Page 57 - Journal of Special Operations Medicine - Winter 2015

Table 2 Practical Nutrition Recommendations for Table 3 Practical Nutrition Recommendations for
SOF Medical Providers Special Operators
1. Actively support unit food service performance-based 1. Be realistic and adjust the focus of daily nutrition to
menu standards and performance nutrition initiatives. actual goals for current duty assignment and medical
situation.
2. Use Human Performance Resource Center material to
evaluate the safety and efficacy of dietary supplements 2. Consume more whole foods in the form of unrefined
through Operation Supplement Safety and the Natural grains, a variety of deeply colored fruits and
Medicines Comprehensive Database, and assess dietary vegetables, legumes, nuts, seeds, lean proteins, and
supplement purity through third-party verification omega-3 rich fishes, and less refined grains, full-fat
entities. dairy products, and red and processed meats.
3. Report all dietary supplement-associated adverse events 3. When consumption of dietary sources of omega-3 fatty
through Natural Medicines Watch, accessed through the acids are not feasible, supplement with no more than
Human Performance Resource Center. 2g EPA/DHA per day.
4. Use recommendations for specific event fueling and 4. Influence the availability of performance-based menu
recovery situations outlined in position papers and food choices at dining facilities by requesting, and
fact sheets from organizations such as the Academy choosing, performance-based foods over less beneficial
of Nutrition and Dietetics (AND), American College options.
of Sports Medicine (ACSM), US Olympic Committee 5. Use Human Performance Resource Center material to
(USOC), US Army Research Institute of Environmental evaluate the safety and efficacy of dietary supplements
Medicine (USARIEM) and other organizations that through Operation Supplement Safety and the
provide evidence-based resources.
Natural Medicines Comprehensive Database, and to
5. Set sustainable, individual body composition goals on assess dietary supplement purity through third-party
health, injury prevention, and task-specific performance. verification entities.
6. Incorporate pre- and post-event weighing and urine 6. Report all suspected dietary supplement adverse events
specific gravity assessments into training evolutions, through Natural Medicines Watch, accessed through
where feasible, to educate Special Operators on the Human Performance Resource Center.
individual associations between fluid intake and 7. Use recommendations for specific event fueling
hydration status.
and recovery situations outlined in position papers
7. Test for serum ferritin in Special Operators 8–10 weeks and fact sheets from organizations such as the
prior to training or missions occurring at or above Academy of Nutrition and Dietetics (AND),
moderate altitude. Refer for nutrition counseling and American College of Sports Medicine (ACSM),
prescribe iron supplementation as indicated by test results. US Olympic Committee (USOC), US Army Research
Institute of Environmental Medicine (USARIEM)
8. Screen for vitamin D deficiency or insufficiency by and other organizations that provide evidence-based
testing 25-hydroxyvitamin D levels and recommend resources.
schedule adjustments to accommodate increased sun 8. Set sustainable body composition goals on health,
exposure, provide a referral for nutrition counseling, injury prevention, and task-specific performance.
and/or prescribe supplemental vitamin D3 as indicated
by test results. 9. Check body weight before and after training in various
environmental conditions to determine individual
9. Request clinical nutrition support and refer for nutrition sweat rates. Monitor fluid intake and strive to
counseling as early as possible for all clinical conditions minimize sweat losses to less than 3% body mass loss.
and rehabilitation with nutrition and body composition
implications. 10. Consume small meals or snacks containing
carbohydrates and protein at regular intervals during
training and operations as feasible.
the impact of nutrient timing on physical performance. 11. Substitute energy drinks for purer forms of caffeine
Although not an all-inclusive list, factors such as usual and carbohydrates based on body weight, as outlined
macronutrient intake (i.e., carbohydrate, protein, and in position papers and fact sheets disseminated
fat), time lapse between macronutrient intake and com- by AND, ACSM, USOC, USARIEM, and other
mencement of physical activity, event duration and in- organizations that provide evidence-based resources.
tensity, environmental conditions, logistical availability 12. Monitor responses and sensitivities to caffeine intake
of macronutrients, individual gut tolerance, personal to minimize sleep disturbances.
taste preference, duration of fueling strategy, and body 13. Refrain from low carbohydrate diets in the
composition goals impact performance and must be weeks prior to training or missions occurring above
considered when choosing pre-event, during, and post- moderate altitude and consume adequate calories with
event fueling and recovery nutrition strategies. 47–49 Such a focus on carbohydrate- and protein-rich foods while
at altitude.
a wide variety of factors make short-term all-inclusive
recommendations inadequate and potentially harm- 14. Seek nutrition counseling for wound healing, delayed
rehabilitation outcomes, and unintentional body
ful to long-term performance goals. Special Operators composition changes related to recovery.
and medical providers should use recommendations for

Comprehensive Performance Nutrition for SOF 45