text: Nutritional Readiness
  Energy Intake
  8-83. When working at the same rate in water as on land, the energy expenditure to accomplish the same
  task is greater in water. The reasons for this increased energy expenditure during water operations include—
  * Greater resistance offered by water.
  * Decreased efficiency of movement when thermal protective clothing are worn.
  8-84. Soldiers rapidly use glycogen stores when performing hard work in cold water. They must replace
  these stores between operations to prevent performance decrements. Increasing carbohydrate intake before
  an anticipated dive has been shown to improve and extend exercise performance during prolonged dives.
  Fluid Intake
  8-85. Immersion in water increases urinary excretion by 2–10 times above normal. Without adequate
  hydration, a diver can quickly become dehydrated and suffer from decline in performance. For example,
  immersion during a single dive for 3–6 hours can result in a 2–8 pound loss in body weight by urination; this
  is equivalent to losing 1–3 quarts of fluid. Importantly, a diver must drink fluids with carbohydrate whenever
  possible to maintain blood glucose. A decline in blood glucose is known to negatively affect performance.
  Mineral Balance
  8-86. Immersion in water, especially cold water, increases urinary losses of magnesium, calcium, zinc, and
  chromium. Soldiers need to consume foods high in these important minerals to restore immersion-included
  losses.
  THERAPEUTIC NUTRITION
  8-87. Fundamental risks associated with mission requirements, and the environments in which Soldiers’
  operate, increase the potential for medical treatment over a Soldier’s career. Medical nutrition therapy is the
  use of specific nutritional interventions to treat an illness, injury, or nutrition-related condition. Continuous
  nutrition support from the time of diagnosis, to management or remission, is essential for rapid return to duty.
  INJURIES
  8-88. Good nutrition aids in recovery. Management of calories and essential nutrients—based on pre-injury
  nutrition status and severity or type of trauma suffered—helps the treatment of common combat- and training-
  related injuries. These injuries include burns, minor and traumatic wounds, and traumatic brain injuries.
  8-89. Though wound healing often increases calorie and protein needs, dietitians need to balance these
  requirements with decreased needs associated with long periods of injury-induced reductions in physical
  activity. If body fat and muscle mass changes are not monitored closely by a registered dietitian throughout
  the rehabilitation process, the Soldier’s return to full duty may be delayed. Soldiers should seek nutrition
  counseling from a registered dietitian for wound healing, delayed rehabilitation outcomes, and unintentional
  body composition changes related to recovery.
  MEDICAL CONDITIONS
  8-90. Beyond acute injuries and illnesses, medical nutrition therapy for the treatment of familial-and
  lifestyle-associated conditions also contribute to a Soldier’s readiness and longevity. These conditions can
  include hypertension (high blood pressure), insulin resistance (high blood sugar), and dyslipidemia (high
  cholesterol and/or triglyceride (fats) in the blood). Soldiers should seek nutrition counseling from a registered
  dietitian for the treatment of familial- and lifestyle-associated conditions.