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.

Contributed by Paul J. Anderson, M.D.

As a firefighter, food may be one of the last things on your mind. You may work one or two other jobs while trying to hold down a busy family life, and you’re committed to showing up for a fire call, ready to get to work. With this number of responsibilities, you eat when you can. But putting food last on your list will eventually leave you unprepared for an emergency because you are too tired or too unhealthy to rise to the challenge. While being unprepared could cause you injury, it could also keep you, your fellow firefighters, your family or the public from getting help when they need it.

We get it. On top of juggling all of those things, nutritional advice is overwhelming and confusing for most of us. So, here is a great saying from Michael Pollan to get you started: “Eat real food, not too much, mostly plants.”

Eat real food

Eating real food means eating items that naturally occur in the world as things you can eat. Think about an apple, a carrot, black beans, nuts or fish. Processed foods, on the other hand, are edible substances that come out of machines or go through heavy processing like puffed snacks, soft drinks, protein drinks or candy bars. Real food is better fuel because it has more nutrients and fewer calories. Plus, it contains the full variety of nutrients our bodies need to do work and stay healthy.

Not too much

Eating too much of anything provides excess energy (calories) which the body stores as fat. Only about 10 to 20% of your weight should come from fat. The rest (80 to 90%) should be muscle, bone, blood, organs and water. But what is too much?

The average person needs somewhere around 2,000 calories per day just to support basic body functions like thinking, moving around, digestion and breathing. Divide this by three meals per day and you are talking about 675 calories per meal (less if you snack), which is not a lot of food. So, besides learning to eat more real food and less processed foods, the next action you can take is to pay attention to how many calories you eat in a day. There are a number of apps you can use for free (such as myfitnesspal.com) that help you easily track your food intake if you want to learn how many calories you eat.

Mostly plants

No, you don’t have to be a vegetarian or a vegan. But you do need to understand that meat is best kept as a “once in a while” part of your diet, instead of a daily dietary staple. All types of meat contain everything an animal ate and was exposed to during its lifetime, not all of which is good.  In addition, certain components of meat, especially red meat, can create inflammation in your body and that can speed up the development of disease in your blood vessels and heart.

Lifestyle changes such as regular exercise and quality nutrition can improve job performance and help your body reach its full potential. Nutrition is a key pillar of a healthy lifestyle that will improve your ability to be present for your colleagues, your family and yourself. You can read more about other healthy lifestyle pillars, such as physical fitness, on the MnFIRE blog.

Learn how to create and maintain good physical fitness and healthy eating habits to support your firefighter training, work demands and long-term health by signing your department up for the new Firefighter Fitness & Nutrition training from MnFIRE. These trainings are available whenever it’s convenient for your crew, and it’s completely free for all fire departments in Minnesota. Sign up today!

Contributed by Paul J. Anderson, M.D.

As firefighters, we’re no strangers to hard physical work. Wearing turnout gear and equipment in extreme heat while dealing with an emergency can push you to your physical limits. In fact, heart attacks are the number one cause of death on the job for firefighters year after year.

Other physical tasks like moving medical patients, some quite large, out of homes or down stairways can tax you physically, or even leave you with an injury. Increasingly, modern fire departments understand that firefighters need to be strong and fit to do the work of firefighting in a way that avoids injury and promotes safety for everyone.

Maybe your department is starting to promote strength and fitness, or maybe you believe that more strength and physical fitness could help you individually as a firefighter. Here are a few ideas to move you forward.

All firefighters need to have a fitness routine running in the background to support their time on duty. Doing nothing and getting out of shape is not a safe option for firefighters, especially as they age.

If you don’t currently have a routine, you’re not alone. According to the CDC, more than 60% of U.S. adults do not engage in the recommended amount of physical activity.

An easy way to kick-start your routine is walking 30 minutes a day for four to five days per week. Find a loop, pick a time, grab a partner and get started.

The bodyweight strength exercises you learned in high school gym class (free squats, sit-ups, crunches, push-ups, pull-ups, etc.) are productive exercises you can also do anywhere. Start easy and work your way up by increasing a few repetitions per week. There are hundreds of 10-minute strength routines on YouTube that you can check out. Here are some more ideas about what you can do to get started.

Interval training is very important for firefighters to train for the intense exertion of a fire evolution. Intervals have you working near your maximum heart rate (Max HR = 220-your age) for two to five minutes followed by an equal period of easy activity that allows you to recover. Then, you work hard again and recover again. In general, an interval workout should contain four to six repeats like this, and can be done on a bike, spin bike, treadmill or stair climber, or you can find a natural environment (a hill, ski trail or stairs) to use for repeat efforts.

Powerlifting is also very important for firefighters, especially multi-joint movements like squats, deadlifts, bench presses and military presses. You want to make sure you learn good technique for these exercises and work with weights that produce stimulus for your muscles and avoid injury. Again, the web is full of programs to help you refine your approach. For technique, take a spin through Juggernaut Training Systems, and for a great power program look up Jim Wendler’s 5-3-1 program.

Interested in diving deeper into the importance of firefighter fitness and nutrition? Check out MnFIRE’s newest training topics and register your department for a free class here.