The Committee on Military Nutrition Research (CMNR, the committee) was established in October 1982 in response to a request from the Assistant Surgeon General of the U.S. Army. It was first organized within the Food and Nutrition Board (FNB) of the National Research Council's (NRC) Commission on Life Sciences and in 1988 moved with the FNB to its new administrative home in the Institute of Medicine.
The committee's mission is to advise the U.S. Department of Defense on the need for and conduct of nutrition research and related issues. Specifically, the committee's tasks are:
Within this context, the CMNR was asked to focus on nutrient requirements for performance during operational missions and deployment rather than requirements for military personnel in garrison, because the latter were judged not to differ significantly from those of the civilian population.
Although the composition of the committee changes through a 3-year rotation policy, the disciplines represented have consistently included human nutrition, nutritional biochemistry, performance physiology, immunology, food science, and psychology.
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--> Background and Introduction History of the Committee The Committee on Military Nutrition Research (CMNR, the committee) was established in October 1982 in response to a request from the Assistant Surgeon General of the U.S. Army. It was first organized within the Food and Nutrition Board (FNB) of the National Research Council's (NRC) Commission on Life Sciences and in 1988 moved with the FNB to its new administrative home in the Institute of Medicine. The committee's mission is to advise the U.S. Department of Defense on the need for and conduct of nutrition research and related issues. Specifically, the committee's tasks are: to identify nutritional factors that may critically influence the physical and mental performance of military personnel under all environmental extremes, to identify deficiencies in the existing database, to recommend research that would remedy these deficiencies as well as approaches for studying the relationship of diet to physical and mental performance, and to review and advise on standards for military feeding systems. Within this context, the CMNR was asked to focus on nutrient requirements for performance during operational missions and deployment rather than requirements for military personnel in garrison, because the latter were judged not to differ significantly from those of the civilian population. Although the composition of the committee changes through a 3-year rotation policy, the disciplines represented have consistently included human nutrition, nutritional biochemistry, performance physiology, immunology, food science, and psychology.
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--> A subcommittee of the CMNR was established to review existing military policies governing body composition and fitness as well as postpartum return-to-duty standards, Military Recommended Dietary Allowances, and physical activity and nutritional practices to determine their individual and collective impact on the health, fitness, and readiness of active-duty women under a Defense Women's Health Research Program grant. In addition to several members of the parent committee, individuals with expertise in body composition assessment, physical fitness and performance, pregnancy and lactation, women's nutrition, weight management, epidemiology and survey design, and cognitive performance were included. This subcommittee was designated the Subcommittee on Body Composition, Nutrition, and Health of Military Women (BCNH committee). In addition, a group of individuals representing the body composition, fitness, and nutrition research and policy making bodies of the Army, Navy, and Air Force were invited by the sponsor to form a liaison panel to advise the BCNH committee. Although this subcommittee operated under a separate grant, the two reports they prepared: Assessing Readiness in Military Women: The Relationship of Body Composition, Nutrition, and Health and Reducing Stress Fractures in Physically Active Military Women are included in this activity report for completeness. Committee Procedures Meetings Meetings have been of three types. Full committee meetings are scheduled at the request of the Army to review nutrition programs, food products, and specific research projects in various stages of development. At these meetings, oral presentations by Army personnel are augmented by written background material on one or more specific items for the Committee on Military Nutrition Research to review. The CMNR subsequently meets in executive session to discuss the materials and write a report to the Army that includes a summary of findings and recommendations. These reports are in the form of letters with attached supporting materials or brief, bound reports. Subcommittee meetings are convened by the committee chair either to plan future work, write reports, or, at the request of the Army, provide on-site review of research projects where the expertise of the entire committee membership is not required. Reports drafted by subcommittees of the CMNR are subject to the review and approval of the entire committee membership prior to completion. Workshop meetings are planned when issues have been presented to the CMNR by the Army that require broader expertise than exists within the committee, or for which the committee would like additional information or opinions. A CMNR workshop includes presentations from Army and other experts in nutrition and related
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--> sciences on an issue relevant to military nutrition research. The invited speakers are chosen for their specific expertise in the topic areas of concern and are asked to provide in-depth reviews of their area of expertise as it directly applies to a series of questions drafted by the sponsor. Speakers subsequently submit written versions of their presentations. These workshops thus provide additional state-of-the-art scientific information for the committee to consider in their evaluation of the issues at hand. At the conclusion of the presentations, the committee meets in executive session to discuss the issues and prepare conclusions and recommendations to be included as part of a book-style workshop report for subsequent release to the sponsors and the public. If a topic is presented by the military where the committee membership does not feel that they can adequately cover the scientific range required, special advisors may be invited to augment the committee expertise and interact with the membership for a specific report. If the committee chair sees that expertise continues to be needed in a specific scientific area, a new member with expertise in that scientific discipline may be added to the committee through the normal 3-year rotation process. Document Format In 1992, the CMNR formalized the document format types that they used for their reports and developed a standardized report cover. This standardized cover presents a ''series effect'' to the CMNR reports and makes them readily identifiable as committee projects. Currently, there are four document formats used by the CMNR that reflect the specific needs of the Army. In 1994, the CMNR created a style guide to be used in future reports. This style was so well received that others in IOM have incorporated some aspects of it into their reports. Letter with attachments. This type of document is prepared in response to a specific request from the Army for a review of a research project or program that requires a rapid response to be effective. The document must be a short, specific statement of recommendations directed to the Army command for rapid action. These items are research projects that are in progress or specific nutritional concerns that have abruptly arisen. The CMNR is presented orally with the findings and provided with the limited documentation available. The timeliness as well as the concise, highly specific, and confidential nature of these documents is specified by the Army when the item is presented to the CMNR. Three examples of letter reports are included in this activity report. Brief report with documentation. This document format is typically used in response to a request for review of a food product, packaging process, completed research project, or planned educational program. The Army
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--> provides an oral presentation as well as extensive documentation or product specifications. The time frame for the committee deliberations is several months, and the summary and recommendations are bound to the specifications to provide a clear understanding of the iteration of the product, process, project, or program that was reviewed. The 1996 CMNR report, Pennington Biomedical Research Center September 1996 Site Visit, is an example of a brief report (see p. 25 and Appendix G) as is the 1999 report (in progress) on Caffeine Formulations for Sustainment of Mental Performance. Workshop proceedings with summary and recommendations. The Army identifies for the committee at least one topic each year for which they require a thorough review of the current literature by experts in the scientific field coupled with the committee's recommendations. This requirement is met with a workshop at which experts are asked to make oral presentations that include an overview of the literature and address specific questions posed by the Army. CMNR staff compile literature reviews and organize these meetings in close collaboration with the sponsor. The CMNR reviews these presentations and writes a detailed summary and recommendations to the Army. The resulting document includes the committee's findings with the presentations. The expected turn-around time for this document type is within 12 to 24 months. Examples of workshop reports are the committee's most recently released books, Military Strategies for Sustainment of Nutrition and Immune Function in the Field (May, 1999; see p. 45 and Appendix L), and The Role of Protein and Amino Acids in sustaining and Enhancing Performance (June, 1999; see p. 49 and Appendix M). Periodic activities reports. The CMNR is also expected to prepare a bound report at variable intervals (3–5 years) that is a summation of the activities undertaken. No new information is presented in these reports. Typically these reports reflect contract periods and serve as a final report for the contract or contract renewal. This report is an example of the periodic activity report of the CMNR. Document Review In accordance with NRC guidelines, each report (with the exception of the activity reports) is reviewed in confidence by a separate, scientific review group. In 1992 the CMNR established a separate Review Panel to facilitate the rapid review of committee reports. When a report is begun, the panel members are alerted and polled as to who among them would be available to review the report. Typically, each report is reviewed by five to seven panel members. Additionally, three to five supplemental reviewers with expertise in the specific area being covered in a report may be approached, as was the case with the
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--> report, Emerging Technologies for Nutrition Research (IOM, 1997). The Review Panel members all have some experience with military nutrition and health issues and therefore have a basic understanding of the concepts under consideration. None are military personnel or have contracts with the military. The Review Panel has facilitated the speed of report review because the participants are interested and knowledgeable about the issues that come before the committee. In addition, as panel members they are prepared to consider reviewing reports with a rapid turn-around time. As with all NRC report reviews, the comments of the Review Panel are anonymous. The committee then reviews the anonymous comments of this Review Panel and incorporates their suggestions where appropriate. Staff then write a response to the reviewers comments with a revised report draft and obtain final approval of the report from the Review Coordinator. Each Committee on Military Nutrition Research report is thus a thoughtfully developed presentation that incorporates the scientific opinion of the CMNR and the comments of National Research Council external reviewers. Organization of this Report This summary of the activities of the Committee on Military Nutrition Research reflects the period of performance from December 1, 1994 through May 31, 1999 supported by grant DAMD17-94-J-4046 from the U.S. Army Medical Research and Materiel Command to the Food and Nutrition Board for the CMNR program. It also includes the activities of the Subcommittee on Body Composition, Nutrition and Health which functioned in this time period. This report has been organized in topical fashion because the committee was requested on occasion to participate in reviews of research projects or products during several stages of their development over the course of this grant period. Activities are presented in the same order they were submitted to the sponsor. A full listing of all committee meetings and members during the grant period are included as Appendixes A and B. At a number of meetings, the CMNR was presented with oral and written reports of research projects in progress or products under development. In a number of instances, the committee deferred a full review of these items until the project was complete. Summaries are provided in the body of this report of all activities in which the committee was requested to participate from December 1, 1994 through May 31, 1999, regardless of whether a report with recommendations was developed. In the appendixes, full copies of each letter report are included in the order mentioned in the text. For the brief reports and workshop reports, due to length, only the committee conclusions and recommendations have been included in the appendixes.
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