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).

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 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.”

Sources

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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.