Golden Slumbers: will corporates one day have sleep and nutrition scores?

In June, we welcomed our core trade finance brokers to the Swiss Re Centre for Global Dialogue near Zurich to deepen our partnerships and consider the future together. Our keynote was a provocative and horizon gazing look at alternative data, entitled “Building holistic medical underwriting into corporate risk analysis: sleep, nutrition, environment and physical activity”.

Our experts were Dr John Schoonbee, Global Chief Medical Officer at Swiss Re, and Dr Adam Strange, Research and Development Manager at the Swiss Re Institute, who tackled how Swiss Re’s “Big Six” lifestyle factors may evolve from markers of personal health to become more relevant to corporate underwriting. This could be in the form of aggregated sleep and nutrition scores of employees that may tell us more about the risks faced by their companies.

Dr Strange first introduced us to the “Big 6” factors – mental wellbeing, physical activity, environment, sleep, nutrition, and substance use. The Swiss Re Underwriting Research & Development team has identified these factors as the most critical health variables that can be measured and often influenced by our personal actions – and perhaps even the actions of companies as employers. We considered how to apply this thinking to the measure of sleep. Dr Strange noted that the sweet spot for adult sleep is 7 to 8 hours of sleep. Sleeping more and less than that, it turns out, is connected to higher weighted average mortality. Put simply, people that sleep more or less than 7–8 hours on average tend to die sooner not because of the sleep pattern per se, but it is a statistical marker of potential ill health. Now, imagine this scenario: If we had an accurate reading of a company’s “sleep score”, the aggregated average of how long its employees sleep, could we consider that as one element in underwriting a corporate? Provided that we had reliable data, we might be able to deduce that a company where employees on average sleep 7 to 8 hours will be more resilient than a company where the average is less than 5 hours. This has implications for risks faced by companies, and the insurers that offer credit risk protection for those companies.

Dr John Schoonbee then turned our attention to the world of nutrition which could also have implications for companies. Despite lack of agreement on many nutrition topics within academic and research powerhouses, he noted that the one point everyone could agree on was reducing sugar and ultra-processed food, often carbohydrates. Of the nine main causes of untimely death or ill health, seven of them are directly or indirectly impacted by metabolic ill health, including insulin resistance syndrome, when the body requires even higher insulin levels than normal (see figure 1).

Insulin resistance syndrome drives hypertension, obesity (insulin signals the body to store fat), diabetes and dyslipidemia (high triglycerides which is bad cholesterol, and low HDL which is the good cholesterol). Dyslipidemia is not due to eating fat, but rather the culprits are eating sugar and too much processed carbohydrates like pasta.

We hypothesized that this knowledge could contribute to how companies support employee health and provide data points for a “company nutrition score” based on what employees are eating, if we can quantify the resulting impact of such actions on health, morbidity and mortality.

Other ideas were more unusual. Of strong intrigue to our group was research around the order and timing in which foods could be eaten to impact our nutrition factors. According to a Chinese study Dr Schoonbee shared, the best combinations were vegetables (V in the study) alone followed by meat (M) and rice (R) together, or vegetables then meat then rice each alone in that order. The worst outcome for insulin control was rice alone followed by vegetables and meat together when the insulin reaction was the highest. Having carbohydrates last seems to have the best (lowest) insulin response (see figure 2).

Dr Schoonbee ended with a fascinating individual case study about Betsy McLaughlin a former CEO who had years of dietary health and weight issues and had tried every diet imaginable, but eventually used a glucose monitor to measure glucose spikes. She learned that lots of the good foods like quinoa and sweet potato caused insulin spikes for her, but finally found thirty foods that did not and critically learned that she had to eat them in the right order, protein and then carbohydrates to avoid the glucose spikes. This reminded us that there is no one size fits all to insulin success, but could the future involve wearables measuring our glucose spikes? Could this be the basis of a future score for employee aggregated nutritional health? Dr Schoonbee guesses that individuals will likely have this kind of data before we know it.

The sleep or nutrition scores hypothesized above are simplistic of course, but it sheds light on a potential future where a matrix of such lifestyle scores could be one additional underwriting factor. This can be likened to ESG scoring (what a company eats) which is quickly becoming a relevant factor of corporate resilience. What do you think? Could such lifestyle factors be combined in a new era of corporate underwriting, where financials alone may not be sufficient to capture a holistic picture of a company’s probability of default?

I’d say the future is wide open. But at the very least, these factors have potential to provide companies with more effective ways of focusing on the personal health and resilience of employees, for the benefit of everyone.