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learn.extension.org/events/3179
This material is based upon work supported by the National Institute of Food and Agriculture, U.S. Department of Agriculture, and the Office of Military
Family Readiness Policy, U.S. Department of Defense under Award Number 2015-48770-24368.
Performance Nutrition Considerations for
Service Members and Veterans
Connecting military family service providers
and Cooperative Extension professionals to research
and to each other through engaging online learning opportunities
militaryfamilies.extension.org
MFLN Intro
Sign up for webinar email notifications at militaryfamilies.extension.org/webinars
Kim Feeney, MS, RD, CSSD, LD,
CSCS
•Served just under seven years as an active
duty Army officer
•Experience working with tactical, collegiate,
amateur, and recreational athletes
•Master’s research project investigated body
composition changes in Soldiers attending
Ranger School
Today’s Presenter
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Disclaimer
• No conflicts of interest
• Any views expressed are mine and do not
necessarily reflect the official policy or
position of the Department of the Air
Force, Department of Defense, or the U.S.
Government
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Learning Objectives
• Accurately assess energy and nutrient needs
and provide a nutrition prescription based on
physical activity level
• Identify potential benefits and risks of popular
dietary trends in athletes
• Objectively evaluate dietary supplements for
safety and effectiveness
5Licensed by J Chilek from AdobeStock
Assessing Energy Needs - RMR
• Indirect calorimetry
• Mifflin-St. Jeor
– Males: RMR = 10W + 6.25H – 5A +5
– Females: RMR = 10W + 6.25H – 5A – 161
• Cunningham
– RMR = 370 + 21.6FFM
• Owen
– Female athletes: RMR = 50.4 + 21.1W
Where W is weight in kg, H is height in cm, A is age, and FFM is fat free mass in kg6
Assessing Energy Needs - TDEE
• Use Physical Activity Levels (PAL) to
account for normal daily activities
• Utilize Metabolic Equivalents (METs) to
account for exercise
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METs
• Ratio of working metabolic rate to resting
metabolic rate
– Oxygen uptake in ml/kg/min
– 1 MET = 3.5 ml/kg/min O2 = 1 kcal/kg/hour
• Does not account for body composition,
age, sex, environment, etc.
– Not a perfect estimate of energy cost
Ainsworth BE, Haskell WL, Herrmann SD, Meckes N, Bassett Jr DR, Tudor-Locke C, Greer JL, Vezina J, Whitt-
Glover MC, Leon AS. The Compendium of Physical Activities Tracking Guide. Healthy Lifestyles Research Center,
College of Nursing & Health Innovation, Arizona State University. Retrieved [date] from the World Wide Web.
https://sites.google.com/site/compendiumofphysicalactivities/8
Using METs
MET x kg x hr
75 kg patient who spends 30 minutes running
7.5 mph
– METs: 11.8 kcal/kg/hr
– 11.8 kcal/kg/hr x 75 kg x 0.5 hr = 443 kcal
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Using METs
MET x kg x hr
65 kg patient completing an Army Physical
Fitness Test (14 min 2 mile)
– METs: 8 kcal/kg/hr (calisthenics); 12.3 kcal/kg/hr (run)
– 8 kcal/kg/hr x 65 kg x 0.05 = 25 kcal
– 12.3 kcal/kg/hr x 65 x 0.23 = 184 kcal
– 25 kcal + 184 kcal = 209 kcal
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Assessing Macronutrient NeedsProtein
• 1.2-1.4 g/kg for endurance
• 1.4-1.7 g/kg for strength
• 1.5-2 g/kg for weight loss or injury
Fat
• 1 g/kg for most athletes
• 2 g/kg for endurance
• 3 g/kg for ultraendurance
Carbohydrate
• 3-5 g/kg for light training
• 5-7 g/kg for moderate training
• 6-10 g/kg for 1-3 hours moderate- to high-intensity
• 8-12 g/kg for 4+ hours moderate- to high-intensity
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Licensed by J Chilek from AdobeStock
Macronutrient Timing
Protein• Limit pre-workout
• 0.3 g/kg post-activity
• Remainder divided into meals/snacks every 3-5 hours
Fat• Limit pre-workout
• Distribute throughout day
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Licensed by J Chilek from AdobeStock
Macronutrient Timing
Carbohydrates
Adequate intake benefits both endurance and
stop-and-go sports
•1-4 g/kg 1-4 hours prior to prolonged activity
•1-2 hr → 30 g/hr, 2-3 hr → 60 g/hr, 2.5+ hr → ≤90 g/hr
•Replenish with 1-1.2 g/kg/hr for 4 hours after activity if
multiple daily activity sessions
– Meeting goal daily CHO intake is adequate for one session a day
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Licensed by J Chilek from AdobeStock
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Assessing Fluid Needs
Licensed by J Chilek from AdobeStock
Assessing Micronutrient Needs
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• Typically similar to non-athlete needs
• Vitamin D >40 ng/ml may be associated with
better performance
• Sweating may increase electrolyte needs
– Cl, Na, K, Ca, Mg
– May use sweat patch to assess
• Iron deficiency is a risk for females
• Some nutrient needs increase at altitude
Licensed by J Chilek from AdobeStock
Alcohol
• Metabolism– Impairs glycogen storage
– Decreases muscle protein
synthesis
• Thermoregulation– Delays rehydration
– Increases peripheral vasodilation
• Skills/balance– Impaired motor skills & strength/power
up to 72 hours after intake
• Injury/illness– Depresses immune function & delays
healing16
Licensed by J Chilek from AdobeStock
Question Break
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Dietary Trends - Paleo
• Diet modeled after foods available for Paleolithic humans
– Include grass-fed meat/organs, seafood, most fresh
fruits/veggies, eggs, nuts/seeds, certain oils
– Exclude grains, legumes, dairy, refined sugar, potatoes,
processed food, refined vegetable oils, salt
– Hard to find consistent definition/rules
• Many health claims
– Short-term may have health benefits;
risk of deficiency long-term
• Expensive
• Lack of research in athletes
• Often encourages exceptions for athletes 18
Dietary Trends – IIFYM
• Freedom to eat whatever fits into your daily
macronutrient needs
• Can be high-effort
• Risk of nutrient deficiency
• Ensure appropriate macronutrient distribution
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Dietary Trends - IF
• Limit intake or fasting for a period (16-24+
hours) with refeed periods
– Ramadan most frequently studied
• Does result in energy restriction for most
• May require strategic fueling for some
athletes
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Dietary Trends - Ketogenic
• Diet focused on fueling from fats rather than carbs
– High fat, adequate protein, low carb (4:1 fat to
protein+carb)
• Many health claims
– Short-term changes in arteries, lipid panel
• Requires time commitment to “adapt”; cannot cheat
• Drastic weight fluctuations when starting/stopping
• No performance benefit/performance decrements
– May make calorie intake easier for some athletes
– Inadequate protein for strength athletes
• Future research: gut flora
Burke LM, Ross ML, Garvican-Lewis LA, et al. Low carbohydrate, high fat diet impairs exercise economy and negates the
performance benefit from intensified training in elite race walkers. The Journal of Physiology. 2017;595(9):2785-2807.
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Dietary Trends – Train Low
• Exercising in a glycogen-depleted state to enhance
fat oxidation
– 2-a-days, training fasted, training without exogenous
CHO
• Perform glycogen-reducing activity followed by
higher intensity activity
• Designed for endurance training (<70%VO2 max) –
not high intensity or resistance exercise
• Results in metabolic changes but limited
performance changes
Jeukendrup AE. Periodized Nutrition for Athletes. Sports Medicine. 2017;47(S1):51-63. 22
Case Study• 36 yo male – 170.2 cm, 72.3 kg, 8% BF (per BodPod)
• Lifts 60-90 min 5-6x/week (3.5 METs) + low-intensity
cardio 20 min 3x/week (5.3 METs)
– Goal of gaining muscle mass/strength with limited body fat gain
• Desk job with some walking (PAL ~ 1.5)
• RMR: 1730 kcal (BodPod), 1805 (Cunningham), 1610
(Mifflin St. Jeor), 1670 (HB)
• Nutrition Rx: 3100-3200 kcal, 360-506 g carbohydrate,
101-123 g protein, 72 g fat– Nutrition Rx from “nutritionist”: 250 g carbohydrate, 250 g protein, 60 g fat
• Back-check to make sure macros fit into calorie needs
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Question Break
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Dietary Supplements
Up to 61% of military men and 76% of
military women use supplements
– Vitamins/minerals, sports drinks, protein,
energy drinks, creatine
– General health, performance enhancement
Knapik JJ, Steelman RA, Hoedebecke SS, Farina EK, Austin KG, Lieberman HR. A systematic review and meta-analysis on
the prevalence of dietary supplement use by military personnel. BMC Complementary and Alternative Medicine. 2014;14(1). 25
Supplement Benefits
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Diet
Workout program
Rest/Recovery
Supplement Benefits
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Diet
Workout program
Rest/Recovery
Supplements
Supplement Benefits
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Supplements
Supplement Red Flags
• Proprietary blends
• Unrealistic claims
• Hormone-related mechanisms
• Alternative to FDA-approved medication
• Quick fixes
• “May cause a positive result on a
performance-enhancing drug test”
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Common Supplements
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Low High
Arginine, glutamine, chromium,
carnitine, quercetin, ribose
Aromatase inhibitors, DHEA, growth
hormone
Amino acid blends, beetroot
extract, beta-alanine, HMB,
BCAAs, protein
EPO, citrus aurantium (bitter orange),
ephedra
Caffeine, creatine, omega-3s
Risk Level
Benefit Level
Low
Modera
teH
igh
Third Party Certification
• Sport-specific certification:– NSF Certified for Sport®: http://nsfsport.com/listings/certified_products.asp
– Informed Choice: http://www.informed-choice.org/certified-product-brands
– BSCG Certified Drug Free®: https://www.bscg.org/certified-drug-free-dietary-
supplements/
– Consumer Lab®:
https://www.consumerlab.com/results/brands_vitamins_supplements_list.asp
• General certification– USP™: http://www.usp.org/verification-services/program-participants
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Case Study
• 24 yo M deployed service member
• Goal: increase muscle mass/gain weight
• Eating low CHO, inadequate calories,
“clean” foods
• Lifting 90-120 min 5+x/week
• Taking preworkout, BCAA,
AA blend, mass gainer,
Vitapak, etc.
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Supplement Resources
• Operation Supplement Safety
– https://www.opss.org/
• Natural Medicines Database
– Linked through OPSS & SCAN
• NIH Office of Dietary Supplements
– https://ods.od.nih.gov/
• US Anti-Doping Agency
– https://www.usada.org
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Take Away Points
• Prioritize carbohydrate and protein volume
and distribution
• Fad diet may be acceptable if sustainable for
patient and nutrient needs are met
• Push smart supplement use
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Questions?
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Connect with MFLN Nutrition & Wellness Online!
MFLN Nutrition @MFLNNW
MFLN Nutrition and Wellness
MFLN Nutrition and Wellness
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Evaluation & Continuing Education Credits
MFLN Nutrition & Wellness is offering 1.0 CPEU
for today’s webinar.
Please complete the evaluation at: https://vte.co1.qualtrics.com/jfe/form/SV_3CTEwye8O9BE901
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MFLN Intro
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We invite MFLN Service Provider Partners
to our private LinkedIn Group!
https://www.linkedin.com/groups/8409844
DoD
Branch Services
Reserve
Guard
Cooperative Extension
MFLN Nutrition & Wellness
Upcoming Event
• Plant-based Eating: Enhancing Health
Benefits, Minimizing Nutritional Risks
• Tuesday, January 23, 2018
• 11:00 am – 12:00 pm Eastern
• learn.extension.org/events/3203
For more information on MFLN Nutrition & Wellness go to:
https://militaryfamilies.extension.org/nutrition-and-wellness
39
militaryfamilies.extension.org/webinars
40This material is based upon work supported by the National Institute of Food and Agriculture, U.S. Department of Agriculture, and the Office of Military Family
Readiness Policy, U.S. Department of Defense under Award Number 2015-48770-24368.
