Promoting good health

Aside from offering traditional OH services, over the past year, Unilever has
been running an innovative pilot project designed to address the physical and
mental health needs of its leaders, by Nic Paton

Unilever is the company behind such household favourites as Marmite, Flora,
Persil and Magnum ice cream.

Less well known is the fact that UK chairman Richard Greenhalgh is a trustee
of the British Occupational Health Research Foundation, and that Unilever’s
founder, William Lever, was famous for recognising the importance of a healthy,
well-motivated workforce.

In the UK alone, Unilever has sales of £2.3bn and employs some 15,000
people. Occupational health services include risk assessment, health
surveillance and promotion, access to medical checks, well-person checks,
absence management and pre- and post-travel medical advice and surveillance.

There is a well-equipped gym at the firm’s London head office, while the OH
team comprises four full-time doctors, about 20 to 30 full-time nurses, plus
support from a pool of part-time nurses.

Pilot project

The company also launched an innovative pilot project last September,
designed to address the physical and mental health of the company’s leaders.

Run by Dr John Cooper, Unilever’s head of corporate occupational health, the
programme has taken as its basic premise the fact that most executives don’t
have a great deal wrong with them medically. What they do need, instead, are
tools to help them become more productive, to sleep better, be more alert, have
more stamina and to deal with stress and pressure more effectively.

While it is still early days, the first results of the programme, revealed
to Occupational Health, have thrown up some interesting findings.

The voluntary programme initially invited the top 42 of its most senior
leaders within the company to take part. All but one agreed to participate,
despite heavy schedules and demands on their time, including a lot of overseas

The first part of the programme was a standard health-risk appraisal,
looking at areas such as sleep patterns, tiredness, energy, blood pressure, and
fats and cholesterol levels. The executives also discussed their own aims and
objectives, which ranged from weight issues to dips in energy and sleep and
food complaints.

This was followed by a personal coaching session with a Unilever
biokineticist, Dean Patterson, in the in-house gym, to assess fitness levels,
body fat and to check whether they were up to continuing with the programme. A
personal fitness programme was then drawn up.

The third element of the programme is a nutritional assessment, looking at
diet to assess what mix of vitamins, minerals and supplements executives are
getting and whether there is more that can be done to maintain energy and
stamina levels, particularly when travelling a lot.

Under Patterson, pre- and post-fitness calculations have been worked out for
the 41 participants, measuring their fitness and body fat levels when they
joined the programme, compared with how they are doing six months later.

While it is still in the early stages, participants have shown an
improvement in energy, stamina, general health, recovery from travel and
motivation, he argues.

Patterson has been looking at areas such as blood tests, cholesterol levels,
hormone levels, upper body strength, body size and waist-to-hip ratio. Between
40 per cent and 60 per cent of participants in the programme have shown
improvement in all these areas, he says.

Fitness on the move

One of the key elements of the fitness programme, bearing in mind these are
executives who travel a lot, has been to make it as personal and as portable as

"Drop-off rates in these sorts of programmes are normally around 40 per
cent, but once you get it personalised, it drops to between 10 per cent and 20
per cent," he argues. "If you push them harder, they seem to enjoy
it, it seems to make them raise their game," he adds.

The participants are encouraged to visit Patterson at least once a week and
a maximum of five times a week. They may only be able to come in for a
half-hour session, so the emphasis is on training and coaching techniques that
they can do themselves at a later time, he explains.

Nutritional element

When it came to the nutritional element of the programme, Dr Cooper is an
advocate of nutritionist Patrick Holford’s Optimum Nutrition movement, which
contends that molecules in certain foods can hinder or enhance the function of
the brain and other cells in the body.

All but one of the participants followed the advice given and took the
supplements and vitamins on offer and adjusted their diets. Of these, all but
one found they lost weight and 25 per cent reported moving towards a normal
weight for their height. So far, one executive has reported improvements in his
cholesterol levels, with the results for the rest of the group yet to come.

When it came to sleep patterns, a quarter again said they had seen
improvements. "They are learning how to get their energy from food so they
are taking less stimulants. They are eating to a better pattern so they are
drinking less caffeine," says Cooper.

The average increase of sleep was an extra hour a night. "Just getting
a better night’s sleep is going to make people function better," adds
Cooper. And a fifth said their skin condition had improved, with one even saying
his hair was thicker.

A third said their digestion had "improved out of all proportion",
with improvements including less bloating and not suffering so much from

"A third of the participants said they have had more energy and more
stamina, particularly when they were going through a long afternoon when they
might typically have had a bit of a dip. In fact, 75 per cent reported at least
one significant improvement," says Cooper.

Comments from executives taking part in the programme included: "the
improvement in my alertness is remarkable", "it has significantly
reduced my desire for sweets", "I have more stamina and energy",
"nuts and seeds, I love them, where have they been all my life?".

With such a small sample, Cooper readily admits his results are unlikely to
make it into any medical journals. But what is significant, he argues, is the
fact these were relatively quick results, after just six months, and were
produced in people who had nothing wrong with them medically.

The next step

The obvious success of the programme has been such that it is now being
extended to a second tranche of managers, a further 80 or so, all of whom are
predominantly still at a senior or middle management level within the company.

Some elements of the programme are still to be fully assessed. The original
blueprint outlined looking at an executive’s heart rate variability, or the
time between each individual heartbeat. Some researchers have linked patterns
of heart rate variability, of which there are always microscopic differences,
with cognitive function.

The programme has been looking at ways and techniques to improve heart rate
variability. However, the external consultant earmarked to take on this part of
the programme has been so tied up on other areas, it has yet to really get off
the ground.

"The initial feedback here has been superb. Three or four people
practising the techniques swear by it," says Cooper.

The next stage will be to try to link the health improvements seen so far to
the possibility of improved productivity, through the introduction of a
scorecard. This will simply ask participants to log their progress on the
programme and any changes that have occurred.

There will also be performance-tracking research carried out, looking at how
far, or if at all, productivity and performance has changed while they have
been on the programme and if there is any association with it. Another element
has been developing coaching on tactics for executives to handle pressure
better, reduce stress and release energy.

A CD on stress has been distributed among the participants and they have
also been given to a net-based questionnaire to help them handle stress,
analyse pressure and to work better on developing coping skills.

"Stress is actually all about how you handle pressure. Often the worst
thing you can do is send someone off to see a doctor," says Cooper. They
are also offered a phone interview from a psychologist to advise them on the
best course of action.

While Cooper’s work may be on a small scale, it holds out the prospect of
changing how organisations think about the health of their key personnel. Even
those who appear outwardly healthy can benefit from clearly thought-out and
targeted strategies, improving their general health, emotional and physical
outlook, productivity and stamina.

"It is not hard science, it is partly subjective, partly
objective," admits Cooper. "But we should never underestimate the
importance of feeling better. It is early days and the numbers are small, but
it is encouraging. People feeling better perform better. If we can build up a
link between health and performance, I think that would be useful," he

Nutrition is key to health and well-being

Nutrition is an area overlooked by
many businesses when it comes to looking at the health and well-being of their
managers and staff, suggests Lorraine Perretta, director of consultancy, which has been working with Unilever on the programme.

Nutritional advice is very much linked to the idea it is not
that you necessarily need to reduce stress, but that you need to look at how
your body handles stress. "People have misconceptions about what we are
going to tell them. I have never asked somebody to soak beans," says

Good nutritional advice needs to fit into a person’s lifestyle,
whether they cook at home or generally eat out. It might be as little as making
sure there is a bowl of fruit on the desk or ensuring they drink lots of water
or snack on nuts rather than chocolate.

"When they increase the amount of water they are taking
in, they are drinking less caffeine," says Perretta.

Setting realistic targets is also vital. It is no use demanding
that staff eat five portions of fruit or vegetables a day when it might be much
more constructive to suggest they start with two pieces of fruit and work from

"We have seen the reduction or elimination of digestive
problems, often ones that have persisted in spite of medical investigations. We
have had improvements in sleep – an extra hour a night works out at a whole
night a week," she explains.

Many of the executives on the programme have also reported
improvements in skin conditions, and increased alertness.

Nutrition can be about weight reduction but it is also normally
about much more – improving people’s whole health, she argues.

Case study: Unilever’s Howard Green

Howard Green, Unilever’s head of
investor relations, considers himself relatively fit and healthy. Green, 53,
plays hockey, squash and golf on a regular basis and tries to eat as well as a
hectic schedule, including a lot of travel overseas, will allow. Yet he has
been impressed by the results of Dr John Cooper’s programme.

"What the programme has given me is a practical and
professional insight into a number of important aspects of my health and
lifestyle," he says. "I now have a little book about optimum
nutrition on my desk, which I flick through now and then."

The programme has also been set up to adjust to his way of
life, rather than trying to fit him into something that doesn’t feel right or
is impractical. "I have not had to change anything, although I might now
take a vitamin supplement or two. There are no horrible grey bowls of muesli,
and I do not have to inflict misery on my body," he says.

He has also found the personalised training regime invaluable
because it has pushed him harder than he might have done by himself, leading to
better results.

"I have lost weight, about nine or 10 pounds. I have more
energy, and people have said I am less stressed. The only thing that has not
changed are my sleep patterns, which are still awful. I have got into a bad
habit but I plan to speak to OH about that. I did not feel unhealthy before,
but I feel a lot better now," he says.

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