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Nutritional Needs in Cold and High-Altitude Environments: Applications for Military Personnel in Field Operations (1996)
Institute of Medicine (IOM)

Page
125
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III
THE COLD ENVIRONMENT

CHANGES IN PHYSIOLOGY AND NUTRIENT requirements due to the cold environment are considered in Part III. The mechanisms to maintain core body temperature and to reduce and restore heat loss during cold exposure are collectively termed thermoregulation. Chapter 7 discusses physiological thermoregulation, or the way in which dry heat loss is reduced through vasomotor responses and replaced through metabolic responses, in relation to physical performance. While involuntary shivering contributes to body-temperature regulation, voluntary physical activity can do more to increase heat production. Individual characteristics, such as body composition and physical fitness, also contribute to the regulation of the rise and fall of body temperature.

Biological clocks control various physiological processes and often conflict with military schedules. Chapter 8 explains the behavioral and physiological responses that the body utilizes to manage these changes and focuses on the physiological process of sleep and how it is disrupted by military operations. To enhance physical and cognitive performance in extreme environments, it may be possible to develop biological and pharmacological agents that may alter circadian rhythms and other biological clocks.

As Chapter 9 explains, environmental extremes can cause disruption in fluid balance, and dehydration is a possibility in cold environments as well as hot environments. The most significant factors associated with dehydration during cold exposure include cold-induced diuresis, respiratory water losses, the metabolic cost of movement, and reduced fluid intake, with the most

Page
125
Front Matter (R1-R16)
I: Committee Summary and Recommendations (1-2)
1 A Review of the Physiology and Nutrition in Cold and in High-Altitude Environments (3-58)
2 Committee on Military Nutrition Research Recommendations and Conclusions (59-80)
II: Background and Introduction to theTopic (81-82)
3 Cold Weather and High-Altitude Nutrition: Overview of the Issues (83-94)
4 Leadership Insights for Military Operations in Cold Weather and at High Altitudes (95-100)
5 Cold-Weather Field Feeding: Military Rations (101-114)
6 Feeding the US Army Sixth Infantry Division (Light) in the Cold (115-122)
Part II Discussion (123-124)
III: The Cold Environment (125-126)
7 The Physiology of Cold Exposure (127-148)
8 Military Schedules vs. Biological Clocks (149-160)
9 Influence of Cold Stress on Human Fluid Balance (161-180)
10 Muscle Metabolism and Shivering During Cold Stress (181-188)
11 Macronutrient Requirements for Work in Cold Environments (189-202)
12 Cold Exposure, Appetite, and Energy Balance (203-214)
13 Effects of Cold and altitude on Vitamin and Mineral Requirements (215-244)
14 Micronutrient Deficiency States and Thermoregulation in the Cold (245-256)
15 Drug-Induced Delay of Hypothermia (257-270)
Part III Discussion (271-292)
IV: The High-Terrestrial Environment (293-294)
16 The Physiology of High-Altitude Exposure (295-318)
17 Physical Performance at High Altitudes (319-330)
18 Fluid Metabolism at High Altitudes (331-356)
19 Maintenance of Body Weight at High Altitudes: In Search of 500 kcal/day (357-378)
20 Energy and Macronutrient Requirements for work at High Altitudes (379-392)
21 Oxidative Stress at High Altitudes and Effects of Vitamin E (393-418)
Part IV Discussion (419-432)
V: Performance in Cold and in High-Altitude Environments (433-434)
22 Effets of Altitue on Cognitive Performance and Mood States (435-452)
23 Food Components and Other Treatments That May Enhance Mental Performance at High Altitudes and in the Cold (453-466)
General Discussion (467-478)
Appendixes (479-480)
A: Environmental Stress Management at High Altitudes by Adaptogens, summary of unpublished manuscript (481-484)
B: Biographical Sketches (485-500)
C: Abbreviations (501-504)
D: Factors Related to Nutritional Needs in Cold and in High-Altitude Environments- A Selected Bibliography (505-554)
Index (555-568)

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--> III THE COLD ENVIRONMENT CHANGES IN PHYSIOLOGY AND NUTRIENT requirements due to the cold environment are considered in Part III. The mechanisms to maintain core body temperature and to reduce and restore heat loss during cold exposure are collectively termed thermoregulation. Chapter 7 discusses physiological thermoregulation, or the way in which dry heat loss is reduced through vasomotor responses and replaced through metabolic responses, in relation to physical performance. While involuntary shivering contributes to body-temperature regulation, voluntary physical activity can do more to increase heat production. Individual characteristics, such as body composition and physical fitness, also contribute to the regulation of the rise and fall of body temperature. Biological clocks control various physiological processes and often conflict with military schedules. Chapter 8 explains the behavioral and physiological responses that the body utilizes to manage these changes and focuses on the physiological process of sleep and how it is disrupted by military operations. To enhance physical and cognitive performance in extreme environments, it may be possible to develop biological and pharmacological agents that may alter circadian rhythms and other biological clocks. As Chapter 9 explains, environmental extremes can cause disruption in fluid balance, and dehydration is a possibility in cold environments as well as hot environments. The most significant factors associated with dehydration during cold exposure include cold-induced diuresis, respiratory water losses, the metabolic cost of movement, and reduced fluid intake, with the most

OCR for page 126
--> the metabolic cost of movement, and reduced fluid intake, with the most significant being the increased fluid loss associated with high metabolic work rates. Dehydration negatively influences physical and cognitive performance and thermoregulation, and increases possible susceptibility to injury. Chapter 10 briefly summarizes some recent research on how skeletal muscle fuels shivering. Understanding shivering can be useful in a survival situation to enhance thermogenesis and delay the onset of life-threatening hypothermia. Chapters 11 and 12 focus on energy requirements in the cold. To determine the optimal macronutrient ratio, several factors must be considered, including the caloric density of fat as compared to carbohydrate or protein, the enhancement of thermogenesis associated with the thermic effect of food, and the preference for a particular nutrient in the diet. As an example of environmental influence on appetite, cold exposure increases energy expenditure which may stimulate appetite to allow an enhanced intake of energy. The thermic effects of food, of cold, and of exercise are important considerations in understanding appetite and weight maintenance in the cold. Using the Military Recommended Dietary Allowances (MRDAs) as a frame of reference, the influence of cold exposure on the need for vitamins and minerals is reviewed in Chapter 13. There is little scientific justification for supplementation above the MRDAs to cope with cold stress and exposure. In Chapter 14, the possible effects of iron, copper, and zinc deficiencies on thermoregulation are discussed. Major emphasis is placed on iron's role in maintaining core body temperature, although the MRDA for iron appears to be sufficient to prevent deficiency. For the most part, any short-term deficiency that may occur during a military operation is not likely to lead to micronutrient deprivation unless there is a preexisting reserve depletion. Finally, this section on the cold environment concludes with a discussion in Chapter 15 of the possibility of a drug-mediated delay of hypothermia during cold exposure. The author is unable to verify the claims of a commercial sports bar and its ability to delay hypothermia, but does find that ephedrine-xanthine mixtures represent a safe agent to enhance cold tolerance in humans.

Representative terms from entire chapter:

metabolic cost