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Emerging Technologies for Nutrition Research: Potential for Assessing Military Performance Capability (1997)
Institute of Medicine (IOM)

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. "2 Committee Responses to Questions, Conclusions and Recommendations." Emerging Technologies for Nutrition Research: Potential for Assessing Military Performance Capability. Washington, DC: The National Academies Press, 1997.

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Emerging Technologies for Nutrition Research: Potential for Assessing Military Performance Capability

Medicine (USARIEM) posed six questions for the CMNR to aid in its evaluation of the techniques reviewed and its provision of guidance to MND concerning their applications to the military.

In this chapter, the CMNR provides its answers to the questions posed by the Army, draws its conclusions on each of the six technologies reviewed, and makes its recommendations. The responses, conclusions, and recommendations were developed in discussion and prepared in executive session of the CMNR.

RESPONSES TO QUESTIONS POSED BY THE ARMY

This section is organized according to the six categories of technologies, with all of the Army's questions being answered under each technology.

Techniques of Body Composition Assessment

1. Will the technologies be a significant improvement over current technologies?

Anthropometric equations currently used by the military could be further refined with additional computer modeling, particularly with regard to their application to all ethnic groups. Computerized axial tomography (CAT) scanning, magnetic resonance imaging (MRI), and dual-energy x-ray absorptiometry (DXA) measurements can and have markedly improved compositional methodology in the clinic. These techniques could be used by the military to improve the accuracy and reliability of derived equations that use anthropometric measures to predict body fat content.

Single-frequency bioelectrical impedance analysis (BIA) is not a reliable measure of body composition, but the methodology may be helpful in answering specific questions concerning hydration status. Multiple-frequency bioelectrical impedance spectroscopy may hold promise for compositional measurement in the future.

2. How likely are the technologies to mature sufficient for practical use?

Body composition (BC) methods are already quite mature, although multiple-frequency BIA requires some specific developmental work. The multifrequency method of BIA involves a simple and low-cost measurement system, but it is not sufficiently developed to provide accurate and reproducible estimates of changes in body composition. Its relative simplicity and low cost suggest that further development may be useful to see if current shortcomings can be overcome.

At present, CAT scanning, MRI, and DXA provide reliable measures of composition but are expensive. CAT requires exposure to x rays, although some

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Front Matter (R1-R18)
I Committee Summary and Recommendations (1-2)
1 Project Overview and Committee Summary (3-50)
2 Committee Responses to Questions, Conclusions and Recommendations (51-68)
II The Current Army Program and Its Future Needs (69-70)
3 Emerging Technologies in Nutrition Research for the Military: Overview of the Issues (71-78)
III Techniques of Body Composition Assessment (79-80)
4 Military Application of Body Composition Assessment Technologies (81-126)
5 Imaging Techniques of Body Composition: Advantages of Measurement and New Uses (127-150)
6 Dual-Energy X-Ray Absorptiometry: Research Issues, and Equipment (151-168)
7 Bioelectrical Impedance: A History, Research Issues, and Recent Consensus (169-192)
Part III Discussion (193-198)
IV Tracer Techniques for the Study of Metabolism (199-200)
8 Stable Isotope Tracers: Technological Tools That Have Emerged (201-214)
9 Measurement of Energy Substrate Metabolism Using Stable Isotopes (215-230)
10 Combined Stable Isotope-Positron Emission Tomography for In Vivo Assessment of Protein Metabolism (231-258)
11 Nuclear Magnetic Resonance Studies of Liver and Muscle Glycogen Metabolism in Humans (259-272)
Part IV Discussion (273-278)
V Ambulatory Techniques for Measurement of Energy Expenditure (279-280)
12 Doubly Labeled Water for Energy Expenditure (281-296)
13 Measurement of Oxygen Uptake with Portable Equipment (297-314)
14 Advances in Ambulatory Monitoring: Using Foot Contact Time to Estimate the Metabolic Cost of Locomotion (315-344)
15 Noninvasive Measurement of Plasma Metabolites Using Near-Infrared Spectroscopy (359-360)
Part V Discussion (361-362)
VI Molecular and Cellular Approaches to Nutrition (363-374)
16 The Role of Metals in Gene Expression (375-388)
17 Metabolic Regulation of Gene Expression (389-400)
18 Use of Isolated-Cell and Metabolic Techniques Applied to Vitamin Transport and Disposition (401-414)
19 Assessment of Cellular Dysfunction During Physiologic Stress (415-416)
VII Assessment of Immune Function (417-430)
20 The Validity of Blood and Urinary Cytokine Measurements for Detecting the Presence of Inflammation (431-450)
21 New Approaches to the Study of Abnormal Immune Function (451-500)
Part VI and VII Discussion (501-504)
VIII Functional and Behavioral Measures of Nutritional Status (505-506)
23 Involuntary Muscle Contraction to Assess Nutritional Status (507-518)
24 Application of Cognitive Performance Assessment Technology to Military Nutrition Research (519-532)
25 New Techniques for Assessment of Mental Performance in the Field (533-550)
26 The Iowa Driving Simulator: Using Simulation for Human Performance Measurement (551-568)
Part VIII Discussion (569-576)
Appendixes (577-578)
Appendix A: Workshop Agenda (579-584)
Appendix B: Biographical Sketches (585-604)
Appendix C: Abbreviations (605-608)
Appendix D: Emerging Technologies for Nutrition Research - A Selected Biography (609-680)
Index (681-711)