Weight Management State of the Science and Opportunities for Military Programs (2003) / Chapter Skim
Currently Skimming:
6 Programmatic and Research Recommendations
6 Programmatic and Research Recommendations
Pages 125-142
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From page 125... ...
weight-for-height and body-fat standards currently means that an estimated 13 to 18 percent of young men between the ages of 17 and 20 and 17 to 43 percent of young women in this age group would fail to meet military standards for accession (Nolte et al., 2002~. While this situation will-certainly have a negative impact on DOD's ability to meet recruitment goals, the fact that accession standards exist also offers an extremely unique opportunity to develop and study interventions to prevent weight gain.
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From page 126... ...
If the military made a commitment to nutrition education and physical activity as part of the "military lifestyle," generations of young people would have a high possibility of adopting good nutrition and exercise habits as a part of expected behavior. The military currently expects and demands a commitment to physical fitness that far surpasses that which is customary in the civilian population, and recruits change behavior dramatically in regard to physical fitness.
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From page 127... ...
Structured Exercise Current DOD policy dictates regular exercise as part of duty time, but this policy is routinely ignored due to time pressures. Enforcement of these policies by DOD or, for example, by holding commanders accountable for their units' achieving a minimum average level of performance on the physical fitness test, would engage commanders in the quest for routine exercise and attainment of physical fitness.
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From page 128... ...
The competitions should require participation by the entire unit and could include activities such as comparisons of the unit-wide average performance on annual physical fitness tests. Competition among companies or battalions would necessitate that all individuals take part and would require nonmar~dated exercise to attain peak performance.
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From page 129... ...
the price of fresh fruit and other lowcalorie snacks encourages healthier eating behavior. RECOMMENDATIONS ON PREVENTION Each service should provide its members training on diet and health, including the fundamentals of energy balance, the caloric content of common foods, portion sizes, and the importance of maintaining high levels of daily activity even after intensive training periods (e.g., initial entry training)
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From page 130... ...
ASSESSMENT The reissued instruction, DOD Physical Fitness and Bow Fat Program Procedures, states that "service members shall maintain physical readiness through appropriate nutrition, health, and fitness habits," and that "aerobic capacity, muscular strength, muscle endurance and desirable body-fat composition" form the basis for the military's relevant programs (DOD, 2002~. This policy also mandates that all service members, regardless of age, will be formally evaluated and tested for the record at least once annually unless under medical waiver.
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From page 131... ...
Identifying potential risk factors for weight gain (e.g., overweight at time of accession, family history of obesity, poor initial performance on physical fitness test, a weight gain of more than 5 percent over initial entry training weight) may help identify individuals who are at risk.
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From page 132... ...
Performance It is recognized that implementation of the new DOD policy requires that specific physical fitness standards for occupation specialties be established, and that once these standards are identified, physical fitness training and testing would be linked to occupational requirements. This should benefit personnel needs as performance can not always be linked to compliance with standards.
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From page 133... ...
the critical components of the programs should be uniform across the services so that all personnel who are referred to such programs obtain equal assistance, and (2) the personnel administering these programs should have training in weightmanagement principles with respect to diet, physical activity, and counseling on behavior modification.
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From page 134... ...
Although there is still considerable controversy over the ideal macronutrient distribution of a hypocaloric-balanced diet, recent evidence suggests that there may be some benefits to diets with a higher ratio of protein to carbohydrate in terms of stabilization of blood glucose, maintenance of lean body mass during weight loss, and better satiety. In a recent comprehensive review, Astrup and coworkers (2002)
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From page 135... ...
Because military personnel must be combat-ready and side effects and interactions of supplements are largely unknown, personnel should be advised against the use of weight-loss supplements. Physical Activity A weight-reduction strategy based solely upon an increase in~physical activity (in the absence of calorie restriction)
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From page 136... ...
The physical activity component of a weight-loss program should include both structured and unstructured exercise (e.g., aerobics, strength training, increased activities of daily living)
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From page 137... ...
A combination of aerobic and strength training exercise, along with increased activities of daily living, is recommended. Energy expended in physical activity should be at least 200 to 300 min/wk of moderate intensity exercise (3.5-5 fur)
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From page 138... ...
RECOMMENDATIONS ON A WEIGHT-MANAGEMENT MILITARY OCCUPATIONAL SPECIALTY Weight-control training programs should be established to train a multidisciplinary team of personnel associated with implementing weight-loss and weight-maintenance programs. Training standards for a weight-management military occupational specialty should include training in the principles of: - Nutrition - Physical activity/exercise - Behavior modification - Weight-loss aids (e.g., counseling, mentoring, psychological support)
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From page 139... ...
Evaluation of Existing Military Initiatives and Programs for Effectiveness Evaluation of military weight-management programs is essential to determine their effectiveness. Recommendations provided in this report are based almost exclusively on data collected in civilian populations; effectiveness may be quite different in military populations.
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From page 140... ...
Evaluation of the Use of Dietary Supplements and Herbal Remedies Many nonprescription preparations are being used for weight loss by the civilian population and are undoubtedly being used in the military population. Very little is known about their effects on body weight, body composition, overall health, and physical performance.
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From page 141... ...
· Does competency in estimating portion sizes lead to less maternal weight gain and more rapid return to prepregnancy body weight and body composition?
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From page 142... ...
lead to a more rapid return to prepregnancy body weight and body composition? Genetic Screening Currently, there are about 250 genes and gene markers that have been identified as associated with human obesity (Rankinen et al., 2002~.
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