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

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. "20 Energy and Macronutrient Requirements for work at High Altitudes." Nutritional Needs in Cold and High-Altitude Environments: Applications for Military Personnel in Field Operations. Washington, DC: The National Academies Press, 1996.

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It is increasingly evident that soldiers participating in field training exercises, particularly those in mountainous terrain, consistently have high rates of energy expenditure and limited dietary energy intakes (Hoyt et al., 1991, 1994a) (Table 20-1). Why are soldiers characteristically in negative energy balance? The following discussion will attempt to address this question and others posed by the Committee on Military Nutrition Research.

ENERGY BALANCE

Exercise Energy Expenditure
Duration of Activity

High rates of energy expenditure can be attributed in part to the large portion of the day that soldiers spend in physical activity. For example, monitoring of ambulatory activity showed that soldiers were active around 17.3 ± 0.2 h/d (mean ± SD) (n = 20) over the course of 11 days during a physically demanding winter military training course (Hoyt et al., 1991). Similarly, Special Operations Forces soldiers were active about 16 ± 2 h/d during a 6-d military field training exercise at 2,500 to 3,100 m (8,202 to 10,171 ft) elevation on Mount Rainier (elevation = 4,392 m [14,410 ft], Mount Rainier National Park, Wash.) (Hoyt et al., 1994a).

TABLE 20-1 Ration Consumption and Estimated Energy Expenditure of Soldiers in the Field

Test duration

3 to 34 days

Energy expenditure

3,490 ± 640 kcal/d

(range: 2,000 to 4,700 kcal/d)

Food energy intake

2,410 ± 400 kcal/d

(range: 1,780 to 2,880 kcal/d)

Carbohydrate intake

280 ± 70 g/d

(range: 190 to 385 g/d)

NOTE: These data are from 11 recent field studies of 781 soldiers. Values are means ± SD of study averages for each ration tested. Meal, Ready-to-Eat versions III (n = 61), VI (n = 342), VII (n = 129), and VIII (n = 148); Ration, Lightweight (n = 253); and Ration, Cold Weather (n = 48) were tested. About two-thirds of the available food energy was consumed.

SOURCE: Compiled from Jones et al. (1990).

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380
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)