Efficacy of Weight Loss Interventions in United States Active Duty Military Populations: A Systematic Review

2021 ◽  
Author(s):  
Geralyn T Csizmar ◽  
Melinda Irwin

ABSTRACT Background Since the beginning of overseas contingency operations, the percent of service members who are considered overweight or obese has tripled to 15% for men and 20% for women. This has implications for national security if the country is unable to staff its military with fit-to-fight individuals. The purpose of this systematic review is to move policy efforts forward by illuminating the efficacy of several lifestyle interventions for active duty service members since 2001. It aims to both identify common aspects of successful interventions and also identify interventions without success so DoD leaders may replace those initiatives. Materials and Methods The electronic database PubMed was searched from September 11, 2001 to May 15, 2020. Studies were included if the target population was United States active duty service members from any branch, the study included an intervention, and the measured outcome was weight loss. Seven studies met final inclusion criteria. Results Interventions with corresponding weight loss data are summarized in Table III. This review found that there is not a sufficient body of evidence to determine if interventions to aid active duty service members in losing weight are effective. Conclusion However, as a collection, the studies could support the notion that military members get the best results when interventions are convenient, modern, personalized, and accessible. More studies are needed, and future studies with larger sample sizes and longer durations would be valuable in determining efficacy of weight loss interventions. Undoubtedly, enrollment and compliance is difficult with military member moves and competing mission requirements. Ideally, the DoD should work to aggregate the efforts in this field, as many initiatives are not captured, shared, and utilized by other installations or other services. Data silos and unpublished or underdeveloped research reactively addresses issues and does not proactively address them. Policy change will need to be nested in further research, as well as consider the food environment on bases and possible prevention efforts.

2020 ◽  
pp. 088626052097031
Author(s):  
Cary Leonard Klemmer ◽  
Ashley C. Schuyler ◽  
Mary Rose Mamey ◽  
Sheree M. Schrager ◽  
Carl Andrew Castro ◽  
...  

Prior research among military personnel has indicated that sexual harassment, stalking, and sexual assault during military service are related to negative health sequelae. However, research specific to LGBT U.S. service members is limited. The current study aimed to explore the health, service utilization, and service-related impact of stalking and sexual victimization experiences in a sample of active-duty LGBT U.S. service members ( N = 248). Respondent-driven sampling was used to recruit study participants. U.S. service members were eligible to participate if they were 18 years or older and active-duty members of the U.S. Army, U.S. Navy, U.S. Marine Corps, or U.S. Air Force. This study included a sizeable portion of transgender service members ( N = 58, 23.4%). Sociodemographic characteristics, characteristics of military service, health, and sexual and stalking victimization in the military were assessed. Regression was used to examine relationships between health and service outcomes and sexual and stalking victimization during military service. Final adjusted models showed that experiencing multiple forms of victimization in the military increased the odds of visiting a mental health clinician and having elevated somatic symptoms, posttraumatic stress disorder symptomatology, anxiety, and suicidality. Sexual and stalking victimization during U.S. military service was statistically significantly related to the mental and physical health of LGBT U.S. service members. Interventions to reduce victimization experiences and support LGBT U.S. service members who experience these types of violence are indicated. Research that examines the role of LGBT individuals’ experiences and organizational and peer factors, including social support, leadership characteristics, and institutional policies in the United States military is needed.


2014 ◽  
Vol 16 (2) ◽  
pp. 171-186 ◽  
Author(s):  
R. L. Williams ◽  
L. G. Wood ◽  
C. E. Collins ◽  
R. Callister

Obesity Facts ◽  
2021 ◽  
Vol 14 (2) ◽  
pp. 222-245
Author(s):  
Giovanna Muscogiuri ◽  
Marwan El Ghoch ◽  
Annamaria Colao ◽  
Maria Hassapidou ◽  
Volkan Yumuk ◽  
...  

<b><i>Background:</i></b> The very low-calorie ketogenic diet (VLCKD) has been recently proposed as an appealing nutritional strategy for obesity management. The VLCKD is characterized by a low carbohydrate content (&#x3c;50 g/day), 1–1.5 g of protein/kg of ideal body weight, 15–30 g of fat/day, and a daily intake of about 500–800 calories. <b><i>Objectives:</i></b> The aim of the current document is to suggest a common protocol for VLCKD and to summarize the existing literature on its efficacy in weight management and weight-related comorbidities, as well as the possible side effects. <b><i>Methods:</i></b> This document has been prepared in adherence with Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Literature searches, study selection, methodology development, and quality appraisal were performed independently by 2 authors and the data were collated by means of a meta-analysis and narrative synthesis. <b><i>Results:</i></b> Of the 645 articles retrieved, 15 studies met the inclusion criteria and were reviewed, revealing 4 main findings. First, the VLCKD was shown to result in a significant weight loss in the short, intermediate, and long terms and improvement in body composition parameters as well as glycemic and lipid profiles. Second, when compared with other weight loss interventions of the same duration, the VLCKD showed a major effect on reduction of body weight, fat mass, waist circumference, total cholesterol and triglyceridemia as well as improved insulin resistance. Third, although the VLCKD also resulted in a significant reduction of glycemia, HbA1c, and LDL cholesterol, these changes were similar to those obtained with other weight loss interventions. Finally, the VLCKD can be considered a safe nutritional approach under a health professional’s supervision since the most common side effects are usually clinically mild and easily to manage and recovery is often spontaneous. <b><i>Conclusions:</i></b> The VLCKD can be recommended as an effective dietary treatment for individuals with obesity after considering potential contra-indications and keeping in mind that any dietary treatment has to be personalized. <b><i>Prospero Registry:</i></b> The assessment of the efficacy of VLCKD on body weight, body composition, glycemic and lipid parameters in overweight and obese subjects: a meta-analysis (CRD42020205189).


Appetite ◽  
2015 ◽  
Vol 87 ◽  
pp. 375
Author(s):  
C. Robertson ◽  
A. Avenell ◽  
F. Stewart ◽  
D. Archibald ◽  
F. Douglas ◽  
...  

PEDIATRICS ◽  
1990 ◽  
Vol 86 (6) ◽  
pp. 867-873
Author(s):  
Gregory C. Gray ◽  
Lawrence A. Palinkas ◽  
Patrick W. Kelley

Hospital records for 10 687 United States Army and Navy adult varicella (chickenpox) admissions were reviewed. Annual hospital admission rates for varicells increased more than fourfold in the active-duty army during 1980 to 1988 and more than 18-fold among active-duty navy enlisted personnel during 1975 to 1988. Fifty-seven percent of vanicella admissions occurred in the most junior military members, aged 17 to 20. More than half of the total vanicella admissions occurred in personnel with less than a year of military service. Multivariate analysis of the navy data confirmed increasing time-related trends of risk, suggesting a national temporal trend of increased vanicella susceptibility in US teenagers and young adults. Administering a safe and effective vanicella vaccine to army and navy recruits could prevent more than 7260 hospital-bed days during the first year of use.


SLEEP ◽  
2021 ◽  
Author(s):  
Brian A Moore ◽  
Lynn M Tison ◽  
Javier G Palacios ◽  
Alan L Peterson ◽  
Vincent Mysliwiec

Abstract Study Objectives Epidemiologic studies of obstructive sleep apnea (OSA) and insomnia in the U.S. military are limited. The primary aim of this study was to report and compare OSA and insomnia diagnoses in active duty the United States military service members. Method Data and service branch densities used to derive the expected rates of diagnoses on insomnia and OSA were drawn from the Defense Medical Epidemiology Database. Single sample chi-square goodness of fit tests and independent samples t-tests were conducted to address the aims of the study. Results Between 2005 and 2019, incidence rates of OSA and insomnia increased from 11 to 333 and 6 to 272 (per 10,000), respectively. Service members in the Air Force, Navy, and Marines were diagnosed with insomnia and OSA below expected rates, while those in the Army had higher than expected rates (p &lt; .001). Female service members were underdiagnosed in both disorders (p &lt; .001). Comparison of diagnoses following the transition from ICD 9 to 10 codes revealed significant differences in the amounts of OSA diagnoses only (p &lt; .05). Conclusion Since 2005, incidence rates of OSA and insomnia have markedly increased across all branches of the U.S. military. Despite similar requirements for overall physical and mental health and resilience, service members in the Army had higher rates of insomnia and OSA. This unexpected finding may relate to inherent differences in the branches of the military or the role of the Army in combat operations. Future studies utilizing military-specific data and directed interventions are required to reverse this negative trend.


2018 ◽  
Vol 19 (7) ◽  
pp. 989-1007 ◽  
Author(s):  
L. Cooper ◽  
C. G. Ryan ◽  
L. J. Ells ◽  
S. Hamilton ◽  
G. Atkinson ◽  
...  

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0014
Author(s):  
Andrew S. Murtha ◽  
Matthew R. Schmitz

Background: The primary focus of periacetabular osteotomy (PAO) literature has been survivorship until hip arthroplasty. This endpoint overlooks its impact on young, active patients. Hypothesis/Purpose: This study sought to assess the impact of the PAO on the careers of active duty members of the United States Armed Forces. Methods: A retrospective review identified 38 patients who underwent PAO performed by a single surgeon at an academic, military medical center from January 2014 through April 2017. Twenty-one of the patients were active duty United States military service members (16 female, 5 male) and had a minimum 28 months of post-operative follow-up at the time of review. Preoperative and postoperative duty restrictions were noted and referrals to the U.S Army and U.S. Air Force Medical Evaluation Boards (MEB) were queried. Results: The average age at surgery was 25.6 years (range, 19-40y). Preoperatively, sixteen patients (94.1%) were on duty restrictions, one had been referred to the MEB, and records were not available on three patients who separated from the military prior to review. Average follow-up was 3.4 years (range, 2.3 – 5.4y). Among the patients without a preoperative MEB referral, 85.0% remained on active duty (n = 12) or completed their military service commitment (n=5). Of the fourteen patients with temporary duty restrictions preoperatively, 35.7% (n=5) were relieved of their restrictions and returned to full duty and 50% (n=7) were retained on active service with permanent duty restrictions. Such permanent duty restrictions typically consisted of modifications to the aerobic component of the semiannual military fitness testing. Six patients (28.6%) were referred to the MEB including one who was referred prior to PAO. Of these patients, two were deemed fit to retain on active service with permanent duty restrictions, two were medically separated for non-hip conditions, and two were medically separated for a hip condition. The average Veteran Affairs (VA) disability score related to hip pathology in patients referred to MEB was 16% (range 0-40%). Conclusion: This is the first study to look at the PAO in active duty military service members. In patients with symptomatic acetabular dysplasia, PAO may provide an opportunity to relieve preoperative duty restrictions and allow for continued military service. Further study with the inclusion of patient reported outcomes are necessary assess the impact of the procedure in this active patient population.


2020 ◽  
Vol 17 (4) ◽  
pp. 492-502 ◽  
Author(s):  
Maximiliano Tamae Kakazu ◽  
Israa Soghier ◽  
Majid Afshar ◽  
Jan L. Brozek ◽  
Kevin C. Wilson ◽  
...  

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