- General supplementation of military rations above MRDA levels for the purpose of enhancing immune function is NOT recommended.
- The preferred method of providing supplemental nutrients is through a ration component.
- Gain a better understanding of the prevalence of supplement use and abuse by personnel and make strong recommendations for their appropriate use or nonuse.
- Conduct research to determine the appropriate field measures (see Table S-2) for monitoring nutritionally induced immune responses, particularly the presence of acute-phase reactions and changes in immune function of the type and degree that are likely to occur as a result of the nutritional insults suffered by soldiers in typical deployment situations.
- Carefully design research protocols.
- Increase awareness of and potential military application of findings within the civilian research community regarding nutrition and immune function.
Recommendations for Future Research
- Perform laboratory-based studies as recommended previously (IOM, 1997) to determine if an interleukin-6 (IL-6)—creatinine ratio (or some comparable measure) can be measured in single ''spot'' urine samples as an index of the 24-h excretion of IL-6 and determine if 24-h IL-6 excretion is, in turn, a reliable indicator of acute stress response.
- Develop and field test appropriate cytokine markers in urine and blood that are reflective of ongoing acute-phase reactions and of changes in immune status in multistress environments.
- Research conducted on the ability of nutrients to influence immune status should place priority on the antioxidant nutrients β-carotene and vitamins C and E.
- Keep apprised of research being conducted in the civilian sector on immune function in physically active women and consider conducting studies on military women in situations of deployment to augment the findings of civilian studies.
- The influence of iron status on the risk of infection requires further investigation. This is also an area of interest to the civilian medical community.
The committee's responses to the questions, conclusions, and recommendations from this report are included in Appendix L.