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  1. Interventions to sustain immune function can alter the actions, nutritional costs, and potential changes in levels of proinflammatory cytokines. The proinflammatory cytokines have been proposed to decrease lean body mass, mediate thermoregulatory mechanisms, and increase resistance to infectious disease by reducing metabolic activity in a way that is similar to the reduction seen in malnutrition and other catabolic conditions. What are the benefits and risks to soldiers of such interventions?
  2. What are the important safety and regulatory considerations in the testing and use of nutrients or dietary supplements to sustain immune function under field conditions?
  3. Are there areas of investigation for the military nutrition research program that are likely to be fruitful in the sustainment of immune function in stressful conditions? Specifically, is there likely to be enough value added to justify adding to operational rations or including an additional component?
  4. In Chapter 1, the committee presents an overview of the project using relevant background materials and the proceedings of the workshop held on May 20–21, 1996. The committee then reviews the Army's Ranger studies as well as other Army Operational Training Program studies which have evaluated the effects of multiple physical, psychological, and nutritional stressors on immune system function, and provides a summary of the topics presented at the workshop.

    The detailed answers to the five questions posed by the Army are in Chapter 2, and the committee's conclusions and recommendation, including recommendations for future research are in Chapter 3.

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