Exercise & Diet Effects on CV Risk in Firefighters

Effects of Combined Diet & Exercise Intervention on Cardiovascular Risk Factors in Firefighters & Civilians

The study will explore the capacity for a lifestyle modification in firefighters to improve blood pressure, blood vessel stiffness, inflammation, and reduce oxidative stress. The study will be a pre- post-testing controlled trial with three groups. The intervention will be a weekly circuit workout program and a Mediterranean (high fruit/vegetable) diet. The groups will be firefighters with >10yrs experience, firefighters with <10yrs experience, and control Non-firefighters.

Study Overview

• Status: Completed
• Conditions: Diet Modification; Exercise; Blood Pressure; Health Promotion; Cardiovascular Risk Factor
• Intervention / Treatment: Behavioral: Circuit Training exercise & Modified Mediterranean diet

Detailed Description

Recent statistics from the American Heart Association (AHA) have reported that >92% of adults in the U.S. meet at least 1 metric for cardiovascular disease risk factors. In firefighters, this increased risk is especially concerning. The National Fire Protection Agency (NFPA) estimates there are around 1.3 million firefighters in the United States, 70% of which are volunteer. The prevalence of impaired cardiovascular health is higher in firefighters than in the general population and the leading line-of-duty death (LODD) cause is cardiac related. It is known that exercise and diet mitigate cardiovascular disease risk. Meeting the physical activity guidelines remains a target of ideal cardiovascular health and a major public health concern. However, the NFPA does not require volunteer fire companies to have a fitness program for their crew, and sadly less than a third of the stations actually do. And importantly, cardiovascular-related LODD remains a major issue in the firefighter population. The results could guide clinical treatment for firefighters and may therefore reduce cardiac-related LODD.

• Study Type: Interventional
• Enrollment (Actual): 200
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • California
    • San Marcos, California, United States, 92096
      • California State University San Marcos

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 70 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Adult
• Able to Exercise

Exclusion Criteria:

• More than one anti-hypertensive medication
• More than one cholesterol medication
• Diabetic
• Prior Cardiac incident

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Firefighter (Veteran) Group; Firefighters with >10yrs experience. Circuit Training exercise & Modified Mediterranean diet	Behavioral: Circuit Training exercise & Modified Mediterranean diet; Participants will receive circuit training program and a modified Mediterranean diet program. Educational sessions, serving size training, and portion containers will be provided. Participants will also receive individualized support throughout the 6 week intervention.
Experimental: Firefighter (Novice) Group; Firefighters with <10yrs experience. Circuit Training exercise & Modified Mediterranean diet	Behavioral: Circuit Training exercise & Modified Mediterranean diet; Participants will receive circuit training program and a modified Mediterranean diet program. Educational sessions, serving size training, and portion containers will be provided. Participants will also receive individualized support throughout the 6 week intervention.
Experimental: Control Non-Firefighter Group; Non-Firefighter adults. Circuit Training exercise & Modified Mediterranean diet	Behavioral: Circuit Training exercise & Modified Mediterranean diet; Participants will receive circuit training program and a modified Mediterranean diet program. Educational sessions, serving size training, and portion containers will be provided. Participants will also receive individualized support throughout the 6 week intervention.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in blood pressure	Blood pressure surge response to alarm will be measured by ambulatory blood pressure monitor	Pre-Intervention (Week 0), Post-Intervention (Week 6)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in vascular stiffness	Stiffness will be measured by pulse wave velocity	Pre-Intervention (Week 0), Post-Intervention (Week 6)
Change in cardiopulmonary fitness	Fitness will be measured by treadmill test	Pre-Intervention (Week 0), Post-Intervention (Week 6)
Change in body composition	Body composition will be measured by bioelectrical impedance	Pre-Intervention (Week 0), Post-Intervention (Week 6)
Change in inflammation	Inflammation will be measured by assay of circulating bio-markers through blood draw.	Pre-Intervention (Week 0), Post-Intervention (Week 6)
Change in oxidative stress	Oxidative stress will be measured by assay of circulating antioxidant bio-markers through blood draw.	Pre-Intervention (Week 0), Post-Intervention (Week 6)

Collaborators and Investigators

• Sponsor: University of New Hampshire
• Collaborators: American Heart Association; California State University, San Marcos
• Investigators: Principal Investigator: Deborah L Feairheller, PhD, California State University, San Marcos

Publications and helpful links

General Publications

• Donahue S, McMorrow C, Almeida AA, Feairheller DL. Feasibility and Perception of a Diet and Exercise Intervention Delivered via Telehealth to Firefighters. Int J Telerehabil. 2022 Jun 3;14(1):e6458. doi: 10.5195/ijt.2022.6458. eCollection 2022.
• Almeida AA, Reeve EH, Dickinson RL, Carty M, Gilpin J, Feairheller DL. Civilians Have Higher Adherence and More Improvements in Health With a Mediterranean Diet and Circuit Training Program Compared With Firefighters. J Occup Environ Med. 2022 Jun 1;64(6):488-494. doi: 10.1097/JOM.0000000000002478. Epub 2022 Jan 4.
• Feairheller DL, Smith M, Carty M, Reeve EH. Blood pressure surge with alarm is reduced after exercise and diet intervention in firefighters. Blood Press Monit. 2023 Jun 1;28(3):134-143. doi: 10.1097/MBP.0000000000000649. Epub 2023 Apr 12.
• McLaughlin KC, Perez AN, Donahue S, Feairheller DL. Tactical Circuit Training Improves Blood Pressure and Vascular Health More Than Resistance Training. Int J Exerc Sci. 2021 Nov 1;14(3):1320-1333. eCollection 2021.
• Rynne PJ, Derella CC, McMorrow C, Dickinson RL, Donahue S, Almeida AA, Carty M, Feairheller DL. Blood pressure responses are dependent on call type and related to hypertension status in firefighters. Blood Press. 2023 Dec;32(1):2161997. doi: 10.1080/08037051.2022.2161997.
• McMorrow C, Feairheller DL. Blood Pressure Responses in Firefighters: A Review. Curr Hypertens Rev. 2022;18(2):145-152. doi: 10.2174/1573402118666220103094201.
• Derella CC, Aichele KR, Oakman JE, Cromwell CM, Hill JA, Chavis LN, Perez AN, Getty AK, Wisdo TR, Feairheller DL. Heart Rate and Blood Pressure Responses to Gear Weight Under a Controlled Workload. J Occup Environ Med. 2017 Apr;59(4):e20-e23. doi: 10.1097/JOM.0000000000000997.

Study record dates

Study Major Dates

• Study Start (Actual): November 25, 2018
• Primary Completion (Actual): May 9, 2023
• Study Completion (Actual): May 9, 2023

Study Registration Dates

• First Submitted: October 24, 2017
• First Submitted That Met QC Criteria: November 14, 2017
• First Posted (Actual): November 17, 2017

Study Record Updates

• Last Update Posted (Actual): August 7, 2023
• Last Update Submitted That Met QC Criteria: August 2, 2023
• Last Verified: August 1, 2023

More Information

Terms related to this study

• Keywords: Exercise Training; Cardiovascular Disease; Blood Pressure; Mediterranean Diet
• Other Study ID Numbers: 005-8242-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: data will be entered
• IPD Sharing Time Frame: 2023
• IPD Sharing Access Criteria: must get approval from PI
• IPD Sharing Supporting Information Type: ANALYTIC_CODE

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No