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Not Eating Enough: Overcoming Underconsumption of Military Operational Rations (1995)
Institute of Medicine (IOM)

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. "2 Conclusions and Recommendations." Not Eating Enough: Overcoming Underconsumption of Military Operational Rations. Washington, DC: The National Academies Press, 1995.

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Not Eating Enough: Overcoming Underconsumption of Military Operational Rations

also extremely important. These factors include such situational elements as designation of eating locations, meal schedules, social setting (alone or with others), and provision of rations at appropriate temperatures. The committee believes that multiple logistic, situational, and sensory factors contribute to decreased consumption. Military operational rations are by design all inclusive and do not allow substitution or choice. Failure to provide adequate time, instruction, and encouragement to eat and drink can materially influence consumption. The attitude of the local commander is critical in ensuring that soldiers are aware that daily adequate nutrition is important so as not to degrade performance over a period of time. It would be an important future research step to provide a priority order for the impact of these multiple factors on soldier food intake in the field.

2. What factors influence underconsumption in field operations? Identify the relative importance of rations, environment, the eating situation, and the individual.

A number of factors influence the quantity of operational rations consumed. Generally under field conditions, an underconsumption of rations is observed, which leads to weight loss. Numerous factors including the environment, the specific eating situation, the ration itself, and the individual can affect the amount of rations that will be consumed. Any one of these can be the most important factor depending on the situation. Further review of the relevant military data on eating situations that provides an integrated overview of the ordering of environment, the rations, and the individual factors with situational change would be beneficial. The following are reasonable conclusions/opinions based on available evidence:

Environment: Field environments are generally harsh, frequently require increased energy expenditure, and are not conducive to the enjoyment of eating. Proximity to danger, temperature extremes, unappetizing local conditions, and lack of protection from the elements are all conditions that are encountered in a military scenario and can contribute to an impairment of appetite and underconsumption.

Eating Situation: The opportunity for social interaction,information exchange, and appropriateness of meal to the time of day, are all elements of the eating situation that can contribute to food intake.

Rations: Acceptability of rations to the soldier includes temperature,sensory properties (taste, smell, texture, color, and temperature), packaging,individual food preferences, ease of use, nutritional content, stability of product, appropriateness to time of day, delivery, presentation,

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Front Matter (R1-R13)
I Committee Summary and Recommendations (1-2)
1 Introduction and Background (3-40)
2 Conclusions and Recommendations (41-54)
II Background and Introduction to the Topic (55-56)
3 Introduction to the Concepts and Issues: Underlying Underconsumption in Military Settings (57-64)
4 Army Field Feeding System-Future (65-76)
5 Commanders' Perceptions and Attitudes About Their Responsibilities for Feeding Soldiers (77-90)
6 Nutritional Criteria for Development and Testing of Military Field Rations: An Historical Perspective (91-108)
7 Evolution of Rations: The Pursuit of Universal Acceptance (109-120)
8 An Overview of Dietary Intakes During Military Exercises (121-150)
9 The Effects of Ration Modifications on Energy Intake, Body Weight Change (151-174)
III Factors Underlying Food Intake and Underconsumption--Food (175-176)
10 The Role of Image, Stereotypes, and Expectations on the Acceptance and Consumption of Rations (177-202)
11 Effects of Food Quality, Quantity, and Variety on Intake (203-216)
12 Effects of Beverage Consumption and Hydration Status on Caloric Intake (217-238)
13 Industry Approaches to Food Research (239-250)
IV Underconsumption and Performance (251-252)
14 When Does Energy Deficit Affect Soldier Physical Performance? (253-284)
15 Impact of Underconsumption on Cognitive Performance (285-302)
16 The Functional Effects of Carbohydrate and Energy Underconsumption (303-316)
V Factors Underlying Food Intake and Underconsumption--The Eating Situation and Social Issues (317-318)
17 The Physical Eating Situation (319-340)
18 Eating Situations, Food Appropriateness, and Consumption (341-360)
19 From Biologic Rhythms to Chronomes Relevant to Nutrition (361-372)
20 Social Facilitation and Inhibition of Eating (373-392)
21 Lessons from Eating Disorders (393-410)
22 A Plan to Overcome Ration Underconsumption (411-416)
Appendixes (417-418)
A Biographical Sketches (419-432)
B Abbreviations (433-436)
C Factors Related to Underconsumption --A Selected Bibliography (437-464)
Index (465-483)