Air Force Pilot Nutrition"Fly Fit, Fly Safe!"

Jarrett Moore

Air Force PilotsAir Force Pilots Air Force Pilots are Air Force Pilots are

commissioned officers who commissioned officers who take control of a wide variety take control of a wide variety of the most technologically of the most technologically advanced aircraft in the advanced aircraft in the world.world.

These pilots push their minds These pilots push their minds and bodies to the absolute and bodies to the absolute limits in an environment that limits in an environment that has drastic physiological has drastic physiological effects on the human body.effects on the human body.

Because of this demand, Because of this demand, these men and women are these men and women are required to be well rounded required to be well rounded tactical athletes.tactical athletes.

Human FactorsHuman Factors Seventy percent of Seventy percent of

aviation accidents are aviation accidents are caused by human error. caused by human error. 2929

Human factors describes Human factors describes the relationship between the relationship between the human element, the the human element, the working environment, and working environment, and equipment equipment (hardware/software). (hardware/software). 2929

The purpose of examining The purpose of examining human factors is to reduce human factors is to reduce human error in an effort to human error in an effort to improve flight safety and improve flight safety and human performance. human performance.

Nutrition and Human Nutrition and Human Factors Factors

Unlike sport athletes, Unlike sport athletes, tactical athletes are placed tactical athletes are placed in situations where human in situations where human performance could be the performance could be the difference between life and difference between life and death.death.

Technology is no longer the Technology is no longer the limiting factor in pilot limiting factor in pilot performance. Technology performance. Technology now supersedes what the now supersedes what the human body is capable of human body is capable of withstanding.withstanding.

Proper nutrition may Proper nutrition may improve flight readiness and improve flight readiness and pilot performance which may pilot performance which may reduce the chance of human reduce the chance of human error causing an incident. error causing an incident.

Energy SystemsEnergy Systems

Phosphagen SystemPhosphagen System Heavily relied upon during anti-G straining Heavily relied upon during anti-G straining

maneuvers (3-16 seconds).maneuvers (3-16 seconds). F-16 Pilots must endure 9 G for up to 15 F-16 Pilots must endure 9 G for up to 15

seconds.seconds. GlycolysisGlycolysis

Muscular endurance PT component.Muscular endurance PT component. Aerobic SystemAerobic System

Hypoxia stresses the cardiovascular system Hypoxia stresses the cardiovascular system more than normoxia. more than normoxia. 2929

1.5 mile run PFT, PT, and specialty schools.1.5 mile run PFT, PT, and specialty schools.

Air Force Physical Air Force Physical Fitness StandardsFitness Standards

Minimum RequirementsMinimum Requirements 1.5 Mile Run: 13:361.5 Mile Run: 13:36 Push-ups: 33 in one minutePush-ups: 33 in one minute Sit-ups: 42 in one minuteSit-ups: 42 in one minute

Max TestMax Test 1.5 Mile Run: 9:12 or under1.5 Mile Run: 9:12 or under Push-ups: 67 or more in one minutePush-ups: 67 or more in one minute Sit-ups: 58 or more in one minuteSit-ups: 58 or more in one minute

AccelerationAcceleration

Caloric Expenditure in Caloric Expenditure in FlightFlight

ActivityActivity kcal X minkcal X min-1-1

4-G Turns4-G Turns 2.32.3

LandingLanding 2.52.5

RollsRolls 3.03.0

Aerial Combat ManeuveringAerial Combat Maneuvering 4.84.8

Piloting helicopters during aerobaticsPiloting helicopters during aerobatics 1.61.6

Aerobatics by aircraft pilotsAerobatics by aircraft pilots 1.81.8

Barrel RollsBarrel Rolls 3.63.6

Hypoxic HypoxiaHypoxic Hypoxia Hypoxic HypoxiaHypoxic Hypoxia

Insufficient oxygen available to Insufficient oxygen available to the lungs or low PAO2.the lungs or low PAO2.

Boyle's LawBoyle's Law The volume of a gas is inversely The volume of a gas is inversely

proportional to the pressure on proportional to the pressure on the gas as long as the the gas as long as the temperature remains constant. temperature remains constant. 2929

Dalton's Law: PDalton's Law: PTT= P= P11+ P+ P22...P...Pn n The percentage of oxygen in The percentage of oxygen in

the atmosphere is constant. the atmosphere is constant. 2929

The partial pressure of OThe partial pressure of O2 2 decreases proportionately as decreases proportionately as atmospheric pressure atmospheric pressure decreases. decreases. 2929

SymptomsSymptoms Cyanosis, euphoria, increased Cyanosis, euphoria, increased

respiration, mental confusion, respiration, mental confusion, decreased reaction time, and decreased reaction time, and impaired judgment. impaired judgment. 2929

Hypoxia Time of Useful Hypoxia Time of Useful ConsciousnessConsciousness

Effects of Hypoxia at Effects of Hypoxia at AltitudeAltitude

Nutrition Considerations Nutrition Considerations for Air Force Pilotsfor Air Force Pilots

Pilots should be considered weight class athletes because Pilots should be considered weight class athletes because of the weight regulations in the military.of the weight regulations in the military.

Some consideration should be given to pilots or other Some consideration should be given to pilots or other military personnel that compete in team sports, military personnel that compete in team sports, endurance events, or strength/power events.endurance events, or strength/power events.

What pilots consume before and during a flight can have a What pilots consume before and during a flight can have a significant impact on flight performance. significant impact on flight performance. 4, 8 11,13, 15, 17, 18, 21, 23, 24, 27,4, 8 11,13, 15, 17, 18, 21, 23, 24, 27, 2929

Pilots should pay special attention to the following areas:Pilots should pay special attention to the following areas: Hydration StatusHydration Status Pre-Flight Nutrition Pre-Flight Nutrition In-Flight NutritionIn-Flight Nutrition Body CompositionBody Composition SupplementsSupplements

Effects of Dehydration on Effects of Dehydration on PerformancePerformance

Flight performance Flight performance and spatial cognition and spatial cognition test scores are test scores are significantly lower for significantly lower for pilots in a dehydrated pilots in a dehydrated state. state. 1818

Dehydration leads to a Dehydration leads to a reduction in G reduction in G tolerance. tolerance. 2727

Dehydration may also Dehydration may also lead to a reduction in lead to a reduction in peripheral vision. peripheral vision. 27,31 27,31

What Causes What Causes Dehydration?Dehydration?

Ambient EnvironmentAmbient Environment Pressurized low humidity environment (<5%) Pressurized low humidity environment (<5%)

in the cockpit can accelerate fluid loss. in the cockpit can accelerate fluid loss. 25, 28, 2925, 28, 29

Increased temperature in the cockpit from Increased temperature in the cockpit from radiant heat or kinetic heat. radiant heat or kinetic heat. 2929

AltitudeAltitude Renal excretion rates of sodium and water Renal excretion rates of sodium and water

increase during acute hypoxia exposure. increase during acute hypoxia exposure. 4, 6, 12, 4, 6, 12,

22, 29, 32, 3522, 29, 32, 35 Increase in ventilation in response to hypoxia Increase in ventilation in response to hypoxia

accelerates fluid loss. accelerates fluid loss. 28, 29, 3528, 29, 35

Increase in the osmolarity threshold for Increase in the osmolarity threshold for stimulating the release of ADH. stimulating the release of ADH. 2222

Hydration & SodiumHydration & Sodium Sodium helps regulate Sodium helps regulate

fluid balance outside fluid balance outside of cells. of cells. 44

Sodium is excreted Sodium is excreted faster at altitude. faster at altitude. 4, 6, 22, 324, 6, 22, 32

Euhydration is Euhydration is encouraged for most encouraged for most flights. flights. 2929

Urine color chart may Urine color chart may be most effective way be most effective way to monitor hydration to monitor hydration status. status. 2929

Micturition relief Micturition relief capability differs with capability differs with each flight. each flight. 2929

Hydration ProtocolHydration Protocol Pilots who have experienced changes in peripheral Pilots who have experienced changes in peripheral

vision due to dehydration notice an immediate vision due to dehydration notice an immediate improvement in vision after consuming fluids. improvement in vision after consuming fluids. 3131

Pilots should not wait until they are thirsty to Pilots should not wait until they are thirsty to consume fluids. consume fluids. 3232

Because so many factors can influence hydration Because so many factors can influence hydration status on a flight, it is important for the pilot to status on a flight, it is important for the pilot to hydrate before the flight. hydrate before the flight. 3232

Pilots should consume 400-600 ml during the four Pilots should consume 400-600 ml during the four hour period before flights that may involve warm hour period before flights that may involve warm conditions or intense maneuvering. conditions or intense maneuvering.

Hyperhydration is not necessary. Hyperhydration is not necessary. 29, 3229, 32

An additional 10-20 ml of water/fluids is required An additional 10-20 ml of water/fluids is required during each hour of flight. during each hour of flight. 2828

Pre-Flight NutritionPre-Flight Nutrition Researchers found that consuming a high Researchers found that consuming a high

carbohydrate meal before acute hypoxia carbohydrate meal before acute hypoxia exposure improved hemoglobin saturation exposure improved hemoglobin saturation significantly more than a high protein significantly more than a high protein meal. meal. 8, 10, 118, 10, 11

The high carbohydrate meal improved The high carbohydrate meal improved hemoglobin saturation by 4%. hemoglobin saturation by 4%. 8, 10, 118, 10, 11

Altitude there is an increased reliance on Altitude there is an increased reliance on glucose as a substrate during acute glucose as a substrate during acute exposures to altitude. exposures to altitude. 3030

In-Flight Nutrition: Air In-Flight Nutrition: Air SicknessSickness

Because of the dynamic Because of the dynamic environment of flight, it is environment of flight, it is important to consider proper important to consider proper nutritional remedies in case nutritional remedies in case air sickness occurs.air sickness occurs.

Proper pre-flight meal may Proper pre-flight meal may help reduce the chance of air help reduce the chance of air sickness. sickness. 17, 2917, 29

Avoid spicy food and heavily Avoid spicy food and heavily carbonated beverages before carbonated beverages before flight. flight. 17, 2917, 29

Pilots are encouraged to Pilots are encouraged to consume bland food such as consume bland food such as soda crackers and sip on a soda crackers and sip on a soda to help reduce the soda to help reduce the symptoms of air sickness. symptoms of air sickness. 17, 2917, 29

High Altitude AnorexiaHigh Altitude Anorexia This phenomon describes the loss of This phenomon describes the loss of

appetite from acute exposures to altitude. appetite from acute exposures to altitude. 2929

Short-term exposure to hypoxia Short-term exposure to hypoxia suppresses plasma acylated ghrelin suppresses plasma acylated ghrelin concentrations which leads to a loss in concentrations which leads to a loss in appetite. appetite. 2929

This may be accompanied by a loss in This may be accompanied by a loss in body mass. body mass. 29, 25, 3129, 25, 31

Because altitude exposure increases Because altitude exposure increases metabolic rate, pilots will need to increase metabolic rate, pilots will need to increase caloric intake to maintain body mass.caloric intake to maintain body mass.

Air Sickness for FemalesAir Sickness for Females Lindseth et al found that Lindseth et al found that

75% of the female pilots 75% of the female pilots in their study experience in their study experience air sickness. air sickness. 1717

A dietary recall indicated A dietary recall indicated that their diets were low that their diets were low in vitamin A, vitamin C, in vitamin A, vitamin C, and iron. and iron. 1717

Whether or not this is Whether or not this is the cause of air sickness the cause of air sickness is unknown; however, it is unknown; however, it is suggested that is suggested that females increase their females increase their intake of these nutrients. intake of these nutrients. 1717

Body Composition: Obesity Body Composition: Obesity and Decompression and Decompression

SicknessSickness Henry's Law: Henry's Law: At a constant At a constant

temperature, the amount of temperature, the amount of gas that dissolves into a gas that dissolves into a fluid is directly proportional fluid is directly proportional to the pressure. to the pressure. 2929

Decompression sickness, Decompression sickness, known as "the bends", known as "the bends", refers to the dissolution of refers to the dissolution of nitrogen within body nitrogen within body tissues that is caused by a tissues that is caused by a reduction in ambient reduction in ambient pressure. pressure. 7, 297, 29

Because fat tissue retains Because fat tissue retains nitrogen longer, obese nitrogen longer, obese pilots are a greater risk of pilots are a greater risk of developing DCS. developing DCS. 7, 297, 29

Tactical Athlete Diet PlanTactical Athlete Diet Plan 27 year old male: 175lbs and 69 inches tall.27 year old male: 175lbs and 69 inches tall. Trains 3-4 times per week. Trains 3-4 times per week.

Running/RuckingRunning/Rucking Circuit Training/CrossfitCircuit Training/Crossfit

~2,800 kcal per day to maintain body weight.~2,800 kcal per day to maintain body weight. CHO: 5 to 8 g/ Kg per day depending on activity or 55-65% CHO: 5 to 8 g/ Kg per day depending on activity or 55-65%

of caloric intake.of caloric intake. ~390 grams or 1,560 kcal~390 grams or 1,560 kcal

PRO: 1.6-1.8 g/Kg per day or 15-18% of caloric intakePRO: 1.6-1.8 g/Kg per day or 15-18% of caloric intake ~135 grams or 537 kcal~135 grams or 537 kcal

FAT: ~24-27% of caloric intakeFAT: ~24-27% of caloric intake ~80 grams or 723 kcal~80 grams or 723 kcal

Pilots should eat frequently (5-6 times per day) because Pilots should eat frequently (5-6 times per day) because they can be called upon to perform duties on a moment's they can be called upon to perform duties on a moment's notice. notice. 2929

Reduces the incidence of hypoglycemia in flight. Reduces the incidence of hypoglycemia in flight. 2929

2,800 kcal Sample Diet2,800 kcal Sample Diet5:00 AM: 5:00 AM:

Breakfast: (563.5 kcal: 86g CHO 15.5g Breakfast: (563.5 kcal: 86g CHO 15.5g FAT 20g PRO)FAT 20g PRO)

½ cup Kashi 7 Whole Grain Cereal ½ cup Kashi 7 Whole Grain Cereal Nuggets Nuggets

1 medium banana 1 medium banana 1 cup 2% milk1 cup 2% milk 1 tbsp natural peanut butter1 tbsp natural peanut butter 1 cup of coffee+ sweetener 1 cup of coffee+ sweetener

8:00 AM:8:00 AM:Snack: (353.5 kcal: 43g CHO 13.5g Snack: (353.5 kcal: 43g CHO 13.5g FAT 9g PRO)FAT 9g PRO)

7 Kashi Whole Wheat Crackers7 Kashi Whole Wheat Crackers 2 string cheese2 string cheese 1 Fruit Cup1 Fruit Cup 16 fluid oz of water16 fluid oz of water

12:00 PM:12:00 PM:Lunch: (692 kcal: 92g CHO 20g FAT Lunch: (692 kcal: 92g CHO 20g FAT 36g PRO)36g PRO)

Foot Long Subway Turkey and Black Foot Long Subway Turkey and Black Forest Ham SandwichForest Ham Sandwich

12 fluid oz of coke zero12 fluid oz of coke zero

3:00 PM:Snack: (247.5 kcal: 45g CHO 3.5g FAT 9g PRO)

Cliff Bar 16 fluid oz propel zero

6:00 PM:Dinner: (679.5 kcal: 78g CHO 21.5g FAT 43.5g PRO)

5 oz lean turkey burger 1 whole wheat bun 2 cups of mixed salad greens Balsamic Vinaigrette Dressing, low fat 1 whole wheat blueberry muffin

9:00 PM:Snack: (338 kcal: 45g CHO 12g FAT 10g PRO)

Trail mix with 1 cup granola/cereal, ¼ cup dried fruit, and 1/3 cup nuts

TOTALS: 2,852 kcal: 389g CHO 86g FAT 130.5g PRORatio: (55% CHO 27% FAT 18% PRO)

Supplement Supplement ConsiderationsConsiderations

Self-reported surveys Self-reported surveys indicate that 60-85% of indicate that 60-85% of males from various military males from various military groups use or have used groups use or have used supplements (Arsenault).supplements (Arsenault).

Pilots should consult with Pilots should consult with their flight surgeon before their flight surgeon before adding an OTC supplement adding an OTC supplement to their diet.to their diet.

Because of the extreme Because of the extreme environment pilots are environment pilots are exposed, certain exposed, certain supplements may lead to supplements may lead to disastrous side effects that disastrous side effects that may actually impair may actually impair performance.performance.

Military Classification of Military Classification of SupplementsSupplements

Class 1Class 1: Can be taken without permission from a : Can be taken without permission from a flight surgeon. flight surgeon. 11

single daily multivitamin/minerals, vitamin C, E, B6, single daily multivitamin/minerals, vitamin C, E, B6, B12, calcium, folate, and protein supplements.B12, calcium, folate, and protein supplements.

Class 2Class 2: : Pilots must seek permission from the Pilots must seek permission from the flight surgeon. flight surgeon. 11

A, K, D, niacin, riboflavin, thiamine, magnesium, zinc, A, K, D, niacin, riboflavin, thiamine, magnesium, zinc, chromium, selenium, copper, glucosamine with or chromium, selenium, copper, glucosamine with or without chrondroitin, echinacea, saw palmetto, without chrondroitin, echinacea, saw palmetto, creatine, and ginseng.creatine, and ginseng.

Class 3Class 3:: Any supplement that is not listed is not Any supplement that is not listed is not authorized for use. authorized for use. 11

Supplements to AvoidSupplements to Avoid Supplementing with niacin Supplementing with niacin

and Coenzyme Q10 can and Coenzyme Q10 can lead to a decrease in the lead to a decrease in the blood pressure and blood pressure and peripheral vascular peripheral vascular resistance. This decrease resistance. This decrease in vascular resistance can in vascular resistance can reduce G tolerance. reduce G tolerance. 3131

L-arginine L-arginine supplementation increases supplementation increases the prevalence of the prevalence of headaches during acute headaches during acute exposure to altitude. exposure to altitude. 2121

L-arginine is commonly L-arginine is commonly found in pre-workout found in pre-workout supplements.supplements.

Beneficial Beneficial Supplements/NutrientsSupplements/Nutrients

Vitamin A, C, E and L-CarnitineVitamin A, C, E and L-Carnitine Altitude exposure increases oxidatitive stress and leads to Altitude exposure increases oxidatitive stress and leads to

lipid peroxidation. lipid peroxidation. 2626

Hemolysis resulting from acute altitude exposure may be a Hemolysis resulting from acute altitude exposure may be a result of free radicals from lipid peroxidation. result of free radicals from lipid peroxidation. 99

Vitamin A, C, Vitamin E, and L carnitine have been shown Vitamin A, C, Vitamin E, and L carnitine have been shown to reduce oxiditative stress and hemolysis resulting from to reduce oxiditative stress and hemolysis resulting from acute hypoxia. acute hypoxia. 1, 3, 9, 131, 3, 9, 13

IronIron Increased erythropoietic response to altitude exposure may Increased erythropoietic response to altitude exposure may

require higher intake. require higher intake. 3434

Females may want to consider supplementation.Females may want to consider supplementation. Creatine MonohydrateCreatine Monohydrate

May reduce rate of fatigue during high-G aerial maneuvers.May reduce rate of fatigue during high-G aerial maneuvers. Improved thermoregulatory response in hot environments. Improved thermoregulatory response in hot environments.

1414

CaffeineCaffeine Large single doses of Large single doses of

caffeine (600 mg) can caffeine (600 mg) can cause many unwanted cause many unwanted side effects such as side effects such as nervousness, excitation, nervousness, excitation, happiness, abdominal happiness, abdominal pain, nausea, and pain, nausea, and jitteriness. jitteriness. 1515

During prolonged sleep During prolonged sleep deprivation, 300 mg of deprivation, 300 mg of slow releasing caffeine slow releasing caffeine taken every12 hours is taken every12 hours is able to reduce cognitive able to reduce cognitive and vigilance and vigilance impairment without impairment without unwanted side effects. unwanted side effects. 5, 5,

1515

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8.8. Charlot, K., Pichon, A., Richalet, J. P., & Chapelot, D. (2013). Effects of a high-carbohydrate versus high-protein meal on acute Charlot, K., Pichon, A., Richalet, J. P., & Chapelot, D. (2013). Effects of a high-carbohydrate versus high-protein meal on acute responses to hypoxia at rest and exercise. European journal of applied physiology, 113(3), 691-702.responses to hypoxia at rest and exercise. European journal of applied physiology, 113(3), 691-702.

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21.21. Mansoor, J. K., Morrissey, B. M., Walby, W. F., Yoneda, K. Y., Juarez, M., Kajekar, R., ... & Schelegle, E. S. Mansoor, J. K., Morrissey, B. M., Walby, W. F., Yoneda, K. Y., Juarez, M., Kajekar, R., ... & Schelegle, E. S. (2005). L-arginine supplementation enhances exhaled NO, breath condensate VEGF, and headache at 4342 (2005). L-arginine supplementation enhances exhaled NO, breath condensate VEGF, and headache at 4342 m. High altitude medicine & biology, 6(4), 289-300.m. High altitude medicine & biology, 6(4), 289-300.

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