Military Strategies for Sustainment of Nutrition and Immune Function in the Field

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. Table of Contents Front Matter Executive Summary I Committee Summary, Responses to Questions, Conclusions, and Recommendations 1 A Review of the Role of Nutrition in Immune Function 2 Committee Responses to Questions 3 Committee Conclusions and Recommendations II Stage Setting: The Military Situation 4 Why is the Army Interested in Nutrition and Immune Function? 5 Physiological and Immunological Impact of U.S. Army Special Operations Training: A Model for the Assessment of Nutritional Intervention Effects on Temporary Immunosuppression 6 Immune Function Studies During the Ranger Training Course of the Norwegian Military Academy III Introduction to Immune Function 7 Nutrition and Immune Responses: What Do We Know? 8 Cytokines and Nutritional Status: Possible Correlations and Investigations IV Assessment 9 Methodological Issues in Assessment of Human Immune Function 10 Application of Whole-Blood Cultures to Field Study Measurements V Nutrition 11 Glutamine 12 Vitamin A and Immune Function 13 Vitamin E, Vitamin C, and Immune Response: Recent Advances 14 Fatty Acids and Immune Functions 15 Iron Metabolism, Microbial Virulence, and Host Defenses 16 Trace Minerals, Immune Function, and Viral Evolution VI Health and Stress 17 Exercise, Infection, and Immunity: Practial Applications 18 Neuroendocrine Consequences of Systemic Inflammation 19 Inflammatory Stress and the Immune System 20 Chronobiology of the Immune System 21 Conclusion: Militarily Important Issues Identified in this Report Appendixes Appendix A: Overview of the Immune System and Other Host Defense Mechanisms Appendix B: Glossary of Immunological Terms Appendix C: Overview of Immune Assessment Tests Appendix D: Emerging Infections, Nutritional Status, and Immunity Appendix E: Workshop Agenda Appendix F: Biographical Sketches Appendix G: Acronyms and Abbreviations Appendix H: Nutrition and Immune Function: A Selected Bibliography Index