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Combating health concerns through changes in diet

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Registered dietitian Alison Clark looks at specific health issues faced by rail workers and how dietitians can help

With 1.7 billion people travelling by rail each year, the health of workers should be a key focus – if not the key focus – of the industry.

Research shows that healthier eating and drinking choices can help workers in transport whose jobs may involve:

  • High levels of concentration, in order to maintain safety standards;
  • Coping with working different shift patterns e.g. night shifts;
  • Lone working.

Rail workers in particular also have to deal with:

  • Limited access to healthy food and drink;
  • Maintaining adequate hydration with sporadic access to toilets.

In Australia, an evidence review was conducted by dietitians which revealed the four largest health concerns amongst rail workers include: mental health, hypertension, cholesterol, and obesity. Common consequences of these were found to be heart conditions and sleep apnoea – where sleep is interrupted as a result of breathing problems.

All of these health conditions can be treated and prevented by dietetic interventions from qualified healthcare professionals, who can treat disease, prevent nutrition-related problems and flexibly promote nutritional health and wellbeing within a workplace setting using safe, practical advice based on current scientific evidence.

Mental health

The study also revealed that 18 per cent of train drivers and five per cent of train driver recruits were found to have psychiatric conditions, and people with mental health issues are at a higher risk of physical health problems than those who don’t.

Our research shows that food can have a positive impact on stress, depression and anxiety. When it comes to mental health, dietitians can use their expert knowledge and skills to translate evidence-based practice into dietetic practice. Dietetic interventions support mental health by enhancing behaviour and lifestyle as well as someone’s body image and self-esteem as part of a collective approach.

In workplace settings, dietitians can deliver evidence-based workshops and one-to-one consultations with employees, to enable workers to eat better and so better control their mood and mental health.

Photo: iStock


In the rail worker study from Australia, 44 per cent of train drivers were found to have hypertension, which is commonly known as high blood pressure. If left untreated, the risk of heart attacks and stroke increases, as does the risk of kidney and eye damage.

To help control or prevent high blood pressure, key recommendations include:

  • Cutting down on the amount of salt used during cooking and added to food at the dinner table;
  • Having at least five portions of fruit and vegetables every day;
  • Aiming for two to three servings of whole grains such as breakfast cereals and brown pasta per day;
  • Choosing low-fat dairy foods which keep saturated fat to a minimum;
  • Eating at least one portion of oily fish per week;
  • Finally, the most important lifestyle factor is to be physically active.


Almost 35 per cent of train drivers and 31 per cent of train driver recruits were found to have high cholesterol, which can lead to heart disease. Blood carries cholesterol around the body on proteins known as high density lipoproteins (HDL) – or ‘good cholesterol’ – and low-density lipoproteins (LDL) – ‘bad cholesterol’. The latter can cause blood vessels to become narrowed or blocked but a change in diet can help control high cholesterol.

In 2011, in partnership with a dietitian, Merseyrail created a bespoke workplace health awareness initiative for 50 workers. The scheme responded to the workforce’s expressed needs for more support around healthier eating and proved successful with the combined sickness levels of the entrants dropping from 155 days to 35 when compared to the previous year. This resulted in a £11,000 reduction in costs for the train company.


In a study conducted by French national operator SNCF, 2,248 members of staff out of a workforce of 7,724 were found to be overweight. Obesity can have adverse social and economic consequences, which can include lost working days.

Changing a diet is the most effective way of managing obesity. With a patient-centred approach, dietitians work with patients to encourage sustained healthy changes to diet and lifestyle, supporting long-term weight management success.

Early detection and prevention is the key

It is in the best interest of rail companies to invest in the wellbeing of their employees for the best chances of early detection, prevention which in hand results in retention. In 2018, British Dietetic Association-registered dietitian Alison Clark carried out ‘MOT’ health checks on 100 Network Rail employees. The health checks resulted in three urgent referrals for high blood pressure as well as a further 12 cholesterol and glucose check-ups.

It is important to get the right advice and nutritional services. Dietitians are the only qualified health professionals that assess, diagnose and treat dietary and nutritional problems for individuals and whole workforces and they have the skills to effect positive behaviour change.

References can be requested from the British Dietetic Association by emailing [email protected].

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