美国消防员是一种容易患慢性疾病的工作人群，包括肥胖、心血管疾病和癌症。这种风险可以通过健康的饮食来减轻。为了评估地中海营养干预在个人参与者层面上使用行为/环境方法（消防员/消防站/家庭）的效果。这项为期12个月的集群随机临床试验包括来自印第安纳州两个消防部门的消防员。参与者被消防站随机分组为地中海饮食组或对照组（常规护理）。该研究从2016年10月进行到2019年12月，在2022年11月进行了数据分析。在研究的前12个月，随机分配到干预组的消防站的消防员可以获得超市折扣和免费的地中海饮食食品样品、在线营养教育平台、电子邮件公告和提醒、家庭和同伴教育和支持，以及厨师演示。对照组所在的消防站的消防员没有接受任何干预，并且被要求按照他们平时的饮食习惯进行。在12个月时，以修改的地中海饮食评分（范围为0到51分）为基线和6个月和12个月的随访，评估饮食习惯的变化。心脏代谢参数是次要结果。共有485名消防员参加了本研究，其中458名（94.4%）为男性，平均（标准差）年龄为47（7.5）岁。共有241名消防员（27个消防站）被随机分配到地中海营养干预组，244名（25个消防站）被随机分配到常规饮食组。使用广义线性混合模型分析了6个月（n = 336）和12个月（n = 260）时的修改地中海饮食评分的结果，调整了基线年龄、性别、种族和民族、消防部门、体育活动和腰围。与对照组相比，干预组的修改地中海饮食评分在6个月时显著增加了2.01分（95％CI，0.62-3.40；P＝0.005），在12个月时显著增加了2.67分（95％CI，1.14-4.20；P＝0.001）。在次要结果中，心脏代谢风险因素的变化在1年内没有统计学意义。使用多级多次插补法进行缺失性分析所得结果类似。在这个多组件行为/环境变化的地中海营养干预中，职业消防员对地中海饮食的遵循度增加。ClinicalTrials.gov识别号：NCT02941757。

US firefighters are a working population at risk of chronic diseases, including obesity, cardiovascular disease, and cancer. This risk may be mitigated by a healthy diet.To evaluate the effect of a Mediterranean nutrition intervention using a behavioral/environmental approach (firefighter/fire station/home) at the individual participant level.This 12-month cluster randomized clinical trial included US career firefighters from fire stations and homes within 2 Indiana fire departments. Participants were randomized by fire station to either Mediterranean diet or control (usual care). The study was conducted from October 2016 to December 2019, and data were analyzed in November 2022.For the first 12 months of the study, firefighters located at fire stations randomized to the intervention group were provided with access to supermarket discounts and free samples of Mediterranean diet foods, online nutrition education platforms, email announcements and reminders, family and peer education and support, and chef demonstrations. Firefighters in fire stations allocated to the control group received no intervention and were instructed to follow their usual diet.Change in dietary habits at 12 months as measured by a modified Mediterranean diet score (range, 0 to 51 points) at baseline and 6-month and 12-month follow-up. Cardiometabolic parameters were secondary outcomes.Of 485 included firefighters, 458 (94.4%) were male, and the mean (SD) age was 47 (7.5) years. A total of 241 firefighters (27 fire stations) were randomized to the Mediterranean nutrition intervention, and 244 (25 fire stations) were randomized to usual diet. Outcomes were analyzed using generalized linear mixed models for modified Mediterranean diet score at 6 months (n = 336) and 12 months (n = 260), adjusting for baseline age, sex, race and ethnicity, fire department, physical activity, and waist circumference. In the intervention group compared with the control group, the modified Mediterranean diet score significantly increased by 2.01 points (95% CI, 0.62-3.40; P = .005) at 6 months and by 2.67 points (95% CI, 1.14-4.20; P = .001) at 12 months. Among secondary outcomes, changes in cardiometabolic risk factors were not statistically significant at 1 year. Results from analyses with multilevel multiple imputation for missingness were similar.In this Mediterranean nutrition intervention of multicomponent behavioral/environmental changes, career firefighters had increased adherence to a Mediterranean diet.ClinicalTrials.gov Identifier: NCT02941757.