View Full Version : Question about hydration and minimum weight standards
:confused:
Looking for info on how to help keep someone hydrated. My son called a couple days ago. He's currently deployed in the sandbox and is having problems staying hydrated. He's down to less than 130 pounds (and at 6'1", he looks like a walking skeleton). They're living on a nonstandard diet schedule with MREs. The medics use him for starting IV's because they're constantly pumping fluids into him.
I'm concerned that if he keeps loosing weight, he's going to fall out the bottom of the height/weight standard.
Any suggestions are appreciated...
Eagle edit
The Reaper
05-16-2007, 21:18
:confused:
Looking for info on how to help keep someone hydrated. My son called a couple days ago. He's currently deployed in the sandbox and is having problems staying hydrated. He's down to less than 130 pounds (and at 6'1", he looks like a walking skeleton). They're living on a nonstandard diet schedule with MREs. The medics use him for starting IV's because they're constantly pumping fluids into him.
I'm concerned that if he keeps loosing weight, he's going to fall out the bottom of the height/weight standard.
Any suggestions are appreciated...
Most people do not enjoy drinking lots of plain water.
Make sure that he has plenty of powdered drink mixes, Gatorade, PediaLyte (acquired taste), etc. This will help make the water more palatable, as well as replace bvaluable electrolytes and keep him from becoming hyponatremic. Gatorade and some of the other beverage companies make little packets of mix that are exactly the right amount for dumping into a 1 liter water bottle. I stow a few of them in one of my vest pockets so that I have them if I forget to prep the water or are out for an extended time.
If he does not have a Camelbak, send him one with some of the drink mixes.
Most people will either mix the drink in the bladder, then put the filled bladder in the fridge or freezer, or will dump as much ice into the bladder as they can fit, and add mix and water to taste.
He needs to force himself to drink at least four liters of water per day, six would be much better. He can figure out how often he has to drink and how much. I usually try to suck on the Camelbak tube at least a few swallows every time I am off the gun. At least once an hour, you need to take a break and drink a bottle of water or take some long pulls on that Camelbak, maybe a half liter at the time.
HTH.
TR
Eagle edit
Thanks - He's got a camelbak. I'll get some drink mixes off to him ASAP - should have thought of that myself - my Mom used to send me kool-aid packs when I was in Nam. Anything to cover the tase of those water purification tablets!
The Reaper
05-16-2007, 21:36
Thanks - He's got a camelbak. I'll get some drink mixes off to him ASAP - should have thought of that myself - my Mom used to send me kool-aid packs when I was in Nam. Anything to cover the tase of those water purification tablets!
The taste of the water should be better these days. If he is still using tablets, get him a MIOX water purifier as well.
Make sure that he has the cleaning gear for the Camelbak, washes it regularly, and uses the cleaning tablets that Camelbak sells. The funky stuff that will grow in that bladder with drink mix and hot weather will make him sicker than the IVs. He needs to keep it clean.
Good leaders schedule water breaks and require their people to drink a set amount of water at every stop. Easier than letting someone drop and having to hump them out.
I hope he gets better and starts drinking more soon. Don't forget that a quick carb dump goes a long way towards keeping people thirsty and on their energy curve as well. Check and see if he has plenty of quick, non-perishable snacks, especially salty ones and complex carbs.
Too bad they don't make powdered beer.:D
TR
Aequitas
05-16-2007, 21:49
Here some information that we have been given to pass on:
A quick way to find the amount of calories needed to either lose/gain weight is this:
Take the target weight you want to reach and multiply by 15. That will give you an estimated amount of calories to eat each day.
To find your recommended ideal weight for your height follow this:
Men: 106lbs for first 5' + 6lb/inch > 5' Ex. 5'10" = 106 + 60 = 160lbs
Women: 100lbs for first 5' + 5lb/inch > 5' Ex. 5'6" = 100 +30 = 130lbs
This rule of thumb also allows a +/- 10% buffer.
As far as fluid replacements...your son is obviously exercising and working in a hot arid environment at a restless pace. He can end up losing 1-2 liters of water each hour of exercise. He will need water + carbs to stay properly hydrated. TR's suggestions follow the guidance we were given.
Things also to consider for his diet would be keeping him aware of when he eats. After strenuous activities it's important for the body to get carbs within at least 2 hrs. to replace the depleted glycogen stores. Things like powerade, protein bars, yogurt, and chocolate milk would all be ideal. Protein is also important and you can recommend .8gm/kg/day.
Hope this helps...I'll continue to look around for some more information I have filed away.
Eagle5US
05-17-2007, 00:27
Hipshot:
The COPs (Combat Outposts) are running a specific schedule that is preventing normal nutrition input.
There are a number of things that you may look into asking him:
-How many stools is he having per day? Are things getting out of hand with him passing loose / watery / excessive amounts of stool?
-What is the color of his urine? Is it generally light / clear or is it dark / golden colored. This can be an indicator of his hydration status throughout the day. If his urine is straw or clear and he is still losing significant weight, there may be other medical reasons for his weight loss that should be explored by the medical staff his next rotation in. The body may be 70% water, but it needs to be maintained at a significant fill point to function properly. That includes processing of solid intake.
-What is his normal weight? Is there a family history of any mal-absorption syndromes?
-mixing full strength gatorade then cutting it in half with water will help improve his electrolyte absorption.
-When he eats his MREs, he should try and eat ALL of his MRE, or trade up with some of his buddies-even eat their leftovers. MREs have about 2500 calories per.
-on his time back on whichever FOB he rotates to-he should try and eat all 4 offered meals with one meal being high in fats (cheesy omelet potatoes / cheesburger fries / lasagna / etc....) these fats will help to add needed calories for immediate storage with the remainder of the meals being more "healthy" to assist in the processing of those fats and give more balanced nutritional input for sustainment.
-His water SHOULD be the bottled water that is trucked to the COPs-locally plumbed water is off limits in country in all except the most extreme circumstances. All COPs are provided a medical inspection prior to occupation and operations.
-Something we cannot seem to get into these guys heads from the medical side....ripped fuel, hydroxycut, niOx, and everything in between is BAD. SIMILARLY - RIPITS, Caffeine drinks, Red Bull, and the like are also VERY BAD in this environment. We consistently see the line guys coming into the DFAC or little shoppette we have and literally putting CASES of these caffeine drinks into their 1114's to take to their COP or Patrol Base. These drinks dehydrate the men and screw relentlessly with their metabolism of electrolytes. Not because they drink one, but because they are only 6 or 8 ounces, they will drink 4-6 of them at a clip.
-Finally, he may try some protein powder as a supplemental meal. These mix easily with water and can indeed assist in putting on mass with the amount of exercise that is required here in daily activities out in sector.
I hope this helps, and I hope your son stays safe.
Eagle
x SF med
05-17-2007, 10:07
Eagle-
I don't know how many times on this board (and in person, dougie, brianH, a couple of others...) we old fart 18Ds have let people know that supplements are a bad idea for any soldier, besides the dehydration issue, ther is the supplement crash that accompanies the withdrawl from diet. Family members should not send body building supplement items to soldiers, but replace them with gatorade, pedialyte, granola bars, protien bars, peanut butter, dried nuts, and cookies. Mioxx filters, survival straws, camelbacks and cleaning products for camelbaks are great to send too.
Once guys are out of SFAS where they can't get hold of supps, they jump right back on them, to be 'cut' - guys, a good diet, good hydration and lots of PT is much better for you - stay away from gain supplements. Deployment is like SFAS - a denied area - and 2 wks in, do you want to go through a supp crash while on patrol? if I was your TS or Senior, I'd get every punishment I could piled on you and make you everyone's chogeyboy for a year, for endangering the Team.
***rant over***
Hip-
Have your son check with his medical support, just in case - 130 lbs at 6'2" is pushing the low end of the envelope, he may be able to get put on a medically necessary increased calorie diet, tough while deployed, but if he goes down, that's not good. My prayers are with him.
The Reaper
05-17-2007, 10:23
This supplement problem is endemic in our society today.
Want to be thinner, faster, stronger, better looking? Take a pill or get surgery. What are the best supplements, fastest boots, best shooting pistol, etc.? How many times do we see that question here? Forget practice, hard work, exercise; I just want to take a pill, buy a piece of gear, or find the easy way out. We all know that the real answer is not found in a bottle, but is in your heart, head, and in hard work it takes to be better. Unfortunately, far too many American kids today do not get it and look for their immediate gratification in throwing money at problems, taking supplements or pills, getting sugical enhancement, etc.
When someone asks me how to do more push-ups, I explain to them that doing more push-ups is how you get better at doing push-ups.
Every time someone asks if they can wear the latest zero-G boot at SFAS, I want to hit them in the head.
TR
Doczilla
05-19-2007, 21:37
You can dehydrate and lose only so much weight. 10% body weight is about the most you'll lose from straight dehydration, at which point you'll show significant symptoms. If he's lost more than that, he's losing mass as well, and fixing the problem will be more than drinking just water. I calaculate his BMI at 17.1, which is significantly underweight.
The others have posted excellent advice. I would steer clear of Pedialyte if for no other reason than the taste. It's also pretty expensive. If he is eating the MREs, he shouldn't really need any additional sodium in the form of Gatorade, Powerade, Pedialyte, Gookinade, or other electrolyte drinks. Plain water is as good as anything. Koolade will be fine. If he's not eating, he is in danger of getting hyponatremia if drinking too much plain water without enough sodium.
The real question here is, is he eating? A food diary may help him keep track of his calorie intake. It would be very difficult for him to OVEReat at this point. Is he having any physical symptoms such as nausea that keep him from eating? Eagle's questions are spot on; diarrhea from malabsorption, whether from infestation/infection or genetic issues, will waste his calories. If he's not eating, we've got to figure out why. If he is eating, we have to see if he's eating enough. If he's eating enough, then he needs some tests done.
Sudden and profound weight loss is concerning for a larger issue at work. I'd like him to see the doc, whether the BN SN or the folks at the CSH/EMEDS.
'zilla
I've been in a position lately where I've lost a significant amount (~30lbs) of weight due to illness, and was advised by two different certified nutritionists to consume up to 145g of protein a day to assist in healing and weight gain. For those that don't know, that's a LOT of eating if you try to get that amount purely through a normal diet. I've found some salvation in MET-Rx protein plus bars, Carnation Instant Breakfast mixed into 2% milk, drinking up to 2 qts of milk alone, and BeneProtein (from the makers of Metamucil and Benefiber) mixed into milk, iced tea, water, etc. Oh, and peanut butter works well, along with sardines (but not at the same time). These protein boosters have helped me eat normally, and not forego the carbs and veggies because of needing so much protein.
A guide used in the Tactial EMS arena for hydration, borrowed from the Army...
http://www.nh-tems.com/documents/Preventative_medicine_topics/HeatRiskManGuide.pdf
Good luck to your son.
My solution to keep hydrated when I was over in the box and while here working in the feild in North Carolina, Is Saltine crackers with honey on them.
The sodium in the crackers would keep me from getting leg cramp.
and the honey is instant enargy. eating the crackers made me drink alot of water also. just make sure you have alot of H2o with you when you try it.
Taking the comberbun off your body armor and just using the velcro for closure not that elastic band was a big help for air circulation on our Cut away armor also just for FYI
I got a box off to my son yesterday with an assortment of PowerBar Whole Grain snacks, Gatorade mix, beef jerky, a cleaning kit for his CamelBak, additional cleaning tablets and vitamins.
Matt's always been thin - he's wanted to bulk up some but must have a hell of a metabolism because he would eat like a horse and still stays thin. As of his last phone call, he said he was down to 135 - fully dressed (ACUs and boots plus the normal crap you find in your pockets). I'm guessing, but I'd say that you could safely deduct 7 to 8 pounds for the uniform and boots. At 6' that puts him below the Army minimum weight standard. At his current weight he's carrying probably 50% of his body weight in equipment. Thank goodness he doesn't have that DS crap to wear.
http://www.professionalsoldiers.com/forums/showthread.php?t=13762 Frame #5 is a picture of Matt standing next to his vehicle. If you look just below his LBE, you can see how thin he is. I don't worry about him getting shot - there's not much to hit!
I've been in a position lately where I've lost a significant amount (~30lbs) of weight due to illness, and was advised by two different certified nutritionists to consume up to 145g of protein a day to assist in healing and weight gain. For those that don't know, that's a LOT of eating if you try to get that amount purely through a normal diet. I've found some salvation in MET-Rx protein plus bars, Carnation Instant Breakfast mixed into 2% milk, drinking up to 2 qts of milk alone, and BeneProtein (from the makers of Metamucil and Benefiber) mixed into milk, iced tea, water, etc. Oh, and peanut butter works well, along with sardines (but not at the same time). These protein boosters have helped me eat normally, and not forego the carbs and veggies because of needing so much protein.
Jeeez, Razor - you got some strange ideas about food!:D
swatsurgeon
05-28-2007, 20:01
in terms of hydration: watch anything with too much sugar or caffiene, act as diuretics and you lose not hold water. All water retention is based on sodium...but too much salt and you create edema (swelling) and thirst, have to find the right amount. When you pee, should be fairly clear, too yellow/iced tea colored and consistant with dehydration....absolutely clear and likely loosing excess fluid. Usually playing catch up....kidneys are smart organs and will try to maintain the proper salt/fluid balance.
Excess weight loss, need more calories, easy and as hard as that.
In terms of protein, severe injury/trauma or 'significant' exercise or healing, need 2 - 2.5 grams per kilogram per day. Usual daily needs = 1.2-1.5 gm/kg/day (not sick, injured, etc). Need plenty of fluids with excess protein intake to act as a catalyst.
ss
Monsoon65
05-31-2007, 19:57
--Something we cannot seem to get into these guys heads from the medical side....ripped fuel, hydroxycut, niOx, and everything in between is BAD. SIMILARLY - RIPITS, Caffeine drinks, Red Bull, and the like are also VERY BAD in this environment. We consistently see the line guys coming into the DFAC or little shoppette we have and literally putting CASES of these caffeine drinks into their 1114's to take to their COP or Patrol Base. These drinks dehydrate the men and screw relentlessly with their metabolism of electrolytes. Not because they drink one, but because they are only 6 or 8 ounces, they will drink 4-6 of them at a clip.
Last year, my wife did a seminar in Mexico for Hershey Company. One of her fellow speakers was a former nutritionist for the Steelers.
She said the drinks weren't energy drinks, but stimulant drinks, and she hated them with a passion. A player came into her office saying he was having a heart attack because his heart was racing.
He was 26 and had just guzzled 6 Red Bulls. Not the smartest tool in the shed.
I hate the taste of water after about the first week, but my wife sent me some of those little packets of lemonade that were the right size for the smaller water bottles that really hit the spot. I think they were Crystal Lite brand.
Dehydration is one of the top killers of Iraqis. Living on an IA FOB where resupply is sometimes slow to come, or missed because of missions, we fall victim to their food constantly. About 50% of the time, we eat MREs, fresh baked bread, or have to go to the Iraqi DFAC. Once every two or three trips to the Iraqi DFAC, someone is down for 24 hours with the runs and dehydration. Tuna and crackers, gatorade mix, and meal replacement bars and protein shakes are a lifesaver.
On that subject, anyone know of good meal replacement powder that won't cost an arm and a leg?
May be a little late for a timely reply, but my friend's daughter was losing a lot of weight and water for whatever reason, while he and I were deployed. She was only 8 y/o at the time, so I don't think it was a bulimia or anorexia type of situation - details aren't for me to know though.
What they did to help maintain her weight was use Carnation Instant Breakfast. It's not the best, but it's easy calories and nutrients. It's also relatively inexpensive, especially compared to some of the other "powdered meals". There was another type of powdered meal that the doctors recommended, but that averaged out to over $300/month, which pushed my buddy's wallet over his limits. TRICARE wouldn't cover the costs of that one.
This supplement problem is endemic in our society today.
Want to be thinner, faster, stronger, better looking? Take a pill or get surgery. What are the best supplements, fastest boots, best shooting pistol, etc.? How many times do we see that question here? Forget practice, hard work, exercise; I just want to take a pill, buy a piece of gear, or find the easy way out. We all know that the real answer is not found in a bottle, but is in your heart, head, and in hard work it takes to be better. Unfortunately, far too many American kids today do not get it and look for their immediate gratification in throwing money at problems, taking supplements or pills, getting sugical enhancement, etc.
When someone asks me how to do more push-ups, I explain to them that doing more push-ups is how you get better at doing push-ups.
Every time someone asks if they can wear the latest zero-G boot at SFAS, I want to hit them in the head.
TR
So it's not just a problem at PDs then? :D
Seriously, every dude that I work with is on some form of chemical cocktail. Crazy stuff that they can only cycle on for 2 weeks, then have to get off of for 2 or their kidneys will explode or some crap. I just don't get it.... many of them are spending hundreds of buckls a month on weight gainers, cutting agents, protein powder, nitrous explode, etc...
A young cop asked me the other day what suppliments I was on. I told him that I didn't take any... nevr have, never will. He said, "why not, you think it's cheating or something?" I told him no, I just don't feel like having my kidneys fall out of my arse when I hit 40.
Nobody knows the long term effects of this crap on people. It kills me that these dudes are putting all of these unknown substances into their bodies.... Unreal.
Doczilla
04-30-2008, 14:22
To echo mdb23's comments, there is so much weight room voodoo out there that is propagated without any input from legitimate medical folks that it comes as no surprise that our officers and operators are using this shit. If a study comes out showing potential benefit of a supplement in one narrow area of performance, then these snake oil salesmen are more than happy to extrapolate that to all areas of performance. The magazines propagate the myths through articles on the supplements from authors with supposedly neutral interest in the topic, while raking in the advertising dollars.
It's up to us as team docs and medics to give them GOOD information, based on sound evidence, that allows them to maximize performance and minimize risk of illness or injury as a result of improper training supplement use.
Regarding meal replacement powders/etc to maintain or gain weight, there are plenty of nutritionally balanced and well-studied supplements. Carnation Instant Breakfast (milk based) is just fine. Ensure (corn), Boost, Jevity, and Glucerna (for diabetics) are all equally good; balanced sources of protein, carbohydrate, and fats without unnecessary crap supplements in them. Several have fiber, increased protein, or fructoligosaccharides as well for specific dietary needs.
Slim Fast powders are also a good balanced source of calories. I was wary of them at first, fearing some stimulant or appetite suppressant additives, but after detailed review of their ingredients, as well as conversations with the company, they have none.
'zilla
Philkilla
04-30-2008, 15:20
It kills me that these dudes are putting all of these unknown substances into their bodies.... Unreal.
My sentiments exactly. I work security at a hospital, and I see all the different types of patients here and am left only to wonder what the hell they did to get here.
Hipshot
For me drinking water was a need so I did it. Easy enough.
What kept me drink and to keep nut up was drinking meal replacement powders into my water. Buy the ones that are mainly just protein. Like SS and Eagle said.
He is "eating" up him intake of calories. Meal or protein bars really do help. Most of them have everything that is need within them. When he is at a TCP or standing on Duty he can eat one. 5 mins he just took in around 200 calories, which isn't a lot but to stop and "fix" up a MRE. It would take him long and more of a "mess".
Also get him a Walmart Nalgen bottle. They work great and are easily carried in most day packs. He eats a protein bar and drinks a protein drink while on patrol he just up his water intake and eat one BS meal. Real solid food is the best, but out on patrol the powders and bars help out big time.
Say SS said.. Need plenty of fluids with excess protein intake to act as a catalyst. All of these bar and protein he must drink water.
Like everyone has said.. power fruit drinks really help out. You remember what they did for you in Nam.
My .02
Ensure (corn), Boost, Jevity, and Glucerna (for diabetics) are all equally good...
Doc, how about we say Ensure is 'effective' instead of 'good'? Having had to drink 16oz of it a day over a month-long period a while back makes me hesitant to use the word 'good' to describe Ensure. :boohoo
Doczilla
05-03-2008, 14:08
Doc, how about we say Ensure is 'effective' instead of 'good'? Having had to drink 16oz of it a day over a month-long period a while back makes me hesitant to use the word 'good' to describe Ensure. :boohoo
I can't argue with that. We'll say "well balanced" and "nutritious" and "effective".
8oz of ensure blended with a scoop or two of vanilla ice cream, +/- some Hershey's syrup helps it go down easier.
This reminds me of one of the presentations at SOMA this year regarding SOF nutrition. The presenter (I believe she was a dietician that had worked with NAVSPECWARCOM) said that once problem she had seen was operators on deployment taking in too many of the high-calorie supplements like the Gatorade shakes, and they were gaining unwanted weight. Contributing to this was the decreased activity level compared with stateside training, where the increased caloric intake balanced with a lot more PT.
'zilla