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Holly Dlouhy

Publications and source records attributed to Holly Dlouhy.

Appetite and Food Intake During 11 Days of Mild Hypobaric Hypoxia

Introduction Reduced food consumption and loss of body mass and muscle mass have been observed during spaceflight. Hypoxic conditions that astronauts may encounter on exploration missions may further implicate satiety signals and dietary intake. Appetite, food intake, and satiety hormones were investigated under the conditions of mild hypoxia and high energy output during simulated extravehicular activity (EVA) to determine the adequacy of a mission relevant space food system to support energy balance and body composition. Methods Foods realistic to early Artemis missions was packed by meal for each subject for the 11-day test based on estimated energy requirements (EER) and estimated EVA caloric requirements. No hot water or food warmer was provided and only room temperature water was available to rehydrate food and beverages in-mission, mimicking plans for early Artemis missions. Measures included food records (pre-mission, in-mission); fasted body weight (pre-mission, in-mission); Dual-energy X-ray absorptiometry (DXA) (pre-mission, post-mission); subjective ratings and feedback of food acceptability, mealtime and meal preparation sufficiency, appetite, and nausea (in-mission); and circulating ghrelin and leptin concentration in fasted blood samples (pre-mission, in-mission: pre-post EVA). Results All subjects consumed fewer calories in-mission than predicted. On average, subjects consumed 341 calories less on EVA days compared to non-EVA days in-mission (p=0.0511). The total weight loss estimate from daily weight measurements (-1.1 kg, p=0.0028) is consistent with underconsumption and supported by DXA measurements (-1.3 kg total body mass, p=0.0123 and -1.6 kg fat mass, p=0.0016). In general, most foods that were consumed were given acceptable scores, but subject comments indicated that the most acceptable foods were those not intended to be heated. Comments also indicated that subjects found their favorite foods early in the mission and avoided the foods that they did not like throughout the mission. Habitability scores indicated that overall aspects of the food system were considered borderline or unacceptable over the length of this mission. Foods that caused gas were avoided pre-EVA to prevent discomfort during pressure changes. Average fruit and vegetable intake decreased during the mission, dropping from 4.8 servings/d pre-mission to 3.4 servings/d on non-EVA days in-mission (p=0.0872) and 2.3 servings on EVA days (p=0.0020). Fasting ghrelin concentrations tended to be lower pre-EVA and on non-EVA days when exposed to mild hypoxia compared to normoxic conditions pre-mission and post-EVA (p=0.0136). Fasting levels of leptin did not change. Discussion Food intake was reduced in-mission, resulting in a caloric deficit and weight loss for most subjects. Crew food and appetite ratings and comments indicated this was due to a combination of food choices, lack of preference, lack of preparation capability, lack of time for meal preparation, consumption, and cleanup, and physiological challenges with the changing pressure. The regulation of appetite stimulating hormone ghrelin, but not the appetite suppressor leptin, appeared to be sensitive to hypoxic conditions. Conclusions Food preparation capabilities and time for meals are important for promoting adequate food intake. Reduced appetite and food intake during missions may further be aggravated under hypoxic conditions through the suppression of ghrelin. Lack of time for meals on EVA days, and avoidance of potential gas-causing foods (e.g., health promoting fruits and vegetables) prior to EVAs, demonstrate the importance of scheduling ample recovery time between EVA days.

Lichar Dillon↗

Recommendations for Developing Space Suit Integrated Food Systems and Delivering Nutrition Before, During, and After Lunar EVA

The concept of providing hydration and nutrition during extravehicular activity (EVA) is nearly as old as the space program itself. Astronauts currently have access to 32 ounces of water through a disposable in-suit drink bag (DIDB) while they are confined to their space suit. During the Apollo program, methods for providing food/nutrition to crewmembers in space suits were included as contingency solutions (1) but were eventually abandoned. The main reasons that provision of in-suit nutrition beyond water was discontinued after Apollo were the complicated engineering requirements, the additional mass and volume that was required for the applicable food formulations, hardware needed for a suit-specialized food system, and because the perceived need for in-suit nutrition during EVAs was not sufficient during the Space Shuttle and the International Space Station (ISS) eras. A custom-made 165-kcal fruit bar was fitted into the EVA suit during the Space Shuttle program, but crewmembers rarely consumed it during the EVA and rather chose to consume it before or after suited activities (2). Since 2011, between 4 and 13 EVAs have been conducted from the ISS each year, with durations ranging from 1:32 to 8:17 hours (https://www.nasa.gov/mission_pages/station/spacewalks ). It has been acceptable for the crewmembers to schedule food intake around these relatively infrequent suited activities. Because upcoming Artemis missions will include nominal 8-hour lunar exploration EVAs that are expected to increase in frequency to several (4 to 5) sorties per week (3), the desire for an in-suit nutrition system has increased. In preparation for these missions, requirements to provide in-suit nutrition has been outlined in the most recent NASA Human Spaceflight Standards documents (4). Establishing general recommendations for in-suit nutrition systems precedes the selection of a lunar EVA pressure suit system. The current document is intended to define the rationale for nutrition to support EVA (whether in-suit or from the pantry in the habitat), document the requirements, constraints, and crewmember preferences, and recommend necessary next steps for developing an in-suit EVA nutrition system. Assessments presented in this report include a review of commercial off-the-shelf (COTS) food products as potential in-suit formulations, a comparison of conceptual designs for delivering nutrition to a crewmember while confined to a space suit, an evaluation of space suit volume constraints for the placement of in-suit nutrition systems, and feedback from astronauts regarding preferences for nutrition support during EVA. Based on these assessments, recommendations were formulated that can be used to help develop a method to deliver nutrition safely and acceptably to a crewmember while they are confined to a space suit for an EVA duration of up to 8 hours, and a total time in the suit of up to 12 hours.

space suit↗

The Integrated Impact of Diet on Human Immune Response, the Gut Microbiota, and Nutritional Status During Adaptation to Spaceflight

Long-duration spaceflight impacts human physiology, including well documented immune system dysregulation. Diet, the microbiome, and immune system function are interlinked, but diet is the only one of these factors that we have the ability to easily, and significantly, alter on Earth or during flight. As we better understand dietary impacts on physiology, we may then improve the spaceflight diet to improve crew health and potentially reduce spaceflight-associated physiological decrements. Increasing the consumption of fruits and vegetables and bioactive compounds (e.g., omega-3 fatty acids, lycopene, flavonoids) and therefore enhancing overall nutritional intake from the nominal shelf-stable, fully-processed, space food system is expected to serve as a countermeasure to detrimental impacts to human physiology, including dysregulation in immunological profiles, the taxonomic profile of the gut microbiota, and nutritional status during spaceflight. In this study, first we sought to determine the effect of the nominal shelf-stable spaceflight diet compared to an "enhanced" shelf-stable spaceflight diet on human biochemistry, immunology, and the microbiome in a ground-based, simulated space mission. The ground analog portion of this study was conducted in the NASA Human Exploration Research Analog (HERA) Campaign 4 missions, which consisted of four 45-day missions with closed chamber confinement and realistic mission simulation to study effects on crew health and performance. As reported previously, analyses indicate beneficial associations between diet and markers of nutritional status, stress, the microbiome, and cognitive performance. Intake and beneficial associations varied by subject. This data will be used as a ground-based control for spaceflight, where the spaceflight environment (e.g., radiation, microgravity) will have additional impacts and the potential to evaluate effects of the diet will be greater. The second phase of this study is to occur on the International Space Station, where it is currently being implemented. The test plan is similar to that used in the HERA missions. The enhanced diet is intended to provide 25% of the crews’ diet with foods rich in omega-3 fatty acids, lycopene, and flavonoids, along with more fruits and vegetables in general (the other 75% of the diet will be obtained from standard and crew preference items available on the ISS). Biological samples (blood, urine, stool, and saliva) are being collected from participants at selected time points before, during, and after the mission. Data collection also includes dietary intake recording and body mass measurement. Currently, 6 of 9 planned astronauts have completed data collection. Analysis of immune markers, latent herpes virus reactivation, the taxonomic and metatranscriptomic profile of the gut microbiome, and nutritional status biomarkers and biochemical metabolites will occur in batch to minimize sample handling variations. Mixed models statistical analyses will be used, incorporating random effects to account for repeated measures within individuals to assess the impact of diet on physiological outcomes. We expect this study to provide evidence of beneficial impact of this enhanced diet on crew health and adaptation to spaceflight. These data will aid in evidence-based mass-risk trades for food system design and development of targeted dietary interventions for future exploration-class space missions.

Grace L. Douglas↗

Appetite and Food Intake During 11 Days of Mild Hypobaric Hypoxia

Introduction Reduced food consumption and loss of body mass and muscle mass have been observed during spaceflight. Hypoxic conditions that astronauts may encounter on exploration missions may further implicate satiety signals and dietary intake. Appetite, food intake, and satiety hormones were investigated under the conditions of mild hypoxia and high energy output during simulated extravehicular activity (EVA) to determine the adequacy of a mission relevant space food system to support energy balance and body composition. Methods Foods realistic to early Artemis missions was packed by meal for each subject for the 11-day test based on estimated energy requirements (EER) and estimated EVA caloric requirements. No hot water or food warmer was provided and only room temperature water was available to rehydrate food and beverages in-mission, mimicking plans for early Artemis missions. Measures included food records (pre-mission, in-mission); fasted body weight (pre-mission, in-mission); Dual-energy X-ray absorptiometry (DXA) (pre-mission, post-mission); subjective ratings and feedback of food acceptability, mealtime and meal preparation sufficiency, appetite, and nausea (in-mission); and circulating ghrelin and leptin concentration in fasted blood samples (pre-mission, in-mission: pre-post EVA). Results All subjects consumed fewer calories in-mission than predicted. On average, subjects consumed 341 calories less on EVA days compared to non-EVA days in-mission (p=0.0511). The total weight loss estimate from daily weight measurements (-1.1 kg, p=0.0028) is consistent with underconsumption and supported by DXA measurements (-1.3 kg total body mass, p=0.0123 and -1.6 kg fat mass, p=0.0016). In general, most foods that were consumed were given acceptable scores, but subject comments indicated that the most acceptable foods were those not intended to be heated. Comments also indicated that subjects found their favorite foods early in the mission and avoided the foods that they did not like throughout the mission. Habitability scores indicated that overall aspects of the food system were considered borderline or unacceptable over the length of this mission. Foods that caused gas were avoided pre-EVA to prevent discomfort during pressure changes. Average fruit and vegetable intake decreased during the mission, dropping from 4.8 servings/d pre-mission to 3.4 servings/d on non-EVA days in-mission (p=0.0872) and 2.3 servings on EVA days (p=0.0020). Fasting ghrelin concentrations tended to be lower pre-EVA and on non-EVA days when exposed to mild hypoxia compared to normoxic conditions pre-mission and post-EVA (p=0.0136). Fasting levels of leptin did not change. Discussion Food intake was reduced in-mission, resulting in a caloric deficit and weight loss for most subjects. Crew food and appetite ratings and comments indicated this was due to a combination of food choices, lack of preference, lack of preparation capability, lack of time for meal preparation, consumption, and cleanup, and physiological challenges with the changing pressure. The regulation of appetite stimulating hormone ghrelin, but not the appetite suppressor leptin, appeared to be sensitive to hypoxic conditions. Conclusions Food preparation capabilities and time for meals are important for promoting adequate food intake. Reduced appetite and food intake during missions may further be aggravated under hypoxic conditions through the suppression of ghrelin. Lack of time for meals on EVA days, and avoidance of potential gas-causing foods (e.g., health promoting fruits and vegetables) prior to EVAs, demonstrate the importance of scheduling ample recovery time between EVA days.

Grace L Douglas↗

Recommendations for Developing Space Suit Integrated Food Systems and Delivering Nutrition Before, During, and After Lunar EVA

INTRODUCTION Artemis missions will include a higher tempo and frequency of extravehicular activities (EVAs) than any previous space program. Because of the physical demands expected from the crew, future space suit designs are required to incorporate nutritional support to the astronauts during lunar surface EVAs lasting longer than 4 hours. The purpose of this project was to provide recommendations to aid the development of an in-suit system that can adequately, safely, and acceptably deliver nutrition to a crewmember while confined to a space suit during EVA. METHODS Physiological, logistical, and engineering aspects of potential in-suit nutrition approaches were assessed through literature reviews, assessments of commercial off the shelf (COTS) foods, suit volumetric modeling, and feedback from subject matter experts and crewmembers. Key driving factors in the development of in-suit nutrition requirements included how much and what type of nutrition should be included, what food formulations are appropriate and safe, what are inherent limitations of space suits, what are the potential risks to the crewmember in the suit, and what practices and preferences from astronauts should be considered. Design references were conceptualized and assessed for strengths and limitations as potential in-suit nutrition systems for surface EVA. RESULTS Acute exogenous energy demands vary greatly depending on activity intensity and duration, and partial energy replenishment (i.e., 60–80 kcal∙hr-1 of EVA, or 460–680 kcal for EVAs lasting up to 8 hours) during activities could improve performance, safety, and recovery. COTS foods capable of providing these energy requirements exist; however, no COTS foods have been identified that pass NASA flight standards for microbiological safety and stability. In-suit nutrition delivery design references that were considered included in-suit concepts for a prefilled drink bag, a hydratable drink bag, and a solid food stick. In addition, a helmet feed port concept was considered for use with drink bags external to the suit. Volumetric models of the in-suit drink bag concepts, based on xEMU dimensions, indicate challenges of fitting formulations > 200 ml (equating to approximately 200 kcal). Astronaut feedback on the four concepts indicated that despite some individual preferences for inclusion of solid foods and helmet port designs, the prefilled drink bag concept was the most preferred. A prefilled drink bag can only be used if food safety and stability can be ensured, possibly requiring advancements in food delivery hardware. CONCLUSION The ability to meet the increased need for nutrition during surface EVAs through provision of nutrients in the suited configuration would benefit overall crew health, performance, and morale, and thus increase the likelihood of mission success. It is recommended that in-suit nutrition capabilities provide at least 400–600 kcal within the suit during EVAs lasting > 4 hours and that suit designs include a dedicated volume for food grade nutrition systems. The developed food system should either allow for 1) installation of prefilled (sealed sterile) liquid nutrition in the suit and provide a mechanism to break the seal at the time that consumption is desired or 2) demonstrate that the unsealed food product shelf life allows for safe consumption after at least 12 hours of EVA.

space suit↗