Understanding and Overcoming the Challenge of Obesity and Overweight in the Armed Forces Proceedings of a Workshop (2018) / Chapter Skim
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3 Service-Specific Issues Related to Obesity and Overweight
3 Service-Specific Issues Related to Obesity and Overweight
Pages 23-32
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From page 23... ...
the lack of baseline knowledge about personal fitness and nutrition among soldiers and of a minimal nutrition education requirement in the military's con tinuing education pathway, (2) a dynamic work environment that often forces service members to adapt to new and different 23
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TRENDS IN WEIGHT CHANGE IN VETERANS WITH AND WITHOUT DIABETES Margery Tamas, editorial manager at the Institute for Medical and Nursing Education, opened her presentation on trends in weight change among veterans with and without diabetes by reminding participants that weight gain is a risk factor for diabetes and may complicate its management. She began by noting that the Veterans Health Administration (VHA)
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She began by highlighting the mutual struggles of the Navy's reserve and active components, including family needs and difficulty finding time for physical fitness. Within the older, mixed-age reserve population, she cited the need to balance military and civilian careers and the occurrence of dieting right before physical fitness testing.
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From page 26... ...
McCafferty then listed a number of health programs and activities for members of the Navy Reserve: • Crews into Shape, an annual team challenge in which each crew member earns points for exercising, maintaining or achieving a goal weight, eating fruits and vegetables, and engaging in other healthy behaviors; • Soar into Shape, a 12-week program that begins with a baseline Body Composition Assessment (BCA) and includes incentives and weekly clinics, along with a repeat BCA; • ShipShape, a 6-month course offered at six Navy medical treatment facilities that includes weekly sessions for the first 2 months, fol lowed by monthly visits; • Monthly mandatory Physical Readiness Test sessions, often incor porated as one of the two monthly drill sessions; • The Navy Fitness Enhancement Program, a mandatory exercise and nutrition program for individuals who fail their PFA; and • Navy One Source, a venue for phone-based health promotion counseling.
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From page 27... ...
and make roughly four times as many clinic visits during training.1 In addition, she continued, trainees with 1.5-mile run times in the bottom quartile are nearly six times more likely to sustain a stress fracture.2 She speculated about underlying diet inadequacies within the general population from which trainees are recruited, and whether micronutrient deficiencies contribute to substandard bones. Clark shared anecdotes about military members who drastically changed their dietary or physical activity behaviors to enter the military and then struggled to maintain similar habits throughout their careers, affecting both their home and work lives.
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She stressed the importance of having people enter the services with a healthy body weight and fitness appropriate to meeting the challenges they will face, thus advocating for establishing a foundation of health before talking about enhancing performance. ARMY Major Kayla Ramotar, command dietitian and Army holistic health and fitness action officer at the Army's Training and Doctrine Command, described her experience working on a team tasked by the chief of staff and secretary of the Army in 2015 to examine underlying issues affecting the health and performance readiness of the force.
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She stressed the importance of imparting knowledge and strategies for applying it throughout members' military careers. According to Ramotar, accomplishing this will require training personnel throughout various units and levels to be informed messengers of the education and training provided by the armed forces' limited health professional workforce.
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Even with a waiver, McGuire explained, applicants still must be no more than 11 percent above and no more than 7 percent below retention weight, and they must also pass an initial physical fitness test. He added that graduation from boot camp requires meeting retention standards.
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McGuire emphasized the need to educate command leadership about the evidence supporting healthy lifestyle interventions, such as proper postworkout nutrition. Ramotar mentioned an upcoming effort to embed medical personnel, including a registered dietitian, physical therapist, and occupational therapist, in operational units where they can carry out the cognitive, physical, and nonphysical programming necessary to make a long-term impact on health and performance readiness.
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A participant asked how evidence-based interventions to change behavior are being translated from the civilian literature and disseminated to the military population, including those in the reserves and others who do not live on a military installation. Ramotar replied that, instead of relying on one health professional, the Army is working on training and equipping members down to the lowest unit levels to be "advocates and extenders" of information.
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