K. SREEKUMARAN NAIR: That is right.

JEFF ZACHWIEJA: Was there any functional improvement in the muscle of those men?

K. SREEKUMARAN NAIR: In this group we did not measure their muscle strength. It was an outpatient study where the patients were administered testosterone for that study. The UCLA group showed increase of muscle strength on supraphysiological testosterone administration.

GAIL BUTTERFIELD: In terms of the military's interest, do you find the kinds of changes that you observed in mitochondrial protein and myosin heavy chain, with a decrease in energy intake or a decrease in protein intake?

K. SREEKUMARAN NAIR: We do not have any data on that. It is only the first study we have done in the aging population. But certainly, from the military point of view, I am sure that you may have the endurance capacity and also the muscle strength decline with aging. It is an open question what impact the changes in nutrition has on this age related changes.

ROBERT NESHEIM: Last question.

PATRICK DUNNE:With the military situation, it is important to consider the interactions of exercise and dietary carbohydrate intake and their impact on hormones. It may be desirable to design diets that are higher or lower in carbohydrate or protein for their effects on muscle function, but it is necessary to consider whether people will eat those diets. That is a factor that must be included in this discussion.

ROBERT NESHEIM: Thank you very much, Dr. Nair. I guess that one ought to stay young if one is going to be in the military. I am kidding.

Front Matter (R1-R18)

Executive Summary (1-16)

I Committee Summary and Recommendations (17-18)

1 Committee Review (19-76)

2 Responses to Questions, Conclusions, and Recommendations (77-82)

II Authored Papers and Workshop Discussions (83-84)

3 Protein and Amino Acids: Physiological Optimization for Current and Future Military Operational Scenarios (85-92)

4 Overview of Garrison, Field, and Supplemental Protein Intake by U.S. Military Personnel (93-108)

5 The Energy Costs of Protein Metabolism: Lean and Mean on Uncle Sam's Team (109-120)

6 Regulation of Muscle Mass and Function: Effects of Aging and Hormones (121-136)

7 Effects of Protein Intake on Renal Function and on the Development of Renal Disease (137-154)

8 Infection and Injury: Effects on Whole Body Protein Metabolism (155-168)

9 Inherent Difficulties in Defining Amino Acid Requirements (169-216)

10 Amino Acid Flux and Requirements: Counterpoint Tentative Estimates are Feasible and Necessary (217-242)

11 Physical Exertion, Amino Acid and Protein Metabolism, and Protein Requirements (243-254)

12 Skeletal Muscle Markers (255-278)

13 Alterations in Protein Metabolism Due to the Stress of Injury and Infection (279-284)

Discussion I (285-288)

14 Amino Acid and Protein Requirements: Cognitive Performance, Stress, and Brain Function (289-308)

15 Supplementation with Branched-Chain Amino Acids, Glutamine, and Protein Hydrolysates: Rationale for Effects on Metabolism and Performance (309-330)

16 Dietary Supplements Aimed at Enhancing Performance: Efficacy and Safety Considerations (331-340)

Discussion II (341-346)

Appendixes (347-348)

A Workshop Agenda (349-352)

B Biographical Sketches (353-368)

C Acronyms and Abbreviations (369-372)

D Proteins and Amino Acids - A Selected Bibliography (373-410)

E Protein and Energy Content of Selected Operational Rations (411-412)

Index (413-429)