Nutrition and Human Performance in Military Aviation: A Narrative Review

Military aviation imposes physiological and cognitive demands that make nutrition relevant to flight safety, mission performance, aeromedical readiness, and Force Health Protection. Aircrew operate under stressors including hypoxia, high +Gz exposure, thermal strain, circadian disruption, restricted cockpit access to food and fluids, and sustained cognitive burden. This narrative review synthesizes evidence on hydration, macronutrients and nutrient timing, caffeine, dietary supplements, and diet quality as they relate to human performance and aeromedical readiness in military aviation.

We conducted a narrative review of nutrition and human performance in military aviation, using iterative searches of PubMed and Google Scholar supplemented by reference-list review, the Defense Technical Information Center, and relevant Department of War guidance. English-language peer-reviewed studies and authoritative government, military, technical, or policy documents published from 1965 through August 1, 2025 were considered. Evidence was prioritized hierarchically: military aircrew studies, civilian aircrew studies, and extrapolated evidence from related human-performance literature. Findings were weighted qualitatively by directness to aviation operations, realism of operational stressors, and methodological transparency.

Hydration was among the clearest military aviation-specific nutrition concerns identified in the reviewed evidence. Aircrew may begin flights dehydrated, with deficits compounded in-flight by cockpit microclimate, thermal load, flight gear, limited fluid access, and deliberate fluid restriction for bladder management. Dehydration and urinary retention are associated with impaired vigilance, flight-simulator performance, visuospatial processing, and selected cognitive outcomes; foundational centrifuge studies show that 1%-3% dehydration-induced body-mass loss can reduce +Gz tolerance, particularly with heat. This vulnerability is most relevant to high-performance tactical aviation, whereas mobility, rotary-wing, bomber, and remotely piloted aircraft communities may be more affected by hydration-associated vigilance, thermal strain, fueling access, circadian disruption, and mission endurance. Aviation nutrition studies support carbohydrate-centered, gastrointestinal-tolerant pre-mission fueling, while surveys identify missed meals, low carbohydrate and fiber intake, micronutrient inadequacies, and diet-quality gaps. Meal-timing evidence, mostly from civilian aviation and shift-work cohorts, suggests irregular eating may contribute to circadian and metabolic strain, but causality remains uncertain. Caffeine is supported as a fatigue countermeasure when dosing and timing are planned to protect sleep. Dietary supplements provide limited aviation-specific performance benefit and introduce aeromedical uncertainty. Sex-specific evidence remains limited but identifies female aircrew bladder-management constraints and equipment-fit considerations in +Gz tolerance. Cardiometabolic risk factors remain relevant to medical qualification and career longevity.

Nutrition is a modifiable operational and aeromedical variable in military aviation. Practical priorities include hydration planning, bladder-management solutions, carbohydrate-centered pre-mission fueling, disciplined caffeine use within fatigue-risk management, conservative supplement oversight, and cardiometabolic-risk surveillance. Evidence gaps remain, particularly sex-specific military aircrew data and intervention studies across aviation communities.