Mission: Get soldiers to eat enough

When Navy Lt. Dave Moore visited infantry units in the remote, rugged mountains of Afghanistan late last year, the medical officer was surprised to learn that many soldiers and Marines had lost significant weight.

After conducting more than 150 interviews with medics, officers and troops on the ground, Moore concluded that Meals, Ready to Eat -- the portable rations long derided by troops, but valued by the Pentagon for indestructibility -- were not doing the job, causing the soldiers to shed vital pounds.

“The standard Meal, Ready to Eat does not provide adequate nutrition for dismounted operations in this type of terrain,” Moore wrote in his report. “Many Marines and soldiers lost 20 to 40 pounds of bodyweight during their deployment. At least one soldier was evacuated due to malnutrition and a 60-pound weight loss.”

Moore’s conclusions have raised concern among military leaders, as well as designers of the field rations at the Natick Soldier Research, Development and Engineering Center outside Boston.

Moore stressed in an interview that the service members he surveyed represented a small portion of those fighting in Afghanistan -- infantry troops deployed to desolate locations where MREs and local cuisine were the only options. Nonetheless he concluded that the 1,300-calorie MREs were falling short.

A nutrition deficit, he said, could result in fatigue, impaired brain function and lackluster performance.

Recognizing that the reports of weight loss are serious, the Combat Feeding Directorate is planning to ship about 4,000 prototypes of a new meal called the First Strike Ration to Iraq and Afghanistan. Designed for limited use, the ration contains nearly twice the calories of an MRE.

Although mess halls in Afghanistan and Iraq provide the troops at bases three square meals a day, soldiers on the front lines often subsist for long stretches on MREs. These include entrees processed at high temperatures and kept in air-sealed pouches to maintain a shelf life of three years. Other typical components include dehydrated beverage mixes and snacks high in carbohydrates, such as peanut butter, crackers and nuts. Dietitians recommend soldiers eat three MREs a day, including about 3,900 calories.

At the small military installation in Natick, food scientists and dietitians with the Combat Feeding Directorate, which designs the MREs, acknowledged that weight loss among the troops had become an issue.

Dr. Andrew Young, a researcher at the U.S. Army Research Institute of Environmental Medicine at Natick, said his agency had begun collecting data on the weight of troops in Afghanistan and Iraq. It has found anecdotal evidence that service members, particularly those in Afghanistan, are losing 20 to 35 pounds on their deployments.

Much of the problem is caused by heavy packaging, Young said. Troops on dismounted patrols often “field-strip” their bulky MRE packs, bringing only part of the meals to reduce the weight of their rucksacks and save room for cargo such as ammunition. In the process, they throw away calories, Young said.

“The MRE is designed to provide the caloric needs of the largest percentage of war fighters,” he said. “The issue is operational constraints that are imposed on the warriors that prevent them from consuming the optimal calories.”

Moore agreed that field-stripping is a problem, but he also blamed bland food and menus that don’t meet the needs for high-intensity fighting.

“The MRE doesn’t provide enough calories,” Moore said in a telephone interview from the Mountain Warfare Training Center in Bridgeport, Calif. “If you’re in the mountains, you need 4,500 calories a day. Even if a soldier eats everything in the MRE, which they rarely do, they’re going to be running deficient of calories, and over a period of time they’re going to lose weight.”

High-altitude environments can cause anorexia, but Moore said the troops he spoke with had acclimatized. The military has higher-calorie rations available for long-range and cold weather patrols, but they are significantly more expensive and are not widely distributed.

The MRE, which costs the Defense Department about $7.25 per meal, was first introduced in 1980 with a dozen different menus, including a few that soldiers deemed inedible, such as Smoky Franks, which soldiers called the Four Fingers of Death, or Chicken a la King, which was known as Chicken a la Death.

When the MRE went to war in the early 1990s, it fared little better with troops on the ground in Kuwait, Saudi Arabia and Iraq, who derisively referred to the rations as Meals Refused by Everyone.

The MRE developed such a poor reputation that former Joint Chiefs Chairman Colin L. Powell ordered it overhauled. In 1995, the National Academy of Sciences found that troops were under-consuming their rations by 1,000 calories per day.

“It’s not necessarily true, the old adage that they’ll eat anything if they’re hungry enough,” said Gerald Darsch, who heads the Combat Feeding Directorate. “They may eat something if they’re hungry enough, but they might not eat the right things.” Troops in the field, Darsch added, will often bypass MREs for salty or sugary snacks they purchase at the PX or receive from home.

In recent years, the designers of the MRE have focused more on soldiers’ tastes, using menus of restaurants in base towns around the country as guideposts. Soldiers like spicier foods and there is a greater demand for ethnic entrees, said Judith Aylward, a senior food technologist with the Combat Feeding Directorate. So the directorate introduced such items as enchiladas, chicken fajitas and jambalaya and soon hopes to roll out a buffalo chicken entree.

Each year, food scientists, nutritionists and dietitians from Natick head out with a unit in field training to test new menus. They ask the troops what they like and don’t like, and they rummage through the trash to see what was eaten and what was thrown away.

Aylward and a colleague recalled some of the test rations they were certain would be winners -- stuffed cabbage and shepherd’s pie -- flopped when they brought them out to the field. In another case, soldiers balked at dirty rice, but raved about the same MRE entree when it was presented as “Cajun rice with sausage.”

Aylward said the need to produce items with a shelf life remains the biggest hurdle.

“The items we hear they want the most are pizza and breakfast foods,” Aylward said. “We can’t produce a shelf-stable pizza, and the retort [high-temperature processing] affects the color and consistency of the egg dishes.”

Seeking to address the weight-loss problem, the directorate is planning on widespread distribution of the First Strike Ration by this fall. Unlike the MRE, it requires no heating.

It includes a shelf-stable sandwich, and its various components contain more carbohydrates, protein and caffeine. The First Strike Ration, about half a pound heavier than the MRE, is smaller and contains about 2,500 calories. But the ration is only meant to be consumed for three consecutive days, according to rules set by the Army surgeon general. C. Patrick Dunne, a senior advisor to the Combat Feeding Directorate, said it was inevitable that troops would eat too little in the field, adding that the First Strike Rations have been fine-tuned to minimize weight loss and slow the effect on performance for troops.

Dunne added that strides were being made on high-pressure processing that could improve the taste of certain foods. Food scientists also are researching how to include probiotics in the meals, such as yogurt, that would help stave off infection.

In the meantime, Dunne said, tweaks need to be made in diets of soldiers working in highly demanding situations.

“What can we do ... to compensate for the fact that over a period of time we know the [troops] are going to be under-consuming?” Dunne said. “We optimized the carbohydrates to keep the brain functioning, and we optimized the proteins so you don’t degrade the muscle mass.”

Moore, the Navy doctor who reported that troops in Afghanistan were losing weight, said the situation could be improved if scientists figured out how to make the chow more palatable.

“If I were going to design the perfect MRE for austere conditions, I’d put more carbohydrates in them and try to improve the taste, which I know is hard to do,” Moore said. “The people at Natick have done an awesome job with the MREs. They’re so much better than when I started in the early 1990s. But we know that guys eat more and drink more when something tastes good.”