Objectives: Body mass index (BMI) is a widely used proxy of body composition (BC). Concerns exist regarding possible BMI misclassification among active populations. We compared the prevalence of obesity as categorized by BMI or by skinfold estimates of body fat percentage (BF%) in a physically active population. Subjects and methods: 3,822 military firefighters underwent a physical fitness evaluation including cardiorespiratory fitness (CRF) by the 12 min-Cooper test, abdominal strength by sit-up test (SUT) and body composition (BC) by BF% (as the reference), as well as BMI. Obesity was defined by BF% > 25% and BMI ≥ 30 kg/m 2 . Agreement was evaluated by sensitivity and specificity of BMI, positive and negative predictive values (PPV/NPV), positive and negative likelihood (LR+/LR-), receiver operating characteristic (ROC) curves and also across age, CRF and SUT subgroups. Results: The prevalence of obesity estimated by BMI (13.3%) was similar to BF% (15.9%). Overall agreement was high (85.8%) and varied in different subgroups (75.3-94.5%). BMI underestimated the prevalence of obesity in all categories with high specificity (≥ 81.2%) and low sensitivity (≤ 67.0). All indices were affected by CRF, age and SUT, with better sensitivity, NPV and LR-in the less fit and older groups; and higher specificity, PPV and LR+ among the fittest and youngest groups. ROC curves showed high area under the curve (≥ 0.77) except for subjects with CRF ≥ 14 METs (= 0.46). Conclusion: Both measures yielded similar obesity prevalences, with high agreement. BMI did not overestimate obesity prevalence. BMI ≥ 30 was highly specific to exclude obesity. Because of systematic under estimation, a lower BMI cut-off point might be considered in this population. Arch Endocrinol Metab. 2016;60(6):515-25
BACKGROUND: Firefighting is a physically demanding profession. Firefighters (FFs) need adequate physical fitness (PF) to perform duty tasks efficiently. While FFs’ work demands are constant throughout their career, there is an expected age-related decline in PF. OBJECTIVE: To describe longitudinal changes in cardiorespiratory fitness (CRF) based on a fixed (12.0 METs) and an age-adjusted standard and compare the prevalence of fit/unfit firefighters (FFs) over eight years. METHODS: 297 Brazilian male firefighters were randomly selected. CRF was assessed by the 12-minute Cooper test. To compare the prevalence’s of fit/unfit FFs depending on the standard (12 METs vs. age-adjusted), the McNemar test was used. RESULTS: The reduction in the prevalence of fit firefighters was 4.4-fold higher when the analysis did not consider age. CONCLUSION: After eight years, the prevalence of fit FFs decreased by 30.5% based on the fixed standard, while this reduction was only 7% when using an age-adjusted standard.
Neste dossiê temático, a saúde do bombeiro militar foi abordada na perspectiva das pesquisas conduzidas pelo Grupo de Estudos em Fisiologia e Epidemiologia do Exercício e da Atividade Física (GEAFS), da Faculdade de Educação Física da Universidade de Brasília, que conta com importante parceria na área com o Corpo de Bombeiros Militar do Distrito Federal, desde 2011, e com colaboradores internacionais da Harvard University e do Skidmore College, nos Estados Unidos. Em uma abordagem narrativa, a temática foi analisada em sete grandes tópicos: 1as recomendações gerais de atividade física (ATF) para a saúde (tanto em serviço quanto nas folgas); 2-a importância da aptidão cardiorrespiratória; 3a importância do treinamento muscular; 4composição corporal e aptidão física; 5riscos à saúde associados à atividade profissional e a triagem médico-ocupacional; 6-o papel do sono na saúde do bombeiro militar e 7a função autonômica cardíaca e a frequência cardíaca como indicadores de saúde cardiovascular. Todas as análises foram mediadas pela relação com a aptidão física.
BACKGROUND: Minimum cardiorespiratory fitness (CRF) has been recommended for firefighters due to job requirements. Thus, it is important to identify accurate and readily available methods to assess CRF in this population. Non-exercise CRF estimates (NEx-CRF) have been proposed but this approach requires validation in this population. OBJECTIVE: To evaluate the accuracy of a NEx-CRF, as compared to a field maximum exercise test, among career military firefighters of both genders using a comprehensive agreement analysis. METHODS: We evaluated the accuracy of a NEx-CRF estimate compared to the Cooper 12 min running test among 702 males and 106 female firefighters. RESULTS: Cooper and NEx-CRF tests yielded similar CRF in both genders (differences <1.8±4.7 ml/kg–1.min–1; effect size <0.34). However, NEx-CRF underestimated Cooper-derived CRF among the fittest firefighters. NEx-CRF showed moderate to high sensitivity/specificity to detect fit or unfit firefighters (71.9% among men and 100% among women). Among men, the NEx-CRF method correctly identified most firefighters with less than 11 METs or greater than 13 METs, but showed lower precision to discriminate those with CRF between 11–13 METs. CONCLUSIONS: The NEx-CRF method to estimate firefighters’ CRF may be considered as an alternative method when an exercise-based method is not available or may be used to identify those who require more traditional testing (CRF 11–13METs).
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