Contributed by Nicholas E. Blonien, D.O.

As tactical athletes, firefighters require premium fuel for optimal performance. Their shifts bring a range of physiological stressors, from sleep disruption and intense bursts of physical activity to prolonged time on scene in full turnout gear, temperature extremes, and even periods of downtime. This variability makes proper nutrition challenging, and inconsistent health information adds to the difficulties. While it’s easy to get lost in the details, fueling right shouldn’t be complicated. Below are evidence-based principles of tactical athlete nutrition to help design a personalized, high-performance meal plan for firefighters.

1. Athletes need carbohydrates, but timing matters

Carbohydrates are the best fuel for moderate and high intensity physical activity and can be divided into two categories – simple and complex:

• Simple carbs provide quick energy as they are rapidly metabolized to glucose, causing a blood sugar “spike.”
• Complex carbs deliver more sustained energy due to their slow digestion, causing a “slow burn” elevation in blood sugar.

Muscles use glucose for energy, storing it as glycogen to support ongoing exercise. However, eating simple carbs or a large amount of complex carbs at the wrong time can negatively impact health. If you eat more carbs than your body needs for your activity level, the extra get stored as fat and your body may struggle to control blood sugar, increasing the risk of diabetes.

Tips for fueling:

• Simple carbs should be consumed before physical activity to provide immediate energy.
• Complex carbs can be eaten throughout the day but should be moderated, especially during periods of low activity.

2. Eat between 100-200 grams of protein per day for muscle support

Building a strong physique requires plenty of protein, which is the body’s nutritional building blocks. The FDA’s Recommended Daily Allowance (RDA) for protein is 0.36 grams per pound of body weight, which is the minimum to prevent malnutrition. However, as a tactical athlete, the goal is to thrive, not merely survive, requiring significantly more support for the body in this physically demanding profession.

Tips for fueling:

• Space out your protein intake throughout the day to keep your body in build-and-repair mode, aiming for at least 30 grams each meal.
• Each protein-rich meal should include 3 grams of leucine, a key amino acid for muscle building and repair. It can be found in meat, dairy and legumes.

3. Saturated fat intake and cardiovascular disease

Saturated fat is a primary contributor to increased levels of “bad cholesterol” (LDL) in the blood, which significantly increases the risk of cardiovascular disease – a leading cause of death among firefighters. Saturated fat is commonly found in fatty animal-derived foods, which also offer protein and other nutrients, meaning it’s not necessary to eliminate these foods entirely.

Tips for fueling:

• Select low-fat and minimally processed animal-derived foods when consuming them.
• Incorporate plant-based foods that can provide respectable amounts of protein.
• To highlight the importance of limiting saturated fat, a low-fat, plant-based diet is the only nutrition plan shown to facilitate the reversal of coronary artery disease.

4. Sufficient dietary fiber: a critical component of a healthy nutrition plan

Dietary fiber is non-digestible plant material that plays an essential role in maintaining health. While it may seem insignificant, sufficient fiber intake offers numerous benefits, including improved glucose regulation, better cholesterol levels, a healthy gut microbiome, and regular bowel movements. Strong evidence links fiber intake to chronic disease prevention. Good sources of fiber include fruits, vegetables, nuts, seeds, legumes and complex carbohydrates.

Tips for fueling:

• Adults should aim for a minimum of 30 grams of fiber daily, or about 14 grams per 1,000 calories consumed.
• While there isn’t a defined upper limit for fiber intake, consuming more than 50 grams per day may result in gut discomfort and could possibly impair nutrient absorption.

5. Avoid fad diets like the carnivore and ketogenic diets

While restrictive diets can offer short-term weight loss, as they limit intake of major food groups they are likely to result in nutrient deficiencies in the long run unless you rely heavily on supplements, which may not be the healthiest or cheapest choice.

Examples of diets:

• The Carnivore Diet consists solely of eating animal-derived foods, resulting in low fiber intake and high saturated fat consumption – both clear contributors to chronic disease.
• The Ketogenic Diet minimizes carbohydrate intake, leading to low fiber consumption and increased reliance on animal-derived foods. This diet may also hinder muscle glycogen replenishment, negatively impacting physical performance.
• A vegan or vegetarian diet can make it difficult to get enough protein due to the absence of meat and dairy. Careful planning and taking plant-based protein supplements can help meet protein needs.

6. Create your ideal daily diet

A diet primarily composed of plants, along with controlled amounts of animal-derived foods, is the key for health and sustainability. Consider the Mediterranean Diet, which has demonstrated health benefits for firefighters. Achieving proper nutrition requires an understanding of your daily intake for both macronutrients (carbs, protein, fats) and micronutrients (vitamins, minerals). However, scrutinizing every food label and tallying numbers throughout the day can be disruptive, potentially leading to obsession and anxiety.

Instead, spend some time designing your “ideal daily diet,” incorporating a variety of healthy foods you enjoy. Use a food tracking app or website to assess the nutritional value of your meals and adjust as needed to meet recommended guidelines. Aim to stick to this diet most days of the week, and rest easy that occasional deviations are beneficial for variety and less harmful to your health when a solid foundation is in place.

Firefighters can also learn more about nutrition and how it can help them perform more safely and efficiently while on duty, as well as at home, by scheduling a MnFIRE training on Fitness & Nutrition for your department. Learn more here.

Contributed by Nicholas E. Blonien, D.O.

Hitting a hot sauna may be a daunting thought after fighting a fire for hours, but it could help clear toxicants from the body and boost cardiovascular health.

While utilizing sauna therapy for enhancing the clearance of toxic chemicals and cancer-causing compounds is still being studied, the cardiovascular benefits of routine sauna use are much clearer. And remember, cardiovascular disease is a leading cause of firefighter illness and death.

The sauna environment (that is, extreme heat with or without humidity) triggers a physiologic response in the body that is quite similar to aerobic exercise. Core temperature rises, heart rate increases, peripheral blood vessels in the skin dilate and sweating ensues. Repeating this practice causes the body to adapt and can result in the following health benefits:

• Lower blood pressure
• Improved circulation
• Reduced inflammation
• Improved cholesterol levels
• Improved mental well-being
• Improved tolerance to heat exposure (acclimatization)

Many of these results are similar to the benefits of exercise.

Overall, routine sauna bathing multiple times per week appears to profoundly improve heart health and decrease risk of all-cause mortality. For firefighters without serious health conditions, sauna use is a simple practice that may lead to boosting performance and heart health.

Practice points

• Aim for 20-30 minute sauna sessions, at least twice per week, at or near the temperature of 170 degrees Fahrenheit. More frequent use (four to seven times per week) has been shown to be more beneficial, yet shorter and cooler sessions can still be somewhat helpful.
• Stay hydrated in the sauna. Bring a water bottle to drink from while inside.
• Ease into it. The high-heat environment may be unsettling at first. You can certainly start with shorter and/or cooler sessions, advancing to goal temperature and duration over time.
• Confirm you’re healthy enough for sauna therapy. For most firefighters, this shouldn’t be an issue, but sauna is intended to place stress on the body (like exercise). Make sure to talk with your doctor about sauna use before starting. For men, sauna use can decrease fertility. So if you’re trying to start a family, you may want to hold off.

For a deeper dive into how sauna therapy works and why it’s beneficial, you might enjoy Dr. Rhonda Patrick’s summary webpage.

Protect your department from cancer and cardiovascular disease

MnFIRE training provides more guidance and support for firefighters around health and wellness activities like this that can help protect them against cancer and cardiovascular disease. Sign up your department for a FREE training here.

Every year since 2011, hundreds of people have gathered on the grounds of the State Capitol on the last Sunday of September for a solemn ceremony to remember the Minnesota firefighters who have died in the line of duty.

Yesterday, MnFIRE representatives joined others in the fire service, dignitaries including Lt. Gov. Peggy Flanagan, family members and the public once again as part of the 2024 Minnesota Fallen Firefighter Memorial Service.

MnFIRE board members Ken Bence and Ed Hoffman participated in the reading of the honor roll, and Hoffman also led the ceremonial releasing of the doves. MnFIRE board president George Esbensen spoke about the history of MnFIRE, and how the Hometown Heroes Assistance Program is charting a way forward to improve firefighter health.

“I began attending funerals for fallen firefighters and noticed a pattern: cancer, cardiac issues and emotional trauma were consistently primarily responsible for these losses,” Esbensen said in his remarks. “It struck me that what’s predictable is preventable. Could we apply successful fire prevention approaches to firefighter health and well-being?”

According to Esbensen, firefighters of all types across Minnesota are receiving help daily through the Hometown Heroes Assistance Program. Eighty percent of fire departments statewide have received free training on the physical and mental risks of firefighting and strategies for prevention and mitigation. A network of over 1,000 trauma-informed mental health providers has been created, aiming to have support within an hour’s drive of any firefighter or family member in Minnesota.

He also described the thriving peer support network and how every firefighter in the state is automatically enrolled in a critical illness program, providing up to $20,000 in life-changing funds when diagnosed with cancer, cardiac issues, emotional trauma or other qualifying conditions.

“By identifying and addressing the root causes of many of the illnesses and deaths in the Minnesota fire service, we can reduce preventable job-related tragedies among our selfless servants,” Esbensen said.

Since 1881, 249 Minnesota firefighters have died in the line of duty. Their names have been inscribed on columns throughout the nationally recognized memorial, located on the south side of the Capitol grounds. Columns were unveiled Sunday honoring Adam Finseth of the Burnsville Fire Department, who died February 18, 2024; Kayla Giefer of the Courtland Fire Department, who died July 13, 2023; Thomas McDonough, Jr., of the St. Paul Fire Department, who died Aug. 24, 2020; Lloyd Conley, Sr., of the MN State Fire Marshal’s Office, who died Nov. 2, 1921; and Arthur Clark, Sr., also of the MN State Fire Marshal’s Office, who died Aug. 29, 1913.

Contributed by MnFIRE Mental Health Director Melinda Coscarelli, PhD, LPCC, LADC

According to the Minnesota Department of Health, recent data shows more than 800 Minnesotans die by suicide every year. In Minnesota’s fire service, research by the National Alliance on Mental Illness tells us that nearly 50% of firefighters are currently experiencing or have experienced suicidal thoughts. Sadly, approximately four to six Minnesota firefighters will choose to die by suicide each year.

The causes of suicide are complex, but we do know the repeat exposure to traumatic events that firefighters face can pose significant risk to their mental health, and leave them at a higher risk for suicide. Suicide is preventable, but there is a stigma around the topic that stops people from admitting they are struggling and getting the help they need. By raising awareness and learning how to support each other, we can make a positive change and save lives.

Know the risk factors

Being aware of risk factors is one of the first ways you can help prevent suicide. Two of the most common risk factors for suicide are depression and post-traumatic stress injury (PTSI). Studies show that firefighters are five times more likely to experience depression. It usually presents as continuous sadness, hopelessness and a lack of interest for the activities previously enjoyed. Additionally, PTSI can also be a warning sign. In fact, because of the daily high-stress and sometimes tragic calls that firefighters respond to, one in five firefighters meet the criteria for PTSI.

Know the warning signs

Something to look out for when concerned that a person may be suicidal is behavior changes. Warning signs could include isolation or withdrawing from family and friends, a substance abuse disorder, poor sleep habits, mood swings, or lack of hygiene and weight loss. Listen for language that refers to not being included anymore, or the world being better after not being around any longer. It’s important that if you fear someone is in immediate danger of harming themselves, do not leave them alone – call a crisis line or health care provider.

There is help

It’s important for all first responders to have a healthy outlet for releasing their mental and emotional struggles. Counseling can offer professional support by giving you tools to manage and relieve mental and emotional symptoms. Peer support is another great option for having a trusted person you can talk to and relate to with your story. Exploring faith and spirituality can also sometimes help you find more direction, connection and clarity in life.

Life is full of ups and downs and twists and turns. We all experience hard times. But it’s always temporary. Suicide is never the answer. Know that it’s OK to ask for help, and it’s a gift to allow someone to help you.

MnFIRE is here

As a Minnesota firefighter or family member, you have a whole support team behind you thanks to the MnFIRE Assistance Program! The MnFIRE helpline is staffed by masters-level clinicians all day, every day. From one-on-one calls to department debriefs, during the middle of a crisis or after a tough call, we are here for you. Don’t hesitate to use this free, confidential resource available 24/7 to all full-time, part-time, on-call and volunteer firefighters and their families in Minnesota. Just call 888-784-6634.

The Minnesota Firefighter Initiative (MnFIRE) Board of Directors has named Rebecca Otto the new Executive Director of MnFIRE. With a breadth of experience in the public, private and non-profit sectors, Rebecca is well-positioned to help strengthen MnFIRE and further its mission supporting Minnesota’s 20,000 firefighters and their families.

Rebecca joined MnFIRE’s team in May 2024 as Director of Business Affairs, having previously served as Minnesota State Auditor from 2007 to 2019 where she led fiscal/legal compliance oversight of $50 billion in local government spending. More recently, Rebecca was Executive Director of the Ernest C. Oberholtzer Foundation, a conservation-minded nonprofit in Northern Minnesota. She also has experience as a state representative, teacher and small business owner.

“I’m honored and eager to build on MnFIRE’s past successes of providing Minnesota’s firefighters the tools and resources they need to prioritize and protect their health,” said Rebecca. “MnFIRE serves a critical role in the health and wellness of our fire service. Our hometown heroes need support and care so they can respond effectively when we need them most, and live healthy, productive lives.”

“We’re thrilled to have Rebecca take the helm,” said MnFIRE Board President George Esbensen. “Along with her unique and expansive resume, she has built countless statewide relationships that will help us increase our reach to continue to strengthen the Minnesota fire service.”

Rebecca takes over the role from Wayne Kewitsch, who retired in August 2024.

We hope you’ll join all of us in congratulating Wayne Kewitsch as he retires as MnFIRE executive director. He’s been serving the state’s fire service in this role since January 2021, always with an eye towards taking care of our firefighters just as they take care of our communities. And, he’s made sure of that – Wayne’s work contributed mightily to seeing the most comprehensive firefighter well-being legislation in the nation become a reality.

While at MnFIRE, Wayne played an instrumental role in encouraging legislators and other stakeholders to support the Hometown Heroes Assistance Program (HHAP), including the MnFIRE Assistance Program with expanded emotional trauma resources and peer support, an up-to-$20,000 Critical Illness insurance policy, and ongoing health and wellness training – all at no cost to all active volunteer, paid-on-call, part-time and full-time Minnesota firefighters.

Once the HHAP was signed into law, he worked closely with employee assistance program, critical illness insurance and peer support partners to get the program up and running quickly and effectively. Wayne collaborated with MnFIRE’s marketing partners as well to ensure firefighters across the state are aware of the groundbreaking new benefits.

Also, during Wayne’s tenure, MnFIRE developed and implemented the first two Firefighter Health Forums for fire service leaders, mental health providers, medical professionals and peer supporters, with the third forum scheduled for January 2025.

Wayne began his fire service career in 1995 as a paid-on-call firefighter with the St. Louis Park Fire Department, and then for 20 years served as a Firefighter, Lieutenant, Assistant Chief and Fire Chief for the Richfield Fire Department. And while his resume speaks volumes, it’s his passion for firefighter health and wellness that has driven his impact on Minnesota’s 20,000 firefighters, their families and their communities.

Thanks for everything, Wayne. All of us at MnFIRE will continue to be inspired by your passion and commitment to firefighter health and wellness as we work to build upon your legacy.

Contributed by Nicholas E. Blonien, D.O.

Firefighting is stressful, taxing the body and mind in unique ways. Firefighters experience stress while anticipating the next call, upon waking to the alarm in the middle of the night, during work on scene and after tough calls.

Stress 101

Stress is the result of nervous system activation, specifically the sympathetic nervous system, otherwise known as the “fight or flight” response. This response isn’t like an on/off light switch, but rather a light dimmer. The sympathetic nervous system can be mildly activated during times of slight anxiety or fully activated during times of danger/emergency, or anything in between.

The sympathetic nervous system is countered by the parasympathetic nervous system, or the body’s “rest and digest” response. Activation of this component of the nervous system results in calmness and relaxation.

These two systems are in constant opposition of one another, with activity of one predominating appropriately in response to a given situation. When intense physical activity and alertness is required, like when a firefighter is called to action, the sympathetic nervous system predominates. When it’s time to rest, the parasympathetic nervous system predominates.

Some level of stress is good, such as when focus or action is required. But too much too often can take its toll on one’s physical and mental health.

How can I reduce stress?

Structured breathing techniques can help boost parasympathetic nervous system activity and decrease stress during times when increased stress is not appropriate, like preparing for bed or spending time with loved ones. Breathwork can be a powerful tool to help reset after a nighttime call or difficult shift, calm the body in preparation for sleep, or even settle the mind during periods of anxiety and worry.

There are several different breathing techniques that have been shown to decrease stress, and a five to ten-minute session may be all that is needed. Here’s a guide for some of the most common breathing techniques.

Recent research shows the effectiveness of breathwork in improving mood and decreasing physiological arousal. Performing breathwork routinely can be a powerful tool that firefighters can use to combat occupational stress.

Additional resources for managing stress

Confidential mental health resources targeting the stress unique to the fire service – including counseling visits and peer support – are available to Minnesota firefighters and their families at no cost through the MnFIRE Assistance Program. Call 888-784-6634 or click here to learn more and get help.

Contributed by MnFIRE Mental Health Director Melinda Coscarelli, PhD, LPCC, LADC

Summer is a popular time for outdoor gatherings and celebrations with friends and family. So many of these social events, parties and get-togethers will have alcoholic beverages at the ready. Let’s face it: we live in a culture that likes to drink! But how do we know where or when to draw the line? What is considered to be within healthy limits of alcohol consumption and what is abusive or unhealthy drinking behavior?

What is a healthy limit?

The key to enjoying alcoholic beverages within a healthy limit is moderation. Research shows that men who drink eight or more alcoholic beverages weekly could experience internal medical issues such as elevated liver levels, kidney damage, inflammation of the pancreas and several stomach problems, among other ailments. Women typically have slower metabolisms than men so they don’t require as much alcohol to have the same harmful health effects. For women, weekly consumption of six to eight alcoholic beverages can elicit the same medical concerns.

Use within the fire service

A recent study measuring firefighting drinking habits showed over 50% of firefighters abusing alcohol. Firefighters reported using alcohol as a means of taking the edge off, escaping, coping and self-medicating. Some reported being physically dependent and unable to stop.

Do I abuse alcohol?

As an addiction specialist who has worked with firefighters for several years, I have seen several times how alcohol has ruined firefighters’ lives, careers and families all in an instant. Here are a couple of quick questions you can ask yourself to see if you might have an issue:

• Have you felt the need to cut down on your drinking?
• Do you feel annoyed by people complaining about your drinking?
• Do you ever feel guilty about your drinking?
• Do you ever drink an eye-opener in the morning to relieve the shakes?

If you answered “yes” to any of these questions or know someone who needs help with alcohol or substance abuse, please call our 24-hour helpline at 888-784-6634. Free counseling visits, peer support and other resources are available through the MnFIRE Assistance Program. This confidential, free service is available for all active volunteer, paid-on-call, part-time and full-time Minnesota firefighters and their families, and for all levels of support.

Contributed by Nicholas E. Blonien, D.O.

Research and firefighter wellness initiatives, like the Minnesota Firefighter Initiative (MnFIRE), have worked hard to spotlight the pervasive occupational stressors across the fire service: shiftwork, fatigue, hazardous exposures, psychosocial trauma and more. Collectively, these stressors increase the risk for injury, cardiometabolic disease, cancer and mental illness.

While awareness and support for firefighter well-being is increasing and the drive for organizational change seems stronger than ever, large-scale changes take time and money. So how can firefighters take action now? Understanding the basic science of behavioral change can be a good place to start.

Dr. BJ Fogg is a leading behavioral scientist who founded the Behavior Design Lab at Stanford University and wrote the best-selling book Tiny Habits. His Behavior Model has been most successful in helping individuals initiate and sustain behavioral change. The model focuses on simplicity and three key elements that must be present in order for behavioral change to occur: motivation, ability and a call to action, or a prompt.

Behavior (B) = Motivation (M) Ability (A) Prompt (P)

Fogg’s Behavior Model states that in order to achieve behavior changes, people must be motivated to do so. They must also have the ability and resources to do so, and be prompted to initiate the change. Without motivation, ability and a prompt, behavior will not change.

Making lasting behavioral improvements for healthier living in the demands of the fire service is challenging. For firefighters looking to exercise more, eat healthier, sleep better, manage stress more intently, or simply start on a clearer path to well-being and resilience, the journey may begin with building tiny habits.

Train your department on firefighter well-being

Learn more about shifting the culture and building healthier habits in free training classes provided to your department by MnFIRE. These two-hour sessions are available whenever it’s convenient for your department and focus on important health topics like cardiac, cancer and emotional wellness, among others. Sign up your department for a FREE training here.

Kyle Bode has been in the fire service for more than 20 years and he’s a proud MnFIRE peer supporter. Peer supporters like Kyle are a crucial support system for Minnesota’s 20,000 firefighters and their families. They provide free and confidential support to their fire service brothers and sisters experiencing personal, emotional or work-related problems.

We sat down with Kyle to hear more about his experience with MnFIRE Peer Support and how he shows up for fellow firefighters by offering a listening ear.

Tell us a little about yourself, your history with the fire service and who you are outside of your role as a firefighter.

I was recruited by Saint Paul Fire Department’s fire chief at the gym. I had completed active-duty military and I was going to college and working at the gym. I had no clue what I was going to do. It sounded interesting so I applied for the upcoming Saint Paul test. I really didn’t expect to get hired. I remember taking the written test with 3,500 people at the RiverCentre and feeling like I didn’t have a chance. I was hired in the first class off of that list. While I waited for the academy, I was hired as a volunteer for the White Bear Lake Fire Department, where I served for a little over a year. I also served as an Air Force Reserve firefighter for 16 years and retired from the military in 2022.

I live in Blaine with my wife and four kids, ages 4, 8, 12 and 13. Outside of the fire department, most of my time is spent with my family. My wife owns a dance studio, so that also keeps me busy. I enjoy physical challenges and have competed in many marathons, a couple of Ironman Triathlons and also some long-distance rucking events. I prioritize my physical health because it helps me a lot with my mental health.

Why did you become a MnFIRE peer supporter?

I spent several years struggling with my mental health and substance abuse. In 2022, I checked into a first responder treatment facility where I was treated for alcohol abuse and PTSD. I learned so much during that time including better ways to keep myself healthy both mentally and physically. It didn’t take me long to realize that I wasn’t alone. Once I was able to get myself in a healthier space, I realized many of my peers were having similar struggles. In my experience, it is tremendously helpful to be able to talk to another person who has gone through what you are going through, so I pursued becoming a MnFIRE peer supporter.

What is the most rewarding part of being a peer supporter?

I think just being there for another person, so they don’t feel like they are going through it alone. It’s also extremely rewarding to witness and be a part of someone’s journey to feeling better and finding a healthier place in their life.

What is the most surprising part of being a peer supporter?

Unfortunately, I think the most surprising part for me has been witnessing firsthand how many of my peers are struggling. There is a silver lining though, because I have been able to witness some pretty incredible change during that time.

What do you see as the most valuable component of the MnFIRE Hometown Heroes Assistance Program?

The program helps remove a lot of barriers. It makes it much easier for those who need help to get the help. I have sat with peers who have called the hotline and have gotten set up with a therapist, for free, that same day. MnFIRE has done the work and vetted the mental health professionals, so you get connected with the right person. I have used the HHAP and I find it very helpful.

What two suggestions would you share with every Minnesota firefighter to improve their mental health?

I think the most important thing that I would share is that it’s OK to ask for help. We all sign up to do this dangerous job, but the bravest individuals that I have seen are the ones who admit that they are not OK and need help. I also think it’s important to make diet and exercise a priority. I can’t stress enough how much it helps with our mental health. It’s the number-one medicine for our well-being, and it’s free!

Anything else you’d like to add?

In the span of eight years, I tragically lost two of my brothers from the Saint Paul Fire Department to suicide. This heart-wrenching experience underscores the urgent need for anyone grappling with their mental health to reach out for help. Remember, you are not alone. Your loved ones and those around you genuinely care and want to support you. Don’t hesitate to seek assistance.

See more stories like this in our 2024 Taking the Lead impact report.

Help is just a call away

MnFIRE Peer Support is a safe, confidential space to talk about what you’re going through with someone who gets it. Minnesota firefighters and their family members can get connected with a peer supporter by calling our 24-hour helpline at 888-784-6634.