Tactical Nutrition Brief

C R E A T E D B Y:

J I M S H E R R A R D , M S , R D , C H P D

H E A D , D E P L O Y M E N T H E A LT H & W E L L N E S S C E N T E R ,

N AVA L H O S P I T A L P E N S A C O L A

B R E A N N E WA T T S ,I N T E R N, D E P L O Y M E N T H E A LT H

& W E L L N E S S C E N T E R C O M M U N I T Y H E A LT H E D U C A T I O N S T U D E N T,

U N I V E R S I T Y O F W E S T F L O R I D A

Tactical Nutrition Brief

Table of Contents

Introduction to Nutrition & Physical Activity Facts & Statistics 5 Fundamentals of Nutrition The Big Three MRE’s 10 Nutrition Tips to Live by Balancing Calories Portion Control Sum it Up Resources

NUTRITION

“…providing or obtaining food necessary for health and growth”

Why is Nutrition Important? Conditions:

Diet and body weight are related to health status

Reduce the risks for many health conditions

Essential to daily performance and military occupation

Overweight & obesity

Iron-deficiency anemia

Malnutrition Osteoporosis Type 2 diabetes Oral diseaseHeart disease ConstipationHigh blood pressure

Diverticular disease

Dyslipidemia (poor lipid profiles)

Some cancers

Nutrition

HEALTHY PEOPLE 2020

PHYSICAL ACTIVITY

“…any bodily activity that enhances or maintains physical fitness and overall health or wellness”

Why is physical activity important? Conditions:

Regular physical activity can improve the health and quality of life of Americans of all ages, regardless of the presence of a chronic disease or disability

Can also lower the risk for many health conditions

Physical Activity

Early Death StrokeCoronary heart disease

High blood pressure

Type II Diabetes

Breast & Colon Cancer

Falls Depression

HEALTHY PEOPLE 2020

Table of Contents

Introduction to Nutrition & Physical Activity Facts & Statistics 5 Fundamentals of Nutrition The Big Three MRE’s 10 Nutrition Tips to Live by Balancing Calories Portion Control Shopping List Resources

• MORE THAN 80 PERCENT OF ADULTS DO NOT MEET THE GUIDELINES FOR BOTH AEROBIC AND MUSCLE-STRENGTHENING ACTIVITIES.

• MORE THAN TWO -THIRDS (68.8 PERCENT) OF ADULTS ARE CONSIDERED TO BE OVERWEIGHT OR OBESE.

• MORE THAN ONE-THIRD (35.7 PERCENT) OF ADULTS ARE CONSIDERED TO BE OBESE.

Facts & Statistics

CDC

• I N 2 0 0 8 , O N LY 3 7 % O F M I L I TA RY P E R S O N N E L M E T T H E H E A LT H Y W E I G H T C R I T E R I O N ( B M I ≥ 1 8 . 5 A N D < 2 5 . 0 ) , W H I C H I S N O TA B LY B E L O W T H E H E A LT H Y P E O P L E 2 0 1 0 O B J E C T I V E O F ≥ 6 0 %

• C O M PA R E D W I T H R AT E S F O R C I V I L I A N S, H E AV Y A L C O H O L U S E I S H I G H E R F O R M I L I TA RY.

• A M O N G T H E U S E O F I L L I C I T D R U G S, S M O K I N G T O B A C C O, A N D A L C O H O L , M I L I TA RY P E R S O N N E L S H O W E D T H E H I G H E S T R AT E S O F H E AV Y A L C O H O L U S E

• I N 2 0 0 8 , 1 3 % O F M I L I TA RY P E R S O N N E L C O N S U M E D T H R E E O R M O R E S E RV I N G S O F F R U I T S P E R D AY, A N D 1 4 % C O N S U M E D T H R E E O R M O R E S E RV I N G S O F V E G E TA B L E S P E R D AY

• (notably lower than the Healthy People 2010 objectives of ≥75% for fruits and ≥50% for vegetables)

Facts & Statistics

DoD HRB Survey 2008

Table of Contents


5 Fundamentals of Nutrition

EAT CLEAN

EAT OFTEN

HYDRATE

MINDSET

RECOVER

NOFFS

Eat Clean

Try to eat foods in the most natural form possible

Eat foods closest to their original form

Least processed types of food, most of the time

Think Nutrient Density Foods with more nutrients

but less calories Carbohydrate, Protein, &

Fat

Timing of meals Key to Energy & Sustainability

Eat mini meals every 2-3 hours

Maintains energy levels Helps to maintain focus Prevents becoming

overly hungry Better choices Stabilizes blood sugar Boosts metabolism Keeps body in fat

burning zone

Eat Often

Hydrate

WATER…• Performance essential• Aids in digestion/metabolism• Brain function• Regulating temperature• Regulates body temperature• Carries nutrients & oxygen

cells• Provides life & shape to

every cell• Shock absorption for spine

& brain• Cushions joints• Weight Management• Delivery of fuel to muscles• 60-65% of total body weight

is water

Mindset

Behavior change

Lifestyle versus diet

80/20 rule

Use tools & resources available to you

Focus on results, they are rewarding

Don’t Waste Your Workout! Nutrition

Can help to speed the recovery process

Empty fuel stores & broken down muscles need to be re-fueled and repaired

Combination of carbohydrates & proteins within 30 minutes ensures a fast recovery. Helps minimize time needed between

workouts Decreases the risk of injury

Carbohydrates = Re-fuelProtein = Re-build

Recover

Table of Contents


Macronutrients: Daily Recommended Amounts:

CARBOHYDRATE4kcals/gram

PROTEIN4kcals/gram

FAT9kcals/gram

The Big Three

Carbohydrates

4 kcals/gramBody is programmed

to use glucose for energy

Primary fuel source for hard exercise

Faster recoveryMaintains immune

functionPostpones fatigue

Carbohydrates

GRAINS: “Come Back to Earth” Fuel for the brain &

muscles Look for the least

processed form of grain

Think brown & found close to the ground!

The best choices will have >3grams of fiber per serving

2 Main Groups of CHO:

• Complex:Natural “sugars”• Whole grains, Milk, Fruits,

Vegetables

• Simple:Added “sugars”• Refined sugars added to food,

Candy, Soda, Pastries, Cake, & Cookies

Too Much Carbohydrate?

Leads to health problemsTired FeelingObesity

Type II Diabetes Excess of glucose in blood Builds resistance to insulin

Gastrointestinal DistressTriglyceride Levels

Plaque build up in arteries Increase Cholesterol levels Increased risk of heart

attack and stroke

Protein

4 kcals/gramPoor source of Energy

Used for Growth, Maintenance, & Repair

Forms enzymes, hormones, antibodies

Supports structure of muscles and cells

Made up of amino acids 20 total amino acids

9 essential- must be supplied by the diet

11 non essential- body can produce

Protein

RDA for Protein = 0.8 grams/ kg of BW Athletes can range from 0.8 – 1.5

Calculate your requirement:• Take your weight in pounds / 2.2 = wt in kg • Weight in kg x .8 = protein requirement• Example: 180lbs / 2.2 = 81.8 x .8 = 65 grams of

protein

How much Protein do you need?

Too Much Protein?

Excess amino acids cannot be storedin the body as protein

More protein ≠ More muscle! Muscle strength, size, and shape comes from exercise Excess protein (any excess calorie) is stored as fat

Too much protein can result in nutrient imbalance, kidney strain, dehydration, and excess body weight

Fats

9 kcals/gramProvides essential nutrients (fatty acids),

vitamins and some energyLines and insulates the nerves of the brain

and body organsAids in manufacturing of antibodies Regular training improves your body’s

ability to use fat as a fuel source “Fat burns in a carbohydrate flame”

Fats

Unsaturated

Saturated Trans

Too Much Fat?

Leads to health problems including:

• Overweight/Obesity• Diabetes• Heart Disease• Atherosclerosis• Bone Conditions• Some cancers• Stroke

The Big ThreeCARBOHYDRATE- fuel for the brain &

muscles

“Come back to Earth”

________

PROTEIN- building blocks for our bodies

“The Less Legs the Better”

________

FAT- healthy fats = energy density

“Eat Healthy Fat”

Table of Contents


Meals Ready to Eat (MRE)

Each MRE contains:

• Entrée• Side Dish • Crackers / Bread• Spread• Dessert• Candy • Beverages• Hot Sauce /

Seasoning

Totally self contained complete meal. • One MRE = One

Meal

Meals Ready to Eat (MRE)• Each MRE contains an average of:

1250 calories 13% Protein36% Fat 51% CHO 1/3 of the Military Recommended Daily Allowance

• 24 “Menus”

• 4 Vegetarian Meals

• 3 MREs/day are recommended for active duty on patrols or on the front line. (3750 kcals)

Table of Contents


10 Nutrition Rules for a Healthy Life

1. Come back to Earth

Choose the LEAST processed forms of food such as: Fruits Veggies Whole grains High-fiber

carbohydrates• Organic• USDA approved• All-Natural

• Read your ingredients!

2. Eat a Rainbow OftenEat FRUITS &

VEGETABLES with EACH MEAL

Drink fruit juice in moderation Make sure it’s 100% juice

Whole fruits & vegetables are best

Canned/Frozen are a healthy alternatives at a lower cost

Choose a wide variety of colors for the biggest benefit

Have fun with it!

3. The Less Legs the Better

Include a lean protein source with each meal

>

4. Eat Health Fats

Include healthy fats in your diet!Olive oil, nuts, natural nut butters, seeds,

avocado, fish, flaxseed and flaxseed oil

Set the Tone!“Break” – “The” – “Fast”

Breakfast Should Include:

Breakfast: Increases Metabolism Fuels the Brain Increases Energy Levels

Don’t substitute coffee, soda and energy drinks for food or lack of sleep.

Skipping breakfast leads to eating more calories through the day and later at night. Don’t play catch up!

Protein: Eggs, egg whites, ham, beans, yogurt, or low-fat milk

High Fiber Carbohydrate: Whole wheat bread, high fiber cereal, oatmeal, or beans

Color: Fruit in cereal, oatmeal, or yogurt / Veggies in eggs or omelets

5. Eat Breakfast Every Day

6. Three for Three

3 meals & 2-3 snacksEat smaller portionsEat more throughout the

dayYou should be eating 4-6

times per day!Aim for all 3

macronutrients [carbs, protein, & fat]

Eat every 3 hours for optimal fueling!

7. Stay Hydrated Drink at least 3 liters of non-

caloric beverages every day

If you are thirsty, it is too late

Water should be your main source of hydration

Avoid drinking soda, energy drinks, and fruit drinks.

Limit sweetened teas and coffee drinks with added sugar and cream

Only choose sports drinks before, during, and after INTENSE exercise

*Evaluate urine to monitor hydration levels

Dehydration = Decreased Performance

7. Stay Hydrated

Water Requirement by Body Weight

(ounces of fluid or liters per day)

120 pounds: 60 – 120 oz, 2 – 4 liters/day

150 pounds: 75 – 150 oz, 2.5 – 5 liters/day





ARMY TROOP REQUIREMENTS:

• 1 quart of beverage per 1,000 calories expended

Increase water consumption:• in warm temperatures• at high altitudes

• when wearing heavy clothing/gear

• with increased levels of physical activity

(Typically 4-6 quarts/day in these conditions)

U.S. Army Public Health Command

Pre-Workout During Workout

Gives you energy for your workout• Increase intensity of workout• Increase calories burned

during exercise = weight lossEat ½ -2 hrs before

exerciseSimple and bland

carbohydrate rich meal Handful of trail mix Protein oatmeal + fruit Fruit smoothie

Stay Hydrated• Water!• >1 hour: Use a drink that has

electrolytes with a small amount of carbohydrate Ex. Gatorade, Diluted fruit juice

Eat if exercise lasts longer than 60 minutes• Prevents hitting the wall• Helps maintain electrolyte

balance• .5 g CHO/lb. body weight per

hour• Ex. 4 cups of sports drink &

banana

8. Don’t Waste Your Workout

Post-Workout Recovery in 3’s

Makes up one of your 5-6 meals

Best results- immediately or up to 30 minutes after workout

Recovery snack or shake [granola bar or fruit smoothie] At least 5g of protein

Combine carbs & protein

Re-fuel: the more intense the training, the more CHO you need!

Re-build: protein needs post workout are based on body weight (handout from earlier)

Re-hydrate: drink 20-24oz of fluid for each pound lost during training


What do you need to recover?

More Examples:

Body Weight (in pounds)

Grams of Protein

Grams of CHO

120-150 15-20 30-60150-180 20-25 40-75180-215 25-30 50-90215-245 30-35 60-105

20oz low-fat chocolate milk + banana

Turkey and pasta salad Tuna sandwich w/baked chips Meal replacement bar + 20oz

sports drink Scrambled eggs or egg whites

with whole wheat toast and 6oz juice

Turkey sandwich + yogurt Spaghetti and meatballs Fruit smoothie blended with

yogurt or whey protein


FUEL FIRST, SUPPLEMENT SECOND

Add a multivitamin to daily routine if needed

Check 1st with doc or registered dietician

Choose smart Improve performance

without compromising health Can be expensive

What is a dietary Supplement? A product that is taken by mouth

that contains a “dietary ingredient” intended to supplement the diet.

Dietary Ingredients in these products: Vitamins, minerals, herbs,

botanicals, amino acids, enzymes, organ tissues, gland tissue or secretions.

No government testing required for: Hoodia and lead Hydroxycut and liver damage

9. Supplement Wisely


ENERGY DRINKS = BAD NEWS!

Increase Heart Rate

Increase Blood Pressure

Dehydrate the Body

Never Use when Exercising• Combination of fluid loss from sweating and the

diuretic quality of the caffeine can leave the user severely dehydrated!

WARNING SIGNS OF QUACKERY

Quick weight loss or muscle gain

Restriction of any one food or food group

Very low in calories (VLCD)• 800-1200 calories a day

Claims that sound too good to be true

You can eat all you wantPromises an easy solutionBreakthrough findings


Check Food & Drug Administration website if

unsure!


People are looking for:Extra EdgeBetter ResultsEasy way outQuick results with

minimum effort

Supplement Companies:Great marketing

schemesDeceptiveNo regulation

“The Magic Bullet”

People are willing to pay!>$30 billion a year

industry

Do your Research!

• Before purchasing & ingesting any supplement, ask yourself:

Is there research done on humans?

• Double blind, placebo-controlled trials

Will this help me achieve my

performance goals?

Will this compromise my health & well-being?

Does this product have any medication interactions?


10. Sleep

Aim for 8 hours of sleep daily

If can’t get 8 hours, consider power naps when possible

Body recovers & repairs best when sleeping

Health conditions are associated with lack of sleep i.e. memory, cognitive

impairment, injuries, stress, obesity, etc.

Essential for performance i.e. energy, alertness, etc.

Table of Contents


Balancing CaloriesFormulas:See handout

Men10 x weight (kg) + 6.25 x height (cm) - 5 x age

(y) + 5

Women10 x weight (kg) + 6.25 x height (cm) - 5 x age

(y) - 161

Find out how many calories you need in a day

Mifflin St Jeor Equation Daily Caloric Needs Calculator Created in 2005 by American Dietetic Association (ADA) Most accurate

Balance Weight=Calories Eaten & Calories Burned

are equal

Weight Gain=Calories Eaten > Calories Burned

Weight Loss=Calories Eaten < Calories Burned

NEVER… Eat a carb alone, skip meals, or go >4 hours without eating!

http://www.google.com/imgres?q=blood+glucose+response+after+meals+chart&um=1&hl=en&biw=1366&bih=673&tbm=isch&tbnid=CcYBKWt6D1NtxM:&imgrefurl=http://fionasavage.co.uk/weightloss/balancing-blood-sugar/&docid=LbA96xNKfc9_3M&imgurl=http://glowbe.files.wordpress.com/2010/04/breakfast-graph-skip.jpg&w=1202&h=483&ei=opQ5UaWNM4iC2gW4sICYDQ&zoom=1&ved=1t:3588,r:17,s:0,i:130&iact=rc&dur=2941&page=2&tbnh=139&tbnw=336&start=16&ndsp=21&tx=171&ty=52

Alcohol

7 kcals/gram Not a macronutrientPoor source of fluids –

dehydrates Decreases the absorption of

vitaminsCan displace nutrient dense

foods in the dietDecreases appetite Depletes the liver’s glycogen

stores and impairs its capacity to form new glucose

Empty Calories !!

12 fl oz.

5 fl oz.

1.5 fl oz.

Alcohol

One 12 oz. beer has 103 calories. Did you ever stop and think about how many calories are in 6 beers?

618 calories!

Alcohol

One Rum and Coke has 240 Calories. Did you ever wonder how many calories were in 6 Rum and Cokes??

1,440 calories!

http://usgovinfo.about.com/gi/dynamic/offsite.htm?site=http://www.ftc.gov/






Table of Contents


Portion Control

Choose M

yPlate

Portion Control

Table of Contents

Introduction to Nutrition & Physical Activity Facts & Statistics 5 Fundamentals of Nutrition The Big Three MRE’s 10 Nutrition Tips to Live by Balancing Calories Portion Control Time to Sum it Up! Resources

Make Wise Choices

Grilled > FriedFruit > Candy or Dessert2% Milk > Whole MilkFlavored Water > SodaWhole Wheat/Multi Grain

vs. White BreadApple or Carrots > Chips

For a SnackCorn > Flour TortillaTurkey > PorkChicken > Beef

Read the Label!Pay attention to serving

size, may not be entire package!

The more fiber, the betterMonitor your fats,

carbohydrates, and proteinLimit sugars when possibleManage your fats

< 65g/dayWatch your sodium

< 2,300mg/day *may vary with weight, age &

activity levels

Take Small Steps!

Making a drastic change in your

eating & exercise habits may lead

to a stomach ache or injury. It also may lead to

failure. However, making small steps along the way increases the chances you

will stay!

Table of Contents


Government Resources

www.commissaries.com

http://willinteractive.com/products/comprehensive-soldier-fitness

United States Army Public Health Command

THANK YOU!

DON’T FORGET TO TAKE THE POST TEST

QUESTIONS ?

Documents

Tactical Nutrition Brief