Page 90 - Journal of Special Operations Medicine - Fall 2014

Table 1 Selected Questions to Ask Before Purchasing a meal or snack is “oxidized”/used as fuel, rather than
Dietary Supplement for protein synthesis. Although protein is required for
38
1. Does it provide more than 200mg of caffeine per optimal muscle growth and strength gains, all data indi-
serving? cate that a protein intake of 0.9g/lb of body weight each
2. Does it promise a quick fix? day (180g for a 200lb person) is more than adequate
3. Are the ingredients part of a “complex,” “blend,” for even the most serious weightlifter or bodybuilder, as
“proprietary blend,” or “delivery system”?
long as the diet provides sufficient energy. Importantly,
If the answers are “yes,” do more homework before even in the face of an energy deficit, consuming a high-
making a purchase. protein diet does not mitigate any stress-induced decre-
ments in anabolic hormones. 39
death, are reported in association with DSs. Most DS
consumers and medical providers do not know where or Although protein supplements (PSs) generally appear to
how to report an adverse event, and many adverse events be safe for healthy adults, SOF should be educated on
caused by supplements may not be recognized as such. how to choose the best products, given quality control
Importantly, check to see if specific products are on the and contamination concerns with DSs. To achieve rec-
OPSS High-Risk Supplement List (http://hprc-online.org ommended protein intakes, consumption of high- quality,
/dietary-supplements/opss/operation-supplement-safety- protein-containing whole foods is recommended. How-
OPSS/high-risk-supplement-list) before purchasing a sup- ever, when impractical, the use of PS (20−25g/serving
plement. Depending on your specific health conditions or 0.11−0.14g/lb/meal), particularly after periods of
and nutritional needs, a specific DS or a “one-a-day” type stren uous physical work (e.g., military training, combat
vitamin-mineral supplement may be of benefit. Be sure to patrols, etc.), is acceptable and likely beneficial. Again,
check for third-party certification when choosing a DS. special operators should only choose products that are
third-party certified.
4. Beware of protein and amino acid supplements—just Interestingly, newly recognized protein sources are
under 1g of protein per pound of body weight per day is emerging: rice, chickpea, buckwheat, and the like. The
the maximum recommended protein intake.
most complete proteins at this time are still eggs, dairy
The fourth commandment deals with a topic near and products, and “flesh” in the form of meat (beef, pork),
dear to weight lifters, bodybuilders, and many who be- poultry, and/or fish, followed by complementary vegeta-
lieve that the answer to getting bigger and stronger is eat- ble sources (e.g., rice and peas, quinoa and lentils, and
ing more protein. The SOF community, in their quest for corn and beans). A future article may focus on types of
optimal performance, may be prone to ingesting exces- protein, but the current evidence indicates that quality is
sive quantities of protein and amino acid supplements. important and that both vegetable and animal proteins
However, more protein does not necessarily translate are excellent sources.
into more muscle or strength. In November 2012, the
Department of Defense, Center Alliance for Dietary 5. The types of fat in the diet are more important than
Supplements Research sponsored a consensus workshop the amount, but fat intake should be limited.
on the Efficacy and Safety of Protein Supplements for
US Armed Forces Personnel. They concluded that 1.5 Commandment five refers to the intake of dietary fat.
to 2g/kg body weight/day of protein (0.7−0.9g/lb/day) Limiting dietary fat to less than 30% of total calories is
would be more than adequate to maintain muscle mass, important for overall health and for reducing the risk of
strength, and performance during periods of substan- cardiovascular disease, heart attack, stroke, and many
tial metabolic demand and concomitant negative energy types of cancer. 40−43 However, one of the most important
balance. 36,37 This translates into 70 to 90g/day and 140 considerations is the type of fat. In the 1980s, limiting
to 180g/day of protein for a 100- and 200-lb person, re- the intake of saturated fatty acids (SFAs) was recom-
spectively. If metabolic demands are lower, such as dur- mended to the greatest extent possible, and although
ing periods of reduced physical training or operational this remains a key dietary recommendation to reduce
intensity, then protein intake should be within 0.8 to cardiovascular disease, the overall view has been chal-
1.8g/kg/day (0.4−0.8g/lb/day or 40−160g/day). Table 2 lenged for a number of reasons. trans–fatty acids were in
presents the protein content of various foods and shows many foods until they were found to be associated with
that 180g could easily come from a bagel, 6 oz chicken, cardiovascular disease and other health problems. 44,45
a cup of tuna salad, a burrito, a cup of cottage cheese, Although it is difficult to eliminate them totally from
yogurt, and some lentils and rice. the diet, and particularly from military rations, most
46
processed foods no longer contain significant amounts
Another important question is the amount of protein to of trans–fatty acids. Because of the concern about SFAs,
ingest in one snack or a meal. At present, the evidence is omega-6 fatty acids were used as a substitute for trans–
strong that protein in excess of about 25 to 30g at one fatty acids. 40,44,47

82 Journal of Special Operations Medicine Volume 14, Edition 3/Fall 2014