None listed
Conditions
Brief summary
Currently, the health impacts on Australian Army trainees undergoing Infantry Initial Employment Training are unknown. Subsequently, the Australian Army has little evidence to guide prevention strategies in this population. Focused research is required to investigate health outcomes during infantry training and trial interventions to mitigate preventable health problems. With this evidence, the Australian Army can inform future policy and improve practice to preserve and optimise the health of the force, such as increasing nutrition support to trainees. Proper and adequate nutrition is imperative to achieve the aim of every army; to transform civilians into fit, capable and resourceful members. A major gap in the research conducted to date is the paucity of studies that have concurrently measured dietary intakes and physical performance and health indicators to understand whether any shortfalls in dietary intakes lead to reductions in military-relevant health and performance indicators. Moreover, there is a lack of studies that have employed an intervention informed by behaviour change theory while translating eating strategies that are widely used in elite sport to army initial training with the aim of improving training outcomes (such as performance in physical fitness assessments and measures of body composition such as fat-free mass) and reducing the risk of musculoskeletal injury. Thus, the primary aims of this study are to: • Determine the effectiveness of promoting performance nutrition behaviours (intervention) to significantly improve nutrition knowledge; increase dietary energy intakes; and/or enhance macronutrient intake ratios and/or diet quality during the 16 weeks of Infantry Initial Employment Training (IET) compared to usual practice (no intervention). • Determine the effectiveness of promoting performance nutrition behaviours (intervention) to significantly enhance body composition (in particular fat-free mass), physical fitness performance, blood markers of bone metabolism and sex hormones; and/or significantly reduce symptoms of gastrointestinal distress during the 16 weeks of Infantry Initial Employment Training (IET) compared to usual practice (no intervention). • Determine if increases in total energy and/or macronutrient intakes are associated with increases in: nutrition knowledge; fat-free mass; physical fitness assessment performance, blood markers of bone metabolism and sex hormones over the 16 weeks of Infantry IET. The secondary aim of this project is: • Determine the effectiveness of promoting performance nutrition behaviours (intervention) to reduce rates of musculoskeletal injury over the 16 weeks of Infantry IET. The exploratory aim of this project is: • Collect data from various musculoskeletal injury surveillance methods and systems in the ADF and compare injury estimates across methodologies.
Interventions
Volunteer Australian Army trainees undertaking their Infantry Initial Employment Training (Infantry IET) will be allocated to either the Control Group (usual practice) or Intervention Group (Diet and Education).
During week 1 of their 16-week Infantry IET, all participants in the intervention group will receive group education on the following two topics: 1) eating strategies to fuel performance, and 2) eating strategies to maximise muscle adaptations and recovery. This will be delivered in two
Volunteer Australian Army trainees undertaking their Infantry Initial Employment Training (Infantry IET) will be allocated to either the Control Group (usual practice) or Intervention Group (Diet and Education). During week 1 of their 16-week Infantry IET, all participants in the intervention group will receive group education on the following two topics: 1) eating strategies to fuel performance, and 2) eating strategies to maximise muscle adaptations and recovery. This will be delivered in two x 1 hour face-to-face sessions (involving PowerPoint presentations and interactive activities) by an independent Accredited Sports Dietitian (i.e. not a member of the research team) who is qualified and experienced in helping athletes achieve their performance goals through nutrition. Participants' attendance at these sessions will be confirmed by an attendance checklist. To reinforce the content delivered in the lectures, trainees will receive 2 x 2-page handouts on the same two topics (that have been specifically created for this study). For the 16-week duration of their Infantry IET, trainees in the Diet and Education Intervention Group will receive access to additional foods in the common rooms of their accommodation lines that will be accompanied with a signs reading ‘Fuel Station’ and 'Recovery Station' with corresponding pictures of the foods they will provide: rapidly-digestible high-carbohydrate sports foods (i.e. Gatorade/Powerade carbohydrate-electrolyte sports drink, Science in Sport (SIS) Go Energy Isotonic Gels) and high-protein foods that are suitable snacks during recovery from Physical Training (PT) sessions (i.e. Sanitarium Up & Go Protein Energize, True Protein Protein Bars). Participants will be free to self-select these foods as they wish, however, in the lectures by the Sports Dietitian, volunteers in the intervention group will receive the recommendation to drink a 600 mL Gatorade or Powerade and in addition, if possible according to their personal choice and tolerance, consume an energy gel in the 10–15 minutes before commencing their morning PT sessions involving moderate-to-high intensity aerobic activity lasting 60 minutes or more. This will provide them with up to 58 g of carbohydrate, which is within with the optimal levels recommended immediately before and/or during endurance exercise lasting one hour or more and is a level that is unlikely to cause any gastrointestinal symptoms. Additionally, participants in the intervention group will receive the recommendation to fill their 1 L drink bottles up with Gatorade/Powerade sports drinks (according to packet directions) and take this to any morning PT sessions involving moderate-to-high intensity aerobic training that lasts longer than 1 hour. It will be recommended that they drink 500 mL to 1 L of sports drink per hour (providing 30–60 g of carbohydrate), such as by consuming about 250 mL every 15–30 minutes, or 500 mL every 30 minutes to 1 hour, as time permits and according to their personal preference and tolerance. Participants may also choose to fill their drink bottle up with water, and take SIS Go Energy Isotonic Gels to their morning training sessions involving aerobic training. The Accredited Sports Dietitian and researchers will recommend that participants consume 1–2 SiS energy gels per hour (to target a total of 30–60 g of carbohydrate) during their PTI sessions involving moderate-to-high intensity aerobic activity that last longer than 60 minutes. Intervention group participants' intake of foods/drinks from the Fuel and Recovery stations will be determined by food diaries administered on three training days during weeks 1, 7/8 and 16 of their Infantry IET. In accordance with guidelines, volunteers will be encouraged to monitor and adjust their carbohydrate intakes up or down according to their personal tolerance and to find their optimal pre-exercise fueling routine.
Sponsors
Australian Government, Department of Defence, Defence Science and Technology Group
Study design
Allocation
Non-randomised trial
Intervention model
Other
Primary purpose
Educational / counselling / training
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 39 Years
Healthy volunteers
Yes
Inclusion criteria
Voluntarily consenting Trainees undertaking Infantry Initial Employment Training (IET) at Lone Pine Barracks, Singleton, NSW and aged 18–39 years old.
Exclusion criteria
The following exclusion criteria will apply to participation: • A self-reported history of a diagnosed eating disorder • Individuals younger than 18 years of age • Diagnosed disease of the gastrointestinal tract including, but not limited to diverticulitis, inflammatory bowel disease, irritable bowel syndrome, peptic ulcer disease, Crohn's disease, ulcerative colitis, history of gastric bezoar, past gastrointestinal surgery and/or colonoscopy within 3 months of study participation • Diagnosed metabolic or cardiovascular abnormalities (e.g., kidney disease, diabetes, cardiovascular disease, etc.) • Any diagnosed food allergies or intolerances. • Any use of antibiotics during Infantry IET, except topical antibiotics • Anyone who is recommencing Infantry IET after having previously commenced at an earlier date (i.e. those who have been back squadded)
Outcome results
None listed