This Not That!

Fueling The Fight: Performance Nutrition For the Tactical Athlete
Nick Barringer MS, RD, CSSD, CSCS
Outline
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Historical Perspective
ROD/RON‐Planned
ROD/RON‐Unplanned
Arduous Environments: Alt/Cold/Heat
Garrison: Nutrition Before the Fight
Testing: Dietary Analysis to Lab Values
Long Term Training Environment and TDY
Supplements/Pitfalls/Lessons Learned
Achieving Buy In
End State
‐Enhance the ability to construct a Performance Nutrition program for the Tactical Athlete commensurate with the environment (operational or training) that they are in.
Historical Perspective
ROD/RON Planned
Pre Mission
• At least 40 grams of CHO
• 20‐30 grams of PRO
• <200 mg of caffeine • Weigh
During Mission
• 30‐60 grams CHO hour • Na 50‐200mg 8oz – Movement/Actions On
• Gel Packs
• Electrolyte Tabs
• Bars/Eat on the move food
– Security In‐placed • MRE • First Strike
• Caffeine?
Post Mission
• Immediately weigh
• Drink 16‐20 oz for every pound lost before bedding down
• >40 grams of CHO depending on mission length
• 15‐40 grams of protein • Limit/Avoid caffeine
ROD/RON Unplanned
• Nutrition plan to consider if the mission goes long (24 hours or more)
• Coordinate with supply (S4) for specifics of resupply drops
• Caffeine products such as Stay Alert gum
ROD/RON Unplanned: Case Study
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Original mission:6‐12 hours
2 kilometer infil/ 2 kilometer exfil
Each Man carrying a load of 50‐80lbs of equipment. Mix of hilly and urban terrain.
104 degrees F during the day. Still 90‐95 degrees F in the shade.
Each Man carrying: 100 ounces of fluid per man (Camel Bak) 1 Packet of ORS, 1 MRE
Turned into 36 hour mission
Resupply(Air Drop):
– 6 Litters of water per man
– 1 MRE per man
– 2‐3 Cliff Shots per man
Arduous Environments
Altitude
• Increased Kcal/CHO consumption
• Check iron stores >120 days out
• Hydration plan • Vitamin considerations
Cold Environments
• Often goes with altitude
• Hydration
• Increase Kcal/CHO
• Caffeine/Tyrosine
Hot Environments
• Hydration plan
• Time to acclimate?
• Decreased appetite
• Sodium intake
Garrison Nutrition
Because you want….
This
Not That!
Garrison Nutrition: Prepare for a Fight
• Regulations
• More with less
• Focus on improving vegetables, fruit, and lean protein options
Testing?
• Food Analysis Program
• Body Comp
• Potential Lab Values of Interest
– Vitamin D
– Iron Stores
– Omega‐3s
– Blood Glucose
– Markers of Inflammation?
Is there an Ideal Body Comp?
• Pilot Study – APR 08 BRC
– 9 BRC Competitors
– Evaluated at two points: three months and immediately prior to BRC
• At three months prior to competition ‐ average BF% = 14.6%
• At immediately prior to competition ‐ average BF% = 13.2%
• Average of 2 lbs of body fat loss
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5/9 competitors finished
The leanest team intentionally gained fat and placed 4th
The team that lost the most body fat failed to finish BRC
One team placed 1st and had an average BF% = 13.8%
• Average Body Comp 12‐13% Omega‐3s
• A 2011 study compared 800 blood samples from Soldiers who committed suicide (2002‐2008) to 800 non‐suicide samples
• The odds of a sample being in the suicide group increased by 14% for a standard deviation decrease in blood DHA levels
• Samples with the lowest DHA levels were 62% more likely to be in the suicide group
Lewis MD, Hibbeln JR, Johnson JE, et al. (2011) Suicide Deaths of Active‐Duty US Military and Omega‐3 Fatty‐Acid Status: A Case Control Comparison. Journal of Clinical Psychiatry.
Vitamin D
• A 2013 study analyzed 495 blood samples from Soldiers who committed suicide (2002‐2008) and compared to 495 non‐suicide samples
• Notable ‐ 30% of the subjects had Vitamin D below recommended levels
• The lowest octile of Vitamin D levels had the highest risk for suicide while the highest octile had a commensurate decrease in risk
Umhau JC, George DT, Heaney RP, Lewis MD, Ursano RJ, et al. (2013) Low Vitamin D Status and Suicide: A Case‐Control Study of Active Duty Military Service Members. PLoS ONE 8(1): e51543.doi:10.1371/journal.pone.0051543
Physical Activity
• Increased physical fitness and leisure‐time physical activity are associated with higher Health Related Quality of Life scores in a study of military‐age Finnish males
• Cardiorespiratory fitness was associated with higher Health Related Quality of Life scores in a study of young U.S. Navy males
Hakkinen A, Rinne M, Vasankari T, Santtila M, Hakkinen K, et al. (2010) Association of physical fitness with health‐
related quality of life in Finnish young men. Health & Quality of Life Outcomes 2010, 8:15
Sloan RA, Sawada SS, Martin CK, Church T, Blair SN: Associations between Cardiorespiratory Fitness and Health‐Related Quality of Life Health. Health & Quality of Life Outcomes 2009, 7:47
Long Term Training Environment
• JRTC/NTC
• Who is providing the meals?
– Can you coordinate with them?
– Can you coordinate to bring supplemental items?
• Educate leadership on importance
TDY/Traveling
• Give healthy eating on‐the‐go options
• Alternative exercise plan
• Create a packing list
Supplements
• Honest assessment
• Label Reading
• Communication
Lieberman, H. R., Stavinoha, T. B., McGraw, S. M., White, A., Hadden, L. S., & Marriott, B. P. (2010). Use of dietary supplements among active‐duty US Army soldiers. The American journal of clinical nutrition, 92(4), 985‐995.
Potential Supplement Pitfalls
“What I learned”
• 26 yo Soldier reports during deployment for selection physical
• Healthy, no complaints, normal H&P
• No medication use
• Reported he was taking “Oxevol”
What I learned
• PE: Bilateral increased breast tissue. NL testicular exam, NL thyroid exam
• Admitted to prior use of “Oxevol”
What I learned
• The supplement used is Oxevol
by Evolution Labs.
• 2a,17a‐dimethyl‐17B‐hydroxy‐5a‐
etiocholan‐3‐one
• The compound is also known as “Superdrol” or “Methasteron”
What I learned
The FDA only went after the name “Superdrol” not the chemical compound
“2a,17a‐dimethyl‐17B‐hydroxy‐5a‐
etiocholan‐3‐one”
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Other names for this compound are:
• 2a,17a‐dimethyl‐17B‐hydroxy‐5a‐
andro‐3‐one
• 2a,17a‐dimethyl‐17B‐hydroxy‐5a‐
androst‐3‐one
Same chemical compound
just a different name.
What I learned
5 Previously healthy patients who used
methasteron developed jaundice and other
signs of hepatoxicity 2 weeks after
discontinuation.
Severe Cholestasis and Renal Failure
Associated with the Use of the
Designer Steroid Superdrol
(Methasteron)
Cholestatic Jaundice and IgA Nephropathy
Induced by OTC Muscle Building Agent
Superdrol.
What I learned
• M‐DROL by Competitive Edge Labs
• RAGE RV5 by ANC
• Methyl Masterdrol by Legal Gear
• Monster Caps by Bulk Nutrition
• Methadrol by I Force Nutrition
• S‐Drol by Fast Action.
Achieving Buy In
• Get out of the office
• Practice what you preach
• Experience what your guys (or gals) experience
Closing
Thank You!
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Dr. Mike Greenwood
CPT Karen Daigle
LTC Lori Sigrist
LTC(Ret) Danny McMillian
Dr. Travis Harvey
Dr. Jay Hoffman
Questions?