Military services fitness database: development of a computerized physical fitness and weight management database for the U.S. Army.

The Department of Defense (DoD) has mandated development of a system to collect and manage data on the weight, percent body fat (%BF), and fitness of all military personnel. This project aimed to (1) develop a computerized weight and fitness database to track individuals and Army units over time allowing cross-sectional and longitudinal evaluations and (2) test the computerized system for feasibility and integrity of data collection over several years of usage. The computer application, the Military Services Fitness Database (MSFD), was designed for (1) storage and tracking of data related to height, weight, %BF for the Army Weight Control Program (AWCP) and Army Physical Fitness Test (APFT) scores and (2) generation of reports using these data. A 2.5-year pilot test of the MSFD indicated that it monitors population and individual trends of changing body weight, %BF, and fitness in a military population.

Senior military officers' educational concerns, motivators and barriers for healthful eating and regular exercise.

The increasing trend of overweight in the military, the high cost of health care associated with overweight, and the failure to meet some Healthy People 2000 objectives related to diet identify the need for more appropriate nutrition and fitness education for military personnel. The purpose of this study was to assess senior military officers' concerns on various health topics, educational preferences for nutrition and health topics, eating habits, and barriers and motivators for eating healthfully and exercising regularly. The survey was completed by 52 resident students at the U.S. Army War College. Fitness, weight, and blood cholesterol were top health concerns, and respondents wanted to know more about eating healthfully on the run. The primary barrier to eating healthfully and exercising regularly was lack of time, whereas health and appearance were top motivators. Health interventions for this population should include their topics of concern and should address perceived barriers and motivators.

Efficacy of orlistat 60 mg on weight loss and body fat mass in US Army soldiers.

A higher body mass index is associated with exercise-related injuries and increased risk for musculoskeletal and connective tissue disorders, which are relevant to military personnel. Studies show the efficacy of orlistat 60 mg for promoting weight and body fat loss in civilians; however, its efficacy among predominantly young, male soldiers is unknown. This study's objective was to examine the effect of a 6-month, standard education-based weight-management program with and without orlistat 60 mg on changes in weight and body fat in overweight soldiers. Data were collected for this randomized, controlled trial from March 2008 to November 2010 at Fort Bragg, NC. Participants were enrolled in an education-based weight management program (n=435; 75% men) and were randomized to placebo or orlistat 60 mg, three capsules daily with meals. All participants were recommended to maintain a reduced-energy, low-fat diet. Among study completers (14% retention rate; placebo n=22, orlistat n=35) members of both groups lost significant weight from baseline (placebo -3.0±5.2 kg; orlistat -3.2±4.7 kg; P<0.01), but only the orlistat group lost fat mass (-2.5±3.9 kg; P<0.001), whereas the placebo group lost lean mass (-1.4±2.7 kg; P <0.01). An intent-to-treat analysis (?1 follow-up body weight measure) demonstrated that the orlistat group lost more fat mass vs the placebo group (-1.3±2.9 kg vs ?0.6±1.8 kg, respectively; P<0.05), but less lean mass (-0.2±2.0 kg vs -0.8±1.8 kg, respectively; P<0.01). Orlistat 60 mg may be an effective adjunct to an education-based weight management program in a mostly young, male soldier population.

Efficacy of a meal-replacement program for promoting blood lipid changes and weight and body fat loss in US Army soldiers.

Excess weight is associated with negative health outcomes. Meal replacements are effective in promoting favorable body composition changes in civilian populations; however, their efficacy with military service members who have unique lifestyles is unknown. The objective of this randomized controlled trial was to determine the efficacy of the Army's education-based weight-management program, "Weigh to Stay," with and without meal replacements for improving blood lipids, and to promote weight and body fat loss in overweight US Army soldiers. Soldiers (n=113; 76 males/37 females) attending Weigh to Stay at Fort Bragg, NC, in 2006/2007 were randomized to Weigh to Stay only or a commercially available meal-replacement program (two meal replacements per day) in conjunction with Weigh to Stay, and followed until Army body fat standards were met or for 6 months if standards were not met. Study completers (n=46) in both treatment groups lost weight (Weigh to Stay: -2.7+/-4.3 kg; meal replacers: -3.8+/-3.5 kg) and fat mass (Weigh to Stay, -2.7+/-3.2 kg; meal replacers: -2.9+/-2.5 kg), and improved high-density lipoprotein cholesterol concentrations (Weigh to Stay: 13+/-9 mg/dL [0.34+/-0.23 mmol/L]; meal replacers: 8+/-7 mg/dL [0.21+/-0.18 mmol/L]; P<0.05); however, no between-group differences were observed. Attrition was lower (P=0.009) and success in meeting body fat standards tended to be higher (P=0.06) for the meal replacers vs Weigh to Stay participants. Intent-to-treat analysis demonstrated that meal replacers lost more weight (1.2+/-0.5 kg), percent body fat (1.0%+/-0.4%), and fat mass (0.8+/-0.4 kg) compared to Weigh to Stay volunteers (P<0.05). Our findings suggest that meal replacement use can be recommended as a potential adjunct strategy to Weigh to Stay.

Monitoring energy intake: a hand-held personal digital assistant provides accuracy comparable to written records.

New approaches to assess energy intake (EI) may have advantages over traditional written methods, but validity of these emerging methodologies must be demonstrated. This exploratory study compared EI obtained using a hand-held personal digital assistant (PDA) and traditional written records with total energy expenditure measured by doubly labeled water (TEE(DLW)). Twenty-six volunteers (aged 23+/-4 years, body mass index [calculated as kg/m(2)] 24+/-2) participated in a randomized (either PDA or written record group) and matched (for sex, age, and body mass index) study for 7 consecutive days between June 2005 and April 2006 to record EI. Group comparisons were made with t and Mann-Whitney U tests. Bland-Altman plots were used to compare limits of agreement between methods. Volunteers remained weight stable during the study period (0.2+/-0.8 kg; P>0.05). Reported EI by written record and PDA were similar to TEE(DLW); 105% vs 92% of TEE(DLW), respectively (P>0.05). There was a significant relationship between reported EI by PDA and TEE(DLW) (r=0.60, P<0.05), but not for written record (r=0.45, P>0.05). Limits of agreement indicated both written record and PDA had large variability (range 1,394 to -1,472 kcal/day). Findings suggest the bias in using a PDA is similar to that observed when using a written record for estimation of EI in weight-stable volunteers.

Development of an internet/population-based weight management program for the U.S. Army.

A significant number of Army soldiers are sufficiently overweight to exceed the maximum weight allowances defined by the Army weight control program (AR600-9). Also, the body weights of a substantial number of soldiers approach the maximum weight allowances. These soldiers should not gain additional weight if they are to meet Army weight allowances. The conventional approach to this overweight problem is assigning soldiers to remedial physical training and mandatory referral for nutrition counseling by a health care provider. An alternative to this conventional approach is to target the entire population of soldiers (population-based intervention) to promote weight loss in overweight soldiers and weight gain prevention in soldiers who are approaching overweight status. To accomplish this objective, the Healthy Eating, Activity, and Lifestyle Training Headquarters (H.E.A.L.T.H.) program was developed. This article describes the rationale for developing the program, the components of the program, and the utilization promotion strategies of the program. The H.E.A.L.T.H. program includes two primary components: (1) a Web site tailored to the standards established in Field Manual 21-20, Physical Fitness Training, Army physical fitness test, and AR600-9, the army weight control program, and (2) a health promotion program designed to promote awareness of the H.E.A.L.T.H. Web site and to facilitate use of the Web site by soldiers and their family members. The Web site is equipped with personalized planning tools and progress tracking over time related to fitness, caloric intake, and lifestyle behavior change goals. The health promotion program includes media advertisements and "ground roots" efforts to facilitate use by soldiers.