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Suggested Citation:"VI Health and Stress." Institute of Medicine. 1999. Military Strategies for Sustainment of Nutrition and Immune Function in the Field. Washington, DC: The National Academies Press. doi: 10.17226/6450.
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VI
HEALTH AND STRESS

Part VI begins with a description in Chapter 17 of the effects of both acute and long-term exercise on natural killer (NK) cells, neutrophils, macrophage/monocytes, and the lesser effects on T- and B-lymphocytes. In response to acute exercise, a rapid interchange of immune cells between lymphoid tissues and the circulation occurs. While the response depends on many factors, NK cells, neutrophils, and macrophages appear to be most responsive, both in terms of numbers and function. The only consistent finding to date with long-term exercise training is a significant increase in NK cell activity. Work performance tends to diminish with most systemic infections, and data suggest that increased severity of infection, relapse, and myocarditis may result when patients exercise vigorously.

Chapter 18 discusses the neuroendocrine consequences of systemic infection, emphasizing the primary role of the myriad polypeptide cytokines released into the circulation by lymphocytes, monocytes, macrophages, and endothelial cells. These pluripotent mediators induce the pathophysiological response termed the acute phase reaction, which is characterized by fever; nutrient catabolism; changes in protein, carbohydrate, and lipid metabolism; and profound changes in hepatic functions and in all components of the endocrine system.

Recent advances in identifying immune-neuroendocrine interactions are discussed in Chapter 19. The numerous interactions that have been characterized illustrate the important bidirectional communication between these two

Suggested Citation:"VI Health and Stress." Institute of Medicine. 1999. Military Strategies for Sustainment of Nutrition and Immune Function in the Field. Washington, DC: The National Academies Press. doi: 10.17226/6450.
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systems. Perhaps the most important interaction relates to immune activation of the hypothalamic-pituitary-adrenal axis via cytokines. Stimulation of this counter-regulatory response plays a critical role in preventing the host from mounting an excessive defense response against "inflammatory stress". Because of these interactions, regulatory relationships exist whereby behavioral stimuli and inflammatory stress can ultimately modulate the function of the immune system.

The influence of biological rhythms on the immune system is presented in Chapter 20. Biologic rhythmic behavior has been characterized in levels of circulating white blood cells and subsets of these cells, cytokines and their inhibitors, and in the humoral immune response, although circadian time dependence of human responses to vaccination is less well documented. Some of the rhythms affecting the immune system are genetically fixed, but in certain frequencies (e.g., circadian) the rhythm may be adjusted in its timing by periodic environmental factors such as light-darkness, activity-rest pattern, temperature, and for some parameters, the timing of food intake. Many of these rhythms have potential major significance to the military.

Finally, Chapter 21 provides a summary of the workshop presentations, identifying those issues of importance to the military and identifying the issues that the CMNR would consider in their report.

Suggested Citation:"VI Health and Stress." Institute of Medicine. 1999. Military Strategies for Sustainment of Nutrition and Immune Function in the Field. Washington, DC: The National Academies Press. doi: 10.17226/6450.
×
Page361
Suggested Citation:"VI Health and Stress." Institute of Medicine. 1999. Military Strategies for Sustainment of Nutrition and Immune Function in the Field. Washington, DC: The National Academies Press. doi: 10.17226/6450.
×
Page362
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Every aspect of immune function and host defense is dependent upon a proper supply and balance of nutrients. Severe malnutrition can cause significant alteration in immune response, but even subclinical deficits may be associated with an impaired immune response, and an increased risk of infection. Infectious diseases have accounted for more off-duty days during major wars than combat wounds or nonbattle injuries. Combined stressors may reduce the normal ability of soldiers to resist pathogens, increase their susceptibility to biological warfare agents, and reduce the effectiveness of vaccines intended to protect them. There is also a concern with the inappropriate use of dietary supplements.

This book, one of a series, examines the impact of various types of stressors and the role of specific dietary nutrients in maintaining immune function of military personnel in the field. It reviews the impact of compromised nutrition status on immune function; the interaction of health, exercise, and stress (both physical and psychological) in immune function; and the role of nutritional supplements and newer biotechnology methods reported to enhance immune function.

The first part of the book contains the committee's workshop summary and evaluation of ongoing research by Army scientists on immune status in special forces troops, responses to the Army's questions, conclusions, and recommendations. The rest of the book contains papers contributed by workshop speakers, grouped under such broad topics as an introduction to what is known about immune function, the assessment of immune function, the effect of nutrition, and the relation between the many and varied stresses encountered by military personnel and their effect on health.

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