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Nutritional Needs in Cold and High-Altitude Environments: Applications for Military Personnel in Field Operations (1996)
Institute of Medicine (IOM)

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259
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ENHANCEMENT OF COLD TOLERANCE IN HUMANS

As early as 1942, it was reported that the ingestion of caffeine in men exposed to a cool ambient temperature reduced the drop in mean skin temperature (sk) and thus ensured a warmer sk (Scheurer and Hugo, 1942). Similarly, LeBlanc (1987) found that caffeine ingestion before retiring for the night in a cool environment significantly increased oxygen consumption and provided a warmer sk, but without any change in Tre. Other studies that have analyzed the effect of caffeine in the cold have confirmed that it has little influence on Tre. Contrary to LeBlanc's observations, they have also reported that it tends to exaggerate the drop in sk in cold air (Graham et al., 1991; McNaughton et al., 1990) or that it offers no beneficial effect in cold water, in spite of an important increase in M (Doubt and Hsieh, 1991).

Following up on his animal work (described earlier), Wang and colleagues showed that the drop in Tre in cold-exposed individuals can be greatly reduced with the prior administration of theophylline. This was demonstrated in acute cold air studies, with the subjects either at rest or performing intermittent exercise (Wang et al., 1986, 1987, 1989). It was suggested that, as in animals, the effectiveness of theophylline in enhancing human cold tolerance resided in an enhancement of energy substrate mobilization, a factor that was thought to be limiting for cold-induced thermogenesis and consequently cold tolerance (Wang, 1978, 1981; Wang and Anholt, 1982; Wang et al., 1986). Although this theory seems well supported by the animal studies, the corresponding metabolic data in humans are not as convincing, particularly since the marked improvements in the subjects' Tre, described above, were not accompanied by any significant increase in M (Wang et al., 1986, 1987, 1989). To clarify the mechanisms by which cold tolerance can be enhanced, Vallerand and coworkers decided to reinvestigate the concept linking energy substrate mobilization, thermoregulatory thermogenesis, and cold tolerance.

Energy Substrate Mobilization and Cold Tolerance

Based on the theory above, which stated that energy substrate mobilization regulates thermoregulatory thermogenesis, a commercially available recreation and sports bar (Cold Buster™) has been recently developed. It is purported to delay markedly the onset of hypothermia in humans as a result of its energy-containing substrates and theobromine content. After proper subject familiarization (i.e., prior exposure to cold and instruments) to ensure a good reproducibility between cold tests (< 5 percent variability) (Vallerand and Jacobs, 1989) and while fasting seminude (jogging shorts only), subjects were

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259
Front Matter (R1-R16)
I: Committee Summary and Recommendations (1-2)
1 A Review of the Physiology and Nutrition in Cold and in High-Altitude Environments (3-58)
2 Committee on Military Nutrition Research Recommendations and Conclusions (59-80)
II: Background and Introduction to theTopic (81-82)
3 Cold Weather and High-Altitude Nutrition: Overview of the Issues (83-94)
4 Leadership Insights for Military Operations in Cold Weather and at High Altitudes (95-100)
5 Cold-Weather Field Feeding: Military Rations (101-114)
6 Feeding the US Army Sixth Infantry Division (Light) in the Cold (115-122)
Part II Discussion (123-124)
III: The Cold Environment (125-126)
7 The Physiology of Cold Exposure (127-148)
8 Military Schedules vs. Biological Clocks (149-160)
9 Influence of Cold Stress on Human Fluid Balance (161-180)
10 Muscle Metabolism and Shivering During Cold Stress (181-188)
11 Macronutrient Requirements for Work in Cold Environments (189-202)
12 Cold Exposure, Appetite, and Energy Balance (203-214)
13 Effects of Cold and altitude on Vitamin and Mineral Requirements (215-244)
14 Micronutrient Deficiency States and Thermoregulation in the Cold (245-256)
15 Drug-Induced Delay of Hypothermia (257-270)
Part III Discussion (271-292)
IV: The High-Terrestrial Environment (293-294)
16 The Physiology of High-Altitude Exposure (295-318)
17 Physical Performance at High Altitudes (319-330)
18 Fluid Metabolism at High Altitudes (331-356)
19 Maintenance of Body Weight at High Altitudes: In Search of 500 kcal/day (357-378)
20 Energy and Macronutrient Requirements for work at High Altitudes (379-392)
21 Oxidative Stress at High Altitudes and Effects of Vitamin E (393-418)
Part IV Discussion (419-432)
V: Performance in Cold and in High-Altitude Environments (433-434)
22 Effets of Altitue on Cognitive Performance and Mood States (435-452)
23 Food Components and Other Treatments That May Enhance Mental Performance at High Altitudes and in the Cold (453-466)
General Discussion (467-478)
Appendixes (479-480)
A: Environmental Stress Management at High Altitudes by Adaptogens, summary of unpublished manuscript (481-484)
B: Biographical Sketches (485-500)
C: Abbreviations (501-504)
D: Factors Related to Nutritional Needs in Cold and in High-Altitude Environments- A Selected Bibliography (505-554)
Index (555-568)