Nutrition
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Space flight anemia is a widely recognized phenomenon in astronauts. Reduction in circulating red blood cells and plasma volume results in a 10% to 15% decrement in circulatory volume. ⋯ Iron availability increases, and (in the few subjects studied) iron stores increase during long-duration space flight. The consequences of these changes are not fully understood.
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Weightlessness induces bone loss. Understanding the nature of this loss and developing means to counteract it are significant challenges to potential human exploration missions. This article reviews the existing information from studies of bone and calcium metabolism conducted during space flight. It also highlights areas where nutrition may play a specific role in this bone loss, and where countermeasures may be developed to mitigate that loss.
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A strategic use of resources is essential to achieving long-duration space travel and understanding the human physiological changes in space, including the roles of food and nutrition in space. To effectively address the challenges of space flight, the Bioastronautics Initiative, undertaken in 2001, expands extramural collaboration and leverages unique capabilities of the scientific community and the federal government, all the while applying this integrated knowledge to Earth-based problems. Integral to the National Aeronautics and Space Administration's missions in space is the reduction of risk of medical complications, particularly during missions of long duration. ⋯ The early approach applied terrestrial clinical judgment to predict medical problems in space. Space medicine has evolved to an evidence-based approach with the use of biomedical data gathered and lessons learned from previous space flight missions to systematically aid in decision making. This approach led, for example, to the determination of preliminary nutritional requirements for space flight, and it aids in the development of nutrition itself as a countermeasure to support nutritional mitigation of adaptation to space.
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Space flight and the accompanying diminished muscular activity lead to a loss of body nitrogen and muscle function. These losses may affect crew capabilities and health in long-duration missions. Space flight alters protein metabolism such that the body is unable to maintain protein synthetic rates. ⋯ We have demonstrated that minimal resistance exercise preserves muscle protein synthesis throughout bedrest. In addition, ongoing work indicates that an essential amino acid and carbohydrate supplement may ameliorate the loss of lean body mass and muscle strength associated with 28 d of bedrest. The investigation of inactivity-induced alterations in protein metabolism, during space flight or prolonged bedrest, is applicable to clinical populations and, in a more general sense, to the problems associated with the decreased activity that occur with aging.
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Smart medical systems are being developed to allow medical treatments to address alterations in chemical and physiologic status in real time. In a smart medical system, sensor arrays assess subject status, which is interpreted by computer processors that analyze multiple inputs and recommend treatment interventions. The response of the subject to the treatment is again assessed by the sensor arrays, thus closing the loop. ⋯ In particular, this technology can be used to measure blood hematocrit and interstitial fluid pH. The non-invasive measurement of interstitial pH is discussed as a surrogate for blood lactate measurement for the development and real-time assessment of exercise protocols in space. Earth-based application of these sensors is also described.