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Several previous CMNR reports have focused on issues of protein nutriture and performance. In 1992, the CMNR noted in an evaluation of Army Ranger training that trainees experienced significant loss of muscle mass during periods of intense physical exertion (IOM, 1992b). A follow-up report (IOM, 1993b) found that increases in energy intake only partially prevented such losses. The report Food Components to Enhance Performance (IOM, 1994b) briefly considered the influences of protein and amino acids on physical and cognitive performance and response to stress. The most recent CMNR report, Military Strategies for Sustainment of Nutrition and Immune Function in the Field (IOM, 1999), considered the effects of diet, including protein and individual amino acids such as glutamine, on immune response. This report looks further into the many questions regarding the optimal level of protein intake in a high-stress field environment. How to measure protein balance and estimate protein requirements accurately; how these requirements are affected by physical activity, gender, hormonal factors, and stress; and whether muscle function and cognition are influenced by protein intake and by individual amino acids are all active areas of research.

The CMNR decided that the best way to review the state of knowledge in this area was through a workshop. The purpose of this workshop was to bring together leading scientists in the field of protein metabolism to seek their assessment of the current state of knowledge and to determine, based on these assessments, on a careful reading of the literature, and on the expertise of the committee members themselves, whether the recommended intakes of protein or individual amino acids for soldiers should be modified.

In May 1996, CMNR and USARIEM personnel met to frame a series of questions, outline the workshop, and identify qualified speakers. A follow-up planning meeting was held in January 1997 and included several members of the Subcommittee on Body Composition, Nutrition, and Health of Military Women. Invited workshop speakers were asked to prepare a paper for presentation and publication that described the key issues of protein metabolism. USARIEM scientists also participated in the workshop, which resulted in a well-rounded group. At the one-day workshop, held in Washington, D.C. on March 13, 1997, each speaker gave a formal presentation, which was followed by questions and a brief discussion period. The proceedings were tape recorded and professionally transcribed. At the end of each group of presentations, a general discussion of the overall topic was held. Immediately after the workshop, the CMNR met in executive session to review the issues, to draft summaries of the presentations, and to provide responses to the sponsor's task questions. Committee members subsequently met with staff in June 1997 and worked separately and together using the authored papers, additional reference materials provided by the staff through limited literature searches, and personal expertise and experience to draft the overview, summary, conclusions, and recommendations.



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