Let's be careful to not use the word “standard.” The word, by definition, is a level or grade of excellence or attainment regarded as a goal or measure of adequacy. Rather, let's talk of good sense, wellness and fitness.

In my April and May columns, I identified a goal of 45 ml/kg/min for maximum oxygen consumption (VO₂ max), or cardiovascular fitness. That number is based on research that evaluates oxygen consumption relative to the tasks of firefighting. It's a considerably greater challenge to identify a “goal” for body fat. Epidemiologically, we are on very solid ground relative to the health risks associated with “overfatness” or obesity. The greater the overfatness, the greater the risk of disease.

It's much more difficult to determine the threshold of body fat at which one's job performance begins to deteriorate. There are the obvious ones: the seat belt won't fit, the steering wheel is in the way, you can't make it up a flight of stairs. Because the VO₂ value has body weight factored into the equation, an individual who is heavier (by way of fat) will have his or her VO₂ number negatively affected because body weight is in the denominator (divided into the milliliters of O₂ consumed). Therefore, the member who is carrying excess body fat will generally have a lower VO₂ max and won't be able to perform certain tasks.

But we know many overfat people who can perform quite well. In fact, I recently was surprised to observe one of our firefighters, who by appearance was overfat, perform quite well on our quarterly fitness tests. The point that I tried to make with him was that if he dropped the excess weight, his performance and health would be that much better. I know he heard me, but I don't think he was listening.

Therefore, until we have specific and appropriate performance tests, including cardiovascular, strength, flexibility and body composition tests, that are widely used to evaluate an incumbent's fitness, we must emphasize good sense and wellness. It's my hope that a firefighter's or paramedic's individual pride and good sense will kick in and say, “Yes, I could perform better if I were less fat, and I would be healthier.” But can we and should we rely on the individual to determine what his or her body composition should be? Or should the department define that for the member and provide a way to achieve that goal? Lives may depend on this goal being reached.

I think that all of us in the fire service would agree that firefighters and paramedics shouldn't be obese because of the relationship to hypertension, Type 2 diabetes, cerebrovascular disease and atherosclerosis. I would also venture to guess that we can agree that fire service members shouldn't be obese if they're to effectively perform their jobs. We're not talking standards right now, just obesity.

It's generally accepted that for young males, a value of 20% fat represents borderline obesity and for older men, 30%. For young women, borderline obesity begins at 30% and for older women, 37%. For many, this isn't an overnight phenomenon. Studies show that the average American male will gain approximately one pound a year — and for most, this is fat — until age 60.

So, let's just start at this point. Let's eradicate obesity (non-medically related) from the fire service because I believe that obesity and the fire service aren't synonymous. From the good-sense perspective, let's not quibble about how we're going to determine obvious obesity, because it should be reasonably and visually apparent. It's not about tenths of a percent. Good sense suggests that if you are an older male at 28%, you should be concerned about body fat and your weight, even if you aren't “obese.” Don't just chalk it up to being a few pounds overweight. Recognize that in actuality, you're a few pounds away from obesity.

We can determine body fat by underwater weighing, skinfolds, air displacement, circumferences, bioelectrical impedance analysis or body mass index. Body mass index is probably the simplest to calculate, but it doesn't take into account individuals with excess muscle mass. I daresay that in any given department, there are plenty of individuals for which BMI will work fine. For BMI, take your body weight in kilograms (2.2 pounds per kilogram) and divide it by your height in meters (multiply height in inches times .0254) squared.

For example, if you weigh 225 pounds and are 68 inches tall:

225/2.2 = 102.3 kilograms
68 inches × .0254 = 1.727 meters
BMI = 102.3 kilograms/(1.727 × 1.727) meters = 34.3

Obesity is considered to be a BMI greater than or equal to 30, regardless of gender. However, BMI doesn't take into account body composition, thus it has its limitations for athletes. If the member is athletic with a higher amount of muscle weight than average, a measurement that takes body composition into account should be used.

It makes good sense not to be obese. It also makes good sense that a firefighter/paramedic should be considerably less than obese to perform what is considered one of the most dangerous occupations in the world.

Research published in 1992 by G.A. Bray in the American Journal of Clinical Nutrition indicates that the lowest risk categories for both men and women are in the 20-25 range. The risks for high blood pressure, diabetes and heart disease occur when the BMI exceeds 27.8 for men and 27.3 for women.

You'll note that the increased risks of disease occur despite being under the BMI for obesity. It makes good sense to be under 30 and get out of the obese category but it makes even better sense to continue to lose body fat and strive for the lower risk categories. Exercise and good nutrition will help you achieve these goals. Let's head toward wellness and strive for fitness.

What percent fat should we be if we want to be fit? This is a difficult question to answer, as fitness has a range. However, here are some values that allow you to help your members make their own healthy decisions. William D. McArdle, Frank I. Katch and Victor L. Katch state in their Essentials of Exercise Physiology that the average percent fat values for young adult men and women are 15% and 25% respectively. A study of national and international long distance runners shows an average of 3% for males (considered extremely low, as essential fat is considered to be about 3%) and 15% for females (essential fat is approximately 12%).

For fitness, body fat percentage should obviously fall somewhere between essential fat and obesity, and certainly more toward the essential fat direction. Have your members think about their work as firefighters and paramedics. What kind of fitness, as it relates to body composition, do they need to do their jobs? They don't need you or me to tell them. I'll bet you that they know the answer.

An exercise physiologist at California State University, Northridge, Steven Loy was hired by the Los Angeles Fire Department to develop an extensive exercise program as their wellness coordinator. His columns recount his experiences with the LAFD from the combined perspective of an expert fitness consultant and a tax-paying citizen.