• Rosalynn Gill, Harold Robert Superko, Megan M McCarthy, Kepra Jack, Briana Jones, Debanjali Ghosh, Steve Richards, Joi A Gleason, Paul T Williams, and Michael Dansinger.
• Boston Heart Diagnostics, Framingham, Massachusetts (Dr Gill, Ms Jones, Ms Ghosh, Mr Gleason, Dr Dansinger); Cholesterol, Genetics, and Heart Disease Institute, Carmel, California (Dr Superko); Heart Fit for Duty, Gilbert, Arizona (Ms McCarthy, Ms Jack); Mesa Fire Services, Mesa, Arizona (Mr Richards); Children's Hospital of Oakland, Oakland (Dr Williams), California; Tufts Medical Center, Boston, Massachusetts (Dr Dansinger).
• J. Occup. Environ. Med. 2019 Mar 1; 61 (3): 183-189.

ObjectiveWe tested the hypothesis that a lifestyle program would improve risk factors linked to cardiovascular disease (CVD) in first responders.MethodsA 1-year cluster-randomized controlled clinical trial in 10 cities. Participants were 175 first responders, with increased waist circumference and/or low levels of large (α1) high-density lipoprotein (HDL) particles. The intervention group received personalized online tools and access to telephonic coaching sessions.ResultsAt 1 year the intervention significantly reduced body weight (P = 0.004) and waist circumference (P = 0.002), increased α1 HDL (P = 0.01), and decreased triglyceride (P = 0.005) and insulin concentrations (P = 0.03). Program adherence was associated with weight loss (P = 0.0005) and increases in α1 HDL (P = 0.03).ConclusionsIn first responders, a personalized lifestyle intervention significantly improved CVD risk factors in proportion to program adherence. Changes in large HDL particles were more sensitive indicators of lifestyle changes than HDL-cholesterol measurement.Clinical Trial Registration NumberClinicalTrials.gov: NCT03322046.

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