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Body Composition and Physical Performance 1992.
Pp. 57-70. Washington, D.C.
National Academy Press
4
Body Composition in the
Military Services:
Standards and Methods
lames A. Hodgdon
BACKGROUND
This paper will discuss two topics: the development of standards for
body composition in the U.S. Navy and the methods of body composition
assessment in use by the military services today.
In 1981, the Department of Defense (DOD) issued directive 1308.1
(DOD directive 1308.1, 1981~. Part of the policy expressed in that directive
was that the "determining factor in deciding whether or not a service mem-
ber is overweight is the member's percent body fat." (DOD Directive 1308.1,
p. 2 Encl. 2, 1981~. The military services were directed to determine body
composition and fat standards consistent with the mission of the services.
The directive also indicated that there are three concerns relating to the
need for establishing a weight control policy: first, body composition is an
integral part of physical fitness and is, therefore, essential for maintaining
combat readiness. This statement implies a relationship between fatness
and military performance. Second, control of body fat (BF) is necessary to
maintain appropriate military appearance. Third, control of BF is important
in maintaining the general health and well-being of armed forces personnel.
The directive left the task of developing the most appropriate methodol-
ogy for BF determination to the individual services. The directive required
that fat measurement techniques must have a correlation coefficient of 0.75
or better with percent BF from underwater weighing. This coefficient has
57
OCR for page 58
58
JAMES A. HODGDON
since been increased to 0.85. DOD percent BF goals were set at 20 percent
BF for men and 26 percent BF for women.
BODY COMPOSITION STANDARDS
If body composition was presumed to affect military performance, mil-
itary appearance, and general health and well-being, the basis for setting
standards ought to lie with one of these three relationships. Below is the
line of argument followed within the U.S. Navy to arrive at suitable stan-
dards for body composition.
Body Composition and Physical Performance
Performance on the U.S. Navy's biannual Physical Readiness Test (PRT)
is taken to be an indicator of a sailor's readiness for combat. As an adjunct
to setting standards for physical fitness and body composition, studies were
carried out that investigated relationships between performance on the PRT
items and performance of materials handling tasks. The Navy's PRT in-
cludes a body composition assessment, sit-reach distance, time for a 1.5-
mile run, number of sit-ups performed in 2 minutes, and number of push-
ups performed in 2 minutes. Work by Robertson and Trent (1985) at the
Navy Personnel Research and Development Center showed that the majori-
ty of the physically demanding jobs performed by Navy personnel were
materials handling tasks: lifting, carrying, and pulling, with the most com-
mon being carrying while walking (48 percent) and lifting without carrying
(20 percent). Performance on such tasks might form a reasonable basis for
setting standards for shipboard work.
Beckett and Hodgdon (1987) investigated associations between PRT
items, body composition variables, and performance on two materials han-
dling tasks. The two tasks were: the maximum weight of a box that could
be lifted to elbow height (box-lift maximum weight) and the total distance a
34-kg box could be carried (box carry power) on alternate laps of a 51.4-m
course during two 5-minute work bouts. The parameters of the carry task
represented median values of the weight, distance, and timing of Robertson
and Trent's survey of carry tasks performed aboard ship. Table 4-1 shows
the correlations between PRT and body composition items, and performance
on the lift and carry.
Table 4-1 shows percent BF to be only modestly correlated with these
materials handling tasks. These modest correlations suggest that using rela-
tionships between these tasks and percent BF as the basis of setting percent
BF standards would not be particularly fruitful. However, it might be noted
that one of the body composition variables (fat-free mass [FFM]) is highly
correlated with the box-lift maximum weight. In this study, FFM was also
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STANDARDS AND METHODS
TABLE 4-1 Correlations, U.S. Navy Physical Readiness
Test Items, and Body Composition with Materials Handling
Tasks*
Box-Lift
Maximum Weight
Box-CalTy
Power
Sit-reach distance -0.21 0.01
Sit-ups in 2 minutes ~.00 0.31
Push-ups in 2 minutes 0.63 0.56
1.5-mile run time ~.34 ~.67
Percent fat (from circumferences) -0.36 ~.43
Fat-free mass 0.84 0.44
Fat mass 0.08 ~.23
*n = 102 Navy personnel: 64 men and 38 women.
SOURCE: Beckett and Hodgdon (1987) by permission.
59
found to be highly correlated with other muscle strength measures. The
possibility exists for using FFM as an approximation of overall strength in
job assignment.
Body Composition and Appearance
The second stated reason for maintaining appropriate levels of BF is
for proper military appearance. It is the Navy's policy that judgments about
appearance are subjective and not necessarily strongly related to fatness.
Current performance evaluation procedures allow for these subjective as-
sessments, and they need not be anchored to other objective variables.
The soundness of this approach was recently tested by Hodgdon and
colleagues (1990~. A panel of 11 U.S. Army headquarters staff (5 women,
6 men; 6 officers, 5 enlisted; and including both Black and White members)
rated the "military appearance" of 1,075 male and 251 female U.S. Army
personnel dressed in Class A uniform. Physical characteristics of this pop-
ulation sample are provided in Table 4-2. A 5-point scale was used for the
ratings. In this scale, a value of 1 was labeled "poor"; a value of 2, "fair"; a
value of 3, "good"; a value of 4, "very good"; and a value of 5, "excellent".
The raters were instructed to rate the "military appearance" of the soldier
according to their own personal standards, and instructed to evaluate how
the individual looked in uniform, not how the uniform looked. The person-
nel who were rated also had their percent BF determined from underwater
weighing. The inter-rater reliability of the ratings was quite good (alpha =
0.86 for rating of men, 0.87 for rating of women). The results of the regres-
sion analysis to predict measured percent BF from the ratings of appearance
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60
JAMES A. HODGDON
TABLE 4-2 Participant Characteristics in U.S. Army Personnel
Appearance Study
Males
(n*= 1,075)
Females
(n = 251)
Height (cm) 175.1 + 6.9
Weight (kg) 77.1 + 11.2
Age (yrs) 30.1 + 8.9
Body Density (kg/1) 1.052 + 0.015
Body Fat Content (% body wt) 20.6 + 6.9
Fat-free Mass (kg) 60.9 + 7.3
Fat Mass (kg) 16.3 + 7.1
Appearance Rating in Uniform 3.31 + 0.62t
162.5 + 6.2
60.3+8.1
24.0+57
1.036 + 0.012
28.0 + 5.7
43.1 + 4.8
17.1 + 5.2
3.21 + 0.67t
n = number of subjects.
tn = 988.
tn = 233.
are provided in Table 4-3. The correlation between appearance ratings and
percent fat was modest: 0.53 for ratings of male personnel, and 0.46 for
ratings of female personnel. The square of the correlation coefficient indi-
cates the percent of the total variance in one variable accounted for by the
other. Percent fat accounts for only 28 percent of the measured variance in
appearance for men, only 22 percent for women. It does not appear from
this study that percent BE, by itself, constitutes a reasonable indicator of
military appearance. Clearly, other factors play a role in such judgments.
Body Composition and Health
The DOD directive points out that one of the reasons for wanting to set
BE standards is the maintenance of health and well-being of the service
TABLE 4-3 Prediction of Appearance from Percent Fat Scores in U.S.
Army Personnel Appearance Study
Regression
Predictor Coefficient Constant R R2 SEET
Males:
Percent fat -0.047 4.277 0.53 0.28 0.523
Females:
Percent fat -0.054 4.721 0.46 0.22 0.598
*R = multiple correlation coefficient.
TSEE = standard error of the estimate.
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STANDARDS AND METHODS
61
members. It is in the relationship between health and fatness that the Navy
has anchored its body composition standards.
On February 11-13, 1985, the National Institutes of Health (NIH) Of-
fice of Medical Applications of Research; the National Institute of Arthritis,
Diabetes, and Digestive and Kidney Diseases; and the National Heart, Lung,
and Blood Institute convened a consensus development conference on the
health implications of obesity (National Institutes of Health, 1985~. The
conferees determined that obesity is related to a significant impairment of
health, particularly in terms of increased risk of diabetes, hypertension,
coronary artery heart disease, and cancer. They also agreed that obesity
could be defined as a weight-for-height 20 percent above the midpoint weight
listed in the 1983 Metropolitan Life Insurance tables for the medium-frame
individual (Metropolitan Life Insurance Company, 19841.
Armed with this definition, and the information that obesity could be
considered a health risk, the following study determined whether or not
these weight-for-height tables had any reasonable expression in percent BF.
Using the Navy anthropometry data set, the regression between weight and
height and percent BF was determined. Table 4-4 describes the data set
used for development of the regressions.
The regressions that were developed were:
and
Percent BF = 0.464 x weight (kg) - 0.411 x height (cm) + 54.769
(R = 0.75, SEE = 5.33 percent BF) for men,
Percent BF = 0.638 x weight (kg) - 0.409 x height (cm) + 54.367
(R = 0.77, SEE = 4.54 percent BF) for women,
where R = multiple correlation coefficient and SEE = standard error of the
estimate.
TABLE 4-4 Regression Sample Descriptions
Men
(n*= 1,024)
Women
(n = 340)
Mean + standard deviation
Age (years) 31.9 + 6.93 26.6 + 5.29
Height (cm) 177.6 + 6.96 164.5 + 6.71
Weight (kg) 85.7 + 14.45 62.2 + 9.35
Percent fat (underwater weighing) 21.6 + 8.07 26.8 + 7.07
n = number of subjects.
OCR for page 62
62
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JAMES A. HODGDON
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FIGURE 4-l National Institutes of Health critical weights for each height expressed
as percent fat.
Using these equations, we then determined the percent BF value associated
with the NIH critical weights at each height for both men and women. The
results are provided graphically in Figure 4-1. As can be seen from Figure
4-1, the "critical" percent BF values are rather constant across heights,
especially the values for women. Mean values for critical percent BF across
height were 22.0 + 1.20 for men and 33.5 + 0.18 for women.
Standards for percent BF for Navy personnel were derived from these
mean values. The circumference equations used by the U.S. Navy to pre-
dict BF have standard errors of measurement of approximately 3.5 percent
BF. It was decided that the standard for administrative action should be
approximately one standard error above the critical percent BF to minimize
the number of false positives for individuals exceeding the NIH obesity
definition. The values of 26 percent BF for men and 36 percent BF for
women were thus adopted. Any sailor or officer exceeding these limits for
three successive administrations of the PRT is subject to administrative
action. In addition, an "overfat" category was defined. Individuals exceeding
values of 22 percent BF, if men, or 30 percent BF if women, are required to go
on a fat reduction program. This approach allows remedial action on BF
reduction to begin prior to exceeding the limits for admin-istrative action.
The finding that the NIH critical weights represent a relatively constant
percent BF for men and women is intriguing, especially when one considers
that those weights derive from the empirically determined Metropolitan Life In-
surance Tables (Metropolitan LIfe Insurance Company, 1984~. However, there
OCR for page 63
STANDARDS AND METHODS
63
is a paucity of data relating body composition variables themselves to mortal-
ity and morbidity outcomes. Such epidemiological studies need to be done.
In summary, the U.S. Navy, finding a lack of basis for setting body
composition standards based on either performance or appearance, has cho-
sen to base its standards on health considerations. The standards are de-
rived from the NIH consensus definition of obesity.
BODY COMPOSITION MEASUREMENT
The criteria for selecting methods for assessment of body composition
in the military were that the measures must be: usable easily in the field,
able to be made reliably, and be valid indicators of fatness. It was also
important that skill in measurement be relatively easily acquired. To meet
these measurement technique requirements, all four services have adopted
circumference measurements, often in conjunction with height and weight,
as the basis for predicting percent BE.
Reliability and Trainability
In 1987, Mueller and Malina determined intra- and interexaminer reliabil-
ities of skinfold and circumference measurements. They found both tech-
niques to be quite reliable but circumferences to be more reliably measured
than skinfold thicknesses (0.97 and 0.96 for circumference intra-
and interexaminer reliabilities, respectively, and 0.94 and 0.92 for skinfold
reliabilities).
In addition to being slightly more reliably made, circumference mea-
surements appear to be more easily learned. J. H. Heaney and coworkers
(Naval Health Research Center, San Diego, unpublished manuscript) inves-
tigated the time course for acquiring skill in circumference and skinfold
thickness measurement. Thirty-eight active duty Navy personnel were pro-
vided six 1-hour training sessions during which they were trained and eval-
uated in skinfold measurements at two sites and circumference measure-
ments at three sites. Heaney and coworkers found that after 75 skinfold
measurements at each site (150 total measurements), only 24 percent of the
study participants had reached proficiency in skinfold measurement. In con-
trast, 68 percent of the participants had reached proficiency after 45 circum-
ference measurements at each site (135 total measurements). In this study,
circumference measurement was clearly the more easily learned technique.
Equation Validity
Each of the services developed regression equations involving body
circumference measurements, sometimes in conjunction with height or weight
OCR for page 64
64
JAMES A. HODGDON
or both. The regression equations predict either body density, percent BF,
or FFM. For the U.S. Army, Navy, and Marine Corps, the criterion measure-
ment for equation development was either body density from underwater
weighing or percent BF using the Siri (1961) equation to convert body density
to percent BF. The U.S. Air Force equations use as a criterion measure FFM
determined from tritiated water dilution or from body volume and weight
(Allen, 19631. Tables 4-5a and 4-Sb contain the equations and descriptive
data from the equation development samples for the military services. Sample
descriptors are shown as mean plus or minus standard deviation.
U.Se Army
The U.S. Army equations were developed by Vogel and coworkers
(1988) at the U.S. Army Research Institute of Environmental Medicine on a
large sample of Army personnel. The sample was not stratified to reflect
distributions of demographic variables (for example, age, gender, race, job
classification) within the Army population.
These equations are used in conjunction with weight-for-height tables
that serve as an initial screening tool in detecting overfat. Current Army
BF retention standards are based on age (AR 600-9, 1986~. Standards for
men are 20 percent BF for ages 16-20 years, 22 percent BF for ages 21-27
years, 24 percent BF for ages 28-39 years, and 26 percent BF for ages 40
years and older. Standards for women are 28 percent, 30 percent, 32 per-
cent, and 34 percent BF respectively, for the same age groupings as the men.
U.S. Navy
The U.S. Navy equations were developed by Hodgdon and Beckett
(1984a,b) at the Naval Health Research Center. Their large sample of U.S.
Navy personnel was also nonstratified with respect to Navy demographics.
Within the Navy every service member has his or her BF estimated twice
each year using these equations (U.S. Department of the Navy, 1986a).
There are no weight-for-height screening tables used. As noted above, the
current retention standards are 26 percent BF for men and 36 percent BF for
women, irrespective of age.
U.S. Marine Corps
The Marine Corps was the first service to use body composition estima-
tion from circumferences. The Marine Corps equations were developed by
Wright and coworkers (1980, 1981) of the Institute of Human Performance
from data collected by Wright and Wilmore (1974) on Marine Corps per-
sonnel. The Marine Corps uses weight-for-height tables as the basis for
OCR for page 65
65
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OCR for page 67
STANDARDS AND METHODS
67
weight control decisions (U.S. Department of the Navy, 1986b). If a Marine
is overweight by the tables but does not appear to be fat, he or she may
have a BF estimation done. If the individual's BF is less than the Marine
Corps standards of 18 percent BF for men and 26 percent BF for women, a
new maximum allowable weight is calculated and entered into the Marine's
record.
U.S. Air Force
The U.S. Air Force body composition equation for men was developed
by Fuchs and coworkers (1978) at the U.S. Air Force School of Aerospace
Medicine. The equation for women was developed by Brennan (1974) as
part of her master's work at the Incarnate Word College in San Antonio.
Unlike the equations of the other services, the U.S. Air Force equations
predict FFM. Also, the development sample for the women's equation
contained some non-service personnel.
Like the Marine Corps, the U.S. Air Force has a weight-for-height
standard (AFR 35-11, 19851. Individuals whose weight exceeds the stan-
dard will have their body composition determined. If they do not exceed
the U.S. Air Force BF standards (20 percent BF for men less than 30 years
of age, 26 percent BF for men older than 30 years; 28 percent BF for
women less than 30 years, 34 percent BF for women older than 30 years),
new maximum allowable weight can be assigned. Similarly, individuals
whose weight does not exceed the standard, but who appear obese, can have
a new allowable weight assigned based on BF measurement.
Cross-Validation
To provide a basis for comparing the performance of these equations on
a general military population, each of the equations was cross-validated on
the Navy anthropometric sample described in Table 4-2. If the equation did
not predict percent BF directly, the equation output was converted to per-
cent BF. Predicted percent BF was correlated with percent BF derived from
underwater weighing using the Siri (1961) equation. Table 4-4 shows the
results of this cross-validation. Note the U.S. Air Force equation for men is
only cross-validated on a subset of the'U.S. Navy sample. This is because
flexed biceps measurements were only made on a few of the Navy subjects.
It is apparent from Table 4-4 that predicted BF was rather highly corre-
lated with hydrostatic BF in all of the equations. More importantly, the
standard errors of measurement seen here with these equations are compara-
ble to those seen with other generalized equations in common use, including
those using skinfolds (Durnin and Womersley, 1974; Jackson and Pollack,
1978; Jackson et al., 19801. Hodgdon and Beckett (1984a,b) and Wright et
OCR for page 68
68
JAMES A. HODGDON
TABLE 4-6 Cross-Validation of Military Equations,
U.S. Navy Sample
Mean Standard Error
Correlation Difference of Measurement
Coefficient (percent fat) (percent fat)
U.S. Army
Men 0.89 3.15 3.73
Women 0.79 -0.17 4.39
U.S. Navy
Men 0.89 0.02 3.63
Women 0.84 -0.17 3.82
U.S. Marine Corps
Men 0.87 -0.75 4.05
Women 0.80 -2.88 4.25
U.S. Air Force
AL
Mend 0.74 2.67 5.17
Women 0.78 4.18 4.45
*Cross-validation on only 52 Navy subjects.
al. (1980) have already shown that generalized circumference and skinfold
equations have similar validities when applied to these military population
samples.
SUMMARY
Two major summary points can be made: first, there is admittedly a
need to further validate the relationship between body composition and
health outcomes. However, as evidenced by the studies presented here, it
would appear at present that health considerations are the most rational
scientific basis for setting body composition standards. Second, the mili-
tary services have used standard techniques to derive equations to estimate
relative BE from anthropometric measures: body circumferences, height,
and weight. When applied to a general military population sample, these
equations have validities and standard errors of measurement similar to
other published, generalized anthropometric equations and would appear to
be reasonable, useful estimators of body composition.
REFERENCES
AFR 35-11, 1985. See U.S. Department of the Air Force. 1985.
AR 600-9, 1986. See U.S. Department of the Army. 1986.
DOD Directive 1308.1, 1981. See U.S. Department of Defense. 1981.
OCR for page 69
STANDARDS AND METHODS
69
Allen, T. H. 1963. Measurement of human body fat: A quantitative method suited for use by
aviation medical officers. Aerospace Med. 34:907.
Beckett, M. B., and J. A. Hodgdon. 1987. Lifting and carrying capacities relative to physical
fitness measures. Report No. 87-26. Naval Health Research Center, San Diego, Calif.
Brennan, E. H. 1974. Development of a binomial involving anthropometric measurements
for predicting lean mass in young women. M.S. thesis. Incarnate Word College, San
Antonio, Tex.
Durnin, J. V. G. A., and J. Womersley. 1974. Body fat assessed from total body density and its
estimation from skinfold thickness: Measurements on 481 men and women aged 16 to 72
years. Br. J. Nutr. 32:77-97.
Fuchs, R. J., C. F. Theis, and M. C. Lancaster. 1978. A nomogram to predict lean body mass in
men. Am. J. Clin. Nutr. 31:673-678.
Hodgdon, J. A., and M. B. Beckett. 1984a. Prediction of percent body fat for U.S. Navy men
from body circumferences and height. Report No. 84-11. Naval Health Research Center,
San Diego, Calif.
Hodgdon, J. A., and M. B. Beckett. 1984b. Prediction of percent body fat for U.S. Navy
women from body circumferences and height. Report No. 84-29. Naval Health Research
Center, San Diego, Calif.
Hodgdon, J. A., P. I. Fitzgerald, and J. A. Vogel. 1990. Relationships between body fat and
appearance ratings of U.S. Soldiers. Report No. 90-01. Naval Health Research Center,
San Diego, Calif.
Jackson, A. S., and M. L. Pollack. 1978. Generalized equations for predicting body density of
men. Br. J. Nutr. 40:497-504.
Jackson, A. S., M. L. Pollack, and A. Ward. 1980. Generalized equations for predicting body
density of women. Med. Sci. Sport Exerc. 12: 175- 182.
Metropolitan Life Insurance Company. 1984. 1983 Metropolitan height and weight tables. Sta-
tistical Bulletin of the Metropolitan Life Insurance Company 64:2-9.
Mueller, W. H., and R. M. Malina. 1987. Relative reliability of circumferences and skinfolds
as measures of body fat distribution. Am. J. Phys. Anthropol. 72:437-439.
National Institutes of Health. 1985. Health implications of obesity. National Institutes of Health
Consensus Development Conference Statement, vol. 5, no. 9. U.S. Department of Health
and Human Services, Washington, D.C.
Robertson, D. W., and T. T. Trent. 1985. Documentation of muscularly demanding job tasks
and validation of an occupational strength test battery (STB). Report No. 86-1. Naval
Personnel Research and Development Center, San Diego, Calif.
Siri, W. E. 1961. Body composition from fluid spaces and density: Analysis of methods. Pp.
223-244 in Techniques for Measuring Body Composition, J. Brozek and A. Henschel,
eds. Washington, D.C: National Academy of Sciences.
. Department of the Army. 1986. Army Regulation 600-9. "The Army Weight Control
Program." September 1. Washington, D.C.
U.S. Department of the Air Force. 1985. Regulation 35-11. "The Air Force Weight and Fitness
Programs." April 10.
U.S. Department of Defense. 1981. "Physical Fitness and Weight Control Programs." Directive
No. 1308.1. June 29. Washington, D.C.
U.S. Department of the Navy, Navy Military Personnel Command, Code 6H. 1986a. "Physical
Readiness Program." Of rice of the Chief of Naval Operations Instruction 6110.1 C.
August 7.
Department of the Navy, Headquarters Marine Corps, Training Department. 1986b. "Weight
Control and Military Appearance." Marine Corps Order 6100.10a. July 24.
Vogel, J. A., J. W. Kirkpatrick, P. I. Fitzgerald, J. A. Hodgdon, and E. A. Harman. 1988.
Derivation of anthropometry based body fat equations for the Army's weight control
U.S.
OCR for page 70
70
JAMES A. HODGDON
program. Technical Report No. T17-88. U.S. Army Research Institute of Environmental
Medicine, Natick, Mass.
Wright, H. F., and J. H. Wilmore. 1974. Estimation of relative body fat and lean body weight
in a United States Marine Corps population. Aerospace Med. 45:301-306.
Wright, H. F., C. O. Dotson, and P. O. Davis. 1980. An investigation of assessment techniques
for body composition of women marines. U.S. Navy Med. 71:15-26.
Wright, H. F., C. O. Dotson, and P. O. Davis. 1981. Simple technique for measurement of
percent body fat in man. U.S. Navy Med. 72:23-27.
Representative terms from entire chapter:
marine corps
