Diet and Military
The CNP Diet and Military Research Category consolidates research exploring the interdependent relationship between dietary intake and the military. To view each original study on the open internet, click “Original.” To view the CNP-written abstract summary, click “CNP Summary.” While only some of the CNP-written abstract summaries are available below for free, all abstract summaries are available to CNP members through the CNP Library Membership.
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%).
2023
The association between a priori dietary patterns and psychological disorders in military personnel
According to studies, military jobs have a high prevalence of mental health problems like stress, anxiety, and depression. One of the possible risk factors for mental illnesses is poor diet. This study by Parastouei, Rostami, & Chambari (2023) sought to determine whether a priori dietary patterns, such as the Mediterranean diet (MD), Dietary Approach to Stop Hypertension (DASH), the Dietary Inflammatory Index (DII), and the Healthy Eating Index-2015 (HEI-2015), were related to the likelihood of depression, anxiety, and stress in military personnel. 400 military personnel (30 to 60 years old, mean age = 38.67 ± 5.22) participated in this cross-sectional research. Using a 168-item food frequency questionnaire (FFQ), the subjects' dietary consumption and conformance to the DASH, MD, DII, and HEI-2015 were assessed. Using the Depression, Anxiety, and Stress Scale (DASS-21), mental wellness was evaluated. Analysis of the results showed that stress, anxiety, and depression were all fairly common – at 64.5%, 63.2%, and 61.3%, respectively. Higher adherence to DII was associated with a 2.74-fold greater risk of anxiety, whereas individuals with the highest adherence to HEI-2015 were substantially at reduced odds of anxiety. Quartile 2 of the HEI-2015 was linked to lower chances of stress compared to those with the lowest attendance (quartile 10. Finally, dietary habits and depression were not found to be related. The authors conclude that lower chances of anxiety in military personnel are linked with higher HEI-2015 adherence and lower adherence to DII. [NPID: Dietary pattern, mental health, military]
CNP Research Summary can be found in the CNP Library Membership
2022
The effect of the low glutamate diet on the reduction of psychiatric symptoms in veterans with Gulf War Illness: A pilot randomized-controlled trial
A diet that is deficient in glutamate was observed to enhance micronutrient metabolism and ameliorate dietary excitotoxins, which protect the body from glutamatergic excitotoxicity. Brandley et al. (2022) aimed in their pilot study (double-blind, randomized, placebo-control crossover design) to investigate how a low glutamate diet affects post-traumatic stress disorder (PTSD), anxiety, and depression in a population of 40 veterans who suffer from Gulf War Illness (GWI). The participants adhered to a low glutamate diet and submitted psychiatric questionnaires at the start of the study and after one month. They were later divided into two groups, receiving either a placebo or a monosodium glutamate challenge (MSG, an excitotoxin found in diet) for three days per week, with evaluations conducted on the third intervention day. Analysis of the results revealed a substantial improvement in the severity of psychological symptoms, which was most profound in participants with severe symptoms, after adhering to a low glutamate diet for one month compared to the start of the experiment. Administration of the MSG challenge did not substantially impact PTSD or depression, however, it led to exacerbating anxiety symptoms in participants suffering from severe symptoms at baseline. The authors comment that their results provide evidence that adopting a low-glutamate diet could present a new intervention to manage depression, PTSD, and anxiety in GWI patients. However, to discern whether nutrient intake helps ameliorate the negative impact of glutamate exposure or whether anxiety may be directly caused by glutamate, more clinical trials with a larger population of participants is necessary, which would serve to confirm the results observed, in addition to investigating how increasing the dietary consumption of micronutrients could influence depression, anxiety, and PTSD. [NPID: GWI, PTSD, anxiety, depression, diet, glutamate, intervention]
2021
Effects of high-dose, short-duration β-Alanine supplementation on cognitive function, mood, and circulating Brain-Derived Neurotropic Factor (BDNF) in recreationally-active males before simulated military operational stress
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]
CNP Research Summary can be found in the CNP Library Membership
2020
Dietary assessment methods in military and veteran populations: A scoping review
The purposes of this 2020 review were to firstly determine what is known about the assessment and reporting of dietary intakes within both military and veteran populations and secondly, to find out if studies reporting on the dietary consumption of military personnel/veterans include comparisons with dietary guidelines. Six databases were searched to discover a total of 89 observational and intervention studies that met the inclusion criteria. The majority of the studies (n=76, 85%) assessed diet through one method only while only 15% (13) studies utilised multiple methods. The most frequent methodology used was food frequency questionnaires (FFQ) (n = 40, 45%) followed by 24-hour recalls (n = 8, 9%) and food records (n = 8, 9%). The review also uncovered the main dietary outcome, with 76% of the studies reporting these, were the macronutrients (carbohydrate, protein, fat, and alcohol), with total energy intake measured in 66% (n=59). Comparisons were made with country-specific dietary and military guidelines in 54 (61%) and 14 (16%) studies, respectively. Collins et al. (2020) learnt that dietary intake in military settings were most frequently assessed using food FFQs and 24-hr recalls, the dietary outcomes were mainly related to energy and macronutrient consumption, and that few studies compared dietary intake to the military guidelines, with most comparisons made against national dietary guidelines. [NPID: military, veterans, dietary guidelines]
2018
"Everything else comes first": A mixed-methods analysis of barriers to health behaviors among military spouses
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]
CNP Research Summary can be found in the CNP Library Membership
2019
InDependent but not alone: A web-based intervention to promote physical and mental health among military spouses
Since few interventions have been developed to enhance health among military spouses despite them experiencing multiple threats to their physical and mental health, this 2019 quasi-experimental study implemented either a standard educational intervention or an interactive, theory-based intervention on 231 military spouses. The educational intervention directed participants to content on the existing website, Operation Live Well, while the interactive intervention was based on Self-Determination Theory, delivered weekly content via podcasts, and encouraged participants to complete weekly challenges to improve physical activity, diet, and mental health. Although there were no significant group by time interaction effects, the study observed significant improvements in all mental health outcomes, total physical activity, and sugar consumption. Mailey et al. (2019) deduced from the results that web-based interventions may promote positive changes in mental health and health behaviours among military spouses, and thus suggested future studies to determine the minimum needed from the interventions to elicit meaningful changes in the spouses. [NPID: military, military spouses, Self-Determination Theory, Operation Live Well, sugar]
2014
The potential for military diets to reduce depression, suicide, and impulsive aggression: A review of current evidence for omega-3 and omega-6 fatty acids
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]
CNP Research Summary can be found in the CNP Library Membership
2020
The low glutamate diet significantly improves pain and other symptoms in veterans with Gulf War Illness
This 2020 study on Gulf War veterans aimed to determine if a low glutamate diet can reduce the symptoms of the Gulf War Illness (GWI), a multi-symptom chronic pain condition. The 40 veterans were firstly randomly allocated to either a low-glutamate diet or a wait-listed control group (starting the diet one month later), and then randomized to a double-blind placebo-controlled crossover challenge with monosodium glutamate (MSG)/placebo to assess whether symptoms return/worsen in each condition. The participants were assessed on symptoms, myalgic scores, tender point count, and dolorimetry. After one month, the overall average number of symptoms presented was significantly different between those who received the diet with the wait-listed controls (11 in the diet group vs. 18 in wait-listed control group), with a p-value of 0.0007. Also no adverse effects were observed and the effect size of the diet was large (d = 1.17). Furthermore, the mean number of symptoms at baseline (21) dropped after the 1 -month diet to 12 (p<0.0001) among the subjects who were given the low-glutamate diet from the start of the study. The severity of remaining symptoms was also significantly reduced (all P < 0.0001) and 72% of the whole sample met the PGIC criteria for improvement. Highly significant enhancements were observed for myalgic score (P < 0.0001), number of tender points (P < 0.0001), and average dolorimetry (P < 0.001). Holton et al. (2020) presents convincing evidence that suggests low glutamate diets can effectively treat chronic pain and the symptoms associated with Gulf War illness. [NPID: military, glutamate, Gulf War Illness, chronic pain, veterans]
2014
Clinical relevance of optimizing vitamin D status in soldiers to enhance physical and cognitive performance
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]
CNP Research Summary can be found in the CNP Library Membership
2017
Adherence to the dietary guidelines for Americans is associated with psychological resilience in young adults: a cross-sectional study
This 2017 cross-sectional study aimed to assess the relationship between diet quality and psychological resilience, and also the links between resilience and demographics, anthropometrics, socioeconomic status, and health behavior, by analyzing data on 656 male and female Army and Air Force recruits (before initiation of military training). The recruits’ scores for the 2010 Healthy Eating Index (HEI-2010), which measures diet quality and can be used to quantify adherence to the Dietary Guidelines for Americans, were examined using the Block food frequency questionnaire. While the use of the Connor-Davidson Resilience Scale determined the subjects’ psychological resilience, allowing the splitting of the participants into low- and high-resilience groups. The results showed that diet quality was positively associated with resilience, and a higher HEI could predict a greater chance of being in the high-resilience group after including factors such as race, ethnicity, education, smoking, age, body mass index, sex, and military branch in the analysis. Lutz et al. (2017) highlighted a 22% increased chance of being in the high-resilience group, for every 10-point increment in HEI score. Since these findings suggest that even minor improvements in diet quality correlated with better psychological resilience, registered dietician nutritionists are encouraged to continue provoking positive dietary changes. [NPID: military, psychological resilience, anthropometrics, socioeconomic status, resilience]
2019
Design and methods for the ranger resilience and improved performance on phospholipid bound Omega-3's (RRIPP-3 study)
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]
CNP Research Summary can be found in the CNP Library Membership
2020
A systematic review of the effect of dietary supplements on cognitive performance in healthy young adults and military personnel
The purpose of this 2020 systematic review was to identify dietary supplements useful for optimising cognitive performance for military personnel. The search was for studies that involved a legal diet supplement, included a comparison control group, assessed cognitive outcomes, and that recruited healthy young adults (18-35 years old). The majority (73%) of the 37 studies that met the inclusion criteria was deemed of low quality, highlighting the need for sound empirical research in this area. The results did suggest tyrosine or caffeine may be of use to enhance cognitive performance while sleep-deprived, since caffeine potentially improves vigilance and attention despite little sleep. The review did not recommend any other specific dietary supplement due to inconsistent findings and limitations in research methodology. [NPID: military, cognition, tyrosine, caffeine, sleep, sleep deprived, vigilance, attention]
2020
Enhanced physical and cognitive performance in active duty airmen: Evidence from a randomized multimodal physical fitness and nutritional intervention.
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]