Protein Guidelines for Firefighters & EMS Providers
The purpose of this article is to present the latest research on factors that determine an individual’s optimum protein intake along with the best sources of protein, especially as it relates to the goals of firefighters and other emergency responders.
The Recommended Dietary Allowance (RDA) of protein is 0.8 g protein per kg body weight (about 0.35 g/lb). The RDA, however, should be viewed as a minimum recommended intake–the optimal intake being significantly higher for many individuals. The Acceptable Macronutrient Distribution Range (AMDR) of 10-35% total calories for protein more accurately reflects the wide range of recommended protein intakes, with the lowest percent approximately equal to the RDA.1
Below is the AMDR for protein by weight (total calorie need estimated using 36.5 calories/kg body weight).
|Daily Pro (g)||55-190||60-210||65-230||70-260||80-275||85-300||90-320||95-340||100-360|
Protein for Health Maintenance
Cardiovascular disease is the leading cause of death among firefighters, accounting for nearly half of all deaths while on duty.2 For those at risk of cardiovascular disease, diets containing 25% of total calories from protein (roughly 1 g protein per pound bodyweight for average caloric intakes) appear to improve markers of cardiovascular health better than diets providing only 15%.3,4 High protein alone will likely do little to improve your cardiovascular health but may enhance an already cardio-protective diet.5 Plant sources of protein (nuts, seeds, legumes, and soy products) may be especially important to supporting cardiovascular health.6
According to the current scientific literature, there appear to be no negative health effects from protein intakes at the upper extreme of the AMDR among healthy adults. While it was once thought that high protein was detrimental to bone health,7 the current body of scientific literature suggests that higher protein intake is associated with stronger bones throughout all life stages.8, 9 Similarly, correlations between protein intake and cancer appear to be limited only to red meat and processed meats, not protein in general.
Here are some important findings regarding protein intake and health:
- Increasing plant sources of protein in your diet by as few as 3% of total calories can reduce your mortality risk by 5%.10
- Soy—containing a variety of saponins, isoflavones, and other phytonutrients—is thought to be uniquely protective against cardiovascular disease, diabetes, and cancer.11
- Fish, rich in selenium and omega-3s, appears to be particularly effective in reducing the risk of cardiovascular disease and overall mortality.12
- After fish–chicken, eggs, and dairy are typically recommended as the primary sources of animal protein.13
- While lean red meat (beef, veal, pork, and lamb) is generally recommended only in moderation,14,15 some studies suggest lean beef may not be as harmful as once thought.16,17 Use of marinades and avoiding high-heat cooking methods may help reduce some of the byproducts thought to be harmful.18
- Processed meats (those containing large amounts of salt and nitrates) should be limited due to an association with increased rates of cancer19 and cardiovascular disease.20,21
Protein for Weight Management
Maintaining a healthy weight is critical for the effective performance of key firefighter and first responder duties.22 Studies of firefighters have found that those consuming more than the RDA of protein have a lower body fat percentage and higher lean mass than those who consume less than the RDA of protein. Intakes greater than 1 g per kg (0.45 g/lb) were even more beneficial.23 This is consistent with results seen in the general US population, where intakes of 1-1.5 g per kg (0.45-0.70 g/lb) were associated with lower BMI and waist circumference.24 Even greater protein intakes may be required to support weight loss.
For successful weight loss, a caloric deficit is more important than the ratio of protein, fat, and carbohydrate. There is promising evidence, however, that a high-protein intake can help reduce hunger, boost metabolism, and preserve muscle mass during caloric restriction.25 Randomized, controlled trials have found that higher-protein diets are generally more effective than calorically matched, lower-protein diets.26 While there are numerous definitions of high-protein diets, obtaining 20-25% of total calories from protein may be a reasonable goal.27 Protein consisting of 20-25% of total calories is also consistent with recommendations from the International Society of Sports Nutrition for athletes attempting to lose weight.28
Below are protein recommendations for weight maintenance and weight loss based on body weight. Caloric needs are estimated using 36.5 calories per kg with a 500-calorie deficit for weight loss.
|Protein (g) for
|Protein (g) for
Protein for Fitness
Emergency response can be physically demanding and requires a high level of fitness.29 Not only is sufficient protein important to support physical fitness, but the type of protein and timing of intake also contribute. Optimal protein intake may increase strength up to 10% beyond resistance training alone and may be especially important among more advanced lifters to see improvements.30, 31
For those using protein to support physical fitness, the following information is important to consider:
- 1.4-2 g protein per kg (0.6-0.9 g/lb) body weight is likely a sufficient daily intake for most exercising individuals not engaged in weight loss.32
- Animal and dairy proteins are more effective than plant proteins at stimulating muscle growth due to higher bioavailability and amounts of essential amino acids, especially leucine.33 Consuming plant protein at approximately 1.25-1.5x the amounts recommended or combining plant protein sources with a branched-chain amino acid (BCAA) supplement may be effective strategies for vegans and vegetarians.34 Even high-quality vegan blends do not stimulate muscle growth as effectively as whey protein.35
- While protein supplements may be an effective means of meeting protein intake goals, BCAAs alone likely aren’t an adequate substitute.36 BCAAs may have other potential ergogenic benefits beyond muscle growth, however.37
- Protein intake should be evenly distributed throughout all meals during the day.38
- While the common recommendation is to eat protein within 1 hour of exercise, the entire period immediately before and for 24 hours after exercise appears to be an optimal window.39 Protein intake of 20-40 g every 3-4 hours during this window may optimally stimulate muscle growth and support recovery.40
- 40 g casein protein before bed is an effective strategy to improve recovery and muscle protein synthesis overnight.41
- Adequate carbohydrate and calorie intake are also important to support activity, recovery, and optimal muscle growth. Among elite bodybuilders, the most successful often consume more carbohydrates and total calories, even during fat-loss phases.42
For more nutritional information to benefit first responders, check out “Dietary Strategies for Shift Workers to Boost Energy” and “Dietary Strategies for Shift Workers to Improve Heart Health.”
- Institute of Medicine of the National Academies. Dietary Reference Intakes for energy, carbohydrates, fiber, fat, protein and amino acids (macronutrients). Washington (DC): The National Academies Press; 2002/2005.
- Centers for Disease Control and Prevention (CDC). Fatalities among volunteer and career firefighters–United States, 1994-2004. MMWR Morb Mortal Wkly Rep. 2006;55(16):453‐455.
- Swain JF, McCarron PB, Hamilton EF, Sacks FM, Appel LJ. Characteristics of the diet patterns tested in the optimal macronutrient intake trial to prevent heart disease (OmniHeart): options for a heart-healthy diet. J Am Diet Assoc. 2008 Feb; 108(2):257-65.
- Appel LJ, Sacks FM, Carey VJ, Obarzanek E, Swain JF, Miller ER 3rd, Conlin PR, Erlinger TP, Rosner BA, Laranjo NM, et al. Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids: results of the OmniHeart randomized trial. JAMA. 2005;294:2455–64.
- Fleming RM. The effect of high-protein diets on coronary blood flow. Angiology. 2000 Oct;51(10):817-26.
- Song M, Fung TT, Hu FB, Willett WC, Longo VD, Chan AT, Giovannucci EL. Association of Animal and Plant Protein Intake With All-Cause and Cause-Specific Mortality. JAMA Intern Med. 2016 Oct 1; 176(10):1453-1463.
- Delimaris I. Adverse Effects Associated with Protein Intake above the Recommended Dietary Allowance for Adults. ISRN Nutr. 2013;2013:126929.
- Wallace TC, Frankenfeld CL. Dietary Protein Intake above the Current RDA and Bone Health: A Systematic Review and Meta-Analysis. J Am Coll Nutr. 2017 Aug;36(6):481-496.
- Rizzoli R, Biver E, Bonjour JP, et al. Benefits and safety of dietary protein for bone health—an expert consensus paper endorsed by the European Society for Clinical and Economical Aspects of Osteopororosis, Osteoarthritis, and Musculoskeletal Diseases and by the International Osteoporosis Foundation. Osteoporos Int. 2018;29(9):1933–1948.
- Naghshi S, Sadeghi O, Willett WC, Esmaillzadeh A. Dietary intake of total, animal, and plant proteins and risk of all cause, cardiovascular, and cancer mortality: systematic review and dose-response meta-analysis of prospective cohort studies. BMJ. 2020;370:m2412.
- Chatterjee C, Gleddie S, Xiao CW. Soybean Bioactive Peptides and Their Functional Properties. Nutrients. 2018 Sep 1; 10(9).
- Zhao LG, Sun JW, Yang Y, Ma X, Wang YY, Xiang YB. Fish consumption and all-cause mortality: a meta-analysis of cohort studies. Eur J Clin Nutr. 2016 Feb; 70(2):155-61.
- Sacks FM, Obarzanek E, Windhauser MM, Svetkey LP, Vollmer WM, McCullough M, Karanja N, Lin PH, Steele P, Proschan MA, et al. Rationale and design of the Dietary Approaches to Stop Hypertension trial (DASH). A multicenter controlled-feeding study of dietary patterns to lower blood pressure. Ann Epidemiol. 1995;5:108–18.
- Micha R, Michas G, Mozaffarian D. Unprocessed red and processed meats and risk of coronary artery disease and type 2 diabetes–an updated review of the evidence. Curr Atheroscler Rep. 2012 Dec; 14(6):515-24.
- Wolk A. Potential health hazards of eating red meat. J Intern Med. 2017 Feb;281(2):106-122.
- Roussell MA, Hill AM, Gaugler TL, West SG, Heuvel JP, Alaupovic P, Gillies PJ, Kris-Etherton PM. Beef in an Optimal Lean Diet study: effects on lipids, lipoproteins, and apolipoproteins. Am J Clin Nutr. 2012 Jan;95(1):9-16.
- Roussell MA, Hill AM, Gaugler TL, West SG, Ulbrecht JS, Vanden Heuvel JP, Gillies PJ, Kris-Etherton PM. Effects of a DASH-like diet containing lean beef on vascular health. J Hum Hypertens. 2014;28:600–5.
- Sinha R, Cross AJ, Graubard BI, Leitzmann MF, Schatzkin A. Meat intake and mortality: a prospective study of over half a million people. Arch Intern Med. 2009;169:562–71.
- Han MA, Zeraatkar D, Guyatt GH, Vernooij RWM, El Dib R, Zhang Y, Algarni A, Leung G, Storman D, Valli C, Rabassa M, Rehman N, Parvizian MK, Zworth M, Bartoszko JJ, Lopes LC, Sit D, Bala MM, Alonso-Coello P, Johnston BC. Reduction of Red and Processed Meat Intake and Cancer Mortality and Incidence: A Systematic Review and Meta-analysis of Cohort Studies. Ann Intern Med. 2019 Nov 19; 171(10):711-720.
- Rohrmann S, Overvad K, Bueno-de-Mesquita HB, Jakobsen MU, Egeberg R, Tjonneland A, Nailler L, Boutron-Ruault MC, Clavel-Chapelon F, Krogh V, et al. . Meat consumption and mortality–results from the European Prospective Investigation into Cancer and Nutrition. BMC Med. 2013;11:63.
- Micha R, Wallace SK, Mozaffarian D. Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis. Circulation. 2010 Jun 1; 121(21):2271-83.
- Michaelides MA, Parpa KM, Henry LJ, Thompson GB, Brown BS. Assessment of physical fitness aspects and their relationship to firefighters’ job abilities. J Strength Cond Res. 2011 Apr; 25(4):956-65.
- Hirsch KR, Tweedell AJ, Kleinberg CR, et al. The Influence of Habitual Protein Intake on Body Composition and Muscular Strength in Career Firefighters. J Am Coll Nutr. 2018;37(7):620-626.
- Pasiakos SM, Lieberman HR, Fulgoni VL 3rd. Higher-protein diets are associated with higher HDL cholesterol and lower BMI and waist circumference in US adults. J Nutr. 2015 Mar;145(3):605-14.
- Hwalla N, Jaafar Z. Dietary Management of Obesity: A Review of the Evidence. Diagnostics (Basel). 2020;11(1):24.
- Wycherley TP, Moran LJ, Clifton PM, Noakes M, Brinkworth GD. Effects of energy-restricted high-protein, low-fat compared with standard-protein, low-fat diets: a meta-analysis of randomized controlled trials. Am J Clin Nutr. 2012 Dec;96(6):1281-98.
- Sacks FM, Bray GA, Carey VJ, Smith SR, Ryan DH, Anton SD, McManus K, Champagne CM, Bishop LM, Laranjo N, Leboff MS, Rood JC, de Jonge L, Greenway FL, Loria CM, Obarzanek E, Williamson DA. Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med. 2009 Feb 26;360(9):859-73.
- Aragon AA, Schoenfeld BJ, Wildman R, Kleiner S, VanDusseldorp T, Taylor L, Earnest CP, Arciero PJ, Wilborn C, Kalman DS, Stout JR, Willoughby DS, Campbell B, Arent SM, Bannock L, Smith-Ryan AE, Antonio J. International society of sports nutrition position stand: diets and body composition. J Int Soc Sports Nutr. 2017 Jun 14;14:16.
- International Association of Fire Chiefs. Fire Service Joint Labor Management Wellness-Fitness Initiative. Available at https://www.iafc.org/docs/default-source/1safehealthshs/wfi-manual.pdf?sfvrsn=7931df0d_5; accessed February 6, 2021
- Hoffman JR, Ratamess NA, Kang J, et al. . Effects of protein supplementation on muscular performance and resting hormonal changes in college football players. J Sports Sci Med. 2007;6:85–92.
- Hoffman JR, Ratamess NA, Tranchina CP, et al. . Effect of protein-supplement timing on strength, power, and body-composition changes in resistance-trained men. Int J Sport Nutr Exerc Metab. 2009;19:172–85.
- Jäger R, Kerksick CM, Campbell BI, Cribb PJ, Wells SD, Skwiat TM, Purpura M, Ziegenfuss TN, Ferrando AA, Arent SM, Smith-Ryan AE, Stout JR, Arciero PJ, Ormsbee MJ, Taylor LW, Wilborn CD, Kalman DS, Kreider RB, Willoughby DS, Hoffman JR, Krzykowski JL, Antonio J. International Society of Sports Nutrition Position Stand: protein and exercise. J Int Soc Sports Nutr. 2017 Jun 20;14:20.
- Sharp MH, Lowery RP, Shields KA, Lane JR, Gray JL, Partl JM, Hayes DW, Wilson GJ, Hollmer CA, Minivich JR, Wilson JM. The Effects of Beef, Chicken, or Whey Protein After Workout on Body Composition and Muscle Performance. J Strength Cond Res. 2018 Aug;32(8):2233-2242.
- Berrazaga I, Micard V, Gueugneau M, Walrand S. The Role of the Anabolic Properties of Plant- versus Animal-Based Protein Sources in Supporting Muscle Mass Maintenance: A Critical Review. Nutrients. 2019 Aug 7;11(8):1825.
- Brennan JL, Keerati-U-Rai M, Yin H, Daoust J, Nonnotte E, Quinquis L, St-Denis T, Bolster DR. Differential Responses of Blood Essential Amino Acid Levels Following Ingestion of High-Quality Plant-Based Protein Blends Compared to Whey Protein-A Double-Blind Randomized, Cross-Over, Clinical Trial. Nutrients. 2019 Dec 6;11(12):2987.
- Santos CS, Nascimento FEL. Isolated branched-chain amino acid intake and muscle protein synthesis in humans: a biochemical review. Einstein (Sao Paulo). 2019 Sep 5;17(3):eRB4898.
- Gervasi M, Sisti D, Amatori S, Donati Zeppa S, Annibalini G, Piccoli G, Vallorani L, Benelli P, Rocchi MBL, Barbieri E, Calavalle AR, Agostini D, Fimognari C, Stocchi V, Sestili P. Effects of a commercially available branched-chain amino acid-alanine-carbohydrate-based sports supplement on perceived exertion and performance in high intensity endurance cycling tests. J Int Soc Sports Nutr. 2020 Jan 20;17(1):6.
- Morton RW, McGlory C, Phillips SM. Nutritional interventions to augment resistance training-induced skeletal muscle hypertrophy. Front Physiol. 2015;6:245.
- Schoenfeld BJ, Aragon AA, Krieger JW. The effect of protein timing on muscle strength and hypertrophy: a meta-analysis. J Int Soc Sports Nutr. 2013 Dec 3;10(1):53.
- Areta JL, Burke LM, Ross ML, Camera DM, West DW, Broad EM, Jeacocke NA, Moore DR, Stellingwerff T, Phillips SM, Hawley JA, Coffey VG. Timing and distribution of protein ingestion during prolonged recovery from resistance exercise alters myofibrillar protein synthesis. J Physiol. 2013 May 1;591(9):2319-31.
- Res PT, Groen B, Pennings B, Beelen M, Wallis GA, Gijsen AP, Senden JM, VAN Loon LJ. Protein ingestion before sleep improves postexercise overnight recovery. Med Sci Sports Exerc. 2012 Aug;44(8):1560-9.
- Chappell AJ, Simper T, Barker ME. Nutritional strategies of high level natural bodybuilders during competition preparation. J Int Soc Sports Nutr. 2018;15:4.
Ron Beckstrom is a registered dietitian, exercise physiologist, and writer. As a retail dietitian, Ron advises on and writes about the latest food trends and products and has been featured on numerous local news outlets. Ron has worked in various settings as a health professional including hospitals, corporate wellness, and nutritional supplement R&D. Ron is also a member of the Utah National Guard where he serves as an operations officer.