Committee on Military Nutrition Research Activity Report 1994-1999 (1999) / Chapter Skim
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K: Letter Report: Antioxidants and Oxidative Stress in Military Personnel
K: Letter Report: Antioxidants and Oxidative Stress in Military Personnel
Pages 229-256
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Appendix K Letter Report: Antioxidants and Oxidative Stress in Military Personnel Submitted February 12, 1999
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General John Parker Commander U.S. Army Medical Research and Materiel Command 504 Scott Street Fort Detrick, MD 21702-5012 Dear General Parker: At the request of MAJ Vicky Thomas, MS, RD, Nutrition Staff Officer, Office of the Surgeon General, and LTC Karl Friedl, Ph.D., Program Director, Army Operational Medicine, U.S.
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severe air pollution in some urban environments; radiation hazards to crew at altitude; radio frequency radiation hazards on ships and around communications facilities; lung and tissue blast overpressure effects and physical and psychological stresses in extreme training courses such as Ranger training and USMC crucible training)
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standards. It is also quite clear that proactive lifestyle changes have by far the greatest potential for improving the overall health of military personnel and their dependents beyond any benefits that might be identified from supplemental antioxidant use.
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Military personnel living on military bases and those in deployment situations have access to diets that are formulated according to the Military Recommended Dietary Allowances (MRDA)
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In basic training, negative energy balance and weight loss also occur, probably as a result of both decreased energy intake and greatly increased energy expenditure. Such situations may be associated with intakes of vitamins C, E, and ,B-carotene (vitamin A)
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General Blanck concerning the transition of military medicine to a health promotion emphasis. · Aggressive educational efforts be directed to military personnel engaged in operations of various intensities and in stressful environments on the importance of striving to maintain food intakes consistent with physical demands and energy requirements to avoid excessive weight loss.
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Attachments cc: LTG Ronald Blanck LTC Karl Friedl MAJ Vicky Thomas Kenneth Shine Susanne Stoiber Allison Yates Mary Poos
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Presented at IOM Workshop: Antioxidants and the Effects of Oxidative Stress in Military Personnel.
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Although military assignments generally do not involve this type of stress, some duty assignments do involve extremes of exercise which can increase oxidative stress. Examples of military scenarios which would likely result in oxidative stresses severe enough to overwhelm the antioxidant defense mechanisms include battle operations, Ranger/Seals training, basic inductee training, and mobilization of reservists into active duty assignments.
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There is evidence that in addition to strenuous physical activity during basic combat training, special forces training, or field operations, military personnel may also be exposed to other oxidative stresses when carrying out these physical activities in both hot and cold environmental temperature extremes, and at altitude. These additional oxidative stresses include hypoxia and extensive exposure to high intensity UV radiation from sunlight, and light reflection from snow or sand (Askew, 1995; Clarkson, 1993; Simon-Schnass, 1996~.
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resulted in limited duty periods on average of 16.7 days, 3.0 days and 2.8 days per injury respectively. However, very little research has been done to determine if performance decrements are associated with the observed increases in markers of oxidative damage following strenuous exercise.
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severe air pollution in some urban environments; radiation hazards to air crews at altitude; radiofrequency radiation hazards on ships and around communications facilities; lung and tissue effects of blast overpressure; and physical and psychological stresses in extreme training courses such as Ranger training and USMC crucible training)
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. Studies of military personnel living on and off base reveal generally satisfactory dietary intakes of vitamins C, but a summary of data from six intake surveys at different military installations indicated that in all but one survey, median vitamin A/~-carotene intakes were below the MRDA.
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Wayne Askew, Utah State University, personal communication, July 30, 1998~. Another source of stress relatively unique to military personnel is that of blast overpressure.
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The preliminary data showed a protective effect of vitamin E supplementation at this level prior to exposure, but vitamin C was not protective (Nabil Elsayed, Walter Reed Army Institute for Research, personal communication, July 30, 19989. Microwave and radioirequency wave exposure is another potential source of oxidative stress for military personnel.
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Studies of military personnel at high risk owing to their occupational duties are needed. In conclusion, the limited data available suggest that supplementation for individuals exposed to multiple-stress situations associated with diminishedfood intake (e.g.
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Other studies have indicated evidence of systemic conditioning (the accelerated metabolism of ascorbic acid) following abrupt discontinuation of prolonged, high dose vitamin C supplementation (Omaye et al., 1986, Schrauzer and Rhead, 1973; Tsao and Leung, 1988~.
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Data supplied to the committee from Fort Hood, Texas, which houses 41,500 active duty soldiers, indicated that in 1997 44 % of soldiers were taking anti-inflammatory drugs, primarily ibuprofen, naprosyn, piroxicam, and aspirin, and that this estimate was considered to be a very conservative one (MAJ Vicky Thomas, Office of the Surgeon General, personal communication, September 22, 19981. Additional research is needed to define better any potential risk of vitamin E supplementation for those individuals who may be routinely consuming non-steroidal inflammatory drugs or anticoagulants.
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. It would appear that significant improvements in health status of military personnel could best be achieved through the promotion of healthy life-style changes.
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1990. Ascorbic acid: Analysis of factors affecting iron absorption.
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Presented at IOM Workshop: Antioxidants and the E~ects of Oxidative Stress in Military Personnel.
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1973. Ascorbic acid abuse: Effects of long-term ingestion of excessive amounts on blood levels and urinary excretion.
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1988. Urinary ascorbic acid levels following the withdrawal of large doses of ascorbic acid in guinea pigs.
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Kanarek, Ph.D. Professor and Chair of Psychology Health Professor of Nutrition Tufts University Medford, MA APPENDIX K Antioxidants and Oxidative Stress in Military Personnel July29-31, 1998 National Academy of Sciences 2101 Constitution Avenue, N.W.
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D Chief, Pulmonary Biochemistry Section Department of Respiratory Research Division of Medicine Walter Reed Army Institute of Research Washington, D.C.
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256 Whet O Truer Pb.~.
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