Understanding the nutritional demands on serving military personnel is critical to inform training schedules and dietary provision. Troops deployed to Afghanistan face austere living and working environments. Observations from the military and those reported in the British and US media indicated possible physical degradation of personnel deployed to Afghanistan. Therefore, the present study aimed to investigate the changes in body composition and nutritional status of military personnel deployed to Afghanistan and how these were related to physical fitness. In a cohort of British Royal Marines (n 249) deployed to Afghanistan for 6 months, body size and body composition were estimated from body mass, height, girth and skinfold measurements. Energy intake (EI) was estimated from food diaries and energy expenditure measured using the doubly labelled water method in a representative subgroup. Strength and aerobic fitness were assessed. The mean body mass of volunteers decreased over the first half of the deployment (24·6 (SD 3·7) %), predominately reflecting fat loss. Body mass partially recovered (mean þ 2·2 (SD 2·9) %) between the mid-and post-deployment periods (P,0·05). Daily EI (mean 10 590 (SD 3339) kJ) was significantly lower than the estimated daily energy expenditure (mean 15 167 (SD 1883) kJ) measured in a subgroup of volunteers. However, despite the body mass loss, aerobic fitness and strength were well maintained. Nutritional provision for British military personnel in Afghanistan appeared sufficient to maintain physical capability and micronutrient status, but providing appropriate nutrition in harsh operational environments must remain a priority.

The sensory innervation of cat hindlimb muscle spindles was studied by reconstruction, electron microscopy, and examination of teased, silver preparations to ascertain the form of the terminals and their distribution to bag 1 ( b 1 ), bag 2 ( b 2 ), and chain ( c ) muscle fibres. Reconstructions were made of two primary endings, one secondary ending, and the branching of four primary and six secondary axons. For the silver analysis spindles were teased from 14 different hindlimb muscles, the largest samples being from tenuissimus, peroneus brevis, p. longus, p. tertius, superficial lumbrical, extensor digitorum longus, and soleus. Among 310 spindles examined, 40 lacked a b 1 fibre. These were all portions of tandem spindles in which the b 2 fibre was continuous from one capsule, where it was accompanied by b 1 and c fibres, to another, in which it was accompanied by c fibres only. These have been designated ‘ b 2 c spindle units’ as distinct from ‘ b 1 b 2 c spindle units’.

The motor innervation of cat spindles was examined in hindlimb muscles using a variety of techniques employed in light and electron microscopy. Observations were made on teased, silver preparations of 267 spindles sampled from the peroneal, flexor hallucis longus, and soleus muscles, hereafter referred to as the PER/FHL/SOL series. The γ innervation. Trail endings are almost invariably present, and innervate both bag and chain muscle fibres. Trail fibres accounted for 64.6 to 74.8% of the total fusimotor supply to samples of spindle poles in the PER/FHL/SOL series, the mean number of fibres per pole varying from 2.7 to 5.0 in the different muscles, and the mean number of ramifications (areas of synaptic contact) per fibre being 3.7. By contrast, the p₂innervation of a spindle pole generally consists of a single fibre supplying only one plate. In the above samples p(2) fibres accounted for 4.1 to 28.0% of the total fusimotor supply, and the mean number of fibres per pole varied from 0.3 to 1.2 in the different muscles. Ninety per cent of p(2) plates innervate bag fibres. The α innervation. The structure of p₁plates as seen in both light and electron microscopy compares very closely with that of extrafusal plates. After nerve section p₁plates degenerate at the same time as extrafusal plates, being the first of the three types of fusimotor ending to disappear. The frequency of the p₁innervation is similar to that of the p₂innervation. In the same samples of PER/FHL/SOL spindle poles as above p₁ fibres accounted for 6.0 to 28.8% of the total fusimotor supply, the mean number of fibres per pole varying from 0.25 to 2.1 in the different muscles. The majority of p₁ fibres enter a pole to terminate in one plate only. Seventy-five per cent of the plates innervate bag fibres. The three types of fusimotor ending are thus not selectively distributed to the two types of intrafusal muscle fibre. All three types of fusimotor fibre may branch within the spindle so as to innervate both bag and chain fibres. Bag fibres receive both types of plate ending as well as trail endings. Most chain fibres receive trail endings only; the rest receive either a p₁or a p₂plate innervation in addition, 25% of the p₁and 10% of the p₂innervation being distributed to chain fibres. The significance of this nonselective innervation is interpreted as indicating that the type of contraction elicited by stimulating a fusimotor fibre depends upon the type of ending initiating it rather than upon the type of muscle fibre executing it. Reasons are given for concluding that the dynamic response is controlled via the p₁and p₂plates, and that the static response is controlled by the trail endings. The participation of the α fibres in mammalian fusimotor innervation, previously regarded as a vestigial feature, proved to be widespread in the muscles studied and more prevalent in fast muscles (FHL, peroneus digiti quinti) than slow (soleus). A low frequency of p₁innervation is offset by a high frequency of p₂(as in peroneus longus), and vice versa (as in FHL). ...

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BackgroundSusceptibility to exertional heat illness (EHI) is considered multifactorial in nature. The aims of this study were to (1) review traditional susceptibility factors identified in cases of EHI and (2) determine how they are related to risk of hospitalisation.MethodsReview of an electronic database of EHI reported in the British Army between 1 September 2007 and 31 December 2014. Cases were categorised by demographic, situational and susceptibility variables. Univariate and multivariate logistic regression was performed for the OR for hospitalisation by risk factor.Results361 reports were included in the analysis. 33.5% of cases occurred in hot climates, 34.6% in temperate climates during summer months and 31.9% in temperate climates outside of summer months. Traditional susceptibility factors were reported in 193 but entirely absent from 168 cases. 137 cases (38.0%) were admitted to hospital. Adjusted OR for hospitalisation was lower for recruits (OR 0.42, 95% CI 0.18 to 0.99, p<0.05) and for personnel wearing occlusive dress (OR 0.56, 95% CI 0.34 to 0.93, p<0.05) or unacclimatised to heat (OR 0.31, 95% CI 0.15 to 0.66, p<0.01).ConclusionsThe global, year-round threat of EHI is highlighted. Absence of susceptibility factors in nearly half of reports highlights the challenge of identifying EHI-prone individuals. Paradoxical association of traditional susceptibility factors with reduced hospitalisation risk may reflect the contemporary contexts in which severe EHI occurs. These findings also suggest a need for better evidence to inform guidelines that aim to prevent severe EHI concurrent to reducing overall morbidity.