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of health, is recommended to be 19 to 25,4 independent of age. Individuals whose BMI falls within the desirable range and who pass the fitness test need no further screening. Individuals with a BMI greater than 25 should be subjected to a second tier of screening, based on body fat assessment. The committee believes that women with BMIs less than 19 can be fit to perform. However, as BMI decreases below 19, women may be at risk for malnutrition and should be considered for medical evaluation.
Individuals whose body fat is assessed at 36 percent or less and who pass the fitness test will be considered within standard. Individuals whose body fat exceeds 30 percent and who fail the fitness test will be referred to weight management and fitness programs. Individuals whose body fat exceeds 36 percent will be referred to a weight management program, regardless of fitness score.
The BCNH committee also recommends development of a single service-wide equation derived from circumference measurements for assessment of women's body fat, to be validated against a four-compartment model using a population of active-duty women or a population that is identical in ethnic and age diversity to that of military women. Development and validation of this equation may result in reconsideration of the recommended BMI cut-offs, in part as a result of establishing the measurement error.
The BCNH committee recommends an increasing emphasis on general fitness for health and readiness by enforcing uniformly across all services and MOSs regular and monitored participation in a fitness program consisting of a minimum of 3 d/wk of endurance exercise at 60 to 80 percent of maximum capacity for 20 to 60 minutes and 2 d/wk of resistance exercise using all major muscle groups at 85 percent of one repetition maximum (ACSM, 1990). Such a program, in addition to promoting fitness, assists in maintenance of weight and FFM and may result in lower body fat. Periodic fitness and body composition testing adjusted appropriately for gender should be conducted to determine both endurance and strength and should be similar across all services. More frequent testing would promote continuous adherence to weight and physical fitness programs and decrease injurious behaviors that result from efforts to pass performance and body composition tests.
The committee further recommends development of task-specific, gender-neutral strength and endurance tests and standards for use in the determination of placement in MOSs that require moderate and heavy lifting. Additional fitness programs should be created and enforced to develop and maintain the strength, endurance, and flexibility required by these MOSs.
The BCNH committee recommends that, in view of the association between FFM (as an indirect indicator of skeletal muscle mass) and strength, the military consider developing an appropriate minimum recommended BMI for accession of women.
The current appearance standard does not appear to be linked to performance, fitness, nutrition, or health. The BCNH committee recommends that if the military deems appearance standards to be necessary, objective criteria (that do not discriminate on the basis of ethnicity) should be developed and utilized.
4
Table S-2 shows the BMIs corresponding to current Army weight limits for women. Table S-3 shows the weight ranges that correspond to the recommended BMI range of 19 to 25.
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