A large-scale survey of nutrition knowledge and attitudes and food intake practices among active-duty Army personnel worldwide, The Army Food and Nutrition Survey 1996, was recently completed. Of the approximately 3,000 respondents to this survey, nearly 500 were women. Data gathered in the survey show, for example, that women averaged approximately 2.9 servings per day of vegetables and 2.5 servings of fruit (in comparison, the 1991 Five a Day for Better Health Survey showed that 49% of women consumed 2.5 to < 5 servings of fruits and vegetables per day [DHHS, 1991]). Active-duty Army women also consumed an average of 1.8 servings of meat, 2.3 servings of dairy foods, 0.2 servings of grains, 0.6 servings of (breakfast) cereals, and 0.2 servings of legumes per day. The data appeared to suggest that women who held meal cards (ate the majority of their meals in the military dining facility) had a greater intake of fruits, vegetables, dairy products, grains, meat, and french fries per day than those who ate their meals off-post (Warber et al., in preparation). Data on the associations among individual dieting behavior, nutrition knowledge and attitudes, and food intake were not available as of yet from the survey. In addition, no information was available from the survey on the actual nutrient intakes of the respondents or on their nutrient status, and because the survey was anonymous, the results could not be linked to medical records.

Under another Defense Women's Health Research Program grant, James P. DeLany and coworkers are in the process of evaluating energy utilization by female Army personnel in a variety of work situations (IOM, 1996a). Complete assessment of the energy requirements of the average woman soldier will have to await analysis of the results of this and other studies.

The data on nutrient status of active-duty women suggest that in both field and garrison dining situations, women are at increased risk for inadequate iron, calcium, and folic acid intake. The potential consequences to performance and health of deficiencies in these nutrients as well as in protein will be reviewed briefly.

A prolonged inadequate dietary intake of iron can lead to iron deficiency, which may have adverse physical and cognitive effects independent of those associated with restricted energy intake. These effects include depressed immune function, impaired cognitive development, behavioral disturbances (pica), impaired body temperature regulation, and reduced exercise and work performance (Beard et al., 1996). The negative effects have been associated primarily with iron deficiency anemia; the impact of iron deficiency without anemia is more subtle and difficult to detect (Beard et al., 1996).

Physical performance and iron. Iron deficiency anemia is responsible for a significant decrease in work capacity, particularly when hemoglobin concentrations fall to less than 10 g/dl. The decrease in maximum oxygen consumption (VO₂max) is related to the decrease in the capacity of blood to transport oxygen. The effect of iron deficiency without anemia on work capacity

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)