Page 115 - JSOM Winter 2017

of SERE and throughout RS. More specifically, students were Disclaimer
only provided two MREs during RS, resulting in protein in- This study was approved by the Institutional Review Board at
takes 40% to 55% below recommendations necessary to spare the US Army Research Institute of Environmental Medicine.
lean mass with underfeeding. 14,15 With the exception of the The opinions or assertions contained herein are the private
academic phase of SERE, carbohydrate intakes were consis- views of the authors and are not to be construed as official
tently approximately 30% to 50% below necessary levels to or as reflecting the views of the Army or the Department of
sustain endurance-type performance (5–7g/kg). The undercon- Defense. Any citations of commercial organizations and trade
sumption of protein and, in particular, carbohydrate during names in this report do not constitute an official Department
strenuous training may represent an opportunity to educate of the Army endorsement of approval of the products or ser-
SOF personnel about the consequences of underfeeding during vices of these organizations.
actual combat operations, and to provide simple, nontechnical
mitigation strategies to enhance field feeding. For example, if Disclosure
military personnel simply eat more of the foods they are pro- The authors declare no conflicts of interest.
vided during short-term training, they are able to attenuate the
severity of the energy deficit, spare whole-body protein mass, Author Contributions
6
and meet dietary protein recommendations for military opera- S.M.P. designed the research; all authors performed the re-
tions and carbohydrate recommendations by the American search, analyzed the data, wrote the manuscript, and approved
14
College of Sports Medicine, the Academy of Nutrition and the final version.
Dietetics, and the Dietitians of Canada to maintain optimal
performance. 15 References
1. Margolis LM, et al. Energy balance and body composition dur-
HEI score (i.e., diet quality) at the start of ITC (65.6 ± 11.2) ing US Army special forces training. Appl Physiol Nutr Metab.
was 22% higher than that of similarly aged civilians (approxi- 2013;38(4):396–400.
mately 54). HEI scores at the start of ITC were also much 2. Tharion WJ, et al. Adequacy of garrison feeding for Special
16
Forces soldiers during training. Mil Med. 2004;169(6):483–490.
higher than those of US Army recruits at the start of basic 3. Tharion WJ, et al. Energy requirements of military personnel. Ap-
combat training (approximately 47). However, HEI scores petite. 2005;44(1):47–65.
17
were approximately 7% lower after completing ITC, largely 4. Margolis LM, et al. Energy requirements of US Army Special
because Marines ate lower amounts of greens or beans and Operation Forces during military training. Nutrients. 2014;6(5):
more empty calories during ITC. A contributing factor may 1945–1955.
have been availability of dining-hall foods, because Marines 5. Castellani JW, et al. Energy expenditure in men and women dur-
ing 54 h of exercise and caloric deprivation. Med Sci Sports Ex-
had very limited time to eat and no restrictions on outside erc. 2006;38(5):894–900.
foods. Likewise, during DB, the students could purchase con- 6. Margolis LM, et al. Effects of Supplemental Energy on Protein
venience food items through the local economy and often Balance during 4-d Arctic Military Training. Med Sci Sports Ex-
chose with foods with poor nutritional value, including alco- erc. 2016;48(8):1604–1612.
hol, which is not controlled or prohibited during ITC, with 7. Margolis LM, et al. Effects of winter military training on energy
the exception of specific training phases (e.g., SERE, RS, DB). balance, whole-body protein balance, muscle damage, soreness,
These factors likely contributed to the small but statistically and physical performance. Appl Physiol Nutr Metab. 2014; 39
(12):1395–1401.
significant decline in HEI score. Whether consuming more 8. Block G, et al. A data-based approach to diet questionnaire de-
empty calories at the expense of healthier food choices persists sign and testing. Am J Epidemiol. 1986;124(3):453–469.
and negatively impacts health and performance of Marines af- 9. Block G, et al. Validation of a self-administered diet history ques-
ter graduating ITC is not known. tionnaire using multiple diet records. J Clin Epidemiol. 1990;43
(12):1327–1335.
10. Guenther PM, et al. Development of the Healthy Eating In-
In conclusion, the nutritional stress imposed on Marines dur- dex-2005. J Am Diet Assoc. 2008;108(11):1896–1901.
ing MARSOC ITC was similar to that of other SOF programs. 11. Guenther PM, et al. Evaluation of the Healthy Eating Index-2005.
Although undereating led to body mass loss during some train- J Am Diet Assoc. 2008;108(11):1854–1864.
ing phases, on average, it was fully restored between phases, 12. Guenther P, et al. Development and evaluation of the Healthy
and students, on average, graduated ITC at the same body Eating Index-2005: Technical Report. Alexandria, VA: Center for
mass as when they started. HEI scores declined during ITC, Nutrition Policy and Promotion, US Dept of Agriculture: 2007.
and when access to food was intentionally limited, particularly 13. Army Regulation 40-25, Medical Services Nutrition and Menu
Standards for Human Performance Optimization. Washington,
during RS, dietary protein and carbohydrate intake were well DC: US Dept of the Army; February 2017.
below recommendations. Education regarding the importance 14. Pasiakos SM, et al. Efficacy and safety of protein supplements for
of maintaining healthy eating patterns while in garrison, and U.S. Armed Forces personnel: consensus statement. J Nutr. 2013;
consuming sufficient carbohydrate and protein during strenu- 143(11):1811S–1814S.
ous training exercises may be warranted. 15. Thomas DT, et al. American College of Sports Medicine joint
position statement. Nutrition and athletic performance. Med Sci
Sports Exerc. 2016;48(3):543–568.
Acknowledgments 16. Ervin RB. Healthy Eating Index: 2005 total and component
We acknowledge the Marine volunteers who participated in scores for adults aged 20 and over: National Health and Nu-
this study and the US Marine Corps Forces Special Operations trition Examination Survey. 2003–2004. Natl Health Stat Rep.
Command and Staff for providing support and access to the 2011;(44):1–9.
training events. 17. Lutz LJ. Assessment of dietary intake using the healthy eating in-
dex during military training. US Army Med Dept J. 2013:91–97.
Funding
Supported by the US Army Medical Research and Materiel
Command.

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