When Peter Mongeau, vice president of human resources at financial services company John Hancock, was offered the opportunity to have his employees participate in a pilot wellness program focused on nutrition, he jumped at the chance.

John Hancock has a history of providing health and wellness programs - everything from health risk assessments to biometric screenings to onsite gyms and lifestyle management programs - but Mongeau believed "our next step was to put food first and to help them [employees] be mindful of what they eat."

So it jumped on board with The Full Yield, a Danvers, Mass.-based health and wellness company committed to making food the centerpiece of improving public health. The Full Yield piloted a 12-month program with seven Boston-area employers, of which John Hancock was one.

Mongeau and Judith Frampton, principal with Judith Frampton LLC and former vice president of medical management with Harvard Pilgrim Health Care, one of John Hancock's insurers, presented the results of the project at the Care Continuum Alliance Forum last month in San Francisco. Employers from a variety of industries offered the program to their employees on a first-come, first-served basis. In the end, 912 employees from both the private and public sectors participated in The Full Yield's program, which emphasizes whole foods.

And even though obesity ranks as one of America's biggest health care challenges and has severe cost implications for employers, weight loss was not the program's main goal.

"This was about eating in a healthy manner that made you feel good," said Frampton. "For many, weight loss was an outcome but it wasn't the primary goal."

The Full Yield program starts with a 30-day immersion into a whole foods based way of eating. With the help of a robust website and personal coaches, employees were taught how to eat better, cook better, manage their stress and increase their physical activity. Employees worked with their coaches to set realistic goals, which appealed to Mongeau.

"There are quarters in which metrics are done. But what was most important to us was that we provided education and a personal connection and coaching," he said.


The results

Of the 912 employees who participated, 35% had one or more chronic condition, 82% had one or more risk factors and 34% had three or more risk factors. Almost two-thirds (64%) had a body mass index of greater than 25.

After 12 months of following The Full Yield program, 52% had lost weight, 59% had improved their BMI and 95% had improved their cholesterol levels. Other results included:

* 89% increased their intake of health supporting foods

* 86% decreased their intake of health depleting foods

* 34% reported improved sleep quality

Mongeau was so pleased with the results that John Hancock recently launched the program nationally. "The pilot results show the program works, so we're throwing a lot at it," he said.

Mongeau, who described himself as a healthy eater and somewhat of a "food snob" prior to the program, was surprised at how much he learned. "An oat gets refined into a Cheerio. That was an enlightening moment for me when I realized what I was feeding my own four kids," he recalled.

And he believes The Full Yield program will do much to improve employee engagement and loyalty. "Something that was really gratifying was that our workforce saw this as not something that would have been transformational for them had we not brought it to them."


Changing lives

"Our fate is determined by what we put in our mouths, 21 times each week," said Dr. Charles Taylor, MD, medical director with the Taylor-High Clinic Center for Preventive Medicine. Taylor and Anne Gannon, constitutional tax collector for Palm Beach County, presented another session at the CCA Forum focusing on nutrition and the importance of putting food first.

Gannon's office employs 290 people, mostly women. Its health care costs average about $3 million a year.

"We really made a commitment to not just look at the cost issue," said Gannon. "It was about working with our employees to make them healthier. I wanted to help them get to the point where they understood they could change their lives by what they put in their mouths."

The organization's first health risk assessment, conducted in 2008, revealed 67% of employees were clinically overweight. More than two-thirds (68%) were at risk for hypertension, while more than half (56%) had elevated blood sugar.

After gaining the support of senior leaders, Gannon tried the usual methods - providing online HRAs, hosting health fairs, offering pedometers - with some success. But shewanted more. She changed gears and began incenting good health habits with a more comprehensive program that educates employees about their health numbers, teaches prevention and rewards participation.

Employees are encouraged to participate in annual biometric screenings which measure their glucose, lipids, BMI, blood pressure and tobacco use. Employees who participate receive a confidential health report card that places them into various risk categories:

* Low risk - no biometric measures out of normal range.

* Moderate risk - one or two biometric measures fall into moderate risk ranges but none in a high risk range.

* High risk - one or more biometric measures fall into the high risk range category or three or more fall into the moderate risk range.

Moderate risk employees then attend three one-hour sessions with a registered dietician to learn eating and lifestyle strategies to reduce the risk of circulatory disease. High risk employees attend eight nutrition and lifestyle sessions and have weekly individualized coaching to help with risk reduction. Low risk employees can attend three weeks of risk reduction classes on a voluntary basis.

The course content emphasizes plant-based nutrition as a key strategy in risk reduction. The curriculum covers nutrition and disease, principles of nutrition, shopping for good health, substitution principles, food myths and marketing, and the benefits of taking 10,000 steps per day. Classes are held onsite during work hours and class sizes are limited to ensure personal interaction with the dietician.

Employees who participate in the biometric screenings receive a $100 credit in a health reimbursement account, while employees who participate in the lifestyle and nutrition classes receive an additional $250 in their HRA.

The program is entering its second year and employees are slowly becoming more comfortable, said Gannon. Still, "we do have some employees who are still very leery about doing this. They don't want their employer to direct them in how to eat," she said. "But it's a partnership with the public because the public actually pays the health care costs of our employees. We're struggling with getting those employees incorporated into the program."

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