UNDERSTANDING AND OVERCOMING
THE CHALLENGE OF
OBESITY AND OVERWEIGHT
IN THE ARMED FORCES
PROCEEDINGS OF A WORKSHOP
Emily A. Callahan, Rapporteur
Roundtable on Obesity Solutions
Food and Nutrition Board
Health and Medicine Division
THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu
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This activity was supported in part by the Academy of Nutrition and Dietetics; Alliance for a Healthier Generation; American Academy of Pediatrics; American College of Sports Medicine; American Council on Exercise; American Heart Association; American Society for Nutrition; Bipartisan Policy Center; Blue Cross and Blue Shield of North Carolina Foundation; The California Endowment; ChildObesity180/Tufts University; Chobani; Edelman; General Mills, Inc.; Greater Rochester Health Foundation; HealthPartners, Inc.; The JPB Foundation; Kaiser Permanente; The Kresge Foundation; Mars, Inc.; National Recreation and Park Association; Nemours; Nestlé Nutrition; Novo Nordisk; Obesity Action Coalition; The Obesity Society; Partnership for a Healthier America; Reebok International; Reinvestment Fund; Robert Wood Johnson Foundation; Salud America!; Weight Watchers International, Inc.; and YMCA of the USA. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-47676-8
International Standard Book Number-10: 0-309-47676-3
Digital Object Identifier: https://doi.org/10.17226/25128
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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2018. Understanding and overcoming the challenge of obesity and overweight in the armed forces: Proceedings of a workshop. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/25128.
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PLANNING COMMITTEE ON UNDERSTANDING AND OVERCOMING THE CHALLENGE OF OBESITY AND OVERWEIGHT IN THE ARMED FORCES1
BERNADETTE MARRIOTT (Chair), Professor and Director, Nutrition Section, Division of Gastroenterology and Hepatology, Department of Medicine and Military Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina
CAPT. HEIDI MICHELS BLANCK, Chief, Obesity Branch, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention
RENEE COLE, Director, Healthy Eating Behavior Initiative; Deputy, Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine
PAMELA GREGORY, Navy Nutrition Program Manager, Physical Readiness Program
KARI HARRIS, Deloitte Consulting, LLP
JENNIFER B. HARWARD, Deputy Chief, Air Force Health Promotion, Air Force Medical Support Agency
JEFF HILD, Policy Director, Sumner M. Redstone Global Center for Prevention and Wellness, Milken Institute School of Public Health, The George Washington University
LISEL LOY, Vice President, Programs, Bipartisan Policy Center
ESTHER MYERS, CEO, EF Myers Consulting, Inc.
DONNA RYAN, Professor Emerita, Pennington Biomedical Research Center, Louisiana State University
ANNE UTECH, Acting National Director, Nutrition and Food Service, U.S. Department of Veterans Affairs
Health and Medicine Division Staff
LESLIE J. SIM, Roundtable Director
HEATHER DEL VALLE COOK, Senior Program Officer
ELLE ALEXANDER, Associate Program Officer
AMANDA NGUYEN, Associate Program Officer
MEREDITH YOUNG, Research Assistant
CYPRESS LYNX, Senior Program Assistant
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.
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ROUNDTABLE ON OBESITY SOLUTIONS1
BILL PURCELL III (Chair), Farmer Purcell White & Lassiter, PLLC, Nashville, Tennessee
RUSSELL R. PATE (Vice Chair), University of South Carolina, Columbia
MARY T. STORY (Vice Chair), Duke University, Durham, North Carolina
SHARON ADAMS-TAYLOR, The School Superintendents Association, Alexandria, Virginia
KATIE ADAMSON, YMCA of the USA, Washington, DC
ANDREA M. AZUMA, Kaiser Permanente, Oakland, California
CAPT. HEIDI MICHELS BLANCK, Centers for Disease Control and Prevention, Atlanta, Georgia
JEANNE BLANKENSHIP, Academy of Nutrition and Dietetics, Washington, DC
DON W. BRADLEY, Duke University, Durham, North Carolina
CEDRIC X. BRYANT, American Council on Exercise, San Diego, California
HEIDI F. BURKE, Greater Rochester Health Foundation, Rochester, New York
DEBBIE I. CHANG, Nemours, Newark, Delaware
JOHN COURTNEY, American Society for Nutrition, Bethesda, Maryland
ANNE DATTILO, Nestlé Nutrition, Florham Park, New Jersey
MERRY DAVIS, Blue Cross and Blue Shield of North Carolina Foundation, Durham, North Carolina
CHRISTINA ECONOMOS, Tufts University, Boston, Massachusetts
IHUOMA ENELI, American Academy of Pediatrics, Columbus, Ohio
JENNIFER FASSBENDER, Reinvestment Fund
GARY FOSTER, Weight Watchers International, Inc., New York, New York
DAVID D. FUKUZAWA, The Kresge Foundation, Troy, Michigan
MARJORIE INNOCENT, National Association for the Advancement of Colored People, Baltimore, Maryland
SCOTT I. KAHAN, The George Washington University, Washington, DC
AMY KULL, Edelman, San Francisco, California
SHIRIKI KUMANYIKA, Drexel University, Philadelphia, Pennsylvania
CATHERINE KWIK-URIBE, Mars, Inc., Germantown, Maryland
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.
THEODORE KYLE, The Obesity Society, Pittsburgh, Pennsylvania
LISEL LOY, Bipartisan Policy Center, Washington, DC
KELLIE MAY, National Recreation and Park Association, Ashburn, Virginia
MYETA M. MOON, United Way Worldwide, Alexandria, Virginia
JOSEPH NADGLOWSKI, Obesity Action Coalition, Tampa, Florida
BARBARA PICOWER, The JPB Foundation, New York, New York
SUE PECHILIO POLIS, National League of Cities, Washington, DC
ROBERT C. POST, Chobani, New York, New York
AMELIE G. RAMIREZ, Salud America!, San Antonio, Texas
OLIVIA ROANHORSE, Notah Begay III Foundation, Santa Ana Pueblo, New Mexico
NANCY ROMAN, Partnership for a Healthier America, Washington, DC
KEVIN R. RONNEBERG, HealthPartners, Inc., Minneapolis, Minnesota
SYLVIA ROWE, S.R. Strategy, LLC, Washington, DC
JAMES F. SALLIS, University of California, San Diego
EDUARDO J. SANCHEZ, American Heart Association, Dallas, Texas
MARION STANDISH, The California Endowment, Oakland, California
MAHA TAHIRI, General Mills, Inc., Minneapolis, Minnesota
KATHLEEN TULLIE, Reebok International, Canton, Massachusetts
MONICA HOBBS VINLUAN, Robert Wood Johnson Foundation, Princeton, New Jersey
HOWELL WECHSLER, Alliance for a Healthier Generation, New York, New York
JAMES R. WHITEHEAD, American College of Sports Medicine, Indianapolis, Indiana
TRACY ZVENYACH, Novo Nordisk, Washington, DC
Health and Medicine Division Staff
LESLIE J. SIM, Roundtable Director
HEATHER DEL VALLE COOK, Senior Program Officer
ELLE ALEXANDER, Associate Program Officer
AMANDA NGUYEN, Associate Program Officer
MEREDITH YOUNG, Research Assistant
CYPRESS LYNX, Senior Program Assistant
ANN L. YAKTINE, Food and Nutrition Board Director
Consultant
WILLIAM (BILL) H. DIETZ, The George Washington University, Washington, DC
Reviewers
This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.
We thank the following individuals for their review of this proceedings:
LTC. RENEE COLE, U.S. Military-Baylor University
CAPT. KIMBERLY ELENBERG, U.S. Department of Defense
JEFF HILD, The George Washington University
HANNAH MARTIN, Bipartisan Policy Center
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings, nor did they see the final draft before its release. The review of this proceedings was overseen by NICOLAAS PRONK, HealthPartners, Inc. He was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteur and the National Academies.
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Contents
Organization of This Proceedings
2 DEFINING THE PROBLEM AND ITS EFFECTS ON RECRUITMENT, RETENTION, RESILIENCE, AND READINESS
The Basis of Current U.S. Department of Defense Body Fat Standards
Resilience, Readiness, and Deployment
3 SERVICE-SPECIFIC ISSUES RELATED TO OBESITY AND OVERWEIGHT
Trends in Weight Change in Veterans with and Without Diabetes
4 EXPLORING INNOVATIVE STRATEGIES
Policy and Office of Secretary of Defense Strategy
U.S. Department of Veterans Affairs Programs
5 PERSPECTIVES FROM OUTSIDE THE ARMED FORCES
Centers for Disease Control and Prevention
Academy of Nutrition and Dietetics
U.S. Department of Agriculture’s National Institute of Food and Agriculture
6 POTENTIAL FUTURE OPPORTUNITIES FOR THE ARMED FORCES, MILITARY FAMILIES, AND THEIR COMMUNITIES
Box and Figures
BOX
1-1 Workshop Statement of Task
FIGURES
2-1 Body fat limits are key to military appearance, combat readiness, and health
2-2 Nomogram of the equation used to calculate male body fat percentage in the armed forces
2-3 Comparison of Army and U.S. Department of Defense body fat standards
4-1 Total force well-being: Enhancing individual readiness and resiliency
4-3 Example of an Air Force Commander’s Health Scorecard
4-4 Weight outcomes at the 6-month mark for new participants in the MOVE!® program
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