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A dietary and lifestyle worksite intervention to reduce high prevalence of overweight and obesity for London firefighters

Published online by Cambridge University Press:  26 January 2018

G.R. Lessons  and
D. Bhakta
G.R. Lessons
Affiliation:
School of Human Sciences, Health Sciences, London Metropolitan University, London, N7 8DB, UK.
D. Bhakta
Affiliation:
School of Human Sciences, Health Sciences, London Metropolitan University, London, N7 8DB, UK.
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Abstract

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Proceedings of the Nutrition Society , Volume 77 , Issue OCE1: Winter Meeting, 5–6 December 2017, Diet, nutrition and the changing face of cancer survivorship , 2018 , E21
Copyright
Copyright © The Authors 2018 

This abstract was awarded the student prize.

Overweight and obesity in UK firefighters are reaching epidemic proportions exceeding that of the UK general population( Reference Munir, Clemes and Houdmont 1 ). This compromises physical fitness( Reference Poston, Haddock and Jahnke 2 ) and concomitant firefighter and public safety( Reference Moore 3 ). Research has identified specific exposures related to firefighting( Reference Hunter, Shah and Langrish 4 – Reference Dobson, Choi and Schnall 5 ), which may also contribute to uniquely high rates of coronary heart disease (CHD) and acute myocardial infarctions (MI) seen in this occupational group( Reference Kales, Soteriades and Christophi 6 ). These exposures include intense heat which could impair vascular function and increase thrombogenicity( Reference Hunter, Shah and Langrish 4 ), and fire stations as obesogenic environments which perpetuate a culture of over-nutrition alongside increasing sedentary behaviour( Reference Dobson, Choi and Schnall 5 ). Faced with a multitude of exposures, it is imperative that modifiable risk factors for CHD and MI are addressed. This however seems to have been overlooked by UK researchers thus far. We aimed to design, implement and evaluate the efficacy and feasibility of a fire station based dietary and lifestyle weight loss intervention for UK firefighters, factoring in a complex combination of exposures and firefighter specific cultural habits( Reference Dobson, Choi and Schnall 5 ).

Forty London firefighters were recruited via staff email in February 2017. Thirty-eight firefighters (35 males, 3 females; mean age = 44·8, SD = 7·2) from 2 London fire stations (Hornchurch: intervention, Harold Hill: control) completed the one-month, cluster-controlled dietary and lifestyle intervention which ran February to March 2017. Hornchurch firefighters received the programme involving a face-to-face personalised information session; general information sheet; midway face-to-face support session; and nutritionist support throughout. Informational components focussed on fire station obesogenic environmental modification alongside nutrition, physical activity and lifestyle education in a low-intensity/low participant burden format. All firefighters were assessed at baseline and post-intervention for Body Mass Index (BMI), Body Fat Percentage (BF%) and Waist Circumference (WC). Dietary assessment was carried out using the EPIC-Norfolk Food Frequency Questionnaire( Reference Bingham, Welch and McTaggart 7 ). At baseline, 70 % of the sample were classified overweight or obese by BMI (Harold Hill: 67 %; Hornchurch: 74 %). Post intervention, Hornchurch displayed significant mean reductions in BMI and BF% of 0·4 kg/m2 (p = 0·01) and 0·9 % (p = 0·04) respectively, and borderline non-significant improvement in WC of 1·4 cm (p = 0·06). Harold Hill displayed a significant mean reduction of 0·8 cm in WC (p = 0·03), but not for BMI or BF%. Hornchurch firefighters reported favourable changes over the one month period for energy intake: −413kcal/d (p = 0·04); saturated fatty acids: −3·5 g/d (p = 0·01); fats & oils: −3·2 g/d (p = 0·03); sugars, preserves and snacks: −24·1 g/d (p = 0·02); cereals and cereal products: −35·9 g/d (p = 0·04).

With an attrition rate of 5 % the intervention was highly feasible. It was also efficacious, resulting in significant weight loss, reduced body fat and improvements in dietary behaviour. This study represents the first dietary and lifestyle worksite intervention for firefighters in the UK.

References

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