Nutrition, Immune Function, and Infectious Disease in Military Personnel: A Narrative Review

A comprehensive review of dietary supplements mission-specific health and performance enhancement in military soldiers

Soldiers undergo intensive physical training, maintain high levels of concentration, and require rapid recovery from various traumas, making them highly specialized individuals. Under high physical and mental stress conditions, soldiers experience health issues related to decreased muscle function, impaired immunity, depression, and cognitive decline. A growing need exists for dietary supplements to mitigate these issues, and the usage patterns of such supplements are continuously increasing. Therefore, as dietary supplement consumption rises within the military, a sophisticated approach to addressing nutritional supplement requirements is essential. We discuss health problems that may arise under stressful conditions in soldiers, suggesting various nutritional supplements that are essential to address these issues. In conclusion, these nutritional supplements can be used as promising interventions for numerous health problems, including enhanced muscle function, improved immunity, mental stress alleviation, and cognitive enhancement. This ultimately suggests a contribution to military personnel health and the strengthening of national defense capabilities.

The Interplay Between Nutrition and Microbiota and the Role of Probiotics and Symbiotics in Pediatric Infectious Diseases

The interplay between nutrition and infectious diseases has been a central theme in health sciences for the last decades due to its great impact on the pediatric population, especially in immunocompromised patients and critically ill children. As conventional treatment and the development of antimicrobials for most infections standard treatment is either limited or not possible, alternative treatment options should be explored. Recent research shows that early enteral nutrition and nutritional supplements (such as probiotics and symbiotics) could have a pivotal role in promoting a healthy microbiome and subsequently preventing and improving outcomes for certain pediatric infectious diseases. However, understanding the specific mechanism of action and tailoring nutritional interventions remains a significant challenge. The optimal dose range for different probiotic strains and prebiotics and the most effective combination for each treatment indication needs further investigation and is yet to be defined. Additionally, in the era of personalized medicine, goal- and patient-directed treatment are key to optimizing and improving outcomes and minimizing potential complications and side effects, especially in complex and immunocompromised patients. The main objectives of this narrative review are 1. to explore the relationship and the complex interactions between microbiota and the human immune system; 2. to describe the influence of nutrition on infectious diseases; 3. to evaluate the impact of supplementation with probiotics and symbiotics in the prevention and treatment of the most relevant infections in children; and 4. to identify knowledge gaps and potential research priorities regarding the use of these supplements in pediatric patients.

Exploring the role of nutritional strategies to influence physiological and cognitive mechanisms in cold weather operations in military personnel

Introduction

As a basis for performance optimal nutritional balance is key to keep the body functioning at homeostatic capacity. When environmental circumstances become challenging such as in a cold environment extraordinary performance is requested specifically for physiological (i.e., vascular response, diet induced thermogenesis, immune response), and cognitive mechanisms (i.e., cognitive function, psychological and cognitive wellbeing) of the human body. In this review we describe which nutritional strategies could enhance military performance in the cold by mitigation of CWIs.

Methods

We will first describe how exposure to cold affects the physiological or cognitive mechanisms itself and then we will explain how nutrition can be used to optimize these affected mechanisms. We will discuss long-term nutritional solutions preventing shortfalls and potential direct quick fixes for physiological and cognitive mechanisms.

Results

For optimal functioning of the immune system and infection prevention, absence of micronutrient deficiencies is key and should be pursued amongst military personnel. For the effectivity of PUFA's, Echinacea purpurea and probiotics in immune functioning, more research is needed in the CWO context. A multitude of micronutrients (i.e., nitrate, L-citrulline, L-arginine) appears to be able to enhance vasodilation, perhaps partially offsetting the detrimental effect of cold on peripheral blood circulation. Although the direct effect of diet induced thermogenesis is small in comparison to being physically active, it is of interest to investigate the effects of adding a combination of spices to the rations, such as capsaicin from red pepper, cinnamon, ginger, and menthol. Also, of interest for stimulation of thermogenesis are caffeine, and polyphenolic compounds. Caffeine and tyrosine supplementation 1 h, resp. 2 h before a cognitively demanding task during CWOs could be used to mitigate decreases in cognitive performance. Alternatives that are of interest, but need more research, include chocolate polyphenols and omega-3 fatty acids.

Conclusion

Even though some recommendations can be provided, it is evident that much information regarding the effectiveness and application of micronutrients in cold weather operations is still lacking. More focus should be placed on investigating (micro)nutritional solutions, practical feasibility, and implementation in operational military personnel to better understand the magnitude of the possible benefits in cold conditions.

Inflammation in cancer: therapeutic opportunities from new insights

As one part of the innate immune response to external stimuli, chronic inflammation increases the risk of various cancers, and tumor-promoting inflammation is considered one of the enabling characteristics of cancer development. Recently, there has been growing evidence on the role of anti-inflammation therapy in cancer prevention and treatment. And researchers have already achieved several noteworthy outcomes. In the review, we explored the underlying mechanisms by which inflammation affects the occurrence and development of cancer. The pro- or anti-tumor effects of these inflammatory factors such as interleukin, interferon, chemokine, inflammasome, and extracellular matrix are discussed. Since FDA-approved anti-inflammation drugs like aspirin show obvious anti-tumor effects, these drugs have unique advantages due to their relatively fewer side effects with long-term use compared to chemotherapy drugs. The characteristics make them promising candidates for cancer chemoprevention. Overall, this review discusses the role of these inflammatory molecules in carcinogenesis of cancer and new inflammation molecules-directed therapeutic opportunities, ranging from cytokine inhibitors/agonists, inflammasome inhibitors, some inhibitors that have already been or are expected to be applied in clinical practice, as well as recent discoveries of the anti-tumor effect of non-steroidal anti-inflammatory drugs and steroidal anti-inflammatory drugs. The advantages and disadvantages of their application in cancer chemoprevention are also discussed.

Glycemic impact of cereal and legume-based bakery products: Implications for chronic disease management

This review examines the glycemic impact of cereal and legume-based bakery products and their potential role in chronic disease management, particularly in type II diabetes and cardiovascular diseases. The primary objective is to assess the glycemic index (GI) and glycemic load (GL) of bakery products made from cereals such as wheat and barley, and legumes like chickpeas, and to explore their effects on postprandial blood glucose response. Cereal-based products typically exhibit higher GIs (55-80), while legume-based bakery products demonstrate lower GIs (40-50), potentially contributing to better glycemic control. Incorporating legumes into bakery formulations can lower their glycemic index by up to 25 %. Legume-enriched bakery products may effectively manage blood glucose and reduce chronic disease risks like diabetes. However, more long-term studies are needed to confirm their broader benefits. This review emphasizes the need for innovation to improve the nutritional and sensory appeal of functional foods.

Dietary Nutrient Adequacy in Aeronautical Military Personnel in Spain: Strengths and Weaknesses

BACKGROUND/OBJECTIVES

Aeronautical military personnel operate under intense physical and mental stress, requiring high psychophysical aptitude. Adequate nutrition is essential to sustain operational readiness and mitigate the risk of chronic diseases and other health issues. This study aims to evaluate the nutritional status of aeronautical military personnel group in Spain through dietary parameters.

METHODS

A total of 390 male aeronautical military personnel, who attended the Centro de Instrucción de Medicina Aeroespacial (Madrid, Spain), were evaluated. Energy and nutrient intakes were estimated by three non-consecutive 24-h dietary recalls (DIAL® program).

RESULTS

The median energy intake was 2134 kcal/day, with significant variations across professional groups, highest in parachutists (2347 kcal/day). Protein intake was 18.2% TE, while carbohydrate intake was 37.6% TE, below standards, with 83.8% of participants not meeting the EFSA guidelines. However, a high intake of added sugars was observed (10% TE). Fat intake (38.3% TE) and saturated fats (11.7% TE) exceeded recommendations. Micronutrient deficiencies were notable for vitamin D (98% below recommendations), folate (56.4%), vitamin C (40.2%), calcium (50.3%), iodine (76.6%), and zinc (59%). Elevated cholesterol intake (352 mg/day) and inadequate fiber intake (18.5 g/day) were also observed.

CONCLUSIONS

This study highlights imbalanced dietary patterns among Spanish aeronautical military personnel, with high protein, fat, cholesterol and added sugar consumption, low carbohydrate, and inadequate intake of critical micronutrients and fiber. These findings emphasize the need for targeted dietary interventions, nutritional monitoring protocols, and specific guidelines to enhance health and performance in this specialized group.

The effect of macronutrient and micronutrient supplements on COVID-19: an umbrella review

BACKGROUND AND AIMS

A healthy diet play an important role in the prevention and even treatment of various diseases. Proper nutrition plays an important role in boosting of immune system. These include the consumption of macronutrients such as proteins, lipids, carbohydrates, and also micronutrients including vitamins. Here, we aimed to systematically review the effects of macronutrients and micronutrients on the prevention and treatment of COVID-19.

METHODS

We searched the databases of PubMed, Scopus, Embase, and Web of Science on December 23, 2023. The records were downloaded into an EndNote file, the duplicates were removed, and the studies underwent a two-phase screening process based on their title/abstracts and full texts. The included articles were screened and underwent inclusion and exclusion criteria. We included the English systematic reviews and meta-analyses that concurred with the aim of our study. The selected articles were assessed by Cochrane's Risk of Bias in Systematic Reviews for the quality check. The data of the eligible studies were extracted in a pre-designed word table and were used for the qualitative synthesis.

RESULTS

A total of 28 reviews were included in this study. Most studies have shown that micronutrients are effective in morbidity and mortality controlling in viral respiratory infections such as COVID-19 but some studies have shown that micronutrients are sometimes not effective in controlling severity. On the other hand, calcifediol was by far the most successful agent in reducing intensive care needs and mortality between studies.

CONCLUSION

Individuals without malnutrition had a reduced risk of SARS-CoV-2 infection and severe disease. The administration of Vitamin D is effective in reducing the morbidity and mortality of COVID-19 patients. Patients with vitamin D deficiency were more prone to experience severe infection, and they were at higher risk of morbidities and mortality. Other micronutrients such as Vitamin A, Vitamin B, and Zinc also showed some benefits in patients with COVID-19. Vitamin C showed no efficacy in COVID-19 management even in intravenous form or in high doses.