Evidence-Based Strategies to Enhance Weight Management Programs for Adult Military Beneficiaries: A Narrative Review.

INTRODUCTION: Overweight and obesity trends are on the rise among both civilian and military beneficiaries. The purpose of this narrative review was to evaluate nutrition, behavioral, lifestyle, pharmacotherapy, and alternative approaches to weight management (WM) among adults with a focus toward identifying gaps and evidence-based strategies that could support or enhance current and future WM programming among military adult beneficiaries. MATERIALS AND METHODS: A trained research team identified publications (January 2013-January 2020) for abstract review using key search terms and inclusion criteria. Two independent researchers conducted both the abstract review and full-paper bias scoring using selected Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. All eligible studies were assessed for bias and categorized based on key themes. The study was registered in PROSPERO, the international prospective register of systematic reviews. RESULTS: The research team identified 741 articles, with 278 meeting final inclusion criteria. The mean bias score was 7.5 ± 3.9 (score of 0-13; higher indicating fewer bias factors), with 64% scoring ≥9. Factors contributing to low bias included intervention compliance, dropout rate, and inability to blind participants. The most common published weight-loss interventions included a combination of therapies (59%), diet/supplement (17%), other approaches (12%), behavior change (7%), and exercise (6%). Themes identified to improve WM outcomes included leveraging technology, increasing intervention interactions, community support, emphasis on early weight loss, pharmacotherapy risk-benefit, enhanced behavioral component, resistance exercise, mindfulness, and benefits of quality-of-life measures. CONCLUSIONS: Reviewers identified several validated tools and techniques to augment and update existing WM programming to improve health and weight outcomes. The review affirmed use of individualized dietary patterns and not a "one-size-fits-all approach" as well as incorporating more comprehensive and team-approached treatments to make the best use of tools and strategies to enhance outcomes.

Physical Profile of Air Force Special Warfare Trainees.

Physical fitness testing in the military is commonly used to assess whether service members are physically capable of performing the diverse physical tasks that may be required for their job. Body composition can influence an individual's ability to physically perform. This study aimed to analyze the general physical profile of U.S. Air Force (USAF) special warfare candidates by assessing body composition results and physical assessment scores collected over the past four years. Male candidates (n = 1036) were 18.2 years to 39.5 years of age (M = 23.5, SD = 3.9) and weighed 78.8 kg (SD = 8.3) with a BMI of 25.0 (SD = 2.0) at 11.8% body fat (SD = 3.3) as measured using bioelectrical impedance. Body composition and fitness scores were similar to those noted in U.S. Navy special warfare candidates as well as individuals in other elite tactical units. These results highlight the normative body composition profile of individuals assessing for advanced military career fields.

Differential recovery rates of fitness following U.S. Army Ranger training.

OBJECTIVES: To investigate tactically-related physical performance and body composition recovery following U.S. Army Ranger training. DESIGN: Prospective cohort. METHODS: Physical performance was comprehensively assessed using a tactically-related performance battery (i.e., Ranger Athlete Warrior assessment) in 10 male Soldiers at baseline (BL) two-weeks (P1), and six-weeks (P2) post-Ranger School. Body composition was determined using DXA. A one-way repeated measures ANOVA was used followed by Bonferroni-adjusted pairwise comparisons when group differences existed (p≤0.05). Pearson correlation coefficients were used to establish associations between changes in fitness and body composition. RESULTS: All performance domains except the bench press and deadlift worsened following training. Speed/mobility (Illinois agility test, seconds - BL: 16.20±0.86 vs. P2: 18.66±2.09), anaerobic capacity (300-yard shuttle run, seconds - BL: 62.95±6.17 vs. P2: 67.23±5.91), core strength (heel clap, repetitions - BL: 15.80±4.08 vs. P2: 11.50±4.95), and aerobic endurance (beep test, stage - BL: 9.95±2.18 vs. P2: 7.55±1.07) had not recovered by P2. Only upper body muscular endurance and strength (metronome push-up and pull-up, respectively) were similar to BL by P2. Percent body fat increased from 15.62±3.94 (BL) to 19.33±2.99 (P2) (p<0.001). There were no significant associations between changes in body composition and performance. CONCLUSIONS: A comprehensive characterization of physical performance and body composition revealed Rangers did not experience full recovery of fitness six weeks after training. Optimal recovery strategies are needed to return Soldiers to a state of readiness following arduous training.