Ricardo T.

Balagot, MD, FPCOM

DOLE-OSHC OSH Practitioner
Objective:

⚫ Todiscuss the importance of

Nutrition in Occupational Health
Introduction:

⚫ Nutrition is an element of a healthy workplace

The importance of adequate nourishment
for general health and work productivity hardly
needs emphasis.
1930-Scholarly articles on the subject began
1946- Nutrition in industry ( ILO ), a book
about feeding workers in large
enterprises.
⚫ 1956-InternationalLabour Conference
and various ILO committee adopted
Welfare Facilities Recommendation
( No. 102 ), which specifies guidelines
for the establishment of canteens,
cafeterias, mess rooms and other
food facilities.
⚫ Focus change from ensuring
enough food to obesity in develop
countries but the guideline remains
significantly in developing countries
where workers often have poor
diets.
⚫WHATIS GOOD
NUTRITION?
Right Kind of Foods Means
Good Choices of Food Intake

Today, most people have

access to a wide range of
foods.
All foods have their place in a
diet that meets our nutritional,
social and emotional needs.

There are no good foods or bad foods. No food is

forbidden. The key is to find the right balance. One
way of finding this balance is presented by what is
known as the Food.
Right amount of food:

A well balanced daily meal

plan should consist of the
following:
▪ 30-20% Fats

▪ 20-10% Proteins

▪ 50-70% Carbohydrates
 1 gram of Fat = 9 kcalories

1 gram of Carbohydrates = 4 kcalories

1 gram of protien = 4 kcalories

General Recommendation for a healthy diet:

Carbohydrates should consist mostly of the complex

types (starches 90%) and simple carbohydrates (sugars)
should make up 10% of the total carbohydrates intake.
A Balance of Caloric Intake and Caloric output

1. Calories provide the energy that the

body needs to survive.
2. Recommended total daily caloric intake
is 1,500 to 2,000 kilocalories.
3. Each person’s daily caloric and
nutritional needs are different.
4. The dietary sources of calories are fats,
carbohydrates (starch and sugars) and
proteins.
- Saturated fats raises blood cholesterol. Saturated fatty
acids should be less than 10% of total calories (animal
fats, butter, oils, egg yolk, whole milk)

- Polyunsaturated fatty acids should comprise about 10% of

calories and monounsaturated fatty acids make up the rest
of fat intakes, about 10-15% of total calories

- Cholesterol intake should be no more than 300 mg per

day.

- Sodium intake should be no more than 3,000 mg (3gm)

per day.
 Why is Nutrition
essential to
Occupational Health…
Based on 2008 National Nutrition Survey:

⚫ Impaired and high fasting blood sugar

increased with age
⚫ Prevalence of high total cholesterol averaged
7% for men and 13% for women.
⚫ Women are almost twice more likely to be
obese than men.
⚫ Prevalence of obesity was highest among
men in the 30’s and 40’s and among women
in the 40’s and 50’s
⚫ Less than ¼ of adults had work related
physical activity, with little variation by gender
and age group.
Source: ILO 2012
⚫ Micronutrient deficiency account for 2-3%
of loss in GDP in low-income countries
and in South East Asia, iron deficiency
accounts for a loss of 5 billion US dollars
in productivity. Iron deficiency accounts up
to 30% impairment of physical work
capacity and performance. Obesity and iron
deficiency both result in fatigue and loss of
dexterity.
ADDRESSING THE NUTRITIONAL NEEDS OF A WORKER OR
AN EMPLOYEE PROVIDES BENEFITS TO BOTH THE
EMPLOYER AND EMPLOYEE

BENEFITS TO EMPLOYEES:

1. Maintains good health – one way of

maintaining good health is proper
nutrition aside from enough physical
exercise and enough sleep/rest.
2. Promotes a well organized bodily functions.
3. Prevents food-borne disease-sanitary
preparation and handling of food
CLASSIFICATION OF FOOD-BORNE DISEASES
Food Borne
Diseases

Food-borne Food Poisoning or food

infection intoxication

Bacteria Parasistic Viral Bacteria Plant or Chemical

• Cholera •Ascariasis •Hepatitis A • Staphylococcal Animal Accident
• Typhoid Fever •Ameobiasis •Rotavirus • Botulism (C. •Some •Arsenic
• Bacillary •Trichinosis •Others Botulinum) mushrooms •Lead
Dysentery •Giardiasis • Streptococcal •Some •Cadmium
• Salmonella •Balintidiasis • Bacillus cereus mussels •Cyanide
Infection •Others •Certain •Antimony
• Other gastro- herbs •Nitrites
intestinal •Some •DDT, etc.
diseases fishes
•Others
 MODE OF TRANSMISSION OF
FOOD - BORNE DISEASES

Air
POISONS
RESPIRATORY/
ORAL DISCHARGES SUSEPTIBLE
INDIVIDUAL
FOOD
SICK PERSON
HANDS
DISEASES
OPEN WOUNDS
DISABILITY
DEATH

INSECT/RODENT
Infected Animals
CARRIER

INTESTINAL
DISCHARGES DRINKING WATER
Benefits to workers (Cont’d)

4. Increase body resistance – improves immune

system
5. Prevents diseases related to improper food
intake (HPN, CVD, Stroke, Diabetes,
Arthritis, Colonic, Breast and Prostate CA,
Obesity, Vitamin, Iodine, K def.) and food
allergies.
6. Increases job performance - increase physical
strength, good decision making, sense of
well being.
7. Increase possibility of job promotion-
good performer.
8. Less prone to accidents and injuries –
increase physical strength, increase
alertness and good reflexes
9. Reduces medical cost.
10. Improves quality of life and self esteem
Benefits to employer:

1. Reduces absenteeism
2. Increases productivity
3. Maintains a good harmonious workplace
environment
4. Increases company image (decreased
incidence of occupational diseases,
accidents/injuries
5. Reduces total medical cost
Factors to consider:

1. Socio-economic status – ability to buy

right kind and amount of food
2. Number of family members – sharing
food to a larger family
3. Ignorance / individual’s choice of food,
disorderly eating habits
4. Stress, boredom – anorexia or excessive
food intake
Factors to consider:

5. Level of employment – R & F,

Supervisor/Manager, Manual and Non
Manual
6. Food source – cafeteria, restaurants,
canteens, vendors, home-cooked food
7. Health Status – disease of life style,
alcohol, smoking, substance abuse
8. Age- younger worker requires more
energy generating foods
 Factors to consider:

9. Heredity- genes partly influence how you body

manufactures and handle cholesterol. Being
overweight raises LDL-Cholesterol and lowers
HDL-cholesterol
10. Increased physical activity – lowers LDL-
Cholesterol and raises HDL-Cholesterol.
11. Weight Loss – indicative of serious physical
and psychological illness.
12. Shiftwork – Digestive problems
13. Impact on fitness to work
Philippine Data

Overweight and obesity affects 27 adults

in every 200.

About 12 in every 100 adults, 20 years

and over were chronic energy deficient
(CED)

Source: ILO 2012

90% of Filipinos has one or more of these
6 prevalent risk factors:

Diabetes 4.6%
Obesity 4.9%
Hypercholesterolemia 8.5%
Hypertension 22.5%
Smoking 34.8%
Physical inactivity 60.5%
Source: ILO 2012
Global Data

▪ Obesity: People of all ages and

backgrounds face this forms of
malnutrition.
▪ More 1 billion adults are overweight and
at least 300 million of them are clinically
obese.
▪ An estimated 17.6 million children under
five are estimated to be overweight
worldwide.
Source: ILO 2012
Requirements for drinking water facility

⚫ Should be available within 200 ft from any

location of worker
⚫ At least one sanitary drinking fountain for
every 50 employees
⚫ No cross-connections between drinking water
supply and supply for industrial processes
⚫ Label water sources that are not potable
⚫ Drinking water should be protected from
backflow (from industrial processes)
How to address the nutritional
need of a worker
 WORKER HEALTH ADVISORYY

Healthy and Safe Eating in the Workplace

WHAT YOU SHOULD DO!

 Engineering Controls
Use physical /acrylic
barriers between eating
areas or use non
movable chairs to
regulate distance
Maintain adequate Set-up washing
ventilation and facility and sanitizing
exhaust stations
 ADMINISTRATIVE CONTROLS

Wash your hands

thoroughly before and
after each meal

Eat alone on your

work station if Follow floor,
possible table and chair
marking
 ADMINISTRATI VE CONTROLS

Schedule alternate Bring your own

mealtime to limit people utensils and
in the pantry/cafeteria cups

Practice physical distance

when sharing a table or
back to back seating
when possible
PERSONAL PROTECTIVE EQUIPMENT

Replace used mask after eating,

and wear it properly

Throw disposable mask in

designated trash
 WORKER HEALTH ADVISORYY

Healthy and Safe Eating in the Workplace

WHAT YOU SHOULD NOT DO!

Do not put used mask in
your pocket or bag or
place it on the surface of
your work table
Do not pull down your
mask under your chin or
partially cover your nose
or let the mask hang on
your ear when eating
 No face to face small talks
when eating. Don’t talk when
your mouth is full

Do not eat with your bare

hands without washing.
Avoid nibbling snacks
while working
 No sharing of No conversing
meals or when eating
borrowing utensils

Do not share
Do not stay
condiments
longer than
necessary in
common
areas
Standard Drinking Water Facility

No. of Employees No. of SDW Facility

1 - 50 1
51 - 100 2
101 - 150 3
151 - 200 4
201 - 250 5

*Refers to faucet, fountain, dispenser or any other suitable means

Provision of water closet
Continuation:

Advise on lifestyle related diseases

Monitoring of nutritional status of worker

(during APE and daily consults)
BMI (height to weight ratio)
Less than 18.5 – Underweight
18.5 – 24.9 – Normal
25.0 – 29.9 – 1st Degree Obese
30.0 – 39.9 – 2nd Degree Obese
40.0 & Above – 3rd Degree Obese
Continuation:
The higher the BMI – the higher the risk of
developing associated conditions.
> 25 BMI – increase mortality and morbidity

waist circumference
males = < 90 cm.
females = < 80 cm
waist to hip ratio
Laboratory exams- CBC, Blood Chemistry
(FBS, Uric Acid, lipid profile)
Continuation:

Cost effective medical management –

specific medical advise on specific illnesses and
associated conditions. Use of therapeutic agents.
Physical fitness program – aerobic exercises,
sports fest
Risk reduction – smoking cessation, BP control,
stress management, weight management and
control
 Aside from good, healthy diet, there are
other things that one can do to maintain
good health:

Physical fitness program- aerobic

exercises, sports fest, etc.
Good sleep and enough rest
Stress management
Regular exercise and weight loss- at least 30
minutes of regular daily exercise will give a
moderate weight loss of five to seven percent
body weight (10 to 15 pounds). Weight loss
and exercise reduces a person’s ability to use
insulin and manage glucose (blood sugar)
Exercise also reduces the risk of heart
conditions, stroke, some forms of cancer, and
many other health problems.
An easy guide to any physical activity
Be active, get fit and stay healthy
1. For the beginner the amount cumulative activity time is
more important than the specific type and manner of
activity.

2. Everyday physical activity counts. Weaving-in more

activities into you daily routines make you metabolically
efficient. Day to day activities are cheap, convenient,
easy-to-do and should be done habitually.

3. To improve your cardiovascular endurance, you can

choose to do aerobic exercises 3-5 times a week at least
30-45 minutes or longer a day. Doing it regularly also
helps you loose and/ or prevent weight gain
4. Recreational activities are not only enjoyable but also
healthy. If done regularly it can help you improved
your physical fitness level.
5. Strength and flexibility activities are important for
muscle toning. It also helps you burn some excess
fat if you do it often together with other activities.

6. Leisure Activities are enjoyable too. It makes you

burn some calories but is not advised as a principal
or main activity if your goal is weight reduction or
improvement of cardiovascular endurance.

7. To make leisure activities or strength and flexibility

activities effective for health, they have to be done
often: at least 2-3 times a week 30-45 mins or longer.
8. Activities that will burn the least calories should be
avoided.

9. You will feel better, look younger, maintain healthy weight &
live longer with regular physical activities

10. No one is too old to enjoy the benefits regular physical

activities.

11. Select any level in the Activity Pyramid that best fits your
lifestyle and health needs just 30 minutes of the different
activities over the course of the day is healthy.
12. For health: We need to burn 700 kcal – 1000 kcal per week.
e.g. For 60 kg. Female- walking briskly for 30 minutes will
burn 180 kcal x 5 days = 900 kcal per week

13. To loose 0.5 lb a week , burn at least 2,000 kcal-3000 kcal

per week. ( Assuming the person has the same caloric
intake).
e.g. For a 75 kg Male –walking briskly for 45 minutes will
burn 338 kcal x 6 days = 2,028 kcal per wk
14. Talk to your Doctor if you have any health concers before
starting any physical activity.
⚫ Live an active lifestyle - Behavior and
lifestyle modifications are the best
anchor to prevent diseases of lifestyle.

⚫ Risk reduction - smoking cessation,

BP control, stress management, weight
management and control, avoidance of
too much alcohol.
For the employer, workers and
government, proper nutrition in
the workplace is a win-win-win
proposition
 A well balanced dietary intake means
proper nutrition. Proper nutrition means
good health.

“Health is Wealth”
Thank you!