The United States can boast the best-equipped military force in history. It is conventionally understood that both combat readiness and the ability to maintain operations are significantly a function of adequate nutrition. As Napoleon may have said, “An army marches on its stomach.”
One could argue that the relevance of nutrition for the military is a microcosm of its importance for the population at large and that there is much that wider society and the food industry can learn from the achievements and challenges of food and nutrition science in the military. Nowhere is this better embodied than at the U.S. Army Natick Soldier Systems Center in Natick, Mass., where one of the core objectives is to “create a collaborative environment between government, academia, and industry.” Let’s examine some illustrations of military nutrition research in response to specific components of the “performance triad” of activity, nutrition, and sleep (Purvis et al. 2013).
It is only common sense that deployed war fighters need to eat more to sustain energy and muscle mass. But appetite is typically suppressed with stressors and altitude; capacity to prevent injury and sustain physical and cognitive performance are at greater risk of being compromised.
U.S. Army investigators confirmed that hypoxic stress results in anabolic resistance at altitude (Pasiakos et al. 2017). In other words, through mechanisms yet to be defined, hypoxia blunts muscle protein synthesis, in conjunction with enhanced proteolytic activity. Recommen-dations for high altitude missions are based on the assumption that there is a heightened dependence on glucose as a fuel source for exercise at altitude. Interventions have focused on increasing and optimizing carbohydrate intake to buttress glycogen substrate availability that in turn supports energy delivery.
The work of Pasiakos and others suggests that at sea level, in the context of sustained high level exercise or energy deficit, consumption of moderate protein or higher-protein diets augmented muscle protein synthesis and attenuated ubiquitin proteasome system–mediated muscle proteolysis. Higher protein intake at higher elevations may contribute to altitude-related anorexia. Palatable forms of high quality protein supplementation could be a valuable countermeasure in preserving muscle mass and physical performance in the face of the catabolic response to hypoxia.
Army researchers are therefore working to develop nutritional strategies to ensure that war fighters are consuming the right blend of macronutrients during periods of negative calorie balance to protect against muscle wasting, physical performance declines, and cognitive deterioration (McClung et al. 2017, Berryman et al. 2017). This relatively unexplored area may have implications for nutritional interventions for civilian patients with chronic obstructive pulmonary disease and other respiratory conditions.
On another front, consider the challenges of submariners, who live and work with intense pressure and in cramped spaces. Meals become an especially important source of enjoyment and comfort, and in conjunction with the necessarily sedentary duties, overweight and its associated health consequences become salient. The estimated prevalence of overweight and obesity in U.S. submariners has been reported to be 5% higher than among sailors assigned to aircraft carriers and similar to the general population. Interventional studies are called for and would seem to have clear implications for the general population (Gasier et al. 2016).
In conjunction with the Uniformed Services University of Health Sciences, the Defense Advanced Research Projects Agency has looked increasingly at war fighter nutrition. With a mandate to explore nutrient timing, mineral and vitamin supplementation, phytosubstances and potential bioactives, novel delivery methods, metabolomics, epigenetics, and nutrigenomics, the military’s effort mirrors what we see in the civilian research world. What is hopefully prophetic for both arenas is the recognition of the inadequacy of nutritional support of healing, egregiously illustrated in typical hospital food (Deutster et al. 2009). There may now be meaningful investigations into dietary interventions as clinically meaningful adjuncts in the management of traumatic brain injury and its aftereffects and other neurological comorbidities of conditions such as posttraumatic stress disorder.
One additional aspect of nutritional support effected by the U.S. military lies in the realm of humanitarian aid and disaster relief. Obviously, the provision of adequate food and water is central to most humanitarian operations, and one would argue that the character and logistics of these operations is worthy of study and appropriate dietary interventions. Applewhite and others note that the importance of military dietitians in collaboration with local leaders in these efforts extends beyond nutrition support to areas such as sanitation management, education and training, and operational logistics (Applewhite et al. 1997). This is an excellent example of how civilian training can have a positive influence in maintaining peace and health.
Roger Clemens, DrPH, CFS,
Univ. of Southern California School of Pharmacy,
Los Angeles, Calif.
U.S. Army Veteran