SECTION I INTRODUCTION - SB-10-495-10004

SB 10-495-1/NAVSUP PUB 436/MCO P10110.26B/AFMAN 41-121

SECTION I

INTRODUCTION

diets are not provided. To enable the dietitian to plan

A. Purpose

Sodium Restricted Diets, the sodium content of selected

Standard Medical B Ration is planned for subsisting

foods is provided in Section VII. For planning purposes,

patients in Armed Forces medical treatment facilities

it is assumed that 100 % of the staff and 77 % of the

when semiperishable food is required. Patients are

patients will be subsisted on the Regular Diet. 23 % of

exempt from theater ration policy and will receive three

the patients are expected to subsist on a Liquid Diet.

(3) hot prepared meals per day. Use of the Meal Ready-

These percentages were derived for the total theater

to-Eat, Individual (MRE) is authorized only in

requirements. Facilities may need to adjust accordingly.

emergency situations when other rations are not

available. Perishable supplies should be included in the

D. Weight and Cubage

menus as soon as they are available. Staff assigned to

Total weight and cubage includes all menu components,

medical units will be fed according to the Service

accessory foods and condiments for regular and

theater ration policy. To simplify procurement, menu

alternate menus.

preparation and service, when hot meals are served to

medical personnel, they will be served the Regular Diet

Gross

Net Weight

Gross

from the Medical B (MB) Ration.

In unusual

Weight

circumstances (i.e.

facility relocation/movement),

1. Patients

Per Ration

Per Ralion

Cubic

operational rations may be required for staff. In no case

(lbs)

Feet

shall sole use of operational rations exceed ten days.

Per

Special subsistence requirements (Unique Items) to

Ration

support the Medical B Ration menu are listed in Section

REGULAR MENU ITEMS

4,087

3.058

0.131

II; subsistence requirements for the Standard B Ration

(w/o bread or bread ingredients)

which is the basis for the Medical B Ration are listed in

ALTERNATE MENU ITEMS

4.882

3.766

0.145

Section III. Both the primary foods and menu items and

(w/o bread or bread ingredients)

their alternates are listed in these sections. Each

REGULAR MENU ITEMS

4.280

3.174

0.131

Service will decide whether the regular menu item or the

(including bread ingredients)

alternate will be used.

ALTERNATE MENU ITEMS

5.077

3.881

0.152

(including bread ingredients)

B. Meals

2. Staff

To support 24-hour patient care, medical treatment

REGULAR MENU ITEMS

4.164

3.448

0.137

facility kitchens must prepare four (4) meals per day:

(w/o bread or bread ingredients)

breakfast, lunch, dinner and a night meal. The night

ALTERNATE MENU ITEMS

4.618

3.876

0.127

meal may utilize a breakfast or lunch/dinner menu

(w/o bread or bread ingredients)

according to local procedures. Patients requiring late

REGULAR MENU ITEMS

4.279

3.560

0.139

meals will be served as complete a meal as possible

(including bread ingredients)

with items from the preceding meal. The late meals will

ALTERNATE MENU ITEMS

4.821

4.074

0.132

be served in accordance with dietary constraints, local

(including bread ingredients)

procedures, and preventive medicine sanitation

guidelines. Once late tray service from the preceding

E. Supply

meal's menu has terminated, late meals will consist of

Stocks of Standard MB Ration components are

the nourishment for each diet listed on the daily menu.

available through the Defense Logistics Agency.

Diet order changes will become effective at the following

Requisitions will be in accordance with existing supply

meal, given adequate notice.

Diet order change

procedures of each Service. National Stock Numbers

procedures will follow local medical treatment facility

listed in the table, "Requirements for 1000 Rations Per

policy.

Day", Section VI, identify the specific style and package

size of items which will be used. The quantity of each

C. Types of Field Diets

item to be stocked will be determined by each Service

Subsistence and personnel constraints plus quad-

based on the staff and patient census, multiplied by the

service operational procedures and philosophy have

number of days before resupply.

necessitated deviation from the typical dietary practices

used in fixed facilities. The Quad-Service Clinical

F. Nutritional Analysis

Review Committee has approved the types of diets and

Nutritional analysis of selected recipes and components

MB Ration foods. The ration includes a ten-day menu

of the Medical B Ration have been computed using the

for the Regular Diet (with supplementation for the High

University of Massachusetts' Nutrient Data Bank. This

Calorie-High Protein Diet), Dental Liquid, Full Liquid and

data bank is based upon the USDA Composition of

Clear Liquid Diets. The beverage for Forced Fluids is

Foods, Agriculture Handbook No. 8, 1984, and data on

listed on the daily menu. Tube Feedings are discussed

ration components provided by the U.S. Army Natick

in Section IV-C.

Specific menus or preparations

Research, Development and Engineering Center.

required for Dental Soft Diets will be determined at the

Nutritents of Medical B Components are calculated for

individual medical treatment facility. In rare instances

100 gram portions, and Analysis of Selected Recipes

an unplanned diet may be ordered. If the patient will be

use portion measure rather than weight.

evacuated shortly, an available diet should be used, if

its use is not life-threatening. Sodium restricted foods or

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