Understanding and Overcoming the Challenge of Obesity and Overweight in the Armed Forces Proceedings of a Workshop (2018) / Chapter Skim
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2 Defining the Problem and Its Effects on Recruitment, Retention, Resilience, and Readiness
2 Defining the Problem and Its Effects on Recruitment, Retention, Resilience, and Readiness
Pages 5-22
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From page 5... ...
• These body fat standards are related to three key outcomes: military appearance, health, and job performance. The em phasis on abdominal circumference in the standards addresses the primary site of modifiable fat deposition related to each of these outcomes.
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• If the U.S. Army desires the most physically ready soldiers, it may need to institute standards that consider physical fitness and body composition simultaneously.
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, then allowed for a small statistical window and set a reasonable upper limit that would be consistent with maintaining fitness and also help drive healthy eating and physical activity habits to prevent excess weight gain. The panel's recommended upper body fat limit was 20 percent for men and 30 percent for women, he reported.
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. The figure compares the difference between abdominal circumference and neck circumference plotted against stature, demonstrating the difference in body fat computation for a 69-inch-tall male with either FIGURE 2-2 Nomogram of the equation used to calculate male body fat percentage in the armed forces.
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For females, hip circumference would be added to abdominal circumference, Friedl noted. Friedl clarified that using a body composition assessment method such as dual-energy X-ray absorptiometry (DEXA)
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adults are overweight and almost 40 percent have obesity, Smith continued, figures she said are relevant to DoD because it recruits its members from the general population. Indeed, she observed, according to DoD's analysis of national height and weight data collected in 2014, approximately one-third of Americans aged 17 to 24 do not qualify for military service because of their weight (based on a BMI ≥27.5, the military's upper limit for most age and sex groups)
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. Moving on to examine statistics for individuals who apply for military service, Smith referred to 2014 data on applicants who underwent a physical at a military entrance processing station.
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, adding that studies with shorter follow-up periods have yielded similar results. "Taken together," Smith stated, "BMI at accession certainly has important implications for injury risk and does support the importance of upper limits of BMI at accession." Furthermore, Smith continued, relative to soldiers with normal BMI at accession, those who were overweight or had obesity had a higher risk for developing each of the following cardiometabolic risk factors: meta 2 The recruitment targets presented at the workshop are recommendations from the 2013 Defense Health Board report Implications of Trends in Obesity and Overweight for the Department of Defense, published November 22, 2013.
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follow-up time. Smith closed by citing four practical ways in which the information on national trends in overweight and obesity and implications for military personnel provided in the Defense Health Board's 2013 report can be applied to advance efforts to recruit and retain fit armed forces: • The report indicates that existing recruitment and accession stan dards are appropriate, although the indication that the standards are not posing challenges to recruitment goals could change should recruitment demands increase.
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, which includes a 1.5-mile run and other components, was just under 99 percent. Thus, he observed, the average pass rate for the total Physical Fitness Assessment (PFA)
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Heaney went on to report that sailors who exceed age-adjusted body fat standards are enrolled in the Fitness Enhancement Program. This program mandates nutritional counseling and 3 days per week of physical fitness training, and includes routine weight and body composition monitoring and other supportive resources.
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. BMI, Physical Fitness, and Age of Soldiers in Operational Units Next, Jones shared data on soldiers in operational units, where he said age becomes a factor, as compared with basic training, where all trainees are relatively young.
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in basic combat training. SOURCES: Presented by Bruce Jones, May 7, 2018 (data from Jones et al., 2017)
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Injuries are the leading cause of medical nonreadiness, he informed the audience. "If the Army desires the most physically ready soldiers," he argued, "they may need standards that take into consideration both physical fitness and body composition simultaneously." FAMILIES AND COMMUNITIES Obesity and overweight affect children and families throughout the military community said Karen Hawkins, a registered dietitian in the Office of Military Family Readiness Policy.
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She highlighted a recent example from April 2018 in which students on military installations created artwork illustrating the 5-2-1-0 message and how they use it in their daily lives. Next, Hawkins touched on her work with the Military Family Learning Network, which provides research and continuing education for military family service providers and educators to enhance their professional growth and impact.
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In terms of how better to prepare society to help the military meet a possible surge in recruitment needs, Friedl mentioned a potential initiative in Switzerland to provide a fitness tracking system to all prospective male recruits of high school age to provide guidance during the year before they would enter basic training. Citing the high percentage of age-eligible individuals who do not meet military recruitment standards, another participant argued that the military should advocate for society's shared responsibility for raising awareness
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The relationship is not observed in operational units, he continued, explaining that when one controls for physical fitness in basic training, the relative risk "goes from 2.5 to 3 times higher to almost 1 to 1 … maybe 1.2 or 1.3. Our suspicion is that it is mostly related to physical fitness." Asked about the nature of the injuries observed in basic training, Jones responded that 70 to 80 percent are lower-extremity injuries, due mostly to overuse.
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