Relationship Between Body Mass Index and Diagnosis of Obesity in the Military Health System Active Duty Population

Influence of Body Composition, Load-Velocity Profiles, and Sex-Related Differences on Army Combat Fitness Test Performance

ABSTRACT

Boffey, D, DiPrima, JA, Kendall, KL, Hill, EC, Stout, JR, and Fukuda, DH. Influence of body composition, load-velocity profiles, and sex-related differences on army combat fitness test performance. J Strength Cond Res 37(12): 2467-2476, 2023-The Army Combat Fitness Test (ACFT) became the U.S. Army's mandatory physical fitness test in April of 2022. The purpose of this study was to determine the relationship between ACFT performance and both body composition and velocity profiles and to determine sex differences for these variables. Data were collected at 2 timepoints 4 months apart, from male (n = 55) and female (n = 17) Army Reserve Officers' Training Corps (ROTC) cadets. Body composition was assessed with a bioelectrical impedance spectroscopy device, and cadets completed a hex bar deadlift load-velocity profile (LVP) and ACFT on separate days. Stepwise multiple regressions were used to explain the amount of variance in ACFT total score and individual event performance. Significance for statistical tests was defined as an alpha level of p ≤ 0.05. Muscle mass and body fat percentage accounted for 49% of shared variance of total ACFT score, and deadlift maximal power and maximal velocity accounted for 67% of shared variance of total ACFT score. The 3 repetition maximum deadlift, standing power throw, hand-release push-up, and sprint-drag-carry events favored cadets with more muscle mass, whereas the leg tuck was influenced by the body fat percentage and the 2-mile run was affected by fat mass. Sex had greater predictive capability for the 2-mile run than body composition. Men outperformed women on all individual events, with the greatest differences on standing power throw and sprint-drag-carry. It is recommended that Army ROTC cadets taking the ACFT maximize lower-body power production and increase muscle mass.

Relationship between Body Mass Index and Diagnosis of Overweight or Obesity in Veterans Administration Population

Background: This paper examined the gap between obesity and its diagnosis for cohorts of patients with overweight, obesity, and morbid obesity in the Veterans Administration (VA) population. Using the risk adjustment models, it also identified factors associated with the underdiagnosis of obesity. Methods: Analysis was performed on a VA data set. We identified diagnosed patients and undiagnosed patients (identified through BMI but not diagnosed using ICD-10 codes). The groups' demographics were compared using nonparametric chi-square tests. We used logistic regression analysis to predict the likelihood of the omission of diagnosis. Results: Of the 2,900,067 veterans with excess weight, 46% were overweight, 46% had obesity, and 8% of them had morbid obesity. The overweight patients were the most underdiagnosed (96%), followed by the obese (75%) and morbidly obese cohorts (69%). Older, male, and White patients were more likely to be undiagnosed as overweight and obese; younger males were more likely to be undiagnosed as morbidly obese. (p < 0.05) Comorbidities significantly contributed to diagnosis. Conclusions: The underdiagnosis of obesity continues to be a significant problem despite its prevalence. Diagnosing obesity accurately is necessary to provide effective management and treatment.

Association between Diet, Physical Activity and Nutritional Status of Male Border Guard Officers

The main factors that determine the effectiveness and reliability of duties and tasks performed by border guard officers, are very good health and maintaining a high level of psychophysical fitness that depend mainly on adequate diet and physical activity and thus, nutritional status. The aim of the study was to verify the correlations between dietary habits, physical activity level and selected nutritional status indicators. One hundred and sixty-nine male border guard officers participated in the study. A 61-item food frequency questionnaire (FFQ) was used to assess dietary habits and a long-form International Physical Activity Questionnaire (IPAQ) was used to assess physical activity. Fat mass was determined by bioelectrical impedance analysis (BIA) and bone calcification was assessed by the dual energy X-ray absorptiometry (DXA). Many correlations between dietary habits, as well as the physical activity of officers and body mass index (BMI), fat mass index (FMI) and visceral fat level (VFL) were found, while bone mineral density (BMD T-score) negatively correlated only with two food groups and 6 out of 61 products but did not correlate with physical activity. The results also confirmed many poor dietary habits and abnormalities in nutritional status. Thus, there is a need for nutritional education and further monitoring of health-related behaviors, as well as monitoring the nutritional status of border guard officers.

Overweight BMI (25-29) in Active Duty Military: Excess Fat or More Lean Mass? A Look at the Evidence

Many active duty service members and their health care providers feel that the current body mass index (BMI) standard for diagnosing obesity, BMI ≥30 kg/m2, may unfairly overclassify as obese those with higher muscle mass. Unfortunately, a closer look at the data available for service members repeatedly demonstrates the exact opposite: we are actually underestimating the rates of obesity in service members using current BMI cutoffs when compared with body fat mass as measured by either dual-energy X-ray absorptiometry or bioelectrical impedance analysis as the gold standard. Using a lower BMI threshold and refining positive results via history, exam, labs, and/or more specific measurements of body composition would more accurately estimate body fat percentage in active duty service members while remaining convenient and scalable. Given the current obesity epidemic in our nation, this suggests the critical need for new approaches to screening, as well as treatment, of overweight and obesity in our military to improve service readiness.