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Not Eating Enough: Overcoming Underconsumption of Military Operational Rations (1995)
Institute of Medicine (IOM)

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. "16 The Functional Effects of Carbohydrate and Energy Underconsumption." Not Eating Enough: Overcoming Underconsumption of Military Operational Rations. Washington, DC: The National Academies Press, 1995.

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Not Eating Enough: Overcoming Underconsumption of Military Operational Rations

Now, in the studies I showed you an adaptation of ketosis. There may be an uncomfortable thing. We might say, rather than giving that extra 75 g of protein, let's give 75 g of carbohydrate.

So, what you do in that is, you pull the rug out from under the ketoadaptive state. And you may not get the same ability to do that for prolonged exertion, but intermediate intensity of performance that I showed you we could do.

So, I am not sure that we are living on a perfect continuum there, in terms of having a wonderful substitution of carbohydrate and protein.

The way I am reading now is that when you get up to a level of 1.5 g of protein per kilo, some people begin to feel a little uncomfortable with that as being unnecessary. But it is well within the envelope of what the average adult American male typically eats.

ELDON W. ASKEW: In addition, in your weight-loss study, they maintained and actually increased performance capacity.

Did you have an activity monitoring during that? In other words, did they gradually become more active as they lost more weight and basically got more into shape, so to speak, and that had something to do with it?

STEPHEN PHINNEY: Again, the question is, in the weight-loss studies where we saw the improvement in endurance time, was there some improvement in activity? People lived within the metabolic research wards. They were allowed to leave the metabolic research ward on their own for employment or school.

We had people who agreed that they would not increase their exercise. We saw no increase in their peak aerobic power during the course of the studies. So, I don't think there was a training effect, but I can't absolutely rule that out.

WILLIAM BEISEL: A lot has been made well known that the advantage of intake is the declining protein efficiency goes down, but there are also a lot of studies out there that show that increased protein intake increased the efficiency of energy.

STEPHEN PHINNEY: It is always interesting to me, mostly I sit with Mary and Karl over a cup of coffee. I wish that they could stand up and show the data, but first of all, in the Ranger study, that we would ever be able to see a protein deficiency base.

But also, Mary and I have had a lot of discussions about this. Mary has the ability to sock it up, sock it up. So, when I look at her tests I have got a little problem. But you can't tell the immune systems to sock it up.

And Dr. Crane, who is an immunologist, in both studies, he had always had a problem, that we couldn't publish. If you look at human spots(?), they go down. So, they eat and it starts to come back up. Body weight is still going

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Front Matter (R1-R13)
I Committee Summary and Recommendations (1-2)
1 Introduction and Background (3-40)
2 Conclusions and Recommendations (41-54)
II Background and Introduction to the Topic (55-56)
3 Introduction to the Concepts and Issues: Underlying Underconsumption in Military Settings (57-64)
4 Army Field Feeding System-Future (65-76)
5 Commanders' Perceptions and Attitudes About Their Responsibilities for Feeding Soldiers (77-90)
6 Nutritional Criteria for Development and Testing of Military Field Rations: An Historical Perspective (91-108)
7 Evolution of Rations: The Pursuit of Universal Acceptance (109-120)
8 An Overview of Dietary Intakes During Military Exercises (121-150)
9 The Effects of Ration Modifications on Energy Intake, Body Weight Change (151-174)
III Factors Underlying Food Intake and Underconsumption--Food (175-176)
10 The Role of Image, Stereotypes, and Expectations on the Acceptance and Consumption of Rations (177-202)
11 Effects of Food Quality, Quantity, and Variety on Intake (203-216)
12 Effects of Beverage Consumption and Hydration Status on Caloric Intake (217-238)
13 Industry Approaches to Food Research (239-250)
IV Underconsumption and Performance (251-252)
14 When Does Energy Deficit Affect Soldier Physical Performance? (253-284)
15 Impact of Underconsumption on Cognitive Performance (285-302)
16 The Functional Effects of Carbohydrate and Energy Underconsumption (303-316)
V Factors Underlying Food Intake and Underconsumption--The Eating Situation and Social Issues (317-318)
17 The Physical Eating Situation (319-340)
18 Eating Situations, Food Appropriateness, and Consumption (341-360)
19 From Biologic Rhythms to Chronomes Relevant to Nutrition (361-372)
20 Social Facilitation and Inhibition of Eating (373-392)
21 Lessons from Eating Disorders (393-410)
22 A Plan to Overcome Ration Underconsumption (411-416)
Appendixes (417-418)
A Biographical Sketches (419-432)
B Abbreviations (433-436)
C Factors Related to Underconsumption --A Selected Bibliography (437-464)
Index (465-483)