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BODY COMPOSITION
AND
PHYSICAL PERFORMANCE
Applications for the Military Services
Committee on Military Nutrition Research
Food and Nutrition Board
Institute of Medicine
Bernadette M. Marriott and Judith Grumstrup-Scott, Editors
NATIONAL ACADEMY PRESS
Washington, D.C. 1992
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NATIONAL ACADEMY PRESS · 2101 Constitution Avenue, N.W. · Washington, D.C. 20418
NOTICE: The project that is the subject of this report was approved by the Governing Board
of the National Research Council, whose members are drawn from the councils of the National
Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
The members of the committee responsible for the report were chosen for their special compe-
tences and with regard for appropriate balance. Part I of this report has been reviewed by a
group other than the authors according to procedures approved by a Report Review Committee
consisting of members of the National Academy of Sciences, the National Academy of Engi-
neering, and the Institute of Medicine.
The Institute of Medicine was established in 1970 by the National Academy of Sciences
to enlist distinguished members of the appropriate professions in the examination of policy
matters pertaining to the health of the public. In this, the Institute acts under both the Acade-
my's 1863 congressional charter responsibility to be an adviser to the federal government and
its own initiative in identifying issues of medical care, research, and education.
This report was produced under grants DAMD17-86-G-6036/R and DAMD17-92-J-2003
between the National Academy of Sciences and the U.S. Army Medical Research and Develop-
ment Command. The views, opinions, and/or findings contained in chapters in Part II authored
by U.S. Army personnel are those of the authors and should not be construed as official
Department of the Army position, policy, or decision, unless so designated by other official
documentation. Human subjects who participated in studies described in those chapters gave
their free and informed voluntary consent. Investigators adhered to U.S. Army regulation 25
and United States Army Medical Research and Development Command regulation 70-25 on
use of volunteers in research. The chapters are approved for public release; distribution is
unlimited.
Library of Congress Catalog Card No. 92-60574
International Standard Book Number 0-309-04586-X
Additional copies of this report are available from:
National Academy Press
2101 Constitution Avenue, N.W.
Washington, D.C. 20418
S450
Copyright 1992 by the National Academy of Sciences
Printed in the United States of America
The serpent has been a symbol of long life, healing, and knowledge among almost all
cultures and religions since the beginning of recorded history. The image adopted as a logo-
type by the Institute of Medicine is based on a relief carving from ancient Greece, now held by
the Staatlichemuseen in Berlin.
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COMMITTEE ON MILITARY NUTRITION RESEARCH
ROBERT O. NESHEIM, (Chair), Monterey, California
RICHARD L. ATKINSON, Department of Internal Medicine, Veterans
Administration Medical Center, Hampton, Virginia
ANDRE BENSADOUN, Division of Nutrition Science, Cornell University,
Ithaca, New York
WILLIAM J. EVANS, Human Physiology Division, U.S. Department of
Agriculture, Human Nutrition Center on Aging, Tufts University,
Boston, Massachusetts
JOEL A. GRINKER, Program in Human Nutrition, Schoo] of Public
Health, University of Michigan, Ann Arbor
EDWARD S. HORTON, Department of Medicine, University of Vermont,
College of Medicine, Burlington
G. RICHARD JANSEN, Department of Food Science and Human
Nutrition, Colorado State University, Fort Collins
GILBERT A. LEVEILLE, Nabisco Brands Incorporated, East Hanover,
New Jersey
JOHN A. MILNER, Department of Nutrition, Pennsylvania State
University, State College, Pennsylvania
JOHN E. VANDERVEEN, Division of Nutrition, Food and Drug
Administration, Washington, D.C.
ALLISON A. YATES, College of Health and Human Sciences,
University of Southern Mississippi, Hattiesburg
Food and Nutrition Board Liaison:
JOHANNA T. DWYER, Frances Stern Nutrition Center, New England
Medical Center Hospital, Boston, Massachusetts
Committee on Military Nutrition Research U.S. Army Grant Officer
Representative:
COL ELDON W. ASKEW, U.S. Army Research Institute of Environmental
Medicine, Natick, Massachusetts
Stay
BERNADETTE M. MARRIOTT, Program Director
JUDITH GRUMSTRUP-SCOTT, Editor
VALERIE McCADDON BREEN, Project Assistant
. . .
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FOOD AND NUTRITION BOARD
M. R. C. GREENWOOD (Chair), Office of Graduate Studies, Un
California, Davis, California
DONALD B. McCORMICK (Vice Chair), Department of Biochemistry,
Emory University School of Medicine, Atlanta, Georgia
DeWITT S. GOODMAN (Vice Chair) (deceased)," Institute of Human
Nutrition, Columbia University, New York, New York
PERRY L. ADKISSON,* Department of Entomology, Texas A&M
University, College Station, Texas
LINDSAY ALLEN, Department of Nutritional Sciences, University of
Connecticut, Storrs, Connecticut
DENNIS M. BIER, Pediatric Clinical Research Center, Washington
University School of Medicine, St. Louis, Missouri
EDWIN L. BIERMAN,t Division of Metabolism, Endocrinology, and
Nutrition, University of Washington, Seattle, Washington
MICHAEL P. DOYLE, Department of Food Science and Technology,
Georgia Experiment Station, University of Georgia, Griffin, Georgia
JOHANNA T. DWYER, Frances Stern Nutrition Center, New England
Medical Center Hospital, Boston, Massachusetts
JOHN W. ERDMAN, Jr., Department of Food Science and Division of
Nutritional Sciences, College of Agriculture, University of Illinois,
Urbana, Illinois
NANCY FOGG-JOHNSON, Consumer Healthcare Division, Miles, Inc.,
Elkhart, Indiana
CUTBERTO GARZA, Division of Nutritional Sciences, Cornell University,
Ithaca, New York
K. MICHAEL HAMBIDGE, Department of Pediatrics, University of
Colorado Medical Center, Denver, Colorado
JANET C. KING, Department of Nutritional Sciences, University of
California, Berkeley, California
JOHN E. KINSELLA, School of Agriculture and Environmental Sciences
University of California, Davis, California
LAURENCE N. KOLONEL, Cancer Center of Hawaii, University of
Hawaii, Honolulu, Hawaii
SANFORD A. MILLER, Graduate Studies and Biological Sciences,
University of Texas Health Science Center, San Antonio, Texas
MALDEN C. NESHEIM, Office of the Provost, Cornell University,
Ithaca, New York
ROY M. PITKIN (Ex Officio, Department of Obstetrics and Gynecology,
School of Medicine, University of California, Los Angeles, California
. . ~
Verity of
IV
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STEVE L. TAYLOR (Ex Officio), Department of Food Science and
Technology, University of Nebraska, Lincoln, Nebraska
Staff
CATHERINE E. WOTEKI, Director
MARCIA S. LEWIS, Administrative Assistant
SUSAN M. WYATT, Financial Associate
*Member, National Academy of Sciences
"Member, Institute of Medicine
v
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Preface
This publication on body composition and physical performance is an-
other from a series of workshops that have been sponsored by the Commit-
tee on Military Nutrition Research (CMNR, the Committee) of the Food and
Nutrition Board, Institute of Medicine, National Academy of Sciences. Other
workshops or mini-symposia have included such topics as nutrition and
physical performance, cognitive testing methodology, and fluid replacement
and heat stress. These workshops are a part of the response the CMNR
provides to the Assistant Surgeon General of the U.S. Army (U.S. Army
Medical Research and Development Command, Frederick, Maryland) to is-
sues that are brought to the Committee through the Military Nutrition Divi-
sion of the U.S. Army Institute of Environmental Medicine (USARIEM) at
Natick, Massachusetts.
FOCUS OF THE REPORT
The relationship of body composition to performance of physical tasks
is of major interest to the military. Not only is it important in the decisions
of acceptance or rejection of recruits for military service, but it also has
significant implications for the individual relating to retention and advance-
ment while in the services. There are financial implications as well for the
military services, due to the high cost of training replacements when indi-
viduals are discharged for failure to meet the established standards. The
discharge of highly trained and experienced specialists has significant addi-
tional implications concerning unit readiness and performance.
The application of body composition standards in the military on a
. .
V11
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. . .
V111
PREFACE
rational and equitable basis based on ethnicity, gender, and age is therefore
an important issue. A perspective on the current outcome of the applica-
tions of height, weight, and body composition standards for entrance or
retention in the military services was succinctly stated by James A. Vogel,
Director, Occupational Health and Performance, USARIEM, in his intro-
ductory remarks to the workshop, which was held February 6, 1990 at the
National Academy of Sciences, Washington, D.C.
Every day potential new Army recruits are turned away at the recruiter's
door for the reason of overweight or overfatness. Ironically, they often go
next door to the Navy or Air Force recruiter where they are accepted. I am
referring to young women who are unable to meet the Army's entry stan-
dard for body weight.
An outsider might assume that the services have weight-fat standards to
ensure that personnel can meet the physical demands of military service,
that is, that they are performance driven. This may only be partially true.
In the Army, at least, it is apparent that an important factor in the Army's
fat standards is appearance. The Navy, on the other hand, has established
health criteria as important for its body fat standards. Are appearance and
health criteria compatible with physical performance criteria? These ques-
tions lead us to our goals for this workshop:
1. What is the relationship between body composition and physical per-
formance in terms of the military's needs?
2. Can the service's needs in performance, appearance, and health be
blended together in a body composition standard?
3. When the services already have performance standards (various fitness
and occupational tests), do we also need a body composition standard?
Those of us within the services who are dealing with weight and fat
standards need to revisit this issue-at a theoretical and mechanistic level,
at a practical or job task level, and at a population and policy level.
We cannot look at this body composition issue in isolation. So in ad-
dress~ng our goals, we must consider them in the military context where
other factors come into play.
The proceedings of this workshop are published here to provide a) a
review of current knowledge on the relationship of body composition to
physical performance, b) a discussion of the application of this data base to
accession and retention standards in the military services, and c) an evalua-
tion and recommendations for consideration by the military in relating body
composition to physical performance. While the Committee on Military
Nutrition Research recognizes that body composition, physical performance,
and health status are closely linked to the amounts and types of foods
ingested, a comprehensive discussion of nutrition as related to body com-
position and performance was deemed to be beyond the scope of this
workshop. The CMNR has limited the report to a review of the scientific
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PREFACE
IX
evidence relating physical performance to body weight and composition. It
is anticipated that this information will aide the military in establishing
body composition standards that are more appropriate to the task perfor-
mance requirements of military personnel. In addition, the information
from this workshop may be of more general interest to those civilians
concerned with establishing physical testing criteria for jobs requiring
minimum physical performance standards.
HISTORY OF THE COMMITTEE
The Committee on Military Nutrition Research (CMNR) was estab-
lished in October, 1982 when the Assistant Surgeon General of the U.S.
Army requested the Food and Nutrition Board (FNB), National Academy of
Sciences, to establish a committee to advise on the need for and conduct of
nutrition research and related issues for the U.S. Department of Defense.
The overall tasks of the Committee are
· to identify nutritional factors that may critically influence the physi-
cal and mental performance of military personnel under all environmental
extremes,
· to identify deficiencies in the existing database,
· to recommend research that would remedy these deficiencies,
· to recommend approaches for studying the relationship of diet to
physical and mental performance, and
· to review and advise on standards for military feeding systems.
Within this context the CMNR was asked to focus on nutrient require-
ments for performance during combat missions rather than requirements for
military personnel in garrison, because the latter were judged not to differ
significantly from those of the civilian population.
Although the Committee membership has changed periodically, the dis-
ciplines represented have consistently included human nutrition, nutritional
biochemistry, performance physiology, food science, and psychology. When
issues have been presented to the CMNR by the Army that require broader
expertise than what exists within the Committee, or for which the Committee
would like additional information or opinions, workshops have been con-
vened. These workshops provide additional state-of-the-art scientific informa-
tion for the Committee to consider in their evaluation of the issues at hand.
COMMITTEE TASK AND PROCEDURES
In 1989, personnel from USARIEM raised the question with the CMNR
of the relationship of body composition to physical performance. Of partic-
ular interest was the application of then current height-weight standards in
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x
PREFACE
recruitment and retention of military personnel to the performance of mili-
tary tasks. Although the tasks of military personnel are increasingly di-
verse, the Army contends that all individuals need to maintain a certain
level of physical fitness to preserve the combat readiness of the services in
general. However, with the increasing diversity of military personnel in
terms of gender, ethnicity, and age, there was a concern whether current
standards were appropriate and were uniformly applied in recruitment and
retention. The applicability of these standards to the mission requirements
of the services was also questioned. The CMNR reviewed these issues and
concluded that a workshop was needed to review the literature, provide
additional information on military standards, provide the most current re-
search findings from within the Army related to this issue, and hear inter-
pretation of this issue from experts in related fields.
A small planning group was given the task of identifying the pertinent
topics and the participants. This task force, comprised of Cot. E. Wayne
Askew and James A. Vogel of USARIEM and CMNR members Ed Horton,
Richard Atkinson, Robert O. Nesheim, and FNB Staff Officer Susan Berkow,
met at USARIEM in the fall of 1989 to plan the workshop. The workshop
outline and participants were reviewed by the CMNR at its December 1989
meeting, and the workshop was held February 6, 1990, at the National
Academy of Sciences in Washington, D.C.
The invited speakers were chosen for their specific expertise in the areas
of body composition, performance, and obesity. They were asked to provide
in-depth reviews of their area of expertise as it directly applied to a series of
questions prepared by the CMNR and make recommendations on the issues.
Speakers subsequently submitted written versions of their presentations.
The workshop format was a formal presentation by a speaker followed
by questions and a brief discussion with Committee members and other
participants. At the end of the presentations, a general discussion of the
overall issues was held. The next day, the CMNR met in; executive session
to review the various issues, draw some tentative conclusions, and make
assignments for draft reviews and summaries of specific topics by various
Committee members. An initial summary paper discussing some of the
issues was prepared by one of the Committee members, Joel Grinker, to
aide the CMNR in focusing the draft recommendations (See Part III). A
subcommittee composed of Joel Grinker, Richard Atkinson, and Richard
Jansen worked separately and together using the authored papers and addi-
tional reference material to draft the summary and recommendations that
were reviewed and approved by the CMNR.
The summary and recommendations of the CMNR are included as Part
I, and the papers presented at the workshop are included as Part II of this
book. Part I has been reviewed anonymously by an outside group with
expertise in the topic area and experience in military issues. The authored
papers in Part II and Joel A. Grinker's paper in Part III have undergone
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PREFACE
Xl
limited editorial change, have not been reviewed by the outside group, and
represent the views of the individual authors.
ACKNOWLEDGMENTS
As Committee chair I wish to acknowledge the assistance of the FNB
staff: Susan Berkow, who participated in planning and organizing the work-
shop prior to her leaving the FNB, Al Lazen, Ph.D., former acting director
of the FNB for his considerable contribution acting as staff officer during
the workshop and in the interim before Bernadette Marriott joined the FNB
as program officer for the CMNR. Bernadette's strong technical assistance
and organizational skills have been a major factor in pulling the proceed-
ings together and bringing them to publication. I appreciate the extensive
work of Joel Grinker in preparing the discussion paper that focused Com-
mittee discussion on essential areas of concern. I particularly want to ac-
knowledge the major inputs by Richard Atkinson in drafting an initial re-
view of the proceedings and Richard Jansen in bringing together the various
sections provided by Committee members into a consistent format. The
Committee is grateful for their joint effort in drafting, reviewing, and edit-
ing the summary, conclusions, and recommendations.
I also wish to acknowledge on behalf of the Committee, the assistance of
James Vogel and others from his division at USARIEM and Cot. Askew and
his group at USARIEM. The insightful comments of Cot. David Schnaken-
berg during the workshop were also useful to the Committee in summarizing
the proceedings. Major Karl E. Friedl was particularly helpful in providing
the Committee with current information on recent changes in Army regula-
tions. The critiques of the reviewers, Cathie Woteki, and FNB CMNR liaison,
Johanna Dwyer, provided helpful insight to the development of this final
document. The editorial efforts of Judith Grumstrup-Scott are gratefully ac-
knowledged. The Committee is also grateful to Vicki L. Friedl, History Bibli-
ographer, Mugar Library, Boston University, for her research and suggestions
about reference styles for government documents. The assistance of Connie
Rosemont, FNB research assistant, and Valerie Breen, CMNR project assis-
tant, in word processing, editing, and proofreading this report is greatly appre
ciated.
Finally, I wish to acknowledge the individual and collective contribu-
tions of the Committee members. They represent a fine, unselfish example
of busy professionals volunteering their limited time for the consideration
of issues important to our national defense. I am stimulated by the exper-
tise and dedication of this group as we work together on CMNR business.
ROBERT O. NESHEIM, Chairman
Committee on Military Nutrition Research (CMNR)
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Contents
I O VERVIE W 1
1 Introduction and Background........
2 Conclusions and Recommendations
II INVITED PAPERS..................................
3 Body Composition and Military Performance: Origins
of the Army Standards .................................
Karl E. Friedl
4 Body Composition in the Military Services: Standards
and Methods...................................
James A. Hodgdon
5 Effects of Experimental Alterations in Excess Weight
on Physiological Responses to Exercise and Physical
Performance ...................................
Kirk J. Cureton
6 Army Data: Body Composition and Physical Capacity
James A. Vogel and Karl E. Friedl
The Relationship of Body Size and Composition
to the Performance of Physically Demanding
Military Tasks ................................
Everett A. Harman and Peter N. Frykman
8 New Approaches to Body Composition Evaluation and
Some Relationships to Dynamic Muscular Strength.
Frank I. Katch
9 Associations Among Body Composition, Physical
Fitness, and Injury in Men and Women Army Trainees
Bruce H. Jones, Matthew W. Bovee, and Joseph J. Knapik
. . .
xz''
3
25
29
31
...57
89
..105
....... 119
....141
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XlV
10 Body Composition, Morbidity, and Mortality
William Cameron Chumlea and Richard N. Baumgartner
11 Critique of the Military's Approach to Body
Composition Assessment and Evaluation.......
Henry C. Lukaski
12 Body Composition and Performance in Relation
to Environment ................................
Roy J. Shephard
13 Sex Differences and Ethnic/Racial Differences
in Body Size and Body Composition ...................
Stanley M. Garn
III COMMITTEE DISCUSSION PAPER .........................
14 Body Composition Measurement: Accuracy, Validity,
and Comparability...........................
Joel A. Grinker
APPENDIXES ..................................
A Accession Standards for the Military Services
B Retention Standards for the Military Services.
C Weight-for-Height Tables ..........................
D Proposed Revisions to Accession (AR 40-501) and Reten-
tion (AR 600-9), Body Weight and Body Fat Standards
Recent Changes to the U.S. Army Standards
for Accession and Retention
Biographical Sketches......
CONTENTS
175
185
195
207
221
223
237
...... 239
247
341
345
...... 347
............................. 351
