Changes in Firefighter Weight and Cardiovascular Disease Risk Factors over Five Years

PURPOSE: This study aimed to assess changes in cardiovascular disease (CVD) risk factors in firefighters who lost, maintained, or gained weight over 5 yr. METHODS: Anthropometrics and biomarkers of CVD were measured during two occupational medical exams 4.8 yr apart in 656 career firefighters. Weight change subgroups were loss (decrease of >3% body weight), stable (within ±3% body weight), and gain (increase of >3% body weight). Changes in CVD risk factors in the total sample and within weight change subgroups were tested for statistical significance using paired t-tests. RESULTS: After 5 yr, 12% of the sample lost weight, 38% maintained weight, and 50% gained weight. Firefighters on average had significant increases (P < 0.001) in body weight (2.5 ± 0.2 kg), body mass index (0.8 ± 0.1 kg·m(−2)), total cholesterol (5.5 ± 1.4 mg·dL(−1)), LDL cholesterol (5.2 ± 1.2 mg·dL(−1)), and blood glucose (2.1 ± 0.5 mg·dL(−1)). Firefighters who gained weight (6.6 ± 0.2 kg) had significant increases (P < 0.001) in total cholesterol (12.9 ± 1.8 mg·dL(−1)), LDL cholesterol (11.1 ± 1.6 mg·dL(−1)), and blood glucose (2.9 ± 0.7 mg·dL(−1)) with a significant decrease (P ≤ 0.01) in HDL cholesterol (−1.3 ± 0.4 mg·dL(−1)). Firefighters who lost weight (−7.2 ± 0.5 kg) had significant decreases (P < 0.05) in total cholesterol (−8.5 ± 3.9 mg·dL(−1)), LDL cholesterol (−6.7 ± 3.3 mg·dL(−1)), and blood pressure (systolic: −5.3 ± 1.3 mm Hg; diastolic −4.2 ± 1.0 mm Hg) with a significant increase (P < 0.05) in HDL cholesterol (2.3 ± 1.0 mg·dL(−1)). CONCLUSIONS: Although improvements in cardiovascular health among firefighters who lost weight were found, 50% of the sample gained weight with adverse changes in measures of cardiovascular health. Given that sudden cardiac death is the most common cause of duty-related death among firefighters, with increased risk among obese firefighters, the amount of weight gain and the adverse changes in cardiovascular health suggest the need for improvements in health promotion programs for firefighters in the United States.