ABSTRACT

The transformation of legacy military forces to a future force which is capable of responding to threats in a flexible manner will require an unprecedented degree of autonomy. Small units operating with limited support for lengthy periods will place enormous physical and cognitive demands on the individual warfighter. In past conflicts, performance enhancing interventions were largely limited to using stimulants such as amphetamines and caffeine. In the sports world, athletes have used anabolic steroids, blood doping, nutritional supplements, and other interventions to enhance performance, but the effects show large individual variations and tend to be situation specific. Advances in genomics and, more recently, metabolomics and glycomics show promise to precisely tailor performance enhancing interventions to an individual’s physiology. Most of the relevant human research is from the perspective of metabolic disease, and only recently has the research been focused on metabolic health. Much of this research is in sports medicine and has serious methodological flaws. The objective is to develop research objectives to enhance warfighter performance.

THE MILITARY PROBLEM

The problem reduces to the simple premise that the performance of small units will depend on the physical and cognitive stamina of the individual warfighter, and that the demands of future missions will exceed the limits of those capabilities. While training and superior technology are critical factors in mission success, the application of physiological biomarkers (e.g. genomic and metabolomic) to soldier selection, fitness, and readiness are currently feasible. More important, however, will be the ability to exceed physical and cognitive limits by manipulating the physiology of the individual directly.

The precedents in the sports world can be reduced to supplements known as nutriceuticals, drugs such as anabolic steroids, and blood doping.  Recent reviews of publications on supplements and ergogenic (i.e. performance enhancing) compounds of choice for athletes point out wide-spread and serious methodological flaws in much of this research. Also noteworthy are the wide individual variations in response to these compounds as well as differences in the responses of trained vs. untrained test subjects. For example, the popular supplement creatine, a primary source of adenosine triphosphate (ATP, the “currency” of energy) appears to be ergogenic in repetitive cycling and possibly weight lifting, but not in running or swimming. Protein, amino acid, and antioxidant supplements appear to have no ergogenic effect at all, while caffeine is reliably ergogenic. The most well-known performance enhancing drugs are anabolic steroids, which have differential ergogenic effects in children and adult men and women, but also have deleterious side effects such as liver disease, psychological disturbances, and cardiovascular disease.

The research literature on performance enhancement has been focused on chemical interventions, training regimens, and cognitive training. It is also fragmented and contradictory, and much of the literature suffers from methodological and experimental design flaws. The areas of genomics and proteomics have been disease, rather than health, oriented and have not focused on performance enhancement per se. At least, not within the context of warfighter performance. Notwithstanding the corrective and self-regulating mechanisms of metabolic pathways and unresolved ethical issues with manipulating the genome, it is realistic to suggest the possibility of tailoring the genome of somatic cells and organelles and/or metabolic pathways to achieve optimal individual performance.

WORKSHOP APPROACH

The workshop approach is to develop the framework with which to inform a comprehensive research program on Enhanced Warfighter Performance. Research on metabolism and human performance is focused on pathways involved with metabolic diseases rather than optimizing the efficiency of normally functioning physiological systems. While critical aspects of metabolic pathways are evolutionarily conserved, there exists a significant amount of tissue and individual variation to suggest that these could be enhanced via a combination of genetic, pharmaceutical, and nutritional interventions. The scientists participating in this workshop are tasked with developing an enhanced whitepaper(s) focused on this important mission requirement. The expected outcome is at least one white paper which proposes a research idea and goals which have a clear path to a “deliverable” solution to the sponsor.