The FEAT project - Female Endocrinology in Arduous Training
Women are becoming increasingly integrated into military training, and we don’t yet know how undertaking arduous roles physically affects women compared with men. We have recently identified significant health issues facing women in the military, but it isn’t known why. These issues include higher rates of physical injury (such as stress fracture) and psychological injury (such as post-traumatic stress disorder), compared with men in the military, and increased rates of referral to infertility services compared with civilian women of the same age.
Military training is physically very arduous. We know that female civilian athletes are sometimes affected by periods stopping and reduced bone strength, probably because of undereating during training (although the reasons for undereating are complex and not fully understood). These conditions are closely related to changes in the body’s stress response. However, military training is more complex than training for a sport, and other factors like stress, lack of sleep, the cold and altered diet and eating arrangements might make these problems worse.
Hormones are the body’s chemical messengers that cause the physical differences between men and women. Endocrinology (the science of how hormones work) is the focus of the FEAT and E4T studies, because by understanding hormones we can understand the effects arduous training has on women that are specific to their sex.
This research programme is one of several being funded and undertaken by the comprehensive Women in Ground Close Combat Review programme, Army Personnel Research Capability. This is a comprehensive research programme aiming to develop an evidence base for the training, physical employment standards and longitudinal care of female UK serving personnel.
The Female Endocrinology in Arduous Training (FEAT) Study
The purpose of the FEAT Study is to use the year-long training of the RMA Sandhurst Commissioning Course, to understand how the transition into military life can affect female physiology - how the body’s response to stress, reproductive function and bone health are affected. We also aim to understand the balance of energy intake and usage, as this is what scientists think would be the most important cause of such changes. Furthermore, we will study some of these measures in a group of men to see if the changes that occur during the Commissioning Course differ
between the sexes.
Exploring the Endocrine Effects of Extreme Training (E4T) Study
Ex ICE MAIDEN provides an unprecedented opportunity to explore the physical effects on women of the extremes physical and mental endeavour. The E4T Study has been designed to examine the effects of the most arduous training on a group of women. It uses the same measurements as the FEAT Study to assess the patterns of key hormones before and after the Ex, exploring three key hormonal areas: stress, reproductive function and bone health.
The Ice Maidens will then undertake assessment of how the body uses fuel (metabolism) in different conditions, at the Human Metabolic Research Unit at the University Hospitals Coventry and Warwickshire NHS Trust (UHCW) and the Faculty of Human and Life Sciences at Coventry University.
These studies are being undertaken by scientists, nurses and doctors from:
The Army Personnel Research Capability (APRC), Senior Health Adviser (Army) Department
Defence Medical Services,
The University of Edinburgh,
The Carnegie Institute at Leeds Beckett University,
The Human Metabolic Research Unit at the University Hospitals Coventry and Warwickshire NHS Trust (UHCW) and the Faculty of Human and Life Sciences at Coventry University.
Squadron Leader Rob Gifford is the Chief Investigator of the E4T Study. Before commencing a PhD in Aug 2016, Rob was a medical doctor training to specialise in endocrinology and general medicine in Edinburgh. As a RAF medical officer, his role is providing physician aeromedical evacuation and he previously worked in the Role 3 Hospital in Camp Bastion, Afghanistan. He has previously undertaken research in Sri Lanka looking at nerve agent poisoning.
Professor Rebecca Reynolds is Professor of Metabolic Medicine at the University of Edinburgh. Professor Reynolds’s research focuses on understanding the mechanisms linking early life development of hormonal pathways to health and disease across the lifespan, focussing especially on the main hormone system signalling stress, the HPA axis. Her research includes examining the relationship between the HPA axis and fuel metabolism, what factors might modify this, and how it impacts disease in later life.
Colonel David Woods, Professor of Military Medicine, Professor of Exercise Endocrinology, Leeds Beckett University Colonel Woods is a Consultant Endocrinologist in the Defence Medical Services, Defence Professor in Military Medicine and Professor of Sport and Exercise Endocrinology, Leeds Beckett University. His research interests focus on the interaction of the human with the environment, particularly in relation to exercise under hypoxic or thermal stress.
Dr Julie Greeves OBE is the Principal Physiologist at Army HQ, and the Research Director for the Women in Ground Close Combat research programme. Julie has been researching for the MOD for almost 20 years, and has a specialist interest in female health and physical performance.
Dr Sophie Wardle joined Army HQ as a physiologist on the Women in Ground Close Combat research programme in 2015, following her doctoral studies in metabolic physiology at the University of Stirling. Sophie is currently leading research on energy assessment and protein metabolism during arduous training.
Dr Thomas O’Leary is a physiologist at Army HQ with a specialist interest in musculoskeletal function. Tom has recently led a key study on sex differences in response to arduous training at the Army Recruiting and Training Division.
This project is part of the Metabolism, Obesity, and Diabetes research theme at the Centre for Cardiovascular Science, University of Edinburgh