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Hershey MS, Chang CR, Sotos-Prieto M, Fernandez-Montero A, Cash SB, Christophi CA, Folta SC, Muegge C, Kleinschmidt V, Moffatt S, Mozaffarian D, Kales SN. Effect of a Nutrition Intervention on Mediterranean Diet Adherence Among Firefighters: A Cluster Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2329147. [PMID: 37589978 PMCID: PMC10436136 DOI: 10.1001/jamanetworkopen.2023.29147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/09/2023] [Indexed: 08/18/2023] Open
Abstract
Importance US firefighters are a working population at risk of chronic diseases, including obesity, cardiovascular disease, and cancer. This risk may be mitigated by a healthy diet. Objective To evaluate the effect of a Mediterranean nutrition intervention using a behavioral/environmental approach (firefighter/fire station/home) at the individual participant level. Design, Setting, and Participants This 12-month cluster randomized clinical trial included US career firefighters from fire stations and homes within 2 Indiana fire departments. Participants were randomized by fire station to either Mediterranean diet or control (usual care). The study was conducted from October 2016 to December 2019, and data were analyzed in November 2022. Intervention For the first 12 months of the study, firefighters located at fire stations randomized to the intervention group were provided with access to supermarket discounts and free samples of Mediterranean diet foods, online nutrition education platforms, email announcements and reminders, family and peer education and support, and chef demonstrations. Firefighters in fire stations allocated to the control group received no intervention and were instructed to follow their usual diet. Main Outcomes and Measures Change in dietary habits at 12 months as measured by a modified Mediterranean diet score (range, 0 to 51 points) at baseline and 6-month and 12-month follow-up. Cardiometabolic parameters were secondary outcomes. Results Of 485 included firefighters, 458 (94.4%) were male, and the mean (SD) age was 47 (7.5) years. A total of 241 firefighters (27 fire stations) were randomized to the Mediterranean nutrition intervention, and 244 (25 fire stations) were randomized to usual diet. Outcomes were analyzed using generalized linear mixed models for modified Mediterranean diet score at 6 months (n = 336) and 12 months (n = 260), adjusting for baseline age, sex, race and ethnicity, fire department, physical activity, and waist circumference. In the intervention group compared with the control group, the modified Mediterranean diet score significantly increased by 2.01 points (95% CI, 0.62-3.40; P = .005) at 6 months and by 2.67 points (95% CI, 1.14-4.20; P = .001) at 12 months. Among secondary outcomes, changes in cardiometabolic risk factors were not statistically significant at 1 year. Results from analyses with multilevel multiple imputation for missingness were similar. Conclusions and Relevance In this Mediterranean nutrition intervention of multicomponent behavioral/environmental changes, career firefighters had increased adherence to a Mediterranean diet. Trial Registration ClinicalTrials.gov Identifier: NCT02941757.
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Affiliation(s)
- Maria Soledad Hershey
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Chia-Rui Chang
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Mercedes Sotos-Prieto
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red of Epidemiology and Public Health, Madrid, Spain
- Campus of International Excellence (CEI) Universidad Autónoma de Madrid (UAM), Spanish National Research Council (CSIC), Madrid, Spain
| | - Alejandro Fernandez-Montero
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Department of Occupational Medicine, University of Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Sean B. Cash
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Costas A. Christophi
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Lemesos, Cyprus
| | - Sara C. Folta
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Carolyn Muegge
- National Institute for Public Safety Health, Indianapolis, Indiana
| | | | - Steven Moffatt
- National Institute for Public Safety Health, Indianapolis, Indiana
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Stefanos N. Kales
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Occupational Medicine, Cambridge Hospital, Harvard Medical School, Cambridge, Massachusetts
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2
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Marot LP, Lopes TDVC, Balieiro LCT, Crispim CA, Moreno CRC. Impact of Nighttime Food Consumption and Feasibility of Fasting during Night Work: A Narrative Review. Nutrients 2023; 15:nu15112570. [PMID: 37299533 DOI: 10.3390/nu15112570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 05/23/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
Shift work has been associated with an increased risk of developing chronic non-communicable diseases, such as obesity. The reduction in overnight fasting and its physiological consequences seem to affect the metabolic health of shift workers, but little has been discussed regarding the feasibility and implications of maintaining a night-long fast during work. This narrative review aims to discuss the impact of eating behavior on the reduction of overnight fasting in shift workers, as well as possible nutritional strategies involving fasting that have been tested for shift workers, to contribute to the establishment of nutritional guidelines for them. We used various databases and search engines to retrieve relevant articles, reviews, and investigations. Despite the potential benefits of overnight fasting for other groups, few studies have investigated this approach in the context of shift work. Generally, it seems to be a feasible and metabolically beneficial strategy for shift workers. However, it is essential to investigate the potential risks and benefits of reducing the fasting time for shift workers, considering social, hedonic, and stress-related factors. Furthermore, randomized clinical trials are necessary to establish safe and feasible strategies for shift workers to practice different fasting windows.
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Affiliation(s)
- Luisa Pereira Marot
- Chrononutrition Research Group, Faculty of Medicine, Federal University of Uberlândia, Uberlândia 38405-320, Brazil
| | - Tássia do Vale Cardoso Lopes
- Chrononutrition Research Group, Faculty of Medicine, Federal University of Uberlândia, Uberlândia 38405-320, Brazil
| | | | - Cibele Aparecida Crispim
- Chrononutrition Research Group, Faculty of Medicine, Federal University of Uberlândia, Uberlândia 38405-320, Brazil
| | - Cláudia Roberta Castro Moreno
- Department of Health, Life Cycles and Society, School of Public Health, University of São Paulo, Sao Paulo 01246-904, Brazil
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Joe MJ, Hatsu IE, Tefft A, Mok S, Adetona O. Dietary Behavior and Diet Interventions among Structural Firefighters: A Narrative Review. Nutrients 2022; 14:nu14214662. [PMID: 36364927 PMCID: PMC9653630 DOI: 10.3390/nu14214662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022] Open
Abstract
Structural firefighters (SFFs) are exposed to multiple occupational hazards that affect dietary behavior and can contribute to increased risks of cancer and cardiovascular disease compared to the United States’ general population. Dietary behavior is a feasible modification for positive health outcomes. The objectives of this narrative review are to summarize the diet behavior of SFFs, review findings of diet interventions that positively modify diet behavior, identify research gaps, and suggest recommendations for addressing those gaps. PubMed, MEDLINE, Scopus, and CABI Web of Science were searched between February 2020 and June 2022 for peer-reviewed articles. The inclusion criteria were as follows: (1) study population must include SFFs; (2) investigate diet or diet intervention among SFFs; (3) report results specific to SFFs; and (4) be published in the English language. Thirty-four studies were included. Results indicate that SFFs recognize the importance of a healthy dietary pattern, but do not follow one, and that food choices are often influenced by colleagues. Diet interventions, such as the Mediterranean diet, were observed to have positive health improvements, such as improved lipid levels and lower CVD risk. Team counseling was found to be more effective for adopting healthier diets compared to one-on-one counseling; and general counseling was more effective than no counseling. A gap identified by this review is the lack of information concerning differences in dietary intake, diet quality, and dietary behaviors while on- and off-shift, and throughout the career. Diet is an important risk factor for occupational disease development; therefore, effective, consistent dietary interventions are necessary.
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Affiliation(s)
- Margaux J. Joe
- Department of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
| | - Irene E. Hatsu
- Department of Human Sciences, The Ohio State University, Columbus, OH 43210, USA
- OSU Extension, The Ohio State University, Columbus, OH 43210, USA
| | - Ally Tefft
- Department of Human Sciences, The Ohio State University, Columbus, OH 43210, USA
| | - Sarah Mok
- Department of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
| | - Olorunfemi Adetona
- Department of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
- Correspondence:
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Ras J, Leach L. Firefighters' Health Knowledge, Cardiovascular Disease Risk Factors, and Sociodemographic Characteristics as Predictors of Firefighters Attitudes Toward Health. J Occup Environ Med 2022; 64:e705-e713. [PMID: 35973044 DOI: 10.1097/jom.0000000000002679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of the study is to determine the predictors of firefighters' attitudes toward health based on firefighters' knowledge cardiovascular disease (CVD) risk factors and sociodemographic characteristics. METHODS The study used a web-based cross-sectional, descriptive, and correlational research design. Convenience sampling was used to recruit 110 firefighters, males, and females, aged 18 to 65 years. RESULTS Firefighters' health knowledge, age group 30 to 39 years, and having CVD risk factors present were significant predictors of firefighters' attitudes toward regular aerobic exercise ( P < 0.05). Firefighters' health knowledge was a significant predictor of firefighters liking exercise to look physically fit, and health knowledge and the age group 20 to 29 and 30 to 39 years were significant predictors of firefighters liking exercise to be fit for firefighting ( P < 0.05). CONCLUSIONS Health knowledge, age group, years of experience, and having CVD risk factors present were significant predictors of firefighters' attitudes toward health.
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Affiliation(s)
- Jaron Ras
- From the Department of Sport, Recreation and Exercise Science, University of the Western Cape, Cape Town, South Africa
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5
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Manoogian ENC, Zadourian A, Lo HC, Gutierrez NR, Shoghi A, Rosander A, Pazargadi A, Ormiston CK, Wang X, Sui J, Hou Z, Fleischer JG, Golshan S, Taub PR, Panda S. Feasibility of time-restricted eating and impacts on cardiometabolic health in 24-h shift workers: The Healthy Heroes randomized control trial. Cell Metab 2022; 34:1442-1456.e7. [PMID: 36198291 PMCID: PMC9536325 DOI: 10.1016/j.cmet.2022.08.018] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 05/05/2022] [Accepted: 08/23/2022] [Indexed: 12/19/2022]
Abstract
Over a quarter of the workforce in industrialized countries does shift work, which increases the risk for cardiometabolic disease. Yet shift workers are often excluded from lifestyle intervention studies to reduce this risk. In a randomized control trial with 137 firefighters who work 24-h shifts (23-59 years old, 9% female), 12 weeks of 10-h time-restricted eating (TRE) was feasible, with TRE participants decreasing their eating window (baseline, mean 14.13 h, 95% CI 13.78-14.47 h; intervention, 11.13 h, 95% CI 10.73-11.54 h, p = 3.29E-17) with no adverse effects, and improved quality of life assessed via SF-36 (ClinicalTrials.gov: NCT03533023). Compared to the standard of care (SOC) arm, TRE significantly decreased VLDL particle size. In participants with elevated cardiometabolic risks at baseline, there were significant reductions in TRE compared to SOC in glycated hemoglobin A1C and diastolic blood pressure. For individuals working a 24-h shift schedule, TRE is feasible and can improve cardiometabolic health, especially for individuals with increased risk. VIDEO ABSTRACT.
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Affiliation(s)
- Emily N C Manoogian
- Regulatory Biology, The Salk Institute for Biological Studies, La Jolla, CA 92037, USA
| | - Adena Zadourian
- Division of Cardiovascular Medicine, Department of Medicine, University of California, San Diego, San Diego, CA 92037, USA
| | - Hannah C Lo
- Division of Cardiovascular Medicine, Department of Medicine, University of California, San Diego, San Diego, CA 92037, USA
| | - Nikko R Gutierrez
- Regulatory Biology, The Salk Institute for Biological Studies, La Jolla, CA 92037, USA
| | - Azarin Shoghi
- Regulatory Biology, The Salk Institute for Biological Studies, La Jolla, CA 92037, USA
| | - Ashley Rosander
- Division of Cardiovascular Medicine, Department of Medicine, University of California, San Diego, San Diego, CA 92037, USA
| | - Aryana Pazargadi
- Division of Cardiovascular Medicine, Department of Medicine, University of California, San Diego, San Diego, CA 92037, USA
| | - Cameron K Ormiston
- Division of Cardiovascular Medicine, Department of Medicine, University of California, San Diego, San Diego, CA 92037, USA
| | - Xinran Wang
- Regulatory Biology, The Salk Institute for Biological Studies, La Jolla, CA 92037, USA
| | - Jialu Sui
- Regulatory Biology, The Salk Institute for Biological Studies, La Jolla, CA 92037, USA
| | - Zhaoyi Hou
- Regulatory Biology, The Salk Institute for Biological Studies, La Jolla, CA 92037, USA
| | - Jason G Fleischer
- Department of Cognitive Science, University of California, San Diego, San Diego, CA 92037, USA
| | - Shahrokh Golshan
- Department of Psychiatry, University of California, San Diego, San Diego, CA 92037, USA
| | - Pam R Taub
- Division of Cardiovascular Medicine, Department of Medicine, University of California, San Diego, San Diego, CA 92037, USA.
| | - Satchidananda Panda
- Regulatory Biology, The Salk Institute for Biological Studies, La Jolla, CA 92037, USA.
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McMorrow C, Feairheller DL. Blood Pressure Responses in Firefighters: A Review. Curr Hypertens Rev 2022; 18:145-152. [PMID: 34979891 DOI: 10.2174/1573402118666220103094201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/02/2021] [Accepted: 12/13/2021] [Indexed: 01/27/2023]
Abstract
Blood pressure (BP) responses are controlled by various factors and understanding how BP changes is important to occupational health. This paper presents a review of the literature that reports BP responses in the firefighter population. Hypertension is one of the main risk factors underlying the pathophysiology of cardiovascular disease (CVD), and cardiac incidents remain the leading cause of line-of-duty deaths in firefighters. Risk factors for line-of-duty deaths include obesity, previous or underlying heart disease, and hypertension. The occupation of firefighting is one of the most hazardous and dangerous jobs, yet over 50 % of firefighters are volunteers. Tactical operations and the hazardous nature of firefighting are exposures that influence stress responses and, therefore, affect BP. In fact, hypertension in firefighters often remains undocumented or undiagnosed. CVD risk and elevated BP in tactical populations, like firefighters, maybe a combination of physical and emotional stress due to the nature of the job. Cross-sectional studies have reported that firefighters have higher levels of BP and higher rates of hypertension compared to civilians. Interestingly, there is a limited amount of research that reports BP values before and after firefighting- related activities, and very few studies on interventional changes in BP. Here, we synthesize the literature on firefighting and provide a summary of the studies that report pre- and post- BP levels that relate to CVD risk factors, occupational factors, firefighting activities, and the data on exercise training and BP. More studies are needed that examine BP in firefighters and report on the changes in BP with occupational activities.
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Affiliation(s)
- Carly McMorrow
- Department of Kinesiology, University of New Hampshire, Durham NH, USA
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Eating Habits among US Firefighters and Association with Cardiometabolic Outcomes. Nutrients 2022; 14:nu14132762. [PMID: 35807942 PMCID: PMC9268786 DOI: 10.3390/nu14132762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 01/27/2023] Open
Abstract
Cardiovascular disease is the leading cause of on-duty mortality among firefighters, with obesity as an important risk factor. However, little is known regarding the dietary patterns which are characteristic in this population and how these patterns relate to cardiometabolic outcomes. The aim of this study was to identify the dietary patterns of US firefighters and examine their association with cardiometabolic outcomes. The participants (n = 413) were from the Indianapolis Fire Department, and were recruited for a Federal Emergency Management Agency (FEMA)-sponsored Mediterranean diet intervention study. All of the participants underwent physical and medical examinations, routine laboratory tests, resting electrocardiograms, and maximal treadmill exercise testing. A comprehensive food frequency questionnaire was administered, and dietary patterns were derived using principal component analysis. The mean body mass index (BMI) was 30.0 ± 4.5 kg/m2 and the percentage of body fat was 28.1 ± 6.6%. Using principal component analysis, two dietary patterns were identified, namely a Mediterranean diet and a Standard American diet. Following the adjustment for gender, BMI, maximal oxygen consumption (VO2 max), max metabolic equivalents (METS), age, and body fat percent, the Mediterranean diet was positively associated with high-density lipoprotein (HDL) cholesterol (β = 1.20, p = 0.036) in linear regression models. The Standard American diet was associated with an increase in low-density lipoprotein (LDL) cholesterol (β = −3.76, p = 0.022). In conclusion, the Mediterranean diet was associated with more favorable cardiometabolic profiles, whereas the Standard American diet had an inverse association. These findings could help in providing adequate nutrition recommendations for US firefighters to improve their health.
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Lan FY, Scheibler C, Hershey MS, Romero-Cabrera JL, Gaviola GC, Yiannakou I, Fernandez-Montero A, Christophi CA, Christiani DC, Sotos-Prieto M, Kales SN. Effects of a healthy lifestyle intervention and COVID-19-adjusted training curriculum on firefighter recruits. Sci Rep 2022; 12:10607. [PMID: 35739126 PMCID: PMC9226180 DOI: 10.1038/s41598-022-10979-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 04/15/2022] [Indexed: 12/04/2022] Open
Abstract
There are knowledge gaps regarding healthy lifestyle (HLS) interventions in fire academy settings and also concerning the impacts of the pandemic on training. We enrolled fire recruits from two fire academies (A and B) in New England in early 2019 as the historical control group, and recruits from academies in New England (B) and Florida (C), respectively, during the pandemic as the intervention group. The three academies have similar training environments and curricula. The exposures of interest were a combination of (1) an HLS intervention and (2) impacts of the pandemic on training curricula and environs (i.e. social distancing, masking, reduced class size, etc.). We examined the health/fitness changes throughout training. The follow-up rate was 78%, leaving 92 recruits in the historical control group and 55 in the intervention group. The results show an HLS intervention improved the effects of fire academy training on recruits healthy behaviors (MEDI-lifestyle score, 0.5 ± 1.4 vs. − 0.3 ± 1.7), systolic blood pressure (− 7.2 ± 10.0 vs. 2.9 ± 12.9 mmHg), and mental health (Beck Depression score, − 0.45 ± 1.14 vs. − 0.01 ± 1.05) (all P < 0.05). The associations remained significant after multivariable adjustments. Moreover, a 1-point MEDI-lifestyle increment during academy training is associated with about 2% decrement in blood pressures over time, after multivariable adjustments (P < 0.05). Nonetheless, the impacts of pandemic restrictions on academy procedures compromised physical fitness training, namely in percent body fat, push-ups, and pull-ups.
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Affiliation(s)
- Fan-Yun Lan
- Department of Environmental Health, Harvard University T.H Chan School of Public Health, Boston, MA, USA.,Department of Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Macht Building 427, 1493 Cambridge Street, Cambridge, MA, 02139, USA.,Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Christopher Scheibler
- Department of Environmental Health, Harvard University T.H Chan School of Public Health, Boston, MA, USA
| | - Maria Soledad Hershey
- Department of Environmental Health, Harvard University T.H Chan School of Public Health, Boston, MA, USA
| | - Juan Luis Romero-Cabrera
- Department of Environmental Health, Harvard University T.H Chan School of Public Health, Boston, MA, USA.,Department of Internal Medicine, Hospital Universitario Reina Sofia, Córdoba, Spain
| | - Gabriel C Gaviola
- Department of Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Macht Building 427, 1493 Cambridge Street, Cambridge, MA, 02139, USA
| | - Ioanna Yiannakou
- Program in Biomedical Sciences, Boston University School of Medicine, Boston, MA, USA
| | - Alejandro Fernandez-Montero
- Department of Environmental Health, Harvard University T.H Chan School of Public Health, Boston, MA, USA.,Department of Occupational Medicine, Clínica Universidad de Navarra, Pamplona, Navarra, Spain.,Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain
| | - Costas A Christophi
- Department of Environmental Health, Harvard University T.H Chan School of Public Health, Boston, MA, USA.,Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - David C Christiani
- Department of Environmental Health, Harvard University T.H Chan School of Public Health, Boston, MA, USA
| | - Mercedes Sotos-Prieto
- Department of Environmental Health, Harvard University T.H Chan School of Public Health, Boston, MA, USA.,Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Stefanos N Kales
- Department of Environmental Health, Harvard University T.H Chan School of Public Health, Boston, MA, USA. .,Department of Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Macht Building 427, 1493 Cambridge Street, Cambridge, MA, 02139, USA.
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9
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Civilians Have Higher Adherence and More Improvements in Health With a Mediterranean Diet and Circuit Training Program Compared With Firefighters. J Occup Environ Med 2022; 64:488-494. [DOI: 10.1097/jom.0000000000002478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Burris JC, Werner CM, Woolf K. The Relationship Between Dietary Intake and Dietary-Focused Lifestyle Interventions on Risk Factors Associated with Cardiovascular Disease in Firefighters. Curr Nutr Rep 2022; 11:206-224. [PMID: 35347666 DOI: 10.1007/s13668-022-00406-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW Cardiovascular disease (CVD) is the leading cause of death to on-duty firefighters and is a substantial health concern. Preventative measures, including dietary interventions, may improve CVD in firefighters. The purpose of this review is to examine the literature on the relationship between dietary intake, dietary lifestyle interventions, and risk of CVD in firefighters. RECENT FINDINGS Existing evidence, albeit limited, suggests that firefighters do not meet dietary guidelines. Lifestyle modifications featuring dietary interventions are effective in improving risk factors associated with CVD in firefighters. Unfortunately, no consistent nutrition-related trend was identified across the retrieved studies and only a limited number of randomized controlled trials have examined the efficacy of lifestyle intervention studies on CVD in firefighters. Although this review suggests dietary lifestyle interventions may facilitate decreases in risk factors associated with CVD in firefighters, current evidence is limited, and additional research is needed.
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Affiliation(s)
- Jennifer C Burris
- Department of Nutrition, Saddleback College, 2800 Marguerite Pkwy, Mission Viejo, CA, 92692, USA
| | - Charlotte Marie Werner
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, 411 Lafayette Street, 5th Floor, New York, NY, 10003, USA
| | - Kathleen Woolf
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, 411 Lafayette Street, 5th Floor, New York, NY, 10003, USA.
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Magriplis E, Chourdakis M. Special Issue "Mediterranean Diet and Metabolic Diseases". Nutrients 2021; 13:nu13082680. [PMID: 34444840 PMCID: PMC8398808 DOI: 10.3390/nu13082680] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 07/25/2021] [Accepted: 07/27/2021] [Indexed: 02/06/2023] Open
Abstract
The Mediterranean diet (MD) has been considered among the healthiest dietary patterns since a little over 50 years ago, Ancel Keys-as the key figure-provided evidence for the beneficial effects of the MD [...].
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Affiliation(s)
- Emmanuella Magriplis
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 11855 Athens, Greece
- Correspondence: (E.M.); (M.C.)
| | - Michail Chourdakis
- Laboratory of Hygiene, Social and Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- Correspondence: (E.M.); (M.C.)
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12
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The Mediterranean lifestyle (MEDLIFE) index and metabolic syndrome in a non-Mediterranean working population. Clin Nutr 2021; 40:2494-2503. [PMID: 33932793 DOI: 10.1016/j.clnu.2021.03.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/02/2021] [Accepted: 03/17/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND & AIMS The Mediterranean lifestyle (MEDLIFE), as an overall lifestyle pattern, may be associated with a lower prevalence of metabolic syndrome. We assessed the association of a validated MEDLIFE index with metabolic syndrome and its components in a non-Mediterranean working population. METHODS A cross-sectional analysis was conducted at baseline among 249 US career firefighters in Feeding America's Bravest 2016-2018. The MEDLIFE index consisted of 26 items on food consumption, dietary habits, physical activity, rest, and social interactions that scored 0 or 1 point. Thus, total scores could range from 0 to 26 points. Multivariable logistic regression models were used to determine the associations across tertiles of MEDLIFE adherence with metabolic syndrome and each of its individual components. Multivariable linear models further assessed each component as a continuous outcome. RESULTS The prevalence of metabolic syndrome was 17.7%. Participants with higher MEDLIFE adherence (T3: 11-17 points) had 71% lower odds of having metabolic syndrome compared to those with lower MEDLIFE adherence (T1: 2-7 points) (OR = 0.29; 95%CI: 0.10 to 0.90, p for trend = 0.04). Furthermore, significant inverse associations were found for T3 versus T1 on abdominal obesity (OR = 0.42; 95%CI: 0.18 to 0.99, p for trend = 0.07) and hypertriglyceridemia (OR = 0.24; 95%CI: 0.09 to 0.63, p for trend = 0.002). Significant inverse associations for continuous outcomes included total-cholesterol (total-c), low-density lipoprotein (LDL) cholesterol, and total-c:high-density lipoprotein (HDL) cholesterol (p for trend <0.05). CONCLUSION Higher adherence to traditional Mediterranean lifestyle habits, as measured by a comprehensive MEDLIFE index, was associated with a lower prevalence of metabolic syndrome and a more favorable cardiometabolic profile in a non-Mediterranean working population. Future studies employing the MEDLIFE index in other populations are warranted to support this hypothesis.
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