More than the worksite cafeteria: the workplace food environment of small and medium-sized enterprises in the Netherlands

Objective: To characterise the food environment of Dutch small and medium-sized enterprises (SMEs), encompassing physical, sociocultural, economic and policy features and to explore variations within SMEs according to company characteristics (number of employees, location of work and presence of worksite cafeteria). Design: Online cross-sectional survey study of a representative Dutch SME sample by a panel agency. Setting: Dutch SMEs. Participants: Three hundred and fifteen employees of Dutch SMEs responsible for food and drink in their company. Results: Most SMEs did not have a worksite cafeteria, no provision of fruits or vegetables, and did not offer discounts on food or drinks. The food environment of these SMEs varied significantly based on company characteristics. For example, SMEs with a worksite cafeteria were significantly more likely to have fruits (OR = 8<middle dot>76, 95 % CI (4<middle dot>50, 17<middle dot>06)), vegetables (OR = 10<middle dot>29, 95 % CI (5<middle dot>49, 19<middle dot>31)) and company food policies (OR = 5<middle dot>04, 95 % CI (2<middle dot>08, 12<middle dot>20)) than SMEs without. Additionally, SMEs with >= 50 employees were more likely to have fruits (OR = 2<middle dot>39, 95 % CI (1<middle dot>42, 4<middle dot>03)), vegetables (OR = 1<middle dot>89, 95 % CI (1<middle dot>04, 3<middle dot>46)) and company food policies (OR = 2<middle dot>82, 95 % CI (1<middle dot>09, 7<middle dot>29) than SMEs with < 50 employees. Moreover, having a worksite cafeteria (B = 0<middle dot>23, 95 % CI (0<middle dot>08, 0<middle dot>38)) and employees working mostly on-site (B = 0<middle dot>14, 95 % CI (0<middle dot>01, 0<middle dot>28)) were associated with stronger social norms of healthy and sustainable eating at work compared to SMEs without a worksite cafeteria and working mostly off-site. Conclusions: In SMEs, an overall comprehensive picture of the food environment points to its limited active encouragement of healthy food choices, particularly so in small SMEs without a worksite cafeteria. Company characteristics strongly influence SME food environments and should be considered when developing interventions improving SME workplace food environments.