Comparison of Energy and Nutrient Intake vs. Estimated Needs in Warfighters: an Update

Relative energy deficiency in military (RED-M)

“…Except for athletes in severely abusive situations, soldiers confront more extreme, multi-stressor environments arising from unpredictable and hostile physical and psychological challenges (eg, severe sleep deprivation, extended periods of physical effort without proper recovery, prolonged periods of mental stress, lack of food and dehydration) 10 11. Therefore, RED-M should be considered a unique entity with underlying mechanisms and negative effects similar to REDs, but with implications of underperformance that could be extremely catastrophic.…”

“…The lack of consensus regarding assessment protocols for EI and EEE, in general, due to methodological approaches that introduce risk for significant underestimation or overestimation of EI and/or EEE and confound accurate estimations of daily dietary intake, makes EA calculation a challenge itself 19. The military setting makes the estimation of EEE even harder to measure; training does not comprise well-defined sessions of physical activity like a sports training session may 11. However, assessment techniques, including more accurate body composition measurements (eg, from dual-energy X-ray absorptiometry or air displacement plethysmograph), blood tests, ECG or metabolic testing can be applied in the military field 10 17…”