Page 58 - Journal of Special Operations Medicine - Winter 2015

specific situations outlined in position papers and fact are able to adapt. 61,66 Special Operators should weigh
sheets from organizations such as the Academy of Nu- themselves before and after training in various environ-
trition and Dietetics (AND), American College of Sports mental conditions to determine individual sweat rates.
Medicine (ACSM), US Olympic Committee (USOC), Based on this information, Special Operators should
US Army Research Institute of Environmental Medi- monitor fluid intake and strive to minimize sweat losses
cine (USARIEM) and other organizations that provide to less than 3% body mass loss. Medical providers
evidence-based resources. should incorporate pre- and post-event weighing and
urine specific-gravity assessments into training evolu-
Body composition tions, as feasible, to educate Special Operators on indi-
As in sport, optimal strength to weight ratio is also an vidual associations between fluid intake and hydration
important consideration in SOF task-specific perfor- status.
mance success. 50–53 Optimal body composition differs for
athletes playing different positions within the same sport. Of the macronutrients, carbohydrate appears to have
Similarly, the optimal fat-free to fat-mass ratios for Spe- the greatest effect on cognitive performance, particularly
cial Operators differ depending upon their primary and on demanding mental tasks during physical activity.
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secondary mission roles. Special Operators’ service-spe- Nutrient timing, the consumption of macronutrients,
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cific standards, chronic disease risk, individual illness and and, particularly, the intake of carbohydrate at regu-
injury patterns, body composition history, race/ethnic- lar intervals 70,71 have been shown to enhance cognitive
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ity, and specific mission requirements are considered performance. A relatively new area of research has
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when determining their most effective task-specific body examined the effects of omega-3 fish oils on cognitive
compositions. It is important to remember that in human performance, with one study reporting significant im-
performance optimization, a Special Operator’s body fat provement in neuromotor function and potential benefit
percentage has little significance until it is associated with for activities where decision making and complex reac-
desired physical performance outcomes, low incidence of tion time and efficiency are important. Special Opera-
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injury and illness, and sustainable lifestyle factors. Special tors should consume small meals or snacks containing
Operators and medical providers should set sustainable, carbohydrates at regular intervals during training and
individual body composition goals on health, injury pre- operations, as feasible.
vention, and task-specific performance.
Manufacturers market many micronutrients and di-
Mental function etary supplement ingredients as cognitive performance
To function optimally in dynamic life-threatening envi- enhancers; however, researchers have not been able to
ronments and to successfully complete their missions, document consistent benefits to cognitive performance
Special Operators must process multiple sources of in- with multivitamin-, mineral-, or botanical-containing
formation, adapt quickly to unpredictable situations, supplements in the absence of a deficiency. Data from
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and make rapid and effective decisions. Language, recently published studies have shown that 72% of mili-
learning, memory, attention, perception, reasoning, tary personnel reported consuming an energy drink or
conceptual development, and decision making are men- shot, primarily for cognitive enhancement, within the
tal functions integral to SOF tasks. Although hydration, last 30 days of completing the study questionnaire. A
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macronutrient distribution, nutrient timing, and dietary group within SOF has been shown to consume an ergo-
supplements have the potential to affect mental func- genic dose of caffeine daily. Though additional caffeine
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tion, the inconsistencies of study methodologies make has been shown to exert ergogenic effects in both nonus-
clear associations in healthy, young adults difficult to ers and habitual users, a more strategic use of caffeine
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identify. 58–60 One area with a higher incidence of agree- may reduce sleep disturbances and daytime sleepiness
ment, however, is the dose-dependent detrimental effects typically associated with high daily caffeine intake from
of dehydration on mental function. In studies of cog- energy drinks. Though some data support cognitive
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nitive-motor performance, dehydration based on fluid enhancement with energy drink use, other results indi-
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body-mass loss has been defined as mild (<3%), mod- cate that caffeine and carbohydrates are the ingredients
erate (3%–5%), and severe (>5%). Although severe responsible for most of these benefits. 79,80 Since caffeine
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dehydration can lead to global mental status and perfor- has consistently been shown to improve both physical
mance deficits, mild to moderate dehydration has also and cognitive performance without detrimental side ef-
been shown to have significant effects on performance fects when used in moderate doses, independent intake
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and cognitive tasks, particularly when accompanied by of caffeine and carbohydrate, dosed for body mass, may
activity or heat stress. 62–65 Insignificant effects on cogni- be more desirable than energy drinks with multiple, less
tive function have been reported for slowly progressive, rigorously studied, and sometimes unknown, ingredi-
mild to moderate dehydration through fluid restriction ents. Special Operators should substitute energy drinks
and without heat stress in young healthy subjects who for purer forms of caffeine and carbohydrates based

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