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New military study underway looking to prevent stress fractures

Posted on: January 9, 2014   by  Vitamin D Council


A team of researchers from the U.S. Army Research Institute of Environmental Medicine has partnered with the Trainee Health Surveillance Flight 559th Medical Group’s Basic Military Training Team in Lackland, Texas to determine if increased vitamin D and calcium intake can improve bone health in military personnel.

Stress fractures and other bone and muscle injuries are among the most common causes of delay in basic military training. Five percent of males and 20% of females may experience a stress fracture during training. This causes trainees to miss valuable military training and sometimes can lead to drop out from the program.

Additionally, stress fractures are expensive health costs. They can require multiple hospital visits and medical tests, as well as physical therapy. It is estimated that a stress fracture costs the Air Force more than $6,000 per case.

“These injuries are costly to warfighters and to the military, as a significant portion of individuals that suffer from stress fracture leave military service and stress fracture results in substantial health care costs associated with treatment and rehabilitation,” said lead researcher Dr. James McClung.

The researchers, after a pilot study in 2012, set out to continue their research in October 2013. They have recruited both male and female Air Force recruits to undergo the study.

The participants of the study are receiving either a snack bar fortified with vitamin D and calcium or a placebo snack bar.

Dr. McClung added, “Our goal is that findings from these studies will provide the information necessary to determine the optimal vitamin D and calcium requirement of military personnel for the maintenance of bone health and prevention of stress fractures to keep warfighters mission ready for the long haul.”

Upon completion of the study, their data will be shared with senior leaders from the Department of Defense’s medical and training commands.

“Many trainees get demoralized after a stress fracture and quit. If we can prevent stress fractures or other injuries, it is much better for all concerned,” said Thomas Cropper, director of the Trainee Health Surveillance Flight 559th Medical Group.


Sullivan, K. Army conducting joint study to improve bone health in military personnel. U.S. Army, 2014.

4 Responses to New military study underway looking to prevent stress fractures

  1. Ron Carmichael

    “receiving either a snack bar fortified with vitamin D and calcium or a placebo snack bar….”….Is this yet another example of a study doomed to inconsequential and unreliable, or worse, WRONG conclusions because of a failure to reach “mother-nature” appropriate levels of 25(OH)D?

  2. [email protected]

    Why go to the trouble of doing a study if you are guaranteed failure?
    How much vitamin D does the candy bar have, 500 units?
    A study that studies stress factors in those that obtain a vitamin D level of 50 to 80 nanograms would show that stress fractures could be drastically reduced, and save millions of dollars.

  3. Rita and Misty

    [email protected]:

    I agree. And this goes back to my old change–there is no consensus within the vitamin D community as to optimal 25(OH)D level. I happen to think it certainly makes sense to look to current hunter/gatherer cultures to determine “natural” levels. And, this has been done, and it has been shown that natural levels are between 46 ng/ml and 104 ng/ml.

    I would absolutely love to see a study developed utilizing natural 25(OH)D levels upon a specific condition–it would be interesting to view both cost and cost-effectiveness from this perspective.

  4. Jim Larsen

    Bone strength depends on a variety of factors, including D, K, iron, collagen, sufficient calories, etc.

    In addition, the body can only absorb so much at any one time. Additionally, in the basic training environment, there is no food available between dinner and breakfast.

    The Lappe Navy study reduced stress fractures by 20% by giving recruits D and 2,000 mg of calcium (based on the earlier Klesges basketball player study showing that 1,000 mg of calcium was lost/day in sweat).

    The Lappe Leonard Wood study showed relatively high entry rates of osteopenia among women. The current AF anemia screening program shows high rates of iron anemia as well.

    The AF has reduced stress fractures so far by about 60% by giving a daily pre-natal vitamin-mineral, improving the diet, adding an evening protein bar, changing the exercise schedule, etc. Remember although the injury rates are different, the injured N is almost the same since the gender mix is not equal.

    USARIEM had previously done diet, iron, and D studies in Army BCT. Therefore, not sure you can automatically assume the study is going to be done wrong. Reality is a multi-variable condition and can be complex.

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