Endocrine Abstracts

Objective: To evaluate the associations among body mass index, weight perception and cardiovascular risk factors in male career US firefighters.

Design: The present cross-sectional study was nested within a federally-funded multicenter, prospective cohort investigation of cardio-respiratory fitness (CRF), health and employment outcomes among career firefighters.

Subjects: Seven hundred and sixty-eight male career firefighters from two US Midwestern States. A physical examination was performed. Fasting blood samples were taken. CRF was determined from symptom- limited maximal treadmill exercise testing with ECG monitoring and estimation of oxygen consumption (METS) following the Bruce protocol. Self-reports of weight perception were extracted from responses to a health and lifestyle questionnaire with standardized written instructions to complete the multiple choice survey regarding eating, health, exercise, sleep, and work habits.

Results: We found that a high proportion of overweight and obese male career firefighters underestimate their weight categories (68%) and the risk of underestimating one’s weight category increased by 24% with each additional unit of BMI after adjustment for age and CRF. When divided into six groups based on combination of measured BMI category and weight self-perception, there were significant differences among the groups for most cardiovascular risk factors. After adjustment for age and BMI, these differences remained statistically significant for CRF, amount of weekly exercise, prevalence of metabolic syndrome, body fat percentage and cholesterol measurements.

Conclusion: The majority of overweight and obese firefighters incorrectly perceive themselves as belonging to lower weight categories. As a result, they are unlikely to fully appreciate the negative health consequences of their excess weight, which were clearly demonstrated on objective testing. Efforts to improve the accuracy of weight status awareness are probably needed in order to reverse the trend of increasing obesity among public safety occupations.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This work was supported, however funding details unavailable.