Page 54 - Journal of Special Operations Medicine - Winter 2015

duty assignment and medical situation. Though Special Proactive Component: Foundational Health
Operators are, indeed, athletes, they are not always “in- For Special Operators to perform optimally throughout
season” athletes; therefore, nutrition strategies must be their careers in assignments with varying levels of mental
modified accordingly. A comprehensive performance and physical requirements, they must be proactive and
nutrition program addresses specificity of performance place as much emphasis on foundational health as they
outcomes by focusing on individual Special Operator do on task-specific performance. This entails chronic
occupational and medical factors (Table 1).
disease prevention and immune system enhancement.
Comprehensive Performance Nutrition Chronic disease prevention
Program Concept In general, individuals can achieve short-term, task-spe-
Most organizational nutrition programs are focused cific performance goals despite the presence of chronic
on either prevention of chronic disease in the general disease risk factors or chronic conditions. For example, a
population or the medical treatment of illness or injury Special Operator’s elevated low-density lipoprotein cho-
of individual patients. Though these programs indepen- lesterol level can result in atherosclerosis and a higher
dently address the proactive and reactive components risk for heart disease, but, physiologically, it is very un-
of foundational health and medical treatment, respec- likely to decrease the amount of load he can carry or the
tively, they do not address the active component of accuracy of his shooting on any given day. The long-
performance outcomes of in-season athletes and opera- term consequence of dyslipidemia or the medications
tional SOF. By integrating the three components within to control it, however, can affect those abilities over
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the context of an organization’s culture and available time, or possibly contribute to a shortened career. The
resources (Figure 2), a unit’s nutrition program can fa- nutritional foundation established by a Special Opera-
cilitate SOF Operator performance throughout a 20- to tor’s usual intake, or “everyday diet,” can greatly reduce
30-year military career.
preventable future disability. In a systematic review of
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the peer-reviewed literature over more than 60 years,
Table 1 Ten Major Guidelines for an SOF Comprehensive
Performance Nutrition Program and one of the largest meta-analyses ever performed, the
intake of fish, unrefined plant-based foods, and tea were
1. Focus on individual Special Operator outcomes based reported to be protective against diet-related chronic
on occupational and medical factors.
disease (overweight/obesity, type 2 diabetes, and various
2. Support and promote foods and products shown to types of cardiovascular disease and cancer), whereas in-
prevent chronic disease and enhance the immune take of red and processed meats increased risk for these
system.
morbidities. These findings highlight the importance
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3. Base event fueling and recovery plans on event- and of the everyday diet to the longevity of Special Opera-
condition-specific factors.
tors. Special Operators can capitalize on these findings
4. Make body composition recommendations based on by consuming more unrefined whole-grain products,
service-specific standards, chronic disease prevention, fruits, vegetables, legumes, nuts, seeds, and fish, and
and optimal strength-to-weight ratio for task-specific less refined grains, full-fat dairy products, and red and
requirements relative to Special Operator individual
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factors. processed meats. Special Operators can influence the
availability of these food choices at dining facilities.
5. Optimize mental performance through hydration,
macronutrient distribution and timing, and appropriate By requesting, and choosing, these foods over less ben-
dietary supplements. eficial options, Special Operators provide justification
6. Use fluids, macronutrients, micronutrients, and dietary needed by food service managers to secure resources to
supplements, as warranted, to lessen detrimental effects consistently offer a performance-based menu.
of arduous environments.
7. Make unbiased dietary supplement recommendations Immune system enhancement
by balancing scientific evidence for health and Special Operators’ everyday diets can also enhance or
performance benefits with documented safety concerns. diminish their immune systems’ ability to protect against
8. Facilitate nutrition support throughout inpatient pathogens and facilitate recovery from combat- and
and outpatient treatment to the transition from training-related injuries. 9,10 Inflammation in response
rehabilitation to return to duty. to an acute injury is essential to healing, but chronic
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9. Address organizational culture and resources by inflammation has been implicated in chronic disease
providing education and services within the context and associated with daily diet. 12,13 Although there is a
of specific SOF cultures and financial and logistical lack of published data revealing a direct link between
constraints.
specific foods and an acute inflammation response to
10. Use dining facilities as a model of excellence and as a insult, the biochemical fate of dietary fats as either pro-
hands-on educational experience. inflammatory or anti-inflammatory immune mediators

42 Journal of Special Operations Medicine Volume 15, Edition 4/Winter 2015