Role of Drill Sergeants in Nutrition Behaviors of Soldiers in Basic Combat Training

Partnerships to Facilitate Total Force Fitness

Total force fitness (TFF) is a multi-domain framework designed to assess, promote, and sustain human performance optimization across a service member's career arc. During the September 2021, TFF Summit sponsored by the Consortium for Health and Military Performance (CHAMP), a working group explored partnerships that could facilitate effective implementation and sustainment of TFF principles. Many potential partners were identified, both internal and external to the DoD. This report highlights some positions and organizations that provide the highest yield for successfully inculcating TFF across the services.

The US Military's Battle With Obesity

The prevalence of obesity continues to rise among youth and adults in the US and the US military. The US military is negatively impacted by the nation's growing waistline, with drastic reductions in eligible recruits, increasing risks for compromised physical endurance and performance, and ballooning health care costs. This perspective discusses the effects of the obesity epidemic on the US military, previous and continuing research and programming initiatives, the progress made to increase access to healthy foods, and opportunities for future directions in research and practice to combat the obesity epidemic.

Go for Green® Nutrition Program: Translating Evidence Into Practice

Introduction

Go for Green® (G4G) is an evidence-based, multi-component nutrition program for military dining facilities (DFAC) to improve nutritional fitness among Service Members. The program evolved from supporting “fueling” during initial Army training into a robust intervention across all U.S. Military branches. The current G4G program consists of eight program requirements to optimize the nutrition environment, including traffic light labeling, nutritious menus, choice architecture, food promotion, marketing, and staff training. The evolution of the G4G program, development of standardized program requirements, and lessons learned are described.

Materials and Methods

The latest scientific evidence, best practices in health promotion and nutrition education, results and data from G4G implementation in the military community support the current version of G4G. Feedback and observations from program developers, military branch foodservice headquarters, installation leadership, and local G4G DFAC teams provided insight into implementation challenges, successes, facilitators, and barriers.

Results

The G4G program has evolved and expanded from its initial inception over 10 years ago to its current version. Research studies, nutrition science, and feedback from military community stakeholders have informed programmatic changes and improvements.

Conclusions

G4G 2.0 is a robust, innovative, multi-component, performance nutrition program with clear program element requirements. Value was added to elevate the G4G program by setting program requirements, expanding program components, and establishing a centralized resource hub. Performance nutrition initiatives in local military DFAC for dining facilities, such as G4G 2.0, has great potential to impact the health and well-being of Service Members.

Effectiveness of nutrition interventions on improving diet quality and nutrition knowledge in military populations: a systematic review

CONTEXT

Optimizing nutrition in military groups through improved diet quality and nutrition knowledge is key in supporting the high physical and cognitive demands.

OBJECTIVE

The objective of this investigation was to systematically review the effectiveness of nutrition interventions among military personnel in improving diet quality and/or nutrition knowledge.

DATA SOURCES

Medline, Embase, CINAHL, and Scopus were searched from the earliest records to May 2020.

DATA EXTRACTION

Data were extracted by 2 reviewers. The primary outcomes were diet quality and/or nutrition knowledge.

DATA ANALYSIS

Twenty studies were included. The main intervention approaches identified were nutrition education of individuals (i.e., education-based studies; EB) (n = 12), and manipulation of the food service environment (i.e., dining facility studies; DFACs) (n = 8). The most common strategies were face-to-face lectures (n = 8) for EB, and healthier menus (n = 7) and education of catering staff (n = 6) for DFAC interventions. Most studies (18/20) demonstrated favorable within-group effects; however, dietary changes were inconsistent. Five of 10 studies using a comparator group demonstrated positive between-group differences.

CONCLUSION

Although potential exists for improving diet quality and nutrition knowledge in military populations, the heterogeneity of the studies to date limits conclusions on the most efficacious strategies.

Eating Behaviors Are Associated With Physical Fitness and Body Composition Among US Army Soldiers

OBJECTIVE

Examine associations between soldiers' eating behaviors, compliance with body composition and fitness standards, and physical performance.

DESIGN

Cross-sectional study.

SETTING

Eight Army installations.

PARTICIPANTS

US Army Soldiers (n = 1,591; 84% male).

MAIN OUTCOME MEASURES

Characteristics, eating behaviors, compliance with body composition and physical fitness standards, and fitness level were assessed via questionnaire.

ANALYSIS

Bivariate and multivariable logistic regression.

RESULTS

Eating mostly at a dining facility was associated with lower odds of body composition failure (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.26-0.73); whereas, eating at a fast rate (OR, 1.51; 95% CI, 1.05-2.17) or often/always ignoring satiety cues (OR, 2.12; 95% CI, 1.06-4.27) was associated with higher odds of body composition failure. Eating mostly fast-food/convenience meals (OR, 1.75; 95% CI, 1.19-2.59) and eating at a fast rate (OR, 1.42; 95% CI, 1.04-1.93) was associated with higher odds of physical fitness failure. Skipping breakfast was associated with lower odds of high physical performance (OR, 0.41; 95% CI, 0.23-0.74); whereas, nutrition education was associated with higher odds of high physical performance (OR, 1.02; 95% CI, 1.01-1.04).

CONCLUSIONS AND IMPLICATIONS

As eating behaviors are modifiable, findings suggest opportunities for improving the specificity of Army health promotion and education programs.

Soldiers' Perception of Combat Ration Use During Arctic Training: A Qualitative Study

INTRODUCTION

Soldiers work in various extreme environments, including the High Arctic, where energy requirements are increased compared with temperate climates. Soldiers often do not reach their energy needs with combat rations and face additional challenges to feeding in the Artic, which can hinder the performance. The purpose of this study is to document soldiers' perception about individual, dietary, and environmental factors influencing intake of combat rations during Arctic field training.

MATERIALS AND METHODS

This qualitative phenomenological study included in-depth semi-structured individual interviews with 16 soldiers of the Canadian Armed Forces participating in the Arctic Operations Advisor training in Yellowknife (Northwest Territories) and Resolute Bay (Nunavut) from January to March 2019. Interviews were audio-recorded, transcribed verbatim, and then coded using a directed content analysis approach. Data were analyzed with NVivo qualitative data analysis software.

RESULTS

Five themes related to the individual (personal preferences; mood and morale), the diet (water availability; food variety), or the environment (meal preparation time) were identified. A sixth theme found was related to the diet and the environment (food/water temperature). Soldiers explained food and water were frozen, thus limiting water availability and greatly increasing meal preparation time. Food variety was deemed adequate by some, but others preferred more options. Individual food preferences and soldier mood and team morale could be barriers or facilitators to intake. Overall, the complexity of combat ration intake in the Arctic stemmed from the interaction of factors.

CONCLUSIONS

Various factors related to the individual, diet, and environment were found to influence intake of combat rations by participating soldiers during Arctic training. Reducing barriers to combat ration consumption by enhancing operational suitability of rations for the Arctic environment could promote dietary intake. Bearing in mind many interrelated factors influenced intake of soldiers, the military would benefit from further assessing which challenges related to intake in the field could be addressed.