Food intake restriction for health outcome support and education (Firehouse) protocol: A randomized clinical trial

Sophia Kwon, Jessica Riggs, George Crowley, Rachel Lam, Isabel R. Young, Christine Nayar, Maria Sunseri, Mena Mikhail, Dean Ostrofsky, Arul Veerappan, Rachel Zeig-Owens, Theresa Schwartz, Hilary Colbeth, Mengling Liu, Mary Lou Pompeii, David St-Jules, David J. Prezant, Mary Ann Sevick, Anna Nolan

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Fire Department of New York (FDNY) rescue and recovery workers exposed to World Trade Center (WTC) particulates suffered loss of forced expiratory volume in 1 s (FEV1). Metabolic Syndrome increased the risk of developing WTC-lung injury (WTC-LI). We aim to attenuate the deleterious effects of WTC exposure through a dietary intervention targeting these clinically relevant disease modifiers. We hypothesize that a calorie-restricted Mediterranean dietary intervention will improve metabolic risk, subclinical indicators of cardiopulmonary disease, quality of life, and lung function in firefighters with WTC-LI. To assess our hypothesis, we developed the Food Intake REstriction for Health OUtcome Support and Education (FIREHOUSE), a randomized controlled clinical trial (RCT). Male firefighters with WTC-LI and a BMI > 27 kg/m2 will be included. We will randomize subjects (1:1) to either: (1) Low Calorie Mediterranean (LoCalMed)—an integrative multifactorial, technology-supported approach focused on behavioral modification, nutritional education that will include a self-monitored diet with feedback, physical activity recommendations, and social cognitive theory-based group counseling sessions; or (2) Usual Care. Outcomes include reduction in body mass index (BMI) (primary), improvement in FEV1, fractional exhaled nitric oxide, pulse wave velocity, lipid profiles, targeted metabolic/clinical biomarkers, and quality of life measures (secondary). By implementing a technology-supported LoCalMed diet our FIREHOUSE RCT may help further the treatment of WTC associated pulmonary disease.

Original languageEnglish (US)
Article number6569
Pages (from-to)1-15
Number of pages15
JournalInternational journal of environmental research and public health
Issue number18
StatePublished - Sep 2 2020


  • 9/11
  • Biomarkers
  • Firefighters
  • Lung injury
  • Mediterranean diet
  • Metabolic syndrome
  • Metabolomics
  • Particulate matter
  • World Trade Center

ASJC Scopus subject areas

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


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