Committee on Military Nutrition Research Activity Report 1994-1999 (1999) / Chapter Skim
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J: Conclusions and Recommendations from the Brief Report: Reducing Stress Fractures in Physically Active Military Women
J: Conclusions and Recommendations from the Brief Report: Reducing Stress Fractures in Physically Active Military Women
Pages 219-228
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Appendix J Conclusions and Recommendations from the BriefReport Reclucing Stress Fractures in Physically Active Military Women Submitted dare 1998
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Stress fracture rates among female Army military trainees during basic combat training are more than twice those reported for males (Deuster et al., 1997; Jones, 1996; MSMR, 1997~. This greater incidence appears to be due in part to the initial entry level of fitness of the recruits and specifically He ability of bone to withstand the rapid, large increases in physical loading.
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In the training program for female soldiers, rapid and excessive increases in exercise habits and abrupt changes in training load may increase the risk of stress fractures of the lower extremities. The subcommittee concludes that muscle mass, strength, and resistance to fatigue with cyclic loading (bone stress created by excessive or rapid incremental skeletal muscle contraction and loading forces)
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Greater body mass is associated with higher levels of bone mineral mass and density. Stress fractures are associated not only with reduced skeletal muscle mass and its concomitant increased fatigability and lower fitness levels but also with an excessive skeletal muscle mass and its enhanced strength.
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Exogenous estrogen-progestogen hormones may positively affect peak bone mass reached in adulthood, which may be important for future fracture risks in contrast to the use of long-acting progestogens and gonadotropin-releasing hormone agonists. Recommendations Implement measures to ensure that energy intakes by military women are consistent and adequate to maintain weight during intense physical fitness .
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Nutrition education programs are key to providing information and direction on the choice and nutrient content of appropriate foods. It is important that education programs for military women be aimed at their meeting requirements for total energy needs as well as for nutrients supportive of optimal bone health.
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. The subcommittee reinforces the recent efforts of the Army to begin providing complete nutritional labeling of all ration components and to include information to enable identification of nutrient-dense components that would help women meet the MRDAs (Military Recommended Dietary Allowances)
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· The military should continue to gather dietary intake data and evidence concerning calcium intakes throughout the soldier's career, as training programs, food choices, and food supply change over time. · Based on preliminary data from athletes, the potential loss of calcium in sweat due to physical exertion during training and the impact of high levels of activity on calcium requirements needs to be investigated as possible pathophysiological factors in the development of stress fracture.
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From page 228... ...
Committee on Body Composition, Nutrition, and Health of Military Women, Committee on Military Nutrition Research, Food and Nutrition Board. Washington, D.C.: National Academy Press.
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