Diet and Military

Zwilling et. al (2020) declares the critical demand for interventions to enhance human physical fitness and cognitive performance to enable Airmen in particular, who operate under extreme physical and cognitive pressure, to remain resilient and perform well during missions. A twelve-week randomised controlled trial was conducted on 148 active-duty Air Force Airmen to compare the efficacy of a multimodal intervention that consisted of high-intensity interval aerobic fitness and strength training coupled with a novel nutritional supplement [containing β-hydroxy β-methylbutyrate (HMB), lutein, phospholipids, DHA and selected micronutrients including B12 and folic acid] with another program of high-intensity interval aerobic fitness and strength training paired with a standard placebo drink. The study found the exercise program alone improved several physical fitness attributes: strength and endurance (+8.3%); power (+0.85%); mobility and stability (+22%); heart rate (-1.1%); lean muscle mass (+1.4%). Plus, enhancements in cognitive function were observed with regards to processing efficacy (+7.5%), episodic memory (+9.5%), fluid intelligence accuracy (+19.5%) and executive function reaction time (-4.8%). The addition of the nutritional supplement to the fitness regime further boosted the Airmen’s physical fitness and cognitive performance, indicated by the bettering of working memory by 9%, processing efficiency by 1.8%, lean muscle mass by 1.5%, as well as the reductions in fluid intelligence reaction time by 7.7% and heart rate by 2.4%. This study found the multimodal intervention incorporating aerobic fitness and strength training with a novel nutritional supplement to be effective in enhancing military performance and in providing optimal exercise training and nutritional support for the modern warfighter. [NPID: military, cognition, working memory, memory, reaction time, nutritional support]

Marriott et al. (2019) explain the designs and methods of the Ranger Resilience and Improved Performance on Phospholipid bound Omega-3's (RRIPP-3) study - a double-blind randomized controlled trial that tested omega-3 highly unsaturated fatty acids (HUFAs) along with krill oil supplementation in individuals undertaking the United States (US) Army Infantry Basic Officer Leaders Course (IBOLC). Omega-3 HUFAs are essential for neural function, normative neurodevelopment, neurotransmitter, and neural immune functions, already proven in observational studies and randomized controlled trials. But as dietary supplements, omega-3 HUFAs such as fish and krill oils differ substantially in their physicochemical properties and nutrient content from the omega-3 HUFAs obtained through diet. In the RRIPP-3 study, the impact of adding the krill oil with the omega-3 HUFAs on cognitive functioning was compared to placebo, in order to determine whether the krill oil supplementation can improve critical cognitive aspects required for success in the battlefield. Basic advancements were observed in the participants’ IBOLC performances following supplementation with HUFAs and krill oil. [NPID: military, performance, omega-3s, fatty acids, HUFAs, krill oil, neural function, neurodevelopment, neurotransmitter function, immunity, the immune system]

This 2014 review summarizes the relationship vitamin D has with physical and cognitive performance in relation to the needs of military personnel. Deficiencies in vitamin D, which are widespread across the U.S. population and expected to be prevalent in Servicemembers, may be connected to increased risk for muscle or bone injury, muscle weakness, reduced neuromuscular function, cognitive decline, depression, longer recovery times following mild traumatic brain injury (mTBI). Although vitamin D status has not been assessed after mTBI, veterans with traumatic brain injuries also experience chronic endocrine dysfunction, indicating vitamin D deficiency could possibly raise the risk for endocrine dysfunction. Since a relationship between vitamin D status and testosterone levels has been previously identified, and the concentrations of this hormone are low in veterans with posttraumatic stress disorder (PTSD), it has been suggested poor vitamin D status also enhances risk for PTSD. Wentz et al. (2014) makes it clear vitamin D status has a significant impact on Operator health and performance, and therefore supports vitamin D supplementation since the intervention required would be noninvasive and low-cost and would help maintain the Operators’ combat strength. [NPID: military, vitamin D, performance, neuromuscular function, cognition, depression, recovery, brain injury, endocrine dysfunction, testosterone, PTSD, strength]

Hibbeln & Gow (2014) evaluated the effectiveness of nutrients in the military diet in reducing risk of or to treat psychiatric distress, particularly focusing on highly unsaturated essential fatty acids. The increase in omega-6 that accompanies lower fish consumption has been related to greater risk of clinical depressive symptoms while one meta-analysis provided moderate to strong evidence that elevated levels of omega-3 highly unsaturated fatty acids (HUFAs) (eicosapentaenoic acid, docosapentaenoic acid, and docosahexaenoic acid) are associated with decreased risk of clinical depressions. Support also arrived from other meta-analytic reviews of randomized placebo-controlled trials that showed moderate to strong evidence that depressive symptoms improved after subjects consumed a formulation with over 50% eicosapentaenoic acid. There is also modest proof of omega-3 HUFAs’ effectiveness in treating attention-deficit hyperactivity disorder. Hibbeln & Gow (2014) recommended a rebalancing of the essential fatty acid composition of U.S. military diets to help reduce military psychiatric distress and simultaneously increase force efficacy considerably. Since several meta-analyses have indicated that Mediterranean diet patterns lowers depression risk, it may be advisable to aim for tissue compositions of HUFAs consistent with traditional Mediterranean diets. [NPID: military, psychiatric distress, fatty acids, omega-6s, omega-3s, fish, depression, HUFAs, EPA, DHA, ADHD, Mediterranean diet, Med diet]

In this 2018 study, military spouses were evaluated on their barriers to health behaviors using surveys and focus group sessions. Participating in health behaviors such as physical activity and healthy eating may have a positive impact on spouses' physical and mental health, but research into spouses’ behaviors was limited. Subjects taking part in the surveys (n=230) indicated up to 3 of their most frequent barriers to physical activity, diet, social connection, and stress management, while the 22 people who participated in the focus groups allowed the researchers to gain a greater understanding of the challenges military spouses face when trying to maintain a healthy lifestyle. The surveys revealed lack of time was the most prevalent barrier for physical activity, social connection, and stress management, and the second most prevalent barrier for diet. Financial concern was voted most often as a barrier to maintaining a healthy diet, while obstacles related to parent/family responsibilities were also commonly reported across all health behaviors. During the focus group sessions, the transient military lifestyle was found to have a significant impact on all of the health behaviors, while deployments and the necessity to "do it all" alone were also discussed by the spouses and could be a contributor. Interestingly, many of the subjects had rigid definitions of what “counts” as exercise and healthy eating. Generally, the sample population sacrificed participating in health habits to attend other priorities. Although some of the barriers reported here were similar to barriers reported by civilians, this study uncovered unique stressors associated with military life that further impeded participation in health behaviors. [NPID: military, military spouses, social connection, stress management]

Varanoske et al. (2021) reveal that β-alanine (BA) supplementation has demonstrated its ability to enhance cognition, mitigate symptoms of anxiety and depression associated with aging, and positively influence mood and physical performance during military operations. But it is not yet known whether beta-alanine can reduce mood fluctuations and cognitive dysfunction connected to the anticipatory stress before the person has experienced simulated military operations. This study therefore enrolled healthy males with limited inflammation and oxidative stress and randomized the participants to either receive BA or placebo for 14 days before undertaking a 24-hour simulated military operation. The subjects’ cognitive function, mood, and circulating brain-derived neurotrophic factor (BDNF; increase correlates with aging, neurological disorders, and physical exertion) before and after supplementation. The results showed that cognitive function and BDNF concentrations were not significantly affected, but the BA supplementation group reported reduced feelings of depression. Whereas the placebo group felt less vigor. It was concluded that β-alanine given at high dose and for a short period of time may reduce the onset of negative mood states in healthy males prior to a simulated military operation. [NPID: military, β-alanine, BA, cognition, anxiety, depression, aging, mood, performance, military operations, inflammation, oxidative stress, BDNF, brain-derived neurotrophic factor, neurological disorders, physical exertion]