Vending machines and cafeterias at the workplace are perks that employees enjoy. However, some health experts wonder whether the workplace contributes unhealthy eating habits by offering inexpensive and easily accessible food and snacks.

Wellness gurus stress that if employers are seriously committed to creating a healthier workforce, they must take a hard look at the food and snack items in their onsite vending machines and cafeterias. Indeed, some employers are doing just that, recognizing the link between obesity and health care cost.

The Centers for Disease Control and Prevention recently reported that the health cost of obesity in the United States is as high as $147 billion annually, while similar research reports that obesity prevalence in new hires under the age of 40 is actually higher than those over 40.

"Everyone's hungry at 3:30 in the afternoon, and vending machines are solving that problem with the worst possible solution - high-calorie food that only makes you crave additional high-calorie food," says Brad Cooper, chief executive officer at US Corporate Wellness.

Cooper urges employers to negotiate deals with their vending operators that result in healthier snack options or seek out vendors that specialize in vending machines that dispense healthy munchies. Among the growing number of companies heeding his advice is Verizon Communications.

"We've partnered with our key food service vendors to provide healthier choices, whether it's at the vending machine or the cafeteria. We're pushing the nutrition information out front, and we're offering bundled meal options to make the healthier choices easier to select," says Audrietta Izlar, benefits manager for Verizon Communications.

"What we've seen is that when the healthier options are out there, they're well received by employees. Our goal is not to take anything away but to provide healthy choices and valuable information at the point of sale," she adds.

Tough love vs. Big Brother

There are multiple options employers can pursue when adding healthier vending and cafeteria options, but health and wellness experts diverge on whether to implement incremental changes or a tough-love approach.

"We are not talking about elementary schools, but workplaces occupied by adults," says LuAnn Heinen, vice president at the National Business Group on Health. "It's about having choices and steering people in the right direction." Cooper advises employers against feeling discouraged by employee grumbling about switching to vending machines that only dispense healthy items. "About 10% to 20% of employees are going to complain no matter what you do, so just mentally chalk up the first 20% of employee complaints as standard and move on," he explains.

"Don't cower when employees complain or throw out statements [like], 'Big Brother [is] telling us what we can eat.' You're not telling anyone what to eat. You've simply decided it's not in the best interest of employees to provide junk food that will make them sick over the long term," Cooper adds. "If someone would like to bring Ding-Dongs into work, you're not installing a 'Ding-Dong detector' at the office - you're simply not providing unhealthy food in a convenient manner anymore."

For employers not quite prepared to make wholesale changes, research shows pricing can be effective in steering people in making healthier food choices, Heinen says.

For example, at Quest Diagnostics, some worksite cafeterias offer a deal that allows employees a free salad after the purchase of five salads, says Fred R. Williams, director of health benefits management strategies at the company.

Williams believes that employee benefits departments should have more say in vending machine and food services procurements, given that food and snacks function as fuel for employees, thus affecting productivity.

He also sees employees pushing for creative ways to link vending machines to the company's wellness philosophy. For example, workers at one job site decided not to change the items in the vending machines, but required the vendor machine representative to turn all of the packages around, so that the buyer could see the calorie content tables on each item.

Another worksite group wanted nuts in the vending machine, but not peanuts. "They wanted almonds because they help with lowering cholesterol, but the vendor machine guy refused the request. The workers had the vending machine company assign a new person to their route who would fill the machine with only almonds," recalls Williams.

Counting calories at work

Deciding what to eat at work can be a tough call. But when menus and menu boards at job-site cafeterias are labeled with calorie and nutrition information, workers likely will select healthier food and snack options, reports the University of California at Berkley's Center for Weight and Health.

The center studied five Kaiser Permanente cafeterias to see how calorie menu-labeling influenced food selection among customers, including employees, at hospital cafeterias. Researchers examined patrons' lunchtime purchases before and after the cafeterias instituted menu labeling. They analyzed cash register records at two cafeteria sites and made direct observations at the others.

The study involved one of three menu labeling scenarios: calorie labeling on menu boards and placards at the point of purchase, a wall poster with both calorie and detailed nutrition information, and no information.

From August 2008 to November 2008, more than 500 patrons completed cafeteria exit surveys four weeks after labeling was introduced at the various hospitals, researchers report. Two-thirds of the respondents at the menu-board sites noted that the calorie information altered their purchase.

"This research showed that posting calorie counts changes patron food selections," says Karen Webb, co-author of the study and researcher at the center. "Based on the changes we observed on patrons' lunch choices, and the frequency with which patrons go to the cafeteria over the course of a week, this kind of intervention could prevent up to five pounds of unwanted weight gain per year, provided people don't compensate by eating more calories at other meals or in other settings," she adds.

Given the study's results, Kaiser Permanente will post calorie information on menu boards in the cafeterias it operates in California, Oregon and Hawaii. Where the health care provider does not operate its own cafeterias, the programs will be phased in over time.

"We are pleased to set an example that will encourage healthier choices for our employees and communities," says Dean Edwards, vice president and chief procurement officer at Kaiser Permanente.