Military health experts highlight need for U.S. youth to maintain healthy weight

By V. Hauschild, MPH, Defense Centers for Public Health-AberdeenApril 4, 2023

Military health experts highlight need for U.S. youth to maintain healthy weight
Recent studies show low levels of physical activity and poor fitness are the strongest predictors of musculoskeletal injuries among young male and female recruits. The epidemic of overweight and obese children in the U.S. contributes to this problem. (Defense Centers for Public Health-Aberdeen graphic illustration by Jason Embrey) (Photo Credit: Jason Embrey) VIEW ORIGINAL

ABERDEEN PROVING GROUND, Md. – The Centers for Disease Control and Prevention reports that the U.S. is experiencing an epidemic of obesity among children and adolescents aged 2–19 years. This fact is based on 14.7 million cases from 2017–2020.

This means approximately one out of every five U.S. children and adolescents has a serious weight problem that can lead to various long-term health problems, such as high blood pressure, high cholesterol, Type 2 diabetes, breathing problems such as asthma and sleep apnea, and joint problems.

This problem has also translated into a national threat to military readiness.

Over one third of young adult military applicants do not meet the Army’s weight standards for enlistment. The inability to meet these standards is a leading reason why applicants are determined to be non-suitable to enter any of the U.S. military services.

In a July 2022 CDC handout, “Unfit to Serve: Obesity and Physical Activity are Impacting National Security,” retired Army Lt. Gen. Mark Hertling, who served in numerous command roles, commented on how this situation impacts readiness:

“The military has experienced increasing difficulty in recruiting soldiers as a result of physical inactivity, obesity, and malnutrition among our nation’s youth. Not addressing these issues now will impact our future national security.”

Military standards for recruitment exclude potential recruits with extreme obesity and weight conditions. For active-duty service members, Department of Defense policy defines acceptable body fat limits, often translated into body mass index, or BMI, scores.

Public health studies have repeatedly shown that excess weight or high BMI is a risk factor for musculoskeletal injuries, or MSKIs, among military personnel. MSKIs have been labeled the number one medical impediment to U.S. military readiness because they account for over 10 million limited duty days each year and over 70 percent of the medically non-deployable population.

To identify factors that may increase an individual’s risk of MSKI and the overall direct medical cost from MSKIs, a collaborative group of scientists investigated MSKIs at various military basic training installations. Their work, first published in the Journal of Public Health Management and Practice in 2019, showed that less physically fit recruits were most likely to be injured during basic training.

In a more recently published 2022 follow-up study in the journal Progress in Cardiovascular Diseases, the investigators found that recruits from the southern region of the U.S. had the highest occurrence of MSKIs, and the southern region accounted for nearly 50 percent of the overall direct medical cost of MSKIs during basic training.

“These two studies suggest that Army recruits from the southern states disproportionately contribute to the military’s MSKI problem,” says Dr. Daniel Bornstein, lead author for both studies and current chair of the Military Settings Sector for the U.S. National Physical Activity Plan. “More trainees were recruited from southern states than from any other region, yet Army recruits from southern states were less physically fit than recruits from the rest of the country and were injured at a higher rate than recruits from any other region.”

One of the 2022 study’s co-authors, Keith Hauret, a retired Army officer and physical therapist who now works for the Defense Centers for Public Health–Aberdeen, formerly known as the Army Public Health Center, says these risk factors are related to the problem being experienced in the overall general U.S. population. Current low levels of physical activity and high levels of obesity are directly responsible for $117 billion in annual U.S. healthcare costs, which are disproportionately higher in the south.

“Low levels of physical activity and poor fitness were found to be the strongest predictors of MSKIs among male and female soldiers,” says Hauret.

What should be done?

Also cited in the CDC handout is retired Navy Rear Adm. Richard R. Jeffries, who served as the Marine Corps' Senior Medical Officer and Healthcare Advisor:

“If we don’t work to build a healthy foundation for today’s young people, both the military and our nation will pay the price tomorrow.”

These recent MSKI studies highlight the need to encourage American youth to increase their physical activity and physical fitness. Since the studies found weight risk factors to be higher in southern states, they, in particular, may want to promote this public health and national security priority. A more physically active American youth would provide physically healthier military recruits who will be less likely to be injured and more likely to be able to perform their assigned duties.

As one example of a solution, the Army has established the “Future Soldier Preparatory Course” to encourage increased fitness among future recruits.

The goal of April’s “Move More Month” observance is taking part in more physical activity on a regular basis, which is one of several actions the CDC recommends for managing a healthy weight. You can help improve the nation’s health and our military’s readiness by upgrading the physical activity and exercise of all your family members. Resources include:

The Defense Centers for Public Health-Aberdeen advances Joint Force health protection with agile public health enterprise solutions in support of the National Defense Strategy.

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