1. Micronutrient Status During Military Training and Associations With Musculoskeletal Health, Injury, and Readiness Outcomes.
- Author
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Sekel, Nicole M., Lovalekar, Mita, Koltun, Kristen J., Bird, Matthew B., Forse, Jennifer N., Martin, Brian J., and Nindl, Bradley C.
- Subjects
TIBIA physiology ,SKELETAL muscle injuries ,RISK assessment ,VITAMIN D deficiency ,IRON ,IRON in the body ,BONE density ,T-test (Statistics) ,DATA analysis ,MUSCULOSKELETAL system diseases ,IRON deficiency ,COMPUTED tomography ,SEX distribution ,LOGISTIC regression analysis ,MICRONUTRIENTS ,DESCRIPTIVE statistics ,NUTRITIONAL status ,STATISTICS ,DATA analysis software ,MILITARY education ,MEMBRANE proteins ,VITAMIN D ,DISEASE risk factors - Abstract
Objective: Micronutrient status, specifically vitamin D and iron, represent modifiable factors for optimizing military readiness. The primary purpose of this investigation was to determine associations between micronutrient deficiency (i.e., iron status and 25-hydroxy-vitamin D [25(OH)D]) and operationally relevant outcomes (i.e., skeletal health, musculoskeletal injury) at baseline and post-10 weeks of arduous military training. Methods: A total of 227 (177 men, 50 women) Marine Officer Candidates School (OCS) candidates who completed OCS training with complete data sets were included in this analysis. Vitamin D and iron status indicators were collected at two timepoints, pre (baseline) and post OCS. Musculoskeletal outcomes at the mid- and proximal tibial diaphysis were assessed via peripheral quantitative computed tomography. Results: Micronutrient status declined following OCS training in men and women and was associated with musculoskeletal outcomes including greater bone strength (strength strain index) at the mid-diaphysis site in those with optimal status (M = 38.26 mm
3 , SE = 15.59) versus those without (M = −8.03 mm3 , SE = 17.27). In women (p =.037), endosteal circumference was greater in the deficient group (M = 53.26 mm, SE = 1.19) compared with the optimal group (M = 49.47 mm, SE = 1.31) at the proximal diaphysis. In men, greater baseline hepcidin concentrations were associated with an increased likelihood of suffering musculoskeletal injury during training. Conclusions: Vitamin D and iron status declined over the course of training, suggesting impaired micronutrient status. Differences in musculoskeletal outcomes by micronutrient group suggests optimal vitamin D and ferritin concentrations may exert beneficial effects on bone fatigability and fracture reduction during military training. [ABSTRACT FROM AUTHOR]- Published
- 2024
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