Welcome to Feeding America’s Bravest: Survival Mediterranean Style!

We aim to motivate firefighters and their families to incorporate Mediterranean Diet principles at work and home through education, participation and incentives. The ultimate purpose of the study is to lower firefighters’ risks for cardiovascular disease and cancer by successfully getting more firefighters and their families to adopt and incorporate the healthy eating principles behind the Mediterranean diet. This site is created for and inspired by firefighters across the nation and developed specifically as a toolkit to aid firefighters to better health!

Why the Mediterranean Diet?

Nutrition and medical experts agree that following a Mediterranean-style diet improves health. However, the health system has had very limited effectiveness in changing Americans’ eating and other lifestyle behaviors, while limited evidence suggests that workplace-based nutrition interventions can be beneficial. Building on prior work with firefighters and the above, our proposal seeks to establish the effectiveness of behavioral change strategies in the fire service to modify the existing food culture. We aim to motivate firefighters and their families to incorporate Mediterranean Diet principles at work and home through education, participation and incentives.

Getting Started!

Site Guide

It is our goal to guide you through the most user-friendly and effective way to utilize our website. As you navigate our site, scrolling downward, please follow these steps to create a virtual classroom for your firehouse.

1. We have created our Firefighters’ Mediterranean Pyramid as a visual overview for the purpose of introducing you to the elements of the Mediterranean Lifestyle. This can be displayed in your firehouse kitchen or on a bulletin board as a visual reminder and used as a one sheet handout.

2. Next, download our Survival Mediterranean Style: Five Small Steps to Improve Your Health, as a summary of action steps to get you started on the Mediterranean Diet. We have also created a Five Small Steps to Improve Your Health (one sheet) that can be posted next to the Firefighters’ Mediterranean Diet Pyramid.

3. Next, Watch our video series, entitled Mediterranean Diet: Videos for Getting Started, to learn the principles of the Mediterranean Diet and the resources available to you! This six part series is an excellent way to learn about the Mediterranean Lifestyle- a well balanced lifestyle that can be enjoyed for a lifetime! It will answer your questions about how to get started; learn about the benefits of olive oil; discover the nutrition principles of the Mediterranean Lifestyle; learn the difference between saturated and unsaturated fats; hear about the importance of adequate sleep, exercise, managing stress, time with your family… and more!

4. Located under Toolkit for Getting Started, you will find the Firefighter Flyer and Mediterranean Diet Quick Tips for Getting Started, each developed as handouts to be disseminated at firehouse meetings or events. These, along with our video series, can be used as an introductory, classroom-style meeting to introduce the Mediterranean Diet at your next gathering!

5. For a list of Firehouse Favorite Recipes and meals created specifically for firefighters by Chef Maria Loi, download our Firefighter Favorites Recipes and Chef Maria Loi Recipes for you and your family to enjoy.

6. Hear Dr. Stefanos N. Kales discuss the Health Benefits of the Mediterranean Diet, a video that can be shared in your next Firehouse meeting!

7. Hosting a fire service meeting or event? Visit our Catering for a Fire Service Event section and download our Guide to Healthy Fire Service Meetings, developed to help you make your fire service event healthier! Included are buffet style recipes for your event and guidelines to hosting a healthy meeting.

Continue through our site to see our latest events and videos; learn more about the components of the Mediterranean Lifestyle and read about the most up to date news and press.

Firefighters’ Mediterranean Pyramid

Getting Started: Five Small Steps to Improve Your Health

Feeding America’s Bravest Five Small Steps to Improve Your Health

Mediterranean Diet: Videos for Getting Started!

In these newly created videos Heather Fink, Registered Dietician, shares the principles of the Mediterranean Lifestyle and resources available to you!

View All Six Videos Here!

Toolkit for Getting Started and Handouts for Your Fire Service Meetings!

Mediterranean Diet Quick Tips for Getting Started

Mediterranean Diet Booklet

Mediterranean Diet Firefighters Flyer

Feeding America’s Bravest 5 Steps to Improve Your Health

Feeding America’s Bravest Five Small Steps (ONE SHEET)

Adding Nuts to Your Diet

2015-2020 Dietary Guidelines for Americans

Recipes Created Specifically for Firefighters, Including “Firefighter Favorites”

Download these recipes, selected by our Nutrition Team, for your enjoyment and the promotion of healthy eating. Each recipe combines flavorful and fresh ingredients. Our “Firefighter Favorites” recipes, were created by our team and chefs, based on focus groups, with Indianapolis firefighters and their spouses. Please note for all recipes, we recommend adding salt sparingly and using lemon, herbs, and garlic to enhance flavors.

Firefighter Favorites Recipes

Chef Maria Loi’s Med Fire Diet Recipes

Click here to visit recipes from www.oldways.org

Click here to view recipes from www.passionforpasta.com

Mayo Clinic Mediterranean Diet Recipes

In this video below, Stefanos N. Kales, MD, MPH, FACP, FACOEM discusses the health benefits of the Mediterranean Diet

In this video below, the presentation of the Mediterranean lifestyle Dr. Stefanos N. Kales gave in the John P. Redmond Symposium/Dominick F. Barbera EMS Conference with International Association of Fire Fighters (IAFF)

Catering Menus for a Fire Service Event

How often have you attended a fire service meeting (even ones related to promoting health and wellness) and the food served is anything but healthy? Here are some simple plans for catering delicious and healthy meals consistent with the Mediterranean lifestyle. These are meals you can thoroughly enjoy, feel full and still feel great about the next day.

Guide to Healthy Fire Service Meetings

Catering a Fire Service Event

Healthy Meeting Guidelines

Hosting a Healthy Meeting

Listen to Our Fire Service Champions

Click on the links below to hear inspirational videos from fire service colleagues, who have successfully adopted the Mediterranean lifestyle.

*You can pause any of the videos as needed in order to read any of the graphics in more detail.

Latest Videos & Episodes

Facing Emergencies: US Firefighters Surviving Mediterranean Style | Stefanos Kales | TEDxRhodes

Firehouse Kitchen…Mediterranean Style Sizzle! Watch a “taste” of an upcoming episode of Firehouse Kitchen…Mediterranean Style Sizzle! Full episode airing soon!

Water and Beverages

Great Ways to Add More Flavor to Your Water!

1. Squeeze it: Add a squeeze of lime or lemon (or both)

2. Mash it: Mash up blueberries in the bottom of your glass, and then pour your water over

3. Go Citrus: Freeze orange slices and use as ice cubes

4. Mint it: Put in a pinch of mint leaves for a refreshing beverage

5. Make a splash: Pour in a splash of unsweetened cranberry juice

6. Cube it: Make ice cubes out of no-sugar-added juice and add to your water

7. Infuse it: Fill a large jug with water, sliced fruit, and ice. Refrigerate overnight for a yummy morning thirst quencher

8. Cuke it: Add sliced cucumbers for a refreshing zing

9. Tea Time: Brew your green or white tea, and then chill

COFFEE & TEA

A plain cup of brewed coffee/tea has only 2 calories and recognized health benefits but if you add extras, you also add extra calories and remove the healthy benefits. Be aware!

1 Tablespoon of table sugar (12g): 48 calories
1 Tablespoon of heavy whipping cream: 52 calories
1 Tablespoon of half-and-half: 20 calories
1 Tablespoon of fat-free milk: 5 calories

Healthier Fast Food Choices

Considering a busy schedule, fast food is sometimes the quickest way to get a meal in during a hectic day. Below are some tips for making healthier choices when fast food is the only option for a meal.

Healthy Fast Food Tips

Healthier fast food tips:

Choose deli-style; Mediterranean; or Mexican/Southwestern fast food options

Order regular portions, avoid large and super-size options

Choose grilled or broiled instead of fried

Pick leaner meats, like chicken, turkey or shrimp

Choose the salad bar when available

Use olive oil, vinaigrette or mustard, instead of mayo and creamy sauces

Drink water or seltzer instead of juices, soft drinks and other sweetened beverages

Choose a salad or some pickles instead of French fries

Choose the whole grain option

For example: a healthy burrito- ask for a whole grain tortilla, brown rice, beans, salad and vegetables, chicken and a little bit of cheese! Or skip the tortilla and order the above as a burrito bowl.

And how about for the kids? Here are some tips from the Harvard Health Letter:

Don’t let kids drink their calories. Order water, seltzer or fat-free milk instead of a soft drink, juice, milkshake, frappe, or smoothie
Watch the side dishes. Get a side salad or baked potato if possible instead of French fries and onion rings, which can be laden with saturated fat
Don’t super-size. Instead, order smaller portions, such as items on the snack menu
Choose grilled or broiled foods instead of fried foods
Hold the cheese. This eliminates extra calories and fat
Use mustard and ketchup instead of the “special sauce”
Model good eating behaviors. That means following all of the rules yourself

Read here on how to think fast when kids want fast food!

Do you want to know more about healthy fast food? Read more here…
Tips for Choosing Healthier Fast Food Options

Grocery Shopping Templates

Feeding America’s Bravest Mediterranean Grocery List

Med Diet Grocery List from Oldways.org

Physical Activity

Good nutrition, adequate sleep and frequent physical activity (150 minutes of moderate intensity or 75 minutes of vigorous intensity aerobic activity) each week promote weight control and reduce the risks of heart disease and cancer, while lowering stress and its negative consequences.

Please note: Before beginning a new exercise program, including exercises discussed on this website, please consult a medical professional for clearance to engage in the activities. After clearance, we recommend exercising at a pace that is comfortable for you. Please discontinue any exercise that causes pain or discomfort, and when appropriate seek immediate medical consultation.

Finding Your Motivation to Exercise

Exercising Your Way to Lower Blood Pressure

Wearable Technology

Smartphone Fitness Apps

Selecting Running Shoes

Outdoor Activities

Body Weight Training

CrossFit

Delayed Onset Muscle Soreness (doms)

Mobility Rollers

Firefighter Functional Fitness

Sleep

Sleep is essential to our body’s proper function. We require sleep for rest and recovery, maintaining energy levels and for our survival.

Good sleep is necessary for the maintenance of good health and in order to enjoy a high quality of life. The demands of the fire service can interfere with sleep habits.

Lack of sleep can harm your health and increase the risk of workplace accidents. All firefighters should aim to get 7-8 hours of sleep a night when possible, and to use strategic short naps as a means to maintain alertness during extended shifts, as well as to recover from shifts that did not allow sufficient sleep time. Sleep disorders can also impair sleep quality and sleep quantity.

Click here to learn more about sleep from the Harvard Medical School Sleep and Health Education Program

Holidays and Dining Out

Holiday time can be hectic and filled with tempting treats! Follow these tips to keep off unwanted holiday weight gain and unnecessary calories. Remember, a brisk walk during a holiday event can be a fun and bonding tradition with family and friends.

Holiday specific eating tips from Harvard Medical School

Check out these healthy holiday recipes!

Develop a “sugar strategy” for healthy holiday eating

Going out for lunch or dinner?

Use the following tips when you order:

Beverages:

Drink plenty of water- still or sparkling. Ask for lemons and limes for extra flavor.

Try a glass of wine instead of a beer.

Avoid empty calories from sodas and other sugary beverages.

Appetizers:

Fresh salads help to fill you up. Avoid bacon and mayonnaise-based items (macaroni salad, tuna salad, potato salad) and go easy on cheese and croutons.

Go for filling, healthy items like extra virgin olive oil, olives, nuts and seeds.

Skip creamy and artificial salad dressings and ask for olive oil with vinegar, balsamic or lemon juice. Add a dash of salt and some pepper to taste.

Don’t fill up on bread. Limit yourself to one slice and choose whole grain options. Ask for olive oil or hummus to dip your bread, instead of butter.

Choose vegetable, chicken, seafood or bean soups and pass on cream-based soups and bisques.

Look for grilled, broiled or raw seafood with lemon/olive oil or cocktail sauce.

Entrees:

Look for grilled, broiled, baked, or roasted poultry or seafood.

If choosing red meat, choose a smaller, leaner cut and get vegetables or salad, rather than a potato.

Avoid fried, breaded, crispy, tempura, creamed, or buttered items.

Use healthier condiments such as olive oil, lemon, mustard, pickles or salsa, instead of mayonnaise, butter, cheese- or cream-based sauces.

If having pasta, choose a tomato, vegetable or seafood-based dished instead of a cream-based or red meat sauce.

Consider a healthy vegetarian entree cooked in olive oil.

Sides:

Instead of French fries, choose vegetables, salads, hummus, vegetable/bean soup, or fresh fruit.

Be assertive and ask for substitutions.

Desserts:

If available, order berries or fruit.

Try to get some quality food in your sweets: choices that contain dark chocolate with nuts or Greek yogurt with honey and walnuts for example.

Split a rich dessert with the whole table.

Skip dessert and have a coffee or tea.

Healthy Eating for Kids

Download the Kid’s Healthy Eating Plate Guide

Learn more about how much physical activity that children need

Healthy Snacks

Choosing healthy snacks between meals can be made easier by preparing snacks ahead of time. Keep a stash of healthy snacks at work, to avoid eating junk food in a pinch.

Healthy Snack List

Healthy Snack List:

Whole wheat toast with extra virgin olive oil and tomato

Whole wheat toast with peanut/almond butter (choose nut butters that are sugar and additive free)

Fresh whole fruits

Oatmeal with almonds

Mozzarella cheese with tomato and basil

Plain Greek yogurt with berries

Celery sticks and baby carrots with hummus

Nuts, preferably raw and unsalted

Whole grain cracker with spread light cheese and avocado

Resources

News & Press

Examining sugar’s effects on human body, public policy

Teaching America’s Bravest Med-Style Survival

Exercise may help make heart younger, Harvard-affiliated study says

US News and World Report Best Diets Top Ranking –Mediterranean Diet

Inflammatory Diet Colorectal Cancer Risk

Recruit Fitness as a Predictor of Police Academy Graduation

Heart disease kills firefighters. This one is also a scientist, and she is fighting back

Sugary beverage consumption in U.S. declining but remains high among certain groups

Eating nuts linked with better heart health

Harvard researchers examine firehouse cancer threat

New research links enlarged heart to sudden cardiac events among firefighters

How Diet Can Reduce Risk of Premature Death

Eggs

Setting the record straight: It’s best to swap out saturated fats for healthier fats

Feeding America’s Bravest, Study Underway in Indianapolis

HDL Function Improved Olive Oil Enriched Mediterranean Diet Predimed Study

Med Diet / Puerto Rico

Extreme Heat Exposure Linked to Firefighter Heart Attacks

Firefighting and the Heart

NY Post: Why the Mediterranean diet is still the best way to lose weight

Mediterranean Diet and Workplace Health September 27-28, 2014 Harvard Chan School of Public Health Boston, MA

Click here to read Dr. Kales’ discussion on “Eating Like a Greek”

Click here to read more about how the Mediterranean Diet can lower the risk of heart disease

When zero gluten brings zero gain

Saturated Fats Linked To Increased Heart Disease Risk

Terms of Use

The contents of this website are for educational purposes and are not intended to offer personal medical advice. You should seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Supported by a grant from the US Federal Emergency Management Agency (FEMA, Washington D.C., USA) Assistance to Firefighters Grant (AFG) program’s award EMW-2014-FP-00612

Publications

Kales SN, Smith DL. Firefighting and the Heart: Implications for Prevention. Circulation. 2017 Apr 4;135(14):1296-1299. doi: 10.1161/CIRCULATIONAHA.117.027018. PMID: 28373524.
Sotos-Prieto M, Cash SB, Christophi CA, Folta S, Moffatt S, Muegge C, Korre M, Mozaffarian D, Kales SN. Rationale and design of feeding America’s bravest: Mediterranean diet-based intervention to change firefighters’ eating habits and improve cardiovascular risk profiles. Contemp Clin Trials. 2017 Oct;61:101-107. doi: 10.1016/j.cct.2017.07.010. Epub 2017 Jul 11. PMID: 28710052.
Korre M, Sotos-Prieto M, Kales SN. Survival Mediterranean Style: Lifestyle Changes to Improve the Health of the US Fire Service. Front Public Health. 2017 Dec 18;5:331. doi: 10.3389/fpubh.2017.00331. PMID: 29326915; PMCID: PMC5741604.
Sotos-Prieto M, Christophi C, Black A, Furtado JD, Song Y, Magiatis P, Papakonstantinou A, Melliou E, Moffatt S, Kales SN. Assessing Validity of Self-Reported Dietary Intake within a Mediterranean Diet Cluster Randomized Controlled Trial among US Firefighters. Nutrients. 2019 Sep 19;11(9):2250. doi: 10.3390/nu11092250. PMID: 31546768; PMCID: PMC6769698.
Jin Q, Black A, Kales SN, Vattem D, Ruiz-Canela M, Sotos-Prieto M. Metabolomics and Microbiome as potential tools to evaluate the effects of Mediterranean Diet. Nutrients 2019, 11, 207; doi:10.3390/nu11010207.
Hershey MS, Sotos-Prieto M, Ruiz-Canela M, Martinez-Gonzalez MA, Cassidy A, Moffatt S, Kales SN. Anthocyanin Intake and Physical Activity: Associations with the Lipid Profile of a US Working Population. Molecules. 2020 Sep 24;25(19):4398. doi: 10.3390/molecules25194398. PMID: 32987892; PMCID: PMC7582364.
Sotos-Prieto M, Ruiz-Canela M, Song Y, Christophi C, Mofatt S, Rodriguez-Artalejo F, Kales SN. The Effects of a Mediterranean Diet Intervention on Targeted Plasma Metabolic Biomarkers among US Firefighters: A Pilot Cluster-Randomized Trial. Nutrients. 2020 Nov 24;12(12):3610. doi: 10.3390/nu12123610. PMID: 33255353; PMCID: PMC7761450.
Romanidou M, Tripsianis G, Hershey MS, Sotos-Prieto M, Christophi C, Moffatt S, Constantinidis TC, Kales SN. Association of the Modified Mediterranean Diet Score (mMDS) with Anthropometric and Biochemical Indices in US Career Firefighters. Nutrients. 2020 Nov 30;12(12):3693. doi: 10.3390/nu12123693. PMID: 33265967; PMCID: PMC7759922.
Hershey MS, Sotos-Prieto M, Ruiz-Canela M, Christophi CA, Moffatt S, Martínez-González MÁ, Kales SN. The Mediterranean lifestyle (MEDLIFE) index and metabolic syndrome in a non-Mediterranean working population. Clin Nutr. 2021 May;40(5):2494-2503. doi: 10.1016/j.clnu.2021.03.026. Epub 2021 Mar 31. PMID: 33932793.
Romero Cabrera JL, Sotos-Prieto M, García Ríos A, Moffatt S, Christophi CA, Pérez-Martínez P, Kales SN. Sleep and Association With Cardiovascular Risk Among Midwestern US Firefighters. Front Endocrinol (Lausanne). 2021 Nov 11;12:772848. doi: 10.3389/fendo.2021.772848. PMID: 34858343; PMCID: PMC8632221.
Christodoulou A, Christophi CA, Sotos-Prieto M, Moffatt S, Kales SN. Eating Habits among US Firefighters and Association with Cardiometabolic Outcomes. Nutrients. 2022 Jul 4;14(13):2762. doi: 10.3390/nu14132762. PMID: 35807942; PMCID: PMC9268786.

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Feeding America’s Bravest: Survival Mediterranean Style – Firefighters’ Mediterranean Diet Intervention