Body composition changes during 8 weeks of military training are not accurately captured by circumference-based assessments

Foulis, Stephen A.; Friedl, Karl E.; Spiering, Barry A.; Walker, Leila A.; Guerriere, Katelyn I.; Pecorelli, Vincent P.; Zeppetelli, David J.; Reynoso, Marinaliz; Taylor, Kathryn M.; Hughes, Julie M.

doi:10.3389/fphys.2023.1183836

Cited by 4 publications

(3 citation statements)

References 17 publications

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“…Our own – so far unpublished – echo-MRI data show body fat percentages ranging from 2.4% to 20% among special forces soldiers, who would have been classified as overweight according to BMI criteria (BMI ≥ 25 but < 30 kg/m 2 ). However BMI might not be a sufficiently sensitive measure for body fat monitoring after athletic training interventions [ 26 , 27 ]. Additionally, being overweight as indicated by increased BMI may be characterized, at least in part by slightly increased body fat, which may not be linked to an increased cardiovascular or metabolic health risk.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, being overweight as indicated by increased BMI may be characterized, at least in part by slightly increased body fat, which may not be linked to an increased cardiovascular or metabolic health risk. A slight increase BMI (≥ 27.5–29.9 kg/m 2 ) might even be health protective against certain comorbidities among older adults [ 26 – 28 ]. Being underweight or overweight are associated with increased mortality.…”

Section: Discussionmentioning

confidence: 99%

“…While excess body fat causes concern in the general population in relation to cardiovascular and metabolic illnesses, it poses an additional problem for the military, particularly for military readiness [ 26 , 27 ]. Furthermore, Simchoni et al described a negative association between obesity and reduced cognitive performance.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of obesity and associated health risks in soldiers of the German Armed Forces

Scheit,

Schröder,

Will

et al. 2024

J Occup Med Toxicol

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Background Obesity rates are rising in the armed forces of Western democratic countries, impacting military readiness and health. This highlights the need for preventive health risk assessments and countermeasures. Methods Using mandatory health examination data from 2018 to 2022, we analyzed the prevalence of obesity, health risks, and associated specific military risk factors (rank and unit) in 43,214 soldiers of the German Armed Forces. Statistical methods included χ2 contingencies and binary logistic regressions. Results The prevalence of obesity (BMI ≥ 30) was 18.0%. Male soldiers (OR = 3.776) and those with an officer’s rank (OR = 1.244) had an increased chance for obesity. Serving in a combat unit reduced the chance of being obese (OR = .886). Considering BMI and waist circumference, 2.4% of the total sample faced extremely high cardiovascular and metabolic health risks, while 11.0% and 11.6% had very high or high health risks, respectively. Conclusions Our data underscore the importance of targeting obesity-related health risk factors in soldiers to ensure their well-being and deployment readiness.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prevalence of obesity and associated health risks in soldiers of the German Armed Forces

Scheit,

Schröder,

Will

et al. 2024

J Occup Med Toxicol

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Body composition estimation from mobile phone three-dimensional imaging: evaluation of the USA army one-site method

Florez,

Rodriguez,

Siedler

et al. 2024

Br J Nutr

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Within the USA military, monitoring body composition is an essential component of predicting physical performance and establishing soldier readiness. The purpose of this study was to explore mobile phone three-dimensional optical imaging (3DO), a user-friendly technology capable of rapidly obtaining reliable anthropometric measurements and to determine the validity of the new Army one-site body fat equations using 3DO-derived abdominal circumference. Ninety-six participants (51 F, 45 M; age: 23·7 ± 6·5 years; BMI: 24·7 ± 4·1 kg/m2) were assessed using 3DO, dual-energy X-ray absorptiometry (DXA) and a 4-compartment model (4C). The validity of the Army equations using 3DO abdominal circumference was compared with 4C and DXA estimates. Compared with the 4C model, the Army equation overestimated BF% and fat mass (FM) by 1·3 ± 4·8 % and 0·9 ± 3·4 kg, respectively, while fat-free mass (FFM) was underestimated by 0·9 ± 3·4 kg (P < 0·01 for each). Values from DXA and Army equation were similar for BF%, FM and FFM (constant errors between −0·1 and 0·1 units; P ≥ 0·82 for each). In both comparisons, notable proportional bias was observed with slope coefficients of −0·08 to −0·43. Additionally, limits of agreement were 9·5–10·2 % for BF% and 6·8–7·8 kg for FM and FFM. Overall, while group-level performance of the one-site Army equation was acceptable, it exhibited notable proportional bias when compared with laboratory criterion methods and wide limits of agreement, indicating potential concerns when applied to individuals. 3DO may provide opportunities for the development of more advanced, automated digital anthropometric body fat estimation in military settings.

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US Army Accession and Retention Standards: Impact on Obesity and Medical Readiness

Potter,

Friedl

2024

Military Medicine

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Introduction Military body fat standards were implemented in the 1980s to prevent obesity and associated poor military readiness. In the past 2 decades, enforcement of existing Army body composition standards has been eroded by the steady increase in national obesity rates, the demand for new recruits especially during the 2007 surge in Iraq, and the COVID epidemic in 2020. The diminishing qualified recruit pool puts a new focus on accession standards. The purpose of accession standards is to ensure that recruits will meet soldier standards, but accession standards have been relaxed to improve recruitment with an assumption that most recruits will achieve the retention standards during initial entry training. A new method of percent body fat estimation (%BF) adopted by the Army in 2024 further liberalizes both accession and retention standards. This study examined the impact of current accession and retention %BF standards on the proportion of the US population that would be disqualified from Army service. Methods This analysis was based on National Health and Nutrition Examination Survey (NHANES) statistical sampling of the US population, where height, weight, abdominal circumferences, and dual-energy x-ray absorptiometry (DXA) %BF data were available (n = 26,090, including 13,302 men and 12,788 women). The proportion of individuals in the NHANES data failing to meet weight screen and %BF standards based on age and sex categories were calculated using DXA and the new Army anthropometric method. A recent large dataset from another service was used to compare the new method to DXA. Results Near one-third to one-half of American men and women failed to meet the current Army body composition standard (29, 39, 48, and 50% of men and 39, 45, 46, and 50% of women for age groups 17–20, 21–27, 28–29, and 40–59). More men than women benefited from more liberal accession standards to enter the Army above the retention standard to which they will be held after initial entry training (an additional 12, 11, 15, and 15% of men and 7, 1, 2, and 1% of women who met accession standards exceeded retention standards and would be expected to lose %BF after entry). Approximately one-fourth of women exceeded %BF but were under the height–weight screen; <10% of men were in this category. No men but 16% of the youngest women had low lean mass (<35 kg). Discussion Army body composition standards are generous, extending to the limits of increased metabolic health risks and providing underestimates of actual %BF based on the behavior of circumference-based methods of body fat estimation. However, current standards do not accurately select or track physical readiness, especially for women, and should be updated. Modernization of physical readiness standards to meet the needs of the Army of 2030 could include adoption of new technologies that directly assess central adiposity, adequate muscle mass, and replace fitness testing with cardiac output metrics. With half of US adults projected to be obese by 2030, it is time for a review of the strategic goals of modernized military readiness standards.

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Body composition changes during 8 weeks of military training are not accurately captured by circumference-based assessments

Cited by 4 publications

References 17 publications

Prevalence of obesity and associated health risks in soldiers of the German Armed Forces

Prevalence of obesity and associated health risks in soldiers of the German Armed Forces

Body composition estimation from mobile phone three-dimensional imaging: evaluation of the USA army one-site method

US Army Accession and Retention Standards: Impact on Obesity and Medical Readiness

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