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REFERENCE COvt FOR LIBRARY USE ONLY The New Generation Survival Ration A Brief Report Submitted by The Committee on Military Nutrition Research Food and Nutrition Board Institute of Medicine National Academy of Sciences to Lite editing Major General Richard T. Travis Commanding General U.S. Army Medical Research and Development Command February 13, 1991 PROPERTY OF ] in OCT 1 4 1992 Produced under continutation of grant number DAMD17-86-G-6036AC Het PaguRtie National Academy of Sciences and the U.S. Army Medical Research and Development Command.
cf/G 70 3 L493 SPY CS NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, fhe National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competencies and with regard for appropriate balance. This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering and the Institute of Medicine. The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academyâs 1863 congressional charter responsibility to be an advisor to the federal government and its own initiative in identifying issues of medical care, research, and eduction. Dr. Samuel O. Thier is President of the Institute of Medicine. Publication IOM-91-04
0CLE 2USOGk SLO The New Generation Survival Ration Introduction and Background The U.S. Army Natick Research Development and Engineering Center (USANRDEC) has been asked to update the old General Purpose Survival Packet. This packet was type classified in 1961 and has not been updated since its initial procurement. Limited procurement quantities apparently have contributed to problems in obtaining several components as well as the tin-plate can that was part of the original design. The Committee on Military Nutrition Research (CMNR) (See committee roster in Appendix I) of the National Research Councilâs Food and Nutrition Board was asked by the Military Nutrition Division of the U.S. Army Institute of Environmental Medicine (USARIEM) and USANRDEC to review the proposed nutrition standards for the New Generation Survival Ration to determine if they were consistent with current scientific knowledge. The USANRDEC provided the CMNR with an overview of the project, including the critical nutrient specifications and expected conditions of storage and use at the meeting of the CMNR on June 28-29, 1990 at Natick, Massachusetts. The committee examined and tasted the ration product under current development and toured the USANRDEC and USARIEM research buildings where they were shown the facilities for development and testing of both the ration components and its packaging. Copies of the briefing materials and additional military reference materials related to survival rations were provided to the committee and are included in Appendix II. Briefly, the nutrition requirements for the survival ration are that it should provide adequate carbohydrate to prevent ketosis and be low in protein content to conserve water needs. In addition, the ration must be shelf stable at high temperature storage (five years at 80°F and one month at 140°F), require no preparation, and be sufficiently acceptable to have a positive effect on morale. Since the survival ration is designed to be consumed for a period of less than five consecutive days, the nutrient standards for operational rations do not apply. The CMNR also reviewed several scientific articles on the subject of survival rations and discussed with the various service representatives the type of information provided in survival briefings to military personnel. Copies of these materials are attached in Appendix III.
Committee Recommendations 1. The Committee on Military Nutrition Research concluded that in most survival situations conserving the need for water was of major importance. For this purpose adequate carbohydrate must be provided to prevent ketosis, protein intake should be limited and sodium should be restricted to a low level in order to help preserve water needs. In hot climates, additional sodium would be beneficial to help compensate for sweat loss, but only if adequate potable water is available. 2. The Committee has reviewed the scientific data base relative to the appropriate composition of survival rations and concluded that the criteria established by the early 1960âs are still valid. (See, for example, report by Sargent and Johnson in Appendix III.) The criteria summarized in these earlier reports (Calloway, 1960; Sargent and Johnson, 1957) as well as the review of Davenport et al (1971) suggested a maximum of seven to eight percent of total calories as protein; a minimum of 100 grams of carbohydrate per day; and a minimum of one to two grams of sodium per day. Additional sodium should be available for use in hot environments, provided an adequate supply of potable water is available. 3. The current development effort that proposes the use of a series of cereal-type bars having approximately 5 percent calories from protein, 53 percent of calories from carbohydrate and 42 percent of calories from fat, is considered appropriate for meeting the needs of all survival rations. No requirements for micronutrient fortification are considered necessary because of the short duration of use. However, inclusion of a bullion-type source of sodium is desirable provided this product is clearly labeled for use only when adequate water supply is available. 4, The Committee noted that discussion of reports of army personnel swapping survival ration components or discarding components having different amounts of carbohydrate and fat was of concern. The ration components must all be acceptable so selective consumption is not likely to occur. If only the high fat components are consumed and the high carbohydrate components are avoided, the potential for development of ketosis is enhanced with a resulting serious impact on water requirements and the ability to function both mentally and physically. In this regard, additional research in the area of palatability with the current cereal-type bars may be warranted. It would be important to determine that the ration maintains its palatability when subjected to the extreme environmental conditions possibly encountered during extended storage.
5. The Committee on Military Nutrition Research recommends that the development agency and the user agencies engage in close coordination during the development of the new survival ration. The objective is to coordinate the development of labels, directions for use, and the instructional material given to personnel during survival training. Since one ration is envisioned for use in all environmental conditions, it is important that the packaging and recommended instructions for use be carefully coordinated. Instructions that clearly state the appropriate use of the ration components under varying environmental conditions should be included on the ration container. It is suggested that a statement be added to the label emphasizing that all components of the ration should be consumed and that swapping or discarding components could result in adverse health effects. 6. The Committee believes that it is important for potential users to be very familiar with all aspects of the survival ration, and understand its physiological benefits, organoleptic characteristics, the appropriate use of ration components under different anticipated survival situations, and the limitations of the ration in providing long-term nutritional support. The committee therefore suggests that a review of the instructional material used in survival training be conducted as a part of future tasks. Since only one survival ration module is envisioned for all operational conditions, it becomes more important that detailed instructions concerning its use be given in survival training. Training programs should include emphasis on the necessity for maintaining adequate fluid intake regardless of environmental conditions. . 7. The Committee also believes that more information about past actual operational use of survival rations in emergency situations (i.e., Southeast Asia experience) would contribute to the development of a superior ration. Such data should include the extent of ration use, organoleptic attributes, and the condition of individuals who used the rations versus the condition of individuals who did not use the rations during survival conditions. It would also be useful to learn why the rations were not used in a survival situation. An analysis of this nature may provide useful information which will be important to the design of the survival ration and instructions for use in the future. Future research on survival rations should include examination of compositions that may be effective in reducing urinary urea, such as inclusion of purified amino acids and/or ketoacid or hydroxyacid analogues. In addition, recent advances in knowledge of the physiological effects of certain electrolytes should be evaluated in the context of their application to survival rations.
The Committee on Military Nutrition Research is pleased to note the multi- disciplinary effort that has gone into the development of the proposed ration and urges additional dialogue concerning the directions for use and the instructional material given during survival training.
References Calloway, D. H. 1960. Nutritional aspects of the all-purpose survival ration: A critical appraisal. U.S. Armed Forces Med. J. 11 (4):403-417. Davenport, R.E., J.K. Spaide, and R.E. Hodges. 1971. An evaluation of various survival rations. Amer. J. Clin. Nut. 24:513-523. Sargent, F. and R.E. Johnson. 1957. The physiological basis for various constituents in survival rations. Part IV. An integrative study of the All-purpose Survival Ration for temperate, cold, and hot weather. Wright Air Development Technical Report 53-484, Part 4. 18 pp.
APPENDICES Appendix I. Appendix II. Appendix III. Roster: Committee on Military Nutrition Research Agenda, Information Papers, military reference reports, and Presentation Graphics pertaining to The New Generation Survival Ration from the Committee on Military Nutrition Research meeting held June 28-29, 1990 Selected scientific articles pertaining to the nutrient content and use of survival rations
COMMITTEE ON MILITARY NUTRITION RESEARCH Robert O. Nesheim, Ph.D. (Chairman) President Advanced Healthcare, Inc. Monterey, CA Richard Atkinson, M.D. Professor of Internal Medicine VA Medical Center Hampton, VA Andre Bensadoun, Ph.D. Professor of Nutrition Biochemistry Division of Nutrition Science Cornell University Joel Grinker, Ph.D. Program and Human Nutrition School of Public Health University of Michigan Edward Horton, M.D. Professor and Chairman, Medicine Un. of Vermont, Coll. of Medicine William Evans, Ph.D. Chief, Human Physiology USDA, Human Nutri. Center on Aging Tufts University Janet C. King, Ph.D. Professor of Nutrition Dept of Nutrition Science University of California, Berkeley Berkeley Gilbert Leveille, Ph.D. Staff Vice President, Science Nabisco Brands Incorporated John Vanderveen, Ph.D. Director, Division of Nutrition Food and Drug Administration John Kinsella, Ph.D. Dept of Food Science Cornell University Richard Jansen, Ph.D. Professor and Head, Dept of Food Science and Human Nutrition Colorado State University ARMY Liaison: LTC E. Wayne Askew, Ph.D. U.S. Army Research Institute of Environmental Medicine Natick, MA FNB Staff: Dr. Bernadette Marriott Program Officer Nancy J. Fox Senior Secretary
Ila - IIb - IIc - IId - Ile - CONTENTS OF APPENDIX II Committee on Military Nutrition Research Meeting June 28-29, 1990 Agenda and List of Committee Participants Information Paper: New Generation Survival Ration (January 23, 1990) Information Paper: New Generation Survival Ration (June 7, 1990) Graphics from the Presentation: New Generation Survival Ration Judith M. Aylward, MS, RD, Project Officer "Survival Substances", pp. 24-27 excerpted from: Operational Rations, Current and Future of the Department of Defense, U.S. Army Natick Research and Development Laboratories, Natick, Massachusetts. January, 1983. Survival, emergency and individual combat rations - nutritional values and packaging. NATO Standardization Agreement, 11 May 1987. Survival, emergency, and individual combat rations - nutritional values and packaging. American, British, Canadian and Australian Armies Standardization Program, Quadripartite Standardization Agreement 878, Edition 1.,7 September 1989. Ith - Excerpts from Department of the Army technical manuals for survival kits: e Cold Climate Survival Kit: TM 55-1680-348-10 e Survival Kit, Hot Climate: TM 55-1680-349-10 e OV-1 Aircraft, Hot Climate Survival Kit: TM 55-1680-317-CL-5 e OV-1 Aircraft, Cold Climate Survival Kit: TM 55-8465-209-10
APPENDIX IIa. Agenda and List of Committee Participants
FINAL AG A COMMITTEE ON MILITARY NUTRITION RESEARCH U.S. ARMY RESEARCH INSTITUTE OF ENVIRONMENTAL MEDICINE Thursday, June 28: 8:00 AM 8:30 - 8:45 8:45 - 9:00 9:00 - 9:45 9:45 - 11:00 11:00 - 12:00 12:00 - 1:00 1:00 - 2:30 2:30 - 2:45 2:45 - 3:15 3:15 - 4:00 4:00 - 4:30 6:30 7:00 Friday, June 29: NATICK, MASSACHUSETTS JUNE 28 - 29, 1990 Food Engineering Directorate Conference Room - Building E-100 Meet in hotel lobby for transportation to USARIEM Welcome to USARIEM - Col. Joseph Denniston, Commander Chairmanâs remarks, review of status of committee work and plan for the meeting - Robert O. Nesheim, Ph.D. Physiological Considerations for Design of Survival Rations and an Historical Perspective - R. E. Johnson, M.D., D.D. Phil. New Generation Survival Ration - Presentations by staff of the Food Engineering Directorate, NRDEC and discussion Long Life Ration Packet (LRPII) - Presentations by staff of the Food Engineering Directorate, NRDEC and discussion Luncheon: Committee will have opportunity to sample the rations Alaska Cold Weather Comparison of MRE VIII + Supplemental Packet versus the Ration, Cold Weather - Lt.Col. John Edwards, Ph.D., Military Nutrition Division, USARIEM Reconstituted Milk Processing Enhancements - Andre Senecal, Food Engineering Directorate, NRDEC Army Nutrition Initiatives: Follow-up Discussion Discussion of Plans to Review and Revise the MRDAâs (AR 40-25, Nutritional Standards and Allowances) - Background information presentation - Lt.Col. Eldon W. Askew, Ph.D., Director, Division of Military Nutrition, USARIEM Optional Informal Tour of Research Facilities Pick-up at hotel for dinner No host Dinner at Finnertyâs, Wayland, Massachusetts Executive Session of the Committee
COMMITTEE ON MILITARY NUTRITION RESEARCH Robert O. Nesheim, Ph.D. (Chairman) President Advanced Healthcare, Inc. Monterey, CA Richard Atkinson, M.D. Professor of Internal Medicine VA Medical Center Hampton, VA Andre Bensadoun, Ph.D. Professor of Nutrition Biochemistry Division of Nutrition Science Cornell University Joel Grinker, Ph.D. Program and Human Nutrition School of Public Health University of Michigan Edward Horton, M.D. Professor and Chairman, Medicine Un. of Vermont, Coll. of Medicine William Evans, Ph.D. Chief, Human Physiology USDA, Human Nutri. Center on Aging Tufts University Janet C. King, Ph.D. Professor of Nutrition Dept of Nutrition Science University of California, Berkeley Gilbert Leveille, Ph.D. Staff Vice President, Science Nabisco Brands Incorporated John Vanderveen, Ph.D. Director, Division of Nutrition Food and Drug Administration Conference June 28-29, 1990 Committee Participants NRC Staff: Bernadette Marriott, Ph. D. Nancy J. Fox 202/334-1740 FAX 202/334-2939 ARMY Liaison: LTC E. Wayne Askew, Ph.D. U.S. Army Research Institute of Environmental Medicine Natick, MA Not able to attend: John Kinsella, Ph.D. Dept of Food Science Cornell University Richard Jansen, Ph.D. Professor and Head, Dept of Food Science and Human Nutrition Colorado State University
APPENDIX IIb. Information Paper: New Generation Survival Ration (January 23, 1990)
STRNC-WIP (70-1ff) | - 23 Jamuary 1990 INFORMATION PAPER SUBJECT: New Generation Survival Ration PURPOSE: Summarize the status of the Air Force project to update the General Purpose Survival Packet. FACTS: O The New Generation Survival Ration is an Air Force project to update the Judith M. Aylward/AV256-4448/ old General Purpose Survival Packet. This packet was type classified in 1961 and has not been updated since initially procured. Linited procurement quantities have contributed to problems in obtaining several components as well as the tin-plate can that were part of the original Gesign. Survival packets are provided in aircraft, liferafts and in remote storage areas. Storage can extemd for as long as five years including periods of time at very high temperatures, such as would be fourd onboard an aircraft sitting on asphalt during the summer. Due to these environmental conditions, the storage requirement for this ration is five years at 80°F and one month at 140°F. Nutrition requirements state that a survival food packet contain approximately 100 grams of carbohydrate (400 kilocalories) to prevent ketosis; a low protein content (<8 percent of the calories) to spare body water. Nutrient standards for operational rations do net apply to the survival food packet because it is designed to be consume for periods less than five consecutive days. New food components that have been developed include an all carbohydrate glucose bar (wintergreen flavor), a shortbread bar, a chocolate chip cookie bar, a granola bar, and a cornflake cereal bar. The packet prototype contains six bars individually packaged in a trilaminate material and contained in a paperboard box. The total cube is 24.5 inches, weight is 320 grams. It provides 1,343 kilocalories with 17.3 grams protein (5 percent of the calories), 178 grams carbohydrate (53 percent of the calories), and 63 grams fat (42 percent of the calories). Current work includes high temperature, short term storage evaluations; improvement of the fragility of the glucose bar; preparation of components for testing and evaluation of packaging materials; and preparation of components for a long term storage study scheduled to begin in 2Q FY90. A prototype user test, conducted in conjunction with SSD and USARIEM, is being coordinated for 4Q FY90. PHILIP BRANDLER, Acting Director Food Engineering Directorate
