Better Nutrition Can Help Firefighters Fight Cancer

Firefighters are burdened by a disproportionate risk of many cancers (e.g., digestive and respiratory cancers) compared with the general population. Their experiences with cancer and their views on the extent to which diet can help decrease cancer risk have been explored previously. That research sheds light on the relationship between dietary habits and cancer prevention awareness within the firefighting community. Understanding their perceptions can guide the development of targeted interventions to mitigate cancer risks, emphasizing the role of diet in cancer prevention among firefighters.

A recent research article opens in new tab/window in the Journal of Nutrition Education and Behavior opens in new tab/window, published by Elsevier, examined American firefighters’ understanding of cancer history, attitudes towards cancer, and views on diet as a preventive measure against cancer.

Author Ashlea Braun, PhD, RD, TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, explained, "Given the connection between diet and cancer risk and the risk of cancer among firefighters, it is of paramount importance to understand how these risk factors can be mitigated through evidence-based interventions."

The study employed a mixed methods cross-sectional design, reaching out to professional networks across the United States to recruit a national sample. The survey collected data on participants’ cancer history and perceptions of nutrition's role in cancer prevention, using both quantitative and qualitative questions based on established surveys and the Health Belief Model, a tool to help predict health behaviors.

Data analysis included quantitative assessment via SPSS statistical software and qualitative content analysis, seeking to understand dietary changes for cancer risk reduction. A rigorous coding process was used to identify intervention strategies and nutrition-related factors. Specifically, qualitative responses were coded using the Behavior Change Technique Taxonomy Version 1 (BCTTv1) to operationalize what firefighters reported wanting to help them change their diet into evidence-based, established behavior change techniques to inform future interventions.

A total of 471 firefighters participated. Nearly half (48.4%) strongly agreed that they are at risk for cancer, and 44.6% agreed that changing diet could decrease cancer risk. The most common BCTTv1 codes focused on types of education, including “Instruction on how to perform the behavior” (45.1%, n = 189), followed by those centered on behavior execution (e.g., "Action planning" [24.8%, n = 104]). Qualitatively, many were concerned about misinformation and wanted to know exactly what level of risk reduction they could achieve by changing their diet. Many also voiced concerns regarding system-level barriers, such as their fire station food environments.

The study suggests that beyond macro- and micro-level modifications to the food environment, firefighters express a desire for individualized support that addresses their specific risks and helps implement changes with the most significant potential to lower their cancer risk. The COVID-19 pandemic has heightened concerns over misinformation, including in areas related to nutrition, emphasizing the need for credible, specific information that can help in making informed dietary decisions. Future research is encouraged to take these findings into consideration for developing firefighter-focused interventions and to explore similar strategies for other tactical populations.

Dr. Braun commented, "Consistent with previous studies, we found firefighters are aware of their increased risk of cancer and have a willingness to change their diets to promote health. Although there was some doubt about the effects of diet on cancer risk, most participants without a history of cancer believed diet change could lower their risk of cancer.”

Notes for editors

The article is “Perceptions of Preventable Cancer Burden Among US-Based Firefighters: A Mixed Methods Cross-Sectional Study,” by Kristen McClanahan; Pamela Gonzalez Sanchez; Kylie Gant; Jillian Joyce, PhD, RD, and Ashlea Braun, PhD, RD (https://doi.org/10.1016/j.jneb.2024.01.008 opens in new tab/window). It appears in the Journal of Nutrition Education and Behavior, Volume 56, Issue 5 (May 2024), published by Elsevier.

The article is openly available for 90 days at https://www.jneb.org/article/S1499-4046(24)00009-5/fulltext opens in new tab/window.

The authors would like to thank the tactical populations who participated in this study.

Full text of the article is also available to credentialed journalists upon request; contact Eileen Leahy at +1 732 406 1313 or [email protected] opens in new tab/window to obtain a copy or additional information. To schedule an interview with the author(s), please contact Ashlea Braun, PhD, RD, TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Tulsa, OK, at [email protected] opens in new tab/window.

An audio podcast featuring an interview with Ashlea Braun, PhD, RD, and other information for journalists are available at www.jneb.org/content/media opens in new tab/window. Excerpts from the podcast may be reproduced by the media with permission from Eileen Leahy.

About the Journal of Nutrition Education and Behavior (JNEB)

The Journal of Nutrition Education and Behavior opens in new tab/window (JNEB), the official journal of the Society for Nutrition Education and Behavior (SNEB), is a refereed, scientific periodical that serves as a resource for all professionals with an interest in nutrition education and dietary/physical activity behaviors. The purpose of JNEB is to document and disseminate original research, emerging issues, and practices relevant to nutrition education and behavior worldwide and to promote healthy, sustainable food choices. It supports the Society's efforts to disseminate innovative nutrition education strategies, and communicate information on food, nutrition, and health issues to students, professionals, policymakers, targeted audiences, and the public.

The Journal of Nutrition Education and Behavior features articles that provide new insights and useful findings related to nutrition education research, practice, and policy. The content areas of JNEB reflect the diverse interests of health, nutrition, education, Cooperative Extension, and other professionals working in areas related to nutrition education and behavior. As the Society's official journal, JNEB also includes occasional policy statements, issue perspectives, and member communications.

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