Systematic review of the impact of nutrition and physical activity on cardiovascular disease risk among firefighters

Abstract

Background: Fatal heart attacks account for 45-60% of all line of duty firefighter deaths, making cardiovascular disease (CVD) the primary cause of line of duty deaths in the fire service. Firefighters experience numerous occupational risk factors contributing to CVD, however research shows underlying CVD from lifestyle is the major contributing factor. Thus, the purpose of this study was to review and summarize the literature on non-occupational risk factors experienced by firefighters, nutrition and physical activity in particular.

Methods: The current systematic review searched PubMed and Scopus databases using search terms related to CVD, nutrition, and physical activity in firefighters. The PRISMA checklist was followed to ensure a rigorous review. The Academy of Nutrition and Dietetics Quality Criteria Checklist for Primary Research was used for critical appraisal of included studies. The review process was performed by one researcher with plans for an additional reviewer in the near future.

Results: 26 articles were included in the qualitative synthesis (4 nutrition, 4 nutrition and physical activity, and 18 physical activity). Included studies indicate that firefighters do not engage in regular physical activity, tend to poor dietary habits, and work in a poor food environment, which is associated with higher prevalence of CVD and its indicators. They also indicate that firefighters want information, programs, and resources related to improving nutrition and physical activity.

Discussion & Conclusions: Numerous studies exist regarding increased CVD risk related to inadequate physical activity levels, however, few studies address the role of a healthy diet in the development of CVD risk among firefighters. This review is beneficial for practitioners and fire service leaders as it provides insight into the need for initiatives to increase physical activity levels and into the need to further investigate how diet affects CVD risk among the firefighting population.