Table 2 Summary of nutritional recommendations

Energy requirements during a saturation dive are greater than the surface. We recommend saturation divers should consume between 44 – 53 kcal/Kg BM, dependent on the intensity and duration of subsea shift work. Energy dense foods and high-energy meal replacement supplements should be considered to meet the elevated energy expenditure, particularly if periods of suppressed appetite are experienced post lockout

Protein intakes of at least 1.3 g/kg BM are recommended to support diminished WBPS and reduce periods of catabolism

Fat and carbohydrate intake are essential for achieving energy balance. We recommend the percentage of total calorie intake from dietary fat should be at the top of end of the current IOM guidelines (20-35 %), whilst carbohydrate intake should be at the lower end of IOM recommendations (45-65 %). Despite this we suggest that fat and carbohydrate intake should ultimately be dictated by personal preference to attain energy balance

A varied diet high in fruit and vegetables are recommended for achieving micronutrient targets. More specifically, antioxidants, vitamin B12 and folate are of greater interest due to their respective involvement in redox physiology and red blood cell production

Supplementation with Vitamin D is recommended due to the absence of UVB ray exposure

A diet rich in dietary nitrates may enhance decompression safety through attenuating gaseous microbubble formation

Prescriptive recommendations for hydration are difficult due to large inter-individual differences in fluid and electrolyte homeostasis. The challenge for saturation divers is twofold; that of hyperbaric diuresis and prolonged underwater immersion. The addition of sodium within food and beverages may facilitate fluid and electrolyte restoration and maintenance of homeostasis

Meals rich in carbohydrates and fats are recommended prior to and proceeding lockout to increase energy availability for underwater work and enhance recovery post lockout. Consumption of a carbohydrate-based beverage, at a minimum of 16 g/hr, during lockout may also support physical performance underwater

Catering providers have a pivotal role in facilitating appropriate nutritional intake. Catering professionals should be encouraged to place emphasis on the food texture and presentation to increase the sensory appeal of foods in the chamber, thereby supporting increased energy intake