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that a significant percentage of military personnel may engage repeatedly in high-risk behaviors to comply with periodic weight and body composition assessments.
Recommendations
The BCNH committee reinforces the requirement for adequate energy and nutrient intakes to reflect the needs of the body at a moderate activity level (2,000–2,800 kcal/d). To ensure adequate nutrient intakes, female personnel must be educated on how to meet both energy and nutrient needs whether they are deployed and subsisting on operational rations or in garrison. This education is required to enable women to choose foods of higher nutrient density and to maintain a fitness program that will allow greater energy intake. The committee reinforces the recent efforts of the Army to begin providing complete nutritional labeling of all ration components and to include information to enable identification of nutrient-dense components that would help women meet the MRDAs at their usual energy intake. The committee also supports efforts to create ration supplements that would satisfy requirements that may not be readily met through the usual intake of rations. The committee recommends nutritional labeling of all dining hall menu items and provision of food selection guidelines to women in garrison.
The BCNH committee recommends that all military women maintain or achieve healthy weight through a continuous exercise and fitness program. If weight loss is a goal, nutrition education and ongoing counseling should be provided for guidance in achieving a healthy, but reduced energy, diet. Emphasis must be placed on prevention of overweight and on long-term weight management through lifestyle changes, rather than on crash dieting to lose weight for a scheduled weigh-in. Adequate energy intake should be encouraged to reduce risks of injury and amenorrhea.
In view of observed dehydration-induced changes in physiology resulting in performance decrements, and because of evidence that active-duty women in deployment situations may voluntarily restrict fluid intake, adequate intake of fluids must be emphasized (IOM, 1993, 1995). Adoption of the Army fluid doctrine is encouraged by all services.
Discussion
Assessments of nutritional status and dietary intake of active-duty women have been limited to studies of women in basic combat training or on brief field maneuvers. Nevertheless, the results of these studies strongly suggest that because of the nutrient density of operational rations and dining hall menus, active-duty women are at risk for inadequate intake of several nutrients, particularly iron, calcium, and folate, if their energy intake matches expenditure. Education should be aimed at meeting requirements for these nutrients as well as for protein, by helping women to identify and select appropriate foods. Available evidence suggests that the energy needs of the average active-duty woman should reflect a moderate activity level. To ensure adequate energy and nutrient intake, some modifications of operational rations may be needed to increase the nutrient density. Alternatively, use of supplements for iron, calcium, and folate should be considered.
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