Cover Image

Not for Sale



View/Hide Left Panel

Appendix D

Letter Military Review Proposals Nutrition of Three from the Biomedical Report: Committee on Research Research Pennington Research Center

Submitted December 1992



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement



Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole.
Intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text on the opening pages of each chapter. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

Do not use for reproduction, copying, pasting, or reading; exclusively for search engines.

OCR for page 77
Committee on Military Nutrition Research: Activity Report Appendix D Letter Military Review Proposals Nutrition of Three from the Biomedical Report: Committee on Research Research Pennington Research Center Submitted December 1992

OCR for page 77
Committee on Military Nutrition Research: Activity Report This page in the original is blank.

OCR for page 77
Committee on Military Nutrition Research: Activity Report INSTITUTE OF MEDICINE NATIONAL ACADEMY OF SCIENCES 2101 CONSTITUTION AVENUE WASHINGTON, D.C. 20418 FOOD AND NUTRITION BOARD (202) 334-1732 FAX (202) 334-2316December 10, 1992 Major General Richard T. Travis Commanding General U.S. Army Medical Research and Development CommandFort DetrickFrederick, MD21702-5012 Dear General Travis: At the specific request of the COL Eldon W. Askew, Ph.D., Chief, Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine (USARIEM) who is Grant Officer Representative of the U.S. Army Medical Research and Development Command (USAMRDC) for Grant no. DAMD17-92-J-2003 to the National Academy of Sciences for support of the Food and Nutrition Board's (FNB) Committee on Military Nutrition Research (CMNR), members of the CMNR met at the Pennington Biomedical Research Center (PBRC) in Baton Rouge, Louisiana on June 3, 1992. The purpose of this meeting was to assist the Army in discussing plans for three projects that were proposed as part of USAMRDC Grant no. 17-92-V-2009 to the PBRC: “Military Nutrition Research: Six Tasks to Address Medical Factors Limiting Soldier Effectiveness.” This grant to the PBRC was established to implement a program for which funds were specifically appropriated through the Department of Defense Appropriations Bill, 1988. The CMNR has on two previous occasions reviewed the work related to this program of research at the PBRC and submitted letter reports with recommendations. The Committee on Military Nutrition Research's role at the meeting on June 3, 1992 was to assist the Army with identifying research activities that fell within the mandate of the appropriation. The responsibility for the final decisions in program remains with the Army. For this visit, the CMNR was asked to focus its attention on projects in the areas of neuroscience and menu modification.

OCR for page 77
Committee on Military Nutrition Research: Activity Report Prior to the meeting, the CMNR reviewed 1) preliminary research proposals prepared by the scientific staff and principal investigator, Dr. Donna Ryan; 2) an information paper and background materials, including the Grant Statement of Work, previously provided by COL Askew; 3) the final report on the previous USAMRDC Grant to the Pennington Center submitted by Dr. Ryan; and 4) two earlier reports prepared by the CMNR at the request of the USAMRDC reviewing this same research program in 1989 and 1992. Copies of the meeting agenda and list of participants are attached (see attachment A). On June 3, 1992 the CMNR convened at the Pennington Biomedical Research Center (PBRC) where they heard presentations and discussed the program orientations, goals, and preliminary research plans for three projects: basic neuroscience, clinical neuroscience, and menu modification. The role of the CMNR representatives at this meeting was as individuals participating in a discussion of scientific research directions. Since the committee is not in the position of giving real time advice, any comments made by the members of the group were not to be construed as recommendations from the committee. Following the meeting, PBRC scientists prepared formal proposals describing their goals and research plans. The proposals were received by the committee on July 17, 1992 and the CMNR discussed the materials and drafted their report. The report was then reviewed in accordance with National Research Council (NRC) guidelines by a separate anonymous scientific review panel. This report, based in part on discussions from the meeting, review of formal proposals later developed by the scientists at the PBRC, and on executive session discussions by the committee, is a thoughtfully developed presentation incorporating the scientific opinion of the CMNR and comments of an anonymous peer review committee of the NRC. Following is the Committee on Military Nutrition's evaluation of the research proposals as submitted (see attachment B in original report). OVERALL COMMENTS The CMNR continues to be impressed with the rapid expansion and development of the facilities and staff of the Pennington Biomedical Research Center. In only nine months since their last visit to the PBRC, significant new facilities have become available through the opening of the clinical research section and additional new laboratories. The leadership of Dr. George Bray and

OCR for page 77
Committee on Military Nutrition Research: Activity Report the important contributions of Dr. Donna Ryan to the overall program development on the U.S. Army grant were evident. The Pennington Biomedical Research Center provides an excellent environment for scientific study as well as superb facilities for research support services needed by the Army research programs. Now the challenge is to concentrate efforts in areas in which the PBRC can make a unique contribution to USARIEM's overall research effort, and to foster collaboration with other USARIEM research groups in similar areas. The CMNR is concerned, however, after reviewing the protocols for the projects proposed by the PBRC, with what appears to be a lack of focus on the nutritional relevance of the projects to the military. The committee is also concerned about the lack of specific details in the protocols including the variables to be tested in most of the studies. There is also a concern that the complexity and practicality of conducting nutritional trials in people may not be adequately appreciated by the project leaders. While the committee realizes that the project proposals were not written as grant requests, it believes that the objectives of the projects should be clear and the protocols sufficiently delineated to clearly define the proposed work. SPECIFIC PROJECT REVIEWS Project No. 3: Nutritional Neurosciences Basic Science Laboratory Project Summary The purpose of project #3 is to investigate the mechanisms involved in REM (rapid eye movement, sleep phase) deprivation-induced cognitive dysfunction in the rat. Rats subjected to REM deprivation for 96 hours will be tested using behavioral, neurophysiological, and biochemical measurements to characterize the effects of sleep deprivation. Nutritional manipulations will be introduced after the sleep deprivation model is well characterized. These studies will determine if nutritional manipulations can sustain performance under conditions of REM deprivation in rodents. General Comments Sleep (specifically, rapid eye movement [REM] sleep phase) deprivation, and its direct and indirect functional consequences, is a common and significant stressor facing a large number of military personnel and is therefore

OCR for page 77
Committee on Military Nutrition Research: Activity Report an appropriate focus for investigation of dietary effects under this grant. A basic and central question is whether the program will focus on chronic changes in nutrition which might “protect” subjects from the negative consequences of sleep deprivation and other relevant stressors, or on acute changes in the diet (i.e., single meal or short-term supplementation). It is of fundamental importance to decide whether the focus of the proposed research will be an acute or chronic nutritional manipulation when developing the protocols for this research. It is suggested that the investigators refer to the many human and animal studies, for example those involving tryptophan and tyrosine supplementation, in planning and in setting priorities among the specific project protocols. A related issue is whether neurotransmitter precursor supplementation will be at physiologic or pharmacologic levels. In addition, while there is an understandable need for initial method development and refinement, the program seems to overemphasize procedural development to the detriment of dietary studies (at least as indicated by the written proposal and on-site discussions). Notwithstanding, because the basic approach and methods are sound and the available staff and physical resources are adequate, there is a high probability that the program will meet its stated objectives. The neurochemical, histologic, electrophysiologic, and performance measures selected to assess dietary effects on sleep deprivation are appropriate and well-founded in the literature. Responses to comments made by the CMNR during the June visit adequately addressed the basic concerns of the members. Specific comments, concerns and questions The CMNR is pleased to learn that scientific staff of this project from the PBRC will be meeting with staff of the sleep research unit at the Walter Reed Army Institute of Research to discuss research plans and to develop a dialogue for future interaction. This is of primary importance in order to plan protocols that build on prior relevant research. The committee voiced disappointment that no nutritional relevance was described in the basic project that is titled “nutritional neurosciences. ” It seems appropriate to expect that the basic studies laboratory should be testing nutritional hypotheses that relate to the clinical studies aspects of the same overall research program. Plans for dietary manipulations, including neurotransmitter precursor supplementation, are poorly described. The protocols for this research should relate to nutritional objectives with the plans for dietary manipulations, including

OCR for page 77
Committee on Military Nutrition Research: Activity Report neurotransmitter precursor supplementation, clearly described. Ongoing advice from a nutritional scientis with expertise in dietary factors that alter behavior and neurotransmitter levels would assist in these efforts. The number of animals proposed per group (8), although probably adequate to determine neurochemical, histologic, and electrophysiologic effects, may be insufficient to reveal proposed behavioral effects (e.g., changes in shuttle box performance). Recommendations The goals of the project should be specifically detailed, clearly related to the nutrition objectives outlined by the Army, and cognizant of the many human studies dealing with nutritional entities or sleep and performance. Also, in the design it should be decided whether the emphasis will be on acute or chronic manipulations in developing the research protocols. The CMNR recommends that there be a major emphasis placed on increasing communication between the Basic and Clinical neuroscience groups at PBRC. This aspect of the program is necessary for integration of the research outcomes. There was some feeling among the committee membership that this proposal as presented, did not indicate enough ties to the clinical program and remains not particularly relevant to the military needs. Unless these ties become more evident, the project appears to be more appropriate for a standard individual proposal in a competitive grant arena rather than the present program. The research team should seek ongoing advice to strengthen the weak nutritional aspects of their experimental designs from nutritional scientists with expertise on dietary factors that alter behavior and neurotransmitter levels. Throughout the project the researchers should remain alert to unexpected changes in subject behavior and performance, as well as other functional effects, and have sufficient flexibility built into their program to pursue these effects experimentally. The inclusion of female animals as proposed, is important in future studies.

OCR for page 77
Committee on Military Nutrition Research: Activity Report The number of animals should be doubled when assessing behavior. In addition, a minimum of 15 animals per group is needed for the micropunch technique. Project No. 4: Nutritional Neurosciences Clinical Studies Project Summary Project #4 involves human clinical studies of sleep deprivation with a mixed inpatient-outpatient design for a 12-day study. Measures of sleep efficiency, sleep stages, sleep onset, and sleep latency periods, neuropsychological tests, attention-demanding cognitive tests, neuroendocrine and immune function testing, and evaluation of the autonomic nervous system are planned. A listing is provided of potential neurotransmitter precursors that may be selected as nutrient loadings to assess their effectiveness in altering the effects of sleep deprivation. The authors state that several details that are missing from the research design will be determined through the planned pilot studies. General Comments The above comments regarding the issues of chronic versus acute dietary intervention and physiologic versus pharmacologic doses also apply to this program. Review of the written proposal and on-site discussion indicate that the scientific team has a thorough grasp of neurosciences literature on relevant concepts, methods, and measures. Impressively, the researchers recognize the “Catch-22” inherent in studies of factors which, on the one hand may potentially remedy sleep problems that directly and indirectly result in performance decrements, while on the other hand simultaneously would also likely interfere with attentional processes required for optimal performance during waking. Although there is no current solution to this issue, it is an important one to consider during data interpretation. More details on the specific protocols are required before a thorough evaluation can be made. At minimum, it is necessary to discriminate among the “shopping list” of “dietary additives” that may be used. It is difficult to understand why the investigators cannot come forth with a short list of nutrients to be tested, and make reasonable judgement calls on dosages, duration of administration, and the timing as related to meals, sleep, stress, etc. In addition, if there is to be any hope of providing nutritional insight, vigorous

OCR for page 77
Committee on Military Nutrition Research: Activity Report efforts must be made to standardize the nutritional behavior of the subjects prior to initiating the protocol. Little information is provided in the proposal regarding the mechanism of administration for the dietary additives, the amounts to be initially tried, etc., even though a number of possible substances are discussed. For a dietary study, one would expect a great deal more information regarding how the diet will be designed. Even Pilot Study II, which is designed to try out the “nutritional loading” to ascertain whether the protocol is appropriate, does not provide information regarding how the loading will be accomplished. It is obvious that the investigators purposely were trying not to be too specific, but someone needs to decide what substances and or modifications, or both, will be tried. Specific comments, concerns and questions The addition of a nutrition research scientist trained in conducting human dietary studies to the project team would provide needed expertise in dietary design and subject management. The specific protocols should be better described and more relevant to the clinical objectives of the Army. Manipulating caffeine increases the ecological validity of the results, but introduces the issue of “dietary” versus “nutrient component” intervention. Which, if not both, will be the focus of this program? The investigators refer to the project as a “nutritional” study but, as pointed out, they intend to study substances found in foods at greatly increased levels. Rather than refer to these as dietary “additives,” a more conventional term used by the regulatory agencies, industry, and the Congress would be dietary “supplements” if consumed as a tablet, capsule, or liquid, or a “food additive” when added to a food. If the expressed purpose is truly a pharmacological effect, then by law the term used should be “drug” regardless of how it is administered. The confusion over terminology and its ramifications further underscores the need for clarification of this aspect of the protocol. Separating the stresses of caloric deprivation and sleep deprivation may be important. Previous research has shown that weight loss in obese humans is accompanied by marked increases in awakenings, that is, sleep

OCR for page 77
Committee on Military Nutrition Research: Activity Report disturbances. While these findings are not directly relevant to the issue of the effects of sleep deprivation on military performance, they indicate that even short sleep deprivation periods may affect food intake and thus also neurotransmitter levels. In this project, therefore, how will food intake be kept constant to account for issues such as these? The information provided does not indicate if Pilot Study II will test six different dietary additives (based on six subjects) or try one additive on the six subjects for a varying length of time. Since it appears that these will be outpatient studies, how will the investigators “...establish the time required to reach an effective level...?” It would seem that some of the blood work and sleep deprivation would have to be measured periodically as the load was titrated with subject response. If automated (i.e., computerized) assessment of cognitive performance will be employed, it is imperative that subjects be thoroughly familiarized with the equipment and procedures prior to collection of critical data. Instructions for the various cognitive test for the subjects were not addressed in the proposal. Clearly worded instructions are critical to avoid the confounding of speed-accuracy trade-offs frequently made when subjects try to compensate for stress effects. The researchers might consider including a comparison of 1st, 2nd, and 3rd NREM period durations because several studies have shown a disruption of the predictable decline in NREM stage duration over the course of the night. Problems with variability may be encountered when trying to determine urinary catecholamines using 8 or even 12 hour pools; 24-72 hour pools are often needed to reduce variability sufficiently to detect changes in urinary catecholamines. In initially reading the proposal, one might assume that the pilot studies referenced in the first section would be in-house studies, with the larger community study planned as an outpatient study. Given the necessity to develop the methodology (Pilot Study I) and the level of dietary loading needed (Pilot Study II), it would seem extremely difficult to conduct these studies and obtain usable results from them on an outpatient basis. As an example, the number of venipunctures required within the minimum (7 days) or maximum (9 days) protocol length appears to be 56 (14 per day × 4 days during the protocol). This indicates the need for the use of

OCR for page 77
Committee on Military Nutrition Research: Activity Report catheters for the repeated blood draws. Multiple timed urine collections will also be necessary. This really cannot be done on an outpatient basis. It is expected that subjects may try to sleep more (even if instructed not to) during the loading phase in preparation for the sleep deprivation days. Since the investigators are not controlling the subjects' activities or schedules, it seems particularly important, at least in the pilot studies, to be able to control all the variables that may be associated with the response. Will subjects be supine for blood drawings collected for cortisol and catecholamines? Again, very high variability in catecholamine levels can be expected if subjects are not at rest for 15-30 minutes prior to sampling. Despite the questionable reliability of dietary histories and food diaries to assess typical intakes, some such measure should be included to screen for atypical diet histories in potential subjects. Will potential subjects be members of the military or matched to military personnel? It would be more helpful if military personnel were available to serve as subjects at the Pennington Center. It is of concern that the investigators did not consider the venipuncture frequency or the amount of blood drawn as a risk to the subject. No mention was made of human subject panel review procedures, but it is assumed these will meet both LSU and U.S. Army standards and include full informed consent of all participants. Recommendations Prior to initiation of either pilot study, a detailed protocol should be developed that clearly indicates how the concerns described in this review have been addressed. This protocol should include the diet, the specific dietary additives or manipulations that are to be tested, along with the method of administration, subject management (including characteristics that will preclude subject participation), methods for collection of physiological fluids, sleep deprivation routine, and test and performance measures. The protocols should reflect the clinical objectives of the Army. Ongoing participation of a nutritional scientist familiar with human dietary studies will provide needed expertise in protocol development and subject management.

OCR for page 77
Committee on Military Nutrition Research: Activity Report The stress of the repeated blood drawing should be evaluated (assuming that 14 venipunctures per day is what is actually planned), since no mention is made of cannulating the subjects. Any possible reactions to some of the neurotransmitter precursors (glutamine, etc.) must be discussed in advance with the subjects. It is difficult to understand how this project can be conducted on an outpatient basis and still maintain the level of control needed for data interpretation. It is recommended that serious consideration be given to having the subjects remain at the research facilities. This is routinely done in other research laboratories. Pilot studies will need to determine not only loading requirements but also cognitive and neuropsychologic tasks that are sensitive to sleep deprivation yet unaffected by repeated performance/measurement. Auditory noise is recommended as an excellent distractor in attention tasks because its parameters are easily controlled and quantified and it is easily administered. In addition, it is a relatively innocuous stimulus that is accepted well by almost all subjects and it is representative of real-world distractors. Addressing the neuroendocrine system is important because it may help determine whether stressors alter the metabolism of nutrients and whether nutrients alter the physiologic response to stressors. Smoking and exercise habits of potential subjects should be considered as screening factors because of their effects on food intake and sleep behavior. Careful consideration should be given to the issue of whether task/test administration is varied from day-to-day or kept constant. Fatigue and reduced motivation are likely given the large number of tests proposed. Throughout the project the researchers should remain alert to unexpected changes in subject behavior and performance, as well as other functional effects, and have sufficient flexibility built into their program to pursue these effects experimentally. The inclusion of female subjects is important in future studies.

OCR for page 77
Committee on Military Nutrition Research: Activity Report Project No. 5: Menu Modification Project Project Summary The Menu Modification Project has evolved to include changes that address some of the concerns expressed in previous discussions. Specifically, during Phase II of the project, modified recipes will be substituted in the standard menu, and acceptability testing will be conducted. These modified recipes will be lower in fat, cholesterol, and sodium. Phase III will include a week in which modified menus will be served and a week of standard menus. Food acceptability will be assessed using computerized score sheets to be handed out at each meal during Phase III. Additionally, during Phase III, surveys regarding nutrition knowledge, practices, etc. will be administered by graduate students. The proposal calls for developing modified menus and their acceptability in a “real” situation at Fort Polk. Acceptability will testing be ascertained by means of a simple 9-point hedonic rating. General Comments The key to success of this project is the ability to develop acceptable menu items that achieve the stated objectives. The specific menu items to be altered and the ingredient targets for change are not clear. It appears that this will be a serendipitous process. There is no indication of any study of the major contributors of fat, saturated fat, cholesterol, or sodium in current menus. Such information would permit a better defined approach to menu modifications. For example, it is predictable that eggs are the major contributor to cholesterol intake, therefore, it is reasonable to suggest that removing eggs from the menu by providing alternative/substitute menu items would lower cholesterol intake. Further, since eggs are generally consumed at breakfast it is likely that the major impact would be at that meal. Indeed, this was the reported observation. It would seem that a project such as this could benefit from a computer analysis of menus and the food menu item contribution of fat, saturated fatty acids, cholesterol, and sodium. The major contributors could then be targeted for modifications. Better computer modeling would provide options for selecting alternative means for evaluating the dietary plans. The collection of consumption information will be critical in assessing whether compensation for the fat reduction occurs. The proposal indicates that this will be monitored by USARIEM personnel but few details are provided.

OCR for page 77
Committee on Military Nutrition Research: Activity Report The importance of this information should be stressed and every effort made to insure adequacy of these data. It is essential that closer linkages be developed with Army experts who are in charge of the Master Menu and food service facilities. Without review and critique of ideas earlier in the menu item development process, little that is truly useful for the special circumstances under which Army food services must operate is likely to be accomplished. For example, Army food services must operate within strict financial allocations. Many of the suggested changes would likely be hard to accommodate within current allocations. Furthermore, the basic premise that foods that are developed and taste-tested by college students at Pennington are going to be exportable to the U.S. Army is of doubtful validity. Since all of the proposal is based on that premise, very serious consideration must be given to the whole concept of the project. The proposed add-on graduate research projects seem of low priority. If these tasks interfere in any way with the major objectives of the project they should be dropped. Specific comments, concerns, or questions It is unclear whether modified menu items will be substituted in the standard menu in Phase II or modified menu days will be substituted. It is unclear whether the acceptability testing during Phase II will be only on the modified menu items (or days depending on the answer to #1) or also on the standard menu items for which they are substituted (such as low fat biscuits versus standard recipe biscuits, etc.). Such a comparison would provide a control data base, and prevent respondents from identifying the new items as “different”, which may bias their future thoughts on the items. In Phase III, it appears that one week of standard menus will be followed by the week of modified menus. (Or, will the seven days of each set be intermingled with daily testing conducted?) It is important to make sure that the same individuals (to the extent possible) participate in both standard and modified menu acceptance testing. With schedule changes for personnel, might there be a different group eating in the garrison the first week versus the second week? If so, it would be necessary to intermingle the modified days with the standard days.

OCR for page 77
Committee on Military Nutrition Research: Activity Report Will the graduate student surveys be administered only during the week of modified menus, or will they be administered randomly between both weeks? The presence of the graduate student surveys may affect (at least temporarily) the respondents' food selection patterns, thus it would be important to make sure that questions were asked during both the modified and standard meals. No research design is provided for either part of Phase III. What data are to be collected? How are interfering variables to be controlled? How are the data to be analyzed? The evaluation form provided is not adequate to determine acceptability. Also, why does the score sheet to be given to the troops list a “Code” for the menu item? This could surely be accomplished in another less obvious way. In addition, the acceptability trial is too simplistic. One overall scan for a menu item is not adequate. Questions need to be asked that reflect various aspects of preference, not just a single overall score. Sensory testing results need to be compared with acceptability scores versus actual ingestion. It is important to remember that highly preferred foods (such as desserts) are not necessarily eaten frequently, while moderately preferred foods, for example, bread, are eaten daily. Clear mention and delineation of important principles of menu development including such factors as variety, flavor, color, texture, etc. need to be included in the project objectives and project plans. The issue of ethnic food preferences must be addressed in the project plan. It is suggested that an Advisory Committee of NCO's be established at Fort Polk to advise the project staff. This committee would be analogous to the use of student advisory groups in school feeding programs. As a result of the travel distances and time involved, the use of graduate students to collect data at Fort Polk is very inefficient and may be costly. There may be experienced dietitians, as dependents at Fort Polk or its environs, who would be interested in working on this project. This alternative at least should be explored.

OCR for page 77
Committee on Military Nutrition Research: Activity Report The nutrition knowledge and nutrition education components are not relevant to the basic mission of this particular project and should receive lowest priority. The committee is not enthusiastic about ancillary graduate student projects in the area of nutrition education. There is considerable likelihood that such activities will be disruptive and are not likely to yield information of consequence. Unless a much more persuasive argument can be put forth the ancillary graduate student research projects should not be undertaken. The committee does not see enough evidence of the kind of expertise needed for this project in the two curriculum vitae that accompanied the proposals. The lead investigator has good expertise with data bases, but has little experience with large scale food services. The chef is dedicated but also an individual with little experience in very large scale food service with tight cost and ingredient constraints. Someone who had formerly been involved in Army food service would bring more realistic perspectives to the task. As a result, the investigators should lean very heavily on the expertise of personnel involved with Army food service. Recommendations The specific objectives of the project need to be written down so the results of the project can be evaluated, for example, targets need to be delineated for fat, cholesterol, and salt reduction, acceptability level, nutrient composition (including the relationship to the current Military Recommended Dietary Allowances [MRDAs], etc. A systematic approach to the menu modification project should be carefully described, for example, initially a schedule of interactions should be outlined that will take place with Army menu planners to ensure that the project investigators fully understand the menu development process, cost restrictions, etc., and to insure relevance of the planned project to future use in Army menu development; extensive computer modeling should be planned that is based on interaction as suggested in (a) to identify the best opportunities to modify menus to meet objectives as established in the first recommendation stated above;

OCR for page 77
Committee on Military Nutrition Research: Activity Report initial acceptance criteria for modified items need to be clearly developed; and a detailed plan for adequate testing in an adequate military setting must be established. Plans for familiarization with actual preparation capability in the Army menu system must be made to obtain a clear understanding of the actual sites and circumstances under which meals are prepared in the Army, more understanding of the preferences of personnel, and more understanding of the Master Menu and other procedures. The investigators need a more intimate and comprehensive working relationship with USARIEM. Staff on the project should include those who have expertise and credentials in large scale menu planning, and previous experience working with the Army food services. OVERALL CONCLUSIONS AND RECOMMENDATIONS The first two programs in particular address high priority research questions, employ creative yet sound experimental methodologies, and have the potential to yield unique and important insights for the broader question concerning the relationship between diet/nutrition and function, with far reaching applications. However, because these projects may impact not only broad scientific objectives and hypotheses, but also specific future scientific methodology and measurement, it would be important to see the philosophy guiding this research clarified with respect to the scientific issues of acute versus chronic and pharmacologic versus physiologic dietary intervention. Frequent and meaningful communication between the Basic and Clinical neuroscience researchers will greatly benefit both programs. In contrast, the CMNR has serious concerns about not only the staffing but also the adequacy of the approach of the menu modification program. The physical resources available at the PBRC are adequate to accomplish these three projects. While the overall staffing for the basic and clinical neurosciences projects appears well developed, the CMNR believes the projects require on going advice from nutritional scientists with expertise in dietary factors that alter behavior and neurotransmitter levels. This could be accomplished through the addition, at least as consultants on a regular basis,

OCR for page 77
Committee on Military Nutrition Research: Activity Report of nutrition research scientists who are trained in conducting human dietary studies. The committee has reservations about the relevance and appropriateness of the menu modification project. Without appropriate planning, coordination, and staffing this project cannot make a significant impact on modifying Army menus in keeping with current healthful diet concepts. If improperly executed it would likely be a waste of time and resources. The CMNR is pleased to provide this review as part of its continuing response to the U.S. Army Medical Research and Development Command. Sincerely, Robert O. Nesheim, Ph.D. Chairman, Committee on Military Nutrition Research Enclosures cc: D. Schnakenberg E. Askew K. Shine C. Woteki B. Marriott

OCR for page 77
Committee on Military Nutrition Research: Activity Report Attachment A AGENDA COMMITTEE ON MILITARY NUTRITION RESEARCH VISIT JUNE 2-3, 1992 June 2, 1992 4:00 - 5:30 p.m. Dr. Ryan and Dr. Bray meet with Colonel Askew and Colonel Schnakenberg June 3, 1992 7:00 - 8:00 a.m. Breakfast and demonstration of modified menus 8:00 - 8:15 a.m. Introduction from Dr. Bray 8:15 - 8:30 a.m. Overview of new projects by Dr. Ryan 8:30 - 9:00 a.m. Introduction of Dr. Kumar - LSU Medical Center -New Orleans, Dr. Tulley, Dr. Delany 9:00 - 10:00 a.m. Discussion of Clinical Neuroscience Studies Project -Drs. Waters, Magill and Williamson 10:00 - 11:00 a.m. Discussion of Basic Neuroscience Studies Project -Drs. Prasad and Berthoud 11:00 - 12:00 noon Discussion of Menu Modification Project - Dr. Champagne 12:00 - 1:00 p.m. Lunch and demonstration of modified menus 1:00 p.m. Adjourn

OCR for page 77
Committee on Military Nutrition Research: Activity Report COMMITTEE ON MILITARY NUTRITION RESEARCH (CMNR) SUB-COMMITTEE MEETING JUNE 2-3, 1992 Discussion Meeting at the Pennington Biomedical Research Center PARTICIPANTS CMNR U.S. Army Robert O. Nesheim, Chair COL David Schnakenberg James Penland, Special Consultant MAJ John Leu Johanna Dwyer, FNB liaison COL Wayne Askew Allison Yates Harris Lieberman MAJ Cecilia Thomas Staff Bernadette M. Marriott, Program Director PBRC Staff George Bray, Director Donna Ryan, U.S. Army Grant principal investigator Hans-Rudolf Berthoud Catherine Champagne Richard A. Magill Chandan Prasad William F. Waters Donald A. Williamson