Background
EFAD became a member of the EU Platform on Diet, Physical Activity and Health in 2005 as both organizations have shared aims in improving the health of the European population.

As stated in “Diet, Physical Activity and Health – a European Platform for Action” March 2005, the purpose of the EU Platform is to:
 “Provide a forum where interested actors explain their plans to contribute concretely to the pursuit of healthy nutrition, physical activity and the fight against obesity.
 Outcomes and experience from actors’ performance can be reported and reviewed, so that over time better evidence is assembled of what works and Best Practice more clearly defined”.

Dietitians are in a key position to influence the promotion of a healthy lifestyle. They are educated in nutrition, which spans public health/health promotion to the clinical treatment/management of disease, and have the skills to interpret and communicate the theoretical knowledge to enable individuals to make appropriate choices about food.
A fundamental part of the work of the Dietitian has for many years been in counseling and supporting people who are overweight or obese or have obesity related conditions such as diabetes and coronary heart disease.
They have also held a strong commitment to health promotion and disease prevention

In 2007 the EU Platform focused on health in the workplace and held a workshop to share examples of what the Platform members were doing in this arena.
Members of the National Dietetic Associations (NDA) within EFAD play a large role in the promotion of health in the workplace through the development of policy, recommendations about catering provision, lifestyle campaigns for staff and individual staff consultations, so felt they could contribute to this theme 

Purpose of this report
This report has been developed following a workshop held as part of the EFAD General Meeting in 2007. The purpose of the workshop was to:
 raise awareness of work of the EU Platform,
 encourage EFAD members to develop or participate in local Platforms,
 share examples of good practice between participants of the dietetic role in the workplace,
 encourage members to submit examples to create a portfolio of examples to be held on the EFAD website.

This report and portfolio represents a small proportion of work that is actually being undertaken in this area. The examples demonstrate the range and diversity of the dietetic contribution to health in the workplace and it is hoped will provide ideas and a stimulus for others thinking of embarking on work in any of the areas discussed. It creates the opportunity for sharing of information and allows others to learn from the experience of those who have already started work in the area
A further aim is to raise awareness of the diverse nature of the work of Dietitians, and assist other professions in recognizing the contribution dietitians can make to health.

What have we defined as the Workplace?
For the purpose of the workshop and this report the workplace included:
●    Health care – hospitals/clinics/nursing homes/residential care. Dietitians routinely provide clinical nutritional intervention for people being cared for but also work with all staff working in these establishments and visitors to these establishments.
●    Education – schools, colleges and universities. Dietitians are employed on the teaching staff or in a research capacity where nutrition and/or dietetics are on the syllabus. Many also deliver the nutrition component of campaigns aimed at school children, students and staff and support teachers, school meal providers and school nurses to deliver the same message.
●    Other public sector workers – eg, police force, fire service. Campaigns aimed at promoting health to these workers have been developed.
●    Industry – factories, food industry. Dietitians are employed in the food industry as part of product development or in the marketing department  working on food labeling or producing marketing resources such as leaflets, posters, audio or video advertising. In many other industrial plants they work directly with employees in a health promotion capacity. 
●    Prisons. Dietitians are working in a clinical capacity with prisoners but are also in a position to influence the eating habits of both prisoners and prison staff.
●    Military. Some Dietitians are employed as members of the armed forces to provide a dietetic service for the service personnel and their families through campaigns and individual referral or as part of the catering corp, where they can influence food provision. Others work in liaison with the Military Service, delivering the same range of services.

Type of work
Dietitians play a key role in clinical nutrition, public health nutrition and in an administrative (catering) capacity in many settings but are most commonly associated with hospitals and other healthcare settings. The “Education Programmes and Work of Dietitians in the Member Countries of EFAD” EFAD 2003, substantiated by a 2008 survey (in progress) states that ≥ 50% of all Dietitians work in hospitals, ≥ 50% of administrative Dietitians in Norway and Denmark work in Nursing Homes and a significant number of Dietitians across Europe work in health education, the food, catering or pharmaceutical industry, research, education and staff and military restaurants.

In the workplace much of the work of Dietitians will be health promotion, raising awareness of the benefits of a healthy lifestyle and supporting the provision of healthy food. In some cases they will also provide a clinical role in helping employees lose weight or manage heart disease.

Specific Examples of the Dietetic contribution to Health in the Workplace
Health Promotion Campaigns to motivate and encourage employees to adopt a healthy lifestyle.

National
● Government/ other national agencies
A number of National Dietetic Associations (NDA) are working with government or other national agencies, providing dietary advice and specialist knowledge in the development of campaign materials, media information, or support for their members to enable them to participate in the campaign.
The Netherlands Nutrition Centre provides scientifically reliable, honest information to consumers and use active communication campaigns to achieve changes in behaviour. An example of one of the campaigns is “Balansday op het werk” aimed at companies employing more than 250 staff.
The Spanish Dietetic Association – Balearic Islands Dietetic Association are working with other healthcare agencies, education, sports and social activities to develop a strategic, multicentre approach for the prevention of childhood obesity. The programme includes education and promotional material for professionals and families, nutritional and dietary recommendations for menu development for school meals and foods sold in schools and a programme of subsidies for quality products from the region.

● NDA wide campaigns
The British Dietetic Association (BDA) has held an annual campaign related to obesity for a number of years, targeting different sections of the population. The NDA has produced materials for use by their members and information for members of the public accessible from the BDA website. Materials were specifically designed for use in a “Weightwise at Work” campaign.
The BDA had a national media campaign at the start of the new academic year aimed at new university and college students and supported by direct involvement of dietitians in the universities and colleges and fact sheets on the website.
The Spanish Dietetic Association – Balearic Islands Dietetic Association have the support of the Autonomous government department to run workshops on healthy eating for young people within the general programme on healthy lifestyles for the young http:/habitssaludables.caib.es/2.pdf. They have also developed teaching materials and a structured education programme for use by dietitians when teaching healthy eating to school children.

Local
● Dietitians from the Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences deliver nutrition education lessons for children and adolescents in 50 different primary and secondary schools in Warsaw, with the aim of improving nutrition and promoting lifestyle changes.
In1994 the Faculty created a Nutrition Forum for workers and students in the university but open to the public of Warsaw. They deliver 9 lectures/open discussions a year on all aspects of nutrition and lifestyle.

Individual workplaces
● Health promotion activities using the workplace as a venue to reach the workforce are common across Europe. These will include leaflets, displays in canteens and changing rooms, and are often linked to national campaigns like National stop Smoking Week – UK, National Healthy Eating Week - Ireland, Happy Heart at Work – Ireland, Happy Heart for Hospital Staff and Visitors - Ireland

Healthy workplace policies are developed across departments/agencies and usually take a more holistic approach incorporating healthy eating and activity as part of a lifestyle approach. Depending on the setting it would be expected that a healthy eating message is demonstrated in food provided in restaurants, vending machines, and at meetings held on site, is taught at appropriate points in any teaching curricula and activity is promoted by, for example the provision of changing facilities, cycle storage, access/ reduced memberships fees for gyms and sports facilities and the promotion of walking and changes in lifestyle.

National
NDA involvement at national level in the development of policy:
● Covenant Overgewicht - The Dutch Association of Dietitians are partners of the Covenant which is working on combined activities to create a less obesogenic environment.

Local
● Administrative dietitians in Norway, Sweden and Denmark are employed in a variety of workplaces to develop and deliver policies for that workplace covering menus based on national guidelines and campaigns related to healthy food.
● In the UK there are several Dietitians working on city wide schemes involving a number of partner organizations from health and the local authority, developing strategies for the provision of food in the workplace following healthy guidelines eg. Leeds Food Matters and the Barnsley Food Strategy which is part of Barnsley’s Well Being @ work campaign. The Leicestershire Health and Well-being Award is targeting large workplaces that provide dining room facilities and is a co-ordinated approach to achieve minimum standards in four aspects that affect employees health – food hygiene, healthy food choices, smoking and physical activity. 
● In Sweden some food shops employ dietitians for a few hours a week to offer advice on food and lifestyle directly to their consumers and to produce health promotion material for use in the shop.

Menu/recipe development
A major role of Administrative Dieitians is to give advice on the food served in restaurants, dining rooms and in vending facilities. Other dietitians will be involved in this type of work as part of a wider role in for example a hospital or local authority.

National
● NDA involvement.
The Danish Diet and Nutrition Association  are running a 3 year campaign targeting the users who depend on everyday food cooked and served by the dietetic service –“Den gode hverdagsmad” (The Pleasant Everyday Meal) promoting the production of healthy food and meals.
The Spanish Dietetic Association – Balearic Islands Dietetic Association were asked by the local health ministry to produce guidelines for the production of healthy food to be used across the Balearic Islands in hospitals, health centres, social services and libraries.
● In Ireland and the UK dietitians have been involved in the development of standards for the prison food service and nutritional standards for school meals.

Local
● In many countries the dietetic department will advise on the nutritional content of the food served in hospitals. In Greece some hospital food service departments extend this to food and meals served to the staff.

Individual counseling/consultations for staff.
In any of the workplaces identified dietitians in some countries are able to offer individual advice to employees or are involved in training other health professionals to enable them to work with individual employees. This may take the form of:
● Weight management groups
● Individual referral from Occupational Health departments
● In the American College of Greece a Wellness Center, made up of a Dietitian, Nurse, Health Educator and Fitness Professional are targeting college employees and students and offer counseling, workshops, wellness exposition and academic classes.