The U.S. Army has published regulations which define the nutritional responsibilities of the Surgeon General of the Army, the Navy, and the Air Force. These regulations, referred to as the Military Dietary Reference Intakes (MDRI), evaluate the effects of environmental factors on energy and nutrient requirements and outline nutrition education eFT-508 policy [5]. The MDRI is a quantitative estimate of the recommended dietary intake for healthy military populations based on US national standards [5]. The Nutritional Standards for Operational and Restricted Rations (NSOR) was established

to take into account the higher energy expenditure in field exercises and other operational and logistic factors relevant for training [5]. As an example, studies that quantified SC79 chemical structure energy expenditure

during military operations report that Special Forces soldiers had up to 45% higher absolute energy expenditure compared to their non-combat counterparts PF-6463922 nmr [6, 7]. During prolonged training periods, if energy deficits occur, this may endanger the general health of the soldiers and reduce the muscle mass and bone strength needed for optimal performance. Of note, previous reports have found an association between insufficient dietary intake and increased risk for stress fractures among military recruits [8–10]. Bone overuse injuries, also referred to as stress reactions and stress fractures, are the most common overuse injuries among combat soldiers and are observed most frequently among young army recruits who undergo strenuous exercise during basic training [11]. The occurrence of severe cases of stress fracture has even reached rates as high as 64% in the Finnish army

[12] and 31% in the Israeli Defense Forces (IDF) [13]. Stress fractures have been found to be related to several risk factors, both intrinsic and extrinsic [14], over most of which we have no control [13]. These include bone geometry parameters (studied thoroughly in the IDF), gender and hormonal factors, and genetic predisposition. Studies on bone density have been contradictory [14], and biochemical markers of bone turnover are also probably not related to stress fractures [15]. Calcium deficiency has been found deterrent to bone quality in animal models [16, 17] Forskolin but studies on athletes and soldiers have been less conclusive. Calcium and vitamin D are probably important in women [18] and in Finnish males (who may be effected by the latitude) [19], but in general, there is not enough data on males. Lappe et al managed to reduce stress fracture incidence in female navy recruits by about 20% [9]. Smoking (present or history) has also been found to be related to stress fractures, particularly in the US [20], and is possibly related to risk taking behavioral patterns. However, this finding has not been reproduced consistently in other militaries [19, 21]. The purpose of this study was to evaluate nutritional intake in male combat recruits before induction and during a 4-month BT period.