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Military Strategies for Sustainment of Nutrition and Immune Function in the Field (1999)
Institute of Medicine (IOM)

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. "Executive Summary." Military Strategies for Sustainment of Nutrition and Immune Function in the Field. Washington, DC: The National Academies Press, 1999.

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evaluating ongoing research efforts by USARIEM scientists to study immune status in Special Forces troops.

In order to accomplish this task, the CMNR held a workshop, reviewed the literature, and deliberated on its findings to provide responses to the following task questions:

  1. What are the significant military hazards or operational settings most likely to compromise immune function in soldiers?
  2. What methods for assessment of immune function are most appropriate in military nutrition laboratory research, and what methods are most appropriate for field research?
  3. 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. Interventions to sustain immune function can alter the actions, nutritional costs, and potential changes in the levels of proinflammatory cytokines. What are the benefits and risks to soldiers of such interventions?
  4. 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?
  5. 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?
  6. This report focuses on the many stresses encountered by military personnel and the complexity of their immune responses.

    Overview of Nutritional Status and Immune Function

    Immunity, if defined broadly, encompasses all mechanisms and responses used by the body to defend itself against foreign substances, microorganisms, toxins, and incompatible living cells. Such responses may be conferred by the immune system itself or by the protective role of other generalized host defensive mechanisms.

    The immune system resides in no single organ but depends on the interactions and secretions of various organs and white blood cells. The physiologic function of the immune system may be viewed simplistically as a mechanism by which the human body responds to and eliminates an initiating antigen. This process is mediated by a myriad of specialized cells and depends on a pathway involving recognition, activation, differentiation, and response to

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Front Matter (R1-R14)
Executive Summary (1-16)
I Committee Summary, Responses to Questions, Conclusions, and Recommendations (17-18)
1 A Review of the Role of Nutrition in Immune Function (19-98)
2 Committee Responses to Questions (99-124)
3 Committee Conclusions and Recommendations (125-135)
II Stage Setting: The Military Situation (137-138)
4 Why is the Army Interested in Nutrition and Immune Function? (139-162)
5 Physiological and Immunological Impact of U.S. Army Special Operations Training: A Model for the Assessment of Nutritional Intervention Effects on Temporary Immunosuppression (163-184)
6 Immune Function Studies During the Ranger Training Course of the Norwegian Military Academy (185-202)
III Introduction to Immune Function (203-204)
7 Nutrition and Immune Responses: What Do We Know? (205-220)
8 Cytokines and Nutritional Status: Possible Correlations and Investigations (221-232)
IV Assessment (233-234)
9 Methodological Issues in Assessment of Human Immune Function (235-248)
10 Application of Whole-Blood Cultures to Field Study Measurements (249-262)
V Nutrition (263-264)
11 Glutamine (265-278)
12 Vitamin A and Immune Function (279-288)
13 Vitamin E, Vitamin C, and Immune Response: Recent Advances (289-304)
14 Fatty Acids and Immune Functions (305-316)
15 Iron Metabolism, Microbial Virulence, and Host Defenses (317-336)
16 Trace Minerals, Immune Function, and Viral Evolution (337-359)
VI Health and Stress (361-362)
17 Exercise, Infection, and Immunity: Practial Applications (363-390)
18 Neuroendocrine Consequences of Systemic Inflammation (391-408)
19 Inflammatory Stress and the Immune System (409-436)
20 Chronobiology of the Immune System (437-496)
21 Conclusion: Militarily Important Issues Identified in this Report (497-508)
Appendixes (509-510)
Appendix A: Overview of the Immune System and Other Host Defense Mechanisms (511-526)
Appendix B: Glossary of Immunological Terms (527-536)
Appendix C: Overview of Immune Assessment Tests (537-542)
Appendix D: Emerging Infections, Nutritional Status, and Immunity (543-552)
Appendix E: Workshop Agenda (553-558)
Appendix F: Biographical Sketches (559-574)
Appendix G: Acronyms and Abbreviations (575-580)
Appendix H: Nutrition and Immune Function: A Selected Bibliography (581-656)
Index (657-708)