Dietary reference intake for military operations: a scoping review.

Background: Reports that collect and organize dietary reference intake (DRI) data for military operations in different countries and regions worldwide are limited.This scoping review aimed to collect and organize information on the status of formulating a DRI for military operations in each country. Methodology: For the information search, we queried PubMed and Google for literature and reports on the DRI for military operations and summarized the content of the adopted literature and reports. Results: The content and rationale for DRI for military operations in Australia, the United Kingdom (UK), the United States of America (USA), and the North Atlantic Treaty Organization (NATO) can be summarized as follows: (1) Energy requirements: Four reports formulated physical activity levels (PALs) and corresponding energy requirements that differed from those for the civilian public. The PAL range for the military was set as high as 1.50-3.20, as opposed to the standard civilian upper PAL set at 1.20-2.20. (2) Protein: Three military reports outside of the UK had different standards than those for the civilian public with an increased intake in accordance with the high PAL while simultaneously preventing excessive intake.In the military, values were formulated 1.2-4.8 times higher than the standards for civilians (45-65 g/day to 55-307 g/day). (3) Macronutrient energy distribution: Four military reports established macronutrient energy distributions that differed from those for the civilian public. The DRI for the Australian and UK militaries was formulated such that as PAL increased, protein decreased, fat decreased or remained unchanged, and carbohydrate increased. (4) Sodium: Considering that military personnel sweat more due to high physical activity and their environment, two Australian and NATO reports were established with sodium levels that were twice as high as that of the civilian public (460-2,300 mg/day to 920-3,200 mg/day). Increasing sodium intake to <4,800 mg/day is recommended for individuals who sweat a lot or are not accustomed to hot environments. Conclusions: The DRI in Australia, the UK, USA, and NATO consider the physical activity and operating environment of military personnel, differing from those of the civilian population in terms of (1) energy requirements, (2) protein, (3) macronutrient energy distribution, and (4) sodium.