Weight Management State of the Science and Opportunities for Military Programs (2003) / Chapter Skim
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Executive Summary
Executive Summary
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However, increases in food consumption and decreases in daily activity have raised new concerns about the impact of overnutrition and fatness on overall health, physical fitness, and military performance. BACKGROUND AND CHARGE TO THE COMMITTEE Considerable attention has been given to the alarming rise in the incidence of overweight and obesity in the U.S.
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The subcommittee was charged to identify the most effective interventions for weight loss and weight maintenance, particularly those most pertinent to the nonobese overweight individuals (BMI 25.~29.9) found in the military setting, to evaluate the interventions' appropriateness for military application or the need for further research, and to develop a consensus toward a more standard DODwide approach to weight management that utilizes state-of-the-art knowledge and practices.
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Typically, the various branches of the military service have had two sets of weight/fat standards: one set to be met by potential recruits for accession into initial entry training and another equivalent or more stringent set to be retained in the service once admitted. The initial body composition screen consists of a weight-for-height assessment.
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. Genetics Individuals appear to show significant heterogeneity in their body weight and body fatness responses to altered energy balance, dietary components, and changing activity levels, although little is yet known about the specific causes of heterogeneity.
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In contrast to body fat, skeletal muscle mass declines with age beginning around the third decade, and losses of skeletal muscle parallel decreases in bone mass. The mechanisms of body composition changes that accompany aging are multifactorial and include physical inactivity, diet, and hormonal alterations.
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Social and Environmental Factors Other factors that contribute to overweight both in the military and in civilian populations include meal patterns and eating habits, familial and ethnic factors, cultural norms, socioeconomic status, smoking, alcohol consumption, use of certain common drugs such as anti-allergens, and the use of antidepressants, hypoglycemic agents, and certain antihypertensive agents. Members of the military population with unusually sedentary job responsibilities and a work environment that promotes a combination of high-pressured, hasty, and thoughtless overeating along with inactivity are likely to be particularly at risk for weight gain.
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· Priority consideration should be given to commercial eating establishments that routinely offer reasonable portion sizes and low-fat dining options when these establishments are competing for base contracts. Assessment · Assessments for weight-for-height and percent body fat should be conducted quarterly rather than annually or semi-annually.
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Training standards for a weightmanagement military occupational specialty should include training in principles of nutrition, portion control, physical activity/exercise, behavior modification, psychological support, and the use of weight-loss aids. The program should also include mandated continuing education requirements.
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Very little is known about their effects on body weight, body composition, overall health, and physical performance. It is particularly important to assess the use of such preparations as well as their effects on military performance.
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Research indicates that percent body fat increases with age even if weight does not change. The current upper limits of DOD standards of 26 percent fat in men and 36 percent fat in women, however, is well within the limits of the
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Gender On average, women have a higher percent body fat than men. Weight gain and lifestyle changes during the childbearing and childrearing years, as well as the hormonal and metabolic changes that accompany pregnancy and menopause, are associated with higher body fat.
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A weight-loss program should be viewed as treatment for a medical condition and be given comparable priority as treatment for other medical conditions. Since current DOD policy dictates regular exercise as a part of duty time, unit commanders should provide (or require)
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A standardized program across all services would be more efficient and could be easily accessed by military personnel regardless oftheir duty assignment.
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that are less energy-dense; increasing the price of foods high in calories, fat, and refined carbohydrates; and subsidizing the price of fresh fruits and low-calorie snacks in vending machines and exchange service facilities should be considered. In any case, nutrition and lifestyle education is paramount and should be provided early in the initial entry training period and reinforced periodically.
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Scheduling competitions that require participation by the entire unit and that require unstructured exercise to attain peak performance could be tested as a method to improve overall fitness and activity. The usefulness of resistance or strength training and the optimum mix of aerobic and strength training for the purpose of weight management needs to be evaluated among military personnel.
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The prevalence of bulimia, binge eating disorder, and anorexia nervosa in military personnel and whether the military lifestyle and standards promotes such behavior needs to be determined. Computerized Follow-Up of Personnel at Risk An independent, computerized database is needed to identify individuals with risk factors for weight gain or overweight as described above, and to maintain routine contact with these individuals to check on their weight or physical fitness status, to identify problems early, and to intervene as needed.
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