Body mass index misclassification of obesity among community police officers

Accuracy of Body Mass Index and Obesity Status in Police Trainees

The first aim of this study was to compare body mass index (BMI) (indirect method) classification with the body fat percent (PBF) (direct method) and to determine how BMI classifies subjects with different levels of skeletal muscle mass percent (PSMM). The second aim was to determine the prevalence of overweight and obesity status among police trainees (PTs). A total of 103 male PTs participated in this research: age = 21.46 ± 0.64 years, body mass (BM) = 75.97 ± 8.10 kg, body height (BH) = 174.07 ± 6.31 cm, BMI = 25.05 ± 2.12 kg/m2. The InBody 370 multichannel bioelectrical impedance analysis (BIA) measured body composition. Study results indicated that muscular PTs could be misclassified as overweight and that PBF identified more subjects as obese. Namely, three PTs were obese according to BMI, while 13 were obese according to PBF. The information provided by this research could be used to help professionals understand the importance of measuring body composition, and the inaccuracies in BMI classification. In conclusion, whenever possible PSMM and PBF should replace the utilization of BMI to screen overweight and obesity in PTs. Agencies may think of using BIA as non-invasive, quick and inexpensive measurement tool.

Predictors of Arterial Stiffness in Law Enforcement Officers

BACKGROUND

Compare arterial stiffness among law enforcement officers (LEOs) versus general population normative values and identify predictors of arterial stiffness in LEOs.

METHODS

Seventy male LEOs (age: 24-54 years) completed body composition, blood pressures, physical activity level, and carotid-femoral pulse wave velocity (cfPWV) measurements. T-tests and regression analyses were utilized to compare LEO data to normative data and predict cfPWV, respectively.

RESULTS

Compared to similar age strata within the general population, cfPWV was lower among LEO's under 30-years (mean difference = -0.6 m·s^-1), but higher among LEOs 50-55-years (mean difference = 1.1 m·s^-1). Utilizing regression, age, relative body fat, and diastolic blood pressure explained the greatest variance in LEO's cfPWV (adj. R² = 0.56, p < 0.001).

CONCLUSION

This investigation demonstrated that arterial stiffness may progress more rapidly in LEOs and LEOs' relative body fat and blood pressure may primarily affect arterial stiffness and risk of CVD.

Cardiorespiratory Fitness Is Associated with a Reduced Cardiovascular Risk in Occupational Groups with Different Working Conditions: A Cross-Sectional Study among Police Officers and Office Workers

Several studies reported a high prevalence of cardiovascular risk factors among police officers and office workers, and adequate cardiorespiratory fitness was reported to have protective effects in reducing cardiovascular risk. Therefore, the present study aimed to evaluate the effects of cardiorespiratory fitness on reducing cardiovascular risk factors in these occupational groups. This cross-sectional study enrolled 101 male participants (55 police officers and 46 office workers). Cardiorespiratory fitness was assessed via spiroergometry. Cardiovascular risk factors were also examined, and the 10-year cardiovascular risk and heart/vascular age were reported using the Framingham risk score. In both groups, higher cardiorespiratory fitness was associated with lower cardiovascular risk factors. Police officers and office workers with higher cardiorespiratory fitness demonstrated significantly lower values in BMI, waist circumference, body fat percentage, diastolic resting blood pressure, heart rate, triglycerides and total cholesterol values, and 10-year cardiovascular risk and heart/vascular age (all factors p < 0.0077, age adjusted). Police officers and office workers mostly presented low levels of cardiorespiratory fitness: 60% of police officers and 58% of office workers were considered “not fit and obese”. Despite different working conditions, both occupational groups had a high rate of low cardiorespiratory fitness levels and showed no differences in their cardiovascular risk profiles. In both groups, cardiorespiratory fitness reduced cardiovascular risk factors, but there was no difference in the influence of cardiorespiratory fitness on cardiovascular risk factors.

Body mass index and waist-to-hip ratio misclassification of overweight and obesity in Chinese military personnel

BACKGROUND

The rising prevalence of obesity in military personnel has raised great concerns. Previous studies suggest that body mass index (BMI)- and waist-to-hip ratio (WHR)-based obesity classifications in US military personnel and firefighters have high false negative and subsequently cause obesity misclassification.

OBJECTIVE

To determine whether BMI and WHR could reflect the fat mass of Chinese military personnel.

METHODS

Three hundred fifty-three male Chinese military personnel and 380 age-matched male adults were recruited. Obesity classification was defined by BMI, WHR, and body fat percentage (BFP).

RESULTS

Chinese military personnel had extremely low obesity rate determined by either BFP (0.3%) or BMI (0.6%). By combining overweight and obese individuals, BMI- and WHR-determined prevalence of overweight/obesity was 22.4% and 17.0% compared to BFP-based standard (4.0%) (P < 0.05). In reference to BFP, BMI and WHR have high false-positive rate compared to the control group. Further analysis showed that Chinese military personnel consisted of high percentage of BFP^lowBMI^high and/or BFP^lowWHR^high subpopulations. Eighty-one percent of BMI^high and 78.3% of WHR^high of them were BFP low.

CONCLUSIONS

Chinese military personnel has extremely low obesity rate. BMI and WHR have high false-positive rates in reference to BFP, which cannot accurately reflect the mass of adipose tissue and leads to obesity misclassification.

Despite Low Obesity Rates, Body Mass Index Under-Estimated Obesity among Russian Police Officers When Compared to Body Fat Percentage

In some countries, obesity rates among police officers are higher than the general public, despite physically demanding jobs. Obesity rates based on body mass index (BMI) may lack accuracy as BMI does not directly address body composition. Since data are lacking for obesity rates among Russian police officers, this study documented and compared officer obesity rates to the adult Russian population and compared the accuracy of body mass index (BMI) for obesity classification to two direct measures of body composition. Moscow region police officers (N = 182, 84% men) underwent height, weight, waist circumference (WC), and body fat percentage (BF%) bioelectrical impedance measurements during annual medical examinations. BMI-defined obesity rates were 4.6% for men and 17.2% for women, which were >3 and >1.8 times lower than Russian adults, respectively. WC-defined obesity rates were similar to BMI (3.3% for men and 10.3% for women), but BF%-defined obesity rates were much higher (22.2% for men and 55.2% for women). Although obesity rates were lower than those found among police officers in other countries, BMI alone was not a particularly accurate method for classifying weight status among Russian police officers.

Anxiety, depression symptoms, and physical activity levels of eutrophic and excess-weight Brazilian elite police officers: a preliminary study

Background

Police officers are subjected to high work-related stress. This scenario of irregular and insalubrious working conditions may be related to an increase in psychiatric disorders and overweight. In particular, low levels of physical activity and high work stress levels may predispose police officers to obesity, poor lifestyles, and, consequently, major risk of psychological disorders. Thus, our aim was to profile the anxiety/depression symptoms and habitual physical activity (HPA) levels of Brazilian elite police officers classified by body mass index (BMI).

Patients and methods

Eighty-seven male police officers classified as normal-weight (NG, BMI =18.5–24.9 kg/m², n=34) and excess-weight (EG, BMI ≥25 kg/m², n=53) completed (before work routine time) the questionnaires: Baecke (HPA levels), State-Trait Anxiety Inventory (anxiety), and Beck Depression Inventory (depression).

Results

There was a slight trend (despite did not reach statistical significance) of the EG group (which have a significantly [P=0.0369] higher mean [8.8±7.6] of military service time [in years] when compared to NG group [5.8±6.0]) presenting higher values of anxiety-trait (+5.0%) and depression (+16.0%) and lower levels of leisure time HPA (–3.7%) than NG group.

Conclusion

Although our hypothesis was not ratified, our findings have clinical relevance because we profiled the anxiety and depression symptoms and HPA levels of elite police officers. Moreover, it is possible to suppose that the military service time (years) is a relevant factor, that it needs to be studied in depth, and that it may impact the predisposition for mood disorders and low levels of physical activity of police officers.

Cardiovascular health profile among Québec male and female police officers

To document the cardiovascular health profile of Québec police officers (PO). Participants answered an online questionnaire evaluating the presence of cardiovascular disease (CVD) risk factors and symptoms. Two thousand, ninety-nine (2,099) male (age: 40.8 ± 9.2 years) and 756 female (age: 37.9 ± 7.9 years) PO participated in this study. The prevalence of obesity (body mass index ≥30 kg/m²) and diagnosed hypertension was respectively 21.1, and 14.3% in male and 7.3 and 4.1% in female PO. According to 2013 American College of Sports Medicine guidelines, 27.0 and 48.0% of male and 12.1 and 56.7% of female PO were categorized as being at moderate and high CVD risk, respectively. These findings suggest that Québec police departments should help PO to adopt and maintain a healthy lifestyle to decrease CVD risk.

Sleep Architecture in Night Shift Workers Police Officers with Obstructive Sleep Apnea-hypopnea Syndrome

Introduction

Reduced sleep to increase work hours is common among police officers, when this situation is combined with Obstructive sleep apnea/hypopnea syndrome (OSAHS), health consequences are greater, therefore we believe there is a need of research for these alterations. The aim of this study was to measure the changes in sleep architecture (SA) in police officers who currently have Night shift work (NSW) and OSAHS.

Methods

We compared SA in 107 subjects divided in three groups: the first group included police officers with NSW and severe OSAHS (n = 48); the second group were non-police officers with diurnal work time and severe OSAHS (n = 48) and the third group was formed by healthy controls (n = 11). Polysomnography (PSG) variables and Epworth sleepiness scale (ESS) scores were compared.

Results

SA was more disrupted in the group of police officers with NSW and OSAHS than in patients with OSAHS only and in the control group. Police officers with NSW and OSAHS presented an increased number of electroencephalographic activations, apnea/hypopnea index, and sleep latency, and showed lower scores of oxygen saturation, and in the ESS. Multivariate analysis revealed significant influence of age and Body mass index (BMI).

Conclusions

Data suggested with caution an additive detrimental effect of NSW and OSAHS in SA and ESS of police officers. However age and BMI must be also taken into account in future studies.

Comparison of body mass index with waist circumference and skinfold-based percent body fat in firefighters: adiposity classification and associations with cardiovascular disease risk factors

PURPOSE

This study aims to examine whether body mass index (BMI) overestimates the prevalence of overweight or obese firefighters when compared to waist circumference (WC) and skinfold-based percent body fat (PBF) and to investigate differential relationships of the three adiposity measures with other biological cardiovascular disease (CVD) risk factors.

METHODS

The adiposity of 355 (347 males and eight females) California firefighters was assessed using three different measures. Other CVD risk factors (high blood pressure, high lipid profiles, high glucose, and low VO2 max) of the firefighters were also clinically assessed.

RESULTS

The prevalence of total overweight and obesity was significantly (p < 0.01) higher by BMI (80.4 %) than by WC (48.7 %) and by PBF (55.6 %) in male firefighters. In particular, the prevalence of overweight firefighters was much higher (p < 0.01) by BMI (57.3 %) than by WC (24.5 %) and PBF (38.3 %). 60-64 % of male firefighters who were assessed as normal weight by WC and PBF were misclassified as overweight by BMI. When overweight by BMI was defined as 27.5-29.9 kg/m(2) (vs. the standard definition of 25.0-29.9 kg/m(2)), the agreement of the adiposity classification increased between BMI and other two adiposity measures. Obese firefighters had the highest CVD risk profiles across all three adiposity measures. Only when overweight by BMI was defined narrowly, overweight firefighters had substantially higher CVD risk profiles. Obesity and overweight were less prevalent in female and Asian male firefighters.

CONCLUSIONS

BMI overestimated the prevalence of total overweight and obesity among male firefighters, compared to WC and skinfold-based PBF. Overweight by BMI needs to be more narrowly defined, or the prevalence of BMI-based overweight (27.5-29.9 kg/m(2)) should be reported additionally for prevention of CVD among male firefighters.

Leptin, adiponectin, and heart rate variability among police officers

OBJECTIVES

Police officers have a high prevalence of cardiovascular disease (CVD). Reduced heart rate variability (HRV) is known to increase CVD risk. Leptin and adiponectin may be related to CVD health. Therefore, our objective was to investigate the relationship between these variables and HRV.

METHODS

Leptin and adiponectin levels were measured in 388 officers from the Buffalo Cardio-Metabolic Occupational Police Stress study. HRV was assessed according to methods published by the Task Force of the European Society of Cardiology and the North American Society of Pacing Electrophysiology for measurement and analysis of HRV. Mean values of high-frequency (HF) and low-frequency (LF) HRV were compared across tertiles of leptin and adiponectin using analysis of variance and analysis of covariance; trends were assessed using linear regression models.

RESULTS

Leptin, but not adiponectin, was significantly and inversely associated with HRV. Body mass index (BMI) and percent body fat significantly modified the association between leptin and LF (but not HF) HRV. Among officers with BMI < 25 kg/m(2) , leptin was not significantly associated with HRV. However, among officers with BMI ≥ 25 kg/m(2) , leptin was inversely associated with HRV, after adjustment for age, gender, and race/ethnicity; HF HRV, P = 0.019 and LF HRV, P < 0.0001. Similarly, among officers with percent body fat ≥ 25.5%, leptin and LF HRV showed significant, inverse associations (adjusted P = 0.001).

CONCLUSIONS

Leptin levels were inversely associated with LF HRV, especially among officers with increased adiposity. Increased leptin levels may be associated with CVD-related health problems.

Accuracy of Body Mass Index-defined Obesity Status in US Firefighters

Obesity is a significant problem affecting United States (US) firefighters. While body mass index (BMI) is widely used to diagnose obesity, its use for this occupational group has raised concerns about validity. We examined rates and types of misclassification of BMI-based obesity status compared to body fat percentage (BF%) and waist circumference (WC). Male career firefighters (N = 994) from 20 US departments completed all three body composition assessments. Mean BMI, BF%, and WC were 29 kg/m(2), 23%, and 97 cm, respectively. Approximately 33% and 15% of BF%- and WC-defined obese participants were misclassified as non-obese (false negatives) using BMI, while 8% and 9% of non-obese participants defined by BF% and WC standards were identified as obese (false positives) using BMI. When stratified by race/ethnicity, Pacific Islanders showed high rates of false positive misclassification. Precision in obesity classification would be improved by using WC along with BMI to determine firefighters' weight status.

Health-related quality of life and related factors of military police officers

Purpose

The present study aimed to determine the effect of demographic characteristics, occupation, anthropometric indices, and leisure-time physical activity levels on coronary risk and health-related quality of life among military police officers from the State of Santa Catarina, Brazil.

Methods

The sample included 165 military police officers who fulfilled the study’s inclusion criteria. The International Physical Activity Questionnaire and the Short Form Health Survey were used, in addition to a spreadsheet of socio-demographic, occupational and anthropometric data. Statistical analyses were performed using descriptive analysis followed by Spearman Correlation and multiple linear regression analysis using the backward method.

Results

The waist-to-height ratio was identified as a risk factor low health-related quality of life. In addition, the conicity index, fat percentage, years of service in the military police, minutes of work per day and leisure-time physical activity levels were identified as risk factors for coronary disease among police officers.

Conclusions

These findings suggest that the Military Police Department should adopt an institutional policy that allows police officers to practice regular physical activity in order to maintain and improve their physical fitness, health, job performance, and quality of life.

Accuracy of body mass index-defined overweight in fire fighters

BACKGROUND

Overweight, obesity and weight gain are significant problems in the U.S. fire service. While classification of obesity using body mass index (BMI) has demonstrated accuracy and low rates of false positives when compared with body fat percentage (BF%)-based standards, no studies have examined the accuracy of BMI-based overweight and normal weight status with other comparable body composition indices.

AIMS

To compare overweight and normal weight BMI categories with BF% standards from the American Council on Exercise and analogous waist circumference (WC) categories and to examine rates and types of misclassification in fire fighters.

METHODS

Data were collected from 11 randomly selected career fire departments in the International Association of Fire Chief's Missouri Valley Region. Demographics, occupational history, and body composition indices (weight, BF% and WC) were obtained from male career fire fighters who were categorized as normal weight or overweight based on BMI.

RESULTS

There were 293 participants of whom 92 had normal BMI. There were low rates of false positives (12%) and moderate rates of false negatives (22%) when comparing BMI categories to the compar able BF% categories. However, using WC as the standard resulted in very high rates of false positives (63%) and very low rates of false negatives (5%).

CONCLUSIONS

BMI-based overweight status was associated with significant errors in classification depending on the standard to which it was compared.