Institute of Medicine

Committee on Military Nutrition Research

This book reviews the research pertaining to nutrient requirements for working in cold or in high-altitude environments and states recommendations regarding the application of this information to military operational rations. It addresses whether, aside from increased energy demands, cold or high-altitude environments elicit an increased demand or requirement for specific nutrients, and whether performance in cold or high-altitude environments can be enhanced by the provision of increased amounts of specific nutrients.

Applications for Military Personnel in Field Operations

Nutritional Needs in Cold and High-Altitude Environments

It is a commonly held belief that athletes, particularly body builders, have greater requirements for dietary protein than sedentary individuals. However, the evidence in support of this contention is controversial. This book is the latest in a series of publications designed to inform both civilian and military scientists and personnel about issues related to nutrition and military service. Among the many other stressors they experience, soldiers face unique nutritional demands during combat. Of particular concern is the role that dietary protein might play in controlling muscle mass and strength, response to injury and infection, and cognitive performance. The first part of the book contains the committee's summary of the workshop, responses to the Army's questions, conclusions, and recommendations. The remainder of the book contains papers contributed by speakers at the workshop on such topics as, the effects of aging and hormones on regulation of muscle mass and function, alterations in protein metabolism due to the stress of injury or infection, the role of individual amino acids, the components of proteins, as neurotransmitters, hormones, and modulators of various physiological processes, and the efficacy and safety considerations associated with dietary supplements aimed at enhancing performance.

The Role of Protein and Amino Acids in Sustaining and Enhancing Performance

Eating enough food to meet nutritional needs and maintain good health and good performance in all aspects of life--both at home and on the job--is important for all of us throughout our lives. For military personnel, however, this presents a special challenge. Although soldiers typically have a number of options for eating when stationed on a base, in the field during missions their meals come in the form of operational rations. Unfortunately, military personnel in training and field operations often do not eat their rations in the amounts needed to ensure that they meet their energy and nutrient requirements and consequently lose weight and potentially risk loss of effectiveness both in physical and cognitive performance. This book contains 20 chapters by military and nonmilitary scientists from such fields as food science, food marketing and engineering, nutrition, physiology, psychology, and various medical specialties. Although described within a context of military tasks, the committee's conclusions and recommendations have wide-reaching implications for people who find that job-related stress changes their eating habits.

Overcoming Underconsumption of Military Operational Rations

Not Eating Enough

Subcommittee on Body Composition, Nutrition, and Health of Military Women

The incidence of stress fractures of the lower extremities during U.S. military basic training is significantly higher among female military recruits than among male recruits. The prevalence of this injury has a marked impact on the health of service personnel and imposes a significant financial burden on the military by delaying completion of the training of new recruits. In addition to lengthening training time, increasing program costs, and delaying military readiness, stress fractures may share their etiology with the longer-term risk of osteoporosis. As part of the Defense Women's Health Research Program, this book evaluates the impact of diet, genetic predisposition, and physical activity on bone mineral and calcium status in young servicewomen. It makes recommendations for reducing stress fractures and improving overall bone health through nutrition education and monitored physical training programs. The book also makes recommendations for future research to evaluate more fully the effects of fitness levels, physical activities, and other factors on stress fracture risk and bone health.

Reducing Stress Fracture in Physically Active Military Women

Food and Nutrition Board

The activities of the Food and Nutrition Board's Committee on Military Nutrition Research (CMNR, the committee) have been supported since 1994 by grant DAMD17-94-J-4046 from the U.S. Army Medical Research and Materiel Command (USAMRMC). This report fulfills the final reporting requirement of the grant, and presents a summary of activities for the grant period from December 1, 1994 through May 31, 1999. During this grant period, the CMNR has met from three to six times each year in response to issues that are brought to the committee through the Military Nutrition and Biochemistry Division of the U.S. Army Research Institute of Environmental Medicine at Natick, Massachusetts, and the Military Operational Medicine Program of USAMRMC at Fort Detrick, Maryland. The CMNR has submitted five workshop reports (plus two preliminary reports), including one that is a joint project with the Subcommittee on Body Composition, Nutrition, and Health of Military Women; three letter reports, and one brief report, all with recommendations, to the Commander, U.S. Army Medical Research and Materiel Command, since September 1995 and has a brief report currently in preparation. These reports are summarized in the following activity report with synopses of additional topics for which reports were deferred pending completion of military research in progress. This activity report includes as appendixes the conclusions and recommendations from the nine reports and has been prepared in a fashion to allow rapid access to committee recommendations on the topics covered over the time period.

Activity Report 1994-1999

This report from the Committee on Military Nutrition Research reviews the history of caffeine usage, the metabolism of caffeine, and its physiological effects. The effects of caffeine on physical performance, cognitive function and alertness, and alleviation of sleep deprivation impairments are discussed in light of recent scientific literature. The impact of caffeine consumption on various aspects of health, including cardiovascular disease, reproduction, bone mineral density, and fluid homeostasis are reviewed. The behavioral effects of caffeine are also discussed, including the effect of caffeine on reaction to stress, withdrawal effects, and detrimental effects of high intakes. The amounts of caffeine found to enhance vigilance and reaction time consistently are reviewed and recommendations are made with respect to amounts of caffeine appropriate for maintaining alertness of military personnel during field operations. Recommendations are also provided on the need for appropriate labeling of caffeine-containing supplements, and education of military personnel on the use of these supplements. A brief review of some alternatives to caffeine is also provided.

Formulations for Military Operations

Caffeine for the Sustainment of Mental Task Performance

Every aspect of immune function and host defense is dependent upon a proper supply and balance of nutrients. Severe malnutrition can cause significant alteration in immune response, but even subclinical deficits may be associated with an impaired immune response, and an increased risk of infection. Infectious diseases have accounted for more off-duty days during major wars than combat wounds or nonbattle injuries. Combined stressors may reduce the normal ability of soldiers to resist pathogens, increase their susceptibility to biological warfare agents, and reduce the effectiveness of vaccines intended to protect them. There is also a concern with the inappropriate use of dietary supplements. This book, one of a series, examines the impact of various types of stressors and the role of specific dietary nutrients in maintaining immune function of military personnel in the field. It reviews the impact of compromised nutrition status on immune function; the interaction of health, exercise, and stress (both physical and psychological) in immune function; and the role of nutritional supplements and newer biotechnology methods reported to enhance immune function. The first part of the book contains the committee's workshop summary and evaluation of ongoing research by Army scientists on immune status in special forces troops, responses to the Army's questions, conclusions, and recommendations. The rest of the book contains papers contributed by workshop speakers, grouped under such broad topics as an introduction to what is known about immune function, the assessment of immune function, the effect of nutrition, and the relation between the many and varied stresses encountered by military personnel and their effect on health.

Military Strategies for Sustainment of Nutrition and Immune Function in the Field

Committee on Optimization of Nutrient Composition of Military Rations for Short-Term, High-Stress Situations

Recognizing the importance of good nutrition for physical and mental status, the Department of Defense asked the Institute of Medicine to guide the design of the nutritional composition of a ration for soldiers on short-term, high-stress missions. Nutrient Composition of Rations for Short-Term, High-Intensity Combat Operations considers military performance, health concerns, food intake, energy expenditure, physical exercise, and food technology issues. The success of military operations depends to a large extent on the physical and mental status of the individuals involved. Appropriate nutrition during assault missions is a continuous challenge mainly due to diminished appetites of individuals under stress. Many less controllable and unpredictable factors, such as individual preferences and climate, come into play to reduce appetite. In fact, soldiers usually consume about half of the calories needed, leaving them in a state called â€œnegative energy balance.â€ The consequences of being in negative energy balance while under these circumstances range from weight loss to fatigue to mental impairments. An individualâ€™s physiological and nutritional status can markedly affect oneâ€™s ability to maximize performance during missions and may compromise effectiveness. With the number of these missions increasing, the optimization of rations has become a high priority.

Nutrient Composition of Rations for Short-Term, High-Intensity Combat Operations

Committee on Mineral Requirements for Cognitive and Physical Performance of Military Personnel

The U.S. Army Health Risk Appraisal group surveyed 400,000 active duty U.S. Army personnel in the late 1990s to determine whether or not those personnel met the dietary objectives of Healthy People 2000 (HP2000), a national agenda for health promotion and disease prevention. As reported by Yore et al. (2000), Army personnel generally did not meet the HP2000 goals for nutrition even though significant progress had been made during 1991-1998. Although the specific aspects of diet that would be relevant to this Committee on Mineral Requirements for Cognitive and Physical Performance of Military Personnel are lacking, the findings from this survey suggest that there are dietary problems in the military population. The potential for adverse effects of marginal mineral deficiencies among soldiers engaged in training or military operations and the prospect of improving military performance through mineral intakes have spurred the military's interest in this area of nutrition. Mineral Requirements for Military Personnel provides background information on the current knowledge regarding soldiers' eating behaviors as well as on the physical and mental stress caused by military garrison training or operations. This report also offers facts on the mineral content of rations and its intake by military personnel and addresses the potential effects of nutrient deficiencies due to inadequate intake or higher requirements during military operations. Mineral Requirements for Military Personnel provides information and recommendations on the development and uses of MDRIs and a description of strategies to increase intake of specific minerals, whether via usual foods, fortification, or supplementation. This report features a description of the metabolism and needs for selected minerals by military personnel under garrison training, recommendations on mineral intake levels, and an assessment of mineral level adequacy in operational rations. This report also includes a prioritization of the research needed to answer information gaps and details of study designs required to gain such information.

Levels Needed for Cognitive and Physical Performance During Garrison Training

Mineral Requirements for Military Personnel

This volume examines the current state of knowledge concerning the influence of a hot environment on nutrient requirements of military personnel. A parallel concern is ensuring that performance does not decline as a result of inadequate nutrition. The committee provides a thorough review of the literature in this area and interprets the diverse data in terms of military applications. In addition to a focus on specific nutrient needs in hot climates, the committee considers factors that might change food intake patterns and therefore overall calories. Although concern for adequate nutrition for U.S. soldiers in Saudi Arabia prompted the initiation of this project, its scope includes the nutrient needs of individuals who may be actively working in both hot-dry and hot-moist climates.

Nutritional Needs in Hot Environments

Subcommittee on Military Weight Management

The primary purpose of fitness and body composition standards in the U.S. Armed Forces has always been to select individuals best suited to the physical demands of military service, based on the assumption that proper body weight and composition supports good health, physical fitness, and appropriate military appearance. The current epidemic of overweight and obesity in the United States affects the military services. The pool of available recruits is reduced because of failure to meet body composition standards for entry into the services and a high percentage of individuals exceeding military weight-for-height standards at the time of entry into the service leave the military before completing their term of enlistment. To aid in developing strategies for prevention and remediation of overweight in military personnel, the U.S. Army Medical Research and Materiel Command requested the Committee on Military Nutrition Research to review the scientific evidence for: factors that influence body weight, optimal components of a weight loss and weight maintenance program, and the role of gender, age, and ethnicity in weight management.

State of the Science and Opportunities for Military Programs

Weight Management

The physiological or psychological stresses that employees bring to their workplace affect not only their own performance but that of their co-workers and others. These stresses are often compounded by those of the job itself. Medical personnel, firefighters, police, and military personnel in combat settings--among others--experience highly unpredictable timing and types of stressors. This book reviews and comments on the performance-enhancing potential of specific food components. It reflects the views of military and non-military scientists from such fields as neuroscience, nutrition, physiology, various medical specialties, and performance psychology on the most up-to-date research available on physical and mental performance enhancement in stressful conditions. Although placed within the context of military tasks, the volume will have wide-reaching implications for individuals in any job setting.

Committee on Military Nutrition Research

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