Helen W. Lane

Calcium absorption, endogenous excretion, and endocrine changes during and after long-term bed rest.

Negative calcium balance is a known consequence of bed rest, and is manifested in elevated urine and fecal calcium (Ca). Elevated fecal Ca can result from either decreased absorption, increased endogenous fecal excretion, or both. We measured the Ca absorption and endogenous fecal excretion in eight healthy male volunteers before and during 4 months of bed rest. Dual isotope (n = 6) or single isotope (n = 2) methods in conjunction with Ca balance were used to calculate true and net Ca absorption and endogenous fecal excretion. Stool Ca increased from 797 mg/day (mean intake 991 mg/day) to 911 mg/day during bed rest, whereas urine Ca excretion increased from 174 to 241 mg/day. True Ca absorption decreased from 31 +/- 7% of Ca intake pre-bed rest to 24 +/- 2% during bed rest, (p < 0.05) and returned toward pre-bed rest values within 5-6 weeks following reambulation. Endogenous fecal excretion did not change significantly, and therefore, most of the increased fecal Ca resulted from changes in absorption. However, in one individual, endogenous fecal Ca excretion was the major contributor to Ca loss. Ionized Ca and pyridinium crosslinks increased and 1,25(OH)2 vitamin D decreased during bed rest, similar to the decrease in Ca absorption; parathyroid hormone (PTH), calcitonin, serum albumin, phosphorus, and total serum Ca were unchanged. Although alkaline phosphatase, osteocalcin, and PTH were unchanged during bed rest, they were elevated during reambulation. These changes accompanied by increased Ca absorption and balance and decreased ionized and total serum Ca suggest a rebound in bone formation following immobilization.

Energy expenditure and balance during spaceflight on the space shuttle

The objectives of this study were as follows: 1) to measure human energy expenditure (EE) during spaceflight on a shuttle mission by using the doubly labeled water (DLW) method; 2) to determine whether the astronauts were in negative energy balance during spaceflight; 3) to use the comparison of change in body fat as measured by the intake DLW EE,18O dilution, and dual energy X-ray absorptiometry (DEXA) to validate the DLW method for spaceflight; and 4) to compare EE during spaceflight against that found with bed rest. Two experiments were conducted: a flight experiment ( n = 4) on the 16-day 1996 life and microgravity sciences shuttle mission and a 6° head-down tilt bed rest study with controlled dietary intake ( n = 8). The bed rest study was designed to simulate the flight experiment and included exercise. Two EE determinations were done before flight (bed rest), during flight (bed rest), and after flight (recovery). Energy intake and N balance were monitored for the entire period. Results were that body weight, water, fat, and energy balance were unchanged with bed rest. For the flight experiment, decreases in weight (2.6 ± 0.4 kg, P < 0.05) and N retention (-2.37 ± 0.45 g N/day, P < 0.05) were found. Dietary intake for the four astronauts was reduced in flight (3,025 ± 180 vs. 1,943 ± 179 kcal/day, P < 0.05). EE in flight was 3,320 ± 155 kcal/day, resulting in a negative energy balance of 1,355 ± 80 kcal/day (-15.7 ± 1.0 kcal ⋅ kg-1 ⋅ day-1, P < 0.05). This corresponded to a loss of 2.1 ± 0.4 kg body fat, which was within experimental error of the fat loss determined by18O dilution (-1.4 ± 0.5 kg) and DEXA (-2.4 ± 0.4 kg). All three methods showed no change in body fat with bed rest. In conclusion, 1) the DLW method for measuring EE during spaceflight is valid, 2) the astronauts were in severe negative energy balance and oxidized body fat, and 3) in-flight energy (E) requirements can be predicted from the equation: E = 1.40 × resting metabolic rate + exercise.

Nutrition in Space

Nutritional Biochemistry Laboratory (NBL) is one of the Life Sciences Reascarch Laboratories at the Johnson space Center in Houston. The primary responsibility of the NBL is the definition of the nutritional requirements for long-term space flight. To this end, studies have been conducted of energy, protein, and calcium metabolism as well as fluid and electrolyte homeostasis, and red blood cell synthesis and metabolism during space flight. The NBL is also charged with conducting nutritional assessment before, during, and after extended-duration missions to ensure maintenance of crew health for missions longer than 30 days.

Calcium Kinetics with Microgram Stable Isotope Doses and Saliva Sampling

Studies of calcium kinetics require administration of tracer doses of calcium and subsequent repeated sampling of biological fluids. This study was designed to develop techniques that would allow estimation of calcium kinetics by using small (micrograms) doses of isotopes instead of the more common large (mg) doses to minimize tracer perturbation of the system and reduce cost, and to explore the use of saliva sampling as an alternative to blood sampling. Subjects received an oral dose (133 micrograms) of 43Ca and an i.v. dose (7.7 micrograms) of 46Ca. Isotopic enrichment in blood, urine, saliva and feces was well above thermal ionization mass spectrometry measurement precision up to 170 h after dosing. Fractional calcium absorptions determined from isotopic ratios in blood, urine and saliva were similar. Compartmental modeling revealed that kinetic parameters determined from serum or saliva data were similar, decreasing the necessity for blood samples. It is concluded from these results that calcium kinetics can be assessed with micrograms doses of stable isotopes, thereby reducing tracer costs and with saliva samples, thereby reducing the amount of blood needed.

Water and Energy Dietary Requirements and Endocrinology of Human Space Flight

Fluid and energy metabolism and related endocrine changes have been studied nearly from the beginning of human space flight in association with short- and long-duration flights. Fluid and electrolyte nutrition status is affected by many factors including the microgravity environment, stress, changes in body composition, diet, exercise habits, sleep cycles, and ambient temperature and humidity conditions. Space flight exposes astronauts to all these factors and consequently poses significant challenges to establishing dietary water, sodium, potassium, and energy recommendations. The purpose of this article is to review the results of ground-based and space flight research studies that have led to current water, electrolyte, and energy dietary requirements for humans during space flight and to give an overview of related endocrinologic changes that have been observed in humans during short- and long-duration space flight.

History of nutrition in space flight: Overview

Major accomplishments in nutritional sciences for support of human space travel have occurred over the past 40 y. This article reviews these accomplishments, beginning with the early Gemini program and continuing through the impressive results from the first space station Skylab program that focused on life sciences research, the Russian contributions through the Mir space station, the US Shuttle life sciences research, and the emerging International Space Station missions. Nutrition is affected by environmental conditions such as radiation, temperature, and atmospheric pressures, and these are reviewed. Nutrition with respect to space flight is closely interconnected with other life sciences research disciplines including the study of hematology, immunology, as well as neurosensory, cardiovascular, gastrointestinal, circadian rhythms, and musculoskeletal physiology. These relationships are reviewed in reference to the overall history of nutritional science in human space flight. Cumulative nutritional research over the past four decades has resulted in the current nutritional requirements for astronauts. Space-flight nutritional recommendations are presented along with the critical path road map that outlines the research needed for future development of nutritional requirements.

The Role of Nutritional Research in the Success of Human Space Flight

The United States has had human space flight programs for >50 y and has had a continued presence in space since 2000. Providing nutritious and safe food is imperative for astronauts because space travelers are totally dependent on launched food. Space flight research topics have included energy, protein, nutritional aspects of bone and muscle health, and vision issues related to 1-carbon metabolism. Research has shown that energy needs during flight are similar to energy needs on Earth. Low energy intakes affect protein turnover. The type of dietary protein is also important for bone health, plant-based protein being more efficacious than animal protein. Bone loss is greatly ameliorated with adequate intakes of energy and vitamin D, along with routine resistive exercise. Astronauts with lower plasma folate concentrations may be more susceptible to vision changes. Foods for space flight were developed initially by the U.S. Air Force School of Aerospace Medicine in conjunction with the U.S. Army Natick Laboratories and NASA. Hazard Analysis Critical Control Point safety standards were specifically developed for space feeding. Prepackaged foods for the International Space Station were originally high in sodium (5300 mg/d), but NASA has recently reformulated >90 foods to reduce sodium intake to 3000 mg/d. Food development has improved nutritional quality as well as safety and acceptability.

Gravity and space flight: effects on nutritional status

The final decade of the millennium has seen an enormous amount of on-orbit life sciences research, including both short- and long-duration flight research. Life sciences dedicated Space Shuttle flights have made intensive research opportunities available to study on the acute adaptation to weightlessness. The NASA/Mir Science Program combined resources of the USA and Russia to provide the first long-duration flight opportunities for the United States since the Skylab program of the early 1970s. Many of the results of these studies are still being evaluated, and in some cases data are still being collected to assess long-term readaptation to gravity after several months in weightlessness. The surge in life sciences research during this decade serves as a preamble to the opportunities to be provided by the latest addition to the Earth-orbiting structures--the International Space Station.

Short‐Term Space Flight on Nitrogenous Compounds, Lipoproteins, and Serum Proteins

Biochemical variables in blood were measured in venous blood samples from 38 to 72 Space Shuttle astronauts before and immediately after flights of 2 to 11 days. Mean pre‐ and postflight values were compared using the paired t‐test or the Wilcoxon signed‐rank test. The largest change in serum enzymes was a 21% increase (P = .0014) in γ‐glutamyltranspeptidase, which may have been related to stress. The median value of apolipoprotein (apo) A‐I decreased from 152 to 127 mg/dL (P > .0001), but the change in apo B (77 to 73 mg/dL) was not statistically significant, and the mean apo A‐I/apo B ratio remained well above 1.5. A decrease in dietary fat and cholesterol intake during shuttle missions may have been a cause of the change in apo A‐I. Twelve of the 16 nonenzyme serum proteins measured were significantly elevated (P > .05), possibly because of hemoconcentration and increased protein catabolism. The 56% increase in haptoglobin may be related to release of suppressed erythropoiesis at landing.

Metabolic energy required for flight

This paper reviews data available from U.S. and U.S.S.R. studies on energy metabolism in the microgravity of space flight. Energy utilization and energy availability in space seem to be similar to those on Earth. However, negative nitrogen balances in space in the presence of adequate energy and protein intakes and in-flight exercise, suggest that lean body mass decreases in space. Metabolic studies during simulated (bed rest) and actual microgravity have shown changes in blood glucose, fatty acids, and insulin levels, suggesting that energy metabolism may be altered during flight. Future research should focus on the interactions of lean body mass, diet, and exercise in space and their roles in energy metabolism during space flight.