Assessment of the Use of Food Supplements by Military Personnel: Study Protocol and Results.

Due to their specific mode of operation, military personnel are challenged physically as well as mentally. In most countries, the use of food supplements by military personnel is not regulated, and a high prevalence of supplementation is expected. However, data on this are scarce or very limited, without insights into the importance of supplementation for the intake of bioactive substances. Our goal was, therefore, to develop a study protocol to enable an assessment of the prevalence of using food supplements and an estimate of the contribution of supplementation practices to the dietary intake of specific nutrients and other compounds. The protocol was tested in a study of Slovene Armed Forces (SAF) personnel. Data were collected using an anonymous questionnaire in a sample of 470 participants from different military units-about half from the barracks located across the country, and the other half returning from military operations abroad. To provide meaningful results, we recorded the use of food supplements and functional foods available in single-sized portions (i.e., energy drinks, protein bars, etc.). Altogether, 68% of the participants reported supplementation, most commonly with vitamin, mineral, and protein supplements. Military rank, participation status in military operations, and physical activity were the main determinants of the specific supplements used. Surprisingly, a lower prevalence of overall and protein supplementation was observed in subjects returning from military operations abroad (62 vs. 74%) than in personnel stationed in barracks across Slovenia; however, the frequency of the use of energy drinks and caffeine supplements was higher in this population (25 vs. 11%). The study design allowed for estimations of the daily intake of supplemented bioactive compounds. We describe the challenges and approaches used in the study to support similar studies in the future and within other populations.

School nutrition guidelines: overview of the implementation and evaluation.

OBJECTIVE: To holistically evaluate the extent of implementation of dietary guidelines in schools and present various monitoring systems. DESIGN: The study comprises three methods: (i) a cross-sectional survey (process evaluation); (ii) an indicator-based evaluation (menu quality); and (iii) a 5 d weighed food record of school lunches (output evaluation). SETTING: Slovenian primary schools. SUBJECTS: A total 234 food-service managers from 488 schools completed a self-administrated questionnaire for process evaluation; 177 out of 194 randomly selected schools provided menus for menu quality evaluation; and 120 school lunches from twenty-four schools were measured and nutritionally analysed for output evaluation. RESULTS: The survey among food-service managers revealed high levels of implementation at almost all process evaluation areas of the guidelines. An even more successful implementation of these guidelines was found in relation to organization cultural issues as compared with technical issues. Differences found in some process evaluation areas were related to location, size and socio-economic characteristics of schools. Evaluation of school menu quality demonstrated that score values followed a normal distribution. Higher (better) nutrition scores were found in larger-sized schools and corresponding municipalities with higher socio-economic status. School lunches did not meet minimum recommendations for energy, carbohydrates or dietary fibre intake, nor for six vitamins and three (macro, micro and trace) elements. CONCLUSIONS: The implementation of the guidelines was achieved differently at distinct levels. The presented multilevel evaluation suggests that different success in implementation might be attributed to different characteristics of individual schools. System changes might also be needed to support and improve implementation of the guidelines.

Food composition databases for effective quality nutritional care.

BACKGROUND AND OBJECTIVES: The main aim of this study was to validate a nutrient-estimation method applied using OPEN, a Slovenian platform for clinical nutrition. As the most desirable validation is a direct comparison of the calculated values with the values obtained from a chemical analysis of the same food, we performed a chemical analysis and a calculation for a representative set of daily meals (n=20) and compared the data. The secondary aim was to evaluate the usability of the OPEN for dietary assessment. METHODS: We used a Student's t test to observe any differences between the analysed and calculated nutrient-content data, considering the 0.01 significance level. RESULTS: No statistically significant differences were observed in the mean contents of energy, total dietary fibre, water, macro-nutrients, and selected essential minerals: Ca, Fe, Mg, Zn, Na, P, Cu and I. We notice statistically significant difference in the mean calculated and analytical values of selenium. CONCLUSIONS: We noticed remarkable, but not statistically significant, difference in the mean values of iodine (-11%). The present study also indicates that the OPEN is a useful and cost-effective tool for both dieticians and patients.

Impact of intensive physical activity on selenium status.

Various biomarkers were used to assess selenium (Se) status during 3 months of basic military training in a group of recruits. Samples of whole blood and plasma or serum were taken from a group of conscripts three times: at the beginning (n = 15), in the middle immediately after a severely stressful physical activity (n = 15) and at the end of military training (n = 13). Selenium was determined in diet samples, blood, plasma and plasma protein fractions as selenoprotein P (SelP) and glutathione peroxidase (eGPx). Selenium was determined by hydride generation-atomic fluorescence spectrometry and fractionation of proteins performed by affinity chromatography. Total serum glutathione, erythrocyte and serum GPx activity were followed as well. The average Se intake was calculated according to meal consumption questionnaires and Se determined in composite diet samples, giving an assessed intake of 48 ± 10 µg/day. At all three samplings, the average blood Se concentration was within the framework of adequate supply (87 ± 12, 94 ± 15 and 80 ± 13 ng/g). Plasma Se was between 70 and 80 ng/g (71 ± 10, 79 ± 9 and 76 ± 10 ng/g), which is believed to enable the full expression of plasma GPx. The average shares of plasma Se proteins were 61 ± 6%, 58 ± 6% and 54 ± 9% for SelP and 27 ± 4%, 34 ± 7% and 29 ± 5% for GPx. Although the observed tendency of the increases of serum and erythrocyte GPx activities at the second and third samplings with respect to the first was statistically insignificant, it is still indicative of some protection against oxidative stress, while the decreasing SelP levels during training suggest a slowly decreasing biologically active selenium pool.