**4. Discussion**

Since service in the Police is considered a dangerous occupation, it is required that the potential candidate is in excellent health condition [18]. Police officers are a professional group particularly exposed to work-related stress, which may have a negative effect on the health condition. Numerous studies sugges<sup>t</sup> that exposure to both chronic and work-related stress is associated with an increased risk of civilization diseases, including obesity, cardiovascular disease (CVD), and type 2 diabetes (T2DM) [19,20]. Research in this area shows a higher incidence of diseases, especially cardiovascular diseases, among police officers than in other professional groups [21]. This observation is supported by epidemiological reports showing a higher incidence of obesity among police officers in relation to non-police employees [22,23]. Hence, it seems extremely important to study the relationship between body composition and the risk of diet-related metabolic diseases as they may be essential in monitoring the health of police officers. Consequently, obtained observations and results enable the implementation of appropriate preventive measures, which is the main tenet of the National Health Program, partly presented in this paper.

The presented research studies were conducted at the places of service of police officers, which is why we based on measurements performed with mobile equipment. Body composition assessment is a valuable and accessible tool enabling the simple evaluation of physical fitness and health as it results from various factors such as diet, stress, the intensity of physical activity and other daily habits [24,25].

The assessment of nutritional status elements based on anthropometric measurements and BMI revealed excess body weight in the majority of examined Police officers. These results were different depending on the place of the research and ranged from 60.0% to 69.1%. The fact that 71.8% of all male participants and 35.4% of women are overweight is disconcerting. According to the classification of nutritional status based on BMI, 25% of the women and 56% of men were overweight, while obesity was found in 10.4% and 15.8%, respectively. These results align with observations made among uniformed services in recent years, similarly to the civilian population [26].

As we indicated earlier, the assessment of overweight and obesity based on BMI values may not be reliable for adults with increased physical activity and high muscle mass. BMI cannot distinguish between fat mass and lean mass; thus, it is advisable to determine the fat mass and calculate Fat Mass Index (FMI). This indicator assesses the degree of fatness and not the entire body weight, which in the case of a police officer may result in extensive muscle mass, increasing the BMI. The synthesis of those parameters seems to be an optimal approach as it can provide information about the actual number of obese people. The total body fat content measurement in police officers showed that 31.8% of all respondents had increased adipose tissue content. What is essential is that every subject with excessive body fat also had excessive BMI. By sex, irregularities in the body fat content of varying severity were found in 16.7% of female officers and 34.9% of female officers. In our study, the average BMI among Police male officers was above reference values, while the average % fat level and FMI were adequate in both sexes. Our previous research regarding polish soldiers confirmed similar observations [26].

The prevalence of overweight and obesity among police officers is also a significant health problem in other countries. Although the physical demands of police work sugges<sup>t</sup> the importance of maintaining a healthy body weight, studies have shown that 40.5% of U.S. police officers are obese [27]. A similar result was observed in another study of 276 U.S. police officers, where the obesity rate of male police officers was 41.9% [28]. These observations are supported by a study of the nutritional status of 160 Saudi Arabian police officers, where overweight or obesity was found in 66.9% of respondents [29].

Another measure of nutritional status essential for police officers is bone mineral density (calcification). A low value of this parameter leads to osteopenia and osteoporosis. Osteoporosis is a condition that affects the bones, causing them to become weak and fragile and more likely to break (fracture). Changes in bone mass occur due to complex regulatory mechanisms based on genetic factors and the nervous and humoral systems [30]. The role of an adequate supply of calcium and its content in the body for the proper functioning of the skeletal system is indisputable. However, it should be noted that the content of this element in the body undergoes dynamic changes [31]. Therefore, it is essential to achieve the maximum values of peak bone mass, which is the main prognostic factor for the risk of osteopenia or osteoporosis and to monitor bone calcification in the prevention of osteoporosis. This is of particular importance among police officers, as it allows for the early detection of disorders and appropriate therapy and avoiding fractures, which may be the reason for dismissal from service. In the presented study, only half of the examined women revealed a proper BMD (T-score above −1); changes typical of osteopenia were found in 47.7% of subjects, while osteoporosis was found among three of 67 examined women. Significantly better results were obtained in the case of men, as bone calcification disorders concerned only about 20% of the studied population and features of osteoporosis were found in less than 1% of the respondents.

Due to the lack of similar research among police officers, the obtained results can be applied to soldiers who are also subjected to similar conditions of service and training. Our previous research on soldiers trained similarly to candidates in police schools showed that osteopenia and osteoporosis were found in 19.2% of respondents under 30 and 7.4% of soldiers over 30 [32]. On the other hand, studies performed among Polish Land Forces soldiers revealed adequate bone calcification in 75% of soldiers aged up to 30 and among 90% of soldiers aged over 30 [33]. Similarly, 77% of soldiers returning from a mission in Afghanistan, aged up to 30, and 87% of soldiers aged over 30 were characterized by an adequate bone calcification [34].

#### **5. Strengths and Limitations**

The presented research has several strengths. First, it may be considered a unique study as there are limited numbers of studies among police officers in Poland that assess the elements of the nutritional status (anthropometry, body composition, and bone calcification). Moreover, we focused on three nutritional status indicators: indicators of protein-energy status describing body size (BMI) and obesity (FMI) and indicators of mineral nutritional status (BMD T-score) that are considered essential in the evaluation of police officer's health and suitability for the service. The results of bone calcification are unique since there are no studies evaluating this aspect of nutritional status among police officers in Poland. Third, based on the body composition and densitometric analysis, we revealed significant abnormalities in Police officers' nutritional status, which clearly show the necessity to perform educational activities in the health promotion of uniformed services (Police officers). These activities should be primarily focused on nutritional prevention of nutrition-related non-communicable diseases and motivate police officers to respect the basic principles of a healthy lifestyle.

One of the study's limitations is the relatively small group (289 police officers). However, our research aimed to gain cross-sectional knowledge concerning the tested parameters of officers at their service places. Although the surveyed officers come from different units, this group is a representative sample of this uniformed formation. From the above limitation comes another one concerning using a DEXA-based apparatus for measuring body composition. We agree that this method of collecting data concerning body composition is optimal, but because the research study was carried out off-site in various places of police service throughout the country, we used devices characterized by small size and mobility. We agree that another limitation of the study is the lack of information on the other components of the nutritional status (nutrition and physical activity). However, since the presented work is part of the National Health Program project, these results will be

presented in another work comparing research on diet and physical activity in different uniformed services.
