**5. Conclusions**

This MedDiet intervention induces only modest changes in adherence to the MedDiet and consequently in metabolic biomarkers related to lipid metabolism. Further research should confirm these results based on larger study samples in workplace interventions with powerful study designs.

**Supplementary Materials:** The following are available online at http://www.mdpi.com/2072-6643/12/12/3610/s1, Figure S1: Flowchart of participants at time point 1 and 2 of the Feeding America's Bravest trial, Figure S2: Associations of unit changes in mMDS score by SD changes in plasma biomarkers between month 6 (time point 2) and baseline (time point 1) in all participants grouped together, Figure S3: Association between biomarkers and the PREDIMED score adherence (cross-sectional analysis), Table S1: The 6 months effect of the Mediterranean Diet intervention on metabolic biomarkers (linear mixed model analysis with *p*-values corrected for multiple testing).

**Author Contributions:** All authors have participated su fficiently and meaningfully to the research study and the preparation of this manuscript. M.S.-P. formulated the study question and design, interpreted the results, and drafted the manuscript. M.S.-P. and M.R.-C. were involved in statistical modeling. M.S.-P., S.N.K., Y.S. and S.M. contributed to the conception and design of the study and acquisition of the data. All authors contributed to the interpretation of data and critical revision of the manuscript and approved the final version. M.S.P., M.R.-C. and S.N.K. share primary responsibility for the final content. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research was funded by EMW-2014-FP-00612, US Department of Homeland Security, a Ohio University OURC gran<sup>t</sup> and a CHSP Research Innovation grant, and the 2018 Southeast Center for Integrated Metabolomics Pilot & Feasibility Project. M.S.-P. holds a Ramón y Cajal contract (RYC-2018-025069-I) from the Ministry of Science, Innovation and Universities and FEDER/FSE and FIS gran<sup>t</sup> PI20/00896. The funding agencies had no role in study design, data collection and analysis, interpretation of results, manuscript preparation or in the decision to submit this manuscript for publication

**Acknowledgments:** We appreciate the participation of the Indianapolis Fire Departments as well as the firefighters and their spouses. We also thank Noora Kanerva and Heli Julkunen for their help with data analysis, as well as the Indiana Clinical and Translational Science Institute for helping with sample processing, the Kroger Company (coupons and customer loyalty discounts), Barilla America (Barilla Plus Products), Arianna Trading Company, Innoliva and Molino de Zafra, Spain (extra virgin olive oil samples and discounts) and the Almond Board of California (free samples of roasted unsalted almonds) for study support. The sponsors had no involvement in the overall study design; collection, analysis and interpretation of data; writing of the report; or the decision to submit the report for publication.

**Conflicts of Interest:** The authors declare no conflict of interest.
