Page 105 - Journal of Special Operations Medicine - Winter 2015

attenuated endogenous protein loss. Efforts to optimize intake is sufficient, healthy people could consume up
field feeding and emphasize the physiologic importance to three times the RDA for protein without disrupting
of nutrition during metabolically demanding military calcium retention and overall bone health. 51,52 Unfortu-
operations are certainly required. An evidence-based nately, the failure for some to recognize recent scientific
reconsideration of the type and amount of protein, car- advances only increases confusion and perpetuates mis-
bohydrate, and fat, and the distribution of those nutri- conceptions about protein.
ents across shelf-stable, palatable combat rations is also
needed because the current “one size fits all” approach Conclusion
to field feeding does not appear to be adequate.
Protein requirements for military personnel are condition
specific (e.g., garrison versus training and combat opera-
Common Misconceptions About Dietary Protein
tions). Protein requirements for SOF differ from the gen-
Highly active people, to include SOF operators with phys- eral population only in terms of the strenuous physical
ically demanding occupations, often want to consume demands and when sufficient food is not available. The
high amounts of protein (more than than 2.0g/kg BM) muscle-sparing advantages of consuming high-protein
because they believe that “more” translates into “big- diets should be considered during periods of increased
ger” muscles and improved performance. 8,9,43 These SOF metabolic demand and subsequent energy deficits to ac-
Soldiers base their beliefs on information obtained from celerate recovery and maintain muscle mass during SOF
magazines, friends, or fellow operators, and not always missions. Importantly, increasing protein intake should
on evidence-based recommendations from healthcare not come at the expense of other nutrients. Finally, efforts
providers and/or dietitians familiar with performance nu- to develop evidence-based nutritional strategies that pro-
trition recommendations. 8,43 These beliefs are not exclu- mote sufficient protein, carbohydrate, and fat intake to
sive to SOF and are similar to those of athletes and avid sustain performance during SOF missions should be pri-
exercisers. Some occasions require the consumption of oritized. For additional information, refer to http://hprc
44
diets higher in protein, particularly during military opera- -online.org/nutrition/files/ProteinRequirementsTable.pdf.
tions, but the majority of military-age individuals con-
sume well above the RDA for protein. Most people who Disclaimer
consume sufficient energy and maintain a recreationally
active lifestyle have no need to increase protein intake or The opinions or assertions contained herein are the pri-
use supplemental protein. Education regarding the conse- vate views of the authors and are not be construed as
quences of overconsuming energy providing nutrients— official or as reflecting the views of the Army or Depart-
carbohydrate, fat, protein, and alcohol—or favoring one ment of Defense. Any citations of commercial organiza-
over another is critical to maintain body weight, body tions and trade names in this report do not constitute
composition, and nutritional fitness. an official Department of the Army endorsement of ap-
proval or approval of the products or services of these
Diminished kidney function is, perhaps, the most com- organizations.
monly cited health-related concern associated with
high-protein diets. Increasing dietary protein intake will Disclosure
likely increase the amount of work the kidneys have to
do to eliminate the waste products of protein metabo- The authors have no financial relationships or conflicts
lism (e.g., ammonia and urea nitrogen), and elimination to disclose.
of these waste products does require sufficient water or
other fluid intake. This is certainly problematic for re-
nal-compromised individuals but no evidence indicates References
that high protein diets (e.g., two to three times the RDA) 1. Food and Nutrition Board, Institute of Medicine. Dietary ref-
diminish renal function in healthy people. 45–48 Some con- erence intakes for energy, carbohydrate, fiber, fat, fatty acids,
cern also exists that higher-protein diets may be detri- cholesterol, protein, and amino acids. Washington, DC: The
mental to bone because calcium excretion is increased National Academies Press; 2005.
when consuming a high, relative to a low, protein diet. 2. Pasiakos SM, Austin KG, Lieberman HR, et al. Efficacy and
safety of protein supplements for U.S. Armed Forces personnel:
This effect is thought to originate from bone in an at- consensus statement. J Nutr. 2013;143:1811S–1814S.
tempt to buffer the metabolic acidity of protein catabo- 3. Pasiakos SM, Margolis LM, Orr JS. Optimized dietary strate-
lism. 49,50 However, higher-protein diets actually increase gies to protect skeletal muscle mass during periods of unavoid-
intestinal calcium absorption, which suggests that the able energy deficit. FASEB J. 2015;29:1136–1142.
increase in calcium excretion secondary to consuming 4. Pasiakos SM, Lieberman HR, Fulgoni VL 3rd. Higher- protein
diets are associated with higher HDL cholesterol and lower
more protein is a result of dietary calcium intake and BMI and waist circumference in US adults. J Nutr. 2015;145:
not of calcium release from bone. Assuming calcium 605–614.

US Military Dietary Protein Recommendations 93