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Position Stand

International society of sports nutrition position stand: tactical athlete nutrition

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Pages 267-315 | Received 26 May 2022, Accepted 01 Jun 2022, Published online: 23 Jun 2022

References

  • Davis MR, Easter RL, Carlock JM, et al. Self-reported physical tasks and exercise training in Special Weapons and Tactics (SWAT) Teams. J Strength Cond Res. 2016 Nov;30(11):3242–3248.
  • Charles DJJK, Crespo D, Elder CL, et al. Does body mass index influence the physiological and perceptual demands associated with defensive tactics training in state patrol officers?. Int J Exercise Sci. 2018;11(6):319–330.
  • Johnson QR, Goatcher JD, Diehl C, et al. Heart rate responses during simulated fire ground scenarios among full-time firefighters. Int J Exercise Sci. 2020;13(2):374–382.
  • Knapik JJ, Reynolds KL, Harman E. Soldier load carriage: historical, physiological, biomechanical, and medical aspects. Mil Med. 2004 Jan;169(1):45–56.
  • Baran K, Dulla LTJ, Orr R, et al. Duty loads carried by the Los Angeles Sheriff’s department deputies. J Austr Str Cond. 2018;26(5):34–38.
  • R. M. Orr, R. R., Pope, V., Johnston, J, Coyle.2012 The operational load carriage context of the Australian army soldier. In 1st Australian Conference on Physiological and Physical Employment Standards. Australia .
  • Scofield DE, Kardouni JR. The tactical athlete: a product of 21st century strength and conditioning. Strength & Conditioning J. 2015;37(4):2–7.
  • Kraemer WJ, Szivak TK. Strength training for the warfighter. J Strength Cond Res. 2012 Jul;26 Suppl 2(Supplement 2):S107–18.
  • Murphy NE, Carrigan CT, Philip Karl J, et al. Threshold of energy deficit and lower-body performance declines in military personnel: a meta-regression. Sports Med. 2018 Sep;48(9):2169–2178.
  • Nindl BC, Barnes BR, Alemany JA, et al. Physiological consequences of U.S. army ranger training. Med Sci Sports Exerc. 2007 Aug;39(8):1380–1387.
  • Sepowitz JJ, Armstrong NJ, Pasiakos SM. Energy balance and diet quality during the us marine corps forces special operations command individual training course. J Spec Oper Med. 2017;17(4):109–113.
  • Nindl BC, Leone CD, Tharion WJ, et al. Physical performance responses during 72 h of military operational stress. Med Sci Sports Exerc. 2002 Nov;34(11):1814–1822.
  • Castellani J, Nindl B, Lieberman H, et al. Decrements in human performance during 72-84 hours of sustained operations. J Spec Oper Med. 2006;11(1):9.
  • Abriat A, Brosset C, Brégigeon M, et al. Report of 182 cases of exertional heatstroke in the French armed forces. Mil Med. 2014;179(3):309–314.
  • Edholm OG. 1969. The effec of heat on accliatized and unacclimatized groups of very fit men. Proceedings of the Royal Society of Medicine, 62: 1175–1179. SAGE Publications.
  • Armstrong LE, Maresh CM. The induction and decay of heat acclimatisation in trained athletes. Sports Med. 1991;12(5):302–312.
  • Carter IIIR, Cheuvront SN, Williams JO, et al. Epidemiology of hospitalizations and deaths from heat illness in soldiers. Medicine and science in sports and exercise, 2005, 37(8): 1338–1344. doi:10.1249/01.mss.0000174895.19639.ed .
  • Garrett AT, Rehrer NJ, Patterson MJ. Induction and decay of short-term heat acclimation in moderately and highly trained athletes. Sports Med. 2011;41(9):757–771.
  • Basnyat B, Murdoch DR. High-altitude illness. Lancet. 2003;361(9373):1967–1974.
  • Institute of Medicine Committee on Military Nutrition R. In: Marriott BM, Carlson SJ, editors Nutritional needs in cold and in high-altitude environments: applications for military personnel in field operations. Washington (DC): National Academies Press (US) Copyright 1996 by the National Academy of Sciences. All rights reserved; 1996 A Review of the Physiology and Nutrition in Cold and in High-Altitude Environments by the Committee on Military Nutrition Research .
  • Netzer N, Strohl K, Faulhaber M, et al. Hypoxia-related altitude illnesses. J Travel Med. 2013 Jul-Aug;20(4):247–255.
  • Cudaback DD. 4-KM altitude effects on performance and health. Pub Astron Soc Paci. 1984; 96(1):463.
  • Bahrke MS, Shukitt-Hale B. Effects of altitude on mood, behaviour and cognitive functioning. A review. Sports Med. 1993 Aug;16(2):97–125.
  • Yan X. Cognitive impairments at high altitudes and adaptation. High Alt Med Biol. 2014 Jun;15(2):141–145.
  • Hackney AC, Shaw JM, Hodgdon JA, et al. Cold exposure during military operations: effects on anaerobic performance. J Appl Physiol. 1985];71(1):125–130.
  • Gefen A, Epstein Y. The mechanobiology and mechanophysiology of military-related injuries. Vol. 19. Berlin: Springer; 2016.
  • Jaworski RL, Jensen A, Niederberger B, et al. Changes in combat task performance under increasing loads in active duty marines. Mil Med. 2015;180(suppl_3):179–186.
  • Pedersen AV, Stokke R, Mamen A. Effects of extra load position on energy expenditure in treadmill running.Eur J Appl Physiol. 2007;102(1):27–31.
  • Soule RG, Pandolf KB, Goldman RF. Energy expenditure of heavy load carriage. Ergonomics. 1978 May;21(5):373–381.
  • Majumdar D, Pal MS, Majumdar D. Effects of military load carriage on kinematics of gait. Ergonomics. 2010 Jun;53(6):782–791.
  • Seay JF. Biomechanics of load carriage—historical perspectives and recent insights. J Strength Cond Res. 2015;29(Supplement 11):S129–S133.
  • Orr RM, Coyle J, Johnston V, et al. Self-reported load carriage injuries of military soldiers. Int J Inj Contr Saf Promot. 2017 Jun;24(2):189–197.
  • Knapik JJ. Injuries and injury prevention during foot marching. J Spec Oper Med. 2014;14(4):131–135.
  • Fallowfield JL, Blacker SD, Willems ME, et al. Neuromuscular and cardiovascular responses of royal marine recruits to load carriage in the field. Appl Ergon. 2012 Nov;43(6):1131–1137.
  • Scott PA, Ramabhai L. Load carrying: in situ physiological responses of an infantry platoon. Ergonomics. 2000;1:18–24.
  • Crowder TA, Beekley MD, Sturdivant RX, et al. Metabolic effects of soldier performance on a simulated graded road march while wearing two functionally equivalent military ensembles. Mil Med. 2007 Jun;172(6):596–602.
  • Baker-Fulco CJ, Kramer FM, Lesher LL, et al. Dietary intakes of female and male combat support hospital personnel subsisting on meal-focused or standard versions of the meal, ready-to-eat. Army Res Inst Env Med. 2002;
  • Hoyt R, Jones T, Stein T, et al. Doubly labeled water measurement of human energy expenditure during strenuous exercise. J Appl Physiol. 1991;71(1):16–22.
  • Tharion WJ, Baker-Fulco CJ, Bovill ME, et al. Adequacy of garrison feeding for special forces soldiers during training. Mil Med. 2004 Jun;169(6):483–490.
  • Shippee R, Askew E, Bernton E, et al. Nutritional and immunological assessment of ranger students with increased caloric intake. Army Res Inst Env Med. 1994;
  • Fairbrother B, Shippee R, Kramer T, et al. Nutritional and immunological assessment of soldiers during the special forces assessment and selection course. Army Res Inst Env Med. 1995;
  • Barringer ND, Pasiakos SM, McClung HL, et al. Prediction equation for estimating total daily energy requirements of special operations personnel. J Int Soc Sports Nutr. 2018;15(1):15.
  • Shrestha A, Ho TE, Vie LL, et al. Comparison of cardiovascular health between us army and civilians. J Am Heart Assoc. 2019;8(12):e009056.
  • McGraw LK, Turner BS, Stotts NA, et al. A review of cardiovascular risk factors in us military personnel. J Cardiovasc Nurs. 2008;23(4):338–344.
  • Almond N, Kahwati L, Kinsinger L, et al. The prevalence of overweight and obesity among U.S Military Veterans. Military Med. 2008;173(6):544–549.
  • Army US. 2016. Health of the Force Report. Available at https://phc.amedd.army.mil/Periodical%20Library/2016HealthoftheForcereport.pdf2016
  • Shiozawa B, Madsen C, Banaag A, et al. Body mass index effect on health service utilization among active duty male United States army soldiers. Mil Med. 2019;184(9–10):447–453.
  • Patel S. Reduced sleep as an obesity risk factor. Obesity Rev. 2009;10:61–68.
  • Spiegal K, Tasali E, Penev P, et al. Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels and increased hunger and appetite. Ann Int Med. 2004;141(11):846–850.
  • Nedeltcheva AV, Kilkus JM, Imperial J, et al. Sleep curtailment is accompanied by increased intake of calories from snacks. Am J Clin Nutr. 2009;89(1):126–133.
  • Heath G, Roach GD, Dorrian J, et al. The effect of sleep restriction on snacking behaviour during a week of simulated shiftwork. Accid Anal Prev. 2012;45:62–67.
  • Klingenberg L, Chaput J-P, Holmbäck U, et al. Acute sleep restriction reduces insulin sensitivity in adolescent boys. Sleep. 2013;36(7):1085–1090.
  • Donga E, Van Dijk M, Van Dijk JG, et al. Partial sleep restriction decreases insulin sensitivity in type 1 diabetes. Diabetes Care. 2010;33(7):1573–1577.
  • Spiegel K, Leproult R, Van Cauter E. Impact of sleep debt on metabolic and endocrine function. Lancet. 1999;354(9188):1435–1439.
  • Ulmer CS, Bosworth HB, Germain A, et al. Associations between sleep difficulties and risk factors for cardiovascular disease in veterans and active duty military personnel of the Iraq and Afghanistan conflicts. J Behav Med. 2015 Jun;38(3):544–555.
  • Grier T, Dinkeloo E, Reynolds M, et al. Sleep duration and musculoskeletal injury incidence in physically active men and women: a study of U.SArmy Special Operation Forces soldiers. Sleep Health. 2020Jun;63: 344–349.
  • Jacobson IG, Ryan MA, Hooper TI, et al. Alcohol use and alcohol-related problems before and after military combat deployment. Jama. 2008 Aug 13;300(6):663–675.
  • Mysliwiec V, McGraw L, Pierce R, et al. Sleep disorders and associated medical comorbidities in active duty military personnel. Sleep. 2013 Feb 1;36(2):167–174.
  • Fox BD, Judge LW, Dickin DC, et al. Biomechanics of military load carriage and resulting musculoskeletal injury: a review. J orthopedic Sur. 2020;1(1).
  • Sanders JW, Putnam SD, Frankart C, et al. Impact of illness and non-combat injury during operations Iraqi freedom and enduring freedom (Afghanistan). Am J Trop Med Hyg. 2005 Oct;73(4):713–719.
  • Lincoln AE, Smith GS, Amoroso PJ, et al. The natural history and risk factors of musculoskeletal conditions resulting in disability among US Army personnel. Work (Reading, Mass). 2002;18(2):99–113.
  • George SZ, Childs JD, Teyhen DS, et al. Predictors of occurrence and severity of first time low back pain episodes: findings from a military inception cohort. PLoS One. 2012;7(2):e30597.
  • Jones BH, Knapik JJ. Physical training and exercise-related injuries. Surveillance, research and injury prevention in military populations. Sports Med. 1999 Feb;27(2):111–125.
  • Cowan DN, Bedno SA, Urban N, et al. Musculoskeletal injuries among overweight army trainees: incidence and health care utilization. Occup Med (Lond). 2011 Jun;61(4):247–252.
  • Sammito S, Hadzic V, Karakolis T, et al. Risk factors for musculoskeletal injuries in the military: a qualitative systematic review of the literature from the past two decades and a new prioritizing injury model. Mil Med Res. 2021;8(1):66.
  • Kerksick CM, Arent S, Schoenfeld BJ, et al. International society of sports nutrition position stand: nutrient timing. J Int Soc Sports Nutr. 2017;14(1):33.
  • Regulation A. 2017. 40–25, Medical Services Nutrition and Menu Standards for Human Performance Optimization. Headquarters Departments of the Army, The Navy and the Air Force, 1-20.
  • Jager R, Kerksick CM, Campbell BI, et al. International society of sports nutrition position stand: protein and exercise. J Int Soc Sports Nutr. 2017;14(1):20.
  • Kerksick CM, Wilborn CD, Roberts MD, et al. Exercise & sports nutrition review update: research & recommendations. J Int Soc Sports Nutr. 2018;15(1):38.
  • Gwin JA, Church DD, Wolfe RR, et al. Muscle protein synthesis and whole-body protein turnover responses to ingesting essential amino acids, intact protein, and protein-containing mixed meals with considerations for energy deficit. Nutrients. 2020 Aug 15;12(8):2457.
  • Pasiakos SM, Austin KG, Lieberman HR, et al. Efficacy and safety of protein supplements for U.S. armed forces personnel: consensus statement. J Nutr. 2013 Nov;143(11):1811S–1814S.
  • Pasiakos SM, Margolis LM, Orr JS. Optimized dietary strategies to protect skeletal muscle mass during periods of unavoidable energy deficit. FASEB J. 2015 Apr;29(4):1136–1142.
  • Margolis LM, Murphy NE, Martini S, et al. Effects of supplemental energy on protein balance during 4-d arctic military training. Med Sci Sports Exerc. 2016 Aug;48(8):1604–1612.
  • Margolis LM, Murphy NE, Martini S, et al. Effects of winter military training on energy balance, whole-body protein balance, muscle damage, soreness, and physical performance. Appl Physiol Nutr Metab. 2014 Dec;39(12):1395–1401.
  • Carbone JW, McClung JP, Pasiakos SM. Recent advances in the characterization of skeletal muscle and whole-body protein responses to dietary protein and exercise during negative energy balance. Adv Nutr. 2019 Jan 1; 10(1):70–79.
  • Berryman CE, Young AJ, Karl JP, et al. Severe negative energy balance during 21 d at high altitude decreases fat-free mass regardless of dietary protein intake: a randomized controlled trial. FASEB J. 2018;32(2):894–905.
  • Gwin JA, Church DD, Hatch-McChesney A, et al. Essential amino acid-enriched whey enhances post-exercise whole-body protein balance during energy deficit more than iso-nitrogenous whey or a mixed-macronutrient meal: a randomized, crossover study. J Int Soc Sports Nutr. 2021 Jan 7;18(1):4.
  • Gwin JA, Church DD, Hatch-McChesney A, et al. Effects of high versus standard essential amino acid intakes on whole-body protein turnover and mixed muscle protein synthesis during energy deficit: a randomized, crossover study. Clin Nutr. 2021 Mar;40(3):767–777.
  • Church DD, Hirsch KR, Park S, et al. Essential amino acids and protein synthesis: insights into maximizing the muscle and whole-body response to feeding. Nutrients. 2020 Dec 2;12(12):3717.
  • Rodriguez NR, DiMarco NM, Langley S. Position of the American dietetic association, dietitians of Canada, and the American college of sports medicine: nutrition and athletic performance. J Am Diet Assoc. 2009 Mar;109(3):509–527.
  • Kenefick RW, Hazzard MP, Mahood NV, et al. Thirst sensations and AVP responses at rest and during exercise-cold exposure. Med Sci Sports Exerc. 2004 Sep;36(9):1528–1534.
  • Cheuvront SN, Sawka MN. Hydration assessment of athletes. Sports Sci Exchange. 2005;18(2):1–6.
  • Fletcher RH, Fairfield KM. Vitamins for chronic disease prevention in adults: clinical applications. Jama. 2002;287(23):3127–3129.
  • Alver BA, Sell K, Deuster PA. NSCA’s essentials of tactical strength and conditioning. Human Kinetics. 2017;
  • Kris-Etherton PM, Harris WS, Appel LJ. Fish Consumption, Fish Oil, Omega-3 Fatty Acids, and Cardiovascular Disease. Circulation. 2002;106(21):2747–2757.
  • Costello RB, Lentino CV, Boyd CC, et al. The effectiveness of melatonin for promoting healthy sleep: a rapid evidence assessment of the literature. Nutrition Journal. 2014;13(1):106
  • Trexler ET, Smith-Ryan AE, Stout JR, et al. International society of sports nutrition position stand: beta-Alanine. J Int Soc Sports Nutr. 2015;12(1):30.
  • Artioli GG, Gualano B, Smith A, et al. Role of beta-alanine supplementation on muscle carnosine and exercise performance. Med Sci Sports Exerc. 2010 Jun;42(6):1162–1173.
  • Perim P, Marticorena FM, Ribeiro F, et al. Can the skeletal muscle carnosine response to beta-alanine supplementation be optimized?. Front Nutr. 2019;6:135.
  • Hoffman J, Stout J, Harris R, et al. β-Alanine supplementation and military performance. Amino Acids. 2015 07/24; 47;47(12): 2463–2474.
  • Hoffman JR, Landau G, Stout JR, et al. β-alanine supplementation improves tactical performance but not cognitive function in combat soldiers. J Int Soc Sports Nutr. 2014;11(1):15.
  • Hoffman JR, Landau G, Stout JR, et al. β-Alanine ingestion increases muscle carnosine content and combat specific performance in soldiers. Amino Acids. 2015 Mar;47(3):627–636.
  • Knapik JJ, Austin KG, McGraw SM, et al. Caffeine consumption among active duty United States Air Force personnel. Food Chem Toxicol. 2017 Jul;105:377–386.
  • Knapik JJ, Trone DW, McGraw S, et al. Caffeine use among active duty navy and marine corps personnel. Nutrients. 2016;8(10):620.
  • Chaudhary NS, Taylor BV, Grandner MA, et al. The effects of caffeinated products on sleep and functioning in the military population: a focused review. Pharmacol Biochem Behav. 2021 Jul;206:173206.
  • Keisler BD, Armsey TD. Caffeine as an ergogenic aid. Curr Sports Med Rep. 2006;54:215–219.
  • Guest NS, VanDusseldorp TA, Nelson MT, et al. International society of sports nutrition position stand: caffeine and exercise performance. J Int Soc Sports Nutr. 2021;18(1):1.
  • McLellan TM, Bell DG, Kamimori GH. Caffeine improves physical performance during 24 h of active wakefulness. Aviat Space Environ Med. 2004;75(8):666–672.
  • Kamimori GH, McLellan TM, Tate CM, et al. Caffeine improves reaction time, vigilance and logical reasoning during extended periods with restricted opportunities for sleep. Psychopharmacology (Berl). 2015 Jun;232(12):2031–2042.
  • Amendola CA, Gabrieli JDE, Lieberman HR. Caffeine’s effects on performance and mood are independent of age and gender.Nutr Neurosci. 1998;1(4):269–280.
  • Fine BJ, Kobrick JL, Lieberman HR, et al. Effects of caffeine or diphenhydramine on visual vigilance. Psychopharmacology (Berl). 1994;114(2):233–238.
  • Rees K, Allen D, Lader M. The influences of age and caffeine on psychomotor and cognitive function. Psychopharmacology (Berl). 1999;145(2):181–188.
  • Butt MS, Sultan MT. Coffee and its consumption: benefits and risks.Crit Rev Food Sci Nutr. 2011;51(4):363–373.
  • McLellan TM, Riviere LA, Williams KW, et al. Caffeine and energy drink use by combat arms soldiers in Afghanistan as a countermeasure for sleep loss and high operational demands. Nutr Neurosci. 2019 Nov;22(11):768–777.
  • Crawford C, Teo L, Lafferty L, et al. Caffeine to optimize cognitive function for military mission-readiness: a systematic review and recommendations for the field. Nutr Rev. 2017 Jun 1;75(suppl_2):17–35.
  • Tharion WJ, Shukitt-Hale B, Lieberman HR. Caffeine effects on marksmanship during high-stress military training with 72 hour sleep deprivation. Aviat Space Environ Med. 2003 Apr;74(4):309–314.
  • Tikuisis P, Keefe AA, McLellan TM, et al. Caffeine restores engagement speed but not shooting precision following 22 h of active wakefulness. Aviat Space Environ Med. 2004;75(9):771–776.
  • Lieberman HR, Tharion WJ, Shukitt-Hale B, et al. Effects of caffeine, sleep loss, and stress on cognitive performance and mood during U.S. Navy SEAL training sea-air-land. Psychopharmacology (Berl). 2002 Nov;164(3):250–261.
  • Childs E, Hohoff C, Deckert J, et al. Association between ADORA2A and DRD2 polymorphisms and caffeine-induced anxiety. Neuro Psycho. 2008;33(12):2791–2800.
  • Rétey JV, Adam M, Khatami R, et al. A genetic variation in the adenosine A2A receptor gene (ADORA2A) contributes to individual sensitivity to caffeine effects on sleep. Clin Pharmacol Ther. 2007 May;81(5):692–698.
  • Lopes-Silva JP, Choo HC, Franchini E, et al. Isolated ingestion of caffeine and sodium bicarbonate on repeated sprint performance: a systematic review and meta-analysis. J Sci Med Sport. 2019 Aug;22(8):962–972.
  • Drake C, Roehrs T, Shambroom J, et al Caffeine effects on sleep taken 0, 3, or 6 hours before going to bed. J Clin Sleep Med. 2013;09(11):1195–1200.
  • Toblin RL, Adrian AL, Hoge CW, et al. Energy drink use in U.S. Service members after deployment: associations with mental health problems, aggression, and fatigue. Mil Med. 2018 Nov 1;183(11–12):e364–e370.
  • Johnson LA, Foster D, McDowell JC. Energy drinks: review of performance benefits, health concerns, and use by military personnel. Mil Med. 2014;179(4):375–380.
  • Campbell B, Wilborn C, La Bounty P, et al. International society of sports nutrition position stand: energy drinks. J Int Soc Sports Nutr. 2013;10(1):1.
  • Kreider RB, Kalman DS, Antonio J, et al. International society of sports nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017;14(1):18.
  • Wax B, Kerksick CM, Jagim AR, et al. Creatine for exercise and sports performance, with recovery considerations for healthy populations. Nutrients. 2021 Jun 2;13(6):1915.
  • Cooke MB, Rybalka E, Williams AD, et al. Creatine supplementation enhances muscle force recovery after eccentrically-induced muscle damage in healthy individuals. J Int Soc Sports Nutr. 2009 Jun 2;6(1):13.
  • Greenwood M, Kreider RB, Greenwood L, et al. Cramping and injury incidence in collegiate football players are reduced by creatine supplementation. J Athl Train. 2003 Sep;38(3):216–219.
  • Greenwood M, Kreider RB, Melton C, et al. Creatine supplementation during college football training does not increase the incidence of cramping or injury. Mol Cell Biochem. 2003 Feb;244(1–2):83–88.
  • Kilduff LP, Georgiades E, James N, et al. The effects of creatine supplementation on cardiovascular, metabolic, and thermoregulatory responses during exercise in the heat in endurance-trained humans. Int J Sport Nutr Exerc Metab. 2004 Aug;14(4):443–460.
  • Dolan E, Gualano B, Rawson ES. Beyond muscle: the effects of creatine supplementation on brain creatine, cognitive processing, and traumatic brain injury. Eur J Sport Sci. 2019 Feb;19(1):1–14.
  • Cook CJ, Crewther BT, Kilduff LP, et al. Skill execution and sleep deprivation: effects of acute caffeine or creatine supplementation - a randomized placebo-controlled trial. J Int Soc Sports Nutr. 2011 Feb 16;8(1):2.
  • McMorris T, Harris RC, Swain J, et al. Effect of creatine supplementation and sleep deprivation, with mild exercise, on cognitive and psychomotor performance, mood state, and plasma concentrations of catecholamines and cortisol. Psychopharmacology (Berl). 2006 Mar;185(1):93–103.
  • Roschel H, Gualano B, Ostojic SM, et al. Creatine supplementation and brain health. Nutrients. 2021;13(2):586.
  • Kreider RB, Melton C, Rasmussen CJ, et al. Long-term creatine supplementation does not significantly affect clinical markers of health in athletes. Mol Cell Biochem. 2003 Feb;244(1–2):95–104.
  • Kreider RB, Stout JR. Creatine in health and disease. Nutrients. 2021 Jan 29; 13(2):447.
  • Watanabe A, Kato N, Kato T. Effects of creatine on mental fatigue and cerebral hemoglobin oxygenation. Neurosci Res. 2002 Apr;42(4):279–285.
  • Hammett ST, Wall MB, Edwards TC, et al. Dietary supplementation of creatine monohydrate reduces the human fMRI BOLD signal. Neurosci Lett. 2010 Aug 2;479(3):201–205.
  • Dechent P, Pouwels P, Wilken B, et al. Increase of total creatine in human brain after oral supplementation of creatine-monohydrate. Am J Physiol Regul Integr Comp Physiol. 1999;277(3):R698–R704.
  • Kreider RB. Effects of creatine supplementation on performance and training adaptations. Mol Cell Biochem. 2003 Feb;244(1–2):89–94.
  • KREIDER RB, Klesges RC, Lotz D, et al. Effects of nutritional supplementations during off-season college football training on body composition and strength. J Exer Phys. 1999;244(1–2):89–94
  • Kreider RB, Stout JR. Creatine in health and disease. Nutrients. 2021;13(2):447.
  • Kreider RB, Jäger R, Bioavailability PM. Efficacy, safety, and regulatory status of creatine and related compounds: a critical review. Nutrients. 2022;14(5):1035.
  • Tipton KD, Gurkin BE, Matin S, et al. Nonessential amino acids are not necessary to stimulate net muscle protein synthesis in healthy volunteers. J Nutr Biochem. 1999 Feb;10(2):89–95.
  • Wolfe RR, Baum JI, Starck C, et al. Factors contributing to the selection of dietary protein food sources. Clin Nutr. 2018 Feb;37(1):130–138.
  • Cuthbertson DJ, Babraj J, Leese G, et al. Anabolic resistance does not explain sarcopenia in patients with type 2 diabetes mellitus, compared with healthy controls, despite reduced mTOR pathway activity. Clin Nutr. 2017 Dec;36(6):1716–1719.
  • Dillon EL, Sheffield-Moore M, Paddon-Jones D, et al. Amino acid supplementation increases lean body mass, basal muscle protein synthesis, and insulin-like growth factor-I expression in older women. J Clin Endocrinol Metab. 2009 May;94(5):1630–1637.
  • Ispoglou T, White H, Preston T, et al. Double-blind, placebo-controlled pilot trial of L-Leucine-enriched amino-acid mixtures on body composition and physical performance in men and women aged 65-75 years. Eur J Clin Nutr. 2016 Feb;70(2):182–188.
  • Negro M, Perna S, Spadaccini D, et al. Effects of 12 Weeks of Essential Amino Acids (EAA)-based multi-ingredient nutritional supplementation on muscle mass, muscle strength, muscle power and fatigue in healthy elderly subjects: a randomized controlled double-blind study. J Nutr Health Aging. 2019;23(5):414–424.
  • Dreyer HC, Owen EC, Strycker LA, et al. Essential amino acid supplementation mitigates muscle atrophy after total knee arthroplasty: a randomized, double-blind, placebo-controlled trial. JB JS Open Access. 2018 Jun 28;3(2):e0006.
  • Dreyer HC, Strycker LA, Senesac HA, et al. Essential amino acid supplementation in patients following total knee arthroplasty. J Clin Invest. 2013 Nov;123(11):4654–4666.
  • Rasmussen BB, Tipton KD, Miller SL, et al. An oral essential amino acid-carbohydrate supplement enhances muscle protein anabolism after resistance exercise. J Appl Physiol. 2000;88(2):386–392.
  • Tipton KD, Ferrando AA, Phillips SM, et al Postexercise net protein synthesis in human muscle from orally administered amino acids. A J Physiol. 1999 Apr;276(4 Pt 1):E628–34.
  • Tipton KD, Rasmussen BB, Miller SL, et al. Timing of amino acid-carbohydrate ingestion alters anabolic response of muscle to resistance exercise. Am J Physiol Endocrinol Metab. 2001;281(2):E197–206.
  • Kerksick CM, Arent S, Schoenfeld BJ, et al. International society of sports nutrition position stand: nutrient timing. J Int Soc Sports Nutr. 2017;14(1):33.
  • Kerksick CM, Leutholtz B. Nutrient administration and resistance training. J Int Soc Sports Nutr. 2005;2(1):50–67.
  • Miller SL, Tipton KD, Chinkes DL, et al. Independent and combined effects of amino acids and glucose after resistance exercise. Med Sci Sports Exerc. 2003 Mar;35(3):449–455.
  • Tipton KD, Borsheim E, Wolf SE, et al. Acute response of net muscle protein balance reflects 24-h balance after exercise and amino acid ingestion. Am J Physiol (Endocrinol Metab). 2003 Jan;284(1):E76–89.
  • Moore DR, Churchward-Venne TA, Witard O, et al. Protein ingestion to stimulate myofibrillar protein synthesis requires greater relative protein intakes in healthy older versus younger men. J Gerontol A Biol Sci Med Sci. 2015 Jan;70(1):57–62.
  • Gorissen SHM, Crombag JJR, Senden JMG, et al. Protein content and amino acid composition of commercially available plant-based protein isolates. Amino Acids. 2018 Dec;50(12):1685–1695.
  • Moore DR. Maximizing post-exercise anabolism: the case for relative protein intakes. Front Nutr. 2019;6:147.
  • Pasiakos SM, Cao JJ, Margolis LM, et al. Effects of high-protein diets on fat-free mass and muscle protein synthesis following weight loss: a randomized controlled trial. FASEB J. 2013 Jun 5;27(9):3837–3847.
  • Longland TM, Oikawa SY, Mitchell CJ, et al. Higher compared with lower dietary protein during an energy deficit combined with intense exercise promotes greater lean mass gain and fat mass loss: a randomized trial. Am J Clin Nutr. 2016 Mar;103(3):738–746.
  • Beary JF 3rd, Walter LJ Jr., Johns JH. Leading causes of death for active duty military personnel. Mil Med. 1984 Jun;149(6):316–317.
  • Castro CA, Kintzle S. Suicides in the military: the post-modern combat veteran and the Hemingway effect.Curr Psychiatry Rep. 2014;16(8):460.
  • Vincent AS, Roebuck-Spencer T, Lopez MS, et al. Effects of military deployment on cognitive functioning. Mil Med. 2012 Mar;177(3):248–255.
  • Kim HY. Neuroprotection by docosahexaenoic acid in brain injury. Mil Med. 2014 Nov;179(11 Suppl):106–111.
  • Montain S, Jonas WB. Nutritional armor: omega-3 for the warfighter. Mil Med. 2014 Nov;179(11 Suppl):1.
  • Brenna JT, Salem N Jr., Sinclair AJ, et al. alpha-Linolenic acid supplementation and conversion to n-3 long-chain polyunsaturated fatty acids in humans. Prostaglandins Leukot Essent Fatty Acids. 2009 Feb-Mar;80(2–3):85–91.
  • Kitson AP, Metherel AH, Chen CT, et al. Effect of dietary docosahexaenoic acid (DHA) in phospholipids or triglycerides on brain DHA uptake and accretion. J Nutr Biochem. 2016 Jul;33:91–102.
  • Bailes JE, Patel V. The potential for DHA to mitigate mild traumatic brain injury. Mil Med. 2014 Nov;179(11 Suppl):112–116.
  • Oliver JM, Jones MT, Kirk KM, et al. Effect of docosahexaenoic acid on a biomarker of head trauma in American football. Med Sci Sports Exerc. 2016 Jun;48(6):974–982.
  • Heileson JL, Anzalone AJ, Carbuhn AF, et al. The effect of omega-3 fatty acids on a biomarker of head trauma in NCAA football athletes: a multi-site, non-randomized study. J Int Soc Sports Nutr. 2021 ;18(1):65.
  • Black KE, Witard OC, Baker D, et al. Adding omega-3 fatty acids to a protein-based supplement during pre-season training results in reduced muscle soreness and the better maintenance of explosive power in professional Rugby Union players. Eur J Sport Sci. 2018 Nov;18(10):1357–1367.
  • Fontani G, Corradeschi F, Felici A, et al. Cognitive and physiological effects of omega-3 polyunsaturated fatty acid supplementation in healthy subjects. Eur J Clin Invest. 2005 Nov;35(11):691–699.
  • Fontani G, Lodi L, Migliorini S, et al. Effect of omega-3 and policosanol supplementation on attention and reactivity in athletes. J Am Coll Nutr. 2009 Aug;28 Suppl(sup4):473s–481s.
  • Guzmán JF, Esteve H, Pablos C, et al. DHA- rich fish oil improves complex reaction time in female elite soccer players. J Sports Sci Med. 2011;10(2):301–305.
  • Lewis MD, Hibbeln JR, Johnson JE, et al. Suicide deaths of active-duty US military and omega-3 fatty-acid status: a case-control comparison. J Clin Psychiatry. 2011 Dec;72(12):1585–1590.
  • Hallahan B, Hibbeln JR, Davis JM, et al. Omega-3 fatty acid supplementation in patients with recurrent self-harm. Br J Psychiatry. 2007 Feb;190(2):118–122.
  • Hibbeln JR, Gow RV. The potential for military diets to reduce depression, suicide, and impulsive aggression: a review of current evidence for omega-3 and omega-6 fatty acids. Mil Med. 2014 Nov;179(11 Suppl):117–128.
  • Philpott JD, Witard OC, Galloway SDR. Applications of omega-3 polyunsaturated fatty acid supplementation for sport performance. Res Sports Med. 2019 Apr-Jun;27(2):219–237.
  • Lewis NA, Daniels D, Calder PC, et al. Are there benefits from the use of fish oil supplements in athletes? a systematic review. Adv Nutr. 2020 Sep 1;11(5):1300–1314.
  • Shei RJ, Lindley MR, Mickleborough TD. Omega-3 polyunsaturated fatty acids in the optimization of physical performance. Mil Med. 2014 Nov;179(11 Suppl):144–156.
  • Coulter ID. The response of an expert panel to nutritional armor for the warfighter: can omega-3 fatty acids enhance stress resilience, wellness, and military performance?. Mil Med. 2014 Nov;179(11 Suppl):192–198.
  • Heileson JL, Funderburk LK. The effect of fish oil supplementation on the promotion and preservation of lean body mass, strength, and recovery from physiological stress in young, healthy adults: a systematic review. Nutr Rev. 2020 Dec 1; 78(12):1001–1014.
  • VanDusseldorp TA, Escobar KA, Johnson KE, et al. Impact of varying dosages of fish oil on recovery and soreness following eccentric exercise. Nutrients. 2020 Jul 27;12(8):2246.
  • Kyriakidou Y, Wood C, Ferrier C, et al. The effect of omega-3 polyunsaturated fatty acid supplementation on exercise-induced muscle damage. J Int Soc Sports Nutr. 2021 Jan 13;18(1):9.
  • Tsuchiya Y, Ueda H, Yanagimoto K, et al. 4-week eicosapentaenoic acid-rich fish oil supplementation partially protects muscular damage following eccentric contractions. J Int Soc Sports Nutr. 2021 Mar 1;18(1):18.
  • Lieberman HR. Amino acid and protein requirements: cognitive performance, stress and brain function the role of protein and amino acids in sustaining and enhancing performance.J Int Soc Sports Nutr. 1999: 289–307.
  • Mahoney CR, Castellani J, Kramer FM, et al Tyrosine supplementation mitigates working memory decrements during cold exposure. Physiol Behav. 2007;92(4):575–582.
  • Shurtleff D, Thomas JR, Schrot J, et al Tyrosine reverses a cold-induced working memory deficit in humans. Pharmacol Biochem Behav. 1994;47(4):935–941.
  • Ott T, Nieder A. Dopamine and cognitive control in prefrontal cortex. Trends Cogn Sci. 2019;23(3):213–234.
  • Spencer RC, Devilbiss DM, Berridge CW. The cognition-enhancing effects of psychostimulants involve direct action in the prefrontal cortex. Biol Psychiatry. 2015;77(11):940–950.
  • Gao W-J, Krimer LS, Goldman-Rakic PS. Presynaptic regulation of recurrent excitation by D1 receptors in prefrontal circuits. Proc Nat Acad Sci. 2001;98(1):295–300.
  • Pomeroy DE, Tooley KL, Probert B, et al.A systematic review of the effect of dietary supplements on cognitive performance in healthy young adults and military personnel. Nutrients. 2020;12(2):545.
  • Orr R, Hinton B, Wilson A, et al.Investigating the routine dispatch tasks performed by police officers. Safety. 2020;6(4):54.
  • Bissett D, Bissett J, Snell C. Physical agility tests and fitness standards: perceptions of law enforcement officers Police Practice & Research An Int J. 2012;13(3):208–223.
  • Carlton S, Carbone P, Stierli M, et al. The impact of occupational load carriage on the mobility of the tactical police officer. J Aust Str Cond. 2014;22:32–37.
  • Thomas M, Pohl MB, Shapiro R, et al. Effect of load carriage on tactical performance in special weapons and tactics operators. J Strength Cond Res. 2018 Feb;32(2):554–564.
  • Ramstrand N, Zügner R, Larsen LB, et al. Evaluation of load carriage systems used by active duty police officers: relative effects on walking patterns and perceived comfort. Appl Ergon. 2016 Mar;53:36–43.
  • Marins EF, Cabistany L, Farias C, et al Effects of personal protective equipment on metabolism and performance during an occupational physical ability test for federal highway police officers. J Strength Cond Res. 2020 Apr;34(4):1093–1102.
  • Keeler JM, Pohl MB, Bergstrom HC, et al. The effect of tactical tasks and gear on muscle activation of SWAT officers. J Strength Cond Res. 2022;36(1):238–244.
  • Violanti JM, Burchfiel CM, Miller DB, et al. The Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) pilot study: methods and participant characteristics. Ann Epidemiol. 2006 Feb;16(2):148–156.
  • Berg BL. First day at the police academy: stress-reaction-training as a screening-out technique. J Cont Crim Just. 1990;6(2):89–105.
  • Pryor RR, Colburn D, Crill MT, et al. Fitness characteristics of a suburban special weapons and tactics team. J Strength Cond Res. 2012;26(3):752–757.
  • DiVencenzo HR, Morgan AL, Laurent CM, et al. Metabolic demands of law enforcement personal protective equipment during exercise tasks. Ergonomics. 2014;57(11):1760–1765.
  • Dorman LE, Havenith G. The effects of protective clothing on energy consumption during different activities. Eur J Appl Physiol. 2009 Feb;105(3):463–470.
  • Maupin D, Robinson J, Wills T, et al. Profiling the metabolic fitness of a special operations police unit. J Occup Health. 2018;60(5):356–360.
  • Ramey SL, Downing NR, Knoblauch A. Developing strategic interventions to reduce cardiovascular disease risk among law enforcement officers: the art and science of data triangulation. AAOHN J. 2008;56(2):54–62.
  • Varvarigou V, Farioli A, Korre M, et al. Law enforcement duties and sudden cardiac death among police officers in United States: case distribution study. BMJ. 2014;349(nov18 2):g6534.
  • Kales SN, Soteriades ES, Christoudias SG, et al. Firefighters and on-duty deaths from coronary heart disease: a case control study. Environ Health. 2003;2(1):14.
  • Sörensen L, Smolander J, Louhevaara V, et al. Physical activity, fitness and body composition of Finnish police officers: a 15-year follow-up study. Occup Med. 2000;50(1):3–10.
  • Boyce R, JONES G, Lloyd C, et al. A longitudinal observation of police: body composition changes over 12 years with gender and race comparisonS. J Exercise Physiol Online. 2008;11(6): 1–13.
  • Michell V, Samaria C, Júnior Rudy N, et al. Effects of a concurrent physical exercise program on aerobic power and body composition in adults. J Sports Med Phys Fitness. 2014;54(4):441–446.
  • Violanti JM, Ma CC, Fekedulegn D, et al. Associations between body fat percentage and fitness among police officers: a statewide study. Saf Health Work. 2017;8(1):36–41.
  • Williford HN, Scharff-Olson M. Fitness and body fat: an issue of performance. Fire Engineering. 1998.
  • Ricciardi R, Deuster PA, Talbot LA. Effects of gender and body adiposity on physiological responses to physical work while wearing body armor. Mil Med. 2007;172(7):743–748.
  • Dawes J, Orr RM, Elder C, et al. Association between body fatness and measures of muscular endurance among part-time SWAT officers. J Aust Str Cond. 2014;22(4): 33–37.
  • Anderson AA, Yoo H, Franke WD. Associations of physical activity and obesity with the risk of developing the metabolic syndrome in law enforcement officers. J Occup Environ Med. 2016 Sep;58(9):946–951.
  • Andrew ME, Shengqiao L, Wactawski-Wende J, et al. Adiposity, muscle, and physical activity: predictors of perturbations in heart rate variability. Am J Hum Biol. 2013 May-Jun;25(3):370–377.
  • Frykman P, Harman E, Pandorf C. Correlates of obstacle course performance among female soldiers carrying two different loads. Army Res Inst Env Med. 2001;25(3):370–377.
  • Pandorf CE, Harman EA, Frykman PN, et al. Correlates of load carriage and obstacle course performance among women. Work. 2002;18(2):179–189.
  • Abel MG, Palmer TG, Trubee N. Exercise program design for structural firefighters. Strength & Conditioning J. 2015;37(4):8–19.
  • Rodríguez-Marroyo JA, López-Satue J, Pernía R, et al. Physiological work demands of Spanish wildland firefighters during wildfire suppression. Int Arch Occup Environ Health. 2012;85(2):221–228.
  • Eves ND, Jones RL, Petersen SR. The influence of the self-contained breathing apparatus (SCBA) on ventilatory function and maximal exercise. Can J Appl Physiol. 2005 Oct;30(5):507–519.
  • Louhevaara V, Smolander J, Tuomi T, et al. Effects of an SCBA on breathing pattern, gas exchange, and heart rate during exercise. J Occ Med Asso. 1985;27(3): 213–216.
  • Louhevaara V, Tuomi T, Korhonen O, et al. Cardiorespiratory effects of respiratory protective devices during exercise in well-trained men. Eur J Appl Physiol Occup Physiol. 1984;52(3):340–345.
  • Punakallio A, Lusa S, Luukkonen R. Protective equipment affects balance abilities differently in younger and older firefighters. Aviat Space Environ Med. 2003;74(11):1151–1156.
  • Park K, Rosengren KS, Horn GP, et al. Assessing gait changes in firefighters due to fatigue and protective clothing. Saf Sci. 2011;49(5):719–726.
  • Lesniak AY, Bergstrom HC, Clasey JL, et al. The effect of personal protective equipment on firefighter occupational performance. J Strength Cond Res. 2020 Aug;34(8):2165–2172.
  • Taylor NAS, Lewis MC, Notley SR, et al. A fractionation of the physiological burden of the personal protective equipment worn by firefighters. Eur J Appl Physiol. 2012;112(8):2913–2921.
  • Bugajska J, Zuzewicz K, Szmauz-Dybko M, et al. Cardiovascular stress, energy expenditure and subjective perceived ratings of fire fighters during typical fire suppression and rescue tasks. Int J Occup Saf Ergon. 2007;13(3):323–331.
  • Sothmann MS, Saupe K, Jasenof D, et al. Heart rate response of firefighters to actual emergencies. implications for cardiorespiratory fitness. J Occup Med. 1992 Aug;34(8):797–800.
  • Williams-Bell FM, Villar R, Sharratt MT, et al. Physiological demands of the firefighter Candidate physical ability test. Med Sci Sports Exerc. 2009 Mar;41(3):653–662.
  • Lemon PW, Hermiston RT. The human energy cost of fire fighting. J Occup Med. 1977 Aug;19(8):558–562.
  • O’Connell ER, Thomas PC, Cady LD, et al. Energy costs of simulated stair climbing as a job-related task in fire fighting. J Occup Med. 1986 Apr;28(4):282–284.
  • McAllister MJ, Gonzalez AE, Waldman HS. Time restricted feeding reduces inflammation and cortisol response to a firegrounds test in professional firefighters. J Occup Environ Med. 2021;63(5):441–447.
  • von Heimburg ED, Rasmussen AK, Medbø JI. Physiological responses of firefighters and performance predictors during a simulated rescue of hospital patients. Ergonomics. 2006 Feb 10; 49(2):111–126.
  • Gledhill N, Jamnik VK. Characterization of the physical demands of firefighting. Can J Sport Sci. 1992 Sep;17(3):207–213.
  • Sharkey B, Rothwell T. Validation and field evaluation of a work capacity test for wildland firefighters 467. Med Sci Sports Exercise. 1996;28(5):79.
  • Sol JA, Ruby BC, Gaskill SE, et al. Metabolic demand of hiking in wildland firefighting. Wilderness Environ Med. 2018 Sep;29(3):304–314.
  • Fahy RF, Petrillo JT, Molis JL. Firefighter fatalities in the US-2019. NFPA Res. 2019: 1–26.
  • Fahy RF. US firefighter fatalities due to sudden cardiac death, 1995-2004. MA: National Fire Protection Association Quincy; 2005.
  • Kales SN, Soteriades ES, Christophi CA, et al. Emergency duties and deaths from heart disease among firefighters in the United States. N Engl J Med. 2007 Mar 22;356(12):1207–1215.
  • Walker A, Keene T, Argus C, et al. Immune and inflammatory responses of Australian firefighters after repeated exposures to the heat. Ergonomics. 2015;58(12):2032–2039.
  • Wolkow A, Aisbett B, Jefferies S, et al. Effect of heat exposure and simulated physical firefighting work on acute inflammatory and cortisol responses. Ann Work Expo Health. 2017 Jun 1;61(5):600–603.
  • Ridker PM, Rifai N, Stampfer MJ, et al. Plasma concentration of interleukin-6 and the risk of future myocardial infarction among apparently healthy men. Circulation. 2000 Apr 18;101(15):1767–1772.
  • Hunter AL, Shah ASV, Langrish JP, et al. Fire simulation and cardiovascular health in firefighters. Circulation. 2017;135(14):1284–1295.
  • Fahs CA, Yan H, Ranadive S, et al. Acute effects of firefighting on arterial stiffness and blood flow. Vascular Medicine. 2011;16(2):113–118.
  • Fernhall B, Fahs CA, Horn G, et al. Acute effects of firefighting on cardiac performance. Eur J Appl Physiol. 2012;112(2):735–741.
  • Smith DL, Fehling PC, Frisch A, et al. The prevalence of cardiovascular disease risk factors and obesity in firefighters. J Obes. 2012;2012:908267.
  • Bilzon JL, Scarpello EG, Smith CV, et al. Characterization of the metabolic demands of simulated shipboard royal navy fire-fighting tasks. Ergonomics. 2001 Jun 20;44(8):766–780.
  • Budd G, Brotherhood J, Hendrie A, et al. Project aquarius 5. activity distribution, energy expenditure, and productivity of men suppressing free-running wildland fires with hand tools. Int J Wil Fire. 1997;7(2):105–118.
  • Smith DL. Firefighter fitness: improving performance and preventing injuries and fatalities. Curr Sports Med Rep. 2011;10(3):167–172.
  • Rhea MR, Alvar BA, Gray R. Physical fitness and job performance of firefighters. J Strength Cond Res. 2004 May;18(2):348–352.
  • Xu D, Song Y, Meng Y, et al. Relationship between firefighter physical fitness and special ability performance: predictive research based on machine learning algorithms. Int J Environ Res Public Health. 2020;17(20):7689.
  • Houck JM, Mermier CM, Beltz NM, et al. Physical fitness evaluation of career urban and wildland firefighters. J Occup Environ Med. 2020;62(7):e302–e307.
  • Drew-Nord DC, Hong O, Froelicher ES, et al. Cardiovascular risk factors among career firefighters. AAOHN J. 2009;57(10):415–424.
  • Eastlake AC, Knipper BS, He X, et al. Lifestyle and safety practices of firefighters and their relation to cardiovascular risk factors. Work. 2015 Jan 1;50(2):285–294.
  • Webb HE, Weldy ML, Fabianke-Kadue EC, et al. Psychological stress during exercise: cardiorespiratory and hormonal responses. Eur J Appl Physiol. 2008 Dec;104(6):973–981.
  • Webb HE, Garten RS, McMinn DR, et al. Stress hormones and vascular function in firefighters during concurrent challenges. Biol Psychol. 2011 Apr;87(1):152–160.
  • Huang C-J, Webb HE, Garten RS, et al. Stress hormones and immunological responses to a dual challenge in professional firefighters. Int J Psychophysiol. 2010;75(3):312–318.
  • Dobson M, Choi B, Schnall PL, et al. Exploring occupational and health behavioral causes of firefighter obesity: a qualitative study. Am J Ind Med. 2013;56(7):776–790.
  • Poston WSC, Haddock CK, Jahnke SA, et al. The prevalence of overweight, obesity, and substandard fitness in a population-based firefighter cohort. J Occup Environ Med. 2011;53(3):266–273.
  • Can SH, Hendy HM. Behavioral variables associated with obesity in police officers. Ind Health. 2014;52(3):240–247.
  • Rona RJ, Sundin J, Wood P, et al. Agreement between body mass index, waist circumference and skin-fold thickness in the United Kingdom Army. Ann Hum Biol. 2011 May;38(3):257–264.
  • Alasagheirin M. H., Clark M. K., Ramey S. L., Grueskin, E. F., et al. Body mass index misclassification of obesity among community police officers. American Association of Occupational Health Nurses. 2011. 59(11): 469–475. doi:10.3928/08910162-20111017-01.
  • Jitnarin N, Poston WSC, Haddock CK, et al. Accuracy of body mass index-defined obesity status in US firefighters. Saf Health Work. 2014;5(3):161–164.
  • Ramey SL, Downing NR, Franke WD. Milwaukee police department retirees: cardiovascular disease risk and morbidity among aging law enforcement officers. Aaohn J. 2009 Nov;57(11):448–453.
  • Kales SN, Tsismenakis AJ, Zhang C, et al. Blood pressure in firefighters, police officers, and other emergency responders. Am J Hypertens. 2009 Jan;22(1):11–20.
  • Soteriades ES, Smith DL, Tsismenakis AJ, et al. Cardiovascular disease in US firefighters: a systematic review. Cardiol Rev. 2011 Jul-Aug;19(4):202–215.
  • Fatalities among volunteer and career firefighters–United States, 1994-2004. MMWR Morb Mortal Wkly Rep. 2006 Apr 28;55(16):453–455.
  • Tsismenakis AJ, Christophi CA, Burress JW, et al. The obesity epidemic and future emergency responders. Obesity (Silver Spring). 2009 Aug;17(8):1648–1650.
  • Yoo HL, Franke WD. Prevalence of cardiovascular disease risk factors in volunteer firefighters. J Occup Environ Med. 2009 Aug;51(8):958–962.
  • Mifflin MD, St Jeor ST, Hill LA, et al. A new predictive equation for resting energy expenditure in healthy individuals. Am J Clin Nutr. 1990 Feb;51(2):241–247.
  • Roza AM, Shizgal HM. The Harris benedict equation reevaluated: resting energy requirements and the body cell mass. Am J Clin Nutr. 1984 Jul;40(1):168–182.
  • Harris JA, Benedict FG. A biometric study of human basal metabolism. Proc Natl Acad Sci U S A. 1918;4(12):370–373.
  • Ainsworth BE, Haskell WL, Herrmann SD, et al. Compendium of physical activities: a second update of codes and MET values. Med Sci Sports Exerc. 2011 Aug;438:1575–1581. 2011.
  • Kreider RB, Wilborn CD, Taylor L, et al. Exercise & sport nutrition review: research & recommendations. J Int Soc Sports Nutr. 2010;7(1):7.
  • Lupton, J. R., Brooks, J., Butte, N. F., Caballero, B., Flatt, J. P., Fried, S. K. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids, 5, 589–768: 2002. National Academy Press: Washington, DC, USA.
  • Popkin BM, D’Anci KE, Rosenberg IH. Water, hydration, and health. Nutr Rev. 2010;68(8):439–458.
  • Press Na, editor institute of medicine dietary reference intake for water. Washington DC; 2005, p. 75–134.
  • Peacock OJ, Stokes K, Thompson D. Initial hydration status, fluid balance, and psychological affect during recreational exercise in adults. J Sports Sci. 2011 Jun;29(9):897–904.
  • Cronin C, O’Neal E, Simpson J, et al. Natural training hydration status, sweat rates, and perception of sweat losses during crossfit training. J Sports Sci. 2016;9:576–586.
  • O’Neal E, Boy T, Davis B, et al. Post-exercise sweat loss estimation accuracy of athletes and physically active adults: a review. Sports (Basel). 2020 Aug 11;8(8).
  • Armstrong LE, Maresh CM, Castellani JW, et al. Urinary indices of hydration status. Int J Sport Nutr. 1994 Sep;4(3):265–279.
  • Armstrong LE, Soto JA, Hacker FT Jr., et al. Urinary indices during dehydration, exercise, and rehydration. Int J Sport Nutr. 1998 Dec;8(4):345–355.
  • Thomas DT, Erdman KA, Burke LM. Position of the academy of nutrition and dietetics, dietitians of Canada, and the American college of sports medicine: nutrition and athletic performance. J Acad Nutr Diet. 2016 Mar;116(3):501–528.
  • Smith DL, Arena L, DeBlois JP, et al. Effect of base layer materials on physiological and perceptual responses to exercise in personal protective equipment. Appl Ergon. 2014 May;45(3):428–436.
  • Smolander J, Louhevaara V, Tuomi T, et al. Cardiorespiratory and thermal effects of wearing gas protective clothing. Int Arch Occup Environ Health. 1984;54(3):261–270.
  • Larsen B, Snow R, Williams-Bell M, et al. Simulated firefighting task performance and physiology under very hot conditions [original research]. Front Physiol. 2015;6(322).
  • Cheung SS, McLellan TM, Tenaglia S. The thermophysiology of uncompensable heat stress physiological manipulations and individual characteristics. Sports Med. 2000May;29(5):329–359.
  • Cheuvront SN, Kenefick RW. Dehydration: physiology, assessment, and performance effects. Compr Physiol. 2014 Jan;4(1):257–285.
  • Baker LB, Conroy DE, Kenney WL. Dehydration impairs vigilance-related attention in male basketball players. Med Sci Sports Exerc. 2007 Jun;39(6):976–983.
  • Cheuvront SN, Haymes EM. Thermoregulation and marathon running: biological and environmental influences. Sports Med. 2001;31(10):743–762.
  • Casa DJ, Armstrong LE, Hillman SK, et al. National athletic trainers’ association position statement: fluid replacement for athletes. J Athl Train. 2000 Apr;35(2):212–224.
  • Wendt D, van Loon LJ, Lichtenbelt WD. Thermoregulation during exercise in the heat: strategies for maintaining health and performance. Sports Med. 2007;37(8):669–682.
  • González-Alonso J. Human thermoregulation and the cardiovascular system. Exp Physiol. 2012;97(3):340–346.
  • González-Alonso J, Crandall CG, Johnson JM. The cardiovascular challenge of exercising in the heat. J Physiol. 2008;586(1):45–53.
  • Romet TT, Frim J. Physiological responses to fire fighting activities. Eur J Appl Physiol Occup Physiol. 1987;56(6):633–638.
  • Aragon AA, Schoenfeld BJ, Wildman R, et al. International society of sports nutrition position stand: diets and body composition. J Int Soc Sports Nutr. 2017;14(1):16.
  • Donnelly JE, Blair SN, Jakicic JM, et al. American college of sports medicine position stand. appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc. 2009 Feb;41(2):459–471.
  • Liguori G, Medicine Aco S. ACSM’s guidelines for exercise testing and prescription. Philadelphia, PA: Lippincott Williams & Wilkins; 2020.
  • Yang J, Farioli A, Korre M, et al. Dietary preferences and nutritional information needs among career firefighters in the United States. Glob Adv Health Med. 2015;4(4):16–23.
  • Sofi F, Cesari F, Abbate R, et al. Adherence to Mediterranean diet and health status: meta-analysis. Bmj. 2008 Sep 11;337(sep11 2):a1344.
  • Mertens E, Mullie P, Deforche B, et al. Cross-sectional study on the relationship between the Mediterranean diet score and blood lipids. Nutr J. 2014;13(1):88.
  • Yang J, Farioli A, Korre M, et al. Modified Mediterranean diet score and cardiovascular risk in a North American working population. PLOS ONE. 2014;9(2):e87539.
  • Patterson RE, Sears DD. Metabolic effects of intermittent fasting. Annu Rev Nutr. 2017;37(1):371–393.
  • Ravussin E, Beyl RA, Poggiogalle E, et al. Early time-restricted feeding reduces appetite and increases fat oxidation but does not affect energy expenditure in humans. Obesity (Silver Spring). 2019 Aug;27(8):1244–1254.
  • Peeke PM, Greenway FL, Billes SK, et al. Effect of time restricted eating on body weight and fasting glucose in participants with obesity: results of a randomized, controlled, virtual clinical trial. Nutr Diabetes. 2021;11(1):6.
  • McAllister MJ, Pigg BL, Renteria LI, et al. Time-restricted feeding improves markers of cardiometabolic health in physically active college-age men: a 4-week randomized pre-post pilot study. Nutr Res. 2020 Mar;75:32–43.
  • Waldman HS, Renteria LI, McAllister MJ. Time-restricted feeding for the prevention of cardiometabolic diseases in high-stress occupations: a mechanistic review. Nutr Rev. 2020 Jun 1; 78(6):459–464.
  • McAllister MJ, Gonzalez AE, Waldman HS. Impact of time restricted feeding on markers of cardiometabolic health and oxidative stress in resistance-trained Firefighters. J Strength Cond Res. 2020 Oct 30;
  • Moro T, Tinsley G, Longo G, et al. Time-restricted eating effects on performance, immune function, and body composition in elite cyclists: a randomized controlled trial. J Int Soc Sports Nutr. 2020;17(1):65.
  • Moro T, Tinsley G, Bianco A, et al. Effects of eight weeks of time-restricted feeding (16/8) on basal metabolism, maximal strength, body composition, inflammation, and cardiovascular risk factors in resistance-trained males. J Transl Med. 2016;14(1):290.
  • Gonzalez AE, Waldman HS, Abel MG, et al. Impact of time restricted feeding on fitness variables in professional resistance trained firefighters. J Occup Environ Med. 2021;63(4):343–349.
  • McAllister MJ, Gonzalez AE, Waldman HS. Time restricted feeding reduces inflammation and cortisol response to a firegrounds test in professional firefighters. J Occup Environ Med. 2021 May 1;63(5):441–447.
  • Waldman H, Smith J, Lamberth J, et al. A 28-day carbohydrate-restricted diet improves markers of cardiometabolic health and performance in professional firefighters. J Strength Cond Res. 2019;33(12):1.
  • Waldman HS, Smith JW, Lamberth J, et al. A 28-day carbohydrate-restricted diet improves markers of cardiovascular disease in professional firefighters. J Strength Cond Res. 2020 Oct;34(10):2785–2792.
  • Aragon AA, Schoenfeld BJ, Wildman R, et al. International society of sports nutrition position stand: diets and body composition. J Int Soc Sports Nutr. 2017;14(1):16.
  • Mansoor N, Vinknes KJ, Veierød MB, et al. Effects of low-carbohydrate diets v. low-fat diets on body weight and cardiovascular risk factors: a meta-analysis of randomised controlled trials. Br J Nutr. 2016 Feb 14;115(3):466–479.
  • Hashimoto Y, Fukuda T, Oyabu C, et al. Impact of low-carbohydrate diet on body composition: meta-analysis of randomized controlled studies. Obes Rev. 2016 Jun;17(6):499–509.
  • Kantor ED, Rehm CD, Du M, et al. Trends in dietary supplement use among us adults from 1999-2012. JAMA. 2016;316(14):1464–1474.
  • Guest NS, VanDusseldorp TA, Nelson MT, et al. International society of sports nutrition position stand: caffeine and exercise performance. J Int Soc Sports Nutr. 2021 Jan 2;18(1):1.
  • Wassell SD, Edwards ES, Saunders MJ, et al. Effect of caffeine on the hemostatic response to firefighting drills. J Caff Aden Resh. 2020;10(3):117–123.
  • Kellawan JM, Stuart-Hill LA, Petersen SR. The effects of caffeine during exercise in fire protective ensemble. Ergonomics. 2009 Nov;52(11):1445–1454.
  • Menon VP, Sudheer AR. Antioxidant and anti-inflammatory properties of curcumin. Adv Exp Med Biol. 2007;595:105–125.
  • Ambati RR, Phang SM, Ravi S, et al. Astaxanthin: sources, extraction, stability, biological activities and its commercial applications–a review. Mar Drugs. 2014;12(1):128–152.
  • Cao Y, Yang L, Qiao X, et al. Dietary astaxanthin: an excellent carotenoid with multiple health benefits. Crit Rev Food Sci Nutr. 2021;28:1–27.
  • Yoshida H, Yanai H, Ito K, et al. Administration of natural astaxanthin increases serum HDL-cholesterol and adiponectin in subjects with mild hyperlipidemia. Atherosclerosis. 2010 Apr;209(2):520–523.
  • Fassett RG, Coombes JS. Astaxanthin in cardiovascular health and disease. Molecules. 2012 Feb 20;17(2):2030–2048.
  • K-c C, S-c C, P-c C. Astaxanthin attenuated thrombotic risk factors in type 2 diabetic patients. J Funct Foods. 2019 ;53:22–27.
  • Tanabe Y, Maeda S, Akazawa N, et al. Attenuation of indirect markers of eccentric exercise-induced muscle damage by curcumin. Eur J Appl Physiol. 2015 Sep;115(9):1949–1957.
  • Choi Y, Tanabe Y, Akazawa N, et al. Curcumin supplementation attenuates the decrease in endothelial function following eccentric exercise. J Exerc Nutrition Biochem. 2019 Jun 30;23(2):7–12.
  • Nakhostin-Roohi B, Nasirvand Moradlou A, Mahmoodi Hamidabad S, et al. The effect of curcumin supplementation on selected markers of Delayed Onset Muscle Soreness (DOMS). Ann App Spo Sc. 2016;4(2):25–31.
  • Mallard AR, Briskey D, Richards BA, et al. Curcumin improves delayed onset muscle soreness and postexercise lactate accumulation. J Diet Suppl. 2021;18(5):531–542.
  • McAllister MJ, Holland AM, Chander H, et al. Impact of ketone salt containing supplement on cardiorespiratory and oxidative stress response in firefighters exercising in personal protective equipment [research article]. Asian J Sports Med. 2019;10(1):e82404.
  • McAllister MJ, Holland AM, Chander H, et al. Impact of ketone salt containing supplement on cardiorespiratory and oxidative stress response in firefighters exercising in personal protective equipment [research article]. Asian J Sports Med. 2019;10(1):e82404.