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Background: Maintaining adequate nutrient intake in microgravity is important not only to meet health maintenance needs of astronauts but also to help counteract the negative effects of space flight. Beyond this, food provides psychosocial benefits throughout a mission. Objective: The purpose of this presentation is to discuss dietary intake data from multiple space programs, including Space Shuttle and the International Space Station. Description: These data arise from medical monitoring of both dietary intake and crew health, as well as research protocols designed to assess the role of diet in counteracting bone loss and other health concerns. Ground-based studies are conducted to better understand some of the negative issues related to space flight. Examples of these analog studies are extended bed rest studies, vitamin D supplementation studies in Antarctica, and saturation diving missions on the floor of the ocean. Methods and findings will be presented describing the use of weighed records, diet diaries, and food frequency questionnaires in these various environments. Provision of food and nutrients in spaceflight is important for many body systems including cardiovascular, musculoskeletal, endocrine, immune, and others. Some key areas of concern are loss of body mass, bone and muscle loss, radiation exposure, nutrient intakes during spacewalks, depletion of nutrient stores, and inadequate dietary intake. Initial experimental research studies using food and nutrition as a countermeasure to aid in mitigating these concerns are underway. Conclusion: Beyond their importance for the few individuals leaving the planet, these studies have significant implications for those remaining on Earth.

Vitamin D deficiency has reemerged as a public health concern in the United States. It is also a concern for astronauts because spacecraft are shielded from ultraviolet light, leaving diet as the sole source of vitamin D. We report here the findings from four studies: one evaluation of astronauts before and after 4- to 6-month missions to the International Space Station, and the other three from a ground-based analog for space flight, long-term bed rest. For the space flight study, blood samples were collected before the flight and within hours of landing after it. Crewmembers (n = 11) were provided vitamin D supplements (as cholecalciferol (10 g/d) throughout the mission. The average number of vitamin D supplements reported to be consumed per week was 5.7 plus or minus 4.0. The vitamin D status indicator serum 25-hydroxycholecalciferol was 25% less after landing (48 plus or minus 20) than before flight (63 plus or minus 16) (P less than 0.01). A series of three studies was undertaken to evaluate nutritional changes during and after 60 or 90 days of -6 deg. head-down-tilt bed rest. A total of 11 subjects (8 M, 3 F; age 26-55 y) participated in the studies. Blood and urine were collected twice before bed rest and once per month during bed rest. During bed rest the average dietary intake of vitamin D for the three studies was 4.84 plus or minus 0.16 (study 1), 6.24 plus or minus 0.81 (study 2), and 7.16 plus or minus 1.40 (study 3) micrograms/day. In study 1 only, subjects were given a daily supplement of 10 g vitamin D (as ergocalciferol). Data were analyzed using repeated-measures ANOVA. In the first study, 7 days after the end of the bed rest, serum 25-hydroxycholecalciferol was 30% less than it was before bed rest (p less than 0.05). In the second and third studies, during or after bed rest the serum 25-hydroxycholecalciferol concentration was not significantly different from its concentration before bed rest. These data demonstrate that vitamin D intake is critical for individuals not exposed to the sun. Although we studied astronauts and healthy subjects in bed rest, the implications of our results also apply to people living in northern latitudes and others who receive little exposure to sunlight, such as elderly people who seldom go outdoors. The inability of supplements to maintain vitamin D status is also an important finding, and highlights the need for careful food selection to ensure adequate vitamin D intake.

Nutrition has played a critical role throughout the history of exploration, and space exploration is no exception. While a one- to two-week flight aboard the Space Shuttle might be analogous to a camping trip, adequate nutrition is absolutely critical while spending several months on the International Space Station (Figure 1) or several years on a mission to another planet. To ensure adequate nutrition, space nutrition specialists must know how much of the individual nutrients astronauts need, and these nutrients must be available in the spaceflight food system. To complicate matters, these spaceflight nutritional requirements are influenced by many of the physiological changes that occur during spaceflight. In this chapter, we describe some of these changes, their impact on crew health, and ways NASA is investigating how to minimize these changes. We also review the space food systems, issues involved in setting up a cafeteria in a weightless environment, and information about dietary intake of nutrients during space missions

Nutrition is a critical concern for extended-duration space missions (Smith and Lane, 1999). Loss of body weight is a primary consequence of altered nutrition, and is frequently observed during space flight (Smith and Lane; 1999). Other existing dietary concerns for space flight include excessive intakes of sodium and iron, and insufficient intakes of water and vitamin D (Smith and Lane, 1999). Furthermore, dependence on closed or semi-closed food systems increases the likelihood of inadequate intakes of key nutrients. This is a significant concern for extended-duration space missions. Space nutrition research often necessitates detailed recording of all food consumption. While this yields extremely accurate data, it requires considerable time and effort, and thus is not suitable for routine medical monitoring during space flight. To alleviate this problem, a food frequency questionnaire (FFQ) was designed to provide a quick and easy, yet reasonably accurate, method for crewmembers to provide dietary intake information to the ground. We report here a study which was designed to assess nutritional status before, during, and after the 60-d and 91-d chamber stays. An additional goal of the study was to validate a food frequency questionnaire designed specifically for use with space flight food systems.

Studies of fluid and electrolyte homeostasis have been completed since the early human space flight programs, with comprehensive research completed on the Spacelab Life Sciences missions SLS-1 and SLS-2 flights, and more recently on the Mir 18 mission. This work documented the known shifts in fluids, the decrease in total blood volume, and indications of reduced thirst. Data from these flights was used to evaluate the nutritional needs for water, sodium, and potassium. Interpretations of the data are confounded by the inadequate energy intakes routinely observed during space flight. This in turn results in reduced fluid intake, as food provides approximately 70% water intake. Subsequently, body weight, lean body mass, total body water, and total body potassium may decrease. Given these issues, there is evidence to support a minimum required water intake of 2 L per day. Data from previous Shuttle flights indicated that water intake is 2285 +/- 715 ml/day (mean +/- SD, n=26). There are no indications that sodium intake or homeostasis is compromised during space flight. The normal or low aldosterone and urinary sodium levels suggest adequate sodium intake (4047 +/- 902 mg/day, n=26). Because excessive sodium intake is associated with hypercalciuria, the recommended maximum amount of sodium intake during flight is 3500 mg/day (i.e., similar to the Recommended Dietary Allowance, RDA). Potassium metabolism appears to be more complex. Data indicate loss of body potassium related to muscle atrophy and low dietary intake (2407 +/- 548 mg/day, n=26). Although possibly related to measurement error, the elevations in blood potassium suggest alterations in potassium homeostasis. The space RDA for minimum potassium intake is 3500 mg/day. With the documented inadequate intakes, efforts are being made to increase dietary consumption of potassium.

The purpose of this report was to set preliminary nutritional requirements for crewmembers flying from 90 to 180 day missions on Space Station Freedom. Specific recommendations included providing crewmembers with in flight feedback on nutritional intake, weight and strength, and incorporating issues of energy intake, body weight, body composition, strength, and protein intake in the flight medicine program. Exercise must be considered an integral part of any plan to maintain nutritional status, especially those modes that stress the skeleton and maintain body weight. Nutrient intake, amount of exercise, and drugs ingested must be recorded daily; high priority should be given to development of fully automated record systems that minimize astronauts' effort. A system of nutritional supplements should be developed to provide a method for reducing intake deficits that become apparent. Finally, post flight monitoring should include bone density, muscle mass and function, and iron status at three and six months after landing.