Contributed by Nicholas E. Blonien, D.O.

Firefighting is a high-stress job that is highly rewarding, but it can certainly take a toll on fire service members’ health and well-being. When you add up the sleep deprivation, physical exertion and toxic exposures, it can be harmful and cause “free radicals” to form in the body.

Free radicals are molecules that can disrupt cellular function and DNA if not appropriately neutralized. Over time, this excess oxidative stress can increase your risk for cancer, chronic disease and accelerated aging. The good news – there is a way to neutralize free radicals and prevent them from causing harm: antioxidants.

What is oxidative stress?

Oxidative stress happens when free radicals damage cells. Free radicals are short-lived “reactive oxygen species” (ROS) that have an unpaired electron in their orbit. This makes them unstable molecules that try to “steal” electrons from other molecules in order to stabilize themselves. During this process, neighboring molecules will either become dysfunctional or turn into free radicals, too. While free radicals are a normal part of our body processes and even deployed by the immune system to help fight infections, too many of them can cause problems.

Stress overload

When the body faces too much stress, it can struggle to neutralize free radicals and keep them under control, which can cause damage or unwanted ailments. That’s why it’s important to have a plan to boost antioxidants, especially in times of intense physical activity, exposure to toxins or poor nutrition.

How to boost antioxidants

Two common-sense ways to boost antioxidants in your body include:

Exercise – While physical exercise can temporarily increase stress and free radical formation, it strengthens antioxidant activity over time. Regular exercise causes the body to adapt and become better at handling stress.

Nutrition – The best way to get dietary antioxidants is by eating fruits and vegetables. Diets that limit these foods, such as the ketogenic diet or carnivore diet, are not recommended as a long-term or sustainable nutrition strategy. Here are some great foods that are high in antioxidants:

• Fruits: berries, apples, cherries, pomegranates, tomatoes
• Vegetables: kale, spinach, broccoli, brussels sprouts, beets, carrots, sweet potatoes, beans
• Nuts/seeds: walnuts, pecans, almonds, chia seeds, flaxseed
• Extras: coffee, green tea, cinnamon, turmeric, oregano

The above list is NOT exhaustive. There are MANY foods packed with antioxidants.

To stay healthy, it’s important to neutralize free radicals with antioxidants. You can do this by getting enough sleep, exercising regularly and eating a diet full of fruits, vegetables, nuts and seeds. ​

How can I learn more?

MnFIRE offers professionally led training sessions on sleep, nutrition and fitness, as well as occupational health risks including cancer, cardiac and emotional wellness. Click here to learn more and register your department for a no-cost training and help strengthen your team from the inside out.

Contributed by Nicholas E. Blonien, D.O.

What if you were told there is a drug that prevents cancer, cardiovascular disease, and mental illness? Not only is the drug free, but it also has zero negative side effects, is nearly impossible to overdose on and offers seemingly endless additional health benefits. Would you take it?

That “drug” exists, though not in pill form. Exercise is medicine, and the potent tool we have for fighting off chronic disease and improving overall wellness. Some is better than none, and more is generally better.

Consistent exercise decreases inflammation, improves immune function, inhibits abnormal cell growth, enhances clearance of dysfunctional cells and improves metabolic health. This has a favorable impact on warding off cancer and cardiovascular disease. Exercise can also be effective in helping prevent, manage and treat behavioral health conditions like anxiety and depression.

For firefighters, this is especially important. Firefighters are at increased risk for cardiovascular disease, some cancers and mental illness, given their routine exposure to hazardous environments, circadian rhythm disruption, sleep insufficiency and psychosocial trauma.

Low-intensity exercise

Even low-intensity exercise can be beneficial to the goal of improved wellness. Lower-intensity aerobic exercise improves mitochondrial function. Mitochondria are the power plants of cells, using fuel (carbohydrates, fat, etc.) and oxygen to generate energy. The healthier and more numerous your mitochondria, the more efficiently you can burn fuel (fat stores, dietary intake) and avoid the metabolic dysfunction that leads to diabetes, fatty liver and other chronic diseases.

This low-intensity exercise is commonly referred to as Zone 2 exercise. If you’re exercising at Zone 2 intensity, you can likely carry on a conversation without too much difficulty but will need to take a breath every sentence or so. Another method for guiding Zone 2 intensity is subtracting your age in years from 180. Your heart rate during Zone 2 exercise should hover slightly below this number. Experts recommend at least three hours of Zone 2 exercise weekly for optimal health, and at least 45 minutes per session, but any amount is better than none. Examples include a slow-pace jog, a leisurely bike ride or a brisk walk either uphill or while carrying some extra weight (rucking).

High-intensity exercise

Higher-intensity aerobic exercise offers similar benefits to lower-intensity exercise, but also induces cardiovascular adaptations that make your circulatory system more resistant to diseases like high blood pressure. It increases your exertional capacity and improves your ability to utilize oxygen for physical activity, something proven to have strong correlation with living healthier for longer (“health-span”). Recent research has suggested that high-intensity interval training (HIIT) might offer similar benefits to lower-intensity exercise, but require less time with less monotony.

Put them together

Endurance athletes often follow “polarized” training programs, where they spend about 80% of their exercise time performing lower intensity (Zone 2) exercise, and the other 20% focused on higher intensity exercise that approaches maximal aerobic output. Firefighters don’t need to train like world-class endurance athletes. The take-home point here is when it comes to aerobic exercise, firefighters should:

• Get a lot of it.
• Aim for getting a few hours of lower intensity exercise in per week.
• Toss in higher-intensity cardio 1-2 times per week.

Resistance training

But it’s not all about cardio. Resistance exercise builds strength and helps prevent injury – both of which are incredibly important for all firefighters, whether full-time, part-time or volunteer. Up-tempo full-body weight training several times per week may be a useful strategy for building both muscle and aerobic capacity simultaneously. Peripheral Heart Action (PHA) training is a style of exercise that has shown some promise here. The military has recommended PHA training for special operators and combat fighter pilots, but it could be useful for anyone looking to improve fitness. When it comes to resistance exercise:

• Aim to train muscle groups 2-3 times per week.
• Remember that in general, muscles need at least 48 hours to recover from resistance exercise.
• Up-tempo whole-body resistance exercise (like PHA training) may be an efficient way to get both strength and cardio benefits.

Mental health benefits

Consistent exercise, whether it’s low-intensity, high-intensity or resistance training, can also promote mental wellness. Some research has demonstrated exercise can be just as effective as medication in the management of anxiety and depression.

Exercise is medicine, and one of the six pillars of a healthy lifestyle according to the American College of Lifestyle Medicine. Move daily and often at low-moderate intensity, and with vigor a few times per week. In the fire service, this is perhaps the most powerful tool for preventing the chronic health conditions that burden this community.

Learn more about functional fitness for firefighters in MnFIRE’s fitness & nutrition training. Sign up your department for this free class here.

Contributed by Nicholas E. Blonien, D.O.

Cancer remains a leading cause of firefighter mortality. Despite marvelous advances in diagnostic technologies and therapeutics, healthy lifestyle choices are still a powerful prevention strategy, especially for those in the higher-risk firefighting field.

Earlier in 2023, leaders in firefighter research published a review of current evidence supporting the effectiveness of lifestyle interventions in preventing cancer in the fire service. Here are the main lifestyle interventions they recommend:

1. Target obesity

Obesity increases risk of many cancers by as much as 30-80%, including some that already impact the fire service disproportionately. By decreasing body fat percentage, we can decrease risk of cancer. This starts with nutrition and exercise.

2. Get moving

With increasing rank within the fire department comes increased risk of sedentary behavior, especially when the job calls for more time at a desk behind a computer. By intentionally replacing inactivity with movement, such as “exercise snacks,” cancer risk can go down.

3. Prioritize sleep

Getting a good night’s sleep during a busy shift is impossible, but the negative health effects of this can be limited by optimizing sleep when it’s available, both at the fire station and at home. Establishing a bedtime routine, eating during times when your body is prepared for it, limiting nightly snacking and managing stress will make a huge difference.

4. Minimize alcohol

While there continues to be debate about the harmful effects of alcohol on the cardiovascular system, evidence for alcohol consumption as a risk factor for cancer development is much clearer. And rates of alcohol consumption and binge drinking are high among firefighters. Less is better, none is ideal.

5. Dial in the diet

Firefighters tend to follow a standard Western diet, consisting of processed foods and comfort food snacking. This type of eating has been clearly associated with increased cancer risk. Alternatively, a nutrition plan resembling the Mediterranean diet has been associated with decreased cancer risk. Sticking to mostly plants, healthy oils, nuts/seeds, fish and minimal meat/dairy is the best fuel plan for tactical athletes like firefighters.

A cultural shift is needed to tackle these issues, and a unified firehouse can be powerful. Talk with family and friends, engage leadership, partner with colleagues and ask healthcare providers questions. Little improvements can make a difference and add up to bigger change.

Protect your department from cancer

Learn more about shifting the culture in MnFIRE’s cancer deep-dive training. In this class, firefighters learn the activities that put them at higher risk for developing cancer, proper PPE strategies for mitigating cancer risks and what types of screenings can be done to catch cancer early. Sign up your department for a FREE training here.