Cover Image

PAPERBACK
$59.00



View/Hide Left Panel

Emerging Technologies for Nutrition Research

Potential for Assessing Military Performance Capability

Committee on Military Nutrition Research

Food and Nutrition Board

Institute of Medicine

Sydne J. Carlson-Newberry and Rebecca B. Costello, Editors

NATIONAL ACADEMY PRESS

Washington, D.C.

1997



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement



Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole.
Intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text on the opening pages of each chapter. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

Do not use for reproduction, copying, pasting, or reading; exclusively for search engines.

OCR for page R1
Emerging Technologies for Nutrition Research: Potential for Assessing Military Performance Capability Emerging Technologies for Nutrition Research Potential for Assessing Military Performance Capability Committee on Military Nutrition Research Food and Nutrition Board Institute of Medicine Sydne J. Carlson-Newberry and Rebecca B. Costello, Editors NATIONAL ACADEMY PRESS Washington, D.C. 1997

OCR for page R1
Emerging Technologies for Nutrition Research: Potential for Assessing Military Performance Capability NATIONAL ACADEMY PRESS 2101 Constitution Avenue, N.W. Washington, DC 20418 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. Part I of this report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The Institute of Medicine was established in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy’s 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine. This report was produced under grant DAMD17-94-J-4046 between the National Academy of Sciences and the U.S. Army Medical Research and Material Command. The views, opinions, and/or findings contained in chapters in Parts II through VIII that are authored by U.S. Army personnel are those of the authors and should not be construed as official Department of the Army positions, policies, or decisions, unless so designated by other official documentation. Human subjects who participated in studies described in those chapters gave their free and informed voluntary consent. Investigators adhered to U.S. Army regulation 70-25 and United States Army Medical Research and Development Command regulation 70-25 on use of volunteers in research. Citations of commercial organizations and trade names in this report do not constitute an official Department of the Army endorsement or approval of the products or services of these organizations. The chapters are approved for public release; distribution is unlimited. Library of Congress Catalog Card No. 97-68316 International Standard Book Number 0-309-05797-3 Additional copies of this report are available from: National Academy Press 2101 Constitution Avenue, N.W. Lock Box 285 Washington, D.C. 20055 Call (800) 624-6242 or (202) 334-3313 (in the Washington metropolitan area), or visit the NAP’s on-line bookstore at http://www.nap.edu. Copyright 1997 by the National Academy of Sciences. All rights reserved. Printed in the United States of America. The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The image adopted as a logotype by the Institute of Medicine is based on a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.

OCR for page R1
Emerging Technologies for Nutrition Research: Potential for Assessing Military Performance Capability COMMITTEE ON MILITARY NUTRITION RESEARCH ROBERT O. NESHEIM (Chair), Salinas, California WILLIAM R. BEISEL, Department of Molecular Microbiology and Immunology, The Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland GAIL E. BUTTERFIELD, Nutrition Studies, Palo Alto Veterans Affairs Health Care System and Program in Human Biology, Stanford University, Palo Alto, California WANDA L. CHENOWETH (from September 18, 1996), Department of Food Science and Human Nutrition, Michigan State University, East Lansing JOHN D. FERNSTROM, Department of Psychiatry, Pharmacology, and Neuroscience, University of Pittsburgh School of Medicine, Pennsylvania G. RICHARD JANSEN, Department of Food Science and Human Nutrition, Colorado State University, Fort Collins ROBIN B. KANAREK, Department of Psychology, Tufts University, Boston, Massachusetts ORVILLE A. LEVANDER, Nutrient Requirements and Functions Laboratory, U.S. Department of Agriculture Beltsville Human Nutrition Research Center, Beltsville, Maryland GILBERT A. LEVEILLE (through December 31, 1996), Nabisco Foods Group, East Hanover, New Jersey JOHN E. VANDERVEEN, Office of Plant and Dairy Foods and Beverages, Food and Drug Administration, Washington, D.C. DOUGLAS W. WILMORE, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts Food and Nutrition Board Liaison JOHANNA T. DWYER, Frances Stern Nutrition Center, New England Medical Center Hospital and Departments of Medicine and Community Health, Tufts Medical School and School of Nutrition Science and Policy, Boston, Massachusetts U.S. Army Grant Officer Representative HARRIS R. LIEBERMAN, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts JAMES A. VOGEL (through September 1, 1995), U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts

OCR for page R1
Emerging Technologies for Nutrition Research: Potential for Assessing Military Performance Capability Staff REBECCA B. COSTELLO, Study Director (from July 15, 1996) BERNADETTE M. MARRIOTT, Study Director (through November 22, 1995) SYDNE J. CARLSON-NEWBERRY, Program Officer SUSAN M. KNASIAK-RALEY, Research Assistant DONNA F. ALLEN, Senior Project Assistant

OCR for page R1
Emerging Technologies for Nutrition Research: Potential for Assessing Military Performance Capability FOOD AND NUTRITION BOARD CUTBERTO GARZA (Chair), Division of Nutrition, Cornell University, Ithaca, New York JOHN W. ERDMAN, JR. (Vice Chair), Division of Nutritional Sciences, College of Agriculture, University of Illinois at Urbana-Champaign PERRY L. ADKISSON (through December 31, 1996), Department of Entomology, Texas A&M University, College Station LINDSAY H. ALLEN, Department of Nutrition, University of California, Davis DENNIS M. BIER (through December 31, 1996), Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas BENJAMIN CABALLERO, Center for Human Nutrition, The Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland FERGUS M. CLYDESDALE, Department of Food Science, University of Massachusetts, Amherst ROBERT J. COUSINS, Center for Nutritional Sciences, University of Florida, Gainesville MICHAEL P. DOYLE, Center for Food Safety and Quality Enhancement, Department of Food Science and Technology, The University of Georgia, Griffin JOHANNA T. DWYER, Frances Stern Nutrition Center, New England Medical Center Hospital and Departments of Medicine and Community Health, Tufts Medical School and School of Nutrition Science and Policy, Boston, Massachusetts SCOTT M. GRUNDY, Center for Human Nutrition, University of Texas Southwestern Medical Center at Dallas CHARLES H. HENNEKENS, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts JANET C. KING, University of California, Berkeley, and U.S. Department of Agriculture Western Human Nutrition Research Center, San Francisco SANFORD A. MILLER, Graduate School of Biomedical Sciences, University of Texas Health Science Center, San Antonio ROSS L. PRENTICE, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington A. CATHERINE ROSS, Department of Nutrition, Pennsylvania State University, University Park ROBERT E. SMITH, R. E. Smith Consulting, Inc., Newport, Vermont ALFRED SOMMER (through December 31, 1996), The Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland

OCR for page R1
Emerging Technologies for Nutrition Research: Potential for Assessing Military Performance Capability VIRGINIA A. STALLINGS, Division of Gastroenterology and Nutrition, The Children's Hospital of Philadelphia, Pennsylvania VERNON R. YOUNG, Laboratory of Human Nutrition, School of Science, Massachusetts Institute of Technology, Cambridge Ex-Officio Member STEVE L. TAYLOR, Department of Food Science and Technology and Food Processing Center, University of Nebraska, Lincoln Institute of Medicine Council Liaison HARVEY R. COLTEN, Northwestern University Medical School, Chicago, Illinois Staff ALLISON A. YATES, Director CAROL W. SUITOR, Acting Director (April–July 1997) BERNADETTE M. MARRIOTT, Associate Director (through November 22, 1995) GAIL SPEARS, Administrative Assistant

OCR for page R1
Emerging Technologies for Nutrition Research: Potential for Assessing Military Performance Capability Preface This publication, Emerging Technologies for Nutrition Research: Potential for Assessing Military Performance Capability, is the latest in a series of reports based on workshops sponsored by the Committee on Military Nutrition Research (CMNR) of the Food and Nutrition Board (FNB), Institute of Medicine, National Academy of Sciences. Other workshops or symposia have included such topics as food components to enhance performance; nutritional needs in hot, cold, and high-altitude environments; body composition and physical performance; nutrition and physical performance; cognitive testing methodology; and fluid replacement and heat stress. These workshops form part of the response that the CMNR provides to the Commander, U.S. Army Medical Research and Materiel Command, regarding issues brought to the committee through the Military Nutrition Division (currently the Military Nutrition and Biochemical Division) of the U.S. Army Research Institute of Environmental Medicine (USARIEM) at Natick, Massachusetts.

OCR for page R1
Emerging Technologies for Nutrition Research: Potential for Assessing Military Performance Capability HISTORY OF THE COMMITTEE The CMNR was established in October 1982 following a request by the Assistant Surgeon General of the Army that the Board on Military Supplies of the National Academy of Sciences set up a committee to advise the U.S. Department of Defense on the need for and conduct of nutrition research and related issues. The committee was transferred to the FNB in 1983. The committee's current tasks are: to identify nutritional factors that may critically influence the physical and mental performance of military personnel under all environmental extremes, to identify deficiencies in the existing database, to recommend research that would remedy these deficiencies as well as approaches for studying the relationship of diet to physical and mental performance, and to review and advise on standards for military feeding systems. Within this context, the CMNR was asked to focus on nutrient requirements for performance during operational missions rather than requirements for military personnel in garrison (the latter were judged to be not significantly different from those of the civilian population). Although the membership of the committee has changed periodically, the disciplines represented consistently have included human nutrition, nutritional biochemistry, performance physiology, food science, and psychology. For issues that require broader expertise than exists within the committee, the CMNR has convened workshops or utilized consultants. The workshops provide additional state-of-the-art scientific information and informed opinion for the consideration of the committee. FOCUS OF THE REPORT The request for this review originated with scientists at USARIEM who were concerned that research, using traditional techniques, that focused on more complex issues of maintenance or enhancement of performance might not be sufficiently substantive to measure changes that may occur or might not be predictive of the effects of the stresses of operational environments. The request for this review also arose from a Science and Technology Objective to prevent soldier performance degradation under the stress of sustained field operations, as part of an overall initiative, "The Soldier as a System." This initiative recognized the importance of all aspects of the soldier's equipment and person for enhanced capabilities necessary for the future (Army Science Board, 1991). Past reports of the CMNR usually have been focused on current issues of concern to the military. Traditional methods of research, data gathering, and

OCR for page R1
Emerging Technologies for Nutrition Research: Potential for Assessing Military Performance Capability analysis have provided the factual base for study of a problem and recommended solutions. This report looks further into the future at newer technologies that are being employed to identify and study basic issues that may be significant in nutrition research. Of specific interest are those techniques that can be applied to nutritional problems and that may result in improved performance by soldiers, particularly those exposed to the stress of military operations. The focus of this report is to identify those research techniques that may be applicable to maintaining or enhancing soldiers' performance and to suggest that those deemed most likely to be useful be incorporated into the nutrition research program and related areas at USARIEM. Recognizing that there were a large number of technologies that could be reviewed and the need to limit the scope of this review to those areas of most interest to USARIEM, USARIEM personnel identified six relevant research areas for review. The primary criterion for inclusion was the possibility for application to field research. Those areas were body composition, tracer techniques to evaluate metabolism and energy expenditure, ambulatory methods to determine energy expenditure, molecular and cellular approaches to nutrition and immune function, and functional and behavioral measures of nutritional status. The factors that the CMNR was asked to consider in its evaluation of these research areas are summarized in Chapter 1. The CMNR decided that the best way to review the state of knowledge in these disparate areas was through a workshop at which knowledgeable researchers could review published research and speculate with the committee on potential applications to the military environment. Such a workshop would enable the CMNR to review the state of the science and to identify the potential for application of the methods to the assessment of military performance capability. A committee subgroup, USARIEM personnel, and CMNR staff participated in a series of conference calls to solicit suggestions for participants who were active in the research fields identified by USARIEM personnel as being of interest to them. Invited speakers were asked to prepare a paper for presentation and publication describing the techniques and their applications in the speakers' areas of expertise and making specific recommendations in response to several questions posed prior to the workshop. USARIEM scientists also participated in the workshop, which resulted in a well-rounded group. At the workshop, each speaker gave a formal presentation, which was followed by questions and a brief discussion period. The proceedings were tape recorded and professionally transcribed. At the end of each group of presentations, a general discussion of the overall topic was held. Immediately after the workshop, the CMNR met in executive session to review the issues, draw some tentative conclusions, and assign the preparation of draft reviews and summaries of specific topics to individual committee members. Committee members subsequently met with staff several times over the course of a year and worked separately and together

OCR for page R1
Emerging Technologies for Nutrition Research: Potential for Assessing Military Performance Capability using the authored papers, additional reference materials provided by the staff, and personal expertise and experience with the methods to draft the overview, summary, conclusions, and recommendations. A draft of the report was sent to a group of scientists, each of whom was identified as being an expert in one of the areas covered by the report. Their evaluations and suggestions were taken into consideration in preparing the final report, which was reviewed and approved by the entire committee. ORGANIZATION OF THE REPORT A project overview and summary, as well as the conclusions and recommendations of the CMNR, constitute Part I of this volume. Parts II through VIII include papers contributed by speakers at the workshop. Part I has been reviewed anonymously by an outside group with expertise in the topic areas and experience in military issues. For the most part, the authored papers in Parts II through VIII appear in the order in which they were presented at the workshop (see the Workshop Agenda in Appendix A). These chapters have undergone limited editorial changes, have not been reviewed by the outside group, and represent the views of the individual authors. Selected questions directed toward the speakers and the speakers' responses are included when they provide a flavor of the workshop discussion. The invited speakers also were requested to submit a brief list of selected background papers prior to the workshop. These recommended readings, relevant citations collected by CMNR staff prior to the workshop, and selected citations from each chapter are included in the Selected Bibliography (see Appendix D). ACKNOWLEDGMENTS It is my pleasure as chairman of the CMNR to acknowledge the contributions of the FNB staff, particularly the excellent technical and organizational skills of Bernadette M. Marriott. This is the last report in a series emanating from workshops sponsored by the CMNR for which Dr. Marriott was study director. She accepted a new and challenging position as the Director, Office of Dietary Supplements Research in the Office of the Director, National Institutes of Health, effective November 1995. She directed the planning for this workshop prior to accepting her new position. The CMNR past and present will sorely miss the quiet professionalism and utmost dedication that she brought to committee activities. The excellent series of published CMNR reports is testimony to her commitment to timely and quality publication of these proceedings. I wish to acknowledge as well the excellent contributions by the speakers and their commitment to participating in the workshop and preparing papers on their assigned areas with relatively short notice.

OCR for page R1
Emerging Technologies for Nutrition Research: Potential for Assessing Military Performance Capability Sydne J. Carlson-Newberry joined the FNB staff as staff officer for the CMNR in September 1995 and had the leadership role in the publication of the workshop proceedings. Rebecca B. Costello joined the FNB staff in July 1996 as the study director of the CMNR. We are pleased to have her leadership in staffing CMNR activities. Also, I wish to acknowledge the excellent editorial efforts and able assistance of Susan M. Knasiak-Raley, research assistant to the CMNR, and of Donna F. Allen, senior project assistant to the CMNR, in word processing and preparing the camera-ready copy for this report. Finally, I express my appreciation to the members of the CMNR who have participated in the proceedings of the workshop and the discussions and preparation of summaries and recommendations in this report. Their continued dedication to providing sound, timely recommendations on issues brought to our attention is commendable. Thank you for your commitment to the success of this program. ROBERT O. NESHEIM, chair Committee on Military Nutrition Research REFERENCES Army Science Board 1991 The Soldier as a System. 1991 Summer Study Final Report. Assistant Secretary of the Army Research, Development, and Acquisition. Washington, D.C.: U.S. Department of the Army.

OCR for page R1
Emerging Technologies for Nutrition Research: Potential for Assessing Military Performance Capability This page in the original is blank.

OCR for page R1
Emerging Technologies for Nutrition Research: Potential for Assessing Military Performance Capability CONTENTS PREFACE   vii I COMMITTEE SUMMARY AND RECOMMENDATIONS     1   Project Overview and Committee Summary   3 2   Committee Responses to Questions, Conclusions, and Recommendations   51 II THE CURRENT ARMY PROGRAM AND ITS FUTURE NEEDS     3   Emerging Technologies in Nutrition Research for the Military: Overview of the Issues James A. Vogel   71

OCR for page R1
Emerging Technologies for Nutrition Research: Potential for Assessing Military Performance Capability III TECHNIQUES OF BODY COMPOSITION ASSISSMENT     4   Military Application of Body Composition Assessment Technologies Karl E. Friedl   81 5   Imaging Techniques of Body Composition: Advantages of Measurement and New Uses Steven Heymsfield, Robert Ross, ZiMian Wang, and David Frager   127 6   Dual-Energy X-Ray Absorptiometry: Research Issues and Equipment Wendy M. Kohrt   151 7   Bioelectrical Impedance: A History, Research Issues, and Recent Consensus Wm. Cameron Chumlea and Shumei S. Guo   169 Part III   Discussion   193 IV TRACER TECHNIQUES FOR THE STUDY OF METABOLISM     8   Stable Isotope Tracers: Technological Tools That Have Emerged Dennis M. Bier   201 9   Measurement of Energy Substrate Metabolism Using Stable Isotopes Robert R. Wolfe   215 10   Combined Stable Isotope-Positron Emission Tomography for In Vivo Assessment of Protein Metabolism V. R. Young, Y-M. Yu, H. Hsu, J. W. Babich, N. Alpert, R. G. Tompkins, and A. J. Fischman   231 11   Nuclear Magnetic Resonance Studies of Liver and Muscle Glycogen Metabolism in Humans Gerald I. Shulman   259 Part IV   Discussion   273 V AMBULATORY TECHNIQUES FOR MEASUREMENT OF ENERGY EXPENDITURE     12   Doubly Labeled Water for Energy Expenditure James P. DeLany   281 13   Measurement of Oxygen Uptake with Portable Equipment John F. Patton   297

OCR for page R1
Emerging Technologies for Nutrition Research: Potential for Assessing Military Performance Capability 14   Advances in Ambulatory Monitoring: Using Foot Contact Time to Estimate the Metabolic Cost of Locomotion Reed W. Hoyt and Peter G. Weyand   315 15   Noninvasive Measurement of Plasma Metabolites Using Near-Infrared Spectroscopy Donald Bodenner   345 Part V   Discussion   359 VI MOLECULAR AND CELLULAR APPROACHES TO NUTRITION     16   The Role of Metals in Gene Expression Raymond K. Blanchard and Robert J. Cousins   363 17   Metabolic Regulation of Gene Expression Howard C. Towle   375 18   Use of Isolated-Cell and Metabolic Techniques Applied to Vitamin Transport and Disposition Donald B. McCormick   389 19   Assessment of Cellular Dysfunction During Physiologic Stress Guy Miller   401 VII ASSESSMENT OF IMMUNE FUNCTION     20   The Validity of Blood and Urinary Cytokine Measurements for Detecting the Presence of Inflammation Lyle L. Moldawer   417 21   New Approaches to the Study of Abnormal Immune Function Gabriel Virella, Candace Enockson, and Mariano La Via   431 22   New Technologies for Producing Systemic and Mucosal Immunity by Oral Immunization: Immunoprophylaxis in Meals, Ready-to-Eat Arthur O. Anderson   451 Parts VI and VII   Discussion   501 VIII FUNCTIONAL AND BEHAVIORAL MEASURES OF NUTRITIONAL STATUS     23   Involuntary Muscle Contraction to Assess Nutritional Status James S. Hayes   507 24   Application of Cognitive Performance Assessment Technology to Military Nutrition Research Mary Z. Mays   519

OCR for page R1
Emerging Technologies for Nutrition Research: Potential for Assessing Military Performance Capability 25   New Techniques for Assessment of Mental Performance in the Field Harris R. Lieberman and Bryan P. Coffey   533 26   The Iowa Driving Simulator: Using Simulation for Human Performance Measurement Ginger S. Watson and Yiannis E. Papelis   551 Part VIII   Discussion   569 APPENDIXES     A   Workshop Agenda   579 B   Biographical Sketches   585 C   Abbreviations   605 D   Emerging Technologies for Nutrition Research—A Selected Bibliography   609 INDEX   681

OCR for page R1
Emerging Technologies for Nutrition Research: Potential for Assessing Military Performance Capability Emerging Technologies for Nutrition Research Potential for Assessing Military Performance Capability

OCR for page R1
Emerging Technologies for Nutrition Research: Potential for Assessing Military Performance Capability This page in the original is blank.