Page 114 - JSOM Winter 2017

Table 3 Dietary Intake and Conformance to International Recommendations During Selected ITC Training Phases
SERE Academic SERE Field
c
c
Dietary Component ACSM a AR 40-25 b n = 10 n = 10 RS, n = 14 CQB, n = 10 DB, n = 13
Total, g
Carbohydrate — 510 425 ± 63 d 48 ± 0.0 294 ± 65 d,e 316 ± 54 d,e 319 ± 55 d,e
Protein — 102 149 ± 29 d,f 15 ± 0.0 76 ± 29 d 145 ± 25 d,f 131 ± 25 d,f
Fat — <113 142 ± 26 d 10 ± 0.0 103 ± 27 d,e 101 ± 23 d,e 100 ± 24 d,e
Relative, g/kg
Carbohydrate 5–10 4–8 5.1 ± 1.0 d 0.6 ± 0.1 3.6 ± 1.0 d,e 3.6 ± 1.0 d,e 3.7 ± 1.0 d,e
Protein 1.2–2.0 0.8–1.6 1.8 ± 0.3 d,f 0.2 ± 0.0 0.9 ± 0.4 d 1.7 ± 0.3 d,f 1.5 ± 0.3 d,f
Fat — — 1.7 ± 0.3 d 0.1 ± 0.0 1.3 ± 0.3 d,e 1.2 ± 0.3 d,e 1.2 ± 0.3 d,e
Total energy, %
Carbohydrate — 50–55 48.0 ± 5.0 56 ± 0.0 49.4 ± 5.1 44.8 ± 4.3 d 49.5 ± 4.4 g
Protein — 10–35 17.1 ± 3.7 f,g 17 ± 0.0 12.4 ± 3.9 22.1 ± 3.3 f 19.4 ± 3.5 f
Fat <30 <30 35.1 ± 4.2 d 27 ± 0.0 38.2 ± 4.4 d 32.5 ± 3.7 f 31.3 ± 3.8 f
Data given as mean ± standard deviation. ACSM, American College of Sports Medicine; AR, Army Regulation; CQB, Close-Quarters Battle; DB,
Derna Bridge; RS, Raider Spirit; SERE, Survival, Evasion, Resistance, and Escape.
a Recommendations are from the ACSM’s 2016 Joint Position Stand (ACSM, Academy of Nutrition and Dietetics, and Dietitians of Canada) on
Nutrition and Athletic Performance. Carbohydrate relative intake range reflects recommendations for moderate to increased training. 14
b Medical Services Nutrition and Menu Standards for Human Performance Optimization. Recommendations based on a reference male body
mass of 85kg. 13
c n = 10 for both SERE academic and SERE field.
d Different from SERE field, p < .05.
e Different from SERE academic, p < .05.
f Different from RS, p < .05.
g Different from CQB, p < .05.

Table 4 Changes in Healthy Eating Index-2010 Score Before and After ITC
a
Food Reference Max Score Before ITC After ITC Δ HEI p Value
Total vegetables 5 3.5 ± 1.3 2.9 ± 1.3 −0.6 ± 1.3 .07
Greens and beans 5 3.3 ± 1.7 2.6 ± 1.7 b −0.7 ± 1.4 .05
Total fruit 5 3.4 ± 1.6 2.8 ± 1.3 −0.6 ± 1.9 .20
Whole fruit 5 3.8 ± 1.5 3.5 ±1.4 −0.4 ± 1.7 .38
Whole grains 10 4.6 ± 1.8 4.0 ± 2.7 −0.6 ± 2.2 .23
Dairy 10 6.8 ± 2.4 6.6 ± .2.3 −0.2 ± 2.4 .69
Total protein foods 5 4.6 ± .65 4.6 ± .62 0.1 ± .41 .54
Seafood and plant protein 5 4.1 ± 1.2 4.1 ± 1.3 0.0 ± 1.7 .98
Fatty acid ratio 10 4.8 ± 2.5 4.3 ± 2.0 −0.5 ± 2.4 .33
Sodium 10 3.6 ± 2.5 4.7 ± 2.1 1.0 ± 2.6 .09
Refined grains 10 8.9 ± 1.6 8.7 ± 1.5 −0.2 ± 2.2 .69
Empty calories 20 14.2 ± 3.4 12.1 ± 4.1 b −2.1 ± 2.5 .00
Total score 100 65.6 ± 11.2 60.9 ± 9.7 a −4.7 ± 7.5 .01
Data given as mean ± standard deviation (n = 20). ITC, Individual Training Course.
a The HEI-2010 comprises 12 components, nine adequacy components, and three moderation components. The adequacy components include
total fruit, whole fruit, total vegetables, greens and beans, whole grains, diary, total protein foods, seafood and plant proteins, and fatty acids;
moderation components include refined grains, sodium, and empty calories. Whole fruit includes all forms except juice, which is included in total
fruit. Total vegetables and greens and beans include any beans and greens not counted as total protein foods. However, beans and greens are
included within the total protein foods and seafood and plant protein components when those standards are not otherwise met. Plant proteins
include nuts, seeds, and soy products (excluding beverages), and beans and greens are counted as total protein foods. The empty calories compo-
nent is made up of calories from solid fats, alcohol, and added sugars. The threshold for counting alcohol is >13g per 1,000 calories.
b Different from before the ITC, p < .05.

exposes students to a variety of extreme mental and physical were able to purchase their own food in the local economy.
stressors, including near-complete starvation (i.e., approxi- During DB, the Marines were able to consume enough of their
mately 350kcal/d) during the evasion and captivity to train daily allotment of combat rations (two MREs), food from the
survivability and coping strategies while hungry. RS is the local dining facility, and convenience food items purchased in
most physically demanding phase of ITC; TDEE was 165% the local economy to limit the total daily energy deficit (i.e.,
higher than EI because only two combat rations (MREs, ap- <40% of TDEE) and attenuate body mass loss.
proximately 2,600kcal/d) were provided per day during RS.
For students to achieve energy balance, they would have had to Macronutrient intake during the four training phases was
receive five MREs per day and consume them in their entirety largely consistent with military and sports nutrition recom-
to match TDEE. EI during CQB more closely matched TDEE, mendations, 14,15 except during the field phase of SERE and
and body mass was maintained when Marines had access to during RS. It is important to recognize, however, that food
breakfast, lunch, and dinner at the local dining facility and availability was intentionally limited during the field phase

112 | JSOM Volume 17, Edition 4/Winter 2017