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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
293
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IV
THE HIGH-TERRESTRIAL ENVIRONMENT

PART IV BEGINS BY EXPLORING THE PHYSIOLOGICAL and mental responses that uniquely characterize high altitudes. Chapter 16 details the physiological and pathological effects of high-altitude exposure. An initial weight loss accompanies the ascent to altitude because of increased water losses and decreased energy intake relative to expenditure. Altitude-related illnesses, such as acute mountain sickness and high-altitude cerebral edema, may cause further complications because they affect nutrition. Chapter 17 reviews the effects of lowered oxygen transport on physical performance as well as cardiac, hematologic, and nervous system responses at high altitudes. In Chapter 18, fluid metabolism at high altitudes is discussed. The literature presents conflicting data due to the differences in methodology and the presence of variables such as the effects of altitude-related sickness. Water retention contributes to the development of these illnesses, and exercise stimulates the accumulation of body water and electrolytes.

At high altitudes, diuresis, decline in appetite, and increase in basal energy needs contribute to weight loss. Chapter 19 finds that adequate energy intake can eliminate this problem, as well as decrease the diuresis that results from acute altitude exposure. Carbohydrate is the metabolic fuel that ensures adequate energy intake. Total energy requirements at high altitude are discussed in Chapter 20. The type and duration of physical activity, preexisting

Page
293
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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OCR for page 293
--> IV THE HIGH-TERRESTRIAL ENVIRONMENT PART IV BEGINS BY EXPLORING THE PHYSIOLOGICAL and mental responses that uniquely characterize high altitudes. Chapter 16 details the physiological and pathological effects of high-altitude exposure. An initial weight loss accompanies the ascent to altitude because of increased water losses and decreased energy intake relative to expenditure. Altitude-related illnesses, such as acute mountain sickness and high-altitude cerebral edema, may cause further complications because they affect nutrition. Chapter 17 reviews the effects of lowered oxygen transport on physical performance as well as cardiac, hematologic, and nervous system responses at high altitudes. In Chapter 18, fluid metabolism at high altitudes is discussed. The literature presents conflicting data due to the differences in methodology and the presence of variables such as the effects of altitude-related sickness. Water retention contributes to the development of these illnesses, and exercise stimulates the accumulation of body water and electrolytes. At high altitudes, diuresis, decline in appetite, and increase in basal energy needs contribute to weight loss. Chapter 19 finds that adequate energy intake can eliminate this problem, as well as decrease the diuresis that results from acute altitude exposure. Carbohydrate is the metabolic fuel that ensures adequate energy intake. Total energy requirements at high altitude are discussed in Chapter 20. The type and duration of physical activity, preexisting

OCR for page 294
--> energy stores, and environmental conditions determine these energy needs. Because the energy requirements for work at high altitudes are higher and appetite tends to decline, energy intakes are often inadequate to meet these increases. Chapter 21 presents evidence suggesting that there is increased oxidative stress at high altitudes, which impairs blood flow and physical performance. Inadequate levels of antioxidants may impair metabolic functions at altitude, and some studies show that vitamin E is beneficial.

Representative terms from entire chapter:

energy requirements