LAUSR

Elevated blood pressure (BP) is related to lifestyles and is prevalent among firefighters, but evidence is limited to non-Asian populations. We validated a revised 7-item Mediterranean-diet-based lifestyle score (MEDI-Lifestyle) and utilized it to examine Taiwanese firefighters’ lifestyle and its association with BP. A cohort-based online survey investigated 548 firefighters in Tainan, Taiwan during mid-May 2023. After excluding non-adults, those with missing essential information, and outliers, we analyzed 486 (88.7%) participants. Retests were done five weeks later in a subsample (n=22). We calculated the test-retest intraclass correlation coefficient (ICC) for reliability and the Spearman’s correlation coefficient (ρ) between the Insomnia Severity Index (ISI) and MEDI-Lifestyle for concurrent validity. Multiple linear regression models were built to examine the associations between the MEDI-Lifestyle and BPs. Participants’ BPs were measured following a standard protocol. The R software 4.3.1 and SAS 9.4 were used for analyses. National Yang Ming Chiao Tung University’s Institutional Review Board approved the study (NYCU112057AE). The test-retest ICC was 0.44 (95% CI: 0.035–0.72). The MEDI-Lifestyle was negatively correlated with the ISI (ρ= -0.208, P< 0.001). After multivariable adjustment, a one-point increment in MEDI-Lifestyle was associated with 1.3 and 1.4 mmHg decrement in systolic and diastolic BP, respectively (both P< 0.05). Using the MEDI-Lifestyle to assess Asian firefighters’ lifestyle and its association with BPs is a valid and novel approach. Future research is warranted to establish a causal relationship between MEDI-Lifestyle and BP. With fair reliability and validity, the MEDI-Lifestyle, which is negatively associated with BP, is applicable to Taiwanese firefighters.