Military medicine
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The purpose of the current study was to examine if isometric peak force and rate of force development (RFD) were related to the ability to successfully perform a simulated casualty evacuation task in both unweighted and weighted conditions. ⋯ Isometric deadlift peak force represents an important determinant for the success of a simulated casualty evacuation task and may be a useful marker to include in periodic fitness evaluations of military personnel.
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In order to address the problem of suicide, healthcare providers and researchers must be able to accurately identify suicide deaths. Common approaches to detecting suicide in the healthcare setting include the National Death Index (NDI) and Root-Cause Analysis (RCA) methodology. No study has directly compared these two methods. ⋯ Combining national and local approaches to detect suicide may help to improve the classification of suicide deaths in the healthcare setting.
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Obesity and overweight, defined as body mass index (BMI) of 30.0 and above or 25.0-29.9, respectively, are of significant concern to the military population, due to their associated comorbidities and potential for impaired readiness. In 2016, the US Army reported a prevalence of 17.3% obesity and 52.9% overweight among soldiers, despite both physical demands of the job and Department of Defense (DoD) guidelines which recommend separation from service for those unable to meet body composition standards. This study examines the health service utilization of active duty, male Army soldiers in order to determine the prevalence of obesity and overweight and to estimate the effects of these conditions on readiness. ⋯ More than 70% of soldiers had overweight or obesity in FY 2015, showing the highest prevalence yet measured for these conditions. Previous reports of lower prevalence may be due to the inclusion of circumference-based body fat assessments, which have been criticized for inaccuracy. In our study, disproportionately high health service use by soldiers with obesity suggests decreased readiness, as these soldiers may experience both poorer health and lose necessary training time due to increased provider visits. Proportional usage by soldiers with overweight suggests the protective effect of regular physical activity, though these soldiers should be monitored to ensure that they do not progress to obesity. Additional research should establish the burden of cost, absenteeism, and presenteeism of obesity on the MHS, as well as developing more appropriate field tests for body fat assessment and BMI standards to better support military readiness.
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Cardiorespiratory fitness (CRF) is a crucial performance requirement of specialized military occupations. Age and physical activity are established predictors of CRF, but it is not clear how these predictors combine with each other and/or with genetic predisposition. The goal of this study was to derive inclusive explanatory models of CRF in US Navy Explosive Ordnance Disposal (EOD) operators, synthesizing conventional (e.g., age, body composition, and physical activity) and novel influences (e.g., genetic variance). ⋯ This study signifies a shift toward inclusive explanatory models of CRF and aerobic performance, accounting for combined roles of genetic, physiologic, and behavioral influences. Although we were able to quantify combined effects, we were unable to evaluate interaction effects (e.g., gene-gene, gene-behavior) due to limited statistical power. Other limitations are that this specialized military population may not readily generalize to broader populations, and the current sample was all male. Considering these limitations, we aim to replicate this study in various populations, both male and female. Despite its limitations, this study reflects a shift toward more comprehensive predictive models of CRF, explaining the unique and shared contributions of genetic predisposition, physiology, and behavior. These findings have implications for assessment, selection, and training of specialized military members, and may also impact mission success and survivability. Future studies are needed to better characterize additive, interactive, and mediated effects.
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Ketogenic diets (KDs) that elevate ketones into a range referred to as nutritional ketosis represent a possible nutrition approach to address the emerging physical readiness and obesity challenge in the military. An emerging body of evidence demonstrates broad-spectrum health benefits attributed to being in nutritional ketosis, but no studies have specifically explored the use of a KD in a military population using daily ketone monitoring to personalize the diet prescription. ⋯ US military personnel demonstrated high adherence to a KD and showed remarkable weight loss and improvements in body composition, including loss of visceral fat, without compromising physical performance adaptations to exercise training. Implementation of a KD represents a credible strategy to enhance overall health and readiness of military service members who could benefit from weight loss and improved body composition.