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Background: Emergency foods distributed during a federal disaster relief response must follow the federal Dietary Guidelines for Americans according to the 1990 National Nutrition Monitoring Related Research Act. Nutrition information about emergency foods for household distribution is scarce., Methods: According to structured observation protocols, foods received daily at a federal distribution center in Puerto Rico after Hurricane María (November 10-25, 2017) were grouped into Dietary Guidelines for Americans ChooseMyPlate food groups. Data about their sodium, saturated fat, added sugar, and fiber content per serving were captured. Registered dietitians designed meal plans with the foods distributed., Results: Of 107 unique food items, 41% were snacks and sweets; and 13%, 4%, 13%, and 7% were fruits, vegetables, proteins, and grains, respectively. Fifty-eight percent of all foods were low in fiber (≤1 g); 46% included high amounts of sodium, saturated fats, or added sugars (≥20% daily value). The registered dietitians were able to design meal plans that complied with the Dietary Guidelines for Americans food group recommendations, but they exceeded upper daily limits for sodium, saturated fat, or added sugars., Conclusions: In view of projected increases in natural disasters and diet-related chronic diseases, DGA compliance must be improved so that federal emergency foods can support the health of survivors., (Copyright © 2019 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

The job of military medical planners is to prepare for the unthinkable and then establish a response that allows the civilian system of healthcare to continue to function. This article provides information and perspective that civilian healthcare providers can gain from their counterparts in the military. Two issues need to be considered simultaneously: preparedness, in the form of force health protection, and response, applying consequence management. The critical need for ongoing planning is clear. However, three things remain true despite our best planning efforts: individual behavior drives the response to mass casualty events, flexibility is the key to the success of any plan, and interagency coordination and trust is vital for an effective response.

A National Institutes of Health Consensus Conference recently advocated lowering the serum cholesterol levels required to diagnose moderate and severe hypercholesterolemia. We reviewed 998 active duty United States Navy personnel who underwent routine physical examinations with determinations of serum cholesterol. Analysis of the data revealed a gradual rise in mean serum cholesterol with increasing age. Moderate elevation of serum cholesterol ranged from 11.3% to 34.6% of the study group, depending on age. Severe hypercholesterolemia was also age dependent and occurred in 2.0% to 9.3% the group. Dietary and cholesterol-binding agents have been shown to reduce the occurrence of myocardial infarction in subjects with cholesterol greater than 265 mg/dl. The incidence of Navy personnel with serum cholesterol above this level ranged from 2 to 10%. It is likely that intervention with dietary or medical therapy would prevent the development or delay the occurrence of coronary artery disease in a large number of active duty U.S. Navy personnel.