Weight management behaviours mediate the relationship between weight cycling, BMI and diet quality among US Army Soldiers

Abstract

Weight cycling is prevalent in sports/professions with body composition standards. It has been associated with weight management behaviors that may contribute to suboptimal diet quality and weight gain. US Army Soldiers may be at increased risk of weight cycling relative to civilians due to mandated body composition standards. However, the relationship between weight cycling, weight management behaviors, body mass index (BMI), and diet quality among Soldiers is unknown. In this cross-sectional study, 575 Soldiers (89% enlisted, 90% male, 23±4yr) at Army installations at Joint Base Elmendorf-Richardson, AK, Joint-Base Lewis McChord, WA, and Fort Campbell, KY completed questionnaires on food frequency, health-related behaviors, and history of weight cycling (≥3 weight fluctuations ≥5% body weight). Weight cycling was reported by 33% of Soldiers. Those who reported weight cycling reported higher BMI (27±4 vs. 25±3 kg/m2, p<0.001) and higher prevalence of engaging in weight management behaviors prior to body weight screening, but did not report lower dietary quality (Healthy Eating Index-2015 (HEI) scores 59±10 vs 59±11, p=0.46) relative to those who did not report weight cycling. Results of mediation analyses suggested that weight cycling may affect BMI both directly (c’= 1.19, 95% CI: 0.62, 1.75) and indirectly (ab=0.45, 95% CI: 0.19, 0.75), and HEI scores indirectly (ab=0.69, 95% CI: 0.20, 1.35) through the adoption of weight management behaviors. Weight cycling is common in Soldiers and is associated with higher BMI and higher prevalence of engaging in weight management behaviors that mediate associations between weight cycling, BMI and diet quality.

Weight regain, body composition, and metabolic responses to weight loss in weight cycling athletes: A systematic review and meta‐analyses

“…The quality assessment of the included studies was detailed in Figure 2. Twenty‐one studies had a weak global rating, 4,12–15,39,44,51,52,57,58,66,83,84,86,90,94,96,98,100,101 24 studies were evaluated as moderate, 2,3,11,34,36–38,59,63,65,67–71,74,75,77,92,93,97,99,102 and 29 studies had a strong global rating 16,40–43,50,53–56,60–62,64,72,76,78–82,85,87–89,91,95,103,104 . Considering the high number of studies with no CT groups and balanced CT groups if applicable, cofounders were evaluated as the strongest criteria while the lack of blinding was highlighted in almost a third of the studies.…”

“…BW and weight variations were assessed in 56 studies 2,16,34–43,50,53–72,74–82,85–89,91–93,95,97,101–104 . Most of the body composition (at least FM and/or FFM) measurements were conducted using dual‐energy X‐ray absorptiometry (DXA), which is the most accurate method ( N = 20) 16,34–37,39,41,42,50,54–58,77–82 .…”

“…Weight management and history were assessed in 30 articles 2–4,11–15,44,51,52,56–58,62,67,68,74,77,83,84,90,91,94,96,98–101,104 . Usual WL methods were recorded using the Rapid Weight Loss Questionnaire (RWLQ) ( N = 15) 2,3,11–13,44,83,84,90,91,94,96,98–100 and similar questionnaires ( N = 6), 4,14,67,68,74,77 interviews were conducted in seven studies, 51,52,56–58,70,101 one article initiated a survey, 62 and one used a specific Military Eating Behavior Scale 104 …”

“…Four 34–37 out of 5 34–37,104 studies followed soldiers in training camps and/or ranger courses. Three studies realized BW, FM, and FFM measures at the end of 10 34 or 62 days 35,104 of imposed energy restriction and a high level of military exercises. All soldiers significantly lose BW with an average WL of 9.1 ± 2.8% of BW pre‐WL .…”

“…2-4,11-15, 44,51,52,56-58,62,67,68,74,77,83,84,90,91,94,96,98-101,104 Usual WL methods were recorded using the Rapid Weight Loss Questionnaire (RWLQ) (N = 15) 2,3,[11][12][13]44,83,84,90,91,94,96,[98][99][100] and similar questionnaires (N = 6), 4,14,67,68,74,77 interviews were conducted in seven studies, 51,52,[56][57][58]70,101 one article initiated a survey, 62 and one used a specific Military Eating Behavior Scale. 104 The methods used to assess of the other considered outcomes (EI, dietary and eating behaviors, physical activity and performance, hydration status, metabolic profile, and psychometric variables) are presented and detailed in Table S2.…”