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A Review of the Revision of the Medical Services Nutrition Allowances, Standards, and Education (AR 40-25, 1985)

In 1990, the Department of the Army began to discuss the need to revise the current version of the Military Recommended Dietary Allowances (MRDAs, AR 40-25, 1985). COL Eldon W. Askew, Ph.D., (former) Chief, Military Nutrition Division (currently the Military Nutrition and Biochemistry Division), U.S. Army Research Institute of Environmental Medicine (USARIEM) requested that the Committee on Military Nutrition Research (CMNR) discuss the MRDA review and revision. The committee's role was to evaluate, comment upon, and make specific recommendations regarding changes in the MRDAs designed to reflect changes where appropriate, in the latest version of the Recommended Dietary Allowances (RDAs) (NRC, 1989b) and other relevant national policy statements on nutrition and health, such as the Surgeon General's Report on Nutrition and Health (DHHS, 1988) and Diet and Health: Implications for Reducing Chronic Disease Risk (NRC, 1989a).

In November 1990, the committee heard an historical overview of military involvement with dietary recommendations and presentations on the feasibility of attaining governmentally-established dietary recommendations and the process of establishing RDAs. The committee then began an in-depth discussion of the concerns related to the revision of the MRDA; however, the committee deferred further discussion and formulation of recommendations because the Army was in the process of drafting a revised MRDA.

In 1993 the committee received a draft of the MRDAs for review and comment. A subcommittee of the CMNR reviewed the comparison document and the original and draft revisions in detail. The subcommittee found a number



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--> A Review of the Revision of the Medical Services Nutrition Allowances, Standards, and Education (AR 40-25, 1985) In 1990, the Department of the Army began to discuss the need to revise the current version of the Military Recommended Dietary Allowances (MRDAs, AR 40-25, 1985). COL Eldon W. Askew, Ph.D., (former) Chief, Military Nutrition Division (currently the Military Nutrition and Biochemistry Division), U.S. Army Research Institute of Environmental Medicine (USARIEM) requested that the Committee on Military Nutrition Research (CMNR) discuss the MRDA review and revision. The committee's role was to evaluate, comment upon, and make specific recommendations regarding changes in the MRDAs designed to reflect changes where appropriate, in the latest version of the Recommended Dietary Allowances (RDAs) (NRC, 1989b) and other relevant national policy statements on nutrition and health, such as the Surgeon General's Report on Nutrition and Health (DHHS, 1988) and Diet and Health: Implications for Reducing Chronic Disease Risk (NRC, 1989a). In November 1990, the committee heard an historical overview of military involvement with dietary recommendations and presentations on the feasibility of attaining governmentally-established dietary recommendations and the process of establishing RDAs. The committee then began an in-depth discussion of the concerns related to the revision of the MRDA; however, the committee deferred further discussion and formulation of recommendations because the Army was in the process of drafting a revised MRDA. In 1993 the committee received a draft of the MRDAs for review and comment. A subcommittee of the CMNR reviewed the comparison document and the original and draft revisions in detail. The subcommittee found a number

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--> of aspects of the revised draft confusing and discussed their findings with the full committee. The CMNR concluded that the confusion generated by the present draft could most likely be alleviated through expansion of several sections and the addition of explanatory footnotes and text. The committee verbally conveyed a request for additional materials to Office of the Surgeon General, Department of the Army (OTSG, DA) and deferred further discussion and formulation of recommendations until receipt of additional material or a second revised draft. In late January 1994, the CMNR received another revision of the MRDAs for their consideration and recommendations. The committee included discussion of this revision in their executive session after a workshop in February 1994. After the initiation of the current grant in November 1994, the completion of this letter report (along with other outstanding commitments from the previous grant) was a priority for the committee. The completed report was delivered in October 1995. The letter report is thus based on past reviews of AR 40-25, reviews of military rations and ration developments, workshops on nutrient requirements for military personnel in environmental extremes, and committee deliberations regarding the present version, and is a thoughtfully developed presentation incorporating the scientific opinion of the CMNR and comments of the anonymous peer review panel of the National Research Council. Conclusions and Recommendations It is the view of the CMNR that there does not appear to be a scientific basis to have distinct military recommended dietary allowances for individuals performing duties in normal peacetime military operations and non-field conditions. However, since the MRDAs have an extensive history of use by the military in areas such as menu planning and procurement of military rations, the committee recognizes that they may serve an essential purpose beyond that usually identified with the RDAs. In addition, nutritional standards for the development and procurement of operational and restricted rations are necessary to assure that the issued rations meet the needs of service men and women whose entire diet while under simulated or actual combat conditions may consist of the issued rations for extended periods of time, such as experienced during Operation Desert Shield/Storm and during peace-keeping operations in Somalia and Haiti. The staffs of OTSG, DA and U.S. Army Medical Research and Materiel Command are urged to review whether there continues to be a need to maintain separate MRDAs in light of existing information that has been developed by the Institute of Medicine, U.S. Department of Health and Human Services, and other organizations for the general population.

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--> The CMNR recommends that the table on nutritional standards for operational and restricted rations be retained and that the narrative accompanying the table values explain clearly how the reference values were derived. If it is determined by the OTSG, DA that the military version of the RDAs is to be maintained, the CMNR recommends that serious consideration be given to the future mechanism for development of these sections as well as the nutrient standards for operational or restricted rations. The CMNR cannot identify a group within the existing Department of Defense structure with a sufficient depth and breadth of expertise to develop these recommendations. There is a critical need for a group of individuals who are familiar with the development of RDAs to assist in the derivation of the MRDAs as well as the nutritional standards. The CMNR further recommends that, if it continues to be the view of the OTSG, DA that the MRDAs and nutritional standards for operational and restricted rations are needed, then: the scientific expertise at USARIEM should be involved in the future in the development of such standards to assure consideration of the findings of research conducted by the Military Nutrition Division at USARIEM; a joint review by nutritionists/dietitians from each of the services is desirable to assure consideration of issues of special concern to each of the branches of the military, in the development of these MRDAs and standards since they are applicable to the Army, Air Force, and Navy; and timely consideration by the military of dietary recommendations developed by the Food and Nutrition Board should occur as new versions are released. <><><><><><><><><><><><> The full text of this letter report is included as Appendix D.

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