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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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. "6 Immune Function Studies During the Ranger Training Course of the Norwegian Military Academy." Military Strategies for Sustainment of Nutrition and Immune Function in the Field. Washington, DC: The National Academies Press, 1999.

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would just comment on a couple of variables that may be contributing to that confusing picture, and that is that some cytokine systems may be differentially upregulated, playing a role that you do not know, and also adrenalectomized animals would have very high ACTH levels. ACTH is an immune modulator independent of glucocorticoids. β-endorphin would be high, and that is also an immune modulator. So you have several little variables that you do not know about, and those could then be partially responsible for some of the confusion of the results you are seeing with the adrenalectomy.

BRUCE BISTRIAN: There is a wide range of physiological function between what our daily lives are and what extreme stresses are. Are we really looking at normal variabilities? Unless there is some serious consequence, unless there is some serious [change in] infection rate, or some serious change in the quality of life, or unless there is some serious problem with this, is there any problem? Are we just investigating what is a normal variant when you put a human organism to another range?

PÅL WIIK: It is certain that what we are observing is a physiological response to exercise with no sleep and almost no food for 7 days. And we really have no problem during this period of time. However, if you are trying to make them go through this for a long period of time, you would have problems with immunity and consequently infections are demonstrated for the U.S. Ranger studies.

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202
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)