Is Ultra-Processed Food Intake Associated with a Higher Risk of Glaucoma? A Prospective Cohort Study including 19,255 Participants from the SUN Project.

OBJECTIVE: The aim of this study was to examine the relationship of ultra-processed food (UPF) intake with the incidence of glaucoma in a large sample of Spanish university graduates followed prospectively. METHODS: Prospective cohort study using data from the SUN Project. A final sample of 19,225 participants (60.1% women) was included in this study, with a mean age of 38.2 years (standard deviation (SD) = 12.4). Participants were followed-up for a mean time of 12.9 years (SD = 5.4). Dietary intake was measured using a 136-item semiquantitative food-frequency questionnaire. UPFs were defined based on the NOVA classification system. Glaucoma diagnosis was determined by asking the participants if they had ever been diagnosed with glaucoma by an ophthalmologist. This self-reported diagnosis of glaucoma has been previously validated. RESULTS: After adjusting for several covariates, participants with the highest UPF consumption were at higher risk of glaucoma (hazard ratio (HR) = 1.83; 95% confidence interval (CI) 1.06 to 3.17) when compared to participants in the lowest category of UPF consumption. Regarding subgroup analyses, a significant multiplicative interaction was found for age (p = 0.004) and omega 3:6 ratio (p = 0.040). However, an association between UPF consumption and glaucoma was only found in older participants (aged ≥ 55 years), in men, in the most physically active group, in the group of non- or former smokers, in those with a lower omega 3:6 ratio, and in those with a lower energy intake. Regarding the contribution of each type of UPF group, UPF coming from sweets showed a significant risky effect (HR = 1.51; CI 95% 1.07 to 2.12). CONCLUSIONS: This prospective cohort study shows that participants with a greater UPF consumption have a higher risk of developing glaucoma when compared to participants with a lower consumption. Our findings emphasize the relevance of monitoring and limiting the consumption of UPFs as a means of preventing glaucoma incidence.

The effects of a 6-month mandatory military police academy training on recruits' physical fitness.

BACKGROUND: Physical fitness for health and professional performance play important roles in police workforce considering that policing is a dangerous job, associated with high physical demands. OBJECTIVES: (1) To evaluate the effects of a 6-month course of police academy training on health-related physical fitness (HRPF) of military police recruits. (2) To investigate whether recruits' HRPF still met the academy entry standards after an unsupervised 7-month period prior to academy. METHODS: We conducted an observational and longitudinal study with 219 male police recruits (aged 25.5±3.6 years; BMI of 24.4±2.5 kg/m2). HRPF parameters included the Cooper 12-min running test for cardiorespiratory fitness (CRF), curl-ups, pull-ups and push-ups for muscle strength/endurance which were evaluated 3 times: 7 months prior to academy course and pre- and post-academy training period. RESULTS: Participants maintained optimal age-related HRPF during the unsupervised period prior to academy. After academy training upon graduation, all HRPF parameters further increased an average of 7.7 to 69.0% (p < 0.001; calculated Cohen's d effect size ≥0.95). CRF was the only HRPF that improved less than 10% after the academy course. CONCLUSIONS: Police recruits that had passed the application fitness standards maintained their HRPF prior to academy, and all their HRPF parameters increased after a 6-month academy training period which was not primarily focused on exercise training. Among all components of HRPF, CRF appears to be the most challenging one to improve among police recruits. Our findings suggest that regular training with minimum physical standards could be potentially beneficial to police officers' health and career longevity.

Cardiorespiratory fitness assessment among firefighters: Is the non-exercise estimate accurate?

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 11-13 METs).

Firefighters' basal cardiac autonomic function and its associations with cardiorespiratory fitness.

BACKGROUND: Firefighters' activities require constant adjustments of the cardiovascular system with cardiac autonomic function (CAF) playing an important role. Despite the crucial role of CAF in regulating stress response, little is known about firefighters' CAF. OBJECTIVE: We aimed to characterize the resting on-duty and off-duty CAF of male firefighters, in association with cardiorespiratory fitness (CRF). METHODS: We evaluated 38 firefighters in an on-duty rest condition and 26 firefighters in an off-duty laboratory-controlled condition. CAF was addressed by means of heart rate variability (HRV). We compared HRV measurements between CRF categories (<12METs vs ≥12METs). Wilcoxon, Mann-Whitney texts and Spearman correlation were used and General Linear Model was applied for age and BMI adjustments. RESULTS: Firefighters' resting CAF is characterized by a predominant sympathetic modulation and a large inter-individual dispersion in all HRV indices, in both groups. We found a positive correlation between a higher CRF, the overall CAF and the higher parasympathetic activity (p <  0,03). Firefighters with CRF ≥12 METs showed a higher parasympathetic modulation. CONCLUSIONS: Firefighters' resting CAF is characterized by a predominant sympathetic modulation and a large inter-individual dispersion in all HRV indices, in both groups. Our results support mandatory physical training focused in improving firefighters' CAF as a cardiopretective effect.

Agreement between BMI and body fat obesity definitions in a physically active population.

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/m2. 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.

Agreement between BMI and body fat obesity definitions in a physically active population

ABSTRACT 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/m2. 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.