Nutrition
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The development of space food has been evolving since the Soviet cosmonaut, German Titov, became the first human to eat in space in August 1961. John Glenn was the first American to consume food, applesauce, on the third manned Mercury mission in August 1962. Before these events, there was no knowledge that humans would be able to swallow and, hence, eat in weightlessness. ⋯ Extended planetary stays will require even more variety and more technologic advances. Plants will be grown to recycle the air and water and will provide food for the crew. These harvested crops will need to be processed into safe, healthy, and acceptable food ingredients that can then be prepared into menu items.
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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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Exercise and nutrition represent primary countermeasures used during space flight to maintain or restore maximal aerobic capacity, musculoskeletal structure, and orthostatic function. However, no single exercise, dietary regimen, or combination of prescriptions has proven entirely effective in maintaining or restoring cardiovascular and musculoskeletal functions to preflight levels after prolonged space flight. ⋯ This can be accomplished only with greater emphasis of research on ground-based experiments targeted at understanding the interactions between caloric intake and expenditure during space flight. Future strategies for application of nutrition and exercise countermeasures for long-duration space missions must be directed to minimizing crew time and the impact on life-support resources.
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It is very likely that the human immune system will be altered in astronauts exposed to the conditions of long-term space flight: isolation, containment, microgravity, radiation, microbial contamination, sleep disruption, and insufficient nutrition. In human and animal subjects flown in space, there is evidence of immune compromise, reactivation of latent virus infection, and possible development of a premalignant or malignant condition. ⋯ The clinical conditions of Epstein-Barr-driven lymphomas in transplant patients and Kaposi's sarcoma in patients with autoimmune deficiency virus come easily to mind in trying to identify these conditions. With these thoughts in mind, it is highly appropriate, indeed imperative, that careful investigations of human immunity, infection, and cancer be made by space flight researchers.
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To date, several hundred cosmonauts and astronauts have flown in space, yet knowledge about the adaptation of their immune system to space flight is rather limited. It is evident that a variety of immune parameters are changed during and after space flight, but the magnitude and pattern of these changes can differ dramatically between missions and even between crew members on the same mission. A literature search was conducted involving a total of 335 papers published between 1972 and 2002 that dealt with the key words immune response, microgravity and astronauts/cosmonauts, isolation, gravity, and human health. ⋯ That stress plays an important role in the effects of space flight on immunologic parameters is suggested by the frequent findings that stress hormones are upregulated during and after space flight. Unfortunately, however, the existing data on hormonal parameters are almost as varied as those on immunologic changes, and correlations between the two datasets have only rarely been attempted. The functional implications of space flight-induced alterations in immune response largely remain to be elucidated, but the data suggest that long-term travel will be associated with the development of immune-compromised hosts.