Mission Nutrition for Combat Effectiveness

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Mission Nutrition for Combat Effectiveness
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Overview

• Nutritional Readiness Before Missions
• Sustained Night Operations
• Nutritional Readiness During Missions
• Missions in the Heat
• Missions in the Cold
• Missions at Altitude
• Missions in Water and at Depth
• Mission Scenarios

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Nutritional Readiness Before Missions

• Maximize glycogen stores
• Low glycogen stores fatigue
• Eat 2 - 4g of CHO/pound weight 3 - 4 hrs before
  an operation
• Consume at least 400 g CHO/day
• Minimize fat intake
• Be well-hydrated

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Sustained Night Operations

• Sustained Operations (SUSOPS)
• Work periods of 12 hours
• Expect physical and mental fatigue, sleep loss
• Continuous Operations (CONOPS)
• Expect periods of uninterrupted activity followed
  by some sleep
• Missions include SUSOPS and CONOPS
• Expect fatigue and sleep deprivation

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Sustained Night Operations

• Nutritional Concerns
• ? CHO intake
• Maintain hydration status
• Monitor caffeine intake

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Energy Intake and SUSOPS

• 5070 of energy from CHO
• 10-20 of energy from protein
• 20-35 of energy from fat
• Consume high CHO snacks and/or CHO-containing
  fluid replacement beverages
• To maintain blood glucose and delay fatigue

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Tryptophan and SUSOPS

• Avoid foods high in the amino acid tryptophan,
  which promotes sleep

Foods High in Tryptophan Foods High in Tryptophan
Dairy products and eggs Soy products
Seafood Whole grains
Poultry Rice
Meats Hazelnuts, Peanuts
Beans and Lentils Sesame and sunflower seeds
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Hydration and SUSOPS

• Adequate intake of water is 3.7 L (almost a
  gallon)/day
• Beverages consumed should be 8 CHO (lt 19g/8oz
  or 80 grams/L)
• SOF operators need a lot of water

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Caffeine and SUSOPS

• Increases alertness and may delay fatigue
• Common dose effective for maintaining performance
  and vigilance is 200 mg
• Stay Alert gum in the Military contains 100 mg
  per chicklet
• Current recommendation 2 chicklets every 2 hrs
• Effects of caffeine wears off within 6 hrs
• Factors causing variability in effective dose
• Habitual caffeine intake
• Sensitivity to caffeine

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Nutritional-Related Issues During Missions

• Inadequate ration consumption
• Inadequate energy intake
• Dehydration
• Gastrointestinal complaints

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Rations and Mission Readiness

• Inadequate ration and energy intake
• Causes
• Monotony
• Lack of time
• Results
• Weight loss
• Fatigue
• Prevention
• Consume as much of each part of) the ration as
  possible to maximize nutrient intake for
  performance

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Dehydration and Mission Readiness

• Causes
• Occurs in any condition/environment if sweat and
  urine losses are not replaced by fluids
• Consequences
• Decreased appetite
• Lethargy
• Prevention
• Drink about 4L of fluid per day
• Drink more when environment is hot

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Gastrointestinal Complaints During Missions

• Causes
• Stress/Changes in diet
• Dehydration
• Too much fiber
• Poor sanitary conditions
• Contaminated food
• Unfamiliar bacteria
• Prevention
• Stay hydrated at all times
• Avoid non-issue foods whenever possible

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Missions in the Heat

• Maintain fluid and electrolyte balance by
• Knowing temperature and humidity
• Adjusting work rate
• Being acclimated
• Being aware of rate and volume of fluid intake
• Monitoring urine color
• Energy intake ? by 10 when working and living in
  86 to 104 F (30-40C), unless activity level
  decreases accordingly

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Hydration and Missions in the Heat

• Dark yellow (7 - 9) and smelly urine suggest
  dehydration
• B vitamins may cause urine to be bright (not
  pale) yellow, regardless of hydration status
• ? fluid consumption until urine becomes pale
  yellow (1 - 3)

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Electrolytes and Missionsin the Heat

• Excessive loss of electrolytes through sweat may
  result in
• Muscle cramps
• Severe medical problems
• Preventive measures during and after missions
• Eat snacks with sodium and potassium
• Consume fluids with electrolytes
• Consider electrolytes in SportStrips and gels
• Eat foods naturally high in sodium (salt) and
  potassium (dried foods)

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Missions in the Cold

• In cold environments, blood vessels tighten to
  conserve heat and shivering is initiated to
  generate heat resulting in
• Increased urine output
• Increased energy metabolism
• Nutritional considerations
• Energy intake
• Glycogen stores
• Fluid status
• Vitamin and mineral needs

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Energy Intake and Missions in the Cold

• Energy requirements can increase 25-50 during
  cold weather operations as compared to warm
  weather operations
• Factors that increase caloric intake
• Added exertion due to wearing heavy gear
• Shivering
• Traveling over snow and icy terrain
• Increased activity to keep warm

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Energy Intake and Missions in the Cold

• Fat and CHO are critical energy sources!
• 50-60 of energy from CHO
• 30-35 of energy from fat
• 10-20 of energy from protein
• High protein diets are not advised
• Increase fluid requirements
• Ingest foods that produce heat
• CHO produces more heat than fat or protein
• Hot beverages increase body temperature

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CHO and Missionsin the Cold

• Glycogen stores
• A minimum of 400 grams of CHO per day is
  necessary in cold weather

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Fluids and Missionsin the Cold

• Dehydration common in cold weather
• ? urine output
• ? fluid loss through breathing
• Involuntary reduction in fluid intake
• Sweating
• Hence, drink plenty of water

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Vitamins and Minerals and Missions in the Cold

• Higher requirements for some vitamins and
  minerals due to
• ? energy metabolism (e.g. thiamin)
• ? urinary loses (magnesium, zinc)
• Prevention
• Eat all ration components

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Missions at Altitude

• Major nutritional concerns
• Weight loss
• CHO intake
• Dehydration
• Oxidative Stress

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Weight Loss and Missions at Altitude

• Altitudes lt 5,000m weight loss can be prevented
  by eating on a regular basis
• Altitudes gt 5,000m a 5-10 weight loss is
  unavoidable, but intake critical
• Energy requirements may increase 15-50 above
  requirements at sea level
• Energy intake should range from 3,500-6,000 kcal
  per day (i.e. at least 4 MREs or 2 First Strike
  Rations per day)

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Weight Loss and Missions at Altitude

• ? energy needs to 115-150 of sea level
• ? sense of taste, which ? food intake
• Changes in metabolism of fat and CHO
• Loss of body water from ? breathing and dry air
• Impaired absorption of nutrients
• Acute Mountain Sickness (AMS)
• Nausea, vomiting, headache, and ? appetite

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CHO Needs and Missions at Altitude

• Repletes glycogen stores
• Requires less oxygen than fat to yield energy
• Is most efficient energy source
• Can blunt/delay progression/severity of AMS
• Maintains blood glucose
• CHO must contribute to 50-70 of total energy
  or at least 400g of CHO per day

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Dehydration and Missions at Altitude

• ? respiratory losses due to ? ventilation
• ? urine output due to altitude and cold
  temperature
• Possible diarrheal fluid losses
• Failure to drink water
• Poor access to water
• Maintain a drinking schedule and monitor
  hydration status daily to avoid AMS

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Oxidative Stress and Missions at Altitude

• ? formation of reactive oxidative species
• ? metabolic rate
• Hypoxic conditions
• Preventive measures
• Vitamin E (400 IU/day)
• A combination of 500mg of Vitamin C, 200 IU of
  Vitamin E, and 300 mg of alpha-lipoic acid in the
  morning and evening may be effective
• Excessive use of antioxidants may be harmful!

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Missions in Water and at Depth

• Energy intake
• Fluid intake
• Mineral balance
• Antioxidant balance

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Energy and Missions in Water and at Depth

• Increased energy expenditure due to
• Greater resistance offered by water
• ? efficiency of movements when thermal protective
  clothing is worn
• Preventive measures
• ? CHO intake before an anticipated dive
• Ingest CHO beverage or sports bar

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Hydration and Missions in Water and at Depth

• Fluid losses
• Immersion in water ? urinary excretion 2-10x
  above normal
• Preventive measures
• Drink fluids before and after diving
• Consume beverages should with CHO when dives are
  longer than 2 hr

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Missions in Water and at Depth

• Mineral balance
• ? urinary losses of Mg, Ca, Zn, and Cr
• Preventive measures
• Consume foods containing these minerals
• Antioxidant losses
• Diving ? formation of reactive oxygen species
• ? depth ? O2 tension
• Preventive measures
• Take 1g of vitamin C and 400 IU of vitamin E 2
  hrs before extended dives
• Consume a diet high in natural antioxidants

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Mission Scenarios

• Performance can be sustained for weeks if
• Energy intake gt 2000kcal/day
• CHO intake 300 g
• Protein intake 60 g
• Fluid status is maintained
• Sample nutritional plans in SOF manual
• Typical training day
• SDV Operations
• Unconventional Warfare
• Special Reconnaissance
• Nighttime Air Mission

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Nutrition Requirements Planning Guide
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For Monitoring Dehydration
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Key Points

• Primary ways to be nutritionally prepared for
  all missions
• Eat a high CHO diet
• Be well hydrated
• Eat CHO snacks every 2 to 3 hours to maintain
  blood glucose