Chronic dieting is associated with a number of health and behavioral consequences; these include a negative impact on cognitive function as determined by assessment of reaction time, vigilance, and short-term memory. Common dieting practices that would not be considered severe enough to constitute an eating disorder and may not result in significant changes in body weight or composition appear to increase the risk for amenorrhea and stress fracture, health problems previously believed to be associated only with more extreme energy depletion in the syndrome known as female athlete triad. Research has sought to elucidate the factors that contribute to the syndrome of female athlete triad, the result of a suppression of pulsatile pituitary secretion of LH, but its etiology remains unclear. Several possible dietary variables have been investigated including energy intake, the balance between energy intake and utilization, carbohydrate availability, dietary fiber, dietary fat, the ratio of fiber to fat, protein, and cholesterol intake. To date, it is not clear which of these factors or combination of factors are the most important. Evidence in support of a role for total body fat or body fat distribution in controlling menstrual function is contradictory and suggests that other factors, such as energy balance, may play a greater role. It is not possible at present to assess the impact of dieting practices among active-duty military women on their nutritional status. The prevalence of female athlete triad among these women and its possible contribution to the high level of stress fracture observed among women in BCT is also unknown.

Studies of selected groups of military women have found intakes of several nutrients to be below the MRDA for those nutrients. King (1996) and King et al. (1993) reported the results of several studies showing that women in the field consuming operational rations had intakes of energy and several nutrients (iron, calcium, and folate) that were less than in garrison and below the MRDAs.

The nutrient density of military rations may contribute to inadequate intakes if active-duty women are not able to consume the entire ration without feeling full or gaining weight, which is often the case since the nutrient density is based on intake of a level of energy that is considered adequate for the average male soldier (approximately 3,600 kcal/d).

A study of U.S. Military Academy, West Point, cadets in 1990 showed that a significant percentage of female cadets were at increased risk for iron deficiency anemia, although the number of women taking supplemental iron as well as the occurrence of a recent blood drive confounded interpretation of the results (Friedl et al., 1990). Analysis of food intake for 1 week revealed that female cadets were at risk for consuming low levels of folate (Klicka et al., 1993), although folate status was not analyzed in the 1991 study reported earlier.

A 1993 study of food consumed in garrison by 49 women in BCT at Fort Jackson, South Carolina (King et al., 1994) found that, contrary to previous expectations, the nutrient intake of women in garrison was not substantially greater than that in the field. Again, because the menu

Front Matter (R1-R16)

Executive Summary (1-24)

1 Introduction (25-32)

2 Body Composition (33-60)

3 Physical Fitness Policies and Programs (61-86)

4 Weight Management (87-108)

5 Nutritional Concerns of Military Women (109-126)

6 Pregnancy and Lactation and Postpartum Return-To-Duty Fitness (127-156)

7 Conclusions and Recommendations (157-170)

Appendixes (171-172)

A Workshop Summary, Agenda, Participants, and Abstracts (173-252)

B Practices and Policies Tables (253-262)

C Military Occupational Specialty Classification Tables (263-280)

D Search Strategy for Literature Review (281-284)

E Civilian Inquiry Letter and Table of Responses (285-290)

F Abbreviations (291-294)

G Bibliography (295-334)

H Biographical Sketches (335-338)

Index (339-352)