Nearly a billion people across the world are undernourished, while over one billion are overweight or obese, a stark contrast between the haves and have-nots. This is the disquieting scenario presented by a new International Labor Organization (ILO) book, which stresses that unhealthy eating practices at workplaces will result in a staggering blow to productivity and health.

The publication - 'Food at Work - Workplace Solutions for Malnutrition, Obesity and Chronic Diseases' - says that there is as much as a 30 per cent impairment in physical work capacity and performance reported in men and women with iron deficiency or Hypoglycaemia. (Hypoglycaemia, or low blood sugar, can occur when one skips a meal. It shortens attention span and slows the speed at which humans process information.) Iron deficiency affects up to half the world's population, predominantly in the developing world. Thus, poorer nations remain in a cycle of poor nutrition, poor health, low productivity, low wages and no development.

he book, released here in November, addresses a simple question - how do workers eat while at work? It observes ironically that employers do not give much thought to this question, though it is in their interests to provide their workforce with nourishing food or at least access to healthy food in order to maximize productivity. ILO's Sub-regional Director Leyla Tegmo-Reddy says that, in South Asia, iron deficiency alone accounts for a loss of US$ 5 billion in productivity. "Employers bear the cost of lost productivity, whether this arises from reduced output by sluggish workers or sickness, disability, absenteeism or premature death."

The stresses inherent at the modern-day workplace, be it a plush office in a high-rise complex, stuffy shops and factories or the laborer on the street and fields, employers tend to bypass a healthy eating programme at work.

Work, instead of being accommodating, is frequently a hindrance to proper nutrition. Canteens, if they exist, routinely offer an unhealthy and unvaried selection. Vending machines are regularly stocked with unhealthy snacks, while local restaurants can be expensive or in short supply and street foods can be bacteria-laden.

The importance of food at work is reflected in the Millennium Development Goals (MDGs), which set targets of halving, by 2015, the proportion of people who suffer from hunger and those without sustainable access to safe drinking water and basic sanitation. But the grim reality is that workers sometimes have no time to eat, no place to eat or no money to purchase food.

Some workers are unable to consume enough calories to perform the strenuous tasks expected of them. Agricultural and construction workers often eat in dangerous and unsanitary conditions. Mobile workers and day laborers are expected to fend for themselves. Migrant workers, far from home, often find themselves with no access to local markets and no means to store or cook food. Night shift workers find they have few meal options after hours. Hundreds of millions of workers face an undesirable eating arrangement every day and many go hungry and fall sick, sooner or later.

The book also highlights the gender dimension to this problem. Women of child-bearing age are particularly at risk of low blood iron and access to healthy foods at work during pregnancy and nursing. The right to nurse at work and adequate rest will also help to ensure better health for the baby and mother, it stresses.
"When this is added to cultural practices, which often result in women receiving the smallest share of whatever food is available at home - after their husbands and children - it can be seen how important the need for access to sufficient food at work is," adds Tegmo-Reddy.

The book presents mostly positive examples of how governments, employers and unions are trying to improve the nutritional status of workers. In wealthier countries - where obesity and related chronic diseases, like cancer, diabetes, cardiovascular disease and kidney problems are almost an epidemic - examples are given of employers offering healthier menus or better access to healthier foods, such as on-site farmers' markets. In developing and emerging economies - where hunger and micronutrient deficiencies, such as anemia are epidemic - are the problem, there are instances of employers offering free, well-balanced meals or access to safer street food.

The West Bengal government has found praise in the book for what is described as the "Calcutta model", under which the state government and street food vendors have joined hands to improve hygiene and infrastructure to provide clean, nutritious street food, which is widely popular among the city's workers.
The "Calcutta model" is based on a case study by Indira Chakravarty, Dean of the Department of Biochemistry and Nutrition, All India Institute of Hygiene and Public Health, Kolkata who found that workers in the informal sector have no option but to eat street food. Vendors, however, had little knowledge of basic hygiene and illegal food additives, thereby jeopardizing workers' nutrition. The study revealed that both the government and vendors were willing to improve the situation, with vendors agreeing to zoning, unions agreeing to training and the government agreeing to infrastructure improvements like more rubbish bins and potable water sources, as well as low-interest loans. The "Calcutta model" has since spread to neighboring areas, Chakravarty adds.

As per India's Factories Act, 1948, employers are required to provide canteens at establishments that have more than 250 employees at a facility. Companies can bypass this rule by offering vouchers. A case in point is the TELCO factory in Mumbai, owned by the TATA group, whose management decided to provide tickets to employees to purchase lunch in the dozen or so eating places situated close to the factory. However, some of these places were not very clean and the food not nutritious, so TELCO created coupons of a set value that could be used at better restaurants.

The bottom line, says Dr Arjun Sengupta, Member of Parliament and Honorary Advisor, National Commission on Enterprises for the Unorganized/Informal Sector, is not for employers to just open canteens or provide food vouchers. They must look into the whole question of nutrition deficiency and work out the costs of providing these to their employees.

He feels the voucher system could address the issues of malnutrition and iron deficiency in India because "it (vouchers) has specific items which provide the nutrition". He also favors employee-run canteens, but adds that employers need to work with unions and the government to explore viable, economical options on providing food at the workplace without compromising on hygiene and nutrition.
Nutrition is a wise company investment, 'Food at Work' advises employers. In industrialized nations, employers are increasingly aware that merely providing a meal programme or access to food can be counterproductive if that food is not healthy. Employers in developing countries need to wizen up as "good nutrition will make for a stronger, better-equipped workforce that, in the long run, will make their company and country more competitive and more attractive to investors."