September 2025 - Get Fit For Duty Newsletter
- Get Fit For Duty
- Sep 30
- 12 min read
Welcome
Hello & Welcome to the Get Fit For Duty Research Newsletter!
The aim of this newsletter is to provide a monthly update on recent research focused on the health and wellbeing of firefighters. Each month will aim to have a guest researcher, who will give a insight into their current research and the positive impact their work will make to firefighters.
If you are currently undertaking research within the fire service sector, we would love to hear about your project, please email us at info@getfitforduty.co.uk.
Included in the September newsletter,
Scroll down to read the August edition of our newsletter.
September Monthly Roundup
Hello,
Thanks to those who subscribed and have read the newsletter. I hope that you have found it interesting and a useful insight to some of the work being carried out to support the health and wellbeing of firefighters.
Last month marked “National Fitness day” which was held on 24th September. The following weekend I took part in the London Vitality 10km run along with an estimated 20,000 other runners. It was a great day and I was fortunate enough to be joined on the run with family members and friends of the family. The day had a nice personal touch as I completed the 10km with a new PB time!
We are now into our fourth issue of the newsletter. Our guest this month is Dr Ashley Beckett the Service Fitness and Wellbeing Advisor for Bedfordshire Fire and Rescue Service. Dr Beckett recently completed his PhD and has provide an in depth review of his research, the findings and the future directions of his work.
The article of the month is a systematic review with meta analysis on the association between Cardiovascular Disease Risk Factors and Cardiorespiratory FItness in Firefighters.
As mentioned previously, to help build this community, I need your help. If you know anyone who would be interested in this newsletter, please share it on your social channels and invite them to join our group on LinkedIn. Simply search for “Get Fit For Duty - Firefighter Health & Wellbeing Group”
Stay healthy,
Dr Liam Noll
Sport & Exercise Science, PhD
Newsletter Abstract
Don’t have time to read the full newsletter now? No problems, the Newsletter Abstract provides you will a brief summary of the guest researcher and article of the month included in this month’s issue.
Guest Researcher of the Month - Dr Ashley Beckett, Service Fitness Advisor for Bedfordshire Fire and Rescue Service
Dr Ashley Beckett has recently completed his PhD. His thesis was titled “Cardiovascular Disease Risk Factors, Chrononutrition and The Feasibility of Time Restricted Eating for UK Firefighters”.
Dr Beckett’s thesis was comprised of four studies:
Study 1: A systematic review and meta-analysis to determine the global prevalence of cardiovascular disease (CVD) risk factors in firefighters worldwide.
Study 2: A behavioural survey to explore novel factors (such as dietary habits, sleep, and lifestyle behaviours) that may contribute to elevated CVD risk in firefighters.
Study 3: A cross-sectional health screening of UK firefighters, measuring blood pressure, blood biomarkers, body composition, and aerobic fitness to establish national prevalence of CVD risk.
Study 4: A feasibility intervention study using time-restricted eating (TRE), where operational firefighters trialled restricted eating windows. Outcomes were measured through changes in cardiometabolic health markers, body composition, and self-reported wellbeing.
Dr Beckett summarised his findings by stating the following:
“My research underlines that traditional approaches to firefighter health may no longer be enough. Simply assessing BMI does not capture the whole picture of health, particularly as firefighters age and the focus should be on preserving muscle mass while reducing body fat. Fire Services should be investing in bioelectrical impedance analysis (BIA) scales as a minimum standard during recruitment and annual fitness testing. Monitoring blood pressure is also essential, but reliance on one-off clinical measurements can be misleading due to white coat syndrome. Firefighters identified with high BP should be encouraged to monitor their blood pressure at home to provide a more accurate assessment. Finally, my work highlights that firefighter wellbeing is not only about what is eaten but also when. The timing of food intake — known as chrononutrition — may be a key factor in reducing obesity risk among shift workers. Importantly, this may be an easier behavioural change than overhauling diet quality immediately, acting as a gateway to broader, long-term lifestyle improvements.”
Research Article of the Month - Association between Cardiovascular Disease Risk Factors and Cardiorespiratory FItness in Firefighters: A Systematic Review and Meta-Analysis- Ras, J., Kengne, A. P., Smith, D. L., Soteriades, E. S., & Leach, L. (2023).
The aim of this systematic review was to identify the association between cardiovascular disease (CVD) risk factors and cardiorespiratory fitness in firefighters. The results indicated that CVD risk factors had significant association with cardiorespiratory fitness in firefighters. Additionally, there were further associations with age, obesity, blood pressure and blood lipid concentration. The authors concluded that the current systematic review and meta analysis conducted supported previous findings which highlighted the importance of firefighters maintaining optimum cardiovascular health and cardiorespiratory fitness throughout their operational careers. Recommendations were made for fire services to adopt behavioral intervention strategies to maintain optimum cardiovascular disease risk factor profiles and cardio respiratory fitness among firefighters to ensure their occupational wellbeing.
Guest Researcher of the Month - Dr Ashley Beckett, Service Fitness Advisor for Bedfordshire Fire and Rescue Service
Please tell us a bit about yourself and your background (Including your current role, how long you have been in your role)
I am the Service Fitness and Wellbeing Advisor for Bedfordshire Fire and Rescue Service. I first joined during my PhD through a contract with the University to help remove an HMICFRS cause of concern action plan for firefighter fitness testing. This coincided with collecting data for two of my PhD studies, which involved assessing dietary patterns and cardiovascular disease risk in Bedfordshire firefighters.
After successfully resolving the backlog of fitness testing, I was appointed permanently. My role has since expanded to include wellbeing initiatives, rehabilitation and return to work fitness testing, VO2max assessments, and ongoing health projects. Alongside this, I have also lectured in sport and exercise science at both undergraduate and postgraduate level.
Please tell us about your research topic and what makes your passionate about this area of study.
Having completed my undergraduate in Strength and Conditioning, I was given the opportunity to work with Beds FRS for my BSc dissertation. This opened my eyes to the contrast of a physically demanding occupation combined with a high stress and potentially obesogenic environment. During my PhD proposal, I was shocked to find the cardiovascular related fatalities has consistently been the leading cause of firefighter fatalities since the National Fire Protection Association began collecting this data. With most of these fatalities occurring in individuals with elevated cardiovascular disease risk. I.e., those with obesity, elevated blood pressure, high cholesterol, type 2 diabetes and those > 45 years old.
In the UK, most health research among firefighters have simply used Body Mass Index (BMI) to estimate CVD risk through the prevalence of BMI defined obesity. Within this research, elevated BMI remains an issue, with a high proportion of overweight (53 – 58%) and obesity (11 – 22%) among firefighters from 2008 - 2021. However, the inherent limitations of BMI are well understood, particularly in an occupation where increased muscle mass is encouraged for physically demanding duties.
I therefore decided to concentrate most of my efforts during the PhD to further the understanding of cardiovascular disease risk via the diagnosis of metabolic syndrome - the clustering of > 3 CVD risk factors, which includes hyperglycaemia, hypertension, hypertriglyceridaemia, abdominal obesity, and dyslipidaemia. Then, to identify novel behaviours that may contribute to these risks and assess practical and cost-effective ways to reduce the risk of developing CVD risks among firefighters.
What methodologies have you used within your research project?
My PhD used a mix of statistical analysis, cross-sectional assessments, behavioural surveys, and intervention trials, spread across four main studies:
Study 1: A systematic review and meta-analysis to determine the global prevalence of cardiovascular disease (CVD) risk factors in firefighters worldwide.
Study 2: A behavioural survey to explore novel factors (such as dietary habits, sleep, and lifestyle behaviours) that may contribute to elevated CVD risk in firefighters.
Study 3: A cross-sectional health screening of UK firefighters, measuring blood pressure, blood biomarkers, body composition, and aerobic fitness to establish national prevalence of CVD risk.
Study 4: A feasibility intervention study using time-restricted eating (TRE), where operational firefighters trialled restricted eating windows. Outcomes were measured through changes in cardiometabolic health markers, body composition, and self-reported wellbeing.
How do you hope your research can help address current challenges firefighters face in terms of health and wellbeing?
My research underlines that traditional approaches to firefighter health may no longer be enough. Simply assessing BMI does not capture the whole picture of health, particularly as firefighters age and the focus should be on preserving muscle mass while reducing body fat. Fire Services should be investing in bioelectrical impedance analysis (BIA) scales as a minimum standard during recruitment and annual fitness testing. Where budgets are limited, waist circumference can be used as a cost-effective alternative until BIA becomes feasible — having worked in the Fire Service, I fully appreciate the reality of budget constraints.
Monitoring blood pressure is also essential, but reliance on one-off clinical measurements can be misleading due to white coat syndrome. Firefighters identified with high BP should be encouraged to monitor their blood pressure at home to provide a more accurate assessment.
Finally, my work highlights that firefighter wellbeing is not only about what is eaten but also when. The timing of food intake — known as chrononutrition — may be a key factor in reducing obesity risk among shift workers. Importantly, this may be an easier behavioural change than overhauling diet quality immediately, acting as a gateway to broader, long-term lifestyle improvements.
Can you share any findings or results from your research
Study 1: Systematic Review & Meta-Analysis, 25 studies, 31,309 firefighters
Across the globe, 22.3% of firefighters had metabolic syndrome, with hypertension (39.2%), abdominal obesity (37.9%), hypertriglyceridemia (30.2%), dyslipidaemia (30.1%), and hyperglycaemia (21.1%) all prevalent. Overweight and obesity prevalence were 44.1% and 35.6%, respectively. The risk of being diagnosed with metabolic syndrome increased by 5% with every 1 unite increase in BMI. A gap was identified in UK-specific data and behavioural risk factors, with no current data reporting metabolic syndrome prevalence among UK firefighters.
Study 2: Survey, 164 UK firefighters:
When categorised by self-reported BMI, 48.2% of firefighters were overweight and 23.2% obese. The chrononutrition profile questionnaire revealed on workdays, earlier wake up time and first eating events led to longer eating windows. Obese firefighters had significantly longer eating windows, skipped breakfast more often, and ate more late-night snacks than their healthy weight colleagues.
Study 3: CVD risk measurement, 92 UK firefighters
Among both wholetime and retained firefighters, metabolic syndrome prevalence was 7.6%. The prevalence of its components varied: hypertension (44.6%), dyslipidaemia (20.7%), hypertriglyceridaemia (12.0%), abdominal obesity (10.9%), and hyperglycaemia (6.5%).
Those with BMI defined obesity consistently had elevated CVD risks:
· Abdominal obesity prevalence was 56.3% in obese vs. 0% in healthy weight.
· Hypertension prevalence: 81.3% in obese vs. 25% in healthy weight
· Hyperglycaemia prevalence: 12.5% in obese vs. 3.6% in healthy weight.
· Hypertriglyceridaemia prevalence: 37.5% in obese vs. 7.1% in healthy weight.
· Dyslipidaemia prevalence was broadly similar (18.8% vs. 17.9%).
· ≥ 3 CVD risk factors (metabolic syndrome diagnosis): 25% of obese firefighters vs. 3.6% of healthy weight.
The chrononutrition profile questionnaire revealed obesogenic behaviours:
On non-working days, obese firefighters had a later last eating event (21:41 ± 2:03 h) compared with healthy weight (19:02 ± 1:29 h) and overweight (20:35 ± 2:17 h) (p = 0.024).
Obese firefighters also had a longer eating window (13.1 ± 2.4 h) than healthy weight (10.9 ± 2.2 h) and overweight (11.3 ± 1.9 h) (p = 0.026).
A later last eating event positively correlated with elevated:
· Waist circumference: r = 0.257
· Diastolic blood pressure: r = 0.203
· Fasting blood glucose: r = 0.231
· Triglycerides: r = 0.194
A longer eating window also positively correlated with elevated:
· Waist circumference: r = 0.352
· Systolic BP: r = 0.209
· Diastolic BP: r = 0.248
· Fasting blood glucose: r = 0.286
Study 4: Time Restricted Eating (TRE) Intervention, 24 UK firefighters:
A 4 week self-selected 10-hour TRE protocol, on non-working days led to significant reductions in body mass, BMI, BF%, waist circumference, blood pressure, and fasting blood glucose. Adherence was high (79.2%), and firefighters reported positive biological, psychological, and social effects. On average firefighters actually went below the 10 TRE protocol (8.32 ± 1.45 h) suggesting an 8 hour TRE intervention may be feasible and warrants future research over a longer duration.
Body mass: TRE group decreased from 99.8 → 98.9 kg (p = 0.014), significantly more than control group (p = 0.002).
BMI: TRE decreased from 30.3 → 30.1 kg·m² (p = 0.017), significantly greater than control (p = 0.003).
Body fat %: TRE decreased from 26.4 → 25.4% (p < 0.001), significantly more than control (p < 0.001).
Waist-to-height ratio: TRE decreased from 0.53 → 0.52 (p < 0.001), significantly more than control (p = 0.003).
Fasting blood glucose: TRE decreased from 4.88 → 4.51 mmol/L (p < 0.001), significantly greater than control (p < 0.001).
Systolic blood pressure: TRE decreased from 133.7 → 128.8 mmHg (p = 0.004), significantly more than control (p < 0.001).
Where can our readers learn more about your research project?
Study 1 meta-analysis: https://www.mdpi.com/1660-4601/20/19/6814
What are the next steps or future directions for your research?
The next steps for my research are to further explore how time-restricted eating (TRE) affects energy balance and dietary quality in firefighters, as well as the long-term sustainability of this intervention across different duty systems, including flexi-duty officers and other shift work patterns. I also aim to investigate the impact of TRE on other health outcomes, such as sleep quality, fatigue, and overall wellbeing, to better understand how behavioural strategies can reduce cardiovascular risk in shift-working populations. Finally, I hope to scale the intervention to larger firefighter cohorts and other emergency services, to assess its feasibility and effectiveness at an organisational level.
How can readers contact you for more information regarding your research?
Work email: Ashley.beckett@bedsfire.gov.uk
Or you can connect with me on Linkedin
Research Article of the Month - Association between Cardiovascular Disease Risk Factors and Cardiorespiratory FItness in Firefighters: A Systematic Review and Meta-Analysis
Ras, J., Kengne, A. P., Smith, D. L., Soteriades, E. S., & Leach, L. (2023)
Introduction:
This study highlighted that 45% of on-duty related mortalities were due to sudden cardiac death. Many of these incidents were related to cardiovascular disease and overexertion whilst undertaking operational duties. The aim of this systematic review was to determine if there was any association between cardiovascular disease risk factors and cardiorespiratory fitness in firefighters.
Methodology:
A literature search was conducted. Studies included full time, part time and volunteer adult male and female firefighters between the ages of 18 and 65 years. Cross-sectional, observational and experimental (intervention) study designs were all included in the search.
The figure below provides an overview of the search results and the screening procedure conducted.
Key Findings:
Age
The findings indicated that cardiorespiratory fitness levels were significantly lower in older firefighters when compared with younger firefighters. The authors referenced that previous research had indicated that firefighters tend to become more physically inactive as they age, which may assist in the steady decline in cardiorespiratory fitness seen in this population with time.
Obesity
The findings indicated that obese firefighters had a significantly lower cardiorespiratory fitness level as compared with non-obese firefighters. In addition, firefighters who did not meet the minimum cardiorespiratory fitness levels had a higher BMI than those who did met the required aerobic fitness standards.
Additionally, the authors stated that obesity has been shown to increase the incidence of duty-related fatalities in firefighters. Obesity increases non-functional mass in firefighters that are required to be carried. Previous research has reported that Increased peripheral resistance subsequently increases blood pressure, which reduces atrial preload, negatively affecting stroke volume and oxygen uptake to working muscles. Increased fat mass increases the effort of respiratory muscles to expand the rib cage, reducing the available oxygen content toward working muscles.
Blood Pressure
The authors stated that firefighters who met the minimum cardiorespiratory standard had lower systolic and diastolic blood pressure when compared with firefighters who did not meet the minimum requirements. Increased blood pressure, due to reduced vascular elasticity and increased total peripheral resistance, directly reduced stroke volume.
The authors recommended that firefighters should aim to maintain normal and preferably optimal blood pressure levels throughout their careers to maintain adequate cardiorespiratory fitness levels.
Conclusion
The authors concluded that given firefighters who actively maintain their cardiorespiratory fitness levels are expected to benefit from a positive effect on their cardiovascular health, subsequently reducing the risk of CVD-related morbidity and mortality.
The authors recommended that fire services should promote regular physical activity and behavioral medication programs designed to not only increase the cardiorespiratory fitness of firefighters but improve their overall cardiovascular health status.
One recommended method of achieving this would be for fire services to adopt scheduled physical activity or exercise programs while firefighters are on-duty and ensure that firefighters are regularly assessed to measure their cardiorespiratory health.
Do you need participants for your research project?
Are you looking for participants for your upcoming fire related research project? If you are, send me an email about your project and I would be happy to feature it in an upcoming newsletter to try and help increase participation for your research project.
