Mediterranean Diet Lowers Risk of Heart Disease in U.S. Firefighters

Would fol­low­ing a Mediterranean-style diet help reduce risk of heart dis­ease and meta­bolic syn­drome in young American pro­fes­sion­als?

Investigators from Harvard School of Public Health and Cambridge Health Alliance set out to answer this ques­tion. According to the researchers, this is the first study that assessed the effect of a mod­i­fied Mediterranean style dietary pat­tern on risk of heart dis­ease in young, active Americans. Most pre­vi­ous stud­ies that addressed this issue were con­ducted in Mediterranean coun­tries, among older pop­u­la­tions, or among those with pre-exist­ing health issues.

For this study, pub­lished in the jour­nal ​“PLOS ONE” on February 4, 2014, the researchers selected 780 U.S. male fire­fight­ers from 11 fire depart­ments in the Midwest.

Firefighters in the U.S. are at high risk of car­dio­vas­cu­lar dis­ease, which causes as many as 45 per­cent of deaths in on-duty fire­fight­ers, reported a 2011 arti­cle in the jour­nal ​“Cardiology in Review.” Lack of phys­i­cal fit­ness, obe­sity, and high preva­lence of other risk fac­tors for car­dio­vas­cu­lar dis­ease are cited as rea­sons for the high inci­dence.

Rather than chang­ing dietary habits of their sub­jects, inves­ti­ga­tors for the recent study cal­cu­lated adher­ence to a mod­i­fied Mediterranean style diet pat­tern using an adher­ence scor­ing sys­tem based on foods con­sumed by the fire­fight­ers. The sub­jects responded to ques­tions regard­ing their eat­ing habits: choice of cook­ing oils; con­sump­tion of foods made with whole or refined grains; and their fre­quency of con­sump­tion of fried foods, fast foods, seafood, fruits and veg­eta­bles, desserts and bev­er­ages, and wine or alco­hol.

Some of the results were not sur­pris­ing: Obese fire­fight­ers fre­quently con­sumed fast foods, take-out foods and sug­ary bev­er­ages. They also scored lower on the mod­i­fied Mediterranean style diet scor­ing sys­tem than nor­mal weight fire­fight­ers.

Firefighters who fol­lowed the mod­i­fied Mediterranean style diet were less prone to be obese, had lower body fat, were phys­i­cally fit, and did not report any weight gain in the past five years. They also had lower lev­els of LDL cho­les­terol and higher lev­els of HDL cho­les­terol, sug­gest­ing a lower risk to heart dis­ease. Additionally, sub­jects with the high­est scores on the mod­i­fied Mediterranean style diet ques­tion­naire reduced their risk of meta­bolic syn­drome by 35 per­cent com­pared to sub­jects with the low­est scores.

These are sig­nif­i­cant find­ings because meta­bolic syn­drome, deter­mined by a large waist­line, ele­vated fast­ing blood glu­cose, high lev­els of triglyc­erides, and low lev­els of HDL cho­les­terol (or the ​“good” cho­les­terol), increases risk of devel­op­ing car­dio­vas­cu­lar dis­ease and type 2 dia­betes mel­li­tus, accord­ing to the Joint Scientific Statement on Harmonizing the Metabolic Syndrome in the jour­nal ​“Circulation.”

The authors sug­gest that edu­cat­ing young, active Americans on the ben­e­fits of the Mediterranean diet, and encour­ag­ing a change in dietary habits could be effec­tive in reduc­ing risk of car­dio­vas­cu­lar dis­ease and improve over­all health of this vital seg­ment of our pop­u­la­tion.

• PLOS One: Modified Mediterranean Diet Score and Cardiovascular Risk in a North American Working Population


• Cardiology in Review: Cardiovascular dis­ease in US fire­fight­ers: a sys­tem­atic review.


• Joint Scientific Statement Harmonizing the Metabolic Syndrome