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Metabolic Syndrome Is Inversely Related to Cardiorespiratory Fitness in Male Career Firefighters

Baur, Dorothee M.1,2; Christophi, Costas A.1,3; Kales, Stefanos N.1,2

The Journal of Strength & Conditioning Research: September 2012 - Volume 26 - Issue 9 - p 2331–2337
doi: 10.1519/JSC.0b013e31823e9b19
Original Research

Baur, DM, Christophi, CA, and Kales, SN. Metabolic syndrome is inversely related to cardiorespiratory fitness in male career firefighters. J Strength Cond Res 26(9): 2331–2337, 2012—Cardiovascular disease (CVD) accounts for 45% of on-duty fatalities among firefighters, occurring primarily in firefighters with excess CVD risk factors in patterns resembling the metabolic syndrome (MetSyn). Additionally, firefighters have a high prevalence of obesity and sedentary behavior suggesting that MetSyn is also common. Therefore, we assessed the prevalence of MetSyn in firefighters and its association with cardiorespiratory fitness (CRF) in a cross-sectional study of 957 male career firefighters. The CRF was measured by maximal exercise tolerance testing (standard metabolic equivalent [METS]). The MetSyn was defined according to modified criteria from the Joint Scientific Statement. Group differences were compared using χ2-test and logistic regression. The prevalence of MetSyn was 28.3%. Firefighters in the lowest fitness category (METS ≤ 10) had a nearly 10-fold higher prevalence of MetSyn (51.2%) compared with colleagues in the highest fitness category (METS > 14) (MetSyn prevalence 5.2%) (p value < 0.0001, adjusted for age). In multivariate regression models, every 1-unit increase in METS decreased the odds of having the MetSyn by 31% (odds ratio 0.69 [95% confidence interval 0.63–0.76] [age adjusted]), whereas age had no significant effect after adjusting for CRF. We found a high prevalence of the MetSyn in this group of career emergency responders expected to be more active, fit, and relatively younger than the general population. Moreover, there is a highly significant inverse, dose-response association with CRF. Firefighters should be given strong incentives to improve their fitness, which would decrease prevalent MetSyn, a likely precursor of on-duty CVD events and contributor to CVD burden in this population.

1Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology (EOME), Harvard School of Public Health, Boston, Massachusetts

2The Cambridge Health Alliance, Harvard Medical School, Employee Health and Industrial Medicine, Cambridge, Massachusetts; and

3Cyprus International Institute for Environmental and Public Health in Association with Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus

Address correspondence to Stefanos N. Kales,,

© 2012 National Strength and Conditioning Association