performance of military personnel. Also recommended was evaluation of the long-term outcome of individuals referred to military weight management programs for failure to adhere to standards.

At the autumn 1994 conference of DACOWITS, one of the concerns identified by the group was the need to address the body composition and physical fitness standards of the military and the impact of these standards on the health of women, particularly with regard to the potential influence of the standards on food intake and nutritional status. A report released by the IOM in 1995 to provide recommendations for research on the health of military women identified a number of gaps in research pertaining to the health and performance of military women. These included research on optimal physical fitness for military women, injury prevention, and ways to achieve and assess physical fitness, as well as fitness standards, including those for fitness during pregnancy and the postpartum period.

In 1995, in light of efforts to consider creation of DoD-wide fitness and body composition standards, calls to ensure that all personnel are physically able to perform their assigned tasks, and evidence suggesting that attempts to adhere to body composition and appearance standards may place active-duty women at special risk for inadequate nutrient intake, the CMNR was asked to appoint a subcommittee to examine issues of body composition, fitness, and appearance standards and their impact on the health, nutritional status, and performance of active-duty military women. Specifically, they were asked by the Army to address the following questions:

•  What body composition standards best serve military women's health and fitness, with respect to minimum lean body mass, maximum body fat, and site specificity of fat deposition? Are the appearance goals of the military in conflict with military readiness?
•  Should any part of the Military Recommended Dietary Allowances (MRDAs) be further adjusted for women? Should there be any intervention for active-duty women with respect to food provided, dietary supplementation, or education?
•  What special guidance should be offered with respect to return-to-duty standards and nutrition for women who are pregnant or breastfeeding?  

In April 1996, the CMNR convened a subcommittee comprising experts in the areas of body composition, exercise physiology, obesity, women's nutrition, epidemiology and survey design, cognitive psychology, and pregnancy and lactation. Several members of the parent committee were included to provide continuity. The subcommittee was designated the Committee on Body Composition, Nutrition, and Health of Military Women (BCNH committee).

In considering the questions posed by the military, the subcommittee consulted with a liaison panel composed of military researchers and health care personnel. A workshop was convened in September 1996 to bring together additional military personnel in the areas of physical fitness assessment, training, medicine, and nutrition, as well as civilian researchers and practitioners in the areas of physical fitness and performance, pregnancy, eating disorder assessment, and

Front Matter (R1-R16)

Executive Summary (1-24)

1 Introduction (25-32)

2 Body Composition (33-60)

3 Physical Fitness Policies and Programs (61-86)

4 Weight Management (87-108)

5 Nutritional Concerns of Military Women (109-126)

6 Pregnancy and Lactation and Postpartum Return-To-Duty Fitness (127-156)

7 Conclusions and Recommendations (157-170)

Appendixes (171-172)

A Workshop Summary, Agenda, Participants, and Abstracts (173-252)

B Practices and Policies Tables (253-262)

C Military Occupational Specialty Classification Tables (263-280)

D Search Strategy for Literature Review (281-284)

E Civilian Inquiry Letter and Table of Responses (285-290)

F Abbreviations (291-294)

G Bibliography (295-334)

H Biographical Sketches (335-338)

Index (339-352)