Understanding and Overcoming the Challenge of Obesity and Overweight in the Armed Forces Proceedings of a Workshop (2018) / Chapter Skim
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4 Exploring Innovative Strategies
4 Exploring Innovative Strategies
Pages 33-50
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Andy Vu) • Joint nutrition initiatives provide support for food and nu trition needs across the military environment.
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He described this support as including a holistic assessment of well-being and readiness based on a Total Force Fitness Framework that encompasses eight domains of fitness -- social, physical, environmental, medical and dental, nutritional, spiritual, psychological, and behavioral -- that together best portray the readiness level of military service members across the deployment cycle (see Figure 4-1)
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He gave the example of Army Wellness Centers, which help service members stay fit and mitigate musculoskeletal-related injuries, explaining that the RPM analysis identified these types of injuries as a frequent medical point of failure for service members who return home early from deployment. Moreover, he added, the RPM was able to suggest that the use of wellness care appointments at Army Wellness Centers decreased deployment incompletion rates, that is, the likelihood of premature return from deployment.
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He noted that the reserve component represents 50 percent of military service members, who increasingly live away from military installations but are expected to maintain the same readiness standards and deploy at a similar rate relative to active duty members. JOINT NUTRITION INITIATIVES Lieutenant Colonel (retired)
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is used to assess environmental factors and policies that support healthy eating on military installations. The proposed Joint Buyer's Guide1 is intended as a tool for use by the food programs of the Army, Air Force, Navy, and Marine Corps to leverage their purchasing power and communicate to the food and beverage industry the detailed guidance and specifications provided to the Defense Logistic Agency's troop support, which acts on behalf of the services to purchase food in the services' dining facilities.
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Go for Green® 2.0 Moylan described Go for Green® 2.0 as a joint service performance nutrition initiative targeting military dining facilities to optimize the performance, readiness, and health of military service members (aged 18–35)
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Finally, she cited the need for better technology infrastructure that can push nutrition information from a central location to dining facilities at various military installations. SERVICE-SPECIFIC INITIATIVES Six speakers highlighted specific initiatives to address obesity and overweight among members of each military service, as well as veterans.
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She noted that the program was created and modified based on the Navy's ShipShape program -- an example of collaboration among the services. According to Osgood, evaluations of the Army's standardized weight management programs have shown that soldiers who complete all of the sessions experience statistically and clinically significant weight loss.
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She added that food stakeholders convene to discuss results and implement potential improvements to the food environment to facilitate healthier choices. Osgood closed her presentation on an enthusiastic note: "All these stakeholders have come to the table, which is a pretty amazing fact because they are all competing against each other financially." Air Force Initiatives The Air Force has used the CDC's Community Guide to select programs that incorporate guidelines and recommendations of the Community Preventive Services Task Force, said Utech as she introduced Lieutenant Colonel Jennifer Harward, deputy chief, Air Force health promotion, at the Air Force Medical Support Agency.
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She added that the Smart Fueling Initiative also provides an opportunity to test mNEAT 2.0, described earlier, which can be used to assess the food and nutrition environment, establish a baseline, and then measure improvements. Finally, Harward briefly described a newly developing health promotion program that will target high-risk squadrons (based on previously collected health assessment data)
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McGuire began by telling the audience that the Marine Corps has a 6-week program that trains members to be force fitness instructors -- unitlevel fitness experts who will help develop programs and refer individuals to dietitians and other health professionals. After cultivating a desired "density" of these instructors, he continued, a success that the Marine Corps has observed is a decreased incidence of injury and assignment to body composition programs and increased general and occupational fitness among service members.
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Navy Health Promotion and Wellness Initiatives James Sherrard, head of health promotion and wellness at Naval Hospital Pensacola, highlighted three of the Navy's health promotion initiatives targeting the obesity and overweight concerns of active duty and reserve sailors, their families, and DoD civilian staff. Sherrard began with ShipShape, the Navy's official weight management program, which is open to all DoD beneficiaries.
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® Weight Management Program for Veterans, an evidence-based, population-focused initiative that is integrated into the health care system to assist veterans with obesity or overweight who have an obesity-associated condition in achieving clinically significant weight loss. Integration with the health care system is particularly important, she 2 See http://www.med.navy.mil/sites/nmcphc/health-promotion/Pages/health-promotion-tool box.aspx (accessed July 13, 2018)
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Every VA medical center is required to offer this level of intensity in weight management services for veterans, she explained. According to Raffa, data collected since 2008 indicate that 15 to 20 percent of new participants have achieved clinically significant weight loss (at least 5 percent of body weight)
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® data tools to support program staff, educating providers about their prescribing practices, and providing realtime program guidance through a virtual work hub. Healthy Teaching Kitchen Veterans and their families across the country can be exposed to new foods and learn healthy cooking skills through the VA's National Healthy Teaching Kitchen program, said Sean Walsh, a registered dietitian and certified sous chef who co-leads the program.
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According to Walsh, many veterans want to cook and get healthy, but feel trapped because they lack the knowledge to do so. By demystifying the cooking process and appealing to personal and regional food preferences, he explained, the program helps redefine healthy foods as tasty foods that people want to eat.
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Vu noted that DoD is partnering across the board on multiple health promotion initiatives, including updating the DoD instruction that guides the military services on how they are to construct their policies. Defining a Healthy Diet One participant stated that no consistent definition of a healthy diet exists, and asked the speakers what their definition would be.
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