Predictors of low physical fitness in a cohort of active-duty U.S. Air Force members.

BACKGROUND: Each branch of the U.S. armed forces has standards for physical fitness as well as programs for ensuring compliance with these standards. In the U.S. Air Force (USAF), physical fitness is assessed using submaximal cycle ergometry to estimate maximal oxygen uptake (VO2(max)). The purpose of this study was to identify the independent effects of demographic and behavioral factors on risk of failure to meet USAF fitness standards (hereafter called low fitness). METHODS: A retrospective cohort study (N=38,837) was conducted using self-reported health risk assessment data and cycle ergometry data from active-duty Air Force (ADAF) members. Poisson regression techniques were used to estimate the associations between the factors studied and low fitness. RESULTS: The factors studied had different effects depending on whether members passed or failed fitness testing in the previous year. All predictors had weaker effects among those with previous failure. Among those with a previous pass, demographic groups at increased risk were toward the upper end of the ADAF age distribution, senior enlisted men, and blacks. Overweight/obesity was the behavioral factor with the largest effect among men, with aerobic exercise frequency ranked second; among women, the order of these two factors was reversed. Cigarette smoking only had an adverse effect among men. For a hypothetical ADAF man who was sedentary, obese, and smoked, the results suggested that aggressive behavioral risk factor modification would produce a 77% relative decrease in risk of low fitness. CONCLUSIONS: Among ADAF members, both demographic and behavioral factors play important roles in physical fitness. Behavioral risk factors are prevalent and potentially modifiable. These data suggest that, depending on a member's risk factor profile, behavioral risk factor modification may produce impressive reductions in risk of low fitness among ADAF personnel.

U.S. Air force recruit injury and health study.

OBJECTIVES: To assess the types, rates, and risks of injury for male and female USAF recruits. DESIGN: Outpatient visits for female (5250) and male recruits (8656) were collected and analyzed for rate of injury, types of injuries, and risk of injury throughout a 6-week training period. RESULTS: One third of female recruits and one sixth of male recruits were injured at least once during recruit training. The overall rate for injuries in women and men was 63.0 and 27.8 per 1000 person-weeks, respectively. The adjusted relative risk for women versus men for all injuries was 2.22, and was consistent (1.67 to 3.27) across injury sites. Despite declining absolute rates of injury by week (106.1-13.4 for women and 53.7-13.2 for men), relative risk of injury for women versus men remained fairly constant throughout each training week. The relative risk for injury serious enough to result in medical hold was 1.69 for women vis-a-vis men. Approximately half of all medical discharges for women and men were for injuries. CONCLUSIONS: Female recruits were injured twice as often as male recruits, and were 1.5 times more likely to be removed from their training cohort for injury. Relative risk for injuries to specific body areas remained fairly consistent, indicating that no gender-specific injuries were occurring. Further efforts to determine the cause of injuries should be undertaken, and interventions aimed at reducing the disparate risk of injuries in women should be developed and evaluated.