Not Eating Enough Overcoming Underconsumption of Military Operational Rations (1995) / Chapter Skim
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1 Introduction and Background
1 Introduction and Background
Pages 3-40
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National Academy Press 1 Introcluction en c} Backgrouncl The Committee on Military Nutrition Research (CMNR) has reviewed many studies over the past 10 years that evaluated the acceptance and intake of military food items as part of its continuing task of assessing the nutritional adequacy of military operational rations (see IOM, 1992a for summary)
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This report originated from a concern within the military about the consistency of the deficit in energy intake and whether such a decrement could lead to meaningful reductions in ohYsical and/or cognitive performance of troops during military operations. The report focuses on the various factors that may contribute to the reduced intake of operational rations, the potential effect on soldier performance, and suggested steps that may be taken to overcome the problem.
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to strategize ore how to overcome underconsumption of military operational rations. The CMNR's task was to review the data on ration intake in controlled field settings, to determine whether the consistently reported suboptimal energy intake could be termed underconsumption, to evaluate whether this lowered intake could be detrimental to performance, and to discuss strategies that might be effective for increasing ration consumption.
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dependent (Mason et al., 1982; NLABS, 19839. Throughout Part I the committee uses the term ration collectively to represent the five types of current military operational rations (Meal, Ready-to-Eat tMRE]
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In addition, there are 13 unique items that are either dehydrated or chunked and formed. Preparation of these meals in the field using field kitchens is a demanding task that requires considerable culinary skill.
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A review of research findings in these general areas is then presented in the sections that follow with an overview of newly proposed plans for changes of military operational rations and field feeding programs. The CMNR concludes its research synopsis with a discussion of the potential impact of these proposed changes on the underconsumption problem and incorporates a discussion of alternative research and operational strategies suggested at the workshop.
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. There was weight loss in both groups, but the MRE group lost twice as much weight over 30 days (4.8 percent of body weight versus 2.4 percent in the control group)
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In the MRE field studies using doubly labeled water, there appears to be an energy deficit of 500 to 2,000 kcal/d and resultant weight loss for the study participants. When men and women trainees were given the opportunity to augment their rations with snack food or when regularly scheduled hot meals were provided, body weight was maintained.
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A loss of body weight, over time, thus appears to be the easiest guide for quantifying dietary underconsumption. However, for an accurate evaluation of weight loss data, it is important to know the changes in body composition that account for the lost weight.
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Therefore, when evaluating the effects of underconsumption of operational rations and resulting weight loss, it is necessary to eliminate dehydration as a factor and be concerned with well-hydrated individuals in assessing the effect of weight loss on perform ance. The rate of weight loss is also an important consideration in healthy and adequately hydrated individuals and is Primarily related to the energy deficit.
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There is the suggestion from the data on Ranger Training School (Moore et al., 1992; Shippee et al., 1994; see Chapter 14 in this volume) that body weight loss of less than 10 percent in hydrated individuals may not significantly reduce physical performance.
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A study of the impact of ibuprofen on appetite may determine if a cytokine-mediated underconsumption situation would disappear with ingestion of an agent that blocks cytokine formation. In summary, historical evidence combined with recent detailed studies of weight loss during military special forces training suggest that essential physical performance is maintained in most individuals until hydrated weight loss approaches 10 percent of initial weight, provided the rations available are of adequate nutritional composition.
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, the effects of suboptimal ration consumption on cognitive performance paralleled the effects on physical performance, but there were many fewer studies. If weight loss can be equated with underconsumption, decrements in cognitive performance resembled those in physical performance in that no effects of minor degrees of weight loss were detected in tests of cognitive performance.
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16 a' o Cal a)
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serious problems found in previous research, such as the establishment of suitable control groups, normative baseline control data, cognitive test standardization and reliability, test condition standardization, subject motivation, and measure performance over a range of body weight losses. Implications of Underconsumption of Macronutrients Related to the underconsumption of military operational rations is the optimum composition of rations in terms of the macronutrients carbohydrate, fat, and protein.
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In this review actual measured carbohydrate intake of a variety of male athletes ranged from 373 to 596 g/d with energy intakes of 3,034 to 5,222 kcal/d. Corresponding data for female athletes were 290 to 428 g of carbohydrates per day with energy intakes of 1,931 to 3,573 kcal/d.
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Depending on circumstances and hydration state, early weight loss will include loss of water, loss of body fat, and loss of lean body mass unless protein intake is maintained at a high level. Energy deficits induced by increased physical activity are not likely to result in loss of lean body mass if protein intake is maintained at least at 1 g per kg of body weight per day, according to Phinney.
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. Ration consumption in the field may also be affected by changes in circadian rhythms, soldiers' attitudes toward weight loss and food intake while in the field, meal timing, meal frequency, meal duration, meal regularity and predictability, ease of access to the food, food appropriateness, and lack or reduction in food sensory cues due to packaging.
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Whenever possible, deployment to field training exercises should provide ample opportunities for soldiers to eat and drink. The resulting exercises should take into account changes in circadian rhythms, meal timing, and the appropriateness of meal items to encourage food intake.
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relaxing the individual and thereby decreasing inhibition of food intake. In summary, research on social facilitation of feeding suggests strategies that could be employed to increase consumption of military operational rations.
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; provide USARIEM Technical Note 93-3 (Thomas et al., 1993) , Nutrition for Health and Performance: Nutritional Guidance for Military Field Operations in Temperate and Extreme Environments, to commanders; and · periodically survey Army War College and Command and General Staff College classes to measure understanding of the importance of ration consumption to performance.
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ATTRIBUTES OF FOOD THAT AFFECT CONSUMPTION Food Stereotypes and Food Image Military operational rations and garrison food have a negative image both with the American public and with the soldier. This image is perpetuated in the media through articles whenever soldiers are deployed and, more consistently, through well-known, long-standing comic strips such as "Beetle Bailey." In a recent questionnaire, active-duty soldiers rated the expected acceptability and expected quality of 12 different foods as served in 7 different types of commercial and military eating establishments (A.
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Cardello in Chapter 10 in this volume, for military operational rations this model predicts that if expectations for rations are low, then acceptance of the rations will be low. Given the poor image of military operational rations among both soldiers and civilians, continued poor acceptance of even the newly developed rations would be expected.
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Food intake is also affected by portion size, with greater intake occurring when portion size is larger (Booth et al., 1981; Edelman et al., 1986; Shaw, 1973~. Greater energy intake can also
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In summary, the key concepts for maximizing energy intake based on food quality and variety are the following: (1) the initial palatability of foods should be high, with self-selection allowed whenever possible; (2)
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discusses the relationship of water intake to survival and performance. She focuses her discussion particularly on the factors that influence fluid intake and on how fluid intake affects energy intake.
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A careful examination o~ meal timing in relation to the daily performance cycle in military personnel in the field might thus reveal if meal timing might be useful in optimizing body weight and performance. NEW CHANGES IN MILITARY OPERATIONAL RATIONS AND FIELD FEEDING Ration Evolution Development and testing of military operational rations has been an ongoing component of the military, and the use of nutritional standards for rations has been in place since World War II (for a review see Schnakenberg, Chapter 6 in this volume)
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This concept has been called "Kitchens in a Carton." In summary, military operational rations are under almost continual revision. Ration developers are concerned to provide the best possible product for their consumers and at the same time be cognizant of the factors related to packaging, shelf-life, transport, and distribution.
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The MRE has some advantages in these circumstances, but when it does not include a blameless heater, lack of hot foods is still a significant deterrent to energy intake (for a discussion, see Motrynczuk, Chapter 4 in this volume)
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Other suggested manipulations are to prevent some of the trauma frequently associated with deployment, provide scheduled meals and snacks, create a protected environment for feeding, provide easy ways to heat the ration, and ensure adequate fluid intake. The proposal suggests that company-sized units might be exposed to the variable, individually and food intake measured relative to energy expenditure.
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Underconsumption of military operational rations may only be a problem if it has negative impact on physical and cognitive performance. Long-term or repeated usage of rations may result in more significant weight losses and thus may have the potential for larger effects on physical or cognitive performance.
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Bacon, and R.L. Weinsier 1983 The effects of high and low energy density diets on satiety, energy intake, and eating time of obese and nonobese subjects.
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1992a Body Composition and Physical Performance. A report of the Committee on Military Nutrition Research, Food and Nutrition Board.
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Levine, A.S., and C.J. Billington 1994 Dietary fiber: Does it affect food intake and body weight?
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Cole, and L Brace Changes in body weight, body composition, and energy intake in women fed high- and low-fat diets.
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Young 1989 Adaptation to low protein and energy intakes.
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Army Research Institute of Environmental Medicine) 1986 Combat Field Feeding System-Force Development Test and Experimentation (CFFSFDTE)
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