IntroductionUntil recently, women were excluded from British combat roles. Their risk for musculoskeletal injury during basic training is two to three times higher than men. To better understand the musculoskeletal injury risk of women in British Army infantry basic training, we compared injury incidence between (1) men in standard entry training and men in infantry training, to assess the risk of infantry training; and (2) men and women in both standard entry and officer basic training, to assess the risk in women compared with men.MethodsThe incidence of musculoskeletal injury was determined from defence medical records for all men entering infantry training, and for all men and women entering standard entry and officer training, between April 2015 and March 2016.Results7390 men (standard entry, n=4229; infantry, n=2683; officer, n=478) and 696 women (standard entry, n=626; officer, n=70) entered basic training. Men in infantry training had a lower incidence of musculoskeletal injury (391 vs 417 per 1000 personnel, OR 0.90 (95% CI 0.81 to 0.99), p=0.028) and a higher incidence of stress fracture (14 vs 5 per 1000 personnel, OR 2.80 (95% CI 1.64 to 4.80), p<0.001) than men in standard entry training. Women had a higher incidence of musculoskeletal injury than men in standard entry training (522 vs 417 per 1000 personnel, OR 1.53 (95% CI 1.29 to 1.81), p<0.001) and a higher incidence of stress fracture than men in officer training (114 vs 19 per 1000 personnel, OR 6.72 (95% CI 2.50 to 18.07), p<0.001).ConclusionWomen in infantry training may be at similar risk for musculoskeletal injury, but at higher risk for stress fracture, compared with their non-infantry counterparts. Women in infantry training may be at higher risk for musculoskeletal injury and stress fracture compared with men in infantry training.

BackgroundBritish Army Phase One training exposes men and women to challenging distances of 13.5 km·d− 1 vs. 11.8 km·d− 1 and energy expenditures of ~ 4000 kcal·d− 1 and ~ 3000 kcal·d− 1, respectively. As such, it is essential that adequate nutrition is provided to support training demands. However, to date, there is a paucity of data on habitual dietary intake of British Army recruits. The aims of this study were to: (i) compare habitual dietary intake in British Army recruits undergoing Phase One training to Military Dietary Reference Values (MDRVs), and (ii) establish if there was a relative sex difference in dietary intake between men and women.MethodResearcher led weighed food records and food diaries were used to assess dietary intake in twenty-eight women (age 21.4 ± 3.0 yrs., height: 163.7 ± 5.0 cm, body mass 65.0 ± 6.7 kg), and seventeen men (age 20.4 ± 2.3 yrs., height: 178.0 ± 7.9 cm, body mass 74.6 ± 8.1 kg) at the Army Training Centre, Pirbright for 8-days in week ten of training. Macro and micronutrient content were estimated using dietary analysis software (Nutritics, Dublin) and assessed via an independent sample t-test to establish if there was a sex difference in daily energy, macro or micronutrient intakes.ResultsEstimated daily energy intake was less than the MDRV for both men and women, with men consuming a greater amount of energy compared with women (2846 ± 573 vs. 2207 ± 585 kcal·day− 1, p < 0.001). Both sexes under consumed carbohydrate (CHO) when data was expressed relative to body mass with men consuming a greater amount than women (4.8 ± 1.3 vs. 3.8 ± 1.4 g·kg− 1·day− 1, p = 0.025, ES = 0.74). Both sexes also failed to meet MDRVs for protein intake with men consuming more than women (1.5 ± 0.3 vs. 1.3 ± 0.3 g·kg− 1·day− 1, p > 0.030, ES = 0.67). There were no differences in dietary fat intake between men and women (1.5 ± 0.2 vs. 1.5 ± 0.5 g·kg− 1·day− 1, p = 0.483, ES = 0.00).ConclusionsDaily EI in men and women in Phase One training does not meet MDRVs. Interventions to increase macronutrient intakes should be considered along with research investigating the potential benefits for increasing different macronutrient intakes on training adaptations.

We evaluated the impact of protein supplementation on adaptations to arduous concurrent training in healthy adults with potential applications to individuals undergoing military training. Peer-reviewed papers published in English meeting the population, intervention, comparison and outcome criteria were included. Database searches were completed in PubMed, Web of science and SPORTDiscus. Study quality was evaluated using the COnsensus based standards for the selection of health status measurement instruments checklist. Of 11 studies included, nine focused on performance, six on body composition and four on muscle recovery. Cohen’s d effect sizes showed that protein supplementation improved performance outcomes in response to concurrent training (ES = 0.89, 95% CI = 0.08–1.70). When analysed separately, improvements in muscle strength (SMD = +4.92 kg, 95% CI = −2.70–12.54 kg) were found, but not in aerobic endurance. Gains in fat-free mass (SMD = +0.75 kg, 95% CI = 0.44–1.06 kg) and reductions in fat-mass (SMD = −0.99, 95% CI = −1.43–0.23 kg) were greater with protein supplementation. Most studies did not report protein turnover, nitrogen balance and/or total daily protein intake. Therefore, further research is warranted. However, our findings infer that protein supplementation may support lean-mass accretion and strength gains during arduous concurrent training in physical active populations, including military recruits.

Increasing retention of female recruits throughout Basic Training (BT) is a key priority for the British Army. The aims of this study were two-fold; (i) quantify breast health issues and sports bra usage within female British Army recruits, and (ii) assess the influence of professionally fitted sports bras on breast health and bra fit issues across 13 weeks of BT. A survey was completed by 246 female recruits that identified the incidence of breast health issues during BT. Subsequently, 33 female recruits were provided with professionally fitted sports bras during Week-1 of BT. Recruits completed a survey in Week-1 (Pre) and Week-13 (Post). There was a high incidence of bra issues during BT, which did not reduce following the implementation of professionally fitted sports bras. The authors recommend further research into the specific functional requirements of breast support relative to the demands of BT and the needs of the female recruit.