E;Onopa J;Shi P;Micha R;Mozaffarian D
工作场所为有效促进健康提供了独特的机会。我们的目的是全面研究多组分工作场所健康计划对改善饮食和心脏代谢危险因素的有效性。我们按照PRISMA指南进行了系统的文献回顾和荟萃分析。我们检索了PubMed-MEDLINE、Embase、科克伦图书馆、Web of Science和教育资源信息中心，从1990年1月1日到2020年6月30日，寻找具有控制评价设计的研究，这些研究评估了多组分工作场所健康计划。调查人员独立评估证据并提取数据。结果包括饮食因素、人体测量和心脏代谢危险因素。合并效应通过逆方差随机效应荟萃分析计算。对异质性和研究偏倚的潜在来源进行了评价。在10169篇综述的摘要中，121项研究（82项[68%]随机对照试验和39项[32%]准实验性干预）符合合格标准。大多数研究在北美（57 [47%]）和欧洲，澳大利亚或新西兰（36 [30%]）进行。中位参与者人数为413·0（IQR 124·0-904·0），中位干预持续时间为9·0个月（4·5-18·0）。工作场所健康计划改善了水果和蔬菜的消费（每天0.27份[95% CI 0.16至0.37]），水果摄入量（每天0.20份[0.11至0.28]），体重指数（−0·22 kg/m2 [−0·28至−0·17]），腰围（−1·47 cm [−1·96 to −0·98]），收缩压（−2·03 mm Hg [−3·16 to −0·89]），和LDL胆固醇（−5·18 mg/dL [−7·83至−2·53]），并在较小程度上改善了总脂肪摄入量（每日能量摄入量的− 1.18%[− 1.78至− 0.58]），饱和脂肪摄入量（每日能量的−0·70%[−1·22至−0·18]），体重（−0·92 kg [−1·11 to −0·72]），舒张压（−1·11 mm Hg [−1·78至−0·44]），空腹血糖（−1·81 mg/dL [−3·33至−0·28]）、HDL胆固醇（1·11 mg/dL [0·48至1·74]）和甘油三酯（−5·38 mg/dL [−9·18至−1·59]）。摄入蔬菜没有观察到显着益处（每天0.03份[95% CI-0.04至0.10]），纤维（每天0.26克[-0.15至0.67]），多不饱和脂肪（每日能量的-0.23%[-0.59至0.13]），或体脂肪（−0·80% [−1·80 to 0·21]）、腰臀比（−0·00 ratio [−0·01 to 0·00]）或瘦体重（1·01 kg [−0·82 to 2·83]）。杂合度值范围为46.9%至91.5%。研究设计、地点、人群或异质性分析中的类似因素不能显著解释研究间结局差异。工作场所健康计划与特定饮食、人体测量和心脏代谢风险指标的改善有关。当使用这些方案作为改善心脏代谢健康的策略时，应考虑研究设计和结果中确定的异质性。
The workplace offers a unique opportunity for effective health promotion. We aimed to comprehensively study the effectiveness of multicomponent worksite wellness programmes for improving diet and cardiometabolic risk factors. We did a systematic literature review and meta-analysis, following PRISMA guidelines. We searched PubMed-MEDLINE, Embase, the Cochrane Library, Web of Science, and Education Resources Information Center, from Jan 1, 1990, to June 30, 2020, for studies with controlled evaluation designs that assessed multicomponent workplace wellness programmes. Investigators independently appraised the evidence and extracted the data. Outcomes were dietary factors, anthropometric measures, and cardiometabolic risk factors. Pooled effects were calculated by inverse-variance random-effects meta-analysis. Potential sources of heterogeneity and study biases were evaluated. From 10 169 abstracts reviewed, 121 studies (82 [68%] randomised controlled trials and 39 [32%] quasi-experimental interventions) met the eligibility criteria. Most studies were done in North America (57 [47%]), and Europe, Australia, or New Zealand (36 [30%]). The median number of participants was 413·0 (IQR 124·0–904·0), and median duration of intervention was 9·0 months (4·5–18·0). Workplace wellness programmes improved fruit and vegetable consumption (0·27 servings per day [95% CI 0·16 to 0·37]), fruit consumption (0·20 servings per day [0·11 to 0·28]), body-mass index (−0·22 kg/m2 [−0·28 to −0·17]), waist circumference (−1·47 cm [−1·96 to −0·98]), systolic blood pressure (−2·03 mm Hg [−3·16 to −0·89]), and LDL cholesterol (−5·18 mg/dL [−7·83 to −2·53]), and to a lesser extent improved total fat intake (−1·18% of daily energy intake [−1·78 to −0·58]), saturated fat intake (−0·70% of daily energy [−1·22 to −0·18]), bodyweight (−0·92 kg [−1·11 to −0·72]), diastolic blood pressure (−1·11 mm Hg [−1·78 to −0·44]), fasting blood glucose (−1·81 mg/dL [−3·33 to −0·28]), HDL cholesterol (1·11 mg/dL [0·48 to 1·74]), and triglycerides (−5·38 mg/dL [−9·18 to −1·59]). No significant benefits were observed for intake of vegetables (0·03 servings per day [95% CI −0·04 to 0·10]), fibre (0·26 g per day [−0·15 to 0·67]), polyunsaturated fat (−0·23% of daily energy [−0·59 to 0·13]), or for body fat (−0·80% [−1·80 to 0·21]), waist-to-hip ratio (−0·00 ratio [−0·01 to 0·00]), or lean mass (1·01 kg [−0·82 to 2·83]). Heterogeneity values ranged from 46·9% to 91·5%. Between-study differences in outcomes were not significantly explained by study design, location, population, or similar factors in heterogeneity analyses. Workplace wellness programmes are associated with improvements in specific dietary, anthropometric, and cardiometabolic risk indicators. The heterogeneity identified in study designs and results should be considered when using these programmes as strategies to improve cardiometabolic health.