My work as the London Fire Brigade’s (LFB’s) nutritionist originates from a pilot worksite intervention I designed. This improved dietary behaviours of firefighters, helping them to lose body fat. Several months later this got the attention of (the now) London Fire Commissioner who seconded me as the first fire brigade registered nutritionist. I began to develop and expand my nutrition intervention programme across numerous fire stations in the capital. This involves educating teams of firefighters on the associations between dietary behaviour and risk factors for non-communicable diseases, suggesting both personal and environmental modification strategies to improve nutritional intakes in order to reduce risk.

Whilst important to harness the team dynamic which firefighters exemplify, I also undertake personalised nutrition consultations for individual firefighters which involves dietary assessment, body composition analysis and personalised plans. This focuses on suggesting small, simple changes, as research indicates this approach to improve habitual behaviours more rapidly. So far this has proved to be promising in terms of sustained mean reductions in dietary energy intake from free sugars and saturated fat which have resulted in significant body fat reduction.

As firefighters can be considered “industrial athletes” it is important they maintain/increase muscle mass, therefore I tailor advice accordingly and monitor changes in both skeletal muscle and body fat. I use a blend of public health nutrition and sports & exercise nutrition which enables me to maintain skills in both areas of nutrition for which I hold specialisms. For example, as dehydration is a major concern for firefighters, I monitor their fluid balance, teach them how to make homemade hypotonic solutions for rapid rehydration, and how to self-monitor their hydration status. As shift workers, firefighters are exposed to sleep deprivation which can lead to metabolic consequences including cortisol dysregulation and impaired glucose tolerance. I therefore advise switching over to whole grains from refined grains, increasing fibre and resistant starch intake, and improving snacking behaviour to reduce their intake of free sugars.

Most firefighters will tell you that fire stations are full of tempting sugary foods. Due to the aforementioned sleep deprivation, they are more likely to succumb to such temptation.  Part of my strategy to improve their food environment is to educate the firefighters who purchase and prepare meals for their teams (mess-managers). This involves myself giving kitchen-based practical demonstrations on how to prepare healthy meals on a budget which fulfil public health nutrition guidelines whilst meeting the specific nutritional demands of fighting fires. For examples of these meals go to: https://www.youtube.com/playlist?list=PLpuO2dPoVI0PJEY74UoUV0VWTW2BFp-rc.

Mess-managers have a demanding job in feeding their colleagues. To further assist them I’ve written a firefighter cookery book which offers a resource for healthy meal ideas. Aside from being healthy and nutrient dense, they have to be relatively quick to prepare as firefighters can be called out at a moments notice. Additionally, the meals have to be edible cold or reheated without losing flavour/texture. Fortuitously, reheating certain starchy foods after cooling can increase the level of resistant starch and improve blood glucose control .

The LFB is a huge organisation with many support staff who I also get to support through nutrition consultation drop-in clinics; interventions to help the more sedentary areas of the workforce, e.g. the emergency call centre operators and admin teams; creating and delivering seminars and webinars; educational literature creation for the LFB Health and Wellbeing intranet portal. I also educate staff on Nutrition and Mental Health. Dealing with the situations which firefighters face can have a huge impact on mental health, and nutrition can have a significant effect.

At time of writing I’m involved in the development of bespoke tools for the assessment of firefighter nutritional status. These exciting innovations will help take the firefighter nutrition programme to the next level. I feel privileged to work with and support some of the bravest and best people on the planet… long may it continue.

Bringing nutritional science into the medical profession is vital and thankfully finally beginning to happen. I fully support Nutritank’s core principles in promoting this important concept using their forward thinking approach.