A few years back, I evaluated a fire chief with perfect numbers. Low cholesterol, no family history of heart disease, a clean resting EKG and a normal stress test. He worked out regularly and ate a Mediterranean-style diet. On paper, he was healthy. Then one day, out on a run, he had a cardiac arrest.
That case has stuck with me: doing everything right does not take away the stresses of being a firefighter. Firefighters carry roughly double the cardiovascular risk of the general population, and not because most of them are unhealthy. It is the shift work, the adrenaline surges, and the exertion of carrying heavy gear that stress the cardiovascular system over and over, year after year.
The laws of physiology and physics apply to us all. We can’t change what the job asks of a firefighter. What we can change is how well the body is prepared to tolerate it, and that comes down to daily habits: food, sleep, exercise, preventive care, and the people around you.
Why It Matters
Sudden cardiac events remain the leading cause of firefighter line-of-duty deaths, but the good news is that many are preventable through earlier detection and better daily habits. Add a roughly 40% higher risk of diabetes and obesity tied to rotating schedules, chronic sleep disruption, and repeated exposure to heat, smoke, and chemical byproducts, and you get a body that is fighting inflammation around the clock, not just during a working fire.
Strong daily habits protect your mind, body, and spirit. The daily choices that firefighters make around food, sleep, recovery, and company are the real levers crews have between calls to mitigate their health risk. Here are five habits worth building in the firehouse for managing crew health.
Understand how shift work affects your body
Rotating shifts and disrupted sleep won’t just make you tired. Ongoing, dysregulated cycles raise cardiovascular risk, worsen mood, and make it harder for the body to regulate blood sugar and inflammation, even in people who feel fine and pass their fitness test every year.
Consistency is the fix. Take steps to protect your sleep environment with blackout shades and a white noise machine, get bright light soon after waking, and avoid caffeine in the six hours before you plan to sleep — whether you are on shift or off.
Use high-phenolic olive oil as an anti-inflammatory tool
Not all olive oil is the same. High-phenolic extra virgin olive oil is rich in oleocanthal, a compound that laboratory research suggests acts on the same inflammatory pathway targeted by ibuprofen. It is food, not medicine, but for a body absorbing daily wear on the joints, heart, and lungs, it is a small habit worth building. About a tablespoon and a half per day of high-phenolic olive oil provides a meaningful dose of these compounds; the rest of your cooking oil can simply be good extra virgin olive oil.
This approach extends the Firefighters’ Mediterranean Diet Pyramid, developed through Dr. Stefanos Kales’s Feeding America’s Bravest program at Harvard for the fire service: olive oil at every meal, lean meats, fish and legumes several times a week, red and processed meat kept to a minimum, and sugary drinks replaced with water. It is not a restrictive diet. It is a default pattern you return to between shifts, the way you return to your training on a difficult call.
Bring ‘blue zone’ habits into the firehouse
Researchers who study the world’s longest-lived communities, known as blue zones, have identified nine shared habits often called the Power 9. Several of the nine translate directly to station life. In Ikaria, the Greek blue zone, three of those nine come down to a single word: παρέα (paréa), literally “company,” the circle of friends you eat with and spend the evening with. Nothing shapes your habits more than the company you keep, and a firehouse crew is already paréa.
Another blue zone habit is the 80% rule.****In Okinawa, people say “hara hachi bu” before meals, a reminder to stop at about 80% full. On shift, that means plating your food instead of eating straight from the pan between calls.
In addition, consciously practice downshifting.****Chronic stress drives the inflammation behind many conditions screened for in this job. A short walk, a call home, or 10 quiet minutes after a hard run can reset your nervous system before the next tone drops.
Finally, take a nap.****Twenty-to-30 minute naps have been shown to measurably improve alertness, and regular short naps have been linked to lower cardiovascular risk. So, nap when you can. It is not a luxury, it is a restorative tool.
Treat peer support as part of your care plan
Most crews know someone who struggled quietly instead of speaking up on shift. While that hesitation is understandable in a culture built on toughness, it also helps explain why depression, anxiety, and PTSD run well above general-population rates. The paréa principle works here, too. The same table where you talk about meals and workouts is the easiest place to talk about life. You do not need a diagnosis to check in on a crewmate, or to wait for someone else to go first. Asking, “How are you sleeping?” alongside “What’s for dinner?” helps normalize conversations about the whole picture of health, not just the physical half.
Get two exams a year, not one
Your family doctor’s annual physical is necessary care: it treats what is wrong and bills through insurance. An NFPA 1582 medical surveillance exam does a different job. It is tied to your exposures and years of service, and it trends your labs year after year. This means that a number that is still “normal” but drifting the wrong way gets caught before it becomes a diagnosis. Ask for an ApoB test with your lipids; it counts the artery-clogging particles a standard cholesterol panel can miss. Have both exams, about six months apart. If your department does not offer surveillance, ask why.
Practical eating tips you can start this shift
The benefits of making small swaps in the firehouse food pantry add up faster than most crews expect, and they’re relatively easy to implement:
- Swap butter and margarine for extra virgin olive oil in cooking and at the table
- Replace energy drinks and soda with water. If you want caffeine, keep it early in the shift, add up what you’re really taking in across coffee, pre-workout, and drinks, and stay below 400 mg a day
- Reach for chicken, fish, eggs, and beans over red meat and processed meat most days of the week
- Put fruit or vegetables on every plate, reach for berries when the dessert craving hits
- Choose whole grains over refined carbs where you can: brown rice, whole wheat, oats
- Eat one meal a shift as a crew, phones down, at the table. That is paréa, and it is as much a part of the plan as anything on the plate
None of this requires a grocery overhaul. It requires a decision, made one shift at a time, that what’s on your plate matters as much as your training. The job will always demand a lot from your body. Take care of yourself first, so you can take care of others.
