Introduction Healthy lifestyles play an important role in the prevention of premature death, chronic diseases, productivity loss and other social and economic concerns. The aim of this systematic review is to investigate the impact of worksite dietary and physical activity interventions, focused on environmental and organisational structure, on employees’ productivity, work performance and work ability.

Methods A comprehensive literature search in Medline, Cochrane Library and PROPSERO was conducted. Studies were identified from reference lists from all the systematic reviews with resembling objective as in this search and were included if they fulfilled our inclusion criteria. An updated search (2015–2016) in Medline, Embase, Cochrane Library and Scopus, was also conducted. Two or more researchers independently screened abstracts and full-texts for study eligibility as well as assessed risk of bias. Disagreements were resolved by a consensus procedure.

Result A total of 29 randomised control trials and non-randomised controlled studies were included. Nearly thirty percent of the included studies were high quality, while sixty four percent were of medium quality. The studies covered a broad range of multi-level, organizational-level and environmental-level interventions. Fourteen effective worksite nutrition and physical activity interventions were identified. Seven of these showed positive effects on sick leave, two studies showed effects on work performance, one study showed effects on work ability and one study showed effects on productivity.

Discussion The scientific evidence shows that it is possible to influence work-related outcomes, especially sickness absence, positively through health promotion efforts that include components aimed at the workplace’s physical work environment and organisational structure. There is a lack of knowledge regarding the impact of interventions on work ability, work performance and productivity and thus more research is needed. In order to draw further conclusions regarding work-related outcomes in controlled high-quality studies, long-term follow-up using objective outcomes and/or quality assured questionnaires are required.