Impact of Protein and Carbohydrate Supplementation on Musculoskeletal Injuries in Army Initial Entry Training Soldiers

Abstract

This project investigated whey protein and/or carbohydrate supplementation effects on musculoskeletal injury (MSI) outcomes. Four groups of Initial Entry Training soldiers consumed either: (1) one protein (38.6 g, 293 kcal); (2) one carbohydrate (63.4 g, 291 kcal); (3) two protein (77.2 g, 586 kcal); or (4) two carbohydrate servings/day (126.8 g, 582 kcal) after physical training and before bed, or before bed only. Odds Ratio, Chi-square and Wilcoxon ranked-sum test compared supplementation/no supplementation, number of servings, and protein/carbohydrate for MSI and limited/missed duty rates and limited/missed training days. Non-matched pairs group averages were compared to 2015/2016 historical data. Non-supplemented soldiers were approximately 5× more likely to sustain a MSI (χ2 = 58.48, p < 0.001) and 4× more likely to miss training (χ2 = 9.73, p = 0.003) compared to two servings. Non-supplemented soldiers missed five additional training days compared to two servings (W = 6059.5, p = 0.02). Soldiers consuming one serving were approximately 3× more likely to sustain a MSI than two servings (χ2 = 9.55, p = 0.002). There was no difference in limited/missed duty rates or limited/missed training days between consuming one or two servings. There was no difference between consuming one serving versus no supplementation or protein versus carbohydrate supplementation for any outcome variable. Soldiers consuming 2 servings/day of protein or carbohydrate had lower MSI rates, limited/missed duty rates, and limited/ missed training days compared to non-supplemented soldiers.

Markers of Bone Health and Impact of Whey Protein Supplementation in Army Initial Entry Training Soldiers: A Double-Blind Placebo-Controlled Study

“…WP supplementations may not provide the same benefits to those with the lower fitness levels often found in Army recruits. Our previous research did find an overall reduction in MSI in soldiers supplementing with WP or CHO compared to a non-supplemented group [33]. However, this may simply be due to the additional calories consumed.…”

“…Those wishing to participate read and signed the informed consent documents. The study protocols were completed as previously described [32,33]. The Army training unit (company) had four platoons; each platoon trained together and were housed together.…”

“…Several studies have indicated that IET soldiers do not consume the necessary nutrients to sustain the unfamiliar and often intense military training encountered during IET [32][33][34]. Supplementations with whey protein (WP) have been found to improve muscle mass, strength [35], bone metabolism [36,37], and performance [38], while reducing MSI [33]. However, to date, no studies have assessed biomarkers for bone health and WP supplementations upon entry and across IET soldiers.…”

Dietary Intake and Nitrogen Balance in British Army Infantry Recruits Undergoing Basic Training

“…It has been shown that the initial weeks (weeks 1–2) of training expose men to higher training impulses compared to later training weeks in a similar cohort [ 1 ]. The significantly lower CHO intake in week two may compromise muscle and liver glycogen storage [ 11 ], immune responses to training [ 41 ], mood and exercise performance [ 42 ] and increased risk of musculoskeletal injury [ 43 ]. Therefore, in-line with other research [ 30 ], it is proposed that recruits aim for 5–8 g·kg −1 ·day −1 of CHO [ 10 ] to mitigate against the negative outcomes of inadequate CHO intake.…”

“…The cause of musculoskeletal injury is multifactorial, yet a lower CHO intake during the initial weeks of BT may further exacerbate the risk of musculoskeletal injury. A recent study conducted by McGinnis et al [ 43 ] found U.S. Army recruits who increased CHO intake were five times less likely to suffer a musculoskeletal injury and four times less likely to miss training when compared to a control group. Moreover, inadequate CHO intake is also a risk factor for stress fracture in male infantry recruits [ 44 ].…”