Weight Management State of the Science and Opportunities for Military Programs (2003) / Chapter Skim
Currently Skimming:
5 Responses to the Military's Questions
5 Responses to the Military's Questions
Pages 113-124
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From page 113... ...
The greatest likelihood of success requires an integrated program, both during and after the weight-loss phase, in which assessment, increased energy expenditure through exercise and other daily activities, energy intake reduction, nutrition education, lifestyle change, environmental change, and psychological support are all components. Essential Components of an Effective Weight/Fat Loss Program The first component of an effective weight/fat loss program is an appropriate assessment.
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From page 114... ...
However, if the height and weight measurements indicate that the individual exceeds the service's standards or that the calculated BMI exceeds the newly adopted DOD maximum of 27.5, then additional anthropometric measures should be taken to assess body-fat content. DOD has extensively validated the circumference equations used to estimate percent body fat, and a single equation for men and one for women has now been mandated across all service branches (DOD, 2002~.
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From page 115... ...
For military personnel who stand to lose their livelihood if they cannot reduce their weight, options such as highprotein diets should not be precluded. Recent data suggest that these types of diets may better preserve lean body mass, lower insulin levels, and enhance energy expenditure (protein has the highest thermal effect of feeding)
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From page 116... ...
Sustaining Weight Loss Most studies in which patients are not provided weight-maintenance assistance following achievement of weight-loss goals show that complete weight regain will occur in a majority of the patients within 5 years (Stalonas et al., 1984; Wadden et al., 1989~. A recent review of studies on the effectiveness of weight-maintenance strategies show that programs that incorporate continued professional guidance, skills training for coping with challenges, enhanced social support, enhanced aerobic exercise, and techniques for sustaining behavior change lower the rate of relapse (Perri et al., 1993~.
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From page 117... ...
Weight loss is more difficult with age due to decreases in physical activity, strength, and endurance without concomitant decreases in energy intake, coupled with decreases in lean body mass and increases (either absolute or relative) in percent body fat.
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From page 118... ...
The safest program designed for weight loss and maintenance is an increase of energy expenditure through exercise and daily activity coupled with control or reduction of energy intake, behavior modification, and lifestyle changes. A key factor in the control of energy intake is behavior modification—individuals who have an overweight problem have a pattern of food consumption and/or energy expenditure that contributes to positive energy balance.
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From page 119... ...
A comprehensive program that individualizes the degree of direct participation intervention will increase the success rate of weight/fat loss and support an improved level of weight maintenance. If only monitoring and guidance are provided, individuals may seek help from unqualified nonmilitary weight-loss sources or pursue other unhealthy weight-loss approaches to meet their monitoring goals.
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From page 120... ...
Given the benefits of exercise for longterm obesity prevention, long-term health outcomes, and possibly for enhanced mental performance, the military might consider mandatory exercise at fixed times each day or other schemes to ensure that the vast majority of military personnel exercise several times per week. Current DOD policy dictates regular exercise as a part of the duty day.
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From page 121... ...
. Body Composition Standards The current DOD target for body fat, with a maximum body fat of 36 percent for women and 26 percent for men, seems appropriate based on considerations of health and chronic disease risk.
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From page 122... ...
In several small studies, an increased BMI was associated with reduced performance in 1- and 2-mile runs, sit-ups, and push-ups by men, and also was associated with an increased injury rate during initial entry training. Body Composition Measurements New technologies for measuring body composition should be adopted service-wide as they become available, once they are validated for accuracy and ease of use.
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From page 123... ...
For those military personnel who are on ships or are dependent on mess halls, more healthy, low-fat food choices and sufficient time for meal consumption are imperative. In any case, nutrition and lifestyle education are paramount and should be provided early in the initial entry training period and reinforced periodically.
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From page 124... ...
This report does not address the fundamental issues of the relationship of body weight/fat standards to performance, nor does it consider the impact of military service policies on manpower needs. Additional research on the impact of modest overweight/overfat on performance in various military occupational specialties is recommended to address these issues.
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