Teaching America’s Bravest Med-Style Survival

Stressful work­ing con­di­tions, high adren­a­line, and risk. These are some com­mon char­ac­ter­is­tics of the every­day day life of fire­fight­ers when on duty, but it turns out that flames and fumes are not their biggest prob­lem.

In America, it has been found that car­dio­vas­cu­lar dis­ease is the lead­ing cause of on-duty deaths of fire­fight­ers, and no strate­gies to encour­age healthy eat­ing are estab­lished. Stefanos Kales, a pro­fes­sor of med­i­cine at Harvard Medical School, wants to pave a safer path for fire­fight­ers by chang­ing their food cul­ture to adapt to the dietary prin­ci­ples of coun­tries bor­der­ing the Mediterranean sea with olive oil in the van­guard.

“Some fire­fight­ers and their fam­i­lies already used olive oil, many did not,” Kales told Olive Oil Times. ​“They really appre­ci­ate the olive oil, how­ever, other items such as Greek olives were not big hits. This appears to be a mat­ter of what peo­ple are used to eat­ing or not and will­ing to try,” he explained.

Kales descends from a Greek fam­ily which moved to the United States about 100 years ago.

“In Greece, the con­sump­tion of olive oil per per­son is dou­ble than in Italy or Spain,” he said. ​“We lit­er­ally bathe our food in olive oil. We also have strained yogurt and table olives which, if pre­pared in the tra­di­tional way, are a super­food.”

He unremit­tingly fol­lows the Mediterranean diet and acknowl­edges that his grand­mother was the most influ­en­tial per­son in shap­ing his every­day menu.

“She was not edu­cated, but she had com­mon sense and had mas­tered the art of tra­di­tional cook­ing,” he said. ​“My par­ents were lured by the nutri­tional trend of the time which treated good and bad fats the same and pro­moted dietary prod­ucts, while my grand­mother insisted on using olive oil, col­lect­ing wild veg­eta­bles, and using them to make pies for us.”

As a senior in col­lege back in 1992, Kales was assigned the task to med­ically attend to a haz­mat team, which con­sisted of spe­cially trained fire­fight­ers to deal with haz­ardous chem­i­cal mate­ri­als.

He soon real­ized that the team mem­bers were not suited for their job — not because they were not prop­erly trained — but because of their eat­ing habits; many were obese and their lab exam­i­na­tion results were not look­ing good.

“One of them weighed almost 200 kilos (441 Lbs.), another had extremely high triglyc­erides. We had to do some­thing,” Kales recalled.

“I totally respect the fire­fight­ers as pro­fes­sion­als. However, about 35 to 40 per­cent of fire­fight­ers do not exer­cise or do any sport, and half of the vol­un­teers were over­weight,” he said. ​“The chances for fire­fight­ers to undergo a heart attack increase ten-fold to one-hun­dred-fold when in the field than when in the sta­tion.”

Kales has been work­ing with fire­fight­ers for 25 years now, along with his other research inter­ests and teach­ing at the uni­ver­sity. He came up with a pio­neer­ing approach to help Indianapolis fire­fight­ers per­form bet­ter in the field and with­stand the on-duty per­ils.

The fire­fight­ers tak­ing part in the pro­gram were sep­a­rated into two groups: one group received eat­ing rec­om­men­da­tions based on the Mediterranean diet, while the oth­ers kept eat­ing habits unchanged. Then, the groups will switch roles and dietary rou­tine.

“In 2015 we received a state fund of $1.5 mil­lion and we ini­ti­ated a pro­gram with the fire­fight­ers of Indianapolis,” he said of his ven­ture. ​“About 350 fire­fight­ers enrolled and remain in the Indianapolis study. One half of these were first intro­duced to our pro­gram’s edu­ca­tional mate­ri­als and web­site a year ago. They also received some sam­ples of free extra vir­gin olive oil and other Mediterranean food sta­ples at sev­eral points dur­ing the year.”

The project is no walk in the park for Kales and his team. ​“With 44 fire sta­tions dis­trib­uted through­out the city of Indianapolis, it is chal­leng­ing to pro­vide face-to-face edu­ca­tion and inter­ac­tion. Thus, we have relied on a par­tic­i­pant web­site that pro­vides infor­ma­tion, recipes, videos, etc.,” he said.

“When in the inter­ven­tion, the fire­fight­ers also get coupons monthly for healthy foods at a major super­mar­ket chain. The other group of fire­fight­ers went one year with­out any changes and they are now enter­ing the inter­ven­tion phase. The feed­back we are get­ting is they are anx­ious to try it out. Time will tell how well it goes.”

The project is still ongo­ing and it is sched­uled to last for two years. ​“We are now enter­ing month 13 of 24 months. We need to await the full data col­lec­tion and analy­ses to see how effec­tive we were in get­ting peo­ple to use olive oil and use more olive oil if they were already con­sumers,” Kales explained. At the end of the project, the col­lected data will be ana­lyzed to indi­cate dif­fer­ences between the two groups of fire­fight­ers in terms of eat­ing pref­er­ences and phys­i­cal con­di­tion.

According to the sci­en­tific report of the Dietary Guidelines Advisory Committee of 2015, the Mediterranean diet is accepted and rec­om­mended as a healthy eat­ing pat­tern for Americans. The work of Kales and his team is one of the few that exam­ine effec­tive appli­ca­tions of the diet in real-world set­tings and, apart from help­ing the fire­fight­ers, it will pro­vide the basis for inter­ven­tions in other pro­fes­sional groups like the mil­i­tary and law enforce­ment employ­ees.

• Rationale and design of feed­ing America’s bravest


• Kathimerini