{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T11:50:17Z","timestamp":1781956217797,"version":"3.54.5"},"reference-count":88,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T00:00:00Z","timestamp":1781913600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Military aviation imposes physiological and cognitive demands that make nutrition relevant to flight safety, mission performance, aeromedical readiness, and Force Health Protection. Aircrew operate under stressors including hypoxia, high +Gz exposure, thermal strain, circadian disruption, restricted cockpit access to food and fluids, and sustained cognitive burden. This narrative review synthesizes evidence on hydration, macronutrients and nutrient timing, caffeine, dietary supplements, and diet quality as they relate to human performance and aeromedical readiness in military aviation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We conducted a narrative review of nutrition and human performance in military aviation, using iterative searches of PubMed and Google Scholar supplemented by reference-list review, the Defense Technical Information Center, and relevant Department of War guidance. English-language peer-reviewed studies and authoritative government, military, technical, or policy documents published from 1965 through August 1, 2025 were considered. Evidence was prioritized hierarchically: military aircrew studies, civilian aircrew studies, and extrapolated evidence from related human-performance literature. Findings were weighted qualitatively by directness to aviation operations, realism of operational stressors, and methodological transparency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Hydration was among the clearest military aviation-specific nutrition concerns identified in the reviewed evidence. Aircrew may begin flights dehydrated, with deficits compounded in-flight by cockpit microclimate, thermal load, flight gear, limited fluid access, and deliberate fluid restriction for bladder management. Dehydration and urinary retention are associated with impaired vigilance, flight-simulator performance, visuospatial processing, and selected cognitive outcomes; foundational centrifuge studies show that 1%-3% dehydration-induced body-mass loss can reduce +Gz tolerance, particularly with heat. This vulnerability is most relevant to high-performance tactical aviation, whereas mobility, rotary-wing, bomber, and remotely piloted aircraft communities may be more affected by hydration-associated vigilance, thermal strain, fueling access, circadian disruption, and mission endurance. Aviation nutrition studies support carbohydrate-centered, gastrointestinal-tolerant pre-mission fueling, while surveys identify missed meals, low carbohydrate and fiber intake, micronutrient inadequacies, and diet-quality gaps. Meal-timing evidence, mostly from civilian aviation and shift-work cohorts, suggests irregular eating may contribute to circadian and metabolic strain, but causality remains uncertain. Caffeine is supported as a fatigue countermeasure when dosing and timing are planned to protect sleep. Dietary supplements provide limited aviation-specific performance benefit and introduce aeromedical uncertainty. Sex-specific evidence remains limited but identifies female aircrew bladder-management constraints and equipment-fit considerations in +Gz tolerance. Cardiometabolic risk factors remain relevant to medical qualification and career longevity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Nutrition is a modifiable operational and aeromedical variable in military aviation. Practical priorities include hydration planning, bladder-management solutions, carbohydrate-centered pre-mission fueling, disciplined caffeine use within fatigue-risk management, conservative supplement oversight, and cardiometabolic-risk surveillance. Evidence gaps remain, particularly sex-specific military aircrew data and intervention studies across aviation communities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usag277","type":"journal-article","created":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T11:44:56Z","timestamp":1780746296000},"source":"Crossref","is-referenced-by-count":0,"title":["Nutrition and Human Performance in Military Aviation: A Narrative Review"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-8040-7796","authenticated-orcid":false,"given":"James L","family":"Weinstein","sequence":"first","affiliation":[{"name":"Athlete Engineering Institute, Mississippi State University , Starkville, MS 39759,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9187-5003","authenticated-orcid":false,"given":"Stacy","family":"Cappadona","sequence":"additional","affiliation":[{"name":"Consortium for Health and Military Performance, Department of Military and Emergency Medicine, F. Edward H\u00e9bert School of Medicine, Uniformed Services University , Bethesda, MD 20814,","place":["United States"]},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. , Bethesda, MD 20817,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asma S","family":"Bukhari","sequence":"additional","affiliation":[{"name":"Pennington Biomedical Research Center, Louisiana State University , Baton Rouge, LA 70808,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9934-3854","authenticated-orcid":false,"given":"Minette","family":"Herrick","sequence":"additional","affiliation":[{"name":"Department of Biology, United States Air Force Academy , Colorado Springs, CO 80840,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0962-7161","authenticated-orcid":false,"given":"Collin G","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Womack Army Medical Center , Fort Bragg, NC 28310,","place":["United States"]},{"name":"Department of Family Medicine, Uniformed Services University , Bethesda, MD 20814,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelina K","family":"Matherly","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Womack Army Medical Center , Fort Bragg, NC 28310,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abby M","family":"Johnson","sequence":"additional","affiliation":[{"name":"Mississippi State University , Starkville, MS 39759,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Scott","sequence":"additional","affiliation":[{"name":"Department of Military and Emergency Medicine, Uniformed Services University , Bethesda, MD 20814,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,20]]},"reference":[{"key":"2026062006552679700_usag277-B1","first-page":"922","article-title":"The effects of minimal dehydration upon human tolerance to positive acceleration","volume":"36","author":"Taliaferro","year":"1965","journal-title":"Aerosp Med"},{"key":"2026062006552679700_usag277-B2","first-page":"1119","article-title":"Fasting or feeding? A survey of fast-jet aircrew nutrition in the Royal Air Force Strike Command, 1979","volume":"51","author":"Fisher","year":"1980","journal-title":"Aviat Space Environ Med"},{"key":"2026062006552679700_usag277-B3","volume-title":"Crew Factors in Flight Operations X: Alertness Management in Flight Operations (NASA TM-1999-208780; DOT\/FAA\/RD-93\/18)","author":"Rosekind","year":"1999"},{"key":"2026062006552679700_usag277-B4","doi-asserted-by":"publisher","first-page":"e13521","DOI":"10.1111\/jsr.13521","article-title":"Early starts and late finishes both reduce alertness and performance among short-haul airline pilots","volume":"31","author":"Arsintescu","year":"2022","journal-title":"J Sleep Res"},{"key":"2026062006552679700_usag277-B5","doi-asserted-by":"publisher","first-page":"381","DOI":"10.3357\/AMHP.6316.2024","article-title":"Circadian disruption in civilian airline pilots","volume":"95","author":"Yang","year":"2024","journal-title":"Aerosp Med Hum Perform"},{"key":"2026062006552679700_usag277-B6","doi-asserted-by":"publisher","first-page":"e2422266","DOI":"10.1001\/jamanetworkopen.2024.22266","article-title":"Dietary rhythmicity and mental health among airline personnel","volume":"7","author":"Zhang","year":"2024","journal-title":"JAMA Netw Open"},{"key":"2026062006552679700_usag277-B7","author":"Department of Defense","year":"2007"},{"key":"2026062006552679700_usag277-B8","author":"Department of the Army, Department of the Navy, Department of the Air Force","year":"2017"},{"key":"2026062006552679700_usag277-B9","author":"Chairman, Joint Chiefs of Staff","year":"2011"},{"key":"2026062006552679700_usag277-B10","doi-asserted-by":"publisher","first-page":"e217","DOI":"10.1093\/milmed\/usy233","article-title":"Effect of urinary sheath use on hydration status of fighter pilots under severe thermal stress: an observational study","volume":"184","author":"Brescon","year":"2019","journal-title":"Mil Med"},{"key":"2026062006552679700_usag277-B11","doi-asserted-by":"publisher","first-page":"94","DOI":"10.3357\/AMHP.4920.2018","article-title":"Aviator\u2019s fluid balance during military flight","volume":"89","author":"Levkovsky","year":"2018","journal-title":"Aerosp Med Hum Perform"},{"key":"2026062006552679700_usag277-B12","doi-asserted-by":"publisher","first-page":"2574","DOI":"10.3390\/nu12092574","article-title":"Up in the air: evidence of dehydration risk and long-haul flight on athletic performance","volume":"12","author":"Zubac","year":"2020","journal-title":"Nutrients"},{"key":"2026062006552679700_usag277-B13","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/s40779-021-00327-2","article-title":"Hydration status, body composition, and anxiety status in aeronautical military personnel from Spain: a cross-sectional study","volume":"8","author":"Carretero-Krug","year":"2021","journal-title":"Mil Med Res"},{"key":"2026062006552679700_usag277-B14","doi-asserted-by":"publisher","first-page":"116","DOI":"10.3357\/AMHP.6526.2025","article-title":"Aircrew life support equipment experiences in Canadian military operational women pilots","volume":"96","author":"Thorgrimson","year":"2025","journal-title":"Aerosp Med Hum Perform"},{"key":"2026062006552679700_usag277-B15","doi-asserted-by":"publisher","first-page":"555S","DOI":"10.1080\/07315724.2007.10719658","article-title":"Hydration and cognition: a critical review and recommendations for future research","volume":"26","author":"Lieberman","year":"2007","journal-title":"J Am Coll Nutr"},{"key":"2026062006552679700_usag277-B16","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1080\/00039896.1988.9934367","article-title":"Role of dehydration in heat stress-induced variations in mental performance","volume":"43","author":"Gopinathan","year":"1988","journal-title":"Arch Environ Health"},{"key":"2026062006552679700_usag277-B17","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1016\/S0167-8760(01)00142-8","article-title":"Effects of fluid ingestion on cognitive function after heat stress or exercise-induced dehydration","volume":"42","author":"Cian","year":"2001","journal-title":"Int J Psychophysiol"},{"key":"2026062006552679700_usag277-B18","doi-asserted-by":"publisher","first-page":"792","DOI":"10.7205\/MILMED-D-13-00013","article-title":"Effects of hydration on cognitive function of pilots","volume":"178","author":"Lindseth","year":"2013","journal-title":"Mil Med"},{"key":"2026062006552679700_usag277-B19","doi-asserted-by":"publisher","first-page":"79","DOI":"10.3357\/AMHP.6067.2023","article-title":"Voluntary urinary retention effects on cognitive performance","volume":"94","author":"Griswold","year":"2023","journal-title":"Aerosp Med Hum Perform"},{"key":"2026062006552679700_usag277-B20","doi-asserted-by":"publisher","first-page":"R275","DOI":"10.1152\/AJPREGU.00501.2004","article-title":"Effect of water deprivation on cognitive-motor performance in healthy men and women","volume":"289","author":"Szinnai","year":"2005","journal-title":"Am J Physiol Regul Integr Comp Physiol"},{"key":"2026062006552679700_usag277-B21","author":"Greenleaf","year":"1966"},{"key":"2026062006552679700_usag277-B22","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1152\/jappl.1979.47.1.197","article-title":"Heat and acute dehydration effects on acceleration response in man","volume":"47","author":"Nunneley","year":"1979","journal-title":"J Appl Physiol Respir Environ Exerc Physiol"},{"key":"2026062006552679700_usag277-B23","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1007\/BF03021042","article-title":"Pressure breathing in fighter aircraft for G accelerations and loss of cabin pressurization at altitude: a brief review","volume":"50","author":"Lauritzsen","year":"2003","journal-title":"Can J Anaesth"},{"key":"2026062006552679700_usag277-B24","first-page":"456","article-title":"Heat stress effects for USAF anti-G suits with and without a counter-pressure vest","volume":"73","author":"Balldin","year":"2002","journal-title":"Aviat Space Environ Med"},{"key":"2026062006552679700_usag277-B25","first-page":"739","article-title":"Accommodation of females in the high-G environment: the USAF female acceleration tolerance enhancement (FATE) project","volume":"72","author":"Dooley","year":"2001","journal-title":"Aviat Space Environ Med"},{"key":"2026062006552679700_usag277-B26","doi-asserted-by":"publisher","first-page":"764","DOI":"10.1001\/archneur.1990.00530070058012","article-title":"Acceleration-induced loss of consciousness: a review of 500 episodes","volume":"47","author":"Whinnery","year":"1990","journal-title":"Arch Neurol"},{"key":"2026062006552679700_usag277-B27","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1016\/S0031-9384(01)00476-0","article-title":"Cognitive demand and blood glucose","volume":"73","author":"Scholey","year":"2001","journal-title":"Physiol Behav"},{"key":"2026062006552679700_usag277-B28","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1080\/10508414.2011.582454","article-title":"Dietary effects on cognition and pilots\u2019 flight performance","volume":"21","author":"Lindseth","year":"2011","journal-title":"Int J Aviat Psychol"},{"key":"2026062006552679700_usag277-B29","first-page":"537","article-title":"The relationship of diet to airsickness","volume":"66","author":"Lindseth","year":"1995","journal-title":"Aviat Space Environ Med"},{"key":"2026062006552679700_usag277-B30","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1893\/0005-3155(2007)78[95:EOLBGO]2.0.CO;2","article-title":"Effects of low blood glucose on pilot performance","volume":"78","author":"Johnson","year":"2007","journal-title":"Bios"},{"key":"2026062006552679700_usag277-B31","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1249\/MSS.0000000000000852","article-title":"Nutrition and athletic performance","volume":"48","author":"Thomas","year":"2016","journal-title":"Med Sci Sports Exerc"},{"key":"2026062006552679700_usag277-B32","first-page":"837","article-title":"Dietary intake and blood lipid profile survey of fighter pilots at Tyndall Air Force Base","volume":"62","author":"Copp","year":"1991","journal-title":"Aviat Space Environ Med"},{"key":"2026062006552679700_usag277-B33","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1093\/milmed\/157.8.397","article-title":"Effect of age, family status, and physical activity on selected dietary components of TAC pilots","volume":"157","author":"Hart","year":"1992","journal-title":"Mil Med"},{"key":"2026062006552679700_usag277-B34","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1136\/military-2024-002738","article-title":"Nutrition as a military capability to deliver human advantage: more people, more ready, more of the time","volume":"171","author":"Fallowfield","year":"2025","journal-title":"BMJ Mil Health"},{"key":"2026062006552679700_usag277-B35","doi-asserted-by":"publisher","first-page":"780","DOI":"10.7205\/MILMED.173.8.780","article-title":"Dietary intake of pilots in the Israeli Air Force","volume":"173","author":"Stark","year":"2008","journal-title":"Mil Med"},{"key":"2026062006552679700_usag277-B36","doi-asserted-by":"publisher","first-page":"92","DOI":"10.3390\/nu17010092","article-title":"Dietary nutrient adequacy in aeronautical military personnel in Spain: strengths and weaknesses","volume":"17","author":"Carretero-Krug","year":"2024","journal-title":"Nutrients"},{"key":"2026062006552679700_usag277-B37","doi-asserted-by":"publisher","first-page":"399","DOI":"10.3945\/an.115.010777","article-title":"Circadian rhythms, metabolism, and chrononutrition in rodents and humans","volume":"7","author":"Johnston","year":"2016","journal-title":"Adv Nutr"},{"key":"2026062006552679700_usag277-B38","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/j.arr.2016.12.006","article-title":"Circadian rhythms, time-restricted feeding, and healthy aging","volume":"39","author":"Manoogian","year":"2017","journal-title":"Ageing Res Rev"},{"key":"2026062006552679700_usag277-B39","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1002\/oby.23666","article-title":"Associations between circadian disruption and cardiometabolic disease risk: a review","volume":"31","author":"Baidoo","year":"2023","journal-title":"Obesity"},{"key":"2026062006552679700_usag277-B40","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1080\/07420528.2016.1237520","article-title":"It\u2019s not just what you eat but when: the impact of eating a meal during simulated shift work on driving performance","volume":"34","author":"Gupta","year":"2017","journal-title":"Chronobiol Int"},{"key":"2026062006552679700_usag277-B41","doi-asserted-by":"publisher","first-page":"1003","DOI":"10.1080\/07420528.2017.1335318","article-title":"Timing of food intake during simulated night shift impacts glucose metabolism: a controlled study","volume":"34","author":"Grant","year":"2017","journal-title":"Chronobiol Int"},{"key":"2026062006552679700_usag277-B42","doi-asserted-by":"publisher","first-page":"1691","DOI":"10.1080\/07420528.2019.1676256","article-title":"Altering meal timing to improve cognitive performance during simulated nightshifts","volume":"36","author":"Gupta","year":"2019","journal-title":"Chronobiol Int"},{"key":"2026062006552679700_usag277-B43","doi-asserted-by":"publisher","first-page":"641","DOI":"10.3357\/AMHP.5588.2020","article-title":"Caffeine, energy beverage consumption, fitness, and sleep in U.S. Army aviation personnel","volume":"91","author":"Bukhari","year":"2020","journal-title":"Aerosp Med Hum Perform"},{"key":"2026062006552679700_usag277-B44","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1186\/s12937-022-00774-0","article-title":"Prevalence of caffeine consumers, daily caffeine consumption, and factors associated with caffeine use among active duty United States military personnel","volume":"21","author":"Knapik","year":"2022","journal-title":"Nutr J"},{"key":"2026062006552679700_usag277-B45","doi-asserted-by":"publisher","first-page":"399","DOI":"10.3357\/AMHP.4693.2017","article-title":"Caffeine consumption among naval aviation candidates","volume":"88","author":"Sather","year":"2017","journal-title":"Aerosp Med Hum Perform"},{"key":"2026062006552679700_usag277-B46","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1093\/nutrit\/nux007","article-title":"Caffeine to optimize cognitive function for military mission-readiness: a systematic review and recommendations for the field","volume":"75","author":"Crawford","year":"2017","journal-title":"Nutr Rev"},{"key":"2026062006552679700_usag277-B47","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1016\/j.neubiorev.2016.09.001","article-title":"A review of caffeine\u2019s effects on cognitive, physical and occupational performance","volume":"71","author":"McLellan","year":"2016","journal-title":"Neurosci Biobehav Rev"},{"key":"2026062006552679700_usag277-B48","doi-asserted-by":"publisher","first-page":"2031","DOI":"10.1007\/s00213-014-3834-5","article-title":"Caffeine improves reaction time, vigilance and logical reasoning during extended periods with restricted opportunities for sleep","volume":"232","author":"Kamimori","year":"2015","journal-title":"Psychopharmacology (Berl)"},{"key":"2026062006552679700_usag277-B49","first-page":"1034","article-title":"Caffeinated tube food effect on pilot performance during a 9-hour, simulated nighttime U-2 mission","volume":"77","author":"Doan","year":"2006","journal-title":"Aviat Space Environ Med"},{"key":"2026062006552679700_usag277-B50","doi-asserted-by":"publisher","first-page":"982","DOI":"10.7205\/milmed.172.9.982","article-title":"Effect of caffeine on simulator flight performance in sleep-deprived military pilot students","volume":"172","author":"Lohi","year":"2007","journal-title":"Mil Med"},{"key":"2026062006552679700_usag277-B51","doi-asserted-by":"publisher","first-page":"29","DOI":"10.3357\/asem.2435.2009","article-title":"Fatigue countermeasures in aviation","volume":"80","author":"Caldwell","year":"2009","journal-title":"Aviat Space Environ Med"},{"key":"2026062006552679700_usag277-B52","doi-asserted-by":"publisher","first-page":"712628","DOI":"10.3389\/fphys.2021.712628","article-title":"Fatigue in aviation: safety risks, preventive strategies and pharmacological interventions","volume":"12","author":"Wingelaar-Jagt","year":"2021","journal-title":"Front Physiol"},{"key":"2026062006552679700_usag277-B53","doi-asserted-by":"publisher","first-page":"750","DOI":"10.3357\/AMHP.6253.2023","article-title":"Daily caffeine intake and the effect of caffeine on pilots\u2019 performance after extended wakefulness","volume":"94","author":"Wingelaar-Jagt","year":"2023","journal-title":"Aerosp Med Hum Perform"},{"key":"2026062006552679700_usag277-B54","author":"Department of the Army","year":"2016"},{"key":"2026062006552679700_usag277-B55","author":"Department of Defense","year":"2022"},{"key":"2026062006552679700_usag277-B56","author":"Operation Supplement Safety","year":"020"},{"key":"2026062006552679700_usag277-B57","doi-asserted-by":"publisher","first-page":"173206","DOI":"10.1016\/j.pbb.2021.173206","article-title":"The effects of caffeinated products on sleep and functioning in the military population: a focused review","volume":"206","author":"Chaudhary","year":"2021","journal-title":"Pharmacol Biochem Behav"},{"key":"2026062006552679700_usag277-B58","doi-asserted-by":"publisher","first-page":"1195","DOI":"10.5664\/jcsm.3170","article-title":"Caffeine effects on sleep taken 0, 3, or 6 hours before going to bed","volume":"9","author":"Drake","year":"2013","journal-title":"J Clin Sleep Med"},{"key":"2026062006552679700_usag277-B59","doi-asserted-by":"publisher","first-page":"305ra146","DOI":"10.1126\/scitranslmed.aac5125","article-title":"Effects of caffeine on the human circadian clock in vivo and in vitro","volume":"7","author":"Burke","year":"2015","journal-title":"Sci Transl Med"},{"key":"2026062006552679700_usag277-B60","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1080\/24721840.2022.2034505","article-title":"The effect of caffeine and sleep quality on military pilot students\u2019 flight performance-related cognitive function","volume":"32","author":"Utamatanin","year":"2022","journal-title":"Int J Aerosp Psychol"},{"key":"2026062006552679700_usag277-B61","doi-asserted-by":"publisher","first-page":"86","DOI":"10.55460\/C9GO-XEUM","article-title":"Caffeine gum does not improve marksmanship, bound duration, susceptibility to enemy fire, or cognitive performance during tactical combat movement simulation","volume":"21","author":"Stein","year":"2021","journal-title":"J Spec Oper Med"},{"key":"2026062006552679700_usag277-B62","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1124\/pr.117.014407","article-title":"Interindividual differences in caffeine metabolism and factors driving caffeine consumption","volume":"70","author":"Nehlig","year":"2018","journal-title":"Pharmacol Rev"},{"key":"2026062006552679700_usag277-B63","doi-asserted-by":"publisher","first-page":"3495","DOI":"10.1093\/jn\/nxab239","article-title":"Prevalence of and factors associated with dietary supplement use in a stratified, random sample of US military personnel: the US military dietary supplement use study","volume":"151","author":"Knapik","year":"2021","journal-title":"J Nutr"},{"key":"2026062006552679700_usag277-B64","doi-asserted-by":"publisher","first-page":"731","DOI":"10.3357\/AMHP.5055.2018","article-title":"Energy drink and nutritional supplement beliefs among naval aviation candidates","volume":"89","author":"Sather","year":"2018","journal-title":"Aerosp Med Hum Perform"},{"key":"2026062006552679700_usag277-B65","doi-asserted-by":"publisher","first-page":"5017","DOI":"10.3390\/ijerph19095017","article-title":"The prevalence of dietary supplement usage in military aviators","volume":"19","author":"Sammito","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"2026062006552679700_usag277-B66","doi-asserted-by":"publisher","first-page":"545","DOI":"10.3390\/nu12020545","article-title":"A systematic review of the effect of dietary supplements on cognitive performance in healthy young adults and military personnel","volume":"12","author":"Pomeroy","year":"2020","journal-title":"Nutrients"},{"key":"2026062006552679700_usag277-B67","doi-asserted-by":"publisher","first-page":"307","DOI":"10.3390\/ijerph19010307","article-title":"Effects of nutritional interventions on accuracy and reaction time with relevance to mental fatigue in sporting, military, and aerospace populations: a systematic review and meta-analysis","volume":"19","author":"Oliver","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"2026062006552679700_usag277-B68","doi-asserted-by":"publisher","first-page":"1851","DOI":"10.1016\/j.jand.2022.01.014","article-title":"Adverse effects associated with multiple categories of dietary supplements: the military dietary supplement use study","volume":"122","author":"Knapik","year":"2022","journal-title":"J Acad Nutr Diet"},{"key":"2026062006552679700_usag277-B69","doi-asserted-by":"publisher","first-page":"1560","DOI":"10.1016\/j.amjmed.2021.07.026","article-title":"A threat to military combat power: dietary supplements","volume":"134","author":"Whaley","year":"2021","journal-title":"Am J Med"},{"key":"2026062006552679700_usag277-B70","doi-asserted-by":"publisher","first-page":"140","DOI":"10.3357\/asem.2952.2011","article-title":"Reduced G tolerance associated with supplement use","volume":"82","author":"Barker","year":"2011","journal-title":"Aviat Space Environ Med"},{"key":"2026062006552679700_usag277-B71","doi-asserted-by":"publisher","first-page":"872","DOI":"10.3357\/asem.3659.2013","article-title":"Vasodilation associated with supplement use: potential concern for military aviators","volume":"84","author":"Catrambone","year":"2013","journal-title":"Aviat Space Environ Med"},{"key":"2026062006552679700_usag277-B72","doi-asserted-by":"publisher","first-page":"2076","DOI":"10.1093\/milmed\/usaa157","article-title":"Dietary supplements: knowledge and adverse event reporting practices of Department of Defense health care providers","volume":"185","author":"Rittenhouse","year":"2020","journal-title":"Mil Med"},{"key":"2026062006552679700_usag277-B73","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1186\/s12970-018-0247-6","article-title":"Multi-ingredient pre-workout supplements, safety implications, and performance outcomes: a brief review","volume":"15","author":"Harty","year":"2018","journal-title":"J Int Soc Sports Nutr"},{"key":"2026062006552679700_usag277-B74","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1249\/JSR.0000000000000595","article-title":"Essential features of third-party certification programs for dietary supplements: a consensus statement","volume":"18","author":"Eichner","year":"2019","journal-title":"Curr Sports Med Rep"},{"key":"2026062006552679700_usag277-B75","doi-asserted-by":"publisher","first-page":"s3","DOI":"10.1136\/heartjnl-2018-313019","article-title":"An introduction to aviation cardiology","volume":"105","author":"Nicol","year":"2019","journal-title":"Heart"},{"key":"2026062006552679700_usag277-B76","doi-asserted-by":"publisher","first-page":"703","DOI":"10.3357\/AMHP.5374.2019","article-title":"Hypertension and obesity among civil aviation pilots","volume":"90","author":"Bhat","year":"2019","journal-title":"Aerosp Med Hum Perform"},{"key":"2026062006552679700_usag277-B77","doi-asserted-by":"publisher","first-page":"4848","DOI":"10.3390\/ijerph19084848","article-title":"The prevalence of cardiometabolic health risk factors among airline pilots: a systematic review","volume":"19","author":"Wilson","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"2026062006552679700_usag277-B78","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1177\/1753944717711379","article-title":"Metabolic syndrome: pathophysiology, management, and modulation by natural compounds","volume":"11","author":"Rochlani","year":"2017","journal-title":"Ther Adv Cardiovasc Dis"},{"key":"2026062006552679700_usag277-B79","doi-asserted-by":"publisher","first-page":"504","DOI":"10.3357\/ASEM.3004.2012","article-title":"High sensitivity C-reactive protein in airline pilots with metabolic syndrome","volume":"83","author":"Alonso-Rodr\u00edguez","year":"2012","journal-title":"Aviat Space Environ Med"},{"key":"2026062006552679700_usag277-B80","doi-asserted-by":"publisher","first-page":"4314","DOI":"10.3390\/jcm11154314","article-title":"Endogenous risk factors of cardiovascular diseases (CVDs) in military professionals with a special emphasis on military pilots","volume":"11","author":"Maculewicz","year":"2022","journal-title":"J Clin Med"},{"key":"2026062006552679700_usag277-B81","doi-asserted-by":"publisher","first-page":"175","DOI":"10.3357\/AMHP.6371.2024","article-title":"Physiological fitness of U.S. Army aviators compared to the U.S. general population","volume":"95","author":"D\u2019Alessandro","year":"2024","journal-title":"Aerosp Med Hum Perform"},{"key":"2026062006552679700_usag277-B82","doi-asserted-by":"publisher","first-page":"25","DOI":"10.3357\/AMHP.6277.2024","article-title":"Sugar-sweetened beverage consumption and implications for aviation preflight indoctrination students","volume":"95","author":"Sather","year":"2024","journal-title":"Aerosp Med Hum Perform"},{"key":"2026062006552679700_usag277-B83","doi-asserted-by":"publisher","first-page":"603","DOI":"10.2486\/indhealth.2012-0027","article-title":"Effects of physical examination and diet consultation on serum cholesterol and health-behavior in the Korean pilots employed in commercial airline","volume":"51","author":"Choi","year":"2013","journal-title":"Ind Health"},{"key":"2026062006552679700_usag277-B84","doi-asserted-by":"publisher","first-page":"4288","DOI":"10.3390\/nu13124288","article-title":"The effects of a brief lifestyle intervention on the health of overweight airline pilots during COVID-19: a 12-month follow-up study","volume":"13","author":"Wilson","year":"2021","journal-title":"Nutrients"},{"key":"2026062006552679700_usag277-B85","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1007\/BF00867931","article-title":"Influence of diet and physical exercise on plasma lipid concentrations in an homogeneous sample of young Spanish Air Force pilots","volume":"69","author":"Moreno V\u00e1zquez","year":"1994","journal-title":"Eur J Appl Physiol"},{"key":"2026062006552679700_usag277-B86","doi-asserted-by":"publisher","first-page":"1073","DOI":"10.3390\/nu16071073","article-title":"Applications of artificial intelligence, machine learning, and deep learning in nutrition: a systematic review","volume":"16","author":"Theodore Armand","year":"2024","journal-title":"Nutrients"},{"key":"2026062006552679700_usag277-B87","doi-asserted-by":"publisher","first-page":"894","DOI":"10.1186\/s12889-016-3572-1","article-title":"Process evaluation of a tailored mobile health intervention aiming to reduce fatigue in airline pilots","volume":"16","author":"van Drongelen","year":"2016","journal-title":"BMC Public Health"},{"key":"2026062006552679700_usag277-B88","doi-asserted-by":"publisher","first-page":"2242","DOI":"10.1080\/00140139.2023.2194592","article-title":"Integrating physiological monitoring systems in military aviation: a brief narrative review of its importance, opportunities, and risks","volume":"66","author":"Shaw","year":"2023","journal-title":"Ergonomics"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/advance-article-pdf\/doi\/10.1093\/milmed\/usag277\/68562379\/usag277.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/advance-article-pdf\/doi\/10.1093\/milmed\/usag277\/68562379\/usag277.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T10:55:33Z","timestamp":1781952933000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/advance-article\/doi\/10.1093\/milmed\/usag277\/8712095"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,20]]},"references-count":88,"URL":"https:\/\/doi.org\/10.1093\/milmed\/usag277","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,20]]},"article-number":"usag277"}}