The hidden killer in the San Antonio fire department was heart disease. Here's how they fought it and how you can too.

The hidden killer in the San Antonio fire department was heart disease. Here's how they fought it and how you can too.

On a late afternoon, a handful of uniformed men with crew cuts relax on couches in the lounge of the Station 16 firehouse in San Antonio, Texas. Others gather around two long Formica-topped tables, reading the San Antonio Express-News and trading stories about their days off. In the kitchen, John Laskowski, a blond, broad-shouldered firefighter, prepares dinner. An electric mixer buzzes and the mouthwatering smells of roasting pork linger.

Suddenly it's all interrupted by the blare of a piercing alarm and a dispatcher announcing the destination of the next emergency. With the exception of Laskowski, the men hurry into the garage and hop onto the ladder truck. The wail of sirens screams down the street.

With the dangerous nature of their work you might guess that smoke inhalation or other fire-related trauma would be the leading cause of death among firemen. However the number-one culprit is heart attack, according to a recent study by the U.S. Fire Administration. Both the stress and the physical exertion of the job plus the typical fireman's diet figure into the equation. Although firefighters are known as cooks, when they're busy they often opt for the convenience of fast food. And when they cook group meals at the station it's typically not broccoli and boneless chicken breast. Instead it's dishes like chicken-fried steak, barbecued brisket or enchiladas: foods that aren't helping them stay conditioned to perform their extremely physical jobs.

That's where Maria Worley, R.D., L.D., comes in. About a year ago San Antonio fire chief, Charles Hood responded to a national initiative to reduce firefighter fatalities from heart attack and stroke. He decided to implement a wellness program and hired Worley, a retired U.S. Army dietitian and colonel, to lead the nutrition component. The new program requires its 1,650 uniformed staff members to get physical exams and, when needed, nutritional counseling to address health issues.

Back at Station 16 a half hour later, the crew returns with reports of sparking, exposed wires and a faulty ceiling fan. They grab plates and pile servings of pork with raspberry serrano sauce, sweet potatoes and asparagus from the informal buffet arranged on the kitchen counter. Thanks to Worley's guidance, Laskowski's health-conscious dinner offers a real contrast to the station meals of yesteryear.

To date, nearly three-quarters of the San Antonio fire department has undergone physicals and patterns have emerged: elevated cholesterol, insulin resistance, obesity and high blood pressure. According to Betsy Dose, Special Projects Manager for the San Antonio Wellness Center, "Some people are full-blown diabetics and didn't know." Depending on an individual's results, an appointment is set up with Worley so she can give them guidance. "It's about working together to help them make changes that fit into their lives," says Worley. "They're in a high-stress job. They're busy and that often means eating on the run."

EMS Field Supervisor Dwayne Toler jumped at the chance to get help from Worley. "I had always toyed with the idea of losing some weight," he says, "but I didn't want to eat rice cakes and stuff." For breakfast, he often ate a biscuit stacked with eggs, sausage and cheese from Whataburger. A self-described "hamburger freak," the 52-year-old Toler was also a regular at other fast-food joints. His test results came back showing borderline diabetes and high blood pressure. Since working with Worley he's started making smarter choices when he eats out. He's lost 18 pounds in six months.

Toler's co-workers are supportive. "My captain bought me cashews because he knows that's the sort of snack I need," says Toler. "The supervisors are working out twice a week together." And there have been other successes. Melvin Fitzgerald, an EMS paramedic, found out he had high cholesterol and high blood pressure after his screening. Fitzgerald consulted with Worley. "Maria went through my options-what to eat, what not to eat, what's good, what's bad," he says. Fitzgerald now eats salmon, more fruits, vegetables and whole grains, walks on the treadmill for at least 15 minutes a day and takes fish-oil supplements. The results: his "bad" cholesterol has decreased from 164 to 125 and he's dropped 15 pounds from his 6-foot frame.

In addition to individual consultations for firefighters, each firehouse now has a subscription to EatingWell to give them inspiration for healthier meals. And Worley has worked with the EatingWell Test Kitchen to develop recipes for healthier versions of San Antonio's Tex-Mex favorites. We trimmed beef enchiladas by making them with lean beef, adding mushrooms and opting for whole-wheat tortillas. Frito pie turns gourmet with homemade baked chips topped with bean and vegetable-packed chili. And chiles rellenos are stuffed with chicken, corn and just a little cheese, then pan-fried instead of deep-fried. With Maria's efforts-and these five healthier recipes-the San Antonio firefighters are on the road to being in tip-top shape, saving their lives-and others.

Photography by: Jody Horton

January/February 2012